Dr. Cliodhna Foley-Nolan:

I thank the committee for its time. In light of the children's referendum, childhood obesity and being overweight must be factored into the issue of child protection. It is well accepted that children are growing up in hostile, toxic environments where obesity is concerned. As the committee has received a number of presentations, including many graphs and statistics, I will be statistic light this morning.

Unfortunately, one in five children in preschool is overweight or obese. This is the 2012 figure and increases to one in four in terms of eight year olds. The first communion is a milestone for children. One in four children requires clothes that are larger than what would have been required some years ago. Data from the late 1940s bring the issue into sharp focus, in that 14 year olds have gained 8 in. in height but are three stone heavier than their 1940s counterparts. This disproportionate increase in weight is a large physical burden.

We are in relative denial. According to research, parents and society in general are accepting of children being overweight, "generously sized" or so on. We do not recognise the issue. There is clear evidence that obesity and being overweight track into adulthood. One tends not to grow out of it. If one is overweight or obese at ten years of age, one is twice as likely to be overweight or obese as an adult. It is a real problem.

Thanks to our new investigative facilities and the current level of technology, we know that children begin depositing fat and calcium in their arteries from the time they become overweight. It is not confined to 50 year olds, 60 year olds and 70 year olds. We are also finding overweight children as young as ten years of age with high blood pressure. The terms "overweight" and "obesity" are not interchangeable, as they form part of a spectrum, but we tend to view obesity rather than overweight as being serious. If a child is overweight, metabolic damage is being done to his or her system. Of overweight children in the US, 50% show clear evidence of a metabolic syndrome, which is essentially pre-diabetes. In Ireland, 9% of overweight 12 year olds have pre-diabetes. Concrete evidence shows that there is nothing benign about being overweight as a child.

Parenthood in general is a blame game, particularly so in the case of overweight children. Is industry, parenting or something else to blame? The information clearly points to society. Genetics play a part, but we are over-reliant on this excuse. Genes are switched on by environments. If one is not exposed to certain environmental factors such as high-energy foods or inactivity, one's genetic predispositions will be less expressed. This is an important consideration.

There is some good news, in that early intervention and family intervention have been shown to work. It is not down to the child alone and one cannot just send a child on a programme. A change in or development of lifestyle is necessary. Many statistics support this viewpoint.
safefood has adopted a practical, evidence-based and realistic approach to the issues of healthy eating and tackling obesity. Our mass media campaigns, our work in schools and the evidence base we have built through commissioning certain forms of research comprise an approach that is based on science, provides parents and others with practical tips and tries to influence policy, which is the reason we are at this meeting.

The challenges are significant. This is not a sprint, as there is no quick-fix solution. It is a long-term project. The goals set by the World Health Organization, WHO, and our European counterparts involve halting the increase. We are not discussing something so dramatic as having a healthy childhood generation within three years. After we have halted the increase, we will decrease the levels to what they were in 2000. Most of us would consider that as being only yesterday.

We are fighting the denial and stigma associated with this issue, as well as the fact that parents and society attach blame to the terms "overweight" and "obese", which they perceive as being harsh. A challenge for us is to produce information and campaigns that engage, are adequately hard-hitting and do not alienate people from the realities of the situation.

Ireland possesses no exemplars of the final challenge facing safefood. We are familiar with the economic situation. There is no simple solution. The basis of our work is energy balance, that is, changing the amount of high-energy food that is available everywhere and is marketed to children and changing what occurs in schools and homes.

We have collectively been sitting on the sidelines or getting overexcited about individual pieces of research or advances in treatment methods, for example, diabetes drugs or bariatric surgery. These merely manage the few, in that they only help a relatively small number of individuals who have extremely established diseases. Although this is exciting, appeals in the short term and allows waiting lists for treatment to be discussed, we are giving it undue focus instead of concentrating on overweight children, the number of whom would fill the Aviva Stadium and Croke Park together. By focusing on a minute number of children, we are neglecting prevention and wellness for the others.

We do not have absolute answers - it would be dishonest and misleading of me to claim otherwise - but we have a pathway that will help.

I urge the committee to put more due emphasis on prevention and wellness at the expense, perhaps, of treating the few.