1 Making the Healthy Choice the Easy Choice Policies for Reducing Screen Time and Increasing...

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Making the Healthy Making the Healthy

Choice the Easy ChoiceChoice the Easy Choice

Policies for Reducing Screen Time and Policies for Reducing Screen Time and Increasing Physical Activity in Early Increasing Physical Activity in Early

ChildhoodChildhood SettingsSettings..

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Making the Healthy Making the Healthy Choice the Easy ChoiceChoice the Easy Choice

By the end of this session you will be able to:By the end of this session you will be able to: List causes of childhood overweightList causes of childhood overweight Describe policies to prevent overweight in child Describe policies to prevent overweight in child

carecare Plan to encourage physical activity and reduce Plan to encourage physical activity and reduce

TV and other screen time activities in your child TV and other screen time activities in your child care setting. care setting.

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Childhood Overweight:Childhood Overweight:

Growing Problem?Growing Problem?

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Obesity Trends* Among U.S. Adults BRFSS, 1991, 1995 and 2000

(*BMI 30, or ~ 30 lbs overweight for 5’4” woman)

1991 1995

2000

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

No Data <10% 10%-14% 15-19% >20%

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Weight Trends

Trends in Overweight* Prevalence, Children and Adolescents, by Age Group (%), US, 1971-2000

*Overweight is defined as at or above the 95th percentile for body mass index by age and sex based on reference data. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

54 55

7 67

11

5

10

15

11

0

5

10

15

20

2 to 5 years 6 to 11 years 12 to 19 years

Pre

vale

nce

(%)

NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94) NHANES 1999-2000

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Why is this Why is this happening? happening?

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140 calories 3-inch diameter

Calorie Difference: 210 calories

350 calories 6-inch diameter

BAGELBAGEL 20 Years Ago Today

National Heart, Lung, and Blood InstituteObesity Education Initiative http://hp2010.nhlbihin.net/portion/

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20 Years Ago Today

270 calories 5 cups

POPCORNPOPCORN

630 calories11 cups



9


590 calories

CHEESEBURGER

20 Years Ago Today

333 calories


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Eating PatternsEating Patterns

More meals away from homeMore meals away from home Larger portion sizes Larger portion sizes More sweetened beveragesMore sweetened beverages Less milkLess milk Skipping Breakfast Skipping Breakfast

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Less Time Being Physically ActiveLess Time Being Physically Active

• More TV and More TV and video timevideo time

• Less recess/PE Less recess/PE in schools in schools

• Safety issues in Safety issues in neighborhoodsneighborhoods

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Physical Activity in PreschoolsPhysical Activity in Preschools

Pate RR, et al. Pate RR, et al. Physical activity Physical activity among children among children attending attending preschools. preschools. Pediatrics, 2004Pediatrics, 2004

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What the study tells us…What the study tells us…

Children are not meeting the goal for Children are not meeting the goal for a total of 2 hours of activity each daya total of 2 hours of activity each day

The preschool a child attended made The preschool a child attended made a huge difference in the child’s activity a huge difference in the child’s activity levellevel

Preschool policies mattered more Preschool policies mattered more than any other factorthan any other factor

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The case against television….The case against television….

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How much television should How much television should children watch?children watch?

The American Academy of Pediatrics (AAP) The American Academy of Pediatrics (AAP) recommendations for children and TV recommendations for children and TV watching:watching:Children under 2 should watch NO TVChildren under 2 should watch NO TVChildren 2 and older should watch less Children 2 and older should watch less

than two hours a daythan two hours a day

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What’s the reality? What’s the reality?

The average child watches 20 hours of television The average child watches 20 hours of television per week per week

Children in America currently spend more time Children in America currently spend more time watching TV than anything else other than watching TV than anything else other than sleeping sleeping

1/3 of preschoolers live in homes where TV is on 1/3 of preschoolers live in homes where TV is on “almost all” or “most” of the time“almost all” or “most” of the time

31 % of preschoolers have a TV in their bedroom.31 % of preschoolers have a TV in their bedroom.

