Stamp Out Childhood Obesity

Jodi Jakey, Renee Ivers, Sara Towers,

Sheri VanDeBurg, Zach Holmes

Introduction
Definition

Obesity

Obesity Trends

US Trends

2012 Data

Vulnerable Population
US

Citizens. Michigan residents

Men

of higher income, women of lower income (but not

impoverished) (Ogden, Lamb, Carroll,& Flegal, 2010)

Women,

not college educated (Ogden, Lamb, Carroll,&

Flegal, 2010)

Black,

Mexican, Hispanic,& Native American decent (CDC,

2013)
Obese

parents are more likely to have obese children,

which are more likely to become obese adults (American
Academy of Child & Adolescent Psychiatry, 2011) (CDC,
2013)

Trends in Children
Childhood

obesity has more than doubled in children and

tripled in adolescents in the past 30 years.

The

percentage of children aged 611 years in the

United States who were obese increased from 7% in 1980
to nearly 18% in 2010. Similarly, the percentage of
adolescents aged 1219 years who were obese increased
from 5% to 18% over the same period.

In

2010, more than one third of children and adolescents

were overweight or obese. (CDC,2013)

Income and Behavior

Childhood

obesity rises as income lowers

(Eagle, et al, 2012)

Decreased

community resources results in

decreased physical activity and increased screen
time (T.V., internet, etc.)

Cultural Influences
Highest increases in childhood obesity occurred in
Hispanic and Mexican-American boys & girls
Cultural

eating practices

Cultural

distrust of the medical profession

Fatalism
Persons

of certain cultures fail to recognize their

children are overweight
(Fitzgibbon & Beech, 2009)

Health-risk factors in Obese Adolescents

Increase

cardiovascular disease
Increase blood pressure
Pre-diabetes and Type 2 diabetes
Bone and joint problems
Sleep apnea
Increase risk for some types of cancer

www.Michigan.gov, http://www.healthykidshealthymich.com, Ludwig, D.S,

Peterson K.E., Gortmaker, S.L. (February 2001). Relation between consumption
of sugar-sweetened drinks and childhood obesity: a prospective, observational
analysis. Lancet. (9255:505-8)

Health-risk factors in Obese Adolescents

Increase
Sugary

risk for some types of cancer

drinks lead to tooth decay

Gout
Social

and emotional trouble

Peer

stigmatization

Discrimination
Bullying

www.Michigan.gov, http://www.healthykidshealthymich.com, Ludwig, D.S,

Peterson K.E., Gortmaker, S.L. (February 2001). Relation between consumption
of sugar-sweetened drinks and childhood obesity: a prospective, observational
analysis. Lancet. (9255:505-8)

Statistics related to population and

health risk factors
18.2%

of Michigan youth ages 10-17 years old are

overweight and 12.4% are considered obese compared
to the U.S. percentage of 15.3 overweight and 16.4
obese. (National Survey of Childrens Health,2007)

Between

1979 & 1999, obesity associated hospital costs

for children tripled from 35 million to 127 million.

(www.healthykidshealthymich.com)

 80%

of youth did not consume adequate (5 or more)

servings of fruits and vegetables per day

28%

of youth drank at least one pop or soda a day.

Males

(32%) drank soda more often than females (23%)

Youth

participation in physical education classes on a

daily basis was very limited (31%)

(www.michigan.gov/.../Overweight_and_Obesity_in_Michigan_Surveilla.)

 Only

47% of youth were physically active for at least 60

minutes per day on five or more of the past seven
days.

On

an average school day, approximately 30% of youth

spent 3 or more hours watching television, while 23%
of youth uses computer or video games 3 or more
hours.

Black

youth had the highest prevalence of excessive

television viewing (48%) and computer or video game
use (28%)

(www.michigan.gov/.../Overweight_and_Obesity_in_Michigan_Surveilla.)

Statistics related to population and

health risk factors continued
In

2009, male youth (15.7%) had a significantly higher obesity rate

than females (8.0%)

Only

34% of youth in Kent County report eating healthy balanced

meals.

