Growing Healthy Kids

1
Growing Healthy Kids
2
Alarming Trends

• The U.S. Surgeon General states that, during the
  last 20 years, the number of overweight children
  has doubled, and the number of overweight
  adolescents has tripled.

Source Institute of Medicine, 2004
3
Overweight Defined by BMI

• Body Mass Index (BMI) percentiles help determine
  if a childs weight is right for his
• or her height.
• A BMI number is calculated for children and teens
  using height and weight.
• weight (lb) / height (in)2 x 703
• For children and teens, BMI is age and gender
  specific and is often referred to as BMI-for-age.

Source Centers for Disease Control and
Prevention (CDC) Growth Chart Slides
4
BMI-Percentiles-for-Age
Example Chart for Boys 2 to 20 years

• The BMI number is then plotted on CDCs
  BMI-percentile-for-age growth charts (for either
  girls or boys) to obtain a percentile ranking.

BMI
Source CDC Growth Chart Slides
5
BMI-for-Age What does it mean?
6
A Snapshot of America

• 34 of all children and teens in the U.S. are
  either overweight or at risk of overweight
• Source Pediatrics, 2006
• In minority populations, 20 of children and
  teens are overweight Source Time, 2004
• 10 of pre-school children are overweight
• Source Department of Health and Human Services,
  2002

7
Pennsylvania Statistics

• 18.2 of eighth graders are overweight
• 17.0 of eighth graders are at risk
• of overweight

Source Pennsylvania Department of Health
8
Perception versus Reality
Has our perception of healthy weight changed
over the past 20 years? These drawings show an
average healthy weight child on the left and an
overweight child on the right.
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Why does healthy weight matter?

• Immediate benefits may include
• More energy
• Better ability to focus on tasks
• Increased academic performance
• More self-esteem and confidence
• Healthy habits may lead to a lifetime of good
  health
• Obese children have an 80 chance
• of becoming obese adults

• Source American Academy of Adolescent and Child
  Psychiatry (AACAP), 2003

10
Complications of Obesity in Children

• Asthma
• General poor health
• High blood pressure
• Joint problems

• Sleep apnea
• Type 2 diabetes
• Psychosocial effects stigma
• Eating disorders
• Poor self-esteem

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Heart Disease Risk Factor Levels in Children

• Percent of children, aged 5-10, with at least 1
  heart disease risk factor
• 60

Percent of overweight children, aged 5-10, with
2 or more heart disease risk factors
25
Source Pediatrics, 2006
12
Type 2 Diabetes

• Rates of type 2 Diabetes, formerly known as
  adult onset diabetes, are increasing in youth.
• Approximately 85 of children diagnosed with type
  2 diabetes are overweight or obese.
• As the U.S. population becomes increasingly
  overweight, researchers expect type 2 diabetes
• to appear more frequently in younger children.
• Source American Diabetes Association

13
What has contributed to the current health status
of children and teens?
14
Food
What are kids eating or not eating?
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The Top 10
In 1999-2000 the top 10 items consumed by boys
and girls, aged 6-19, were

• 1. Carbonated beverages
• 2. Low-fat milk
• 3. Fruit drinks
• 4. Whole milk
• 5. Grain mixtures (pizza, pasta)

• 6. Meat mixtures (hamburgers, etc.)
• 7. White potatoes (French fries)
• 8. Sugars / sweets
• 9. Cakes / cookies
• 10. Non-citrus juices

Source A Nation at Risk Obesity in the United
States
16
Soda Consumption

• Children who drank more than 12 ounces of
  sweetened drinks
• Gained significantly more weight than children
  who drank less than six ounces a day
• Drank less milk
• Took in 244 more calories/day
• Source Journal of Pediatrics, 2003

17
Carbohydrates

• In 1994-95, intake of whole grains for children
  was 1 serving or less
• Between 1989-1995, the increase in carbohydrates
  in children and teens came from
• Pizza
• Pasta
• Mexican food
• Soft drinks

Source A Nation at Risk Obesity in the United
States
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Fruits Vegetables

• Between 1994 and 1996, only 14 of children ages
  6-19 met the recommendations for daily fruit
  intake, and only 20 ate enough vegetables.
• Among high school students, only 23.6 of males
  and 20.3 of females eat five or more vegetables
  per day.
• In 1980, about 50 of high school seniors
  reported eating green vegetables
• nearly every day.

