• IOM APOP• Texas

CORD

REDUCING CHILD OBESITY

STEVEN H KELDER, PhD , MPH

Beth Toby Grossman Distinguished Professor of Spirituality and Healing

Co-Director, Michael & Susan Dell Center for Healthy Living

THANK YOU FOR INVITING ME!

PORTRAIT OF AN OVERWEIGHT CHILD

5

75 percent of young Americans are ineligible to join the military.

Obesity is the leading reason applicants fail to qualify for military service.

Otherwise excellent recruits, some with generations of family military service, are turned away because they are obese.

HEALTH CONSEQUENCES

SCOPE AND SOCIETAL COSTS

NHANES AGE 12-20

1971-1975 1976-1980 1988-1994 1999-2002 2003-2006 2007-20100.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

# Overweight Kids # Obese Kids# Severe Obese Kids

Overweight is defined as 85-95 percentileObese is defined between the 95% and 120% of 95 percentileSeverely Obese is defined as greater than 120% of the 95th percentile

All 34%White 31%Black 41%Hispanic42%

NHANES AGE 12-20HOW MANY KIDS ARE WE TALKING ABOUT?

1971-1975

1976-1980

1988-1994

1999-2002

2003-2006

2007-2010

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

8,000,000# Overweight Kids # Obese Kids # Severe Obese Kids

2.5 million X $25,000 = $62.5 billion

Overweight is defined as 85-95 percentileObese is defined between the 95% and 120% of 95 percentileSeverely Obese is defined as greater than 120% of the 95th percentile

No Data

10.7% - 13.8%

13.9% - 14.6%

14.7% - 15.7%

15.8% - 19.5%

PERCENTAGE OF HIGH SCHOOL STUDENTS WHO WERE OVERWEIGHT,* 2011

* Students who were = 85th percentile but < 95th percentile for body mass index, based on sex- and age-specific reference data from the 2000 CDC growth charts.

State Youth Risk Behavior Surveys, 2011

No Data

7.3% - 10.8%

10.9% - 11.9%

12.0% - 14.6%

14.7% - 17.0%

PERCENTAGE OF HIGH SCHOOL STUDENTS WHO WERE OBESE,* 2011

* Students who were = 95th percentile for body mass index, based on sex- and age-specific reference data from the 2000 CDC growth charts.

State Youth Risk Behavior Surveys, 2011

PHYSICAL ACIVITY AND HEALTH

Activity

Ris

k of

“D

isea

s e”

Prevention of Weight Gain

Diabetes Mellitus

Musculoskeletal Injury

Functional Health Status

CHD

Stroke

Osteoporosis

ADOPT POLICIES AND IMPLEMENT PRACTICES TO REDUCE OVERCONSUMPTION OF SUGAR-SWEETENED

BEVERAGES.

SSBs provide more calories and added sugars to American diets

than any other food or beverage.

WE KNOW WHAT TO DO

ACCELERATING PROGRESS IN OBESITY PREVENTION

HBO’S THE WEIGHT OF THE NATION

• Documentaries (4) for adult audience• Short documentaries (12) on specific topics in obesity prevention• Documentaries (3) for children and families• Trade publication for general audiences• Website (http://theweightofthenation.hbo.com/)• Social media (Facebook, Twitter, Youtube, and

GetGlue)• Screening kits with discussion guides• Marketing efforts, including reaching families with

children• Written materials for school-age children and teachers

(Scholastic, Inc.)

• Briggs, M., et. al, (2010). Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: comprehensive school nutrition services. Journal of nutrition education and behavior, 42(6), 360-71. Society for Nutrition Education.

• Kann, L., et. al, (2007). Health Education: Results from the School Health Policies and Programs Study 2006. The Journal of school health, 77(8), 408-34. doi:10.1111/j.1746-1561.2007.00228.

7600 food ads/year153 F&N/ year

HOW MUCH NUTRITION EDUCATION IS ENOUGH?

School Day

Physical Educatio

n

Recess &Breaks

Classroom

Before School

After-school time

After-school Programs

Intramural Sports

Extramural Sports

~6-7 hrs/dActive Commute

To~15 minutes

Active Commute From

~15 minutes

~60 min/d

~2-3hrs /d

WHOLE-OF-SCHOOL

CAN SCHOOL SUPPORT 60 MINUTES OR MORE OF PHYSICAL ACTIVITY PER DAY?

IF YOU BUILD IT THEY WILL COME…

GO NOODLE!

TE

Sep, Oct Nov, Dec Jan, Feb Mar, Apr, May

TEA 6-8 foundation curriculum

Math

English/ Reading

Science

Social Studies

Activity break formats

Aerobic

Anaerobic

Stretching

Breathing

Delivery Type

Peer Led

Video Led

Teacher Led

TEA Foundation Curriculum: http://bit.ly/13fsUzj

SCHOOL YEAR SCOPE AND SEQUENCE

28

• Physical activity improves academic achievement, including grades and standardized test scores.

• Physical activity impacts cognitive skills, including enhanced concentration, attention, and improved classroom behavior.

• Increasing physical education time does not reduce academic performance.

CATCH 2.0EVIDENCE | COST-EFFECTIVE | SCALABLE |

NATIONWIDE | RECOGNIZED| APPROVED

CATCH

Preschool CEC

Grades K-2

Grades 3-5

Grades 6-8

After School

CKC

Parks & Recreati

on

CATCH FAMILY OF PROGRAMS

Campus Team –

Program Champi

on

Physical

Education

Nutrition

Services

Classroom

Education

Family Educati

on

After School

Activity

Breaks

CATCH MODEL FOR SCHOOL HEALTH IMPLEMENTATION

A CATCH SCHOOL YEAR

Cafeteria supervisors post daily menus with GO, SLOW, and WHOA foods identified.

GO, SLOW, WHOA Menu Signs

Randomized Control TrialEl Paso replication studyTravis County replication studyChild Obesity Research & Demonstration project

EVIDENCE

PASS & CATCH IMPROVES STANFORD MATH & READING SCORES

Tmt-Ctl Male Female Not At Risk At Risk0

1

2

3

4

5

6

1.651.32

1.96

1.15

4.94

**

*

Murray (UTSPH), under review

At Risk: adaptability, social skills, leadership, study skills, functional communication

First year investment ~ $10.00 per childSecond year investment ~ $4.00 per child“Childhood school-based programs such as CATCH are

beneficial investments”

COST EFFECTIVENESS

Sources: Brown et al., 2007; Cawley et al, 2010

“Based on the published literature, the most cost-effective way to prevent obesity in youth is CATCH…” – Harvard Economist, Cawley et al, 2010.