Running head: USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 1

USA Childhood Obesity Intervention Portfolio

Student Name
Affiliated Institution
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 2

Executive Summary
The objective of this portfolio is to meet the module requirements: Well-being, Health, and
Positivity. The objective of the portfolio is to discuss the importance of well-being and health,
to explain the influences on health and well-being from social, political, economic and
environmental reasoning. The portfolio is a presentation of an understanding and knowledge
of childhood obesity, the children health and well-being, obesity influences and impact on
health and proposal for positive health and well-being in relation to obesity. In the last
section, personal reflection on health and well-being and strategies to prevent obesity are
presented.
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Table of Contents

Executive Summary........................................................................................................2
SECTION 1 PORTFOLIO INTRODUCTION........................................................4
1.1 Background of the Study........................................................................................4
1.2 Obesity as a Health Risk........................................................................................4
1.3 Environmental, Social, Political and Economic Concerns.........................................4
SECTION 2 WORKSHOP – REDUCING OBESITY.............................................7
2.1 Introduction..........................................................................................................7
2.2 Objectives.............................................................................................................8
2.3 Impact..................................................................................................................8
2.4 UK-CEN Intervention Program..............................................................................8
2.5 Past Interventions Review......................................................................................9
2.6 Evaluation of Intervention Program........................................................................9
2.7 Advantages of UK-CEN Program.........................................................................10
SECTION 3 REFLECTIVE WRITING................................................................10
References....................................................................................................................13
Appendices...................................................................................................................14
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 4

USA Childhood Obesity Intervention Portfolio

SECTION 1 PORTFOLIO INTRODUCTION
1.1 Background
It is essential for an individual's general health to have a sense of well-being since it
allows him to successfully subdue problems and to make their life dreams and goals.
Attitudes, health, life experiences, physical and mental stress, can all impact on an
individual’s well-being. Children with learning and developmental problems may be
vulnerable to significantly higher stress levels compared to the normally growing children,
bringing negative impact on their health and general well-being. Parents and caregivers of
such children face a similar challenge, as they must try to assist them in overcoming their
day-to-day challenges while also enabling them to prepare for what lies ahead in the future.
When it comes to children, their well-being will be influenced by their parents and guardians’
well-being, thus it is important that the parents take time for themselves in this regard. This
report presents an understanding of the importance of health and well-being, and obesity as a
societal health challenge. The report further presents an analysis of obesity as a health
challenge, its influences on health and well-being, and suggested solutions to help young
people lead a healthy life free of obesity.
1.2 Obesity as a Health Risk
Overweight and obesity are chronic diseases that afflict increasing numbers of
children, adolescents, and adults. The rates of children obesity in the US have more than two
times since 1980, and they have more than tripled among adolescents. Heart ailments, the
type 2 diabetes, and blood vessel illnesses in children and teenagers, as well as obesity-
related depression and social isolation, are all becoming increasingly common, according to
medical authorities. The longer an individual remains obese, the more severe the risk factors
associated with obesity grow. Because of the chronic diseases and ailments that are connected
with obesity, and given that it is not easy treating obesity, obesity prevention is critical. It is
very important to prevent child obesity because there are high chances that the situation may
last to the child’s adulthood.
1.3 Environmental, Social, Political and Economic Concerns
Obesity is a severe public health concern, one that is even more dangerous than the
opioid crisis. This substance has been related to chronic disorders such as coronary heart
disease, and cancer, etc. As demonstrated in a 2013 study, obesity is responsible for 18 percent
of fatalities among American citizens between the ages of 40 and 85, a finding that challenges
the scientific consensus, which had previously estimated the figure to be about 5 percent (CDC,
2021). This means that obesity is on par with cigarette smoking in terms of being a public
health hazard; smoking is responsible for one out of every five deaths in the United States and
is the biggest cause of death in the country yet it is preventable.
The obesity pandemic may be less fatal when compared to the American opioid
epidemic that is currently engulfing the country, but it is every bit as dangerous. In 2016,
opioids were responsible for over two-thirds of the sixty-four thousand deaths resulting from
drug abuse. Excessive body weight associated with cancer accounts for around 7% of all deaths
related to cancer, or approximately 40,000 deaths every year (Wellman & Friedberg, 2002).
This figure does not include the deaths caused by the numerous additional medical issues
connected with being overweight or obese. Obese persons are about 1 1/2 to 2 1/2 times more
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 5

likely to lose their lives from a heart disease compared to individuals having normal body mass
indices, according to the American Heart Association (BMIs).
Figure 1: Children BMI by Age

