1. Creating Environments That Promote Healthy Choices Dr. Ivan Barrow, Assistant Chief of Pediatrics Kaiser Permanente West Los Angeles Medical Center

2. Some Children are More Likely to be Overweight % Overweight Kids & Teens in 2000 NHANES 1999-2000 JAMA 2002;288:1728-1732 10.1 8.4 11.1 11.8 19.5 23.7 12.7 23.6 23.4 0 5 10 15 20 25 2-5 Yr6-11 Yr12-19 Yr White Non-HispanicBlack Non-HispanicMexican American % Overweight  Teenagers  Black, Mexican American, American Indian, Alaskan Native  Children of overweight parents

3. Childhood Obesity In Los Angeles County

4. The older the overweight child is, the more likely he/she will continue to be overweight as an adult. 8 out of 10 overweight teens will continue to be overweight as adults. Preventive Medicine 1993; Vol. 22:pp. 167-177 Arch Pediatr Adolesc Med Vol. 158 May 2004 pp. 449-452 Do Overweight Children Grow Up to be Overweight Adults? % Overweight Children who Become Obese Adults 10 35 50 80 0 10 20 30 40 50 60 70 80 90 100 Percentage Infants Preschool School Age Adolescent

5.  Type 2 diabetes  Heart disease  Hypertension  Asthma  Sleep apnea  Depression and low self-esteem Pediatrics Vol. 112 No. 2 August 2003 pp. 424-430 What Health Problems are Related to Being Overweight?

6.  Not enough physical activity  Too much screen time TV, computer, video games  Not enough milk, dairy, fruits and vegetables  Too many sweetened drinks  Too much fast food  Skipping meals Position Paper - Prevention of Childhood Overweight What Should Be Done? Center for Weight and Health - U.C. Berkeley 10/02 Behaviors Related to Children Becoming Overweight

7. Our Approach to Overweight and Obesity MEDICAL OFFICE VISIT INTERVENTIONS  BMI Screening  Physician Counseling  Patient Education Materials  Referral and Follow-Up WEIGHT MANAGEMENT INTERVENTIONS  Individual Counseling  Group Programs  Intensive Programs  Internet Resources ENVIRONMENTAL CHANGES  School Programs  Work Site Programs  Community Programs  Legislation & Partnerships

8.  BMI as a vital sign is now the KP standard of care, as well as a HEDIS requirement.  Counseling for Physical Activity, Nutrition, and Screen Time 5-2-1-0 Messaging Pediatric Medical Office Visits

9. HEAL Cities Los Angeles County Department of Public Health The Weight of the Nation documentary series and campaign A nationwide campaign launched by Kaiser Permanente, HBO, the Institute of Medicine, the Centers for Disease Control and Prevention, the National Institutes of Health, and the Michael & Susan Dell Foundation theweightofthenation.hbo.com Community Partnerships

10. Kaiser Permanente West Los Angeles Medical Center Public Affairs Department (323) 857-4496 Public-Affairs-WestLA@kp.org Contact Information