Daniel Clark MD/PhD/MPH/RN/BS/GED/Promotoro/CHW and Kuei Lee
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Transcript of Daniel Clark MD/PhD/MPH/RN/BS/GED/Promotoro/CHW and Kuei Lee
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Daniel Clark MD/PhD/MPH/RN/BS/GED/Promo
toro/CHW and Kuei Lee
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Childhood Obesity• Increasing in prevalence
(1976-1980 vs 2003-2006)– 6-11 yrs old: from 6.5% to 17.0%– 12-19 yrs old: from 5.0% to 17.6%
• 1 of 10 key health indicators for Healthy People 2010
• 15% of American children are overweight
• Inactivity and poor diet cause 300,000 deaths/year in U.S.
• Obesity-related diseases cost over $100 billion/year in U.S.
Kuei
Source: http://www.cdc.gov/obesity/childhood/prevalence.html
http://www.sph.uth.tmc.edu/catch/cns.htm
Dan
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School-Based Interventions• 3 Basic Approaches:
(1) Nutrition- Guidelines- Price Interventions- Product regulation
(2) Physical Activity(3) Environmental
- Community and Family Interventions
Source: http://www.cdc.gov/obesity/childhood/prevalence.html
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School-Based Interventions
• Meta-analysis• “Do School Based Food and Nutrition Policies
Improve Diet and Reduce Obesity?”
• Published and unpublished literature
• U.S. and Europe
• 18 studies met inclusion criteria
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
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School-Based Nutrition Interventions: Meta-Analysis
Nutritional guidelines• Decreased total and saturated fat• Increased fruit & vegetable
availability• Improved students’ dietary intake
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
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School-Based Nutrition Interventions: Meta-Analysis
Price Interventions• Increased fruit & vegetable
sales
• No negative effect on profits
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
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School-Based Nutrition Interventions: Meta-Analysis
Product regulation• Decreased sale of foods with
minimal nutritional value• Unintended negative
consequences
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
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Physical Inactivity• Independent risk factor for CHD
• 30% CV deaths
• 30% DM deaths
• 60% of cancer deaths
Source: Stone et. al., Am J Prev Med 1998;15(4).
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CATCH PROGRAM• First initiated as a research study involving the University of California at San Diego, University of Minnesota, Tulane University and the University of Texas Health Science Center – Houston
• Purpose: to develop an elementary school-based program to reduce the risk factors related to cardiovascular disease.
• Four Components:
1.Eat Smart school nutrition program2.K-5 and 6-8 Classroom curriculum3.Physical Education Program4.Family Programs
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CATCH: Eat Smart
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CATCH: Eat Smart
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CATCH: Classroom Curriculum
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CATCH Activities and Games
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CATCH: Family Activities
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CATCH: Family Activities
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CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
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CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
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CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
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CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
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CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
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CATCH: Follow Up Conclusions
• Intervention group demonstrated significantly healthier behaviorsas compared to the control group.
• Behavioral differences between both groups persisted for 3 years after intervention.
• The difference between experimental and control groups, though still statistically different over time, are narrowing over time.
• More research needs to be done to develop the best modalities formaintaining intervention effects beyond elementary school level.
• Programs to alter environments for elementary, middle, junior, and high schools are warranted.
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Acknowledgements
LaredoLaredo• Roger PeralesRoger Perales• Kelsey VaughnKelsey Vaughn• Sylvia ArellanoSylvia Arellano• All the SpeakersAll the Speakers• La Bestia BlancaLa Bestia Blanca
HarlingenHarlingen • Pat BortoniPat Bortoni• Noe GarzaNoe Garza• Beatriz TapiaBeatriz Tapia
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Questions?