SUPERSIZINGOur ChildrenThe Childhood Obesity Epidemic

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Objectives• Describe prevalence and contributing factors of

overweight and obesity in infants and children.• List possible consequences of being overweight as a

young child.• Describe the role of the child care environment and

of child care staff in helping to prevent overweight in children.

• List ways in which the child care facility can help children eat healthier and get more activity.

Obesity in America

Obesity is Caused by Long-Term Energy Imbalance

Energy Intake

Energy

Expenditure

FatFatStoresStores

BMI Chart created by Vertex42.com. Used with permission.

2000

Obesity Trends* Among U.S. AdultsBRFSS 1990, 2000, 2010

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

2010

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Based upon BMI measurements: 69% of the US adult population is

overweight More than one third of adults (35.7%) are

considered obese

SOURCE: http://www.cdc.gov/obesity/data/adult.html

Obesity Trends for Maine (1990-2012)

Source: America’s Health Rankings Report, The United Health Foundation, http://www.americashealthrankings.org/ME/Obesity

• Only about 14% of U.S. adults eat the recommended servings of fruits and vegetables each day.

• More than 60% of American adults do not get the recommended amount of physical activity to provide health benefits.

• Nationally, 25% of all adults are not active at all.

SOURCES: Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012; 31:219-30. AND Wang CY, McPherson K, Marsh T, Gortmaker S, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011; 378:815-25.

The Estimated Cost…• Adults:

– Obesity accounted for 21% of medical spending – or $190 Billion – in 2005

– It’s estimated by 2030 obesity-related medical costs could go up by $48 to $66 billion a year in the U.S.

• Children:– 1979 to 1999 saw a tripling of annual costs, rising from $35

million to $127 million. – The annual cost nearly doubled from 2001 to 2005 due to

hospitalizations relating to obesity (from $125.9 million to $237.6 million.

SOURCES: Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012; 31:219-30. AND Wang CY, McPherson K, Marsh T, Gortmaker S, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011; 378:815-25.

What Factors Affect Obesity?

• Biology~Genes

• Behaviors~Diet ~Physical activity

• Environments~Social~Physical

Focus on what we can change!

Why the Increase In Obesity?

• Rising obesity rates result from increases in caloric intake and/or decreases in caloric expenditure

• The rise in obesity rates in the last decade could be explained by as little as an average net increase of 100 calories per day.

FOODS Calories

2 Oreo cookies 106

4 Hershey’s Kisses 100

8 fl oz Coca-Cola 162

1 Tbsp ranch dressing 90

2 slices white bread 130

SOURCE: www.calorieking.com

ACTIVITIES Calories

Walking 1 mile 96

Biking 4 miles (@10 mph) 102

Jogging 1 mile (@5 mph) 120SOURCE: www.healthyheart.org/nutrition/caloricostofexercise.htm

Changes in Caloric Intake from 1970 to 2000

• Adults– Men: 2,450 to 2,618 kcal/day (+7% )– Women: 1,542 to 1,877 kcal/day (+22% )

• Children– Boys: 2,550 to 2,800 kcal/day

(+10%)– Girls: 1,780 to 1,900 kcal/day (+7%)

In the past decade intakes have remained fairly stable.

Help, the Environment is Making US Fat!

Brainstorm

What factors in the environment make it hard for us to eat smart

and move more?

IdeasIdeas??

Urban Sprawl and Time Spent in Cars

Street Connectivity and Mixed Use

Poor Access to Recreational Facilities

Lack of Parks and Green Spaces

Are children from rural areas, like much of Maine, more or less active?

• Higher percentages of rural children have been identified as obese compared to urban children.

• It may be harder for rural children to participate in after-school activities such as sports; transportation may be one of the reasons why

• Rural children may spend MORE time being inactive as well

Source: Center for Rural Affairs 2009

Density of Fast Food Restaurants

Eating Away from Home Contributes to Portion Distortion

FRENCH FRIES

30 Years Ago Today

Calorie Difference: 400 Calories

210 Calories2.4 ounces

610 Calories6.9 ounces

Presence of Convenience Stores and Absence of Grocery Stores

Prices Matter

School and Work

• Poor food choices in cafeteria or vending machines• Minimal PA opportunities, even in schools• School or work environments that don’t support

or encourage healthy eating or PA – Time limitations– Difficult to bring food from home

• Technology that makes work easier, but reduces PA

Home – Food Environment• Availability and accessibility of fruits & veggies

and healthy snacks• Family meals, especially for children • Family traditions (walks after dinner; playing

with the kids)

Adults control what enters the home!

