A COORDINATED APPROACH WILL RESULT IN...

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Nutrition Task Force
Community Resources and The Growth Screening
Program Workshop
School Nursing in 2005 Monday, January 17,
2005 1200 PM to 300 PM
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Washington County Health Partners, Inc.

• Not-for-profit, 501(c) 3 organization
• Dedicated to the enhancement of the health and
  well-being of Washington County residents.
• Assesses the countys health status periodically
• Works through volunteer task forces and programs
  to address identified health issues
• Currently 7 task forces and 2 programs

Nutrition Task Force
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Nutrition Task Force Background

• Created in July 2004
• Focus on promoting and supporting healthy
  lifestyles for all children and the adults that
  impact their homes, schools, and neighborhoods.
• Healthy lifestyles defined as living actively,
  eating in healthy ways, and encouraging positive
  body image and self esteem.

Nutrition Task Force
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Task Force Members

• American Cancer Society, Kathleen Row
• Burgettstown School District, Jan Marietta, RN
• Canonsburg General Hospital, Sandy Hoffman, RN
• Community Action Southwest WIC Program, Judy
  Holtz, RD
• Family Health Council, Nancy Pauli
• Gateway Health Plan, Connie Osborne
• Highmark Corporation, Lynne Marchese
• Monongahela Valley Hospital, Debbie Hutcheson,
  RD, MS, CDE and Linda Kolano, RD, LDN
• PA Educational Network for Eating Disorders,
  Anita Sinicrope Maier, MSW and Jen Sylves
• Pediatric Associates of Washington, Fran Sylvers,
  CRNP
• Penn State Cooperative Extension, Carolyn
  Wissenbach
• Pennsylvania Department of Health, Maureen Smith,
  RN, BSN
• Private Registered Dietitian, Lea Ann Ostergaard,
  MS, RD, LDN
• Retired Medical Doctor, Jon S. Adler, MD
• University of Pittsburgh Graduate School of
  Public Health, Ravi Sharma, PhD and Katie Hindes,
  MPH
• UPMC for you, Carol Kelley
• The Washington Hospital Teen Outreach, Karen
  McFedries

Nutrition Task Force
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Outline of Workshop

• Coordinated School Health Program Overview
• Growth Screening Progam and Available Resources
• Eating Disorder Sensitivity/Screening
• Hands-on Learning (small group break out)
• Anthropometric measurements
• NutStat Program
• Action Plan Brainstorming

Nutrition Task Force
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Objectives

1. To understand the concept of a Coordinated School
   Health Program
2. To be aware of available resources for the growth
   screening program
3. To recognize signs and symptoms of eating
   disorders and those at risk for development
4. To understand how to implement the Growth
   Screening Program with sensitivity to issues
   surrounding eating disorders
5. To understand how implementation of the Growth
   Screening Program could affect negatively affect
   eating disorder behaviors
6. To understand how to work with NutStat Program

Nutrition Task Force
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The American Cancer Society is the nationwide
community-based voluntary health organization
dedicated to eliminating cancer as a major health
problem by preventing cancer, saving lives and
diminishing suffering from cancer through
research, education, advocacy, and service. 
Coordinated School Health Program Overview
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Causes of Cancer A Review of the Evidence
Estimated Percentage of Total Cancer Deaths
Attributable to Established Causes of Cancer
Tobacco Adult Diet/Obesity Sedentary
lifestyle Occupational factors Family history of
cancer Viruses/other biologic agents Prenatal
factors/growth Reproductive factors Alcohol Socioe
conomic status Environmental pollution Ionizing/ul
tra-violet radiation Rx drugs/medical procedures
Salt/additives/contaminants
Source Harvard Report on Cancer Prevention,
Cancer Causes and Control, November/December,
1996
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(No Transcript)
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(No Transcript)
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ACS Serves as a Resource and Advocate

• Materials
• Information sharing
• Training opportunities

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American Cancer Society 1-888-227-5445www.cancer
.org
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• Procedures for the Growth Screening Program
  for Pennsylvanias School-age Population

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Growth Screening Program

• Pennsylvania will be one of the first states in
  the nation to track physical growth among the
  entire K-12 population on an annual basis.
• .
• Screening for the upcoming school year is
  voluntary mandatory tiered implementation will
  start in the '05-'06 school year and will expand
  three additional grades each year thereafter.
  By the '08-'09 school year, all grades will be
  screened.

