1. The Family Perspective “Being on the front lines” Lisa Hark, PhD, RD Director, Nutrition Education and Prevention Program University of Pennsylvania School of Medicine www.lisahark.com

2. Objectives/Questions Why are more kids overweight now? What is the role of the family? What common themes did I encounter? What lessons did I learn? What are my hopes for the future?

3. Media Attention Let’s use it!

4. OK, SO THERE IS A PROBLEM! But why is this happening?

5. Factors Contributing To Weight Gain Unhealthy Lifestyle Calories TV, Video and Computer Game Time Sweetened Drinks/Snacks Portion Sizes Exercise, Gym, Recess Fruits and Vegetables Fast Food Snack Food Low-fat milk Source: Lisa Hark, PhD, RD

6. Calorie Balance Too High Weight Gain Results GrowingDevelopingMetabolizingExercising Food Intake Source: Lisa Hark, PhD, RD

7. Media in the Bedroom Percent of 8-18 year-olds with each medium in their bedroom: Television Internet access VCR/DVD player Video game console 68% 20% 49% Cable/satellite TV Computer 37% 31% 20% 54% Premium cable channels Source: Kaiser Family Foundation, Generation M: Media in the Lives of 8-18 Year-Olds, March 2005: kff.org

8. What is the role (and responsibility) of the family?

9. Front Line Themes Huge consumption of sweets, drinks, snacks. Kids eating what ever they wanted day and night. Many diets low in vitamins and minerals. Rotten teeth, poor sleep, lack of energy, HTN, pre-diabetes, excess weight, mood swings. Highly sedentary lifestyles  TV and video games in most bedrooms  Kids vegging out for hours and hours

10. TV Rules: Parent’s Role Percent of all 8-18 year-olds who say they have: TV rules that are enforced “most” of time 26% 53% 20% TV rules that are enforced some, a little or never some, a little or never No rules about TV Source: Kaiser Family Foundation, Generation M: Media in the Lives of 8-18 Year-Olds, March 2005: kff.org

11. Household Media Environment Percent of 8-18 year-olds living in homes where: TV is “usually” on during meals 63% 36% TV not usually left on during meals Source: Kaiser Family Foundation, Generation M: Media in the Lives of 8-18 Year-Olds, March 2005: kff.org

12. Lessons Learned Under reporting of TV and videogame use Children are running the household Parents want to take control but can’t Healthy lifestyle is a low priority when busy

13. So what can we do?

14. A Public Health Framework to Prevent and Control Overweight and Obesity Energy Intake Energy Expenditure Energy Balance Prevention of Overweight and Obesity Among Children, Adolescents, and Adults Note: Adapted from “Preventing Childhood Obesity.” Institute of Medicine, 2005. Individual Factors Behavioral Settings Social Norms and Values  Home and Family  School  Community  Work Site  Healthcare  Genetics  Psychosocial  Other Personal Factors  Food and Beverage Industry  Agriculture  Education  Media  Government  Public Health Systems  Healthcare Industry  Business and Workers  Land Use and Transportation  Leisure and Recreation  Community- and Faith-based Organizations  Foundations and Other Funders Food and Beverage Intake Physical Activity Sectors of Influence

15. Community Public Policy Organizations Family Individual Addressing the Problem

16. Creative packaging on healthy foods

17. Character licensing primarily on healthy foods

18. My Hope for the Future Parents prioritize & discipline better-starting early. Food industry creates more healthy foods for kids. Advertising unhealthy foods to kids is prohibited. Recess everyday and gym at least 1 x per week is mandated in ALL U.S. schools. TV shows increase coverage of healthy lifestyles.