Analyzing Canada's obesity landscape
Painting a more accurate picture of national obesity rates to fuel effective health interventions
October 11 2018: Dr. Geoff Ball and a national team in Bariatric Care (Team ABC3) from the University of Alberta, University of British Columbia, University of Toronto and McMaster University are continuing their studies in severe obesity (SO) in children. They are conducting eight projects across the country including cross sectional analyses of trends to determine the prevalence, health risks and health outcomes of obesity across the lifespan. The researchers and clinicians are also evaluating weight management programs, interventions and health service delivery for children and families. Meanwhile, Dr. Louise Masse, at the University of British Columbia, is leading a national clinical trial, LiGHT (Living Green, Healthy, and Thrifty) to evaluate e-health lifestyle and behavioural intervention with personal health coaches for managing SO treatment plans, adherence and health outcomes in children as part of the Team ABC3 projects. For more information, read the Faces of Health Research profile, The ABCs of Severe Obesity in Children.
January 18, 2016
Audio – Interview with Dr. Geoff Ball
Obesity is a chronic and often progressive condition, and if current trends continue, it is estimated that 70 million will be obese worldwide by 2025. One in four adult Canadians and one in 10 children currently qualify for clinical obesity, a leading cause of type 2 diabetes, high blood pressure, heart disease, stroke, arthritis and cancer.
Dr. Geoff Ball, researcher at the University of Alberta's Department of Pediatrics, and his team have proposed a number of studies that aim to better understand obesity among children by redefining it and painting a more accurate picture of its trends. They are taking a multidimensional approach to identifying risk factors, understanding the needs of patients and their families, and exploring the effectiveness of health interventions.
This is David Coulombe for CIHR's Health Research in Action news. According to statistics, around 42 million infants and young children are overweight or obese worldwide and 70 million young children will be overweight or obese by 2025 if current trends continue. Also, childhood weight and obesity rates have been rising steadily in Canada in recent decades.
So to talk about this situation, my guest today is Dr. Geoff Ball. He's an Associate Professor, Department of Pediatrics, University of Alberta and a CIHR-funded researcher. Dr. Ball, welcome to the interview.
Dr. Geoff Ball: Thanks very much, David.
Mr. David Coulombe: Maybe a first question for you: can you define what severe obesity in children is exactly?
Dr. Geoff Ball: Sure. It's an interesting question and one that we hope to answer through our team grant. Historically, health professionals and researchers have defined severe obesity as a body mass index above the 99th percentile using growth charts. So that includes comparing individual children to a growth reference, but there's been a number of studies over recent years that have shown that that definition is probably a little bit too liberal and it's also statistically derived.
So ideally whatever definition we recommend, it should be based on clinical outcome, so with measures like high blood pressure, high cholesterol, high glucose and high insulin.
So within our team grant we've got two or three separate studies that will compare and contrast different definitions of severe obesity and hopefully that'll help us to make an evidence-based recommendation.
Mr. David Coulombe: So you can confirm that severe obesity in children is a real concern in Canada?
Dr. Geoff Ball: Well, that's another good question because we don't really know, just because of the situation of national data in our country. So I think this is another one of the reasons why we were funded to help provide information to answer this question.
So unfortunately there aren't any nationally representative studies in Canada that will allow us to answer that question definitively, so we're going to rely on some provincial level datasets and some information collected through some existing clinical networks and that'll give us some insight. So it's not going to be the complete national picture, but it's a step or two in the right direction.
Mr. David Coulombe: So what kind of research can we expect in the next couple of years from your team?
Dr. Geoff Ball: Yes, so within our team we've proposed a number of studies that were designed to better understand severe obesity and also test a couple different novel intervention models.
So for instance, along with some epidemiological studies, we're looking at large datasets that are - data that are already being collected, we're also going to look at a study to identify predictors of treatment initiation because we know that's a barrier for families to access weight management care. And we're also looking at health risks, specifically among children with severe obesity. And then along with that we've got a qualitative study plan where we want to explore families' needs and experiences of not only living with severe obesity, but also a physical disability, because we know that can be a very complex and a complicating factor with respect to weight management.