45%

of youth report being physically inactive (less than 60 minutes

of exercise during the last 7 days.)

Television

is an obesity machine= Kids watch an average of 20 hours

of TV per week, over 1000 hours per year- TV is believed to be one
of the most sedentary activities that exists. Kids average
approximately 6 hours of screen time per day.

(www.kentcountyhealthconnect.org/TheFacts.aspx)

Environmental Risk factors

Increase
Larger

consumption of foods away from home

portion sizes

Increase

TV viewing

Decrease
Increase
Lack

walking and biking to/from school

consumption of soft drinks or sugar-sweet drinks

of physical education in schools

Thoms, S Childhood Obesity: Fitkids 360 aims to reverse the tide in Kent County.
Retrieved from www.mlive.com/living/grandrapids/index.ssf/2012/12/childhood_obesity_fitkids_360.html

Community Risk Factors

Lack

of healthy food resources

Dependence

on corner stores that do not always carry

healthy food options or do at cost prohibitive prices

Food

and drink choices made based on convenience,

affordability, prevalence of fast food chains.

Kent County Health Needs Assessment. (2011). Michigan Public Health Institute. Retrieved
November 16, 2013 from www.spectrumhealth.org/documents/kent_county_CHNA
_report_no_cover.pdf,
Supplemental Nutrition Assistance Program Eligible Food Items. Retrieved November 18,
2013 from http://www.fns.usda.gov/snap/eligible-food-items

Why do kids consume sugary drinks?

$3.2

billion spent in advertising carbonated

beverages in 2006

Lack

of education regarding risks

Drink

juice instead of eating fruit

Caffeine

buzz

Convenience

Nola Penders Health Promotion Model

(Pender, Murdaugh, Parsons, 2011)
Characteristics=

each person is unique with defining characteristics,

behaviors and experiences that impact their actions. These
characteristics and experiences include prior behaviors.

Prior

behavior and habit formation impact the likelihood and success

maintaining health promoting behaviors.

Health

promotion model highlights that-

If short term benefits are experienced early in the course of the

behavior, the behavior is more likely to be repeated. (p. 46)
An individuals expectations to engage in a particular behavior hinge on
the anticipated benefits.(p. 46)

Nola Penders Health Promotion Model

(Pender, Murdaugh, Parsons, 2011)
Perceived

Barriers-

Barriers consist of perceptions about the unavailability,

inconvenience, expense, difficulty or time-consuming
nature of a particular action. (p. 47)
Loss of satisfaction from giving up health damaging
behaviors such as smoking or eating high fat foods to adopt
healthier lifestyles may also constitute a barrier. (p. 47)

Nola Penders Health Promotion Model

Perceived

self-efficacy= the belief that one has the

personal capability of carrying out a particular action.

Activity-Related

effect=the feeling that impacts the

person-is it negative or positive- and how this feeling
impacts the persons likelihood to continue the healthier
behavior.

Interpersonal

- Influences= the influence of family, peers,

and people on the health promoting behavior.

Nola Penders Health Promotion Model

Situational

Influences

Situational influences on health promoting behaviors

include perceptions of options available, demanding
characteristics, and aesthetic features of the environment in
which a given behavior is proposed to take place. (p. 48-49)
Commitment

to a Plan of Action- Initiates a behavioral

event.
Commitment alone without associated strategies often
results in good intentions but failure to perform the health
behavior. (p.49)

Effects of Soft Drink Consumption on

Nutrition and Health
Soft

drink consumption is believed to be a major contributor

to obesity and health related problems (para3)

Soft

drinks are banned from schools in Britain, France, and

portions of the United States. (para3)

People

who consume soft drinks do not decrease intake in

other areas of eating, thus increase overall caloric
consumption. (Para 22)

