watch?v=wv1woreo0dq€¦ · nutrition and weight status - 11 (developmental) prevent inappropriate...

K A N I S H A B E L T

B O B B I B O W M A N

J E S S I C A C A V I N E S S

J E N N I F E R F E V R I E R

A Y R A T G I M R A N O V

K R I S T I N E K R U K A R

K A R O L I N A L E T H U E U R D E J A C Q U A N T

J A M I E S Q U I B B S

J O H N W A R D

http://www.youtube.com/watch?v=wv1WorEo0dQ

http://www.youtube.com/watch?v=wv1WorEo0dQ

HEALTHY PEOPLE 2020 OBJECTIVE

Nutrition and Weight Status - 11 (Developmental) Prevent inappropriate weight gain in youth and

adults

U.S. Preventive Services Task Force Recommends children over 6 be screened for obesity

Overweight = 85-94th percentile

Obese = greater than 95th percentile

(U.S. Preventive Services Task Force, 2010; U.S Department of Health and Human Services, 2012)

SCOPE OF THE PROBLEM

Childhood obesity has increased 3-6 fold since 1970

12-18% of children are obese

Rates higher in older children, males, and racial minorities

Medical costs per year are greater than $147 billion in the

United States

(U.S. Preventive Services Task Force, 2010)

GLOBAL STATISTICS

Worldwide obesity has more than doubled since 1980.

In 2008, more than 1.4 billion adults, 20 and older, were overweight.

Of these, over 200 million men and nearly 300 million women were obese.

65% of the world's population lives in countries where overweight and obesity kills more people than underweight.

More than 40 million children under the age of five were overweight in 2010.

Obesity is preventable.

(World Health Organization, 2012b)

WORLDWIDE OBESITY

Affects all income levels

Mainly in urban settings

35 million children are overweight in developing countries

8 million children are overweight in developed countries

Low and middle income countries have limited pre-natal care

High fat, high sugar, high salt, energy dense, micronutrient poor foods are lower in cost

(World Health Organization, 2012b)

WHY DOES IT MATTER?

Obesity increases risks for:

Diabetes Mellitus

Asthma

Nonalcoholic fatty liver disease

Cardiovascular disorders

Complicates administering

anesthesia

(U.S. Preventive Services Task Force, 2010)

Obesity Rates: 40% + 30-40% 20-30% 10-20% 5-10% 0-5% No data

GLOBAL STATISTICS

Highest: Nauru 78.5%

United States : #9 with 33.9% (World Health Organization, 2012a)

Nauru

USA STATISTICS

In 2012 there were 12 states with an obesity prevalence of 30% or more. This

shows a dramatic increase from previous years. In 2000, no state had an

obesity prevalence of 30% or more.

(Centers for Disease Control and Prevention, 2012a)

2009-2011 COUNTY OBESITY PREVALENCE

AMONG LOW-INCOME CHILDREN AGED 2-4

YEARS

Even in states where there is not a high prevalence of

obesity in children, there are still counties with a high

prevalence. (Centers for Disease Control and Prevention, 2012b)

OBESITY TRENDS FROM 2001-2011

The Centers for Disease Control and Prevention (CDC) collects obesity trend data on a yearly basis using the Behavioral Risk Factor Surveillance System (BRFSS)

Dramatic obesity increase from 1990 to 2010



In 2011,

• No state without

prevalence less than 20%

• 39 states with prevalence

of 25% or more

• 12 states with 30% or more:

Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri,

Oklahoma, South Carolina, Texas, and West Virginia

OBESITY TRENDS IN

VIRGINIA

• Obesity rates in VA continue to steadily increase

• In 2001:

• VA ranked 25th lowest obesity rate nationally

• In 2010:

• VA ranked 20th lowest obesity rate nationally

• According to the BRFSS 2011:

• Prevalence of obesity in Virginia was 29.2%

• In 2008:

• Hampton – Highest – 34.4%

• Arlington – Lowest – 20.7%

• In 2010:

• Hampton Roads = 2nd lowest obesity rate in VA at 25.3%

(Council on Virginia’s Future, 2012)

OBESITY TRENDS IN CHILDREN

Age (in

years)

NHAN

ES

1963-

1965

1966-

1970

NHAN

ES

1971-

1974

NHAN

ES

1976-

1980

NHAN

ES

1988-

1994

NHAN

ES

1999-

2000

NHAN

ES

2001-

2002

NHAN

ES

2003-

2004

NHAN

ES

2005-

2006

NHAN

ES

2007-

2008

Total (3) 5.0 5.5 10.0 13.9 15.4 17.1 15.5 16.9

2-5 (3) 5.0 5.0 7.2 10.3 10.6 13.9 11.0 10.4

6-11 4.2 4.0 6.5 11.3 15.1 16.3 18.8 15.1 19.6

12-19 4.6 6.1 5.0 10.5 14.8 16.7 17.4 17.8 18.1

Obesity prevalence in children has tripled

17% of children and adolescents aged 2-19 years are obese

Prevalence of obesity among U.S. children and adolescents

aged 2-19, for selected years 1963-1965 through 2007-2008

(Centers for Disease Control and Prevention, 2012a; Ogden & Carroll, 2010)

