Amber France

Concordia University

Childhood Obesity: A Growing Problem in the Childhood Obesity: A Growing Problem in the United StatesUnited States

IntroductionIntroduction• Rates have tripled over the past 30 years (Ogden & Carroll, 2010)

• Due to an increase in high calorie, high sugar, high fat foods and sedentary lifestyle

• Complex issue with multiple influential factors: (Karnik & Kanekar, 2012)

• Genetics

• Behavioral

• Environmental

BiostatisticsBiostatistics

• Obesity rate research examines:

• BMI

• Location and socioeconomic status to determine prevalence

• Physical activity

• Nutrition

• Collection of data through surveys:

• National Survey for Children’s Health (NSCH)

• National Health and Nutrition Examination Survey (NHANES)

• NHANES Youth Fitness Survey

(CDC, 2013)

EpidemiologyEpidemiology

Obesity Rates Based on Age Obesity Rates Based on Race & Gender

(Ogden & Carroll, 2010)

Socioeconomic StatusSocioeconomic Status• Rates increase with (CDC, 2011)

• Decrease in household education

• Family below 400% poverty

• Children >2 hours screen time per day

• Less than a bachelor’s degree

• Less likely to breastfeed through at least 3 months• Study in New York public elementary school

(Thorpe, List, Marx, May, Helgerson, & Frieden, 2004)

• 43% had BMI >85th percentile

• 1 in 4 children obese

• 31% Hispanic children

• 23% black children

• 16% white children

• 14% Asian children

Examining BMI ChartsExamining BMI Charts• Study to identify predictors of severe obesity

• Data obtained through interviews with children, parents, childcare, early-education providers, and teachers

• Questions pertaining to child’s nutrition, physical activity, health care, & experiences

• Looked at parental characteristics (maternal weight, behaviors, and MD counseling)

• Results:

• Crossing 85th percentile prior to kindergarten increased risk

• At 9 months: double risk

• 2-4 years: 8x more likely to be obese by kindergarten

• Major contributors:

• Formula feeding

• Early introduction to solids

• Lack of health care

• Poor nutritional behaviors

(Flores & Lin, 2013)

Maternal InfluencesMaternal Influences

• Maternal obesity triples odds of childhood obesity

• Younger maternal age increases risk

• Smoking

• Profession or level of education

• Not breastfeeding exclusively for the first 6 months of life (Reilly et al, 2005)

(Flores & Lin, 2013)

BiomedicalBiomedical• Obesity:

• Chronic energy imbalance resulting in fat accumulation

• Associated with chronic disease such as diabetes, hypertension, heart disease, and cancer

• Influences on obesity

• Genetics

• Environment

(CDC, 2011)

GeneticsGenetics• Not solely to blame

• Variants in genes cause decrease sensitivity to satiety

• Multiple genes play a factor & operate under multiple mechanisms such as (Farooqi & O’Rahilly, 2007)

• Energy intake

• Dividing nutrients between fat & lean muscle

• Thrifty Genotype

• Gene that helps survive during famines now coupled with todays environment & behaviors being challenged

(CDC, 2012)

Environmental InfluencesEnvironmental Influences• Abundant availability of low cost energy dense foods

• Sedentary lifestyle

• Increase in automobiles

• Lack of safe sidewalks

• Building structures & designs

• “Obesogenic Environment” (Bouchard, 2007)

• Large portion sizes

• High fat, sugar, and caloric diets

• TV, video games, computer use

(Farooqi & O’Rahilly, 2007)

Social and Environmental FactorsSocial and Environmental Factors• Obesity is a public health crisis

• Poor diet & physical activity 2nd leading cause of death in US

• Factors:

• Behavioral

• Environmental

• Social

• Parental

• School-based

• Community

(Karnik & Kanekar, 2012)

Behavioral FactorsBehavioral Factors• Contributors:

• High fat, sugar, and caloric diets provided to children

• Sedentary lifestyle

• Leads to:

• Consuming more calories

• Burning less energy

• Weight gain and obesity

(Karnik & Kanekar, 2012)

Environmental & Social FactorsEnvironmental & Social Factors• Food intake & physical activity influenced by surroundings

• Influences

• Parents are most influential to lifestyle choices

• Children spend most of their day in school

• Community offers affordable and accessible healthy options

(Karnik & Kanekar, 2012)

