Childhood Obesity Prevention A School and Home Partnership
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Transcript of Childhood Obesity Prevention A School and Home Partnership
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Childhood Obesity Prevention A School and Home Partnership
Janis Hogan RNMay 2014
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Maine Center for Public HealthMaine Chapter of American
Academy of Pediatrics
The Economist
The Problem
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How Big is the Problem?
The Changing Picture of Obesity in the US Examine CDC data on self-reported rates of
obesity in adults
Watch trend from 1985-2010
Colors represent percent of population in state who are obese
Light blue color is “good” – darker blue, tan, and red are BAD! (higher rates of obesity)
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2000
Obesity Trends* Among U.S. AdultsBRFSS, 1990, 2000, 2010
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2010
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Obesity Trends* Among U.S. AdultsBRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data < 10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No No Data <10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
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Obesity Trends* Among U.S. AdultsBRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
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Obesity Trends* Among U.S. AdultsBRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
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Obesity Trends* Among U.S. AdultsBRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
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Obesity Trends* Among U.S. AdultsBRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
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Obesity Trends* Among U.S. AdultsBRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
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Obesity Trends* Among U.S. AdultsBRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
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Obesity Trends* Among U.S. AdultsBRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
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Obesity Trends* Among U.S. AdultsBRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
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Obesity Trends* Among U.S. AdultsBRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
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Obesity Trends* Among U.S. AdultsBRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2002
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends* Among U.S. AdultsBRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends* Among U.S. AdultsBRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends* Among U.S. AdultsBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Obesity Trends* Among U.S. AdultsBRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Obesity Trends* Among U.S. AdultsBRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Obesity Trends* Among U.S. AdultsBRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Obesity Trends* Among U.S. AdultsBRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Obesity Trends* Among U.S. AdultsBRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Why Childhood Obesity Prevention Matters! A Call to Action!
• 1 out of 3 children is overweight or obese
• In children, rates of overweight doubled in 20 years
• In teens, rates of overweight tripled in 20 years
• An obese 4-year-old has a 20% chance of becoming obese as an adult, and an obese teenager has up to an 80% chance of becoming an obese adult.
Prevention is better than the outcomes for treatment.
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Why Should We Care?
Health risks! Diabetes, heart disease, depression, high
blood pressure, joint problems and sleep apnea.
Health care costs! Obesity related illness spending in 2008 was
at a cost of $148 billion or 21% of all medical spending in the US.
Healthy weight children are more likely to grow up to be healthy adults!
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A Look Below the Surface
Unhealthy EatingSoda & sugar drinks
Larger portions High Calorie/Low cost foodsMore Fast Food & Eating Out
Less home cooking & family meals
Less Physical ActivityMore TV & screen timeLess Physical Education
Change in the Environment
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Portion Distortion
Do you know how portions have grown
over the past 20 years?
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BAGEL 20 Years Ago Today
140 calories 3-inch diameter
How many calories are in this bagel?
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140 calories 3-inch diameter
Calorie Difference: 210 calories
350 calories 6-inch diameter
BAGEL 20 Years Ago Today
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*Based on 130-pound person
Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out
How long will you have to rake leaves to burn 210 calories?
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*Based on 130-pound person
Calories In = Calories Out
If you rake the leaves for 50 minutes you will burn the extra 210 calories.*
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SPAGHETTI AND MEATBALLS20 Years Ago Today
500 calories1 cup spaghetti with sauce and 3 small meatballs
How many calories do you think are in today's portion of spaghetti and meatballs?
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Calorie Difference: 525 calories
1,025 calories 2 cups of pasta with sauce and 3 large meatballs
20 Years Ago Today
500 calories1 cup spaghetti with sauce and 3 small meatballs
SPAGHETTI AND MEATBALLS
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*Based on 130-pound person
Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out
How long will you have to houseclean to burn the extra 535 calories?
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*Based on 130-pound person
Calories In = Calories Out
If you houseclean for 2 hours and 35 minutes, you will burn approximately 525 calories.*
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Sugar Sweetened DrinksWhat’s the big deal?
• Sugar sweetened beverages are the largest source of added sugar in the diet.
• On any given day, half the US population consume sugary drinks.
• Children in the US average 224 cal/per day from sugary drinks – 15 teaspoons!
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Don’t forget the hidden Sugar!Look for low sugar options!
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Sugar – How much is too much?
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American Heart Association Healthy Diet Recommendations
Focus on Nutrient Rich Foods
• Fruits and vegetables• Whole grains• Low fat, low sugar dairy
products• Poultry, fish and nuts• Limit red meat and sugary
foods and beverages• Limit added sugar
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Physical Activity Another piece of the puzzle!
• Americans get very little physical activity
• Our environment has changed ( less walking, more TV and video gaming etc.)
• Exercise has become more of a personal choice
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2008 Physical Activity Guidelines for AmericansChildren and Adolescents
• 1 hour (60 minutes) or more of daily physical activity that is at least moderate:
- Most of the 1 or more hours a day should be either moderate- or vigorous-intensity aerobic
physical activity.
