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---------- Forwarded message ---------
From: <[1][email address]>
Date: Wed, 20 Oct 2021 at 17:39
Subject: Re: Freedom of Information request - Identification of child
obesity cases through Family Health Services
To: <[2][email address]>

Dear Mr. WANG,

Thank you for your enquiry on 3 October 2021 regarding obesity rate of
children in Hong Kong and the promotion of the message of reducing sugar
in diet and drinks for children to parents by the Department of Health. 
Our reply is as follows.

Obesity rate of children

Family Health Service of Department of Health (DH) provides a
comprehensive range of health promotion and disease prevention for
children from birth to 5 years through a network of Maternal and Child
Health Centres (MCHCs).  Under the Child Health Service
([3]http://s.fhs.gov.hk/rrl3b), health and developmental surveillance is
provided to all children attending MCHC during their visits at scheduled
ages.  You may refer to the visit schedule table at our website:
 [4]http://s.fhs.gov.hk/l77nn.  In the year of 2020, about 41000 children
newly registered with the Child Health Service of MCHCs.

Children's weight is measured at the routine visits.  At their visits at 4
year of age, weight, height and BMI of children are measured and
collected.  Health care professionals provide a clinical consultation for
children who are obese or overweight.  Family Health Service keeps a
record of the children’s weight, height and BMI.  Information about
children’s school or kindergarten is not included.  

The following table showed the detection rate of obesity and overweight of
4 year old children attended MCHCs in 2011 to 2020 according to the
definition of obesity based on the World Health Organisation Child Growth
Standard (0-5 years).  Obesity is defined as BMI-for-age greater than 3
standard deviations above the WHO Child Growth Standards median.
Overweight is BMI-for-age greater than 2 standard deviations above but
below or equal to 3 standard deviations above the WHO Children Standards
median.
([5]http://www.who.int/childgrowth/training/...
)

Table 1 : the detection rate of obesity and overweight of 4 year old
children attended MCHCs in 2011 to 2020.   The information can also be
accessed at [6]DATA.GOV.HK via the link:
[7]https://data.gov.hk/en-data/dataset/hk-d....

+-------------------------------------------------------------------------------------------------------------------+
| | |Obesity|Overweight| |Obesity |Overweight|Overweight | Obesity | |
|Year |Overweight |in boys|or Obesity| Overweight |in girls|or Obesity|in boys and| in boys | Overweight or Obesity |
| |in boys (a)| (b) | in boys |in girls (c)| (d) | in girls | girls (e) |and girls|in boys and girls (e+f)|
| | | | (a+b) | | | (c+d) | | (f) | |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2011 | 3.81% | 1.44% | 5.25% | 2.17% | 0.45% | 2.62% | 3.01% | 0.96% | 3.97% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2012 | 3.37% | 1.47% | 4.84% | 1.84% | 0.46% | 2.30% | 2.63% | 0.98% | 3.62% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2013 | 3.24% | 1.51% | 4.75% | 1.54% | 0.47% | 2.01% | 2.42% | 1.01% | 3.43% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2014 | 3.00% | 1.32% | 4.32% | 1.80% | 0.47% | 2.27% | 2.42% | 0.91% | 3.33% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2015 | 2.63% | 1.28% | 3.91% | 1.45% | 0.45% | 1.90% | 2.07% | 0.89% | 2.95% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2016 | 2.47% | 0.99% | 3.46% | 1.54% | 0.37% | 1.91% | 2.02% | 0.69% | 2.72% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2017 | 2.44% | 1.18% | 3.62% | 1.60% | 0.45% | 2.05% | 2.04% | 0.83% | 2.86% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2018 | 2.50% | 1.18% | 3.68% | 1.67% | 0.47% | 2.14% | 2.10% | 0.83% | 2.93% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2019 | 2.42% | 1.20% | 3.62% | 1.49% | 0.47% | 1.96% | 1.98% | 0.85% | 2.83% |
|-----+-----------+-------+----------+------------+--------+----------+-----------+---------+-----------------------|
|2020*| 3.86% | 2.61% | 6.47% | 2.79% | 0.60% | 3.39% | 3.36% | 1.67% | 5.03% |
+-------------------------------------------------------------------------------------------------------------------+

*The attendance of 4-year old children in 2020 had been seriously affected
as a result of interruption of the MCHC services due to COVID-19
pandemic.  Direct comparison of the data in 2020 with that of previous
years has to be done with caution.

For children of school age, Student Health Service of DH collects
anthropometric measurement of primary and secondary students attending
Student Health Service Centres.   Student Health Service makes reference
to growth charts for Hong Kong children developed by the Chinese
University of Hong Kong (CUHK) in 1993 and defines overweight (including
obesity) as weight > 120% of the median weight for height for male
students with height between 55 and 175 cm and for female students with
height between 55 and 165 cm.  For male students with height > 175 cm and
female students with height > 165 cm, obesity is defined as a body mass
index of 25 or above.  

Table 2: the detection rate of overweight (including obesity) of school
children in school year 2010/11 to 2019/20.

