Childhood Obesity

Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% CDC, 2011

Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% CDC, 2011

Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% CDC, 2011

Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% CDC, 2011

Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% CDC, 2011

Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% CDC, 2011

Obesity Trends* Among U.S. Adults BRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% CDC,2011

Prevalence Currently, about 16% of our children (10-17 y/o) are obese and 18% are overweight. –(Levi, Segal, Laurent, & Kahn, 2011) –Our youngest kids are affected. –Which states stack up the best / worst? Overweight and obesity has increased in all ethnic groups, all ages and both genders.

Obesity & Racial / Ethnic Disparities More common in African Americans and Hispanics. Why? –Fewer grocery stores and more fast-food restaurants –Less likely to be involved in physical activities –Higher poverty rates Other disparities?

(Mirvis, 2009)

Children/Teens & BMI BMI: Body Mass Index It does not measure body fat directly For children & teens: BMI is plotted on a BMI-for-age growth chart Given a percentile rank Underweight: Less than 5 th percentile Healthy weight: 5 th to 84 th percentile Overweight: 85 th to 94 th percentile Obese: 95 th percentile and greater Cdc.gov

cdc.gov

BMI Initially calculated the same as adult BMI But interpreted differently –Amount of body fat changes with age –Amount of body fat is different for boys and girls –Healthy weight ranges change with each month of age for each sex –Healthy weight ranges change as height increases –Cdc.gov

Costs of Obesity Shorter, less healthy lives Increased economic costs Decreased productivity / earnings as an adult Disease: CVD, Type 2 Diabetes, asthma, etc Societal costs

Worldwide Obesity Which is more prevalent? –Global obesity or global starvation? –WHO has declared obesity to be one of the top ten global health problems. (Science, February 2003) –Of all nations, the United States is number one with regard to obesity (Fat Land: How Americans Became the Fattest People in the World, Greg Critser, 2003)

Causes of Childhood Obesity

Causes of obesity Bigger portions –From 1977 – 1994: Calories increased 9% in adolescent boys and 7% for adolescent girls –Portions: Salty snacks increased from 132 calories to 225 calories Soft drinks increased from 144 calories to 193 calories Hamburgers increased from 389 calories to 486 calories. »American Heart Association

Causes: Less Nutrition Fruits & Vegetables –Only 14% of children (6-19 y/o) meet the daily recommendation for 2-4 daily servings of fruit. –Only 20% get the recommended daily serving of vegetables Whole grains –Although at least two servings are recommended: Children get less than one serving per day.

Causes: Milk consumption American Heart Association

Causes: Added sugar Found in: soft drinks, fruit drinks, sports beverages, energy drinks, and processed foods. Girls’ soda consumption doubled while boys’ consumption tripled. American Heart Association

(Stender, 2009)

Causes: Eating Out Approximately 40% of budgeted food money is spent away from home. Americans’ spending on fast food: Increased from $60 billion to $110 billion in the last 30 years. Children y/o eat fast-food an average of twice a week. American Heart Association

(Stender, 2009)

Kids and Fast Food “One-quarter of children ages five to 10 years show early warning signs of heart disease.” »CSPI, 2008 Most fast-food menus – especially kids’ menus –High in saturated fat, trans fat, sodium and calories

Food & Advertising  “Children view an average of 3 ½ hours of television commercials per week, and each year they spend the equivalent of a week watching TV ads.” (CSPI, 2003)  About half of these ads are for food.  There is much debate on whether advertising should be banned for children under the age of 8.

TV Advertising for Food vs. Public Service Announcements for Fitness or Nutrition, 2005 SOURCE: Kaiser Family Foundation, Food for Thought: Television Food Advertising to Children in the United States, March Average number of food ads and PSAs on fitness or nutrition seen by children per year by age: Age2-7 Age8-12 Age ,400 per year 7,600 per year 6,000 per year 164 per year 158 per year 47 per year Food ads PSAs on fitness or nutrition

Distribution of Types of Food in TV Advertising Targeted to Children or Teens, % 10% 28% Candy and snacks Fast food Among all food ads targeted to children or teens, percent that are for: 4% 9% 7% Sugared cereal Sodas & soft drinks Dine-in restaurants Prepared foods Dairy Breads and pastries 2%Fruit juices 1% SOURCE: Kaiser Family Foundation, Food for Thought: Television Food Advertising to Children in the United States, March 2007.

