Part 1: The Ministry of Health’s approach

1.1
The Ministry of Health (the Ministry) delivers a range of nutritional and physical activity programmes to help combat child obesity.¹

1.2
In the light of new evidence and changing international practice, the Ministry told us that it is testing and evaluating new ideas and approaches to identify the most effective focus for New Zealand’s efforts to combat obesity. The Ministry is considering how its current range of health promotion-based programmes can be complemented by introducing an emphasis on interventions that target critical periods of human development to achieve the greatest effect.

1.3
For example, the Ministry said that it might implement an obesity prevention programme with, for example, a strong emphasis on maternal and infant services. This would mean supporting women to achieve a healthy weight during and after pregnancy, and a focus on child nutrition in the first few years to potentially prevent obesity developing in childhood and later in life.  

1.4
The Ministry told us that the effect of maternal and infant health on obesity is still a largely untested hypothesis. Staff we interviewed said that there was good science to back up the hypothesis and that the Ministry was continuing to evaluate it. This evaluation includes the work of the Prime Minister's Chief Science Advisor, Professor Sir Peter Gluckman. The Ministry also told us that improving maternal and infant nutrition is only one component of addressing obesity in New Zealand. The Ministry will continue to develop and implement programmes based on its assessment of the information and scientific evidence available.

1.5
In the meantime, the Ministry is continuing with its range of existing interventions and Health Target initiatives,² such as screening people for type II diabetes.

1.6
It might take time before noticeable changes from a different range of interventions could be measured. However, the Ministry expects that some measurable effects should be seen within a few years of implementation – for example, through routine monitoring of birth-weight and of the weight of four-year-old children, as part of the B4 School Checks.

1.7
The Ministry is also collaborating with international colleagues to prepare health standards and guidelines for obesity research and treatment. Work with the World Health Organisation (WHO) has enabled the Ministry to develop guidelines for breastmilk substitutes. The Ministry has incorporated WHO standards and recommendations into services it is currently running; into hospital databases; and when preparing food-based dietary guidelines. The Ministry believes that this continued collaboration with WHO enables it to stay up to date with international best practice on weight-related health issues, including obesity.

1: See paragraph 2.4 for examples of the nutritional and physical activity programmes.

2: Information about Health Target Initiatives can be found at www.health.govt.nz.