Obesity has also been linked to significant economic losses in several countries. In
2008, it is predicted that medical costs for diagnosis, prevention, and treatment were $147
billion dollars. Dropping economic activity and productivity contributes to the increase in these
losses. Given that increasing obesity is being ascribed to a rise in caloric consumption and a
decrease in physical activity, several proposed treatments place a strong emphasis on nutrition
and physical activity. While such cures may be effective in certain circumstances, policy
measures will almost probably be necessary to combat this frightening disease on a large scale.
Figure: Obesity Prevalence by Deprivation Decile
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Although the weight-loss industry in the United States is prospering ($66 billion in
2017), there is no proof that diet-related initiatives will help to reduce obesity (Enterprises,
2017). A large number of research have found that diets are ineffective at either controlling or
reversing weight gain. According to one study, 50 percent of dieters were more than 11 pounds
heavier than they were at the beginning of their diet five years after they started (Wolpert,
2007).
Studies has shown some promising results in taxing potentially dangerous food items;
however, it is a problematic approach in terms of politics. Only a tiny number of cities in the
United States have started placing taxes on sugar-sweetened beverages, including Philadelphia,
Boulder, Colorado, and Berkeley, California (Falbe et al., 2016). Early studies indicate that a
sugary drink excise tax in Berkeley resulted in a 21 percent decrease in the use of sugary
beverages (Storcksdieck et al., 2012). The nutrition labels are also misguiding since they do
not indicate the true sugar levels of the packed foods.

Figure: Sweetened Beverages Consumption After and Before Tax

There is evidence to show that advertising and marketing have an impact on children's
dietary preferences and meal choices. According to a study conducted in the United
Kingdom, 8.7% of the sugar introduced into the home was discovered in foods and beverages
advertised or offered at a discounted price. Although restrictions on advertising in the United
States are subject to First Amendment issues, protecting unaware children from aggressive
marketing of potential unhealthy foods and dangerous sugary drinks may have a good effect
on the youth obesity crisis in the country. The use of opiates can cause death fast and
spectacularly, but fat is just as lethal. This outbreak necessitates immediate intervention. As
obesity continues to devastate the United States, it will become increasingly impossible to
provide cheap health care to the population of the country.
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 7

SECTION 2 WORKSHOP – REDUCING OBESITY

2.1 Introduction
The rate of Obesity in the US and around the globe reached an epic proportion
beginning sometime in 2016, with 2.8 million people reported by the WHO to be dying every
year from being obese or overweight. Obesity is not just a problem for developed nations. A
significant percentage of the global population today lives in countries where the majority are
overweight than underweight (Flegal et al., 2012). A McKinsey Global Institute report
confirms that obesity is costing more than $2 trillion every year in the world. Obesity is
almost on par to armed conflict and smoking. While there are several approaches in place to
help deal with obesity, introducing sugar taxes is said to be a long-term solution to the
obesity problem. Introduction of healthy nutritional habits is another approach that would go
a great length in helping reduce childhood obesity.
2.2 Objectives
Following the proposed intervention program, and based on the research question, this
paper looks forward to measure the effectiveness of the UK_CEN program by carrying out a
randomised controlled trial on the selected sample in UK preschools. Here are the core
objectives;
i) To explore wider literature about earlier interventions for obesity amongst
children aged 2 to 4 years
ii) To propose an intervention program and to provide solutions for obese children
aged 2 to 4 years
iii) To provide recommendations to solve childhood obesity
2.3 Impact
There are a lot of initiatives that have been taken by different organizations and
governments in the UK to help minimize the effect of obesity. These include the CDC guide
to increase in the physical activity amongst people in the community including children,
guides to more eating of fruits, roots, vegetables and healthy foods, breastfeeding
interventions, local government interventions amongst others. However, these interventions
have failed to work, the WHO reports a slow response to the community base interventions
(WHO, 2013). Therefore, this study has resolved to champion the way forward for
implementation of early childhood intervention mechanisms to prevent obesity at the
preschools, and specifically guided by the teachers and parents since they are the primary
influencing factors in the lives of young children (Reilly et al., 2003).
2.4 UK-CEN Intervention Program
The UK-CEN program is specifically intended to help solve the obesity problem in
children by introducing a healthy lifestyle in early childhood. UK-CEN for children aged 2 to
4 years will be a multidimensional way of adding a healthy lifestyle to the children. This
program will be free for all families with children of all weights, whether obese or not obese.
UK-CEN program will run for 12 weeks, and it will be community-based. Precisely, UK-
CEN will encourage children aged 2 to 4 years to engage in healthy eating habits and to take
on physical activities from an early age. This program will specifically seek the help of the
parents and the teachers in its implementation to ensure it is sustainable (World Health
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 8

