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