Vartanian, L. R., Scwartz, M. B., & Brownell, K. D. (2007, April). Effects of soft drink consumption on nutrition
and health: A systematic review and meta-analysis. American Journal of Public Health, 97(4), 75-667.
doi:10.2105/ajph.2005.083782

Effects of Soft Drink Consumption on

Nutrition and Health
The

increased carbohydrate intake associated with soft drink

consumption primarily reflects greater consumption of added
sugar. (Para 31)

The

fact that soft drinks offer energy with little accompanying

nutrition, displace other nutritional resources, and are linked
to several key health conditions such as diabetes is further
impetus to recommend a reduction in soft drink consumption.
(Para 50)

Vartanian, L. R., Scwartz, M. B., & Brownell, K. D. (2007, April). Effects of soft drink consumption on nutrition
and health: A systematic review and meta-analysis. American Journal of Public Health, 97(4), 75-667.
doi:10.2105/ajph.2005.083782

Plan of Action to address health issue

Strategies for Reducing Sugar-Sweetened
Beverage Consumption
Modifiable
Easily

accessible

Diabetes
Limit

behavior

Prevention Program

access to sugar-sweetened beverages

Potential Action Steps

Price

adjustments

Greater

proportion

Assemble

a meeting

Collaborate
Redefine

with state and school district officials

or eliminate beverage pouring

contracts in schools.

Promote access to and consumption of

more healthy alternatives to sugarsweetened beverages
Meeting

daily nutrient needs

Reducing

sugar-sweetened beverages
consumption

Beverage
Provide
Support

consumption patterns of parents

education

Evaluation of the plan of action

No

single solution to this problem exists

The

highest consumers of sugar-sweetened

beverages are adolescents aged 12 to 19 years

Bottled

water sales have increased

2004-2008

changes

School Beverage Guidelines

Elementary

Schools

Bottled water
Up to 8 ounce servings of milk and 100% juice
Fat-free or low-fat regular and flavored milk and nutritionally
equivalent (per USDA) milk alternatives with up to 150 calories/
8 ounces
100% juice with no added sweeteners, up to 120 calories / 8
ounces, and with at least 10% of the recommended daily value
for three or more vitamins and minerals

School Beverage Guidelines

Middle

School

Same as elementary school, except juice and milk may be

sold in 10 ounce servings
As a practical matter, if middle school and high school
students have shared access to areas on a common campus
or in common buildings, then the school community has
the option to adopt the high school standard

School Beverage Guidelines

High

School

Bottled water
No- or low-calorie beverages with up to 10 calories / 8 ounces
Up to 12 ounce servings of milk, 100% juice and certain other drinks
Fat-free or low-fat regular and flavored milk and nutritionally equivalent
(per USDA) milk alternatives with up to 150 calories / 8 ounces*
100% juice with no added sweeteners, up to 120 calories / 8 ounces, and
with at least 10% of the recommended daily value for three or more
vitamins and minerals
Other drinks with no more than 66 calories / 8 ounces
At least 50% of non-milk beverages must be water and no- or low-calorie
options

Nutrition and Weight Status

Goal
Promote health and reduce chronic disease risk through the consumption of
healthful diets and achievement and maintenance of healthy body weights.
Overview
The Nutrition and Weight Status objectives for Healthy People 2020 reflect
strong science supporting the health benefits of eating a healthful diet and
maintaining a healthy body weight. The objectives also emphasize that efforts
to change diet and weight should address individual behaviors, as well as the
policies and environments that support these behaviors in settings such as
schools, worksites, health care organizations, and communities.
The goal of promoting healthful diets and healthy weight encompasses
increasing household food security and eliminating hunger.

Americans with a healthful diet:

Consume a variety of nutrient-dense foods within and
across the food groups, especially whole grains,
fruits, vegetables, low-fat or fat-free milk or milk
products, and lean meats and other protein sources.
Limit the intake of saturated and trans fats,
cholesterol, added sugars, sodium (salt), and alcohol.
Limit caloric intake to meet caloric needs.

