jurnal obesitas anak

7/25/2019 jurnal obesitas anak

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T

The Caloric CalculatorAverage Caloric Impact of Childhood Obesity Interventions

Y. Claire Wang, M, !c, Amber "siao, M#", C. Tracy Orleans, #h, !teven $. %ortma&er, #h

This activity is available for CM' credit. !ee page A( for information.

)ac&ground* The childhood obesity epidemic re+ects the daily accumulation of an energygap- e/cess calories consumed over calories e/pended. #opulation0level interventions to

reverse the epidemic can be assessed by the degree to 1hich they increase energy e/penditureand2or reduce caloric inta&e. "o1ever, no common metric e/ists for such comparative

assessment.

#urpose* To develop a common metric, the Average Caloric Impact 3ACI4, for estimating andcomparing population0level effect si5es of a range of childhood obesity interventions.

Methods* An iterative, collaborative process 1as used to revie1 literature from 6778 to 9:69

and select illustrative interventions sho1ing effects on youth diet and2or activity levels, energybalance, and 1eight. The ACIs of physical activity interventions 1ere estimated based on

program reach, fre;uency, duration, and intensity and mean body 1eight of the targeted age andgender group from the 9::7


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E 9:6B American ournal of #reventive Medicine #ublished by 'lsevier Inc. Am #rev Med 9:6B(D394*eB


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e( Wang et al 2 Am #rev Med 9:6B(D394*eB


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in TN 1atching is associated 1ith a 6:D.D0&cal increase in net totalenergy inta&e, or a 790&cal increase in energy inta&e for video0 or

computer0game playing. Their ndings are consistent 1ith a

111.aLpmonline.org
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Wang et al 2 Am #rev Med 9:6B(D394*eBR4a

Intervention S M'Ts 3minutes2day4 basedb

3&cal2day4c

)oys, age in years

9, basal metabolism rate MN#A, moderate0to0vigorous physical activity #', physical education !#A>O, !ports, #lay, and Active >ecreationfor ids

previously published randomi5ed trial, 1hich found that reducing

TN 1atching among children led to lo1er caloric inta&e.68

It 1as

hypothesi5ed that children 1ho spend more time 1atching TN orplaying video games may be more e/posed and2or in+uenced by

food advertising through characters present in commercials and

interactive games that can shape food preferences and inta&e.6Hesults

The estimated caloric effect of the 6D interventions in

the tool, by gender and age group, are summari5ed

in Tables 9 and B. ?or instance, for high school boys

and girls, adding 6D minutes of #' time per day for a

full school year 1as estimated to increase mean energy

e/penditure by 9D &cal2day replacing !!)s 1ith 1ater

in schools for the same group 1ould reduce mean

energy inta&e by 6D &cal2day. ?or this group, ho1ever, anaverage


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August 9:6B


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Wangetal2AmA

#revMed9

: 6

B C

( D

3 9

4 * e B < e

6 B

111aLpmo nlin

Table 9. Caloric impact of physical activity interventions for average student, by age group

Inputs for caloric calculations

Avg.

caloric

#opulation 3age Target Avg.1eight impact

Intervention group, years4 M'Tsa

3lbs4

b

3&cal2day4 Assumptions

Modeled estimates

Add 1al&ing at a )oth 39idley et al.

6B

Wal&ing to and )oth 39


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Wangetal2AmA

#revMed9

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B C

( D

3 9

4 * e B

< e

6 B

eH

August9:6B

Table 9. 3continued4


Avg.

caloric

#opulation 3age Target Avg.1eight impact

Intervention group, years4 M'Tsa

3lbs4b


Ma&e current #' )oth 39idley et al.

6B

Implemented for a full academic year.b

aM'Tse/presses ho1 much energy is needed for physical activities. Caloric impacts e/pressed in this table are calculated assuming the physical activity is above a baseline of 6.: M'Ts 3e/cept 1herenoted, as 1ith implementing !#A>O4, 1hich is the baseline resting metabolic rate 1hen sitting ;uietly.

bIntervention is applied over a full school year 3on average, 6J: days4. The total caloric impact is averaged over B8D days to account for no change in activity on holidays, 1ee&ends, and summer

vacation. CATC", The Child and Adolescent Trial for Cardiovascular "ealth M!#A=, The Middle0!chool #hysical Activity and =utrition intervention MN#A, moderate0to0vigorous physical activity #',physicaleducation !#A>O, !ports, #lay, and Active >ecreation for ids TAA%, The Trial of Activity for Adolescent %irls


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Wangetal2AmA

#revMed9

: 6

B C

( D

3 9

4 * e B < e

6 B

111aLpmo nlin

Table B. Caloric impact of dietary and other interventions for average student by group


Affected Avg. caloric#opulation 3age group, population, impact

Intervention years4 Amounta

b


Modeled estimates

>educe unhealthy All 60o5 bag of chips 6:: 6D( Intervention models estimates based onfood inta&e All per day 6:: DD published caloric values of average bag of

6 coo&ie per day regular potato chips and single Oreo coo&ie.

>educe !!) inta&e All 690o5 can per day 6:: 6B8All 9:0o5 bottle per day 6:: 9(:

Intervention models estimates based onpublished caloric values of average can orbottleof regular caffeinated cola.

>eplace !!)s 1ith )oth 39


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Wangetal2AmA

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< e

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August9:6B Table B. 3continued4


Affected Avg. caloric#opulation 3age group, population, impact

Intervention years4 Amounta

b


%irls 36Deduce video0 or All 79 6:: 79 !ame calorie change for other age groupscomputer0gamelaying time, 8:inutes2day

aTheamount designates the current pre0intervention consumption level of the item by the selectedpopulation amounts are &ilocalories unless other1ise specied.

bThe impact designates the percentage of the selected eligible population that is affected by the intervention.

cIntervention is applied over a full school year 3on average, 6J: days4. The total caloric impact is averaged over B8D days to account for no change in activity on holidays, 1ee&ends, and summervacation.

="A='!,=ational "ealth and =utrition '/amination !urvey=YC,=e1 Yor& City !!), sugar0s1eetened beverage


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Wang et al 2 Am #rev Med 9:6B(D394*eB


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111.aLpmonline.org

e69 Wang et al 2 Am #rev Med 9:6B(D394*eBobert Wood ohnson

?oundation 3grant no. 8J6894. This 1or& is solely the

responsibility of the authors and does not represent the

ofcial vie1s of the >obert Wood ohnson ?oundation.

=o nancial disclosures 1ere reported by the authors of

this paper.
http://www.ajpmonline.org/http://www.caloriccalculator.org/http://www.caloriccalculator.org/http://www.caloriccalculator.org/http://www.ajpmonline.org/


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August 9:6B

Wang et al 2 Am #rev Med 9:6B(D394*eBeferences

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