Source Robert Wood Johnson Foundation
19
Vegetables

• Only ¾ of children (all ages) report eating at
  least one vegetable every day
• Most popular vegetable is French fries!
• Next is tomato products (spaghetti sauce)
• Lower is green beans, corn, and peas
• Lowest is nutrient-packed dark green
• or deep yellow vegetables

• Source United States Department of Agriculture

20
Eating Out

• On average, children ages 11-18 eat
• at fast-food restaurants twice a
• week
• Away-from-home foods eaten by
• children are higher in fat and
• saturated fat and lower in fiber and
• calcium than those eaten at home
• Children eat nearly twice as many calories (770)
  
• at restaurants as they do during a meal
• at home (420)

Source Robert Wood Johnson Foundation
21
Super Size It?

• Portion sizes are getting bigger and bigger!

22
Spaghetti and Meatballs
20 Years Ago
Today
1,025 calories 2 cups of pasta with sauce and 3
large meatballs
500 calories 1 cup spaghetti with sauce and 3
small meatballs
Calorie Difference 525 calories
23
Soda
Today
20 Years Ago
250 Calories 20 ounces
85 Calories 6.5 ounces
Calorie Difference 165 Calories
24
Bagel
20 Years Ago
Today
140 calories 3-inch diameter
350 calories 6-inch diameter
Calorie Difference 210 calories
25
Blueberry Muffin
20 Years Ago
Today
500 calories 4 ounces
210 calories 1.5 ounces
Calorie Difference 290 calories
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Portion Size Influences Amount of Food Eaten

• Children 3-5 years old consumed 25 more of an
  entrée and 15 more calories at lunch when
  presented with portions that were double an
  age-appropriate standard size.
• Source American Journal of Clinical
  Nutrition, 2005
• Adults ate more food when given larger portions
  but rated hunger the same as smaller size
  portions.
• Source Journal of the American
  Dietetic Association, 2004

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Physical Activity
How are kids spending their free time?
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Favorite Activities
A survey of young people ages 8 18 showed their
daily activities accounted for the following
hours

• Watching TV - 3 hours, 51 minutes
• Using the computer - 1 hour, 2 minutes
• Video games - 49 minutes
• Reading 43 minutes

Source Robert Wood Johnson Foundation
29
Television

• Obesity levels increase as the amount of time
  spent watching TV increases, especially among
  female children and teens.
• Source Archives of Pediatric and Adult
  Medicine
• Kids who have a TV in their bedroom watch about
  1.5 hours more per day than those who do not.
• Source Kaiser Family Foundation

30
Screen Time

• The typical American child spends
• about 44.5 hours per week using
• media outside of school.
• Boys spend an average of 1 hour and 12 minutes
  playing video games daily, while girls average 25
  minutes a day.
• Kids who have a computer in their bedroom use it
  about 45 minutes more per day than those who do
  not.

Source Robert Wood Johnson Foundation
31
Physical Activity

• Physical activity declines steadily during
  adolescence.
• Source CDC, 1997
• Only 25 of high school students participate in
  at least 30 minutes of moderate physical activity
  on five or more days of the week.
• Source Institute of Medicine
• 50 of children ages 12-21 rarely
• or never exercise.
• Source CDC

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The Future of our Children
Children today have a shorter life expectancy
than their parents for the first time in 100
years.
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How can we combat this overweight epidemic?

• Prevention is the key!
• Habits such as healthy eating and physical
  activity MUST be established in childhood AND
  practiced throughout a lifetime.

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It takes everyone working together
"You can't educate a child who isn't healthy, and
you can't keep a child healthy who isn't
educated."    Source Former U.S. Surgeon
General Joycelyn Elders
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• The Role of Schools
• Schools not only teach our children to read and
  write, but also to take care of their bodies and
  minds. Schools are really ideal places to
  promote good health because most young people are
  in school five days a week during most of the
  school year.
• Source Former U.S. Secretary of Health and Human
  Services
• Tommy G. Thompson, 2001

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What is a Student Wellness Policy?

• The Child Nutrition and WIC Reauthorization Act
  of 2004 requires implementation of local school
  wellness policies that address healthy eating and
  physical activity.
• All schools participating in the federal school
  lunch and/or breakfast program must comply.

