Sydney and Fudan partnership tackles childhood obesity

By Beth Quinlivan

In 30 years, obesity – particularly child obesity – has become a major health challenge in China. A collaboration between Fudan University and Sydney Medical School, is looking at new ways of delivering health messages to new mothers, to tackle the escalating problem..

A mother and child of Xi’an, China

A mother and child of Xi’an, China.

Mu Li remembers growing up in northern China, spending hours playing outside with cousins and friends in the community courtyard. These days, she says, in cities like Shanghai, with concerns about safety, more people living in apartments, more sedentary lifestyles generally, children are more likely to spend their spare time indoors.

Sound familiar?

In the past 30 years, obesity – including obesity in children – has become a major health issue in China. Rapid urbanisation, more western food with higher fat and sugar levels, changing lifestyles, television, are all part of contemporary China. On recent studies using BMI as indicator, children in urban China are faring as poorly as are children in the United States and Australia. Among Chinese adults, there are more than 92 million people with diabetes and 148 million have pre-diabetic conditions.

Mu Li, Associate Professor in the School of Public Health, and Louise Baur, Professor of Paediatrics and Child Health, are collaborating with colleagues at Fudan University in Shanghai to tackle the escalating problem of obesity in Chinese children.

“It began in 2008, when a delegation from Fudan University Medical School visited Sydney. In discussion over the day, we looked at areas where we could work together and decided initially on two of them – prevention, particularly tobacco control, and maternal and child health,” said Professor Li.

Fudan, with a large School of Public Health and expertise in child and maternal health, was a good fit with Sydney. After a follow up meeting in Shanghai, and successful application to the University of Sydney’s International Development Fund, Professor Li spent part of her sabbatical in 2010 at Fudan.

Meanwhile, a group of five Sydney researchers including Professor Baur, were brought into the project. Five Fudan researchers and clinicians are also involved.

The aim, initially, is a pilot study using mobile phone text messages, to support new mothers and help them establish healthy eating and physical activity habits for their children from a young age.

“Providing support to new mothers is more important now that it was to previous generations,” Louise Baur said. “In previous generations, they had family support but with all the changes of the past 10 to 15 years, more people are living in cities away from those networks. Children are terribly precious, and they live in very protective circumstances. Although that is understandable, it is having very poor health consequences.”

Using text messages is a way of capturing the 99% of population who own a mobile phone, rather than wait for the women to contact their local community health centres.

“We can fit 160 characters into each text. It doesn’t seem a lot but still we can include such information as the best time to initiate breast feeding, what to do in case of common breast feeding problems, what is an appropriate time to introduce solid food,” Louise Baur said.

“The response so far has been good,” according to Dr Li. “We’re working with four community health centres in Shanghai, 94% of people we asked have said they would be happy to receive the information. For the planned RCT, we will have a larger number of women, but the indications to this point are all good.”

“What we get out of it, I think, will be useful for other developing countries. The challenges faced in China are very similar to those in Indonesia, Vietnam, India and more.”

Longer term, there are plans to develop from simple text messaging into more sophisticated computerised systems which are interactive.

First published in Radius: March 2011.