Presentation on theme: "Tackling the Childhood Obesity Problem - Adults as Role Models Claudia Raya, RD Massachusetts Department of Education, Nutrition Programs and Services."— Presentation transcript:
Are we facing a problem with overweight and obesity in the United States?
Prevalence of overweight among children and adolescents ages 6-19 years Notes: Excludes pregnant women starting from 1971-1974. Pregnancy status not available for 1963-65 and 1966-70. Data for 1963-65 are for children 6-11 years of age; data for 1966-70 are for adolescents 12-17 years of age, not 12-19. Source: CDCNHCS, NHES, NHANES. Age in Years 6-1112-19
Contributing factors to obesity crisis in U.S. Environment Genetics –metabolism, predisposition Diet/Nutrition Intake Physical Activity Cultural/Psychological Toxic Food Environment
Shifts in Food Practices in the United States Use of the microwave Fast food consumption Consumption of soft drinks - increased from 27 to 44 gal/y from 1972-92 30,000 products in supermarkets (doubled since 1981) 12,000 new food products/year (doubled since 1986)
Contributing Environmental Factors Environment of Ease –cars –decrease in safe walking paths/sidewalks –drive thru society –remote control –internet/TV
Hypothesized Impact of Television Viewing on Obesity Obesity Television Viewing Dietary Intake Inactivity
Dietz WH, Gortmaker SL. Do we fatten our children at the tv set? Obesity and television viewing in children and adolescents. Pediatrics, 1985; 75:807-812. Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. Archives of Pediatrics and Adolescent Medicine, 1996;150:356-362.
Consequences of overweight / obesity crisis in U.S. Overweight children will grow into overweight adults Medical conditions –chronic diseases –mental disease
Evaluation Checklist Adult Risk of Associated Disease According to BMI 25.0 - 29.9 = Overweight 30.0 - 34.9 = Obese, High 35.0 - 39.9 = Obese, Very High Very High 40 or greater= Extremely Obese Children Risk of Associated Disease According to BMI BMI-for age at or above the 95th percentile of CDC Growth Charts BMI for age > 95th = Overweight BMI for age > 85th and > 95th = At Risk of Overweight http://www.cdc.gov/nccdphp/dnpa/growthcharts/00b inaries/growthchart.pdf
What Do the Numbers Mean? Risk of Associated Disease According to BMI and Waist Size Risk of death increases as BMI over 30 increases Obese adults have a 50 - 100 % increased risk of premature death If classified as overweight, losing 5- 10 % of current body weight and keeping it off can begin to alleviate symptoms associated with chronic diseases ( i.e. high blood pressure) and lower risk of developing chronic diseases Surgeon General asks Communities to Address Obesity, healthlink.mcw.edu/article
Health Implications of Overweight and Obesity Increases Risk for Developing Chronic Diseases –Diabetes –Heart Disease (CVD) –Stroke –High Blood Pressure –Gall bladder disease –Some types of Cancer –Osteoarthritis –Sleep apnea/other breathing problems High blood cholesterol Complications of pregnancy Menstrual irregularities Psychological disorders Increased surgical risk
Health Care Costs for Overweight/Obese Children? Adult diseases are showing up in children States and your taxes are paying for their healthcare? – 4 million obese children are recipients of Medicare
Economic Consequences of Overweight and Obesity Workplace – absenteeism – lost of productivity –depression –anxiety –higher healthcare premiums US Govt.,States and YOU are paying for healthcare costs –Total cost as of 1995: $99.2 billion http://www.niddk.nih.gov.health.nutrit/pub s/statobes.htm Children 6-17 y.o. 1979-81 $35 million 1997-99 $127 million 300 % increase in costs over 20 years. Wang G and Dietz WH, Pediatrics, 2002, 109 (5)