+--------------------------------------------------------------------------------------------------------------------------+
| | | 2010/11 | 2011/12 | 2012/13 | 2013/14 | 2014/15 | 2015/16 | 2016/17 | 2017/18 | 2018/19 | 2019/20* |
|-----------+---------+---------+---------+---------+---------+---------+---------+---------+---------+---------+----------|
| Primary | Boys | 26.0% | 25.6% | 25.5% | 24.4% | 23.0% | 22.2% | 21.9% | 21.8% | 21.7% | 23.1% |
| school | | | | | | | | | | | |
| students | | | | | | | | | | | |
|-----------+---------+---------+---------+---------+---------+---------+---------+---------+---------+---------+----------|
| Primary | Girls | 16.4% | 15.9% | 15.8% | 15.2% | 14.1% | 13.4% | 12.9% | 13.0% | 12.8% | 14.2% |
| school | | | | | | | | | | | |
| students | | | | | | | | | | | |
|-----------+---------+---------+---------+---------+---------+---------+---------+---------+---------+---------+----------|
| Primary | Overall | 21.4% | 20.9% | 20.8% | 20.0% | 18.7% | 18.0% | 17.6% | 17.6% | 17.4% | 19.0% |
| school | | | | | | | | | | | |
| students | | | | | | | | | | | |
|-----------+---------+---------+---------+---------+---------+---------+---------+---------+---------+---------+----------|
| Secondary | Boys | 21.6% | 21.5% | 22.2% | 22.5% | 22.2% | 22.7% | 23.1% | 23.2% | 23.6% | 25.1% |
| school | | | | | | | | | | | |
| students | | | | | | | | | | | |
|-----------+---------+---------+---------+---------+---------+---------+---------+---------+---------+---------+----------|
| Secondary | Girls | 16.1% | 15.5% | 16.2% | 16.6% | 16.6% | 16.7% | 16.7% | 16.6% | 16.1% | 17.2% |
| school | | | | | | | | | | | |
| students | | | | | | | | | | | |
|-----------+---------+---------+---------+---------+---------+---------+---------+---------+---------+---------+----------|
| Secondary | Overall | 18.7% | 18.4% | 19.1% | 19.5% | 19.4% | 19.6% | 19.9% | 19.9% | 19.9% | 21.3% |
| school | | | | | | | | | | | |
| students | | | | | | | | | | | |
+--------------------------------------------------------------------------------------------------------------------------+

*        Annual health assessment had been suspended since 29.1.2020 in
2019/20 school year due to COVID-19. In view of serious service disruption
affecting the number and pattern of attending students in 2019/20 school
year, direct comparison of the data in 2019/20 with that of previous years
has to be done with caution.

Information to parents about the need to reduce sugar intake  

The Family Health Service promotes healthy eating of infant and young
children through various means, namely leaflets, e-newsletters, online and
face-to-face public talks, as well as well as counseling parents about
children diet at their visits at MCHCs.  A series of parent education
resources of feeding 6 to 24 month old children
([8]http://s.fhs.gov.hk/22xa3, [9]http://s.fhs.gov.hk/hfttt,
[10]http://s.fhs.gov.hk/o4d67, [11]http://s.fhs.gov.hk/z4fbs) and healthy
eating for 2 to 5 year olds ([12]http://s.fhs.gov.hk/wveoo) provide
parents information about making healthy food choices for children,
including avoid added sugar in foods and drink for infants, and reading
the nutrition labels to choose foods with less sugar and limiting sugar
added beverage in toddlers and young children.

DH has also launched different campaigns and programmes to advocate for
the reduction of sugar intake through schools to parents. For example, DH
has launched the "Healthy Drinks at School" charter since the 2018/2019
school year, which aims to create a healthy eating environment by
promoting healthy drinks instead of sugary drinks on campuses. By
educating children on the importance of less sugar at school, they will
also be able to deliver this message to their parents. There are promising
results which reflect that children have successfully developed a good
habit of drinking adequate water and less sugary drinks, thus supporting
the continuity of this charter in the future. In addition, various parent
talks and educational materials are given by the DH every year, so that
parents can learn more about the preparation of healthy food and drinks
for their children.

Ken NG
EO(Family Health Service)2
Department of Health

From:        Simon Wang <[13][FOI #805 email]>
To:        FOI requests at Department of Health <[14][Department of Health request email]>
Date:        03/10/2021 08:50
Subject:        Freedom of Information request - Identification of child
obesity cases through Family Health Services

--------------------------------------------------------------------------

Dear Department of Health,
                 As a teacher at the Baptist University I am working with
a group of students to investigate issues related to child obesity and
reducing sugar in diet and drinks. As child obesity is a major health
concern for our city, the government has launched various programmes to
help reduce sugar intake among children. Here are my questions for the
department to answer under the Code on Access to Information

1. What is the occurence rate of obesity among schoolchildren in HK?
Please provide the yearly figures for the past 10 years (if available).
Please also indicate the methodology for obtaining the data.

2. Does the department collect data on the weight and BMI of individual
children in Hong Kong, through Family Health Services? If so, please
provide details about how data is collected and analysed.  If not, please
explain why such data is not collected.  

3. In what ways does the department provide information about the need to
reduce sugar intake to the individual parents? For example, does the
nurse/doctor discuss this issue with the parent through Health and
Developmental Surveillance
[15]https://www.fhs.gov.hk/english/main_ser/...

4. How many children have been served through Health and Developmental
Surveillance in 2020? Does the programme cover all the eligible children?
 

4. Does the department have a list of children that are at the risk of
suffering from obesity or developing such conditions?

5. To what extent is it feasible to calculate and track the obesity rates
of individual schools/kindergartens?  For example, does the department
have the info about which schools the children served in Health and
Developmental Surveillance are from?

Thanks in advance for your help

Yours faithfully,
Simon Wang

--
Dr Simon Wang, Ph.D., FHEA 
Lecturer in English 
Language Centre 
Hong Kong Baptist University 
Kowloon Tong, Hong Kong 
Phone: (852) 34117044
[16]http://lc.hkbu.edu.hk/staff_simon.php  
[17]Writing for the Public Project 

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5. http://www.who.int/childgrowth/training/...
6. http://data.gov.hk/
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8. http://s.fhs.gov.hk/22xa3
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