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There is increasing concern about the effect of poor diet on both the health and educational attainment of children. Childhood health problems related to diet, including obesity, have increased substantially over the last twenty years. Poverty has long been regarded as a major cause of poor nutrition but what other factors influence children's diet?
In 1980 the Black Report (Townsend et al; 1988) concluded that the main explanation for inequalities in health (between the higher and lower classes) was deprivation. In 1998 the Acheson report endorsed this view. Poor health, linked to diet, has increased across all social classes but is more pronounced among manual classes. ( Babb et al; 2004)
Barry and Yuill (2008) highlight statistics that show that people living in poverty make bad nutritional choices and diets are often high in fat and sugar leading to heart disease and increased risk of certain cancers. Caraher and Dowler in 'The Great Food Divide' agree, ‘living in poverty more often than not leads to poor diet and people dying younger'. Food poverty today differs greatly from Victorian times when large sections of the population were unable to afford to eat while food poverty today is more to do with dietary imbalance than under-nourishment.
Many of the UK's poorest households are clustered together in estates suffering from high unemployment and poor housing. Many have experienced the withdrawal of food shops as large out of town supermarkets have put the smaller local stores out of business. The Local Action on Food network highlight four main factors as influencing consumption of affordable and healthy food; accessibility; availability; affordability and awareness. People that live within communities lacking local shops or transport links may find it difficult to shop regularly for fresh foods. Local shops that remain may not stock fruit and vegetables due to low shelf life and poor profit margins. Local shops cannot compete with the buying power of the big supermarkets and are unable to compete on price with their larger rivals. It is the poorest in society that pay the highest price for their food. People on low incomes are likely to pay other bills before buying food and will spend only what is left over on their shopping for the week, Some Mothers on tight budgets worry about spending money on healthy foods that their children may not eat so instead buy unhealthy products that they know their children enjoy. Many individuals lack the knowledge needed to budget, shop and cook: such skills are generally learned from parents and grandparents but, if previous generations also lacked the skills, this problem becomes common through the generations. The Local Action on Food Network defines food poverty as ‘the inability to obtain healthy, affordable food'. People on low incomes are likely to have a lower intake of fruit and vegetables and an over reliance on ‘junk' food which leads to cancer, diabetes, obesity and heart disease.
In times of recession where family budgets are stretched, outlets such as MacDonald's, KFC and Greggs are reporting increased sales. Poorer families avoid expensive restaurants and choose cheaper ones where the food on offer has a high fat content. Children perceive such an outing as a treat and visits are often organised for birthdays and other family celebrations. Three pieces of chicken and fries from KFC contains 940 calories: well over half of the daily calorie intake recommended for a child under 16 years old.
In the current recession, sales of supermarket value ranges have leapt. Dispatches screened on channel 4 last year undertook a survey on the content of some of the 'value' lines with shocking results.: a beef pie which contained only 18% beef with the rest made up of ‘connective tissue' , a pork sausage just 40% pork with pig skin for ‘bulk' or an apple pie only 14% apple. Would anyone choose to purchase such products if it wasn't for the cost? Sales of value ranges have leapt during the current economic recession. For those on very low incomes eating healthily is not a priority: feeding their families with the cheapest food available is often the only option. (Dispatches, 2009).
BBC News in December 2009 reported that the class gap with regard to diet is widening.. However, the situation is more complex than that. There is research to show that the children of middle class, working Mothers have poor diets. In September 2009 an article in the Daily Mail said that children with stay at home mothers have a healthier lifestyle. Children of working mothers snack more on junk food and spend more time in front of the TV and so less time working off excess calories. Lack of time is most likely to be the strongest influence on diet. Yet working mothers are normally better educated, have a higher social status and live in middle class areas. Seventy five percent of women work and preparation of a healthy meal can be perceived as time consuming resulting in families' nutritional welfare suffering. Many families now regularly consume food from takeaway outlets. Family meals have become fragmented around the working hours of parents, children regularly eat in front of the T.V. and fewer meals are taken together, around the dining table. A further study by the Consumption research Laboratory in Paris also concluded that having a Mother at home had a positive impact on the total nutritional intake of children. Darren Osborne writing fir ABC Science called Mothers the ‘gatekeepers of children's health'.
