Targeting Childhood Obesity from All Sides at Once

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Dec 14, 2018
by Kwasi Gyamfi Asiedu
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Targeting Childhood Obesity from All Sides at Once

Amsterdam’s Healthy Weight Programme aims for all children to have a healthy upbringing Photo by Jace & Afsoon on Unsplash

“It is often easier to have an unhealthy snack or food moment than it is to have a healthy food moment,” says Karen den Hertog, program manager of the Amsterdam Healthy Weight Programme (AHWP).

In 2012, 21% of young people aged zero to 19, in Amsterdam were overweight or obese. The problem was especially visible in children from low earning and immigrant households. “We [have seen] that number lower to 18 percent. So, that’s a reduction from 21 to 18 percent and the difference in the numbers is even bigger among the families with the low and the extreme low socioeconomic status,” den Hertog says.

Den Hertog has run the program on three key messages: active behavior, food, and sleep. Success has not come without ruffling some feathers, however. Den Hertog says, “We stopped the food industry [from] sponsoring sports events or handing out funding materials... we said ‘We want to work together, but we want you to change something to the core of your entire enterprise... We can’t have you subsidize sporting events anymore because no amount of sporting can help children trade off the calories they have just eaten or drunk'.”

She adds, “So, food reformulation or from the package labeling to smaller portion sizes charged with marketing, if you’re willing to do stuff like that we’re willing to work with you… I mean it’s not very strange [to] actually say ‘I want you to work in the core of your business.’” The program scored a significant win when one of the industry’s large retail chains in the country came on board.

Den Hertog reveals she has also faced pushback from her colleagues at various other city departments. She says, “It’s not that they don’t want to help. But it is asking something different from them to include health in all their policies.” Citing the millions of tourists that visit Amsterdam annually, she says, “Inventing policies to balance out the crowded city center is difficult as it is, let alone if you need to include health in there as well.”

So, how to do you gain the buy-in from colleagues? “You need to adapt more to the language of the other policy departments,” one of her colleagues, Thomas de Jager (who is also attending the program) told her - a point she agrees with. Den Hertog says, “It really takes time and shared language to actually understand each other really and to help each other.”

Asked about what a straightforward initiative if adopted in other cities can help reduce childhood obesity, Den Hertog refers to an often ignored message of her program: sleep.
“The evidence of how important sleep is is incredible. If a child - and the same applies to us as adults, but we don’t want to listen - doesn’t sleep enough, so many hormones get upset... It is unhealthy [and] you become overweight and obese far more quickly than if you would sleep enough.

“It’s a very simple thing, and it’s of course very difficult because so many parents are struggling [with] multiple jobs, or they have poor living conditions with multiple children in one room, or they might live next to big roads or train tracks or [have] lots of light in the living room.

“We should really take sleep as an essential thing as healthy food and [daily] physical activity.”

AHWP's Outputs and Results

  • 11 neighborhoods have a joint local Healthy Weight Pact
  • More than 1,200 preschool parents are involved in Amsterdam Healthy Weight Programme activities
  • Every year, an average of 60 information meetings of healthy eating and a healthy lifestyle are organized
  • 1,200 severely obese children identified and being treated
  • 300 health ambassadors highlight the importance of a healthy lifestyle in the focus neighborhoods
  • 1,734 healthy eating consultations for overweight children and their parents
  • 50 community initiatives a year
  • 67 healthy school playgrounds
  • More than 150,000 neighborhood residents reached
  • 18 courses on healthy shopping and healthy cooking involving 150 participants
  • 80 additional water fountains in the city
  • 24,500 businesses reached through social media campaigns
  • One Amsterdam Standard of Care, which is adopted throughout the city
  • 160 curative interventions involving more than 1,000 participants

The program Healthy Children, Healthy Weight is part of Salzburg Global's multi-year series Health and Health Care Innovation. This year’s program is being held in partnership with the Robert Wood Johnson Foundation.