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Social Perspectives on Childhood Obesity

epidemic

epidemic: Social Perspectives on Childhood Obesity

a public epidemic . . . 4societal changes . . . 6social stigma . . . �2making a change . . . �4• parents . . . �6• schools . . . �8• companies . . . 22current initiatives . . . 24

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a public epidemic

Childhood obesity is no longer a private affair. According to a recent International Journal of Pediatric Obesity report, nearly half of children in North America will be overweight by 2010 . The size of this problem alone has sprung an initially touchy subject into the thoughts of many Americans.

Public awareness of the childhood obesity epidemic is on the rise due to increased media coverage. Reports on nutritional values for children, parental responsibility and the current statistics of childhood obesity, childhood obesity-related surgery and the like are consistently seen on major news channels and in newspapers. Despite the attention given to the state of the problem, media and the public play a large part in all aspects of childhood obesity. In the following pages, we will discuss public perception and the societal pressures involved in childhood obesity.

15%

2 - 5 years

12 - 19 years6 - 11 years

��.0% obese

2000

1990

1980

�5.5% obese

�5.�% obese

1963

10%

5%

1970

Rise in childhood obesity from 1963 - 2000 .�

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Awareness is not enough.

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February 2007 - This highly publicized case features 8 year old Connor McCreadie, who currently weighs over 200 pounds - four times the average for a child of his age . The boy and his mother have been attacked by public officials and media hounds regarding claims of child abuse as the British National Obesity Forum threatens to turn him over to private care.

February 2007 - President Bush recently called a forum to discuss the growing childhood obesity epidemic with executives from the food, beverage, and entertainment industries .

March 2006 - Following the release of an International Journal of Pediatric Obesity report, news reporters ran a multitude of stories on the growth of obesity in children over time . Reports also focused on the projected obesity rates for the year 20�0 .

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societal changes

1970

6:00

1977 - Over twenty percent of children walk or bike to school.

1976 - Microwave ovens become widespread. Obtain 60% U.S. market share.

Calories per capita remained relatively constant from 1970 until the mid-1980’s, but then increased. Taking a look at the macronutrient supply during this time, the association can be made between a sudden caloric intake increase and the rise in carbohydrate consumption.

This change can be attributed to the decline in food prepared and consumed at home . In 1970, Americans spent one third of their food dollars on food away from home; this amount grew to 39% in 1980, 45% in 1990 and 47% in 2001. The assumption can be made that increasing income and more two-income households give people the means and the incentive to eat more convenient meals on the go.

Consuming more carbohydrates .5

5

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2000

1992 - School bus usage peaks after a large, steady increase in its role beginning in �9�� (subsequently declines).

1990 - Suburban sprawl growing rapidly. Over �9 million acres of rural land have been developed since �9�0.

1985 - Nintendo entertainment system first sold in America.

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protein

total fat

carbohydrates

1970

6:00

1977 - Over twenty percent of children walk or bike to school.

1976 - Microwave ovens become widespread. Obtain 60% U.S. market share.

Over the past 20 years, the prices of sugars, sweets and soft drinks have noticeably decreased while the cost of fresh produce has sharply risen. While the consumer price index increased to 180 by 2002, the price index for fresh fruit and vegetables increased to 258 .

These price differences can be attributed to a number of societal and environmental causes. Primarily, lower gasoline and overall transportation costs have helped soda and sweets become cheap and widespread.

Unhealthy food gets cheap, produce prices increase.

societal changes

soft drinks

fresh fruits and vegetables

sugars and sweets

consumer price index5

9

2000

1992 - School bus usage peaks after a large, steady increase in its role beginning in �9�� (subsequently declines).

1990 - Suburban sprawl growing rapidly. Over �9 million acres of rural land have been developed since �9�0.

1985 - Nintendo entertainment system first sold in America.

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100.0

150.0

250.0

1970

6:00

1977 - Over twenty percent of children walk or bike to school.