HAMPTON ROADS INTERVENTIONS

“Public school students may not be able to buy snack foods like

those [jelly beans, lollipops, flamin’ hot baked Cheetos] under

a state proposal meant to help fight childhood obesity”

(Garrow, 2011)


“School divisions are overhauling school menus and

beefing up physical educating programs in an effort to

curb the growing childhood obesity crisis”

(Chufo, 2010)


“The Commonwealth’s Healthy Approach and

Mobilization Plan for Inactivity, Obesity, and Nutrition

(CHAMPION) represents the collaborative effort to put

forth recommendations specifically targeting obesity

issues identified throughout the Commonwealth”

(Virginia Department of Health, 2012)

OTHER EXISTING COMMUNITY PROGRAMS

Communities Putting Prevention to Work

(CPPW) National effort, CDC lead, to grant communities initiatives

To improve the health of Americans especially thru obesity &

tobacco use preventions

To create long-lasting impact on communities

(Centers for Disease Control and Prevention, 2012c)

COMMUNITIES PUTTING PREVENTION

TO WORK

$120 million to states promoting wellness, prevention of chronic disease, and tobacco cessation

Enables local communities to prevent obesity-associated health problems

Encourages initiatives such as: Increases healthy foods and drinks in schools

Development of sidewalks and pedestrian-friendly roads

Implements physical activity requirements for after school programs

Encourages farmers to accept Supplemental Assistance Nutrition Program Electronic Benefits Transfer cards to make fresh food affordable


SUCCESSFUL PROGRAMS

North Carolina Division of Public Health (NCDPH), the Department of

Agriculture and Consumer Services, the Division of Social Services,

and Leaflight Inc., a nonprofit organization

Texas Farm-to-Work Program

Works with Sustainable Food Center.

Enacted Farm to Cafeteria ,and Farm to School Programs, and Sprouting Healthy

Kids

In Jefferson County, Alabama all kindergarten through fifth grade

students are to participate in a daily 30 minute exercise routine

Smart Code Policy encouraging walkable communities and green spaces

(Centers for Disease Control and Prevention, 2012c; 2012d; Ogden & Carroll, 2010)

MORE SUCCESSES

“Since March 19, 2010, more than 330,000 American students in 8 CPPW communities have increased their physical activity at school to improve their overall physical fitness”

Other State efforts to promote EBT in the farmer’s markets are: Rhode Island, Michigan, New York, California


Safe Routes to School

Alexandria, Va

Walking Wednesdays

Fitness Friday

“Frequent Walker/Bicyclist” cards

Emphasis on Safety

COMMUNITY PROGRAMS

(Safe Routes, n.d.)

COMMUNITY PROGRAMS

CANFIT

MO Project

500 successful programs in CA

Engages youth ages 13-18 to build healthier

community

Interactive, culturally relevant

(CANFIT, 2011)

NEED FOR INCREASED PHYSICAL ACTIVITY

Decreased physical activity level is directly associated with increased risk of obesity

Let’s Move campaign, along with the Presidential Active Lifestyle Award, addresses physical activity of kids to some extent, but without the needed regulations that some food programs, like the Healthy Hunger-Free Kids Act, have.

Increased physical activity requirements and more structure are needed!

(Hills, Andersen, & Byrne, 2011; Hockenberry & Wilson, 2011)

NEED FOR STRICTER REGULATIONS ON

MARKETING FOOD AND BEVERAGES TO

CHILDREN Marketing is big business! Effective marketing campaigns can bring in big

money, and make lifelong customers…

Many large food and beverage companies employ marketing tactics that directly and indirectly target children, and the parents that feed them

Kids are bombarded with advertisements everywhere they go!

Food and beverage marketing has influential effects on children, and the parents who buy food for them…

Marketing influence has a correlational relationship to obesity prevalence

Lax regulations do little to control or limit child marketing tactics

(Harris, Schwartz, & Brownell, 2010)

NEED FOR CHILD NUTRITION EDUCATION

AT AN EARLIER AGE Promote earlier childhood nutritional education,

around age 2-3 yrs., to form better eating habits

Often, learning at a younger age produces better long-term results – result that stick with you for life

The early years hold promise as a time during which obesity prevention education may be most effective

To accomplish these goals, education of toddler parents will likely be necessary.

(Campbell, Hesketh, Crawford, Salmon, Ball, & McCallum, 2008)

NEED TO ADDRESS BODY IMAGE CONCERNS

Improve body image awareness. Some groups

of youth population care less about being

obese and have changed their perception

about ideal body image (IBI).

There are studies that demonstrate lower

dissatisfaction with their body image

among Hispanic/Latino and male African

American adolescents, which could be

targeted as an additional effort in obesity

prevention

(Ceballos & Czyzewska, 2010; Chen & Wang, 2012)

NEEDED RESEARCH

Development and evaluation of treatment and

prevention programs

Such as:

When medical risks of childhood obesity begin

How eating and activity patterns develop

Accurate techniques in measuring food intake and

physical activity

Identify markers for measuring success

NEEDED RESEARCH

What are successful programs doing?

