Preventing Childhood Obesity

Kim Gorman, MS, RD Anschutz Health and Wellness Center kim.gorman@ucdenver.edu

Objectives
State the obesity statistics among youth State at least 4 of the AMA/CDC expert committee recommendations to prevent childhood obesity Increase your awareness of factors that are often times less reported but essential

Guidelines
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Sporting Event Snacks

485 calories 6 cal/oz

12 cal/oz

400 calories

14-15 cal/oz

250 calories

Good Behavior/Task Completions

Grades

Potty Training

Celebrations

Guidelines
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Childhood/Youth Obesity
NHANES 2003 -2004 / 2007-2008 Prevalence overweight and obesity at 32% (> 85th%tile for BMI) 16.9 % of youth 2-19 years are obese
Healthy People 2010 goal was < 5%

Healthy People 2020

Reduce the proportion of youth ages 2-19 years that are obese by 10%
start: 16.1% goal: 14.5%

NHANES: Prevalence of obesity among U.S. children and adolescents aged 2-19, for selected years 1971-1974 through 2007-2008
by Cynthia Ogden, Ph.D., and Margaret Carroll, M.S.P.H., Division of Health and Nutrition Examination Surveys

Age (in years) Total 2-5 6-11 12-19

19711974 5.0 5.0 4.0 6.1

19761980 5.5 5.0 6.5 5.0

19881994 10.0 7.2 11.3 10.5

19992000 13.9 10.3 15.1 14.8

20012002 15.4 10.6 16.3 16.7

20032004 17.1 13.9 18.8 17.4

20052006 15.5 11.0 15.1 17.8

20072008

16.9
10.4 19.6 18.1

NOTE: Obesity defined as body mass index (BMI) greater than or equal to sex- and agespecific 95th percentile from the 2000 CDC Growth Charts.
http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm

Prevention, Assessment and Treatment of Child/Adolescent Overweight and Obesity

AMA /CDC Expert Committee

Assessment Recommendations: BMI > 95th percentile is considered Obese

BMI > 85th but <95th percentile is considered Overweight

Energy Requirements
Gender Age (years) 2-3 4-8 9-13 14-18 Sedentary Moderate Activity 1000-1400 1400-1600 1800-2000 2000 Active

Child Female

1,000 1200 1600 1800

1000-1400 1400-1800 1800-2000 2400

Male

4-8 9-13 14-18

1400 1800 2200

1400-1800 1800-2200 2400-2800

1800-2200 2000-2800 2800-3200

Source: 2005 US Dietary Guidelines

Choose MyPlate 2011

Prevention, Assessment and Treatment of Child/Adolescent Overweight and Obesity

AMA/CDC Expert Committee (2005)

Prevention Recommendations:
Eating more fruits and vegetables Eating breakfast daily Limiting screen time to <2 hours/day for those over 2 years of age, and NO TV if under 2 years of age

http://www.fruitsandveggiesmatter.gov/health_professionals/maps_youth.html

http://www.fruitsandveggiesmatter.gov/health_professionals/maps_youth.html

http://www.fruitsandveggiesmatter.gov/health_professionals/maps_youth.html

AMA/CDC Expert Committee cont

Prevention Recommendations: Limit eating out at restaurants specifically fast food restaurants Encourage family meals meaning parents and children Limit portion sizes Limit consumption of sugar-sweetened beverages***

http://www.cdc.gov/nchs/data/databriefs/db71.htm

http://www.cdc.gov/nchs/data/databriefs/db71.htm

National School Lunch Program

National School Lunch Act 1946 by Harry TrumanTo ensure kids receive adequate nutrition NSLP includes 100,000 educational sites NSLP feeds over 31 million kids daily For complete presentation on Nutrition Standards and roll-out, visit:
http://www.fns.usda.gov/cnd/Governance/Legislation/FinalRulePresentation22012.pdf

NSLP:Standards for Schools 2012

<10% saturated fat and 0 grams trans

Calorie ranges for lunch

Elementary 550-650 kcal Middle School 600-700 kcal

High School 750-850 kcal

Protein (ounces), Vit A/Vit C/Iron-rich food offerings per weekly menu, and Calcium (skim/1%) targets Analyzed weekly menu averages

NSLP:Standards for Schools 2012

Sodium roll-out
SY 2013-2014: < 1230-1420mg SY 2017-2018: < 935-1080mg SY 2022-2023: < 640-740mg

Whole Grain Roll-out

7/1/2012: at least half of grains must be whole grain 7/1/2014: all grains must be whole grain rich

Sample Lunch Menus

Fresh Sliced Turkey Breast, Whole Wheat Bread, Cheddar Cheese, Lettuce, Tomato, Baked Chips, Whole Fresh Apple

Homemade Banana Bread, LF Cottage Cheese, Fresh Fruit Salad, Organic Baby Carrots, LF Ranch
BBQ Roasted Chicken or Tofu with Roll, Fresh Fruit & Salad Bar, LF or fat-free milk

AMA/CDC Expert Committee cont

Prevention Recommendations: Promote moderate to vigorous physical activity for AT LEAST 60 minutes each day (60 minutes can be accumulated during the day)

Preventing Childhood Obesity Health in the Balance

Food/Nutrition Board, Institute of Medicine

Major Conclusions and Findings:

Childhood obesity is a serious nationwide health problem requiring urgent attention and a population-based prevention approach

Preventing Childhood Obesity Health in the Balance

Food/Nutrition Board, Institute of Medicine

Immediate Steps for Confronting the Epidemic: 1. Parents and Families: Engage in and promote more healthful dietary intakes and active lifestyles (increased physical activity, reduced TV and other screen time and more healthy eating)

5th Gear Kids Mission

We will engage and empower 5th graders to make healthy decisions regarding food and physical activity through understanding energy balance.
This year, approximately 7200 5th graders in Cherry Creek School District and Aurora Public Schools will be taught energy balance skills in physical activity and nutrition

In science curriculum and PE class

School-to-home projects

Intervening Across Multiple Levels

Preventing Childhood Obesity Health in the Balance

Food/Nutrition Board, Institute of Medicine

Immediate Steps for Confronting the Epidemic: 2. Industry and Media: Develop healthier food and beverage product and packaging innovations Expand consumer nutrition information Provide clear and consistent media messages

Efforts
We Can! (2005)
NHLBI with NIDDKD

Play 60 (2007)
NFL campaign to get kids moving 60 minutes per day

Alliance for a Healthier Generation

Clinton Foundation and AHA

Lets Move! (Feb 2010)

Michelle Obamas campaign

Kids Eat Right (Oct 2010)

Academy of Nutrition and Dietetics

Disney Anti-Obesity Initiative (2015)

Complete ban on all junk food ads on TV, websites, radio shows that cater to children + revamp of park foods Governing question: Is this good for our kids?

Visit www.americaonthemove.org for Family Tools