Backchat (1995 TV series)

Transcription

Good morning and welcome to BackChat. I'm Hugh Chiverton. Your co-host today is Zohan Abdul Kareem of Time Magazine Zohan, put down that coffee and say Good Morning. Good Morning (right) morning everyone Our main topic today is childhood obesity as the Department of Health releases figures showing one in five of our primary students are obese. That figure is down slightly from last year but still worrying. In 2006 the department launched a "eat smart" campaign; What sort of effect is that having? What more should be we be doing? How can we encourage children to exercise and discourage them from eating fatty and sugary food. Give us a call with your comments. Our number is 2338 8266 and you can email [email protected] or you can go to our FaceBook page - Backchat on RTHK Radio 3 and comment there. After 9:15 the government asks the Court of Final Appeal to consult Beijing. Is that a threat to our judicial independence? Joining us for the first discussion we have Dr Regina Ching, Assistant Director of Health Promotion, with the Administration Dr Alvin Chan, he's a pediatrician and vice President and Central Coordinator of the Hong Kong Medical Association Dr. Patrick Lau, a Professor in the Department of Physical Education, at the Baptist University. Dr Ching, we'll start with you, good morning. Thanks very much for joining us. So, figures down very slightly uh... but still one in five ..That's a lot isn't it? yes yes...of primary school children Looking around I don't see that many overweight It's not my impressions generally; for a start, when you say obese, you mean is it like with adults that you can be overweight and then if you are very overweight you become obese,are you talking about children who are seriously overweight? Well we have a way of measuring childhood obesity and the figure I'm uh... quoting we measured childhood obesity by measuring the height against the weight so if the median weight for height exceeds twenty percent of the median, then we call that overweight well many a time parents are not aware of this definition so they may consider that the child as normal but in fact the weight is a bit over. So, we need an objective measurement and we're doing it every year for children and they have a free assessment to come to us and children have centres for that assessment Sorry, you relating them to the median...? weight? for height for height .. yes.. okay.. So just it just mean that children are getting bigger? well of course they are growing ...so it's important to I mean... the children are generally getting bigger, they are actually getting fatter? They're getting fatter. For the same height, they're.. weighing heavier so disproportionate...disproportionately they are heavier yes..right And, when did you first start detecting... I mean was there a time five years ago or ten years ago that you started to detect this change this shift of children getting heavier compared to previous documentation that your department might have done? Well because we have the student health service started in 1995 and that was a very good time when we decided to collect our very comprehensive data of how our children are weighing because every child has an opportunity every year to come to our centre for that measurement so from that year onwards, we found that the childhood obesity although their weight their weight increasing year after year and uh... we started to this you know um... be very concerned and at the same time we notice all-around us, in fact it's a global problem that children are getting heavier and heavier and there's no difference in the trend uh... among our children so we think it's time we have to be really serious and look at how we should address this issue. One more question, do you see this perhaps in older children secondary school children as well Yes, it's the same situation. Same thing? Same kind of rates as well? It's not as heavy as a primary school children but the trend is also going up. Is that because there's like a wave of fatness coming up it's starting with the younger children, and will move up with the generation Well, in fact the problem is there among adults as well So it's sort of a whole population issue. And, the root cause of the problem is in society I'm just wondering why the secondary school students wouldn't be so bad as the primary students...overall the rate is not as high but the trend is also going up Why it's not as high with the secondary school..Patrick Lam, do you know? One of the research evidence demonstrates the difference between primary and secondary is ... especially with the girls, during their puberty more recognised weight issue, so actually we not only have the overweight obese uh... schoolchildren in primary, secondary, but also some underweight, there are two extremes actually if I want to...if I can answer your question is the sensitivity of the body size is getting more serious the sensitive to the peers when they get into the puberty or senior high school Dr Lau, I was taken by what you just said that the problem is not just uh... overweight but underweight as well because we have an issue that even thin individuals who do not have a weight problem may not necessarily be fit or healthy.. Actually right now we have iPad on our hands and just click into the Internet type thin crowd thin very thin the crowd, there is a big crowd of people they share um... they share a very extreme dieting practice among the youngsters who uh... as young as young as six years old so thin is beautiful..thin is the best shape..the super model this is very popular around the world including Hong Kong, Japan so as Dr Ching has mentioned this is a global trend and yeah so you have to look to the two extremes uh... actually the figures demonstrate since 1995 and when we discuss the topic today this is not new actually since 2006 according to