Stamp Out Childhood Obesity

Jodi Jakey, Renee Ivers, Sara Towers,

Sheri VanDeBurg, Zach Holmes

Obesity

Obesity Trends

US Trends

2012 Data

Vulnerable Population

US Citizens. Michigan residents

Men of higher income, women of lower income (but not

impoverished) (Ogden, Lamb, Carroll,& Flegal, 2010)

Women, not college educated (Ogden, Lamb, Carroll,&

Flegal, 2010)

Black, Mexican, Hispanic,& Native American decent (CDC,

2013)

Obese parents are more likely to have obese children, which

are more likely to become obese adults (American Academy of
Child & Adolescent Psychiatry, 2011) (CDC, 2013)

Trends in Children

Childhood obesity has more than doubled in children and tripled

in adolescents in the past 30 years.

The percentage of children aged 611 years in the United States

who were obese increased from 7% in 1980 to nearly 18% in 2010.
Similarly, the percentage of adolescents aged 1219 years who
were obese increased from 5% to 18% over the same period.

In 2010, more than one third of children and adolescents were

overweight or obese. (CDC,2013)

Income and Behavior

Childhood obesity rises as income lowers

(Eagle, et al, 2012)

Decreased community resources results in decreased

physical activity and increased screen time (T.V., internet,
etc.)

Cultural Influences
Highest increases in childhood obesity occurred in Hispanic
and Mexican-American boys & girls

Cultural eating practices

Cultural distrust of the medical profession

Fatalism

Persons of certain cultures fail to recognize their children

are overweight
(Fitzgibbon & Beech, 2009)

Health-risk factors in Obese Adolescents

Increase cardiovascular disease

Increase blood pressure

Pre-diabetes and Type 2 diabetes

Bone and joint problems

Sleep apnea

Increase risk for some types of cancer

Sugary drinks lead to tooth decay

Gout

Social and emotional trouble

Peer

stigmatization

Discrimination
Bullying

www.Michigan.gov, http://www.healthykidshealthymich.com, Ludwig, D.S,

Peterson K.E., Gortmaker, S.L. (February 2001). Relation between consumption
of sugar-sweetened drinks and childhood obesity: a prospective, observational
analysis. Lancet. (9255:505-8)

Statistics related to population and

health risk factors

18.2% of Michigan youth ages 10-17 years old are

overweight and 12.4% are considered obese compared to
the U.S. percentage of 15.3 overweight and 16.4 obese.
(National Survey of Childrens Health,2007)

Between 1979 & 1999, obesity associated hospital costs

for children tripled from 35 million to 127 million.

(www.healthykidshealthymich.com)

80% of youth did not consume adequate (5 or more) servings of

fruits and vegetables per day

28% of youth drank at least one pop or soda a day.

Males (32%) drank soda more often than females (23%)

Youth participation in physical education classes on a daily basis

was very limited (31%)

Only 47% of youth were physically active for at least 60 minutes

per day on five or more of the past seven days.

On an average school day, approximately 30% of youth spent 3

or more hours watching television, while 23% of youth uses
computer or video games 3 or more hours.

Black youth had the highest prevalence of excessive television

viewing (48%) and computer or video game use (28%)

(www.michigan.gov/.../Overweight_and_Obesity_in_Michigan_Surveilla.)

Statistics related to population and

health risk factors continued

In 2009, male youth (15.7%) had a significantly higher obesity

rate than females (8.0%)

Only 34% of youth in Kent County report eating healthy

balanced meals.

45% of youth report being physically inactive (less than 60

minutes of exercise during the last 7 days.)

Television is an obesity machine= Kids watch an average of 20

hours of TV per week, over 1000 hours per year- TV is believed
to be one of the most sedentary activities that exists. Kids
average approximately 6 hours of screen time per day.

(www.kentcountyhealthconnect.org/TheFacts.aspx)

Environmental Risk factors

Increase consumption of foods away from home

Larger portion sizes

Increase TV viewing

Decrease walking and biking to/from school

Increase consumption of soft drinks or sugar-sweet drinks

Lack of physical education in schools

Thoms, S Childhood Obesity: Fitkids 360 aims to reverse the tide in Kent County.
Retrieved from www.mlive.com/living/grandrapids/index.ssf/2012/12/childhood_obesity_fitkids_360.html

Community Risk Factors

Lack of healthy food resources

Dependence on corner stores that do not always carry

healthy food options or do at cost prohibitive prices

Food and drink choices made based on convenience,

affordability, prevalence of fast food chains.