Organization, 2013). The program will help the children to adjust their dietary choices to
healthy ones at their own pace. The program will also have the children take on the physical
activities that they love. While this program targets children of all weights, children
considered to be at high risk of obesity will be highly encourage to take part in the study.
Scholars suggest that early interventions for obesity and overweight give a special
opportunity through which to create a lifestyle behavior that will help in promoting health
and reducing their risk of getting obese or overweight. Here are several studies commissioned
by the UK government which has specifically hinted on the relevance and need for early
obese intervention and providing the necessary support for the families having children aged
three years to 5 years. In 2007, the UK government initiated a strategy to reverse the obesity
trends, through the United Kingdom Service Agreement, which was to improve on the health
and wellbeing of preschool children. The program is intended to help significantly reduce the
level of obese children in the UK by 2020. There is the scarcity in the number of intervention
mechanism aimed at children, especially in the preschool settings in the United Kingdom.
There is a limitation in the proper description of the ideal mechanisms to employ in providing
effective interventions for children with obesity or overweight children.
It is estimated that about a fifth of the children in the United Kingdom begin school
when they are already overweight. In the year 2010, on a global measure, 42 million children
who are aged five years and below were discovered to be overweight. There are four chances
that these overweight kids aged two to four years will become overweight when they become
adults. And the members of the society who are at a disadvantaged are likely to be vulnerable
to the societal effects which lead to obesity. Obesity and overweight lead to the following
long-term effects; gall bladder disease, stroke, persistence in obesity, some types of cancers,
fatty liver illnesses, and diabetes amongst others (Olstad and McCargar, 2009).
From research done by early scholars, it has been projected that intervention of
obesity in early years of children provides a special chance through which to create
recommendable lifestyle behavior that will help in promoting the children’s health and
reducing their risk of development of obesity or overweight. Here are several studies
commissioned by the UK government which has specifically hinted on the necessity for
creating intervention mechanisms for dealing with obesity at the early stages of learning. In
2007, the UK government initiated a strategy to reverse the obesity trends, through the PSA,
which was to improve on the children’s welfare. The program is intended to help
significantly reduce the level of obese children in the UK by 2020 (National Health Service,
2009).
2.5 Past Interventions Review
The United Kingdom has become one of the leading spenders in Europe in the
provision of early years’ intervention programs. In the year 2015, the UK government
provided free education to 94% and 99% of 3 years and four-year children respectively in
government schools and some private schools. This is a pointer that the government schools
can be an ideal opportunity to have access to families and children for the purpose of
promoting a healthy way of living a life amongst the children and also monitoring the change
in the behaviors in regards to the subject. The WHO (2013) even hinted that the progress in
providing obesity solutions to children has been very slow, and using the preschools could be
an effective approach to dealing with the situation (Allen, 2011).
The England early years’ providers adhere to the compulsory EYFS. One of the
common EYFS components is to help the children understand the need and importance for
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 9