(Factors associated with success or failure)

Example:

• Parent involvement

• Socioeconomic level

• Parent education level

• Baseline activity of children

• Number of sports offered at schools

• Time allotted for recess (if 30 min. required, then 40 min. needs to

be allotted)

NEEDED RESEARCH

Effect of environment on obesity rates

Comparison of communities with/without accessible

community design

Joined communities

Biking and walking paths, sidewalks

Affordable recreational activities

Effect of education on obesity trends Nutrition

Adult diseases related to childhood obesity

REFERENCES Campbell, K., Hesketh, K., Crawford, D., Salmon, J., Ball, K., & McCallum, Z. (2008). The

Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent

childhood obesity: cluster-randomised controlled trial. BMC Public Health, 8103-

111.

CANFIT. (2011). MO PROJECT youth convening. Retrieved from: http://canfit.org/moproject/

Ceballos, N., & Czyzewska, M. (2010). Body image in Hispanic/Latino vs. European American

adolescents: implications for treatment and prevention of obesity in underserved

populations. Journal of Health Care For The Poor & Underserved, 21(3), 823-838.

doi:10.1353/hpu.0.0333

Centers for Disease Control and Prevention. (2012a). Adult obesity facts. Retrieved from

http://www.cdc.gov/obesity/data/adult.html

Centers for Disease Control and Prevention. (2012b). Data and statistics. Retrieved from

http://www.cdc.gov/obesity/data/childhood.html

REFERENCES

Centers for Disease Control and Prevention. (2012c). Communities putting prevention to

work. Retrieved from http://www.cdc.gov/CommunitiesPuttingPreventiontoWork/p

df/brochure.pdf

Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and

Obesity. (2012d). Farm to where you are programs. Retrieved from http://www.c

dc.gov/obesity/downloads/FarmToWhereYou Are.pdf.

Chen, X. X., & Wang, Y. Y. (2012). Is ideal body image related to obesity and lifestyle

behaviours in African American adolescents?. Child: Care, Health &

Development, 38(2), 219-228. doi:10.1111/j.1365-2214.2011.01227.x

Chufo, V. (2010). Schools combat obesity with revamped menus and P.E. classes. Daily

Press. Retrieved from http://articles.dailypress.com/2010-09-12/health/dp-nws-

childhood-obesity-schools-20100912_1_school-menus-hornsby-middle-school-

school-lunch

REFERENCES Council on Virginia’s Future. (2012). Obesity. Retrieved from http://hamptonroadsperform

s.org/indicators/healthFamily/obesity.php

Garrow, H. B. (2011). Va weighs regulating school snacks to fight obesity. The Virginian

Pilot Online. Retrieved from http://hamptonroads.com.nyud.net/2011/07/va-

weighs-regulating-school-snacks-fight-obesity

Harris, J., Schwartz, M., & Brownell, K. (2010). Marketing foods to children and

adolescents: Licensed characters and other promotions on packaged foods in

the supermarket. Public Health Nutrition, 13(3), 409-417.

Hills, A., Andersen, L., & Byrne, N. (2011). Physical activity and obesity in children. British

Journal Of Sports Medicine, 45(11), 866-870. doi:10.1136/bjsports-2011-09019

9

Hockenberry, M., & Wilson, D. (2011). Wong’s nursing care of infants and children.

(9th ed.). St. Louis: Elsevier – Mosby.

REFERENCES Ogden, C., & Carroll, M. (2010). NCHS health e-stat. Retrieved from http://www.cdc.gov/

nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm

Safe Routes. (n.d.). Alexandria, Virginia: Safe routes to school activities in Alexandria.

Retrieved from: http://www.saferoutesinfo.org/data-central/success-stories/alex

andria-virginia-safe-routes-school-activities-alexandria

U.S. Department of Health and Human Services, Healthy People 2020. (2012). Nutrition

and weight status. Retrieved from http://healthypeople.gov/2020/topicsobjectiv

es2020/objectiveslist.aspx?topicId=29

U.S. Preventive Services Task Force. (2010). Screening for obesity in children and

adolescents: US Preventive Services Task Force recommendation statement.

Pediatrics, 125(2), 361-367. doi: 10.1542/peds.2009.2037

REFERENCES Virginia Department of Health (2012) CHAMPION. Retrieved from http://www.vdh.virgini

a.gov/ofhs/prevention/obesityprevention/documents/2012/pdf/CHAMPION%20

Obesity%20Prevention%20Plan.pdf

World Health Organization. (2012a). Global Database on Body Mass Index. Retrieved

from http://apps.who.int/bmi/index.jsp

World Health Organization. (2012b). Obesity. Retrieved from http://www.who.int/mediac

entre/factsheets/fs311/en/index.html

POST PRESENTATION QUIZ

Question #1:

Obesity only affects low income level

families. True or false?


Question #2:

More than 40 million children under the

age of __?___were overweight in 2010.


Question #3:

What does CPPW mean and who sponsors

it?


Question # 4:

Which foods with minimal nutritional value

are banned from the schools’ vending

machines?


Question # 5:

At what age should we start promoting

earlier childhood nutritional education to

form better eating habits?

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