1976 - Microwave ovens become widespread. Obtain 60% U.S. market share.

societal changes

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16.6

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1977 1990 2001

perc

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rips At left is a comparison of the percentage

of school trips among U.S. children aged five to 15 years in three different years.

With decreases in the prices of gas and suburban sprawl at a peak, more and more children are relying on private automobiles for their ride to school. As a result, the number of children biking and walking to school has dramatically decreased.

Smaller percentage of students walking to school .5

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2000

1992 - School bus usage peaks after a large, steady increase in its role beginning in �9�� (subsequently declines).

1990 - Suburban sprawl growing rapidly. Over �9 million acres of rural land have been developed since �9�0.

1985 - Nintendo entertainment system first sold in America.

At right is a comparison of the average trip length (in miles) among U.S. children aged five to 15 years. As pictured, the average length of biking trips for children has substantially decreased over the past 34 years why the distance of walking trips has remained relatively constant .

Because the amount of physical activity achieved is highly dependent on the length of time in which you are exercising, this decrease has a greater impact than may be apparent.

Shorter average trip length .

mile

s

1977

0.53

1990

0.98

0.59

2001

0.94

0.69

1.31

walking

biking

5

5

1.2

0.8

1.0

1.4

0.6

0.4

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Augustus Gloop - Portrayed as a gluttonous, spoiled boy, Augustus Gloop of Charlie and the Chocolate Factory is remembered for a scene where he gets stuck in a tube due to the size of his belly. Willy Wonka punishes him for his eating habits by leaving him helpless and continued his chocolate factory tour.

Dudley Dursley - As an antagonist in the Harry Potter story, Dudley Dursley is the overweight, spoiled cousin of Harry. Dudley eats excessively while Harry starves and he blames Harry for all the trouble Dudley creates.

Shrek - Although portrayed as a protagonist, Shrek is stuck in a big, ugly body as part of a magical spell. In the end, the skinny princess he is in love with turns into an equally large and ugly monster. Only then can the two be together.

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Obese children are subject to more than just health risks, they are the subject of discrimination. The social stigma associated with obesity can be seen in cartoons and movies as well as in interactions with other children.

In media, obese characters are often portrayed as gluttonous, spoiled and mean. Cartoons use obesity as a form of comic relief. Though now becoming more politically correct, images of giant pigs eating a huge dinner and exploding or bulky people getting stuck in small spaces are still lingering on TV shows and in comic books.

social stigma

According to the American Obesity Association, adolescent females are reportedly subject to direct and intentional weight-related teasing, jokes and derogatory statements. Obese children in general are stereotyped as being lazy, inactive, unclean or a bully. As a result of such discrimination, childhood obesity puts children at risk of depression, low self-esteem and negative body image. Furthermore, a UC Berkeley study claims that overweight adolescent girls are less like to be accepted to college, less likely to be married, and less likely to be economically well off in adulthood.

Teasing and discrimination.

making a change

Recent trends in childhood obesity present a severe public health problem with which all Americans should hold concern. As a society, we are forced to deal with the repercussions of childhood obesity and therefore, as a society, we must address the problem. But what can we do? And who can do it? Whose responsibility is it to protect children from these health risks and to treat those children who have already become obese?

A February 2006 Harris Poll surveyed 2,387 U.S. adults to better understand who the American public believes

is responsible for reversing the childhood obesity trend. Seventy seven percent of the adults surveyed agreed that childhood obesity is a major problem in the United States. Twenty-one percent said childhood obesity is a minor problem and only two percent do not consider it a problem.

In the following pages, we will discuss the preventative measures each societal groups can take to promote more healthy eating habits and active lifestyles in America’s children.

Calling on parents, schools and marketers.

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41%55%The government should play a more active role in regulating the types of marketing and advertising that the food industry directs towards children.

68%Advertising by the food industry that is directed towards children is a major contributor to the rising rate of childhood obesity.

83%Public schools should do more to limit children’s access to unhealthy foods like snack foods, sugary soft drinks and fast food.