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TV & Overweight in ChildrenTV & Overweight in Children

TV may replace physical activityTV may replace physical activity

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Percentage of Children with Percentage of Children with TV in Bedroom by Child BMI GroupTV in Bedroom by Child BMI Group

0

10

20

30

40

50

60

<85th 85-95th >95th

M-H Chi-square= 12.9 (df=1); p<0.0003Bassett-NYS WIC Partnership

BMI Percentile

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Doing the math….Doing the math….

MET = Metabolic equivalents of taskMET = Metabolic equivalents of task Energy used for sitting quietly = Energy used for sitting quietly =

(1 kcal/kg/h) or I MET(1 kcal/kg/h) or I MET Harrell JS et al. Med Sci Sports and Harrell JS et al. Med Sci Sports and

Exercise, 2005. Exercise, 2005. Energy Cost of Pysical Energy Cost of Pysical Activities in Children and Adolescents.Activities in Children and Adolescents.

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Energy Cost of Activities Energy Cost of Activities Children 8-12Children 8-12

ActivityActivity METsMETs

TV watchingTV watching 1.01.0

HomeworkHomework 1.31.3

Video game sittingVideo game sitting 1.51.5

Board gameBoard game 1.51.5

Video game Video game standingstanding

2.32.3

Walking 2.5 mphWalking 2.5 mph 3.03.0 Harrell JS et al. 2005.

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TV & Overweight in ChildrenTV & Overweight in Children

TV may increase TV may increase snacking on snacking on foods high in fat foods high in fat and sugarand sugar

Families buy Families buy what is what is advertised on TVadvertised on TV

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The Power of “Branding”The Power of “Branding”

3-6 year olds are able 3-6 year olds are able to identify brand logos to identify brand logos for all types of for all types of productsproducts

Being able to identify Being able to identify brand logos increases brand logos increases with TV watching with TV watching

Kaiser Family Foundation, January 2005. Effects of Electronic Media on Children Ages Zero to Six: History of Research

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So What Can We Do?So What Can We Do?

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Early Childhood Professionals Can:Early Childhood Professionals Can:

Limit television viewing and media Limit television viewing and media exposureexposure

Use effective physical activity Use effective physical activity policiespolicies

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Early Childhood Program Early Childhood Program Policies MatterPolicies Matter

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Why Develop Policies?Why Develop Policies?

• For the health and safety of children and For the health and safety of children and staffstaff

• A selling point for parents searching for a A selling point for parents searching for a quality programquality program

• To encourage open communicationTo encourage open communication• To make sure everybody at child care To make sure everybody at child care

follows the same rules follows the same rules

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Regulations vs PoliciesRegulations vs Policies

• Regulations:Regulations:• Laws required by the state for licensure Laws required by the state for licensure

• Policies:Policies:• The outline or rules a center uses to guide the The outline or rules a center uses to guide the

way it runs its programsway it runs its programs• GeneralGeneral

• Center wide policiesCenter wide policies• SpecificSpecific

• Classroom policiesClassroom policies

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Making the Healthy Choice the Easy ChoiceMaking the Healthy Choice the Easy Choice

ASSESS:ASSESS: How well your surroundings promote physical How well your surroundings promote physical

activity and limit screen time. activity and limit screen time. Put into ACTION:Put into ACTION:

A physical activity and screen time policy for A physical activity and screen time policy for your programyour program

Get SUPPORT:Get SUPPORT: From staff and parents From staff and parents

FIND:FIND: Physical activity resources for yourself and Physical activity resources for yourself and

your program.your program.