my data from SHS Department of Health every year we have very good communication six years old the primary already go over 20% but we don't recognise ..I mean I recognise but the Government still need to take a kind of action and then a lot of resources to put on that and for the secondary since 2009 it's already go over 20% so it's not unusual I conduct a study intervention in 1999 with the Pediatric Department of Prince of Wales hospital called 'fund and fit programme" the research funding is from the Government health research fund So this is a pretty good result, but another thing is Ok, during the six months, we get extremely good results in the physiological measures the body size.. the BMI whatever but the sustainability of the schools is typical so we're not talking about only the interventions we're talking about lifestyles, and how we can sustain the effect in the long term In fact Hong Kong Medical Association has been advocating uh... exercise for health for a long time because I think other than the diet, the lifestyle just like Patrick has just mentioned uh... is that uh... in Hong Kong even the children in the kindergarten age will begin a sedentary lifestyle they would like to sit and watch the iPad and the parents would like to train them for various sorts of uh... skills that just use their hands and mind and not the body so just also a few days ago the Hong Kong University the Education Department also released a study that in Hong Kong the reading capability of Hong Kong children was superb but then came the motivation and the ahh solving problems uh... uh... aspects will very uh... below the international peers at the same age ...we are training our children to be the examination machine they are good in the scores but not in the thinking this year I am lecturing in the new system, the DSE the 3-3-4 system, and actually I am lecturing both groups, from the old system and the new system big difference in their independent thinking and critical thinking and so.. I'm actually quite worried about that.. are you saying that over a year there's a noticeable difference Not the year but the challenges and those old system, they took the uh... uh... HKCEE, and they took the A Level they have overcome a lot of barriers and train up their strength and competency and critical thinking but for those DSE as Dr Chan just mentioned needed more than that really more than that to get a good score in fact I think uh... uh... rather than just uh... concentrating on the diet problems which we should pay more attention to the lifestyle program also involve our perspectives of life in Hong Kong I guess the parents and the teachers are not really into teaching the children or nurturing them into a do it yourself uh... style of living in Hong Kong our children have always been um... labeled as being uh... princes and princesses to be served by others and uh... so even up to primary school age they still don't know how to tie shoe lace or other manual things so I guess perhaps the the education department and I think uh... social work department and uh... health department.. department of health should have inter-departmental efforts to gear up our children do it yourself way of living Well Dr Chan, I think that you are correct and that's why we are not waiting until primary schools to help children uh... do better for themselves we're starting the uh... anti-obesity campaign uh... as early as age two to three and that is that at the time when children are being sent to kindergarten and child care centres we sort of help the child minders and the teachers to change their mind set that helping themselves with uh... healthy eating .. physical activity is part of their life, so it becomes something so.. uh... into their daily activities and routine that they don't need to pay special attention and make an effort to do as they as they grow older.. I think Dr Ching demonstrates very comprehensively, but this time when I read.. and uh... the results from the news release it purely focus on the diet campaign so, I think this is much easier being exercised professional in universities you see uh... when he try to adopt the comprehensive lifestyle changes, it's much easier relatively easier in the diet changes instead of uh... exercise behavior changes..Well Dr Chan is talking about changing the whole of Hong Kong, the whole attitude of Hong Kong, the whole way that Hong Kong operates, that's a bit of a tall order isn't it? It's easier just to eat more vegetables.. Yeah, this is good but on the other hand when we look at the research literature about exercise behaviour adoption it seems dietary is you are encouraging people to do something less or smart but to increase those exercise consumption and energy, you need people to actually do something, rather than to avoid to do something talking about some kind of initiative, or the initiator in physics you have to do something start to do something sweating uh... muscle pain delay onset of muscle soreness it don't feel very comfortable at the beginning, but if you stop eating chocolate or McDonald, still alright, because you're not paying extra effort, you just stop doing something so from the prospective of exercise research we are... actually uh... confront more barriers than diet to a certain extent Both are important, and in fact Dr Ching is responsible for both aspects she is also engineering exercises for health projects with the HKMA So, I'm not saying.. which one was more important .. what I'm saying the message is this is not talking about only dieting or the exercise, we are talking about the twenty four hours lifestyle everyday every week the whole year and this is exactly the core issue of how difficult to combat childhood obesity All three of you seem to be implying that....correct me if I'm wrong that the the starting point is the family home you know parents, grandparents.. grandparents