Herramientas análisis de causas

The rate of obesity and overweight among children and adolescents is of particular concern, as patterns of food consumption and exercise established while young typically continue into adulthood and affect life-long weight and health (Birch & Fisher, 1998; Ferraro et al., 2003). Thus, interventions that ensure children and adolescents will stay within the healthy weight range are viewed as especially important to long-term population health (Hodgson, 2006a; Ministry of Health, 2003a). Many voices in the debate over how to influence childhood weight place responsibility squarely on parents’ shoulders:

No one is in charge of what goes into kids’ mouths except their parents. It is up to parents more than anyone else to take this matter in hand…if their parents are foolish enough to feed their kids on a diet of Coca Cola and lollies well they should lift their game and lift it urgently (Tony Abbott, Australian Federal Health Minister, 2005, quoted in Baum, 2008, p. 569). There can be little doubt that parents and family directly influence and shape children’s weight-related behaviours (Dietz, 2001; Savage, Fisher, & Birch, 2007). Parents are viewed as important socialisation agents during childhood development, although peers and media influences also contribute to the socialisation process (Hughner & Maher, 2006). Parents are in a position to act as gatekeepers when they purchase food and set

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rules for the family’s consumption (Savage et al., 2007; White & Davis, 2006) and most do seek to control their children’s diets (Brown, Ogden, Vögele, & Gibson, 2008). References to parental responsibility for managing children’s diet, recreation, and weight are common, and because of this parents are nominated as the most appropriate targets for obesity interventions (e.g., Campbell, 2008; Cebrzynski, 2007; Irwin, 2004). Public opinion surveys return similar views; 90 percent of United States adults believe that parents have a lot of responsibility for reducing childhood obesity (Evans et al., 2005). However, many factors may impede parents’ ability to control their children’s diets (Wardle, 1995). Children are not passive participants in household food selection decisions who always abide by their parents’ decisions. It has long been known that children influence purchases and ask for food items even more frequently than they ask for toys. Mothers are more likely acquiesce to requests as children get older, particularly for food purchases (Ward & Wackman, 1972). Children also use specific strategies to gain access to preferred snack foods, which tend to be sweet (Marshall, O'Donohoe, & Kline, 2007). Wilson and Wood’s (2004) research confirmed that children’s influence on consumption decisions continues to grow, and note the increasing trend for child- specific food items and marketing.

The extent to which parents might actively try to modify their children’s behaviours depends on their perceptions of the risks involved (Hughner & Maher, 2006). If parents believe that their child’s weight or dietary intake is poses risk to their health, they are more likely to intervene. Correspondingly, if parents do not see any risk associated with their child’s weight or consumption, they will not try to modify their child’s behaviours. Complicating this, however, is the fact that people are often poor judges of whether they or their children are overweight. In the EarlyBird study, researchers found only one quarter of parents correctly identified when their child was overweight, and one third of parents whose child was obese incorrectly thought their child’s weight was actually ‘about right’ (Jeffery, Voss, Metcalf, Alba, & Wilkin, 2004).

Obesity has been framed as a consequence of insufficient knowledge, with the solution requiring more education (FIG, 2006b). However, evidence presented by the United States Department of Agriculture (USDA) shows that the relationship between children’s weight and parental nutrition knowledge is actually weak: “Large percentages (around 20 in almost every case) of children whose parents have appropriate attitudes and

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knowledge are overweight” (Variyam, 2001, p. 22). Therefore the fact that children are overweight is unlikely to be largely attributable to parental ignorance of the importance of good nutrition and healthy diets. However, if parents are to be responsible for the healthiness of their children’s diets, then they must know certain food choices are riskier than others and be able to evaluate which products are nutritionally better.

New Zealand parents are quite confident that their own children know which foods are healthy and which should be limited (85 percent agree, Athena Marketing Research, 2008). Furthermore, several studies report that adults and children are generally capable of identifying foods as ‘healthy’ or ‘unhealthy’ (Hill, Casswell, Maskill, Jones, & Wyllie, 1998; Kesketh, Waters, Green, Salmon, & Williams, 2005). However, the dichotomisation appears based upon simplistic category stereotypes, such as stating fresh and unprocessed produce is good while products like cakes, pizza and confectionery are bad5_{. This strategy for evaluating healthiness does not help consumers identify which}

products within the same category have better or worse nutritional profiles. It fails to account for the fact that consumers purchase many processed foods, which have differing nutritional values across competing brands. These variations mean parents cannot use the simple category stereotype heuristic to inform their choices.

Findings from the United States report that parents acknowledge difficulty distinguishing between healthy and less-healthy snacks (Kesketh et al., 2005). While parents also routinely claim that nutritional value is a very important determinant when selecting foods (e.g., Spungin, 2004), these studies typically do not report whether respondents are actually able to assess nutritional profiles accurately. In short, there are many factors that complicate the task of ensuring that children remain a healthy weight.