83%

The government should take companies to court if they mislead children and their parents about the nutritional value of the foods they sell. 58%

If children in the U.S. are becoming obese it’s because parents are not paying enough attention to their eating habits, not because of the food industry’s marketing and advertising.

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Harris Interactive Poll. February 15, 2006. www.harrisinteractive.com/news

Agree (or somewhat agree) Disagree

making changes at home

Avoid snacks. Children who snack while watching television or doing homework tend to have increased caloric intakes.

Encourage kids to play outside. For example, riding a bicycle or playing basketball with friends - instead of staying in the house.

Remove televisions from children’s bedrooms and bathrooms to aid in creating a healthy-weight environment .�0

Take small steps. Small, gradual changes work best. Switch from soda to milk or water or turn the TV off after dinner.

Sit down for family meals. Eat together as a family for at least �0 minutes a day .�0

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Encourage an active lifestyle and healthy eating habits.

Preventing and treating obesity requires the entire family. Not only must the family change its behavior as a whole, but parents must create a healthy environment for their children. The Institute of Medicine has suggested the following steps to be taken by parents towards confronting the epidemic.

1. Encourage an active lifestyle for your child.

2. Limit television watching.

3. Engage in and promote more healthful dietary intakes (use caution - a high degree of parental control of diet is linked to a child’s inability to regulate fod intake.

4. Serve as a healthy role model.

5. Learn to keep track of your child’s BMI index.

making changes at school

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Schools should use walk-a-thons or other benefits to replace money recieved from sale of competitive goods .

School health services can play a more prominent role in addressing obesity by measuring each student’s weight, height, and body mass index (BMI) regularly .8

According to the National Academies, nutritional standards must be implemented for vending machines .8

Provide a consistent environment that is conducive to physical activity and healthful eating habits.

Schools are one of the primary locations for reaching the nation’s youth. Schools must begin to focus more on what foods and drinks they serve their students, what meal programs are available and what competing foods exist on campus. The following are suggested immediate steps to be taken towards confronting the childhood obesity epidemic in schools.

1. Improve the nutritional quality of foods and beverages served and sold in schools and as part of school- related activities.

2. Increase opportunities for frequent, more intensive and engaging physical activity during and after school.

3. Implement school-based interventions to reduce children’s screen time.

4. Develop, implement and evaluate innovated pillot programs for both staffing and teaching about wellness, healthful eating and physical activity.

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grains

fruits vegetables

meats dairy

sweets

applesauce, 4 oz.65 calories1 serving fruit

french fries, 14 ct.290 calories, 9g fat2 servings fat/oils

cupcake, 1ct.220 calories1 servings fat/oils

fish sticks, 5ct.310 calories, 8g fat1 serving meat

Serving a well-balanced meal.

The meal pictured below is typical of American school lunch menus. At present, competitive foods sold at lunch time (i.e. cupcakes, cookies, shakes, potato chips) not only fail to meet nutritional standards but also detract children from eating more nutritious parts of their meal. By applying current FDA nutritional standards to all food items for sale, children will be more likely to consume a well-balanced meal.

making changes at school

8

Schools should use walk-a-thons or other benefits to replace money recieved from sale of competitive goods .

School health services can play a more prominent role in addressing obesity by measuring each student’s weight, height, and body mass index (BMI) regularly .8

According to the National Academies, nutritional standards must be implemented for vending machines .8

Provide a consistent environment that is conducive to physical activity and healthful eating habits.

Schools are one of the primary locations for reaching the nation’s youth. Schools must begin to focus more on what foods and drinks they serve their students, what meal programs are available and what competing foods exist on campus. The following are suggested immediate steps to be taken towards confronting the childhood obesity epidemic in schools.

1. Improve the nutritional quality of foods and beverages served and sold in schools and as part of school- related activities.