- Do vigorous-intensity physical activity at least 3 days a week.
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Where to start?• If you have been inactive – start slow and build up
over time!
• Make it fun! Find activities you and/or your family can do together.
• For everyone, some activity is better than none!
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Whose Responsibility is it?Everyone’s!
• National • State• Local (Schools, Community organizations etc.)• Parents/Caregivers• Individuals
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The School’s Responsibility “Home away from home”
• Students spend ½ their waking hours at school and eat one or more meals.
• Responsibility to provide nutrition education and promote physical activity
• Responsibility to provide foods and beverages that promote health and learning.
• Adopt Wellness Policies to promote consistent health messages throughout the school
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Home/Parent Responsibility
• Be a good role model - When parents live a healthy lifestyle, children will follow.
• Provide children with healthy food choices.• Serve appropriate portion sizes• Encourage children to be active
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Parent’s Feeding Jobs:What, When, Where
• Choose and prepare food• Provide regular meals and snacks• Make eating time pleasant• Be considerate of child’s food
inexperience without catering to likes and dislikes
• No food or beverages (other than water) between meals and snack times
• Teach about food and mealtime behavior
Children’s Eating Jobs:How much, Whether
• Children will eat• They will eat the amount they
need• The will learn to eat the food
their parents eat• They will grow predictably• They will learn to behave well at
mealtime
Ellyn Satter’s “Responsibility of Feeding”
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What more can we do?
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School staff can…….
• Be positive role models• Integrate physical activity - every day in every
way• Not reward children with unhealthy food• Support healthy fundraising activities• Make healthy foods available at all venues
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Parents/Caregivers can….
• Be an advocate for health at your child’s school
• Advocate for strong school Wellness Policies that support nutrition education, 60 minutes of physical activity a day, & healthy food and beverages served/sold at school
• Support Let’s Go 5210 efforts in school and at home
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Need Help?
Concerned about an overweight child?
Consult your child’s health care provider.
Take a family approach to health. Everyone benefits!
The Light Life Program – A Family Guide for Weight Control and Healthy Living by Lauri Jacobs, MS, RD, CDE and Heather Leclerc, MS, RD, CDE.
Zing Program – A coordinated family based program through Pen Bay Healthcare
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Knowing is not enough; we must apply.
Willing is not enough; we must do.
Geothe
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The next generation!
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ReferencesSlide 2
“The Shape of Things to Come”. The Economist, The Econ0mist Newspaper Limited. London: December, 2003.
Slide 3 – 30“Prevalence of Obesity in Adults”. http://www.cdc.gov/obesity/data/index.html
Olshansky SJ, Passaro DJ, Hershow RC, et al. “A potential decline in life expectancy in the United States in the 21st century.” New England Journal of Medicine, 352(11):1138-1145, 2005.
Slide 31
Ogden, Cynthia L., Carroll, Margeret D., Kit, Brian K., and Flegel, Katherine M.“Prevalence of Childhood Obesity in the United States, 2011-12”. The Journal of the American Medical Association, pp. 806-814.
Guo SS, Chumlea WC. “Tracking of body mass index in children in relation to overweight in adulthood.” American Journal of Clinical Nutrition. 70(suppl):145S- 148S, 1999.
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Slide 32Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and
excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. 2007;150(1):12—17.e2.
Dietz W. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 1998;101:518—525.
Finkelstein, Eric A., Trogdon, Justin G., Cohen,Joel W., and Dietz ,William. “Annual Spending Attributable to Obesity.” Health Affairs, 28, no.5 (2009)
Slide 35-42National Heart, Lung, and Blood Institute; U.S. Department of Health and Human Services. http
://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/portion/menuview.htm#slide1
Slide 43Wang YC, Bleich SN, Gortmaker SL.” Increasing caloric contribution from sugar-sweetened
beverages and 100% fruit juices among US children and adolescents”, 1988-2004. Pediatrics. 2008;121(6):e1604-1614.
Ogden CL, Kit BK, Carroll MD, Park S. “Consumption of sugar drinks in the United States, 2005-2008”. NCHS Data Brief. 2011(71):1-8.
References(cont.)
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References(cont.)
Slide 48http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/The- American-Heart-Associations-Diet-and-Lifestyl
Slide 49-51http://www.health.gov/paguidelines
Slide 54-55Glickman, Dan, Parker, Lynn, Sim, Leslie J., Del Valle Cook, Heather, and Miller, Emily A., eds.
Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. Washington D.C.: National Academies Press, 2012; 332-333. Slide 56
Satter, Ellyn. “Division of Responsibiity” http://www.ellynsatterinstitute.org/dor/divisionsofresponsibility.php (April 15, 2014)
Slide 58-59U.S. Department of Health and Human Services (2001). The Surgeon General's call to action to prevent
and decrease overweight and obesity. Rockville, MD: Author. Available: www.surgeongeneral.gov/topics/obesity/default.htm