When I bring them into the land flowing with milk and honey that I promised on oath to their fathers, and they eat their fill and grow fat and turn to other gods and serve them, spurning Me and breaking My covenant. Deuteronomy 31:20 (The Israel Bible™)
Many of the world’s children – even those from disadvantaged backgrounds – are getting fat, even obese. Attached to their TV and smartphone screens as if they were umbilical cords, youngsters are not going out to exercise and pursue sports as they once did. And they are eating too much cheap processed junk foods and drinking too much cola and other sweetened beverages.
Childhood obesity has reached epidemic proportions, affecting youngsters’ health and wellbeing and leading to obesity, heart disease, diabetes, and cancer later in life. The number of children with obesity continues to rise globally, particularly for children living in poverty.
Although Israel is not immune to this problem – and too many of its children are overweight and even obese, Prof. Mary Rudolf, head of the department of population health at the Azrieli Faculty of Medicine of Bar-Ilan University in Ramat Gan near Tel Aviv is helping to fight this dangerous phenomenon.
She has helped Leeds – England’s third-largest city – to buck this global trend with a program she developed and helped implement both in Britain. As a result, Leeds has seen a significant decline in obesity among children, according to a recent study she published in the journal Pediatric Obesity. Furthermore, the largest decrease in obesity occurred among the city’s poorest and most disadvantaged children.
Her work has had such a positive impact that Rudolf has been invited to speak about her research before the Food and Health Forum at the British Parliament. This cross-party forum meets regularly and advises Parliament on how the health of the nation can be improved.
Rudolf conducted her research on the growth measurements of children in England from 2009 to 2017. She found that, unlike England as a whole and comparable cities, the number of obese children in Leeds fell by 6.4%. “We used nationally collected data in our study, so it was very obvious that something different was happening in Leeds,” she explained.
The decline in obesity coincided with a strategy introduced by the city in 2009 aimed at coping with the obesity epidemic by focusing on families with preschool children in the poorest areas of Leeds. At its heart was HENRY (Health Exercise Nutrition for the Really Young) – an intervention Rudolf and colleagues for children under the age of five. HENRY, which has been widely adopted in the UK over the past decade, offers a range of programs and trains health and community practitioners to work in innovative ways to help parents provide their families with a healthier start in life.
Childhood obesity wrote Rudolf in her study, “is one of the greatest public health challenges of our time. More than one-third of children are affected by overweight or obesity by the time they leave primary school, and severe obesity within this group has reached its highest point yet, with stark social inequalities continuing to increase.”
The high risk of overweight and obesity from childhood into adulthood means the development of chronic diseases, lower quality of life and reduced life expectancy,” she warned. Successful interventions to prevent obesity in childhood should make it possible for children to live longer, healthier lives, reduce health inequalities and bring about future savings to health care systems and the wider economy.
Israel has not been immune to the epidemic. According to the Health Ministry in Jerusalem, 20% of Israeli kids are obese or overweight by the time they start first grade, rising to one in three by seventh grade.
To address the problem, the ministry brought HENRY to Israel in 2014. A team of four professionals was sent to Oxford to learn the approach, and subsequently trained nurses, dieticians and social workers who worked directly with families that participated in the program, and in particular specialists in early childhood. The training was also provided to parents participating in the program. HENRY has been translated into Hebrew and Arabic and has been piloted in a variety of disadvantaged towns, such as Safed, Kiryat Yam, Dalyat al-Karmel, Ussefiya, Baqa al-Gharbiyye, Ramle, Jerusalem, Yeruham, and Dimona.
Known in Israel as Efshari bari mishpachti (A Healthy Family is Possible), the program has been suited to families with children under the age of three and is under evaluation by Prof. Orna Baron-Epel of the University of Haifa. Results show that group work with parents is particularly successful in changing family lifestyle. Plans are now being considered to extend the program to the nation’s health maintenance organizations.
Rudolf says it remains to be seen whether Israeli cities can be as successful as Leeds in tackling the problem of child obesity, but when society invests in early childhood, it gets the best returns for doing so. “If we are going to make a difference, we must start at a young age, before the onset of obesity. This can reduce the impact of poor lifestyle later on,” concluded Rudolf, who was born in London and worked in Leeds before settling in Israel.