Nutrition: The deadly combination of the proliferation of nutrient-poor junk food, sedentary lifestyles, the widening poverty gap and affordability of food for those on lower incomes means that a total of 1.2 million Kiwis are now classed as 'obese'. Obesity is a term describing a body mass index (BMI) of 30 or more, calculated by dividing a weight in kilograms by the square of a person's height in metres. Three in 10 Kiwi adults are obese, with a further 34 per cent classed as overweight.
More concerning is that one in nine of our children are now classed as 'obese', representing the fifth highest rate of childhood obesity in the OECD.
Our expanding waistlines are putting us at greater risk of heart disease, osteoarthritis, strokes, cancers, high blood pressure and reproductive issues. If current trends continue, obesity will overtake tobacco use as the biggest risk factor for disease by 2016.
Type 2 diabetes is considered the major consequence of obesity. Nearly a quarter of a million New Zealanders have diabetes (mostly the type 2 variety) and one quarter of adults are undiagnosed. A further 18.6 per cent display 'pre-diabetes' (higher-than-normal glucose levels), likely to develop into diabetes in the absence of treatment.
Attempting to provide the necessary care for diabetes-related illness, such as heart disease, strokes, blindness, kidney disease and limb amputation could cripple our healthcare system. Ten years ago estimates from PriceWaterhouseCoopers put the cost per year of the diabetes epidemic at NZ$247. By 2021 costs are expected to reach more than a billion dollars.
In total, obesity-related health issues will likely cost at least eight billion dollars over the next 10 years, says the University of Otago's Department of Public Health Associate Professor Louise Signal.
"Given the increasing rate of obesity among our children, and the likelihood of that playing out in their adulthood, it's going to be even more than that."
Junk food (energy-dense, nutrient-poor food high in fats, sugar and sodium and low in fibre) is widely available, heavily promoted and often cheaper than healthy food.
We're also endorsing junk food like it's going out of fashion. Of advertised food, some 70 per cent is deemed 'counter to improved nutrition'. The number of television food ads also increased from eight per hour in 1997 to 12 per hour in 2005, meaning the average box-ogling child will be exposed to around 5,000 unhealthy food ads each year.
At the 2013 Munch Awards - designed to promote healthy eating choices for children - Sanatarium Weetbix Tryathlon won Best Kids Food Marketing Campaign, with McDonald's Happy Meals taking out the wooden spoon. Best Kids' Food Product went to All Good Bananas, while worst went to Coca Cola.
The poverty trap
The recently released Child Poverty Monitor identified that one in four children, and six per cent of the entire population, live in poverty. One in ten children lives in severe poverty.
For Maori and Pasifika people the stats are higher; one in three children will live in poverty compared with one in seven Pakeha. According to the 2006 NZ Index of Deprivation, 65 per cent of Maori and 78 per cent of Pasifika people live in the most deprived neighbourhoods.
"Part of the ethnic inequality evident in health statistics is inequality playing out," says Signal.
Adults suffering serious financial hardship are nine times more likely to experience psychological distress and six times more likely to have experienced an unmet need for a GP in the past 12 months compared to those with good or very good living standards. They are more likely to smoke and suffer from a range of diseases including obesity and obesity-related illnesses such as type 2 diabetes. For example, rates of childhood obesity in deprived areas are 19 per cent compared to three per cent for those in the least deprived areas.
Research emphasises that low-income families make food-buying decisions based on what their children will eat and how satisfying it is, rather than buying 'healthy' food, says Child Poverty Action Group (CPAG) spokesperson and Associate Professor at the University of Auckland's Faculty of Education Dr Mike O'Brien.
Exercise protects against heart disease, type 2 diabetes, and certain types of cancer, osteoarthritis and depression. Yet only 54 per cent of adults are doing the recommended 30 minutes of exercise per day, five days a week. Even the 15-to-24 year-olds are lagging behind, with only 58 per cent taking the recommended exercise. The Youth 2007 report indicated that a mere 11 per cent of secondary school students are meeting recommendations of 60 minutes of exercise daily.
You are what you eat
A healthy diet is one of the best ways to keep in good general health. Keep an eye on:
• Salt/sodium intake (New Zealand soils are iodine-deficient so make sure if you use salt, you opt for the iodised variety)
• Saturated fat levels (no more than 10 per cent of daily energy intake)
• Sugar intake (work out your intake with the RDI calculator at consumer.org.nz/reports/rdi-calculator)
• Fruit/veggie intake (at least three servings of veggies and two of fruit a day)
What are the solutions? Check out the second part of our special report.