Kent County Health Needs Assessment. (2011). Michigan Public Health Institute.
Retrieved November 16, 2013 from
www.spectrumhealth.org/documents/kent_county_CHNA _report_no_cover.pdf,
Supplemental Nutrition Assistance Program Eligible Food Items. Retrieved
November 18, 2013 from http://www.fns.usda.gov/snap/eligible-food-items

Why do kids consume sugary drinks?

$3.2 billion spent in advertising carbonated beverages in

2006

Lack of education regarding risks

Drink juice instead of eating fruit

Caffeine buzz

Convenience

Nola Penders Health Promotion Model

(Pender, Murdaugh, Parsons, 2011)

Characteristics= each person is unique with defining characteristics,

behaviors and experiences that impact their actions. These
characteristics and experiences include prior behaviors.

Prior behavior and habit formation impact the likelihood and success
maintaining health promoting behaviors.

Health promotion model highlights that-

If short term benefits are experienced early in the course of the behavior,
the behavior is more likely to be repeated. (p. 46)
An individuals expectations to engage in a particular behavior hinge on
the anticipated benefits.(p. 46)

Nola Penders Health Promotion Model

(Pender, Murdaugh, Parsons, 2011)

Perceived Barriers-

Barriers consist of perceptions about the unavailability,

inconvenience, expense, difficulty or time-consuming
nature of a particular action. (p. 47)
Loss of satisfaction from giving up health damaging
behaviors such as smoking or eating high fat foods to adopt
healthier lifestyles may also constitute a barrier. (p. 47)

Nola Penders Health Promotion Model

Perceived self-efficacy= the belief that one has the personal

capability of carrying out a particular action.

Activity-Related effect=the feeling that impacts the person-is it

negative or positive- and how this feeling impacts the persons
likelihood to continue the healthier behavior.

Interpersonal - Influences= the influence of family, peers, and people

on the health promoting behavior.

Situational Influences

Situational influences on health promoting behaviors include perceptions of options

available, demanding characteristics, and aesthetic features of the environment in
which a given behavior is proposed to take place. (p. 48-49)

Commitment to a Plan of Action- Initiates a behavioral event.

Commitment alone without associated strategies often results in good intentions

but failure to perform the health behavior. (p.49)

Effects of Soft Drink Consumption on

Nutrition and Health

Soft drink consumption is believed to be a major contributor to obesity and

health related problems (para3)

Soft drinks are banned from schools in Britain, France, and portions of the
United States. (para3)

People who consume soft drinks do not decrease intake in other areas of eating,
thus increase overall caloric consumption. (Para 22)

The increased carbohydrate intake associated with soft drink consumption

primarily reflects greater consumption of added sugar. (Para 31)

The fact that soft drinks offer energy with little accompanying nutrition,
displace other nutritional resources, and are linked to several key health
conditions such as diabetes is further impetus to recommend a reduction in soft
drink consumption. (Para 50)

Vartanian, L. R., Scwartz, M. B., & Brownell, K. D. (2007, April). Effects of soft drink consumption on nutrition
and health: A systematic review and meta-analysis. American Journal of Public Health, 97(4), 75-667.
doi:10.2105/ajph.2005.083782

Plan of Action to address health issue

Strategies for Reducing Sugar-Sweetened
Beverage Consumption

Modifiable behavior

Easily accessible

Diabetes Prevention Program

Limit access to sugar-sweetened beverages

Potential Action Steps

Price adjustments

Greater proportion

Assemble a meeting

Collaborate with state and school district officials

Redefine or eliminate beverage pouring contracts in

schools.