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New Screen Procedure
New Screening Procedure

• Measure height
• Measure weight
• Determine Body Mass Index (BMI)
• Graph BMI on 2000 CDC growth charts
• Provide information to parents

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Epidemic
Why Worry About Pediatric Obesity?

• 27 of children age 5-10 have 1 or more heart
  disease risk factor
• 1 in 3 children born in the year 2000 will
  develop Type II Diabetes (based on current
  trends)
• Obesity is now the most prevalent nutritional
  disease of children and adolescents in the United
  States.

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Conseqin Children
Consequences of Obesity in Children

• Cardiovascular health -hypercholesterolemia,
  dyslipidemia, hypertension (metabolic syndrome)
• Endocrine system -hyperinsulinism, insulin
  resistance, impaired glucose tolerance, type 2
  diabetes mellitus, and menstrual irregularity
• Mental health depression, low self-esteem

• Pulmonary -asthma, obstructive sleep apnea
• Orthopedic - slipped capital femoral epiphysis
• Gastrointestinal / Hepatic - nonalcoholic hepatic
  steatosis, cholecystitis

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Percentage of Overweight Children Youth Who
Become Obese Adults
Percentage of Overweight Children and Youth Who
Become Obese Adults
National Institute for Health Care Management,
Nov 2003
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BMI-for-Age Cutoffs in Children and Youth
gt95th percentile Overweight
85th to lt95th percentile Risk for Overweight
lt5th percentile Underweight
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Categorizing Weight in Adults and Youth
Categorizing Weight in Adults and Youth
Category Adults (21 years) Youth (2-20 years)
Underweight BMI lt 18.5 lt 5th BMI-for-age percentile
Normal weight BMI 18.5 24.9 BMI-for-age gt5th percentile to lt 85th percentile
At risk of overweight Not Typically Used in Adults BMI-for-age 85th percentile to lt 95th percentile
Overweight BMI 25-29.9 BMI-for-age 95th percentile
Obesity BMI 30-39.9 Not Used in Youth
Extreme Obesity BMI 40 Not Used in Youth
National Institute for Health Care Management,
Nov 2003
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Body Mass Index (BMI)Advantages
Body Mass Index (BMI) Advantages

• Best single measure for obesity in children
• Highest correlation with skinfold thickness
• Simple and useful measure
• Track growth from childhood, through adolescence,
  to adulthood
• Performed reliably and easily
• Recommended by AAP, WHO, AMA

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Body Mass Index (BMI)Limitations
Body Mass Index (BMI) Limitations

• Screening tool ONLY.. not diagnostic
• Individual assessment, skinfold measurements,
  family history, physical examination, metabolic
  findings
• Influenced by pubertal status
• Not specific for children with special health
  care needs
• Does not differentiate between central adiposity
  and peripheral adiposity
• Lean muscle mass vs. fat tissue mass.
• Sensitive to minor changes in weight and height

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Key Messages
Key Messages

• The prevalence of childhood overweight and
  obesity is increasing at an alarming rate in the
  United States as well as in other developed and
  developing countries.
• BMI is currently the best tool we have to assess
  adiposity in children and adolescents.
• Surveillance data for BMI can serve to assess
  nutritional status of populations, monitor
  changes over time, promote epidemiological
  research, screen and refer individuals at risk,
  and develop and evaluate programs and policies.

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Available Resources

• Growth Screening Program
• Sample parent letters (pre-screening and results)
• Health Care Resources Brochure
• Parent nutrition and physical activity resource
  list
• Parent BMI brochure and insert
• School nurse informational resource list
• Floppy disk (Electronic copies of above items)
• Nutrition and physical activity brochures
• CD ROM (Copy of NutStat Program)
• NutStat step-by-step instructions
• Growth screening charts
• BMI wheels
• Eating disorder screening/sensitivity training
  materials
• List of task force members and resources offered
• Coordinated school health program brochure and
  Model Program
• Community Action Southwest brochure
• Preventing Childhood Overweight and Obesity
  Parents Can Make a Difference--ProjectPA Kit

Nutrition Task Force
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Hands-on Learning

• Two break out groups
• (need to rotate each)
• Digital and balance beam scale and stadiometer
• Laptop with Nutstat Program

Nutrition Task Force
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Action Plan

• Brainstorming Session

Nutrition Task Force
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Thank you!
Contact Washington County Health Partners,
Inc. 190 North Main Street, Suite 208
Washington, PA 15301 (P) 724-222-6511
(F) 724-222-6685 (E) info_at_wchpinc.org