often in Hong Kong uh... and domestic helpers obviously a high incidence of that in uh... in Hong Kong .. certainly in my own household I've one son who is now eighteen I don't necessary practise what I preach myself but my wife and I were quite strict on on educating him and the household about what he ate, like my mother his grandmother would want to give him chocolates, but we said no, now he consumes copious amounts of fruits and vegetables every day you know if he doesn't have a sweet tooth and he's quite fit This is what we call four two one syndrome in China four grandparents because two families the father and mother and two is the parents because there was the one child policy so uh... very few uh... kids but many many seniors ...in Hong Kong we have to add two domestic helpers ..I guess it's very good in your family but in general in Hong Kong because junk food are just all around us and it's very difficult to resist temptations and then also the advertisement on the television and the media about the um... the uh... uh... the omnipotence of the milk powder the milk powder company they are also playing a role to uh... suggesting that they giving a superb nutrition aspect to the parents, which the parents believe when in fact that is a source of making children over-weight in Hong Kong and in other developed countries. Do a lot of these milk powders have a lot of sugar..or something like that? Definitely, a lot. Zohar, you've got to tell me your secret, because I've got two children and uh... it's just a battle to get them to eat anything, to be quite honest especially the one who has just turned three, and he just wants chocolate and he will go for a day without eating... ..tough love ..there's no easy answer.. Ok, we can do it for a day, but the second day, you've go to give him something.. if it's only sweet things, that's the.. that's why you have to start early...there's is one very important piece of advice and it's that parents of the best models for children if a parents eats junks food, and serves healthy food for their children .. why should the child follow suit and .. yeah So role modelling effect is one of the major influences.. If you want your kid to do something but you are going to other direction you eat the fatty food, and then you ask them not to watch television with a beer in your hand you ask them not to drink a soft drink or whatever it doesn't work so this is a role model the support family uh... you have to demonstrate sporty habit [right] and a healthy eating or we are not saying don't eat that and don't eat others but you eat smartly still you know the sweet foods and fatty foods are more attractive Not exactly I have a very young daughter, she is 5 right now She didn't eat candy no chocolate why..because as Dr Ching had a conversation before we get in the studio we say in Chinese [saam sui ding baat sap] (3 years old we know what will be like when 80 years old) so what we are saying is that in the younger age in the 3 year old is determine the future that eighty years old adult When we present them correct messages about the correct body size the correct eating habit, to have the discipline organize their daily exercise or behavior pattern of course it's difficult but since I am a very disciplined guy and I start to discipline her when she was two or three years old so I think it's possible but it takes a lot all energy to stop or explain the reasons behind So, I don't have any difficulty to uh... to forbid her to go into McDonald we don't get into McDonald, there's no problem at all...So I think it's not just disciplinary It's the way you educate children is to let them understand clearly understand because that's their right of knowing and that their rights of choice of foods but many a time parents didn't really explain to them in their language that they could understand and didn't give them the right to choose because they just give them anyway ahead supposing the children could not resist the temptation if they can really understand I think that is possible that the children would choose not to eat the junk food Dr Chan just mentioned one thing I want to know what planet you are living on! I really don't think that's true! What do you do with a child who won't eat, when you do home-cooked food with lots of vegetables and you eat it and you you praise the vegetables and everything and you try to make it attractive portions, and you give a choice and you don't force them to eat one particular vegetable or anything else, and you do all these positive things it's difficult, it's not easy..well assuming you child is normal, and does not have any medical problem, then why shouldn't he or she eat? when when when they get hungry you are the doctors, you tell me! Well, maybe they are taking so many junk food the challenges is that there are so many accessible varieties before you present them the correct choice so my tactic is, don't present them too many attractive junk food beforehand until it they have the ability to differentiate the good food and the bad food [yeah] so I'm not saying that they're not eating ice cream, or chocolate or pizza, we go to pizza but we know how many pizzas, we know this is enough because she knows fact is it's not good in the long term for her health..you know you cannot underestimate how smart our kids are now from 3 to 5 years old so smart to understand so many things one of the major problems for the change is parents Another issue I think now is children from an early age onwards they are so brainwashed by the TV advertisements and they can recognize the brands and the logos and and that sort of recognition helps them to choose food whenever they go out they ask for the same brand without realizing the content whether it's good for health or not and if parents are not aware of that they keep sending children to these sort of brands and collect the toys and