REDUCING CHILDHOOD OVERWEIGHT: A ROADMAP TO SUCCESS

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REDUCING CHILDHOOD OVERWEIGHT A ROADMAP TO
SUCCESS

• LINDA MATTSON
• MS Candidate
• Registered Dietitian
• Food Services, SJUSD

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Introduction

• Overweight is now more prevalent among American
  children, including low-income children, than
  underweight or growth retardation.
• Childhood overweight is now such a threat to our
  nations future health that it is considered a
  major contributor to chronic diseases later in
  life.

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Introduction

• In 2001, the U.S. Surgeon general issued the
  Call to Action to Prevent and Decrease
  Overweight and Obesity starting the impetus for
  the development of programs designed to decrease
  the number of obese children and youth in the
  United States.

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Introduction

• My name is Linda Mattson. I am the Registered
  Dietitian for Food Services and the San Juan
  Unified School District. Every day I love to
  meet the challenge of feeding the minds and the
  stomachs of hungry children.
• Teaching students that are eager to learn new,
  healthy habits is especially rewarding.

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Topics

• Facts and Figures
• Causes
• Stakeholders
• Prevention/Intervention
• Recent Research
• Conclusion

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Facts and Figures

• On March 12, 2005 The Journal of Clinical
  Endocrinology Metabolism published a consensus
  statement from an international summit with a
  recommendation to classify obesity as a disease.
• Since the 1970s, in the U.S. The prevalence of
  obesity has more than doubled for preschool
  children aged 2-5 years and adolescents aged
  12-19 years, and it has more than tripled for
  children aged 6-11 years. Now, approximately
  nine million children over six years of age are
  obese.

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Facts and Figures

• Childhood overweight involves risks to physical
  and emotional health. In 2000, an estimate of 30
  percent of boys and 40 percent of girls born in
  the United States were at risk for being
  diagnosed with type 2 diabetes at some point in
  their lives.
• Children are also at risk for chronic diseases
  such as coronary heart disease, stroke, cancer,
  osteoarthritis, glucose intolerance, high
  cholesterol, hypertension, gall bladder disease,
  sleep apnea, liver disease, asthma, womens
  reproductive problems, and death.
• Young people are also at risk of developing
  psychosocial difficulties due to the societal
  stigmatization and poor body image associated
  with being overweight.

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Facts and Figures

• Obesity related annual hospital costs for
  children and youth more than tripled over the
  last two decades, rising from 35 million in
  1979-1981 to 127 million in 1997-1999.

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Causes

• Excess dietary intake
• Inappropriate food choices
• Sedentary lifestyle
• Increased restaurant food consumption
• Large portion sizes
• Shifts in beverage consumption
• Meal patterns and frequency

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Stakeholders

• The Institute of Medicine presented a report to
  Congress specifying stakeholders in Childhood
  Obesity prevention. Institute of Medicine Web .
• Federal Government
• Industry and Media
• State and Local Governments
• Health-Care Professionals
• Community and Nonprofit Organizations
• State and Local Education Authorities and Schools
• Parents and Families

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Prevention/Intervention(Guidelines by IOM)

• Federal Government
• Establish an interdepartmental task force and
  coordinate federal actions.
• Develop nutrition standards for foods and
  beverages sold in schools.
• SB 12 and SB 965 (see handouts)
• Fund state-based nutrition and physical activity
  grants with strong evaluation components.
• Develop guidelines regarding advertising and
  marketing to children and youth by convening a
  national conference.
• Expand funding for prevention intervention
  research, experimental behavior research, and
  community-based population research strengthen
  support for surveillance, monitoring, and
  evaluation efforts.

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Prevention/InterventionGuidelines by IOM

• Industry and Media
• Develop healthier food and beverage product and
  packaging innovations.
• Expand consumer nutrition information.
• Provide clear and consistent media messages.

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Prevention/Intervention(Guidelines by IOM)

• State and Local Government
• Expand and promote opportunities for physical
  activity in the community through changes to
  ordinances, capital improvement programs, and
  other planning practices.
• Work with communities to support partnerships and
  networks that expand the availability of and
  access to healthful foods.

