childhood obesity. obesity trends* among u.s. adults brfss, 1985 (*bmi ≥30, or ~ 30 lbs....

Childhood Obesity

Obesity Trends* Among U.S. AdultsBRFSS, 1985(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

CDC, 2011

Obesity Trends* Among U.S. AdultsBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

CDC, 2011



No Data <10% 10%–14% 15%–19%

CDC, 2011



No Data <10% 10%–14% 15%–19% ≥20%

CDC, 2011



No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

CDC, 2011



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 IndexIt does not measure body fat directly

For children & teens:BMI is plotted on a BMI-for-age growth chartGiven a percentile rank

Underweight: Less than 5th percentileHealthy weight: 5th to 84th percentileOverweight: 85th to 94th percentileObese: 95th 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.


(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 11-18 y/o eat fast-food an average of twice a week.


(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 2007.

Average number of food ads and PSAs on fitness or Average number of food ads and PSAs on fitness or nutrition seen by children per year by agenutrition seen by children per year by age::

AgeAge2-72-7

AgeAge8-128-12

AgeAge13-1713-17

4,400 per year4,400 per year

7,600 per 7,600 per yearyear

6,000 per year6,000 per year

164 per year164 per year



Food adsFood ads

PSAs on PSAs on fitness or fitness or nutritionnutrition

Distribution of Types of Food in TV Advertising Targeted to Children or Teens, 2005

34%

10%

28%

Candy and snacks

Fast food

Among all food ads targeted to children or teens, percent that are for:

4%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 / Company Budget (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)

• http://www.youtube.com/watch?v=JCT7h-jwCWA&NR=1

http://www.youtube.com/watch?v=JCT7h-jwCWA&NR=1

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

Children Adolescents

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-strengthening Jumping 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 9th-12th 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?

http://oregon.gov/DHS/ph/copi/docs/sb931obesitytaskforce2009final.pdf

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

• http://www.bing.com/images/search?q=Dr.+Seuss&FORM=BIFD#focal=63163831efb7ade168441645aa125464&furl=http%3A%2F%2Fwww.ci.everett.ma.us%2FEverett_files%2Fmayor%2Ftemp%2Fimages%2Fbackground_gif.”

childhood obesity. obesity trends* among u.s. adults brfss, 1985 (*bmi ≥30, or ~ 30 lbs....

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