2. Increase opportunities for frequent, more intensive and engaging physical activity during and after school.

3. Implement school-based interventions to reduce children’s screen time.

4. Develop, implement and evaluate innovated pillot programs for both staffing and teaching about wellness, healthful eating and physical activity.

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grains

fruits vegetables

meats dairy

sweets

scho

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applesauce, 4 oz.65 calories� serving fruit

grilled cheese, � ct.240 calories, 9g fat� serving dairy,2 servings grains

carrots, celery, �2 oz.20 calories2 servings vegetable

tomato soup, 8 oz.90 calories� serving vegetable

Serving a well-balanced meal.

The ideal American school lunch would touch on the majority of food groups - essentially dairy, fruit, vegetable and grains. It would also allow for a greater portion of calories generated by natural and nutritious foods as opposed to fats from grease and oil. In addition to serving healthier meals, the Institute of Medicine recommends banning vending machines from school to prohibit competitive food sale altogether.

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making changes in mediaEncourage an active lifestyle and healthy eating habits.

There exists great potential in the advertising and marketing industry to positively portray healthful eating habits and an active lifestyle to children, and thereby help to change social norms regarding childhood obesity. The following are the Institute of Medicine’s suggested immediate steps to be taken towards confronting the epidemic in marketing and advertising.

1. Develop healthier food and beverage product and packaging innovations.

2. Expand consumer nutritional information.

3. Provide clear and consistent media messages.

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”Food is the number one product advertised to kids, followed by media such as music, video games, and movies,” said Vicky Rideout, vice president of the Foundation’s Program for the Study of Entertainment Media and Health regarding a 2005 media study . The study found that more than a third of commercials targeting children or adolescents are for candy and snacks -- often high-fat, sugary foods that are likely to fuel the on going childhood obesity epidemic.

Children 8 to 12 years old watch the most food commercials, averaging 21 ads daily, according to the findings. That adds up to 7,600, or nearly 51 hours, annually. Teens, 13 to 17 years of age, see 17 food ads daily, or more than 6,000 per year, while youngsters 2 to 7 view 12 foods ads per day, or 4,400 yearly .

The American Institute of Medicine has deliberated that these sorts of advertisements should be carefully controlled by marketers, and government if necessary.

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Advertising to children.

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current initiatives

Cartoon Network’s “Rescuing Recess” campaign .

Begun in early 2006, the Cartoon Network’s “Rescuing Recess” campaign is fighting to have recess reinstated in schools where it has been taken away. The first stage of the campaign had over 100,000 children write letters to policymakers reminding them that they are big fans of recess. During “National Recess Week” in September 2006, the Network had parents sign up online for a free “recess kit” that included all the supplies necessary to hold a recess rally . 6

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Moving towards a healthier future.

As the public becomes more aware of the problem of childhood obesity, non-profit and government organizations as well as influential corporations are beginning to take strides towards a solution. As previously discussed, the government has contracted the Institute of Medicine to make recommendations to the public while President Bush does the same to companies that come into contact with children.

At right is a brief sample of what such companies are doing to make a change in the weight of this country’s youth. These programs may address foods and advertising or inactivity and school policy.

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Ad Council and Dreamworks’ Coalition for Healthy Children .

The Ad Council has begun a campaign that focuses on the importance of eating healthy and being physically active through two complementary efforts. The “Be a Player” PSAs feature characters from DreamWorks Shrek encouraging children ages 6 to 9 years old to get up and play for at least one hour every day - and demonstrate the fun that they can have doing it. The “Can Your Food Do That?” PSAs let kids know that eating healthy can help them do the things they really love to do, and do them better .9

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Kraft’s “Sensible Solutions” program and changes to advertising campaign .

In 2005, Kraft foods launched the “sensible solutions” program to help consumers identify the healthier foods that the brand offers. In conjuction with this program, the company decided to shift the mix of products it advertises in television, radio and print media viewed primarily by children ages 6-11, such as many popular cartoon programs, toward products that qualify for the flag, and phase out advertising in these media for products that don’t. Such products include Kool-Aid beverages, Chips Ahoy! and Oreo cookies .