• Measurable goals must be established for
• Nutrition guidelines
• Nutrition education
• Physical education
• Physical activity
• Other school-based
• activities related to
• healthy eating and
• physical activity

Source Child Nutrition and WIC Reauthorization
Act
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Nutrition Education

• The goal of nutrition education is to teach,
  encourage, and support healthy eating among
  students.
• Promoting student health and nutrition enhances
  readiness for learning and increases student
  achievement.

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Nutrition Guidelines

• In order to develop lifelong healthy eating
• patterns, children need to be introduced to a
  variety of nutritious foods in a positive manner.
  
• Foods available in district schools during the
  school day shall be offered to students with
  consideration for promoting student
• health and reducing childhood obesity.

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The Goal of Physical Education

• Physical activity is critical to the development
  and maintenance of good health.
• The goal of physical education is to develop
  physically educated individuals who have the
  knowledge, skills, and confidence to enjoy a
  lifetime of healthful physical activity.

Source National Association for Sport and
Physical Activity
40
Todays PE Class

• To achieve a quality physical education program,
  a certified physical education teacher

• Provides a variety of physical activities that
  make a physical education class fun and enjoyable
• Creates maximum opportunities for students of all
  abilities to be successful

• Assists students in setting and achieving
  personal health-related fitness goals
• Prepares and encourages students to practice
  skills and be active for a lifetime

• Source National Association of State Boards of
  Education, December 2004

41
Beyond the Gym

• The goal of a comprehensive school physical
  activity program is to provide a physical and
  social environment that encourages safe and
  enjoyable activities that are developmentally
  appropriate and designed to promote optimal
  health.

42
Physical Activity

• Physical activity, broadly defined, includes
  exercise, sport, dance, as well as other movement
  forms.
• Opportunities may include
• Recess and/or activity breaks
• Intramural sport programs and/or physical
  activity clubs
• Interscholastic sports
• Walk/bike-to-school programs
• Incentive programs for students
• and/or families

Source National Association of State Boards of
Education, December 2004
43
Integration is Key to Success

• An effective coordinated school wellness program
  integrates the cafeteria, classroom and gym to
  reinforce positive healthy behaviors throughout
  the day and makes clear that good health and
  learning go hand in hand.

Source CATCH Texas
44
School-Based Activities

• Signs posted in the cafeteria to
• promote healthful eating choices
• Home assignments for the family
• Parent newsletters
• Promotional activities, campaigns
• and/or programs
• Role modeling of healthy behaviors by teachers,
  food service staff and administrators
• Student taste-testing

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What can be done outside of school?
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Simple Steps for Healthful Family Eating

• Use MyPyramid and Go, Slow Whoa food lists to
  make healthy food choices
• Adjust portions
• Start the day with breakfast
• Serve a rainbow of fruits veggies every day
• Serve low-fat milk with meals and water with
  snacks

• Steer clear of sugary drinks and fruit juices
• Read food labels
• Save fast food for a once or twice a week treat
• Plan and make family meals together
• Be a role model

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Fit Families Happy Families

• Encourage children to be physically active for at
  least 60 minutes every day
• Limit TV, video games, and computer time to
• 1-2 hours a day combined
• Play with your children and plan activity time
• for your entire family
• Give gifts that promote fitness
• Plan parties with active themes
• such as skating
• Be a role model

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For More Information

• Nutrition
• www.mypyramid.gov
• www.nhlbi.nih.gov/health/public/heart/obesity/weca
  n/
• www.fns.usda.gov/eatsmartplayhard/
• www.dolesuperkids.com
• Physical Activity
• http//www.presidentschallenge.org
• www.tvturnoff.org
• http//www.bam.gov/index.htm
• http//verbnow.com
• Body Mass Index
• www.cdc.gov/growthcharts
• .

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Acknowledgments
WellSpans Community Health Improvement
department developed this presentation and
authorizes its use by school district personnel.
Any other uses or copying is strictly
prohibited. For more information, contact
Community Health Improvement at 717-851-3222.
This presentation has been adapted from materials
produced by the Center for Health Promotion and
Prevention Research, University of Texas-Houston
School of Public Health. For additional
information about the CATCH Texas program, visit
www.catchtexas.org