Home – Media Use

• Media importance in home (use of TV at meals, video games, etc)

• Number and location of TVs– Particularly access to media

in the bedroom• TV watching:

– Decreased movement– Increased calories and

cravings

Home – Outdoor Play Time

• Free play outdoors is important– Increased fitness levels– Decreased stress– Stronger immune systems– Better test scores– More creativity– Happier demeanor

Childhood Obesity

Overweight and Children

• Weight categories for children are determined by growth charts

Overweight

Obese

Obesity in Children

0%

2%

4%

6%

8%

10%

12%

14%

16%

1971-1974 1988-1994 1999-2000 2003-2004

Total Boys Girls

Overweight Infants?

• In 2003-2004, NHANES estimated 9.5% percent of infants and children less than 2 years of age were obese.

SOURCE: The 2003-2004 National Health and Nutrition Examination Survey (NHANES),

Should We Be Concerned?

• Overweight is now the most common nutritional disease of children.

• Preschool children who are overweight are almost 5x more likely to be overweight as young adults

• Carrying extra body weight is a risk factor for many chronic conditions and health problems.

Brainstorm

What are the health risks to overweight or

obese children?

IdeasIdeas??

Health Risks of Obesity

• Heart Disease Total cholesterol Serum triglycerides Blood pressure

• Breathing Problems• Type 2 Diabetes• Musculoskeletal Problems• Fatty Liver• Weight Discrimination

Contributors to Child Obesity

• Food choices• Physical activity• Eating patterns

Contributors to Childhood Obesity

• Obese parents• Parenting style• Parents with poor

health behaviors

Contributors to Childhood Obesity

• Diabetes during pregnancy

• Low-birth weight• Excessive weight gain in

pregnancy• Formula feeding• Demographic Factors

THE CHILD CARE ENVIRONMENT

The Child Care Environment• Nearly 28% of children

(infants to age 5 years) are in some kind of organized child care.

• 55% of 3-6 year olds are in early care and education programs.

• Child care setting is an ideal setting for promoting early development of healthy behaviors

What Can We Do?

• Focus on what we can change!– Nutrition– Physical activity– Feeding interactions– Role Modeling!

Brainstorm

• What can YOU do to help prevent obesity in preschoolers?

IdeasIdeas??

Use a Consistent Message

Implement the Strategies for Success

Implement the Strategies for Success

Provide healthy choices for snacks and celebrations;

limit unhealthy choices.

Implement the Strategies for Success

Provide water and low fat milk; limit or eliminate

sugary beverages.

Implement the Strategies for Success

Provide non-food rewards.

Implement the Strategies for Success

Provide opportunities for children to get physical

activity every day.

Implement the Strategies for Success

Limit recreational screen time.

*Keep TV/Computer out of the bedroom. No screen time under

the age of 2.

Implement the Strategies for Success

Participate in local, state, and national initiatives that

promote healthy eating and active living.

Implement the Strategies for Success

Engage community partners to help support and promote

healthy eating and active living at your site.

Implement the Strategies for Success

Partner with and educate families in adopting and

maintaining a lifestyle that supports healthy eating

and active living.

Implement the Strategies for Success

Implement a staff wellness program that includes

healthy eating and active living.

Implement the Strategies for Success

Collaborate with Food and Nutrition Programs to offer

healthy food and beverage options.

Implement the Strategies for Success1) Provide healthy choices for snacks and celebrations; limit unhealthy choices.

2) Provide water and low fat milk; limit or eliminate sugary beverages.

3) Provide non-food rewards.

4) Provide opportunities for children to get physical activity every day. 5) Limit recreational screen time. *Keep TV/Computer out of the bedroom. No screen time under the age of 2.

6) Participate in local, state, and national initiatives that promote healthy eating and active living.

7) Engage community partners to help support and promote healthy eating and active living at your site.

8) Partner with and educate families in adopting and maintaining a lifestyle that supports healthy eating and active living.

9) Implement a staff wellness program that includes healthy eating and active living.

10) Collaborate with Food and Nutrition Programs to offer healthy food and beverage options.

YOU CAN MAKE A DIFFERENCE!

Child care providers are advocates for healthy

children!!

Summary

• Obesity is increasing in America, especially among children.– More than 1 in 4 preschoolers are overweight or obese.

• Childhood obesity increases kid’s risk for health problems later in life.

• Obesity is more than just a personal decision!!• Child care providers can help keep kids healthy.• The 5210 message encourages healthy choices for

children and their families.

Making Changes at YOUR Child Care

• List three ways you can help the children at your facility reach one of the behaviors every day.

• Pick one of the 5 priority strategies and list 3 ways you can work on implementing this strategy at your child care program right now.

• BONUS: Challenge all the teachers at your facility to think of a 5210 Goes to Childcare motto or catchphrase for your program. Then, let the kids vote on the best one! 

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Thank you!!