And in addition to that, probably two of the more interesting studies are related to interventions. So one of them is an online lifestyle and behavioural intervention and we know that's important for families who live in rural and remote communities who might not be able to access health services like people who live in metropolitan areas.
And the other intervention we're working on or will be evaluating is actually one done in partnership with public health nurses where we're doing some home-based visits for younger boys and girls with severe obesity and helping to support parents and families and kids and we'll be evaluating that.
So it's a variety of studies and that capitalizes on our team's interests, but we've also got a lot of research methods expertise and together it'll be a nice picture to help to have a better understanding, a better insight into models that help to manage obesity, severe obesity in children.
Mr. David Coulombe: Very interesting. Best of luck to you and your team, Dr. Ball.
Dr. Geoff Ball: Thanks very much, David.
Audio – Interview with Dr. Louise Masse (in French only)
Obesity is a chronic and often progressive condition characterized by excess body fat. One in four adult Canadians and one in 10 children have clinical obesity, which is a leading cause of type 2 diabetes, high blood pressure, heart disease, stroke, arthritis and cancer. If current trends continue, it is estimated that 70 million will be obese worldwide by 2025.
Dr. Louise Mâsse, professor at the University of British Columbia, and her team have proposed a number of studies that aim to better understand obesity among children by redefining it and painting a more accurate picture of its trends. They are taking a multidimensional approach to identifying risk factors, understanding the needs of patients and their families, and exploring the effectiveness of health interventions.
This is David Coulombe for CIHR's Health Research in Action news. According to statistics, around 42 million infants and young children are overweight or obese worldwide and 70 million young children will be overweight or obese by 2025 if current trends continue. Also childhood weight and obesity rates have been rising steadily in Canada in recent decades.
To discuss this phenomenon, my guest today is Dr. Louise Mâsse from the Child and Family Research Institute, professor at the University of British Columbia and a researcher funded by the Canadian Institutes of Health Research.
David Coulombe: Dr. Mâsse, hello.
Dr. Louise Mâsse: Hello.
David Coulombe: So, what are we referring to when we talk about severe obesity?
Dr. Louise Mâsse: Well, currently, we determine which children are suffering from severe obesity using the body mass index, and that index is calculated from the child's weight and height, but we interpret it a little differently than we do in adults. We compare the value obtained with the child population of the same age and sex, and then we essentially look at the growth curve and the body mass index, and children in the 99th percentile are considered to be suffering from severe obesity. That's how it works at the moment.
The problem is that the definition that we currently use is far from perfect. We have several projects that will, basically, try to arrive at a better definition of which children are suffering from severe obesity using data that's based more on clinical results; information that would be understood in a clinical setting, such as children's blood pressure or blood lipid or sugar levels. That way, we hope to arrive at a definition that is based on the actual impact of obesity on children's health.
David Coulombe: OK, so if I understand correctly, right now it's hard to diagnose whether a child really has a severe obesity problem. So your research will help determine this?
Dr. Louise Mâsse: That is the goal of research projects, after all: to find better definitions so we can have a better idea of what the real problem is.
David Coulombe: Are you hopeful that one day we'll be able to curb the obesity epidemic in children?
Dr. Louise Mâsse: If we're hopeful? Well, yes, there's always a hope that we can curb it. Some current data from the US show that it has stabilized. Obesity rates are more or less stable; we see some groups improving and others getting worse.
The problem is that in Canada, we don't have as much data or information on the subject. So we certainly hope that we'll be able to make changes, but we can't overlook the fact that a third of the child population in Canada is either overweight or considered obese. We still have a long way to go.
And our goal is not necessarily to curb the trend, but also to reverse it—basically, to change the percentage of children who have weight or severe obesity problems. Naturally, the situation will always be a complex one to change because it must be addressed at the source, at several levels and in several different areas. We'll need more coordinated solutions that target the environment, the community, schools and even marketing practices. We have a lot of work on our hands. We hope we can make a difference over time.
David Coulombe: In any case, we wish you the best of luck in your research project. Thank you very much, Dr. Mâsse.
Dr. Louise Mâsse: Thank you.
- Canadian Obesity Network
- Childhood Obesity, Health Canada
- Geoff Ball – University of Alberta
- Geoff Ball website
- Louise Mâsse – University of British Columbia
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