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Prevention/Intervention(Guidelines by IOM)

• Health-Care Professionals
• Routinely track BMI in children and youth and
  offer appropriate counseling and guidance to
  children and their families.

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Prevention/Intervention(Guidelines by IOM)

• Community and Nonprofit Organizations
• Provide opportunities for healthful eating and
  physical activity in existing and new community
  programs, particularly for high-risk populations.

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Prevention/Intervention(Guidelines by IOM)

• State and Local Authorities and Schools
• Improve the nutritional quality of foods and
  beverages served and sold in schools and as part
  of school-related activities. See SJUSD District
  Wellness Policies AR 3550 and AR 3554 on district
  public website under Gamut.
• Increase opportunities for frequent, more
  intensive, and engaging physical activity during
  and after school.
• Implement school-based interventions to reduce
  childrens screen time.
• Develop, implement, and evaluate innovative pilot
  programs for both staffing and teaching about
  wellness, healthful eating, and physical
  activity. See Food Services department sponsored
  Nutrition Education Shape Team (NEST) curriculum
  materials, Harvest of the Month classroom gift
  packs, SJUSD Power Players Kit (available in
  all elementary schools 2007), Healthy Fundraiser
  Guide, and Wealth of Wellness messages.
• Find out how your local schools are participating
  in childhood overweight interventionthey may
  even employ a Registered Dietitian on staff!
• To find out what the state requires your schools
  for PE go to this site State PE
  Requirements for Elementary School (K-8)
• To look up your schools Fitnessgram results go
  to Look up Fitnessgram results by school

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Prevention/Intervention(Guidelines by IOM)

• Parents and Families
• Engage in and promote more healthful dietary
  intakes and active lifestyles (e.g., increased
  physical activity, reduced television and other
  screen time, more healthful dietary behaviors).

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Prevention/Intervention(American Public Health
Association)

• The American Public Health Association lists
  prescribed goals to prevent and control childhood
  obesity titled Healthy People 2010. The goals
  and objectives are aimed mainly at public and
  private schools, and educational and community
  based programs.
• To find the objectives for your area link to
  Healthy People 2010 Objectives Site

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Prevention/Intervention(American Dietetics
Association)

• Recommendations for dietetics professionals
• Support and promote the Dietary Guidelines for
  Americans for healthy children after the age of 2
  years.
• Support and promote use of the USDAs Food Guide
  Pyramid as a guide for meeting dietary
  recommendations with us of the Food Guide Pyramid
  for Young Children ages 2 to 6 years.
• Support and promote healthful dietary patterns
  among diverse ethnic groups taking into
  consideration regional and cultural differences.
• Support and promote use of the Fitness Pyramid
  for Kids to encourage physical activity among
  children. See "Move It" fitness pyramid
• Support and promote implementation of the Dietary
  Guidelines for American school meals by
  strengthening nutrition education and promotion
  in school nutrition programs, including the
  implementation of integrated nutrition education
  curricula designed to teach students how to make
  informed diet selections based on balance,
  variety, and moderation and the fundamental
  premise that all foods can fit into a healthful
  diet.
• Support the availability of foods and beverages
  that contribute to dietary patterns consistent
  with federal nutrition and dietary guidelines
  throughout the day on the school premises.

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Prevention/Intervention(American Dietetics
Association)

• Publicize existing comprehensive health education
  programs, such as the Child and Adolescent Trial
  for Cardiovascular Health (CATCH), Gimme 5, Know
  Your Body, Heart Smart, Healthy Me, and Planet
  Health.
• Develop and implement programs for educating
  parents and caregivers on how to foster more
  healthful lifestyles in the home and
  school/daycare environment through the use of
  authoritative feeding behaviors.
• Foster communication by building partnerships
  across health-related disciplines and
  professional organizations.
• Conduct effective nutrition education training
  programs for physicians, child nutrition
  personnel, and other health care providers on
  strategies that can be used with children that
  promote healthier eating habits.
• Advocate for the need to increase federal and
  state funding of nutrition intervention programs.
• Support more nutrition studies on young children,
  specifically in the areas of total sugars intake
  and health outcome, childrens fiber intake, and
  better documentation of energy expenditure.