What Can I Do? Look at you own programs What does your food resemble? –Are you serving USDA fast food –Is it enough to meet USDA recommended guidelines? –Evaluate your menu Surgeon General asks Communities to Address Obesity,healthlink.mcw.edu/article
What Can I Do? Look around lunch room? Do you have vending machines a la carte sales? –Are they in direct competition with school meals program? Promotions & Fund raisers with food? What are your school communities eating habits? Surgeon General asks Communities to Address Obesity,healthlink.mcw.edu/article
What Can I Do? Survey the students, parents, teachers Invite parents to come eat with kids Team-up with teachers to encourage healthy eating and PA Start exercise program at school Change perception of obesity to focus on improved long-term health Surgeon General asks Communities to Address Obesity,healthlink.mcw.edu/article
References and Resources SHPPS, 2000. Department of Health and Human Services, Center for Disease Control and Prevention. http://www.cdc.gov/shpps. Flegal K; Carroll MD; Ogden CL; et al. Prevalence and Trends in Obesity Among US Adults, 1999-2000. JAMA 2002;288:1723-1727 The Surgeon Generals Call to Action to Prevent and Decrease Overweight and Obesity http://www.doe.mass.edu/cnp http://www.fns.usda.gov/cnd/Default.htm http://www.fns.usda.gov/cnd/PowerPanther/power. panther.htm
Fighting Obesity with our Forks and our Feet… Bite by Bite and Step by Step Erin Coffield, RD, LDN
Actual Causes of Death in the United States, 1990 Source: McGinnis JM, Foege WH. JAMA 1993;270:2207-12. 400,000 300,000 100,000 90,000 30,000 20,000 0 100,000 200,000 300,000 400,000 500,000 TobaccoDiet/ActivityAlcoholMicrobial agents Sexual behavior Illicit use of drugs
Percent of children, aged 5-10, with 1 or more adverse CVD risk factor levels:27.1% Adverse CVD Risk Factor Levels in Children Source: Freedman DS et al. Pediatrics 1999; 103:1175-82 Percent of overweight children, aged 5-10, with 1 or more adverse CVD risk factor levels: 60.6%
Challenges in the Diets of U.S. Children High intakes –energy –total fat –saturated fat –added sugars Low intakes –calcium –fiber –fruits –vegetables –dairy –whole grains Munoz et al. Pediatrics 1997;100:323-329.
Percent of Children Meeting Recommended Intakes Actual: All children 2-19 31.6 Percent Recommended: 6-11 Servings Source: USDA CSFII, 1989-91, From Munoz et al, Pediatrics 100:323, 1997.
Recommended: 3-5 Servings Actual: All Children 2-19 36.4 Percent Percent of Children Meeting Recommended Intakes Source: USDA CSFII, 1989-91, From Munoz et al, Pediatrics 100:323, 1997.
Actual: All Children 2-19 26.0 Percent Recommended: 2-4 Servings Percent of Children Meeting Recommended Intakes Source: USDA CSFII, 1989-91, From Munoz et al, Pediatrics 100:323, 1997.
Consumption Present –31% of adults (BRFSS 2000) –13% of high school students (2001 YRBSS) consume 5 or more servings of fruits and vegetables a day Future –National goals By 2010, 75% meet recommendations –MA 5 A Day Coalition Vision All residents meet recommendations 5 A Day in Massachusetts
Recommended: 2-3 Servings Actual: All Children 2-19 33.2 Percent Percent of Children Meeting Recommended Intakes Source: USDA CSFII, 1989-91, From Munoz et al, Pediatrics 100:323, 1997.
Mean calcium (mg) intakes of U.S. children USDA CSFII 1994-96, 1998 1997 DRI
Childrens milk consumption and calcium intake Only children who consume milk at the noon-time meal meet their calcium requirements Johnson et al. Child Nutr and Mngt,1998;2:95-100
Childrens beverage consumption patterns Grams US Department of Agriculture
Recommended: 5-7 Ounces Actual: All Children 2-19 28.0 Percent Percent of Children Meeting Recommended Intakes Source: USDA CSFII, 1989-91, From Munoz et al, Pediatrics 100:323, 1997.
