Oral Presentation Australian & New Zealand Obesity Society 2014 Annual Scientific Meeting

Whanau Pakari: a multi-disciplinary intervention for obese children and adolescents - improved accessibility for Maori, but clear health disparities. (#80)

Tami L Cave 1 2 , Michelle S Butler 1 , Kris R Moller 3 , Katharine F Treves 1 , Cervantee E K Wild 1 2 , Lisa E Wynter 1 , Cameron C Grant 4 , Paul L Hofman 2 , Yvonne C Anderson 1 2
  1. Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
  2. Liggins Institute , The University of Auckland, Auckland, New Zealand
  3. Whanau Pakari, Sport Taranaki, New Plymouth, New Zealand
  4. Department of Paediatrics, The University of Auckland, Auckland, New Zealand

Whanau Pakari is a unique intervention programme for obese children and adolescents that targets Maori, given their over-representation in obesity statistics.

Aim: To identify the disparities between Maori and New Zealand European (NZE) obese children and adolescents.

Method: Baseline assessments from January 2012 to August 2014 were reviewed. Referral criteria were BMI>98th centile, or >91st centile with significant weight-related co-morbidities, age 5-16 years.

Results: A total of 240 baseline assessments were analysed. 45% identified Maori as their primary ethnicity (n=109), 45% identified as NZE (n=109), 3% Pacific Island (n=6), 3% Asian (n=6), and 4% identified as Other (n=10). Average age was 10 years, 53% were female. The Maori participation rate was favourable compared with the previous programme available in the region (participation of 39%).1

There was a significant difference between BMI standard deviation score (SDS) on entry to the programme for Maori (3.2, n=109) compared with NZE (3.0, n=109, p=0.02). Average BMI for Maori participants’ accompanying adult was significantly higher than NZE (34.6, n=104 vs. 32.6, n=105, p=0.005).

There was a significant difference between family history of Type 2 Diabetes for Maori patients compared with NZE (30%, n=73 vs. 24%, n=58, p=0.003). Acanthosis nigricans was more common in Maori (26%, n=63) compared with NZE (9%, n=21, p<0.001) however no difference was detected with regard to average fasting insulin levels (Maori 175pmol/L vs. NZE 129pmol/L, reference range 10-80, p=0.13), HbA1c (35 vs 34 mmol/mol), or fasting glucose (5.3 vs 5.2 mmol/L respectively).

Conclusion: Obesity and complications of obesity are more prevalent in Maori tamariki and their whanau than in NZ European children and their families. Maori have a higher BMI SDS than NZ European on entry and the same is reflected in their family member’s BMI. Given the strong familial predisposition to Type 2 Diabetes and insulin resistance, these results are of particular concern.

  1. Anderson Y C, Taylor G M, Grant C C, Fulton R B, Hofman P L. The Active Families programme in Taranaki, New Zealand 2007-2009 – did it reach those children in need? Unpublished, 2014.