Childhood dietary issues have also been shown to be linked with the use of grandparents as carers. Research carried out by The Centre for Paediatric Epidemiology in London analysed data from a cohort study of 12,000 pre-school children and were able to link a poor childhood diet with grandparents being used as daily child carers. The Daily Mail suggested that some grandparents ‘spoil' their grandchildren with high calorie treats and are more likely to give into what the child wants to eat than provide healthier alternatives. Contrary to the belief that childhood diet and resulting health problems are more common in lower class families, this study showed that children who are regularly cared for by grandparents are more likely to be from middle class, educated families with two parents working full time to support their standard of living. Families with two incomes normally live in better, middle class, areas. The cohort study showed that children cared for regularly by a grandparent were a third more likely to be overweight. An additional issue is changes in thinking regarding appropriate age at which to wean a baby. Older generations tended to wean by around 10 weeks while current recommendations are to wait until at least 16 weeks. University college scientists found that children weaned early have a higher chance of being over-weight by age 3 than those weaned later. Career women retuning to work shortly after birth, leave weaning to grandparents who are unaware of current guidelines.
Fat food outlets also have a part to play in the rising obesity tide. McDonalds has been successful in securing working class customers but have now set their sights on the middle class market. During the current recession McDonalds has defied plunging high street sales and increased takings by 10%. McDonald's sales suffered during the BSE scare of the 1990s and negativity was also enhanced by Morgan Spurlock's film ‘Super Size Me' which documented the effect his MacDonald's exclusive diet had on his physical and psychological health. The MacDonald's marketing machine was successful in staging a massive recovery in both the UK and US markets. With the working class market cornered, Macdonald's has set its sights on middle class families. Restaurants have had a cafe-style refit, the brand removed the fibre glass chairs bolted to the floor prison style and replaced them with sofas, pot plants, wall art and fashionable lighting. Even vases on tables contain a white rose. Advertisements declare news of a new ‘quality food' menu aimed at the middle classes in an attempt to encourage a new wave of McDonalds customers. Restaurants are now open longer, have free Wi Fi and serve cappuccinos and lattes alongside burgers and deep fried apple pies.
Breast feeding may also be a factor as mothers who return to work early are more likely to use formulae milk. Studies have shown that babies fed formulae take in 30,000 more calories in their first year than they actually need: calories that are stored and result in early childhood obesity.
Mothers heeding the advice of the fit4 life campaign and taking advantage of free swimming for their children then have to navigate their young children past vending machines within leisure centres stocked with crisps, confectionary and unhealthy drinks. Crisps and chocolate are on sale in leisure centres despite being banned from school canteens and school vending machines. Cafe areas in leisure centres tend to be dominated by chips, hot dogs and pizza. The average calorie content of a mars bar is 467 which would take a 7 year old 88 minutes to burn off.
Alongside the advertisements for fast food, the government spend huge amounts of money (but not a fraction of that of McDonalds) on advertisements urging us to ‘eat well, move more'. The government has also spent £640k on new ads using Homer Simpson urging us to give up the doughnuts. Hardly a healthy role model: Homer is seen replacing his usual popcorn with a healthier snack and encouraging his family to do the same. One thing the Simpsons do enjoy is family meals around the dining table - another aspect of family life which is dying out and being replaced by TV dinners. Ironically the Simpsons used to be sponsored by Dominoes pizza until Ofcom ruled it inappropriate. Dominoes are another giant who have navigated their way around the new rules by advertising within ‘family' shows such as ‘I'm a celebrity...' which attracts young views in millions.
Another area to consider is the various policies in place in school regarding lunch times and whether children are allowed off the premises or not. Fast food outlets deliberately set up new schools to lure children in at lunchtime to spend their pocket money on chips and muffins rather than on the much publicised healthier school dinners.
In conclusion, poverty remains a major factor and statistics published by the National Child Measurement Programme, issued in November 2009, did produce a correlation between diet, health and household income. This latest study showed that 22% of girls in the lowest income group were overweight compared to 9% in the highest income group. Although this remains the case, recent research has also shown that middle class children are starting to suffer health problems arising from poor diet. Working Mums may claim to be working to provide a quality of life for their children but they need to consider carefully the implications of this lifestyle choice on the diet and future health of their child. Large fast food outlets and supermarket chains also need to consider the part they play: the poorest have to take what they decide to give them but is this good enough? If unwilling to make changes to the quality of their lowest priced products, government action may be required to raise the quality of ingredients within meals or at least for the hidden ingredients, fat and salt content to be clearly displayed on the packaging. Parents must be mindful of the persuasive advertising techniques used on their impressionable youngsters and if advertisers cannot follow the spirit of the new code enforced regulation may be needed.