these are all sorts of advertisements that keep brainwashing children and parents and that is doing very bad For the typical trip of the toys you know it leads to that bad choice of eating reinforce a very unhealthy way of but... one more thing is that when a child won't eat anything..when a child has a problem with eating uh... uh... it's difficult for the parent because you want your child to eat that's a primary thing is for the parents to get the child to eat Don't let her to be your boss This is the decision as we as parents we all know when you are starving you eat so suddenly one day you find your kid...you don't need to encourage her to eat after the whole day playing games she eats anything you have to be you know persistent.. it's a battle In an affluent society It is difficult to let your child be hungry that's true but on the other hand the parents can make the environments that is more... I don't want a battle, I don't want it to be a battle.. I think there is also a danger of this turning into a battle..you don't want food to be such an issue, that it's a fight every day to eat or not to eat..I think because you have already lost the battle Just ask yourself one question when a child is born since when has he or she asked for coke soft drinks uh... french fries..never! he's so happy with breast milk... breast milk is very um... it's not sugary, it's very good.. it's simple food and they're very happy they're happy, they're hungry and they get the food and they are satisfied but somehow something went wrong when children start on to more solid feeding and parents start feeding them with unhealthy products I think point is that it's smart not to eat everything, it's smart you have choice, you let them know you have choice, I'm not saying that it's like a very persuasive management tool for the kids but you have to let them know all that there are so many choices in the world you can pick whatever you like but concern your health and uh... one of the ways to make children more receptive to a balanced diet is uh... I have the... you know I write songs uh... I've written songs about uh...the balanced diet and uh... from the age of one or two, the children can listen to those songs of balanced diet... and not to uh... be uh... addicted to uh... sugar, sweet or ice cream so uh... in the way many children when they listen to the songs they could understand what it meant and and then they could adopt the thinking behind now, while my child was five years old so we went to a restaurant where uh... in the menu, there's also a cup of jelly and my son asks me, Daddy, is jelly good or not, because in my song, there's nothing mentioned about the jelly so uh... I told him of course you can eat jelly it's also nutritious in a way, there are lots of different kinds of food inside but uh... you see how it's so colourful, so beautiful, and so sweet because there's might be colouring there might be uh... some uh... sugar and even artificial favouring, and these are not healthy for your body and my child that was five at that time he pushed away the cup of jelly, and he stopped asking for it so I think if he could understand and he could make a choice I think it's possible but of course our parents in Hong Kong usually won't go to this step already they're already subject the child to the...Well you are obviously all model parents except for me Well, it's never too late..The issue of starting early I know with with my son we started when he was a toddler on chickpea puree and broccoli puree you know he was a toddler and he didn't know about it I want to just bring up again the things that the group said that in the States we see that, a diet divide where poorer Americans eat fast food and and have all kinds of other health problems and you have rich individuals who can who eat salads and and so and so forth, and and also have more leisure time for uh... activities and are better educated about it, so does it.. does it this may not be the case in Hong Kong, but in the States people talk about how it is more expensive to eat well like at my company just just two days ago the organic farmers association came in to give a talk about the value of organic vegetables and fruits, and we know all that but the thing is that their products are more expensive Is that an issue in Hong Kong or not? I believe it is, it's an issue everywhere and that's why I am really happy because in our healthy eating programme we target first and foremost all schools and we found out.. in fact our statistics uh... reflected that uh... schools which have a sort of serving parents from a lower socioeconomic background joined our programme more, and they are more committed to our program that reflects that schools are having.. commitment to really serve their students well so they enrol into our program and did a good job You're right based on the literature, um... lower income families they uh... actually facing a higher-risk in the obesity issue so um... because they have no much choice to have the healthy eating or the organic food, it's so expensive in Hong Kong right now if you want to eat organic vegetables that is a social issue the gap between the rich and poor it is related Perhaps it's not just about the money it's about the education (yeah) the parents don't really know that they have to get a balanced diet okay we're going to break for the news at 9 o'clock, please hold off for 3 minutes we're talking about childhood obesity with those worrying figures suggesting that one in five primary school students in in uh... Hong Kong are over weight, your thoughts on that welcome to email us on [email protected] we are also going to be talking about that uh... Court of Final Appeal issue later in the programme, the weather briefly before the news, sunny periods, warm and humid with mist at the weekend twenty degrees at the moment, relative humidity is at eighty percent