Understanding Nutrition and Weight Status

Diet
Diet reflects the variety of foods and beverages consumed over
time and in settings such as worksites, schools, restaurants,
and the home. Interventions to support a healthier diet can
help ensure that:

Individuals have the knowledge and skills to make

healthier choices.

Healthier options are available and affordable.

Increase the proportion of schools that offer

nutritious foods and beverages outside of
school meals
Baseline:

9.3percentof schools did not sell or offer calorically sweetened

beverages to students in 2006

Target:

21.3percent

Target-Setting
Method:

Projection/trend analysis

Data Source:

School Health Policies and Practices Study (SHPPS), CDC/NCHHSTP

Reduce consumption of calories from solid

fats and added sugars in the population aged
2 years and older
Baseline:

15.7percentwas the mean percentage of total daily calorie intake

from added sugars for the population aged 2 years and older in 2001
04 (age adjusted to the year 2000 standard population)

Target:

10.8percent

Target-Setting
Method:

Modeling

Data Source:

National Health and Nutrition Examination Survey (NHANES),

CDC/NCHS

References
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Academy of Child & Adolescent Psychiatry. 2011. Obesity in

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R., Wilson, A., Cabili, C., Dodd, A. (2013). Reducing calories

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County

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http://www.choosehealthla.com/eat-healthy/sugar-loadedbeverages/

More References
Eagle,

Taylor F. et al. 'Understanding Childhood Obesity In America: Linkages

Between Household Income, Community Resources, And Children's Behaviors'.
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Harvard

School of Public Health Department of Nutrition. (June 2012) Fact

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Health

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More References
Healthy

Kids, Healthy Michigan. (2008). In Healthy Kids, Healthy

Michigan: Advocates for Healthy Weight in Children. Retrieved
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(2013). Nutrition and weight status.

http://www.healthypeople.gov/2020/default.aspx
Kent

County Health Needs Assessment. (2011). Michigan Public Health

Institute. Retrieved November 16, 2013 from
www.spectrumhealth.org/documents/kent_county_CHNA
_report_no_cover.pdf
In

Kent county. (2013). In Kent County Health Connect: A Bridge to

Healthy Living. Retrieved November 14, 2013, from
http://www.kentcountyhealthconnect.org/TheFacts.aspx

More References
Ludwig,

D.S, Peterson K.E., Gortmaker, S.L. (February 2001). Relation

between consumption of sugar-sweetened drinks and childhood obesity:
a prospective, observational analysis. Lancet. (9255:505-8)
Michigan

Department of Community Health. (2011) Overweight and

Obesity in Michigan: Surveillance Update 2011. Retrieved November 14,
2013, from
www.michigan.gov/.../Overweight_and_Obesity_in_Michigan_Surveilla..
Ogden,

C. L., Lamb, M. M., Carroll, M. D., & Flegal, K. M.. 2010.

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More References
Pender, N.

J., Murdaugh, C. L., & Parsons, M. (2011). Health

promotion in nursing practice (6th ed., pp. 44-50). Uppder Saddle
River, NJ: Pearson Education, Inc
Supplemental

Nutrition Assistance Program Eligible Food Items.

Retrieved November 18, 2013 from
http://www.fns.usda.gov/snap/eligible-food-items
Thoms,

S Childhood Obesity: Fitkids 360 aims to reverse the tide

in Kent County. Retrieved from www.mlive.com/living/grandrapids/index.ssf/2012/12/childhood_obesity_fitkids_360.html

More References
Thoms,

S Childhood Obesity: Fitkids 360 aims to reverse the tide in Kent

County. Retrieved from www.mlive.com/living/grandrapids/index.ssf/2012/12/childhood_obesity_fitkids_360.html
Vartanian,

L. R., Scwartz, M. B., & Brownell, K. D. (2007, April). Effects of

soft drink consumption on nutrition and health: A systematic review and
meta-analysis. American Journal of Public Health, 97(4), 75-667.
doi:10.2105/ajph.2005.083782
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