Youth InitiativesCristina S. Barroso, DrPH
University of Texas School of Public Health, Brownsville Regional CampusPresented at the Texas Association of School Based Health Centers
14th Annual Child & Adolescent ConferenceFebruary 12, 2010
Children Born Today have a Lower Life Expectancy than their Parents
1 in 3 will develop diabetes
3/5 if African American
½ if Hispanic
> ½ if Native American
Obesity by the Numbers
National Health and Nutrition Examination Survey (NHANES 2007-2008) 9.5% of infants & toddlers ≥ 95th percentile
16.9% of children & adolescents ≥ 95th percentile
11.9% of children & adolescents ≥ 97th percentile
Ogden et al., 2010
BMI = body mass index [weight (kg)/height (m)2]
Impact of Childhood Obesity on Adult Obesity
One out of four obese adults were overweight children
Onset ≤ 8 years – more severely obese as adults (BMI = 41.7 vs. 34.0)
One-half of adults with BMI ≥ 40 were obese as children
Freedman et al. , 2001
Obesity is caused by long-term positive energy balance
FatStores
~ 600 calories per day
A Framework for Obesity Prevention
Toxic Environment Availability & affordability of high fat/high carbohydrate food (fast food,
soft drinks)
Large portion sizes
Marketing to children
Fewer family meals
TV, computers, video games
Safety issue
Decrease in physical education
Schwartz MB & Brownell KD, 2007
Dollars Spent on U.S. Food Advertising in 2005
Food, beverages, candy $7,313,200,000
Restaurants & fast food $5,061,000,000
Advertising Age, 2006
NO SINGLE INTERVENTION WILL REVERSE THE CURRENT
TRENDS IN OBESITY
Legislation & Policy
Passage of Senate Bill 19 9/1/2001 Daily PE (30 min/d or 135 m/week) 4th grade School Health Advisory Councils 4th grade Coordinated School Health Programs (CSHPs) 4th grade
(9/1/2007)
Texas Public School Nutrition Policy all grades (8/2004)
Passage of Senate Bill 42 9/1/2005 CSHP: 6-8th grade (2007-2008 school year)
New Legislation – Senate Bill 530 (2007-2008)(Amends Sections 28.002 and 28.004, Education Code)
K-5: 30 minutes/day 6-8: 30 minutes/day for minimum of 4 semesters
Physical Fitness assessment (Fitnessgram), grades 3-12 Pacer Strength & flexibility
SHAC should determine importance of daily recess for elementary school students
SHAC should evaluate CSHP
4th Grade Prevalence of Obesity* by Health Service Region in Texas, SPAN 2000-2002, 2004-2005
2000-2002
2004-2005
*Obesity is > 95th Percentile for BMI by Age/Sex
Texas Senate Bill 42 (SB42)
• Awareness of & adherence to SB42 in a representative sample of public middle schools
• Impact of SB42 (along Texas-Mexico border):– Frequency of school PE class– Quality of school PE– Prevalence of child self-reported physical activity
& child overweight
Are You Aware that SB42 Requires…?2006-2008 , Key Informants
How Did You Become Aware of SB42…?2006-2008 , Key Informants
What type of PE Class Schedule is Followed? 2006-2008 , Key Informants
How Many Minutes per Class? 2006-2008 , Key Informants
How Many Days per Week? 2006-2008 , Key Informants
Self-Reported Structured Physical Activity of 8th Grade Border Students, 2004-2005 & 2006-2008
Self-Reported Structured Physical Activity of 8th Grade Border Students, 2004-2005 and 2006-2008
(±0.0005)
(±0.05) (±0.15)
(±0.15)
*p<0.001; difference between border districts 2004-2005 and border districts 2006-2008
The Rio Grande Valley Solution
Coordinated Approach To Child Health (CATCH)
Does CATCH Work?
Reduced total fat and saturated fat content of school lunches
Increased moderate-to-vigorous physical activity (MVPA) during PE classes
Improved students’ self-reported eating and physical activity behaviors
Effects persisted over three years without continued intervention
Luepker et al., 1996; Nader et al. ,1999
CATCH
CATCH Characters