Food Advertising Advertising budgets: Program / CompanyBudget (millions) NCI – 5 A Day Program$3.5 CDC – Nutrition & PE$34 USDA – Team Nutrition$10 McDonald’s$665 M&M’s$74 Coca-Cola & Diet Coke$209 Kellogg cereals$284 CSPI, 2003

“Golden Marble Awards” Award for “excellence” Pays tribute to the company that can market to children the most effectively. (Allianceforchildhood.net, 2009)

Direct Advertising & Beyond Advertising goes beyond commericals –Product placement –School sponsorship Contracts Fundraising Channel One Contests / Coupons / Incentives

Causes: Lack of Physical Exercise Schools have dropped PE classes Media has replaced activity Neighborhoods may be unsafe Benefits of exercise –In & Out of the classroom

Physical Activity & Youth CDC, 2008

Physical Activity Recommendations 1 hour (or more) of daily physical activity –Aerobic activity: 60+ minutes of moderate- to vigorous-intensity every day –Muscle-strengthening activity: at least 3 days a week as part of the 60 minutes –Bone-strengthening activity: at least 3 days a week as part of the 60 minutes –Examples of increasing daily physical activity…

Type of Physical Activity ChildrenAdolescents Moderate-intensity aerobic Hiking, bike riding, brisk walking Baseball, yard work, hiking, brisk walking Vigorous-intensity aerobic Bike riding, jumping rope, running, soccer, basketball Jumping rope, bike riding, karate, basketball, cross- country skiing Muscle- strengthening Modified push-ups, sit-ups, rope or tree climbing Exercises with hand- held weights, push-ups, pull-ups, climbing wall Bone-strengtheningJumping rope, running, hopping, skipping, gymnastics Jumping rope, running, sports like gymnastics, basketball Examples of Physical Activities for Children and Adolescents CDC, 2008

Physical Activity: Schools  “In 2007, only 30% of 9 th -12 th grade students said they attended physical education classes every day.” (CDC, 2008)  Does physical activity have any affect on academics?  What can schools do?

Physical Activity: Communities What can communities do to encourage physical activity? Community-wide campaigns Improvements Partner with schools

Junk Food in Schools “74% of middle schools and 98% of senior high schools have vending machines.” (CSPI, 2004) Who regulates this? –The USDA’s role

Foods in Schools What message are our kids getting by the types of foods they can buy in school? Financial impact of selling healthier foods in schools. –Total revenues increased

Changing Schools Child Nutrition and WIC Reauthorization Act of 2004 –Wellness policies for nutrition & PE are required.

Why schools? Schools need to be part of the solution –“Health is an academic issue” Dayle Hayes –More absences –Lower quality of life –Weight bias and stigma –Academic performance

Healthier Schools Program for success: –Updating the meal program menus –Enhancing serving and eating areas –Improving facilities –Student involvement –Challenges?

School Successes Language arts linked to nutrition in “word wall” – Michigan classroom Vending machines with healthier options –Flavored sunflower seeds, water, yogurt, fruit Shakes, smoothies, sundaes & parfaits with fat or sugar- free yogurt –Extremely successful in Wyoming Dance or yoga offered during a lunch period (Source: Dayle Hayes)

Can we fix this?  Key players: › Parents › Schools › Communities › Medical Facilities › Work sites  “Until society becomes involved, we are not going to solve the problem of childhood obesity.” Mark Sperling

What’s happening in Oregon?

Recommendations for Oregon Funding – must support physical education. Healthy Schools Food marketing Farm-to-School & School Gardens (HB2800) Food assistance Worksites

“Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.” - Dr. Seuss ww.ci.everett.ma.us%2FEverett_files%2Fmayor%2Ftemp%2Fimages%2Fbackground_gif.”