Dr. Celine Murrin:

I am a lecturer in public health nutrition in the school of public health, physiotherapy and sports science in UCD. My colleague, Dr. Sylvia Bel-Serrat, is a post-doctoral researcher in the national nutrition surveillance centre, NNSC, also in UCD. On her behalf and that of my colleague, Dr. Mirjam Heinen, who made the original submission but who, unfortunately, cannot be here, I thank the Chairman and committee members for giving us the opportunity to present current research evidence on childhood obesity from the national nutrition surveillance centre.

Before I present the recent findings from the NNSC, I will give some background information on the centre and our role in addressing childhood obesity in Ireland. The national nutrition surveillance centre has been in existence since 1991 and a track record of providing robust surveillance and scientific data for colleagues in the research community and policy makers. Towards the end of the last century, the increasing prevalence of overweight and obese adults led to concerns about similar trends in the childhood population. In 2005 the World Health Organization's regional office for Europe issued recommendations and guidelines for the regular collection of data on weight, height and waist and hip circumference in children worldwide. In the same year the Department of Health published the report of the national task force on obesity and recommended the development of a national database of growth measurements for children and adults to allow for the monitoring of prevalence trends under the headings of underweight, normal weight, overweight and obesity.

In 2008 the Department of Health and the Health Service Executive commissioned the NNSC to commence this surveillance work among primary schoolchildren in the Republic of Ireland. This childhood obesity surveillance initiative was repeated in 2010 and 2012 and most recently in 2015. The data enable us to look at trends over time in the childhood population. I have circulated some slides to the committee which compare data from 2008 with data produced in more recent times. The prevalence among first class children under the headings of overweight and obesity appears to be stabilising overall. However, the prevalence continues to be significantly higher among girls than among boys across all rounds. The second slide I have shown to the committee shows a reduction in recent times in the prevalence in non-disadvantaged schools. Overweight and obesity rates in 2015 in disadvantaged schools were the lowest when compared with previous rounds. Disadvantaged schools continue to have a high prevalence in comparison with children in non-disadvantaged schools. The prevalence in disadvantaged schools appears to increase as children grow up.

We agree with the targets set out in the obesity policy and action plan for the period 2016 to 2025. Clear targets have been set. We need to see a sustained downward trend in the prevalence of obesity and being overweight of approximately 0.5% per annum. We also need to see a reduction of 10% in the gap between obesity levels in the highest and lowest socioeconomic groups.

Tackling obesity requires a multi-level and cross-sectoral approach as outlined by the original task force on obesity and also suggested here.

Schools are just one of the many settings that need to implement strategies to address the determinants of overweight and obesity.

We have been involved in a large piece of European research that identifies schools as being appropriate settings to look at feasible change, but we also need to consider what is feasible to change in the school environment. We know certain areas, such as the eating environment, are feasible to change and might have a larger population level impact. Portion size should be considered, particularly with regard to children. This large piece of data allows us to be able to look not only within Ireland, but also to compare ourselves to our European neighbours to see where we can make changes within the determinants of childhood obesity.

We know also from a piece of work conducted across Europe, within the WHO childhood obesity surveillance initiative, COSI, study, that compared to some of our European neighbours, Irish schools are doing reasonably well with certain types of indicators. For example, if we look at the availability of milk, Irish schools are doing very well. This is also the case with the provision of water. In general, our schools do not physically provide sugar-sweetened beverages, sweet snacks and salted snacks. This is because most European schools have a facility to cater for primary school children. The provision of fruit and vegetables is one area that does require improvement in Irish schools. The National Nutrition Surveillance Centre is planning a fifth round of the childhood obesity surveillance initiative. We are also evaluating, in conjunction with the HSE, the school meals programme, and the new guidelines were launched recently. We are also looking at healthy vending and at present we are particularly focused on HSE hospitals.

Other research projects in which we have been involved include evaluation of the Food Dudes programme. We also have the large Lifeways cross-generational cohort study. We are involved in the DEDIPAC European joint programming initiative, to which I referred earlier. We also work with safefood in looking at certain areas regarding treat behaviours of children. We have quite a range of work and information on which we can draw in trying to inform national strategies on children.