Ranked Importance of Childhood Obesity Determinants: Parents’ Views across Ethnicities in New Zealand

Abstract

Māori, Pacific, Indian, and New Zealand European pre-school children’s caregivers’ views on determinants of childhood obesity are needed to inform strategies that will reduce disparities in prevalence. Nineteen focus groups were conducted to explore the relative influence of factors contributing to body weight in children. Predetermined and participant-suggested factors were ranked. Discussion data were inductively analysed. The cost of healthy foods was the highest ranked factor across all groups. Ranked similarly were ease of access to takeaways and lack of time for food preparation. Cultural factors followed by screen time induced sedentariness in children and lack of time to ensure children exercised was next. Participant-raised factors included lack of familial, social, and health promotion support, and others’ behaviour and attitudes negatively impacting what children ate. All groups rejected stereotyping that blamed culture for higher obesity rates. Compared to the Māori and NZ European groups, the Pacific Island and Indian participants spoke of losing culture, missing extended family support, and not having access to culturally appropriate nutrition education or social support and services. Public health policies need to mitigate the negative effects of economic deprivation on food insecurity. Complementary interventions that increase access to healthier meal choices more often are needed.

Cost and greenhouse gas emissions of current, healthy, flexitarian and vegan diets in Aotearoa (New Zealand)

“…9 10 Cost is a universal concern and significant determinant of food choices in affording healthier foods compared with unhealthy foods. [11][12][13] The EAT-Lancet Commission proposed a planetary reference diet which includes global targets for healthy diets from sustainable food systems aligning with the UN Sustainable Development Goals and Paris Agreement. 14 Diets similar to the planetary diet such as vegetarian, have an association with reduced risk of adverse health outcomes including diabetes, ischaemic heart disease, and cancer risk, and are projected to confer large healthcare system cost savings in Aotearoa.…”

See How They Grow: Testing the Feasibility of a Mobile App to Support Parents' Understanding of Child Growth Charts

“…The lower engagement by Māori compared to non-Māori suggests that SHTG was missing something that could have kept this cohort engaged longer. The role of culture in child-rearing and perceptions of growth and development needs to be better understood and interventions designed that account for these differences, otherwise, it is likely they could increase the disparity [47][48][49].…”

Examining the New Zealand school food environment: what needs to change?

“…For example, parents in New Zealand of Pacific Island descent are knowledgeable about healthy foods; however, cost, affordability and time restraints are more influential on food choices (117) . Similarly, Australian parents (118) and New Zealand parents (119) identified that they did not feel well equipped to choose healthy foods, particularly with increased food marketing, and felt that lifestyle demands, pressure from their children, increased density of food outlets, and peer social influence were barriers to healthy eating.…”

“…Public health policies aim to reduce inequities, particularly for Māori and Pacific peoples, and evidence suggests that societal biases may be a hindering factor. In a recent analysis of parental views on childhood overweight and obesity across ethnicities in New Zealand (n = 180) (119) , Pacific participants rejected the idea that 'big is seen as beautiful', and the idea that 'culture encourages eating' was deemed offensive to some participants. Respondents also commented on the lack of culturally appropriate information, resources and services available.…”

“…Respondents also commented on the lack of culturally appropriate information, resources and services available. Cost of healthy food, relative ease of access of takeaways, and lack of time were the top three perceived factors that influenced a child's weight (119) . Affordability of healthy food will always be relative to the amount of income a family receives.…”