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Childhood Obesity
SUPERSIZINGOur Children
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Objectives Describe the problem of overweight in 2-to
5-year-old children List the 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 some ways in which their child care facility can help children eat healthier and get more activity
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Obesity in America
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1998
Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1998, 2006
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2006
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC.
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Obesity Trends* Among U.S. AdultsBRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC
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Obesity Is Caused by Long-Term Positive Energy Balance
Energy Intake
Energy
Expenditure
FatFatStoresStores
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Body Mass Index (BMI) is the standard measurement of overweight and obesity
Overweight is defined as a BMI of 25-30
Obesity is defined as a BMI ≥30
~ 31% of American adults meet the criterion for obesity - about 59 million American adults
More than 64% of the US adult population have a BMI ≥ 25
SOURCE: http://www.obesity.org/subs/fastfacts/aoafactsheets.shtml
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• More than half of Utah adults are overweight or obese (59.4%)
• The percentage of obese adults in Utah has doubled since 1989 (a 136% increase)
• Only 23% eat fruits and vegetables at least five times a day
• 20% report no leisure time physical activity in the past month
SOURCE: www.cdc.gov
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• 11% of Utah youth (9th–12th graders) are overweight; another 9% are obese
• Only 48% meet physical activity recommendation levels
• Only 18% eat fruits and vegetables five or more times a day
• Nearly 17% drink at least one non-diet soda each day
• 18% watch three or more hours of television each day
SOURCE: www.cdc.gov
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• Obesity affects the economy
COSTS:
-- U.S.: $150 billion per year
-- $1400 per person per year
-- Utah: $393 million per year
• Medical costs associated with overweight and obesity may involve direct and indirect costs
SOURCE: www.cdc.gov
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What Factors Affect Obesity?
• Biology– Genes
• Behaviors– Diet – Physical activity– Screen time
• Environments– Social– Physical
Focus on what we can change!
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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) 120
SOURCE:
www.healthyheart.org/nutrition/caloricostofexercise.htm
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• 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%)
Changes in Caloric Intake from 1970 to 2000
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Help, the Environment is Making US Fat!
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Brainstorm
What factors in the environment make it
harder for us to eat smart and move more?
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Urban Sprawl and Time Spent in Cars
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Street Connectivity and Mixed Use
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Poor Access to Recreational Facilities
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Lack of Parks and Green Spaces
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Density of Fast Food Restaurants
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Eating Away from Home Contributes to Portion Distortion
FRENCH FRIES
20 Years Ago Today
Calorie Difference: 400
210 Calories2.4 ounces
610 Calories6.9 ounces
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Presence of Convenience Stores and Absence of Grocery Stores
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Price Matters
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• Poor food choices in cafeteria or vending machines
• Minimal PA opportunities, even in schools
• Cost: good food does cost more
• School or work environments that don’t support or encourage healthy eating or PA
• Technology that makes work easier but reduces physical activity
School and Work
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Home• 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!
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Home• Presence of exercise or play
equipment
• Outdoor space for child play
• Media importance in home (use of TV at meals,video games, etc)
• Number and location of TVs• Healthy sleep routines
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Childhood Obesity
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• Current child obesity epidemic
• As of 2005, 56% of children aged 3-6 yrs enrolled in child care centers
• Child care setting is ideal for promoting early development of health behaviors
Background
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• BMI = compared to growth charts
• BMI that falls between the 85th-95th percentile = overweight
• BMI at or above the 95th percentile = obese
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Obesity in children
0%
2%
4%
6%
8%
10%
12%
14%
16%
1971-1974 1988-1994 1999-2000 2003-2004
Total Boys Girls
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31
Overweight and ObesityUtah First Graders
Source: Height Weight Measurement Project, Utah Department of Health
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32
Early Childhood Overweight and Obesity
Utah WIC Program, 2009
Source: Pediatric Nutrition Surveillance System, Utah WIC Program, 2009
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33
Early Childhood Overweight and Obesity by Race/Ethnicity, 2009
Source: Pediatric Nutrition Surveillance System, Utah WIC Program, 2009
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Should We Be Concerned?
• Overweight is now the most common nutritional disease of children
• Preschool children who are overweight are nearly 5x more likely to be overweight as young adults
• Obesity is a risk factor for many chronic conditions and health problems
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Brainstorm
What are the health risks for overweight
and obese children?
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Health Risks of Obesity
Heart Disease
Total cholesterol
Serum triglycerides
Blood pressure Breathing problems Type 2 diabetes Musculoskeletal problems Weight discrimination
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Contributors to Child Obesity
Food choices Physical activity Obese parents Parents with poor health behaviors Eating patterns Parenting style Low birth weight Excessive weight gain in pregnancy Formula feeding
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What Can We Do?
• Factors within our control– Nutrition (eating)– Physical activity– Feeding interactions– Support breastfeeding mothers and
children
Focus on what we Focus on what we cancan change!change!
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YOU CAN MAKE A DIFFERENCE!
Child care providers are advocates for healthy
children!!
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What is the role of child care?
What can you do to prevent obesity in preschoolers?
Brainstorm
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Making Changes in the Child Care
Environment
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• Convenience has made things TOO easy
• Obesity is more than just a personal decision!!
• More than 1 in 4 preschoolers are overweight or obese
• Child care providers can help keep kids healthy
Summary