1. ADOLESCENT OBESITY: SIGNIFICANT OF IMPROVING SCHOOL NUTRITION STANDARD FOR OUR CHILDREN BY OMOLARA OBATOLA MPH STUDENT WALDEN UNIVERISTY PUBH 6165-5 INSTRUCTOR: Dr. PATRICK TSCHIDA SUMMER QUARTER, 2011

2. LEARNING OBJECTIVES  BY the end this presentation, the reader will be able to  To understand define obesity  Understand the significant of adolescent obesity  What are the impact of obesity in adolescent  What are the preventive methods  How can the school food nutrition program can eliminate adolescent obesity  How the parent, and the school community can eliminate the barriers to healthy good nutrition.

3. WHAT IS OBESITY  Obesity is an abnormal accumulation of body fat. In clinical terms, it is defined as an ingestion of more calories than what the body can use over a period of time that become accumulated and result in body fat.  Wieland et al support this definition of obesity saying “obesity is generally defined as the abnormal or excessive accumulation of fat in the adipose tissue to the extent that health may be impaired” (Wieland et al, 2004).

4. WHAT IS OBESITY CONT’D  The authors also made a point in which I support; they said that it is not easy to determine when the level of adipose tissue become too risky for health (Wieland et al, 2004).  Whenever obesity is mentioned, overweight and body index mass is always mentioned as well. Although obesity and overweight are closely related in terms of what they means, but they are define differently, while obesity is an accumulation of body fat, “overweight is generally defined as weight that exceeds the threshold of a criterion standard or reference value” (Kuczmarski et al, 2000).

5. WHAT IS OBESITY CONT’D  That is a food for thought for all health care providers and public health profession as a whole. Obesity is a society problem, therefore it is our problem too as public health professionals.  We need to implement tools that will be easy to use so that we can all work together to eradicate this obesity issue

6. PREVALENCE OF ADOLESCENT OBESITY  Although obesity and overweight is a concern for the whole population but it is more rampant among the adolescent Eating this everyday equals This

7. PREVALENCE OF ADOLESCENT OBESITY CONT’D  The prevalence of adolescent is very high in our population today, and if not treated properly it will extend to adulthood which might lead to many disease and possibly death.  Tsiros et al, mentioned that “adolescence is a vulnerable period for the development of obesity, and adolescent weight tracks strongly into adulthood” (Tsiros et al, 2008).  The sole purpose of public health is to prevent diseases and to educate the public to live healthy, and because of the high prevalence, it is public health concern.  The prevalence of adolescence obesity is high to the extent that, it was the main focus for the first lady of United State of America Mrs. Michelle Obama to embark on first by creating a program to reduce or possibly eradicate the prevalence of adolescent obesity.

8. FACTORS THAT IMPACT ADOLESCENT OBESITY  Factors that impact adolescent obesity include behavioral, Psychological, and environmental factors.  Adolescent obesity if not well treated when young and it extend to adulthood, it can lead to “petentially life-threatening complications including diabetes, hypertension, hyperlipidemia, asthma, and arthritis (Mokdad et al, 2003), and substantial reductions in life (Fontaine et al, 2003).  The objective of public health is to implement program that will educate the public to live an healthy life, therefore educating adolescent about obesity is part of the program as well.

9. BEHAVIORAL IMPACT  When most young people understand that they are obese, they start to manifest certain behaviors like spending more hours watching television, they will become conscious of their weight especially among friends by being very uncomfortable, and their self-esteem will begin to decrease.  Sedentary behaviors because they are encouraged around the world by modern lifestyles; as a result, many adolescent are surrounded with overeating, especially eating unhealthy and fatty foods.  They are not encourage to eat healthy foods because they find it difficult to cook, and probably have learn such behavior from their parent.  Most parents that are tired after working long hours, therefore they will rather buy fast food home to their children, and this become an habit that lead to obesity in themselves and their children.

10. PSYCHOLOGICAL IMPACT  Adolescent who are affected with obesity manifest depression, sadness, anger, and overeating.  Depression is a very typical sign that usually first manifest when an adolescent realize that he or she is obese. Some of the obese adolescent manifest this sign because that is the only way they think they can show how unhappy they are with their state of health rather than expressing sadness.  They become dissatisfy with their body and just continue the habit of overeating and sometimes binge eating.

11. ENVIRONMENTAL IMPACT  Environmental manifestation of adolescent obesity includes occupation, family status, living status, and association.  The environment that one grow up in usually determine one’s way of life. For instance a child that grow up in family that don’t cook healthy food, and depend on take out order from fast food restaurant, have a high percentage of growing to live like that unless he or she learn to change the habit to an healthy one.  The school food environment also is known to impact adolescent obesity also because it is the believe that “schools had been unfairly targeted as the cause of adolescent obesity” (Nollen et. al., 2007).

12. SCHOOL NUTRITION STANDARD AS AN ENVIRONMENTAL IMPACT  According to CDC, “given the number of hours children spend at school, the school environment can have a significant influence on children's diets” (CDC, 2009).  It has also been proven through studies that “greater access to less nutritious foods and beverages at school is associated with an increased intake of total calories, soft drinks, total fat, and saturated fat; an increased body mass index; and a decreased intake of fruits, vegetables, milk, and key vitamins and minerals” (CDC, 2009).  Findings of CDC's 2008 School Health Profiles Survey (Profiles), shows that fewer secondary schools in the United States sold less nutritious foods and beverages in vending machines, school stores, canteens, and snack bars in 2008 than in 2006 (CDC, 2009).

