A Coordinated Approach To Child Health

1
A Coordinated Approach To Child Health

2
Kids Diets
What are they eating or not eating?
3
Vegetables

• 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, peas
• Lowest is nutrient packed dark green or deep
  yellow vegetables

• http//www.barc.usda.gov/bhnrc/foodsurvey/Kidspr.h
  tml

4
Percentage of 2-9 year olds who ate the
recommended number of fruits vegetables
Source http//www.barc.usda.gov/bhnrc/cnrg
5
Families are Eating Out!

• Nearly half of family food dollars were spent on
  foods outside of the home in 1997. (USDA Bulletin
  No. 750 1999)
• Children who eat more fast food consume more
  calories, total fat, carbohydrate, added sugars,
  and more sugar-sweetened beverages than those who
  do not. (Pediatrics 2004. Effects of fast-food
  consumption on energy intake and diet quality
  among children in a national household survey.)
• 68 to 75 of U.S. children exceed the current
  dietary recommendations for intake of total or
  saturated fats
• CSFII http//www.barc.usda.gov/bhnrc/foodsurvey/
  home.htm

6
Eating Behaviors

• What is the most influential factor that
  determines how much children and adults eat???
• A. Hunger
• B. Mood
• C. Portion Size
• D. Time of Day
• C. PORTION SIZE

7
National Geographic, August 2004 The Heavy Cost
of Fat, p. 59
8
Soft Drinks and Sweetened Beverages

• Between 1977 1994, consumption of carbonated
  soft drinks increased 41 Bowman, J Am Diet
  Assoc. 20021021234-9
• Children who drank more than 12 ounces of
  sweetened drinks Gained significantly more
  weight, drank less milk, and took in 244 more
  calories/day Mrdjenovic Levitsky. J Pediatr
  2003142604-10

• In a review of over 3,000 children and
  teenagers diets, no other single food provided
  more calories to a childs diet than sodas and
  fruit drinks. In all, these sweet drinks provide
  about 13 of total calories more than cakes,
  cookies, and other sugary foods Abstract from
  Experimental Biology Scientific Conference,
  April 2005 Beverages as a source of energy and
  nutrients in diets of children and adolescents.
  

9
Milk Consumption

• Between 1977 1994, milk consumption declined
• 24 among boys (6-11 years old)
• 32 among girls
• Milk was found to be the primary source in a
  childs diet for Calcium, Phosphorous, Magnesium,
  and Potassium. Those who drank more milk than
  soda weighed less and had less body fat.

• http//www.barc.usda.gov/bhnrc/foodsurvey/Kidspr.h
  tml, Borrud et al., Nutr Week, 1997274-5
• Abstract from Experimental Biology Scientific
  Conference, April 2005 Beverages as a source of
  energy and nutrients in diets of children and
  adolescents.

10
Physical Inactivity

• 48 of girls 26 of boys do not exercise
  vigorously on a regular basis (MMWR CDC
  Guidelines,1997461-36).
• School-aged youth should participate in 60
  minutes or more of moderate to vigorous physical
  activity every day. Review in June 2005 issue of
  Pediatrics

11
Physical Inactivity

• Physical activity declines progressively from
  ages 12 to 21. Cancer Prevention Early
  Detection Facts and Figures 2005.
• Childrens walking trips have declined by 60
  since 1977, and walking and biking to school have
  declined by 50.
• Daily PE enrollment dropped from 42 of students
  in 1991 to 25 in 1995. Surgeon General Report,
  1996

12
Television

• One quarter of U.S. children spend 4 hours or
  more watching television daily. (hours of TV is
  associated with increased obesity) Andersen, et
  al. JAMA. 1998279938-42
• TV confuses children. The more TV kids watch, the
  less able they are to identify what types of
  foods are healthy. June 2005 University of
  Illinois
• What other messages do children get from TV?

13
What is the result of a lifestyle with
consistently too many calories and not enough
physical activity?
14
(No Transcript)
15
Overweight Children and AdolescentsNHANES
Equal or greater than 95 age/sex CDC Growth
Charts
Source National Center for Health Statistics,
Health United States, 2001 Ogden et al.
JAMA2881728-1732, Hedley et al.
JAMA2912847-2850
16
Childhood Obesity

• Health problems Overweight children miss 3-4
  times as much school. Kids born today may have
  lower life expectancies than their parents. March
  2005 New England Journal of Medicine
• Associated with social problems Severely
  overweight kids scored lower on a quality of life
  survey than kids with cancer! Out of 100, the
  overweight kids average score was a 67. Journal
  of American Medical Association
• Cost burden
• Surgeon Generals report 2001 US expenditures
  on obesity - 117 billion
• Child Adolescent Hospitalizations for diseases
  associated with obesity increased sharply between
  1979 and 1999
• From 1987 to 2002 health care spending on obesity
  rose from 2 to 11.6. - Journal of Health
  Policy and Research.

17
Type 2 Diabetes

• Type 2 Diabetes was formerly known as adult
  onset diabetes, but there has been an increasing
  incidence of type 2 diabetes in youth. Rosenbloom
  et al., 1999
• Approximately 85 of children diagnosed with type
  2 diabetes are overweight or obese American
  Diabetes Association
• As the US population becomes increasingly
  overweight, researchers expect type 2 diabetes to
  appear more frequently in younger children
  American Diabetes Association
• Higher prevalence in Hispanics (1.9x) African
  Americans (1.7x) NIDDK, 2000

18
What is . . .

• Coordinated School
• Health Programming?
• CATCH?