On Average, Adolescents Aged 12-17 Get: *Soft drinks = carbonated beverages, fruit-flavored and part juice drinks, and sports drinks Source: USDA, Continuing Survey of Food Intake by Individuals, 1994-96 15 teaspoons of sugar per day 11% of their calories from soft drinks*
Child health consequences of soft drink consumption Consumption of sugar-sweetened beverages is associated with childhood obesity* For every additional serving of sugar- sweetened drink consumed, the odds of becoming obese increased by 60 percent * sugar-sweetened beverages defined as soda, Hawaiian punch, lemonade, Kool-Aid or other sweetened fruit drink, iced tea (not artificially sweetened) Ludwig et al. The Lancet 2001;357 :505-508
Nutritional consequences of soft drink consumption Soft drink intake is associated with: –higher energy intakes –lower intakes of vit C, folate, protein, riboflavin, vitamin A, calcium and phosphorus Harnack et al. JADA 1999;99:436-441
Mean intake of added sugars by U.S. children Guthrie and Morton JADA 2000;100:43-48.
Sources of added sugars in the U.S. diet Guthrie and Morton, JADA 2000;100:43-48.
How to Eat a Healthy Diet USDA Food Guide Pyramid
The Pyramid -- Unstacked The Pyramid -- Unstacked
Food Groups & Key Nutrients Unlock the Pyramid Grain iron, fiber Vegetables vit. A, vit. C, fiber Fruitvit. A, vit. C, fiber Meatprotein, iron Dairyprotein, calcium Fats, Sweets and others
USDA Nutrients P rotein I ron C vitamin C alcium A vitamin Fat (<30% total fat) –Saturated fat (<10% saturated fat)
It Adds Up Consumed twice a week for 36 weeks in addition to the 1/3 RDA for calories provided by NSLP ½ cup of oven french fries 1 cup of oven french fries 1½ cup of oven french fries Potential increase in body weight in one school year 2.3 lbs. 4.5 lbs. 7 lbs.
Do You Know Your Portions? Who wants to volunteer???
(Energy In) - (Energy Out) = loss, balance or gain * Balance exercise with portions
Popular Diets Who do I believe? NO FAT NO CARBS HIGH PROTEIN NO SUGAR LOW FAT HIGH FAT CABBAGE SOUP DIET
Seriousness of the Issue Adverse health consequences How quickly is weight lost Will the weight stay off Motivation and barriers to losing/maintaining weight USDA Nutrition Committee is researching the effectiveness of popular diets: The AHA has declared war on fad diets
Red Flags Recommendations that promise a quick fix. Dire warnings of danger from a single product or regimen. Claims that sound too good to be true. Simplistic conclusions drawn from a complex study. Recommendations based on a single study. *Source: Food and Nutrition Science Alliance (FANSA) comprised of the American Dietetic Association, American Institute of Nutrition, American Society for Clinical Nutrition, and the Institute of Food Technologies.
Red Flags (cont.) Dramatic statements that are refuted by reputable scientific organizations. Lists of good and bad foods. Recommendations made to help sell a product. Recommendations based on studies published without peer review. Recommendations from studies that ignore differences among individuals or groups. *Source: Food and Nutrition Science Alliance (FANSA) comprised of the American Dietetic Association, American Institute of Nutrition, American Society for Clinical Nutrition, and the Institute of Food Technologies.
Physical Activity Late 20th century urban life is a paradise of energy conservation at the level of the individual. People never need to run, they rarely need to walk, and they can often sit. Int J Obes 1996; 20:S1-S8 C 2002 Health Management Resources Corporation, Boston, MA
Percentage of Children Involved in Daily Physical Education Programs C 2002 Health Management Resources Corporation, Boston, MA