13. SCHOOL NUTRITION STANDARD AS AN ENVIRONMENTAL IMPACT CONT’D  Many schools lack nutritional standard because “foods and beverages offered or sold in schools outside of U.S. Department of Agriculture school meal programs are not subject to federal nutrition standards (1) and generally are of lower nutritional quality than foods and beverages served in the meal programs” (CDC, 2009).

14. PREVENTIVE METHODS  There are many ways to prevent adolescent obesity which include surgical procedure, pharmacotherapy, dietary intervention, and increasing physical activity and reducing sedentary behaviors, combined lifestyle approaches and psychological intervention to achieve behavior change.  The most important preventive method I will focus on is how to improve school nutrition and how it can be implemented.  To improve this, there has to be cooperation between parent and school community in other to get positive result

15. HOW TO IMPROVE SCHOOL NUTRITION STANDARD  Although there has been program and education to improve nutritional program in school, but it needs to be increased, and well implemented too.  Center for Disease Control and Prevention mentioned that “a key policy solution includes establishing strong nutrition standards for competitive foods and beverages that restrict availability of low - nutrient, energy-dense foods” (CDC, 2009).  They went further to advice that “if competitive foods are available during the school day, they should consist primarily of fruits, vegetables, whole grains, and nonfat and low-fat milk products, as recommended by the Institute of Medicine” (CDC, 2009).

16. HOW TO IMPROVE SCHOOL NUTRITION STANDARD CONT’D  The report from the United State General Accounting office (GAO), states that “students may need more exposure to nutrition education to effect positive changes in their behavior, and most students have to foods of little nutritional value, such as soft drinks and candy, at school” (GAO, 2003).  I agree with this statement because with education, the student can learn the purpose of eating is to quench hunger, and it is very important to eat healthy food to help them grow healthy rather than obese.

17. LIMITATIONS IN IMPROVING SCHOOL NUTIRON STANDARD  Despite every effort to improve school nutrition standard to encourage healthy eating habit, there are barriers to the program which can affect the program from being implemented properly in schools.  Some of the barrier are limited time to teach student nutrition class because the school curriculum does not permit more classes to be added, and more time are spent on meeting the academicals standard.  GAO also noted that “officials noted that overcoming barriers required strong and persevering leadership” (GAO, 2003).  I believe to strongly implement this program effectively, the cooperative effort of the parent and the school community is needed.

18. LIMITATIONS IN IMPROVING SCHOOL NUTIRON STANDARD CONT’D  Many teachers from different schools said that when healthier foods with lower fat content is introduce by the school food authorities, there is risk that students will not like the changes in the menu, and it result in student purchasing less from school food.  Most of the “school food authorities operate their programs on a break- even financial basis, and student meal payments make up a large part of their revenue, a decrease in meals purchased can throw their budget out of balance” (GAO, 2003).  Another barrier is the fact that many school principals and organizations depend on the money receive from vending machines and sales of other food, and beverages that may be of limited nutritional value because the funds are often used to pay for special activities or items not covered in the school’s budget (GAO, 2003).  In addition, “school food authority officials told us that to help manage their budgets, they have chosen to sell less healthful items in the cafeteria, in competition with the USDA reimbursable meals” (GAO, 2003).

19. REFERNCES  Center for Disease control and Prevention (CDC). (2009) Promoting Healthier Foods and Beverages In U.S. Schools. Retrieved June 22, 2011, from http://www.cdc.gov/Features/SchoolNutrition/.  Center for Disease control and Prevention (CDC). (2009). Availability of Less Nutritious Snack Foods and Beverages in Secondary Schools ---Selected States, 2002-- 2008. Retrieved June 22, 2001, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58e1005a1.htm?s_cid=mm58e 1005a1_e.  Fontaine K.R, Redden D.T, Wang C., Westfall A.O, and Allison D.B (2003). Years of life lost due to obesity. Journal of American Medical Association, vol 289 No. 2 pg 187- 193.  Kuczmarski, Robert J and Flegal, Katherine M (2000). Criteria for definition of overweight in transition: background and recommendations for the United States. American Journal of Clinical Nutrition, Vol. 72, No. 5, 1074-1081.  Mokdad A.H, Ford E.S, Bowman B.A et al. (2003). Prevalence of obesity, and obesity- related health risk factors, 2001. Journal of American Medical Association, vol 289 No.1 pg 76-79.

20. REFERENCES CONT’D  Nollen N.L, Befort C.A, Snow P., Daley C.M, Ellerbeck E.F, and Ahluwalia J.S,(2007). The school food environment and adolescent obesity: qualitative insights from high school pricinpals and food service personnel. International Journal of Behavior, Nutrition and Physical Act, 4-18.  Tsiros, Margarita D., Sinn, Natalie, Coates, Alison M., Howe Peter R.C., and Buckley, Jonathan D. (2008). Treatment of adolescent overweight and obesity. European Journal of Pediatrics, 167: 9-16.  United States General Accounting Office (GAO). (2003, ). School Lunch: Efforts Needed to Improve Nutrition and Encourage Healthy Eating. Retrieved June 22, 2001, from http://www.gao.gov/new.items/d03506.pdf.  Wieland Kiess, Marcus Claude, and Wabitsch, Martin (2004). Obesity in Childhood and Adolescence. Karger Publishers Vol 9 pg 1.

21. FOR FURTHER INFORMATION ON THIS TOPIC VISIT THE FOLLOWING WEBSITE  http://www.cdc.gov/Features/SchoolNutrition/  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58e1005a1.htm? s_cid=mm58e1005a1_e  http://www.iom.edu/Reports/2007/Nutrition-Standards-for-Foods-in- Schools-Leading-the-Way-toward-Healthier-Youth.aspx  http://www.gao.gov/new.items/d03506.pdf