Promote access to and consumption of more

healthy alternatives to sugar-sweetened
beverages

Meeting daily nutrient needs

Reducing sugar-sweetened beverages consumption

Beverage consumption patterns of parents

Provide education

Support

Evaluation of the plan of action

No single solution to this problem exists

The highest consumers of sugar-sweetened beverages are

adolescents aged 12 to 19 years

Bottled water sales have increased

2004-2008 changes

School Beverage Guidelines

Elementary Schools

Bottled water
Up to 8 ounce servings of milk and 100% juice
Fat-free or low-fat regular and flavored milk and nutritionally equivalent (per USDA) milk alternatives with up to 150 calories/ 8
ounces
100% juice with no added sweeteners, up to 120 calories / 8 ounces, and with at least 10% of the recommended daily value for three
or more vitamins and minerals

Middle School

Same as elementary school, except juice and milk may be sold in 10 ounce servings
As a practical matter, if middle school and high school students have shared access to areas on a common campus or in common
buildings, then the school community has the option to adopt the high school standard

High School

Bottled water
No- or low-calorie beverages with up to 10 calories / 8 ounces
Up to 12 ounce servings of milk, 100% juice and certain other drinks
Fat-free or low-fat regular and flavored milk and nutritionally equivalent (per USDA) milk alternatives with up to 150 calories / 8
ounces*
100% juice with no added sweeteners, up to 120 calories / 8 ounces, and with at least 10% of the recommended daily value for three
or more vitamins and minerals
Other drinks with no more than 66 calories / 8 ounces
At least 50% of non-milk beverages must be water and no- or low-calorie options

Nutrition and Weight Status

Goal
Promote health and reduce chronic disease risk through the consumption of
healthful diets and achievement and maintenance of healthy body weights.
Overview
The Nutrition and Weight Status objectives for Healthy People 2020 reflect
strong science supporting the health benefits of eating a healthful diet and
maintaining a healthy body weight. The objectives also emphasize that
efforts to change diet and weight should address individual behaviors, as well
as the policies and environments that support these behaviors in settings
such as schools, worksites, health care organizations, and communities.
The goal of promoting healthful diets and healthy weight encompasses
increasing household food security and eliminating hunger.

Americans with a healthful diet:

Consume a variety of nutrient-dense foods within and across
the food groups, especially whole grains, fruits, vegetables,
low-fat or fat-free milk or milk products, and lean meats and
other protein sources.
Limit the intake of saturated and trans fats, cholesterol,
added sugars, sodium (salt), and alcohol.
Limit caloric intake to meet caloric needs.

Understanding Nutrition and Weight Status

Diet
Diet reflects the variety of foods and beverages
consumed over time and in settings such as
worksites, schools, restaurants, and the home.
Interventions to support a healthier diet can help
ensure that:
Individuals have the knowledge and skills to
make healthier choices.
Healthier options are available and
affordable.

Increase the proportion of schools that offer

nutritious foods and beverages outside of school
meals
Baseline:

9.3percentof schools did not sell or offer calorically sweetened beverages

to students in 2006

Target:

21.3percent

Target-Setting Method:

Projection/trend analysis

Data Source:

School Health Policies and Practices Study (SHPPS), CDC/NCHHSTP

Reduce consumption of calories from solid fats and

added sugars in the population aged 2 years and
older
Baseline:

15.7percentwas the mean percentage of total daily calorie intake from

added sugars for the population aged 2 years and older in 200104 (age
adjusted to the year 2000 standard population)

Target:

10.8percent

Target-Setting Method:

Modeling

Data Source:

National Health and Nutrition Examination Survey (NHANES), CDC/NCHS

References
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D.S, Peterson K.E., Gortmaker, S.L. (February 2001). Relation

between consumption of sugar-sweetened drinks and childhood obesity:
a prospective, observational analysis. Lancet. (9255:505-8)
Michigan

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Obesity in Michigan: Surveillance Update 2011. Retrieved November 14,
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www.michigan.gov/.../Overweight_and_Obesity_in_Michigan_Surveilla..
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Nutrition Assistance Program Eligible Food Items.

Retrieved November 18, 2013 from
http://www.fns.usda.gov/snap/eligible-food-items
Thoms,

S Childhood Obesity: Fitkids 360 aims to reverse the tide

in Kent County. Retrieved from www.mlive.com/living/grandrapids/index.ssf/2012/12/childhood_obesity_fitkids_360.html

More References
Thoms,

S Childhood Obesity: Fitkids 360 aims to reverse the tide in Kent

County. Retrieved from www.mlive.com/living/grandrapids/index.ssf/2012/12/childhood_obesity_fitkids_360.html
Vartanian,

L. R., Scwartz, M. B., & Brownell, K. D. (2007, April). Effects of

soft drink consumption on nutrition and health: A systematic review and
meta-analysis. American Journal of Public Health, 97(4), 75-667.
doi:10.2105/ajph.2005.083782
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