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Recent Research

• A recent study conducted by Dr. Rainville on the
  National School Lunch Program and School
  Breakfast Program revealed that children
  participating in the program have an increased
  intake of fruits, vegetables, milk, milk
  products, vitamins, and minerals. As part of a
  state review, the programs meals are analyzed
  for adequate calories, less than 30 fat, and
  less than 10 saturated fat, appropriate levels
  of iron, vitamins and minerals. Soon school meal
  regulations will include the Dietary Guidelines
  for Americans principles as well.

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Recent Research

• A research study led by Hillary Burdette,
  MD, MS, was conducted in 2004 on outdoor activity
  playtime as a measure of physical activity in
  preschool-aged children. Activity was measured
  by an accelerometer attached around the childs
  waist (similar to a pedometer).
• Conclusions were that outdoor activity
  playtime correlated with an increased level of
  physical activity.
• Emphasis was on early prevention in
  preschool age children.

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Recent Research

• A study published in the February 2005 issue of
  Pediatrics released information based on medical
  records of 587 children referred to
  Endocrinologists at the Childrens Hospital of
  Buffalo. Study authors concluded that early
  intervention is the key to preventing childhood
  obesity by implementing early family-based
  behavioral-lifestyle intervention programs.
• A study in 2004 of more than 3,000 infants and
  toddlers in the US found that children as young
  as 4-6 months of age are consuming too many
  calories and eating inappropriate foods
  including soda and French fries. Children
  between 1-2 years of age were consuming 1,220
  calories per day, more than 30 higher than the
  950 calories per day typically needed for that
  age.

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Recent Research

• The West Virginia Public Employees Insurance
  Agency is conducting an at-home study using the
  video game Dance Dance Revolution to increase
  activity. Two and a half million copies of this
  from Japan have been sold in North America since
  its introduction in 2001.

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Recent Research

• In a study based on teacher and parent-reported
  data childhood overweight is linked to behavior
  problems in girls.
• Based on a study of children from kindergarten to
  first grade, overweight in boys may be a risk
  factor for lower academic performance.

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Conclusion

• Undoubtedly childhood overweight is a serious
  problem for our nation and worldwide. How we
  embrace the multitude of strategies for
  prevention is still to be seen.
• Studies point to the importance of early
  intervention.
• Each of us as individuals can contribute to the
  intervention, prevention and reduction of
  Childhood Overweight.

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References

• 1. Niklas T, Johnson R, Frary C, et al. Dietary
  guidelines for healthy children aged 2 to 11
  years. Journal of the American Dietetics
  Association. 2004 104 660-677.
• 2. Institute of Medicine. Focus on Childhood
  Obesity. Available at http//www.iom.edu/focuson
  .asp?id22593/ Accessed February 22, 2005.
• 3. Medical New Today. Consensus on Childhood
  Obesity Recommends Classification as Disease.
  Available at http//www.medicalnewstoday.com/pri
  nterfriendlynews.php?newsid21133. Accessed
  April 6, 2005.
• 4. Scripps Howard News Service. Obesity
  Statistics, Here and Abroad. School Nutrition
  Association. March 24, 2005.
• 5. Institute of Medicine. Childhood Obesity in
  the United States Facts and Figures. Available
  at www.iom.edu. Accessed February 22, 2005.
• 6. Institute of Medicine. Immediate Steps for
  Confronting the Epidemic. Available at
  www.iom.edu. Accessed February 22, 2005.
• 7. California School Food Service Association.
  Childhood Obesity Workshop 52nd Annual
  Conference. March 2005.
• 8. National Institute for Health Care Management
  Foundation. Obesity in Young Children Impact
  and Intervention. NIHCM Foundation Research
  Brief. August 2004.
• 9. Daniels Dr. Intervening early can lead to
  prevention. Archives of Pediatrics and
  Adolescent Medicine. 2004 4 353-357.
• 10. Quattrin et al. Children at risk for
  obesity need early intervention target families,
  study finds. Pediatrics. February 2005.
• 11. Cassuto D, Frelut M. Child Obesity. Danone
  Institute. December 1999.
• Barker A. West Virginia to use game in effort to
  reduce childhood obesity. Daily Mail. April
  2005.

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Questions?
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Nutrition Education.