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Sample Policy: TV WatchingSample Policy: TV Watching

Because we care about the health and well Because we care about the health and well being of the children in our care, we follow being of the children in our care, we follow the American Academy of Pediatrics’ the American Academy of Pediatrics’ Recommendations on Television viewing:Recommendations on Television viewing:

Children under 2 should watch NO TVChildren under 2 should watch NO TV Children under 5 should watch no more Children under 5 should watch no more

than 2 hours of high quality programming than 2 hours of high quality programming a day (includes all screen time)a day (includes all screen time)

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Sample Policy: Physical ActivitySample Policy: Physical Activity

Because we care about the health and well being Because we care about the health and well being of the children in our care we have policies and of the children in our care we have policies and practices that support practices that support PHYSICAL ACTIVITY. PHYSICAL ACTIVITY.

We include We include at least 3 teacher led physical at least 3 teacher led physical activities per weekactivities per week involving large muscles for involving large muscles for our toddlers and preschoolers.our toddlers and preschoolers.

We strive to follow the NASPE GUIDELINES for We strive to follow the NASPE GUIDELINES for young children.young children.

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NASPE Physical Activity NASPE Physical Activity Guidelines for InfantsGuidelines for Infants

Infants should interact with caregivers in Infants should interact with caregivers in daily physical activities that encourage daily physical activities that encourage exploration of their environment.exploration of their environment.

Infants should be placed in safe settings that Infants should be placed in safe settings that facilitate physical activity and do not restrict facilitate physical activity and do not restrict movement for prolonged periods of time.movement for prolonged periods of time.

Infants' physical activity should promote the Infants' physical activity should promote the development of movement skills.development of movement skills.

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Physical Activity Guidelines Physical Activity Guidelines for Infants (continued)for Infants (continued)

The environment should meet or exceed The environment should meet or exceed recommended safety standards.recommended safety standards.

Care providers should be aware of the Care providers should be aware of the importance of physical activity and importance of physical activity and encourage physical activity in child care encourage physical activity in child care and early childhood facilities.and early childhood facilities.

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Physical Activity Guidelines Physical Activity Guidelines for Toddlers and Preschoolersfor Toddlers and Preschoolers

Toddlers develop movement skillsToddlers develop movement skills Preschoolers develop competence in Preschoolers develop competence in

movement skillsmovement skills Children need indoor and outdoor areas Children need indoor and outdoor areas

that meet or exceed recommended safety that meet or exceed recommended safety standards for physical activitystandards for physical activity

Care providers should be aware of the Care providers should be aware of the importance of physical activity and should importance of physical activity and should promote the child's movement skillspromote the child's movement skills

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Other Resources for Supporting Healthy Other Resources for Supporting Healthy Policies in Your Child Care Setting: Policies in Your Child Care Setting:

Healthy HabitsHealthy Habits

Download Healthy Habits Materials atDownload Healthy Habits Materials at www.waabam.org

and click on Resources for familiesand click on Resources for families

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Policies Make a Difference at Home too!Policies Make a Difference at Home too!

Youth in homes where rules for Youth in homes where rules for screen time use are in place watch 1 screen time use are in place watch 1 hour less TV per dayhour less TV per day

Youth in homes with video game Youth in homes with video game rules spend 1/3 less time using video rules spend 1/3 less time using video gamesgames

Policy are the same as rulesPolicy are the same as rules

Kaiser Family Foundation, Kids & Media @ the New Millennium, March 2005

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For More Ways to Make Policies For More Ways to Make Policies Work in Your Child Care Setting: Work in Your Child Care Setting: See your provider packet:See your provider packet:

Activities for young children Activities for young children Sample policiesSample policies NASPE guidelinesNASPE guidelines Other resources for Providers and ParentsOther resources for Providers and Parents

Visit the Active Bodies, Active Minds website:Visit the Active Bodies, Active Minds website:www.waabam.orgwww.waabam.org Download Healthy Habits materialsDownload Healthy Habits materials Learn about the Washington State Nutrition and Physical Activity Learn about the Washington State Nutrition and Physical Activity

Plan Plan Many more resources for Making the Healthy Choice the Easy Many more resources for Making the Healthy Choice the Easy

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