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Reducing Child Obesity in the United States Requires Caregiver Involvement

By Amber Porter

Children in America are not meeting the necessary dietary and physical requirements to maintain a healthy lifestyle, leading to obesity and increased health risks. According to President’s Council on Fitness, Sports & Nutrition, only one in three children are engaged in activity each day. Correspondingly, only one in three adults meet the recommended 30 minutes of physical activity each day, as set forth by the Office of Disease Prevention and Health Promotion’s Physical Activity Guidelines.

There have been numerous studies on the outlook of an unhealthy and obese future for Americans. More than one-third of adults and 17% of youth in the United States are obese, according to data from the National Health and Nutrition Examination Survey. From 1960, when data was first collected on obesity, to the most current data from 2014, the number of youth aged six through 19 years old classified as overweight saw an increase from around 4% to 16%, an entire 300% transformation.

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“Parents are the primary role models for their kids and research shows that children are more physically active and have healthier eating habits if their parents are physical active and have healthy eating habits,” said Jennifer Slawta, Associate Professor at Southern Oregon University. “When I administered Be A Fit Kid, it was highly successful. Five-year follow up data also indicated that the program had lasting effects on participating children.”

Be a Fit Kid is a program designed and tested in the Oregon school system that endeavored to tackle the issue of obesity in children. It identified four criteria and made a goal to improve each over a three-month time period. The goals were to improve blood cholesterol levels, dietary habits, body composition and physical fitness in children. Slawta and her team found that the program’s success is dependent not the individual but on the families, schools and community of the child in order to be effective. All of the external influences are important to encourage healthy behaviors and change the diet and physical activity levels needed for obesity prevention. Involving and informing parents and educators will be the best prevention for America’s obesity epidemic.

“Behaviors are learned,” said Theresa Sprague, mother of 3-year-old Ryan Sprague. “Children watch how we shop, how we cook, what we eat, if we exercise… my son is always watching and learning from me.”

There are other programs designed to help kids stay healthy by educating parents, such as We Can! (Ways to Enhance Children's Activity & Nutrition). According to the We Can! Website, “We

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Can! Is a national movement designed to give parents, caregivers, and entire communities a way to help children 8 to 13 years old stay at a healthy weight. Research shows that parents and caregivers are the primary influence on this age group. The We Can! national education program provides parents and caregivers with tools, fun activities, and more to help them encourage healthy eating, increased physical activity, and reduced time sitting in front of the screen (TV or computer) in their entire family.”

“I’ve recently switched daycares and I notice a huge difference in his energy levels and overall health,” said Sprague. “His new daycare implements a program that uses fresh fruit and vegetables and no added sugars. There is a parent participation board where we get together with the institution and talk about our children’s preferences and that makes me feel confident that he is receiving the right care and consideration. Both me and my husband work full-time. Although I am the primary influence for him, he does spend a large portion of his weekday at daycare and is influenced by the schooling and the childcare workers.”

What are the effects of obesity in the United States for both adults and children? Obesity can mean substantial increases in health costs. Effects can carry an annual cost of $190.2 billion dollars due to illnesses such as chronic disease, disability and death. This is a trend that continues to grow. Projections estimate that by 2018, obesity will cost $344 billion annually, which is 21 percent of our total healthcare costs.

Obesity can also cause serious health concerns. The World Health Organization ran a report stating, “Globally, 42 million preschool children were overweight in 2013. Childhood obesity is one of the most serious public health challenges of the 21st century. Overweight children are likely to become obese adults. They are more likely than non-overweight children to develop diabetes and cardiovascular diseases at a younger age, which in turn are associated with a higher chance of premature death and disability.”

Mary Jo McKellar, a registered nurse from Hudsonville, Michigan said “It’s upsetting to me as a health educator to see my clients with these medical conditions. Obesity can be harmful to a child’s health. It can cause diabetes, heart disease, high blood pressure and stroke. That’s not even counting the side effects of low self-esteem and poor body image.”

For the parents who are worried about the influence of drugs and alcohol, studies have found that it is the lifestyle habits of youth that have a greater impact on their health and wellbeing. According to the Centers for Disease Control (CDC), lack of physical activity and poor dietary influences have more detrimental effects than the weight of drugs, alcohol and tobacco use combined. The same results by the National Heart, Lung, and Blood Institute (NHLBI) said that today’s children might have a shorter life expectance than their parents. The leading cause of death in the United States is projected to change from smoking to overweight or obese health conditions.

“I take my son to the grocery store and let him help pick out fruits and vegetables,” said Sprague. “He also helps me cook. When he helps make the food he is more likely to eat it, and if he sees our family sit down together without distractions he learns to focus on food and eats

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more. I don't force him to finish either. In Hawaii fresh fruit is his favorite anyway so we love fresh pineapples. His daycare is great about serving real food which was important to me.”

The World Health Organization and CDC found that the main causes of excess weight in children are similar to those of adults. Children's choices, diet and physical activity schedules are influenced by their surrounding environment. Children are also influenced by their own behaviors, their genetic make-up and their activity patterns. The main influence of their lifestyle is based on that of their direct caregiver. Contributing factors are the community in which the child lives. Location is important because of the range of policies in support of agriculture, public and private transportation, urban planning (such as community gardens), and education systems that may or may not implement an in-school physical activity requirement. In the interactive map below, you will find the obesity rates of each state and the ranking of that state, as well as information about the community assistance programs for each state.

INFOGRAPHIC (https://www.youtube.com/watch?v=z5Fr9vIRUgg)

“One of the biggest mistakes I see parents make is that they do not go to the right resources for help,” said McKellar, who has 20 years of experience in the health field. “They look online and they have good intentions but they should be going to their care providers. Doctors can work with you and give you a specialized plan that is appropriate to your individual needs. Many people don’t know this, but under most health insurance plans, you are entitled to work with a health care manager who will figure out your goals and work with various specialists to get you to reach them. Furthermore, because accountability is important, they will check up on you as often as needed for a whole year. There are resources for you if you ask for the right help.”

VIDEO (https://www.youtube.com/watch?v=YX9VxFMd0A0)

Parents who are interested in learning next steps and how to implement lifestyle changes may find resources and tips from the National Heart, Lung, and Blood Institute and from local health providers in their communities.