19

• Coordinated School Health Programming
  Coordinated School Health Programming is a
  process which brings a school community together
  to teach children to be healthy for a lifetime.
  Working together to create a healthy school
  environment.
• The CATCH Program is a resource/tool for
  bringing schools, families, and communities
  together to work toward creating a healthy school
  environment that teaches and rewards positive
  health behaviors.

20
CATCH Research Trial1991-94

• Research study was called the Child and
  Adolescent Trial for Cardiovascular Health
• First research trial to integrate school, child
  family
• Ethnically diverse population, over 5,000
  students involved in nearly 100 schools
• Four geographic areas of the U.S.
• California
• Louisiana
• Minnesota
• Texas

21
Does CATCH Work?

• Reduced total fat and saturated fat content of
  school lunches.
• Increased moderate-to-vigorous physical activity
  (MVPA) during P.E. classes.
• Improved students self-reported eating and
  physical activity behaviors.
• Effects persisted over three years without
  continued intervention.
• Luepker RV, et al (1996). JAMA, 275(10), 768-76.
• Nader PR, et al (1999). Arch Pediatr Adolesc Med,
  153(7), 695-704.

22
For most children . . .

• Eating and exercise behaviors are NOT HEALTH
  behaviors they are SOCIAL behaviors.

23
CATCH Components Bridging the Gap

• CATCH Physical Education
• CATCH Classroom Nutrition Curriculum
• CATCH Eat Smart, School Nutrition Service
• CATCH Family and Community

24
CATCH

• Physical Education

25
GOAL OF CATCH PE

• CATCH PE is designed to promote childrens
  enjoyment and participation of MVPA (moderate to
  vigorous physical activity) during PE classes,
  recess, and extracurricular activities, and
  recreation time with family and friends.

26
Key Objectives of a CATCH PE Class

• Students enjoy physical activity
• Students are involved in MVPA for 50 of class
  time
• All students are provided with many opportunities
  to participate and practice skills
• Students are encouraged to participate in
  physical activity outside of CATCH PE class

27
CATCH

• Classroom Nutrition Curriculum

28
Curricula Focuses On
ABOUT HEALTHFUL FOOD PHYSICAL ACTIVITY

• Childrens Knowledge
• Childrens Attitudes
• Self-Efficacy
• Skills

29
Curricula Objectives

• Students will be able to
• IDENTIFY
• PRACTICE
• ADOPT
• Healthy eating
• physical activity behaviors

30
Focusing on healthful eating and physical
activity behaviors

• CATCH characters model daily healthier lifestyle.
  
• Strategies individual practice, group
  discussion, role plays, projects, reports, goal
  setting, skills training, label reading, snack
  preparation/taste-testing and other activities.
• Promote changes in the environment, promote role
  modeling and create peer support to encourage
  healthy behaviors.

31
GO SLOW WHOA Foods

• GO Foods Almost Anytime foods contain
  the lowest amount of fat. Students are taught
  that GO foods should be eaten more often than
  SLOW or WHOA foods.

SLOW Foods SLOW foods are higher in fat than GO
foods, and lower in fat than WHOA foods. Students
are taught that SLOW foods should be eaten less
often than GO foods and more often than WHOA
foods.
WHOA Foods WHOA foods are the highest in fat of
the three groups. Students are taught that WHOA
foods should be eaten less often than GO or SLOW
foods.
32
2 x 2 Classroom Fitness Activity

• Do 21 3 ___ wall push-ups.
• Name 5 Go Foods.
• Do 2 x 3 ___ jumping jacks.
• Touch 4 x 2 ___ different colors in the
  classroom.
• Look up FITNESS in the dictionary. Use the
  word in a sentence.
• Do a dance for 12 18 ___ seconds.

33

• What are the 4 Ps of
• Eat Smart?

Planning Purchasing Preparation Promotion
34
CATCH

• Family and Community Support

35
Family Component Objective

• Getting parents and families involved
• as much as possible and whenever possible by
  coordinating
• CATCH concepts and activities
• with the family and school community.

36
Take It Home Home Team

• Home Team Programs
• Home Letters (Grades K-2)
• Hearty Heart Home Team (Grade 3)
• Stowaway to Planet Strongheart (Grade 4)
• Health Trek (Grade 5)
• Unpuffables (F.A.C.T.S.-Grade 5)
• Program Content
• 4-6 activity packets per program for home- based
  skills development
• Newsletter/take-home format
• Complements classroom curricula
• Coordinated by teachers and families

37
Family/School/Community Activity

• Family Fun Nights
• Evening activity at least once a year.
• Participation by CATCH students and families,
  teachers, food service staff, physical education
  specialists and administrators.
• Activity booths highlighting healthy snacks and
  activities.
• Aerobic routines by students, nutrition games,
  etc.
• Community involvement opportunity.

38
The most profound truths are often the simplest

• If we want children to make the decision to eat
  healthy foods and be physically active, we must
  provide good nutritional choices and enjoyable
  physical activities that support healthy
  lifestyle choices
• an Environment of Health.

39
CATCH Application Process

• Applications will be mailed to all elementary
  school principals April 11, 2008.
• Funding will be available for CATCH in school or
  CATCH Kids Club after school.
• Funding will be available to public, private,
  parochial and BIA schools for CATCH or CATCH
  Kids Club.
• Contact Shanti Shanti Kaur Khalsa,
  1-505-476-7616, or shantishanti.khalsa_at_state.nm.us
  for further information.