The number of clinically overweight children aged under 10 being seen by a Tauranga dietitian has increased fourfold in two years.
As childhood obesity in New Zealand continues to rise, Rachel Scrivin, of FoodFX in Tauranga, says she has seen the evidence first hand.
"A couple of years ago I was seeing five a year. Now that number would be up to about 20," said the accredited sports dietitian.
"It's a massive trend which is a real shame.
"If you look at the statistics, one in five children [is] overweight. That's huge and it's on the increase.
"I would say 80 per cent of that is about what they are eating.
"Children are eating too many inappropriate, processed, packaged foods - which are high in fat, salt and sugar - and less fresh food. These foods are also less filling so they eat more of them.
"Their diets have moved away from the simple meat, veges, fruit and bread."
Mrs Scrivin said parents had to take responsibility.
"It does require effort from the parents and the amount of effort they're prepared to put in reflects back on their children. Parents have a moral responsibility to make sure they are nourished properly."
She said schools also had a role to play in monitoring what pupils were eating. Children regularly presenting with inadequate or inappropriate meals should have notes sent home re-emphasising the health message.
Exercise was fundamental to tackling the problem, said Mrs Scrivin. "The Ministry of Health recommends one hour of exercise a day but there are plenty that don't do that. And we're not just talking about kicking a ball about. It should be running around, exercise which makes you breathe hard."
Exercise need not be expensive, she said. "People will tell you it's expensive but it doesn't have to cost much, or anything. You can go for a run on the beach or in the park. Get a dog - they need exercising every day."
Mrs Scrivin's comments come as researchers from the University of Auckland announced study results showing excessive weight and obesity in New Zealand costs the country between $722million and $849million a year in healthcare costs and lost productivity.
Ministry of Health statistics state one in five children, aged 2 to 14, in New Zealand is overweight (20.9 per cent). A further one in 12 is obese (8.3 per cent) and the health of three in 10 children (29.2 per cent) is at risk because of excessive weight.
New Zealand was ranked 29th of 30 countries in the Organisation for Economic Co-operation and Development (OECD) 2009 report Doing Better for Children for child health and safety.
Professor Boyd Swinburn, from the School of Population Health at the University of Auckland, said New Zealand and Australia "performed poorly on policies such as reducing junk food marketing to children, simple front-of-pack traffic light labelling on processed foods, and giving the food industry too much influence in developing public policies around food.
"However, Australia clearly outperformed New Zealand by investing in community, school and workplace programmes and by not having GST on fruit and vegetables," he said.
Joe Bourne, who works as a GP liaison for the Bay of Plenty District Health Board, said obesity in children was having serious consequences.
"The most significant change I am noticing is the increasing numbers of teenagers presenting with Type 2 diabetes. Type 2 diabetes was previously known as maturity onset diabetes but the age at onset is coming down.
"Type 2 diabetes has multiple risk factors, including family history and ethnicity, but is also associated with obesity. Type 2 diabetes that develops in young people can be particularly challenging to manage and as such there is an increased risk of complications such as kidney and eye damage."
The organisers of last week'sThe Big New Zealand Play Hour further revealed children's activity levels had fallen by a third in less than a century.
Flavoured water company Water Buddies organised the nationwide event, encouraging one hour of active play, to raise awareness of children's health issues.
Water Buddies co-founder Sian Leonard said times and attitudes to exercise had changed.
"Childhood is vastly different for our kids. Quarter-acre sections are gone, streets are crowded with cars, gaming consoles and TVs are centre-stage in the lounge. And we now know that structured exercise can be seen by today's kids as a bit of a chore. We hope families take our lead and use this as an excuse to play more."
Dr Bourne, who also works for Nga Kakano Foundation Family Health Services based in Te Puke, said the initiative's emphasis was helpful.
"Exercise and activity should be fun. New Zealand has an excellent reputation for producing a disproportionately large number of world-class athletes compared to its population size, but the reality is that very few will reach that level.
"Therefore there needs to be greater focus on exercise for fun as this is the level that most people will participate at."