Childhood Obesity: A Family Affair

1
Childhood Obesity A Family Affair

• Tami Ross, RD, CDE
• mdrosslex_at_aol.com
• Patti Geil, MS, RD, FADA, CDE
• jdgeil_at_pol.net

2
Generation XXL A Profile

• Tall for age (above 50tile)
• Began gaining weight between ages 3-5 years
• Frequent fast food consumer
• Drinks most of his/her calories
• May skip one or more meals each day, then
  starts to graze
• Watches four or more hours of TV each day

3

• Generation XXL
• The Facts
• Prevalence of childhood obesity and overweight
  has doubled in the past 20 years in the United
  States
• 15.3 of 6-11 year olds are at or above 95tile
  for BMI
• 15.5 of 12-19 year olds are at or above 95tile
  for BMI
• Higher rates of obesity and overweight in
  minority and economically disadvantaged children

4
Generation XXL The Consequences

• Hypertension and CVD
• Type 2 diabetes
• Hepatic disease
• Airway disorders
• Back, hip and knee strain

• Dyslipidemia
• 70 chance of becoming overweight adults
• Depression, low self-esteem, lack of
  self-confidence

5
Factors Associated with Childhood Obesity

• Genetics
• Family influence
• Nutrition
• Physical activity
• Other variables

6
Obesitys Genetic Link Its a Family Affair

• Neither parent obese 10 chance of having an
  obese child
• One parent obese 50 chance of having an obese
  child
• Both parents obese 66 chance of having an
  obese child
• Other factors
• high birth weight
• maternal diabetes
• early menarche

7
Family Factors That Influence Weight

• Role models
• Food environment
• Demise of family meal time
• Reinforce dietary behaviors
• ocioeconomic status

8
Healthy Habits for Healthy Kids www.wellpoint.com
9
Newtons First Law of Thermodynamics

• Energy is neither created or destroyed.
• Calories in (food) Calories out (activity)
  weight gain
• Calories in Calories out Weight maintenance
• Calories in
• Calories in Calories out Weight gain
• 3500 calories 1 pound
• .15 daily caloric excess obesity within 5
  years

10
Nutrition Factors

• Four Kid Food Groups
• Forgetting Fruits Vegetables
• Unbalanced Food Pyramid
• Bypassing Breakfast
• Grazing
• Clean Plate Club
• Dashboard Dining
• Portion Distortion
• Food, Food Everywhere
• Self-regulation of Intake

11
Portion Distortion
1960s fries 210 calories 2003 super size
fries 610 calories 1916 cola bottle size 6 ½
ounces 2003 cola bottle size 20 ounces
12
Common Nutrition Blind Spots

• Liquid calories
• 4 cans soda/day 600 calories which could
  promote 1 /week weight gain
• Snacks
• Caloric density

13
Physical Activity Factors

• Increasing urbanization - only 10 of children
  walk to school
• Modern technology
• Screen time

14
Screen Time and Obesity

• Of U.S. children 8-16 years old, more than 25
  watch at least 4 hours of TV per day.
• Children who watch 4 hours of TV/day have
  significantly greater BMI than those watching 2hours/day.
• TV in the bedroom is a strong predictor of
  overweight.

15
The CDC recently recalculated Americans
activities KY had the lowest percentage of
people achieving the minimum physical activity
recommendations of 30 min./day, 4 days/wk.
16
Other Variables Associated with Childhood Obesity

• Smoking
• Alcohol use
• Early sexual experimentation

17
15-20 of Americas teens are either overweight
or at risk. www.ActionForHealthyKids.orgPrevent
ion is the key

• Check BMI once a year.
• Breastfeed babies.
• Begin the day with breakfast.
• Encourage healthy habits at school away from
  home.
• Make moderation the motto.
• Factor in family mealtime.
• Count liquid calories.
• Dont join the clean plate club.
• Keep kid portions kid-sized.
• Cut screen time devise an after-school action
  play.
• Get moving.

18
Family Interventions Its a Family Affair

• Provide encourage healthy food and beverages
• Be a positive role model
• Teach balance, variety, moderation
• One family meal/day
• Avoid using food for rewards, bribes, or comfort

19
Nutrition InterventionsTarget the common
offenders

• Eliminate concentrated sources of empty calories.
• 64 oz. Big Gulp regular soda 750 calories
• Aim to reduce
• fat consumption.

20
Nutrition InterventionsTarget the common
offenders

• Begin every day with breakfast.
• Eat 3 meals/day and reduce grazing.
• Snack calories do count!
• Keep snacks healthy
• Fresh fruit
• Raw vegetables w/ low fat dip
• Graham crackers w/ low fat hot chocolate
• Low sugar cereal w/ low fat milk
• Pretzels salsa
• Fruit sorbet
• Low fat yogurt
• Animal crackers
• Light microwave popcorn

21
Nutrition InterventionsTarget the common
offenders

• Dont join the clean plate club.
• Get in touch with hunger.
• Reduce fast-food frequency.
• Choose kid-size portions, not super-size portions.

22
Portion size check-up

• 1 tsp. thumb tip
• ½ cup medium handful
• 1 cup size of fist
• ½ cup pasta or rice tennis ball or ice cream
  scoop
• 1 slice bread computer disk size of palm of
  hand halfway up fingers
• 1 medium fruit tennis ball
• ½ cup vegetables light bulb
• 2-3 oz meat deck of cards, cassette tape, bar
  of soap, size and thickness of palm of hand
• 2 Tbs. peanut butter ping pong ball

23
Nutrition InterventionsTarget the common
offenders

• Work toward 5-9 fruits vegetables/day.
• ½ cup cooked vegetables or vegetable juice
• 1 cup raw vegetables
• ½ cup cut fruit
• 1 medium fruit
• Get the food pyramid back in balance.

24
Kids Food Pyramid
www.pork4kids.com/images/kidpyramid.pdf
25
Physical Activity Interventions

• Kids need at least 30 minutes of moderate to
  vigorous physical activity most days of the week,
  muscle strengthening exercise at least twice a
  week, lifestyle fitness activity every day.

26
Physical Activity Interventions

• Make activity part of the childs daily routine.
• Expose children to a variety of physical
  activities.
• Buy a pedometer.
• Build activity into the family routine.

27
Physical Activity Interventions

• Cut screen time to no more than 2 hours/day.
• Get moving in front of the tube.
• Take screen breaks.

28
Track Progress Provide Rewards

• Food activity log
• Focus on the positive
• Reward positive changes

29
What Else Can We Do?

• Check blood glucose
• Check blood pressure
• Check for sleep disturbances
• Other interventions Medication Surgery

30
Home is where the HEALTH is!
31
Resources
American Diabetes Association, 2003
www,diabetes.org www.amazon.com
32
Success Stories!!