Parental InfluenceParental Influence• Most influential factor

• Parents responsible for child’s lifestyle

• Interventions:

• Education with parents begin during pregnancy

• Intrapersonal & interpersonal level of influence (Schneider, 2011, pg. 234)

• Child gain knowledge, attitude, & skills to eat healthy & by physically active

(Karnik & Kanekar, 2012)

School-Based InfluenceSchool-Based Influence• Children spend most of their day in school

• Interventions to influence at the institutional level:(Schneider, 2011, pg. 234)

• School lunch programs

• Decrease sugary beverages

• Increase fruit, vegetable, & water

• Physical education classes

• Mandatory classes with moderate to vigorous activities

• Health education classes

• Educate on healthy lifestyles

(Karnik & Kanekar, 2012)

Community InfluenceCommunity Influence• Supports and encourages healthy lifestyles by

• Offering healthy foods at social events

• Imparting healthy messages

• Educational programs on healthy lifestyles

• Ex: walk to school day

• Billboards, media, & entertainment aimed towards healthy lifestyles

• Safe play areas and sidewalks

• Decrease in vending machines

(Karnik & Kanekar, 2012)

Educating Behavior ChangeEducating Behavior Change• Use the health belief model

• Individual feels vulnerable to the threat

• Perceived severity of the threat

• Perceived barriers to taking action to reduce risk

• Perceived effectiveness of taking action

• Important to educate both the parents and the children

• Parents must be involved to make the biggest impact

(Schneider, 2011, pg. 231)

Conclusions and Future StudyConclusions and Future Study• Obesity is a growing problem

• Parents, schools, community, & government all play a role in the lifestyle choices a child makes

• Education is needed for all to make the biggest impact

• Children need to be surrounded with healthy choices

• Instilling lifelong healthy habits will be passed down to each generation stopping this epidemic

• Further research needed on influential exposures during pregnancy

ReferencesReferencesBouchard, C. (2007). The biological predisposition to obesity: beyond the thrifty genotype scenario. International Journal of Obesity,31, 1337-1339. Retrieved from http://www.nature.com/ijo/journal/v31/n9/full/0803610a.html

Centers for Disease Control and Prevention. (2012) Genomics and Health. Retrieved from http://www.cdc.gov/genomics/resources/diseases/obesity/index.htm

Centers for Disease Control and Prevention. (2011) Health, United States, 2011 With Special Feature on Socioeconomic Status and Health. Retrieved from http://www.cdc.gov/nchs/data/hus/hus11.pdf

Centers for Disease Control and Prevention. (2011) Obesity and Genetics. Retrieved from http://www.cdc.gov/features/obesity/

Farooqi, I.S., and O’Rahilly, S. (2007). Genetic Factors in Human Obesity. International Association for the Study of Obesity, 8(1, 37-40. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2007.00315.x/pdf

Flores, G., & Lin, H. (2013). Factors Predicting Severe Childhood Obesity in Kindergartners. International Journal of Obesity, 37. Retrieved from http://www.nature.com/ijo/journal/v37/n1/pdf/ijo2012168a.pdf

Karnik, S., & Kanekar, A. (2012) Childhood Obesity: A Global Public Health Crisis. International Journal of Preventative Medicine, 3(1)1-7. Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278864/

ReferencesReferencesNational Health and Nutrition Examination Survey. (2013). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/nchs/nhanes.htm

Ogden, C.,& Carroll, M. (2010). Prevalence of Obesity Among Children and Adolsecents: United States, Trends 1963-1965 Through 2007-2008. Center for Disease Control. Retrieved from

http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_ 07_08.htm

Reilly, J.J., Armstrong, J., Dorosty, A.R., Emmett, P.M., Ness, A., Rogers, I., … Sherriff, A. (2005). Early Life Risk Factors for Obesity in Childhood: Cohort Study. BMJ Online First, 330. Retrieved from http://www.bmj.com/content/330/7504/1357.pdf%2Bhtml

Schneider, M-J. (2011). Introduction to Public Health (3rd Edition ed.). Sudbury, MA: Jones & Bartlett Learning.

Thorpe, L.E., List, D.G., Marx, T., May, L., Helgerson, S.D., & Frieden, T.R. (2004). American Journal of Public Health, 94(9). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448480/pdf/0941496.pdf