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Works Cited

�. Associated Press. “Study: Childhood Obesity expected to soar world wide.” MSNBC Online. March �, 2006. www.msnbc.nbc.com

2. Zeller, T. “Into the Mouths of Babes: Childhood Obesity.” The Lede. March 6, 200�. thelede.blogs.nytimes.com

�. Institute of Medicinje of the national Academices. “Childhood Obesity in the United States: Facts and Figures.” September 2004. www.iom.edu

4. Office of the Press Secretary. “President and Mrs. Bush Discuss Childhood Obesity.” February �, 200�. www.whitehouse.gov

5. Strum, R. “Childhood obesity - what we can learn from existing data on societal trends, part 2.” Prev Chronic Dis [serial online] 2005 April. www.cdc.gov

6. Radcliffe, Jennifer. “Rescuing Recess.” September �2, 2006. blog.chron.com

�. www.boston.com/business/articles

8. Office of News and Public Information. “National Effort Urgently Needed to Combat Childhood Obesity; Actions Required by Schools, Families, Communities, Industry, and Government.” National Academies Press Release. Sept �0, 2004. http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=��0�5

9. Ad Council. “Childhood Obesity Prevention.” http://www.adcouncil.org/default.aspx?id=45

�0. “Childhood Obesity: Make weight loss a family affair.” www.mayoclinic.com/health/childhood-obesity/FL00058

��. Kraft Newsroom. “Kraft foods announces marketing changes to emphasize more nutritious products.” www.kraft.com/newsroom/0��22005.html

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Acknowledgements (photographs)

Children w/chinese and TV (p2) - gettyone.comDon’t Supersize (p�) - psa.americanheart.org Happy meal promotion (p�) - www.mcdonalds.comPlaystation promotion (p�) - www.playstation.comBoy w/hamburger (p�) - medicineworld.orgTwo boys on PS2 (p�) - www.flickr.com, njum photostreamObesity video (p5) - www.msnbc.comMcCreadie and mother (p5) - thelede.blogs.nytimes.comBush obesity conference (p5) - www.whitehouse.govAugustus Gloop (p�2) - www.imdb.comDudley Dursley (p�2) - www.przygody-harregopottera.blog.onet.plShrek (p�2) - www.imdb.comSoccer kid (p��) - http://farm�.static.flickr.com/5�/�44��6��2_dcc�522d26.jpgMom at doctor (p��) - http://www.hawaii.edu/dyson/Happy-mom-web.jpgMom, kid running (p��) - www.flickr.com, TashaLoz photostreamVending machine (p�8) - www.flickr.com, motocchio photostreamWalk-a-thon kids (p�8) - http://farm�.static.flickr.com/46/�45�990�2_fb�c0bc��a.jpgBMI measurement (p�8) - http://irweb.swmed.edu/chn/naa/images/weight.jpgC Aguilera pepsi ad (p2�) - orangeyogurt.i.phRescuing Recess (p24) - www.cartoonrecessweek.com

Recommended ReadingsFor parents:�. Mayoclinic online reference. “Childhood obesity: Make weight loss a family affair.” http://www.mayoclinic.com/health/childhood-obesity/FL00058, “Fitness for kids: Getting your children off the couch.” http://www.mayoclinic.com/health/fitness/FL000�02. Nemours Foundations Kids Source website. “Overweight and Obesity Guide for Parents.” http://www.kidshealth.org/parent/food/weight/overweight_obesity.html�. Institute of Medicine Childhood Obesity Fact Sheet for Parents. www.iom.edu/File.aspx?ID=226��

For educators:�. The Center for Health and Health Care in Schools website. “School Health Issues: Obesity and Nutrition.” http://www.healthinschools.org/sh/obesity.asp2. Institute of Medicine Childhood Obesity Fact Sheet for Educators. www.iom.edu/File.aspx?ID=226�5