physical activity and to be in a position to make proper diet and exercise choices. As a result,
any intervention program for early age that looks forward to preventing obesity in children
and improving on the family lifestyle choices that are created on these guidelines should be
remitted in a preschool setting (Campbell and Hesketh, 2007). However, the success of the
curriculum intervention programs depends on the training and motivation of the employees
and their ability to successfully deliver the program.
2.6 Evaluation of Intervention Program
There is the scarcity in the number of intervention mechanism aimed at children,
especially in the preschool settings in the United Kingdom. There is a limitation in the proper
description of the ideal mechanisms to employ in providing effective interventions for
children with obesity or overweight children (Barton, 2012). Earlier intervention programs
and research studies suggest that behaviors significantly contribute to obesity amongst the
children. This implies that positively influencing the children behavior in preschool settings
can play an essential role in dealing with obesity. There are also high chances of improving
the physical activity for the children in the school setting. In one study, it was observed that
there was an improvement in the structured curriculum in the preschools and their essential
skills by integrating 10 minute daily structured activities led by a practitioner (Nicholas,
Stevens, Briggs and Wood, 2013).
Additionally, the ability of the parents to help their children and to act by influencing
the food choices their children make is a powerful tool for education. Parents particularly can
achieve this by helping shape the children’s attitudes, and preferences towards certain foods.
The parents and the teachers are considered to be the primary social influences for children
on their eating habits and physical activities.
2.7 Advantages of UK-CEN Program
The UK-CEN intervention program is delivery of dietary advice in early years setting
through the help of the parents and teachers by introducing healthy nutritional behaviors and
introducing physical activities both at home and at school to help sustainably contain
childhood obesity. Therefore, the importance of the UK-CEN program is to measure the
effectiveness of healthy eating amongst children and obesity prevention intervention in
children. This intervention program will help solve obesity amongst children through daily
natural methods like exercising and nutrition. The program will not require much in terms of
finances since the parents will be using the money, they have to buy healthy foods which may
be cheaper compared to the unhealthy foods. After the full completion of this intervention
program, the participants (preschoolers) will show greater eating habits of vegetables and
fruits, reduce consumption of high sugars, juices, soft drinks, and high fats which will be a
win for both researchers, parents, teachers and the government. The UK-CEN program will
also help the children exhibit reduced problems in their eating habits, (less neophilia, less
fussiness, etc.), the children will be taking on more exercises and physical activities, reduced
sedentary behaviors like watching a lot of TV, and lastly, they will show lower BMIs. It is
anticipated that intervention in the childhood days of a child’s growth and development will
have a positive influence on the behavior of the school children. Through this intervention, it
is expected that the children will follow in good healthy eating habits and engage more in
physical activities (National Health Service, 2009.
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 10

SECTION 3 REFLECTIVE WRITING

The magnitude of the obesity epidemic in regards to both economic costs and public
health had grown to very high proportions in the United States and around the globe. The
consumption of sugary beverages has also increased despite the numerous measures put in
place by the responsible governments to curb the situation. The increasing relentless
marketing and accessibility of the unhealthy drinks and foods have even made it more
difficult and challenging for children especially those from lower income classes, and the
racial groups minorities. Due to high levels of marketing and technology-oriented campaigns,
lack of knowledge of the negative consequences of the liquid sugars, the individuals do not
have the ability to make the appropriate choices in what they consume.
The sugary beverages market specifically creates a huge financial cost on the
communities in regards to treating the multiple diseases and conditions related to consuming
these products. There is therefore the need to introduce public health policies at this stage to
help deal with the sugar-related problems, obesity. However, it must be understood that the
sugar industry is massive and their influence is as huge both on policymakers and on public
perception about sugary beverages taxes.
In order to successfully implement the sugar beverage taxes, the support of
policymakers and the public is very important. For instance, the implementation of the South
African sugar beverage tax which was affected on April 2018 has experienced lots of hurdles
along the way. The law was proposed in 2016 and has taken very long to pass due to industry
pushback. The United States cities have also experienced such problem in regards to
implementation of the sugary beverage taxes, but to a lesser extent. The sin taxes actually
work, as evident from the numerous cases illustrated in the essay. There is need to continue
pushing to see a world free of obesity over time.
Based on my experience, and research, I have proposed four basic solutions to
childhood obesity based on lifestyle for the younger people. My proposed solutions include
more apples fewer chips, fast food and obesity, Perceptions of fast-food restaurants, diet and
obesity.
My first proposal is “more fruits, fewer chips.” Studies reveals how unhealthy diets
and food habits have affected the community in terms of health. These unhealthy foods are a
cause of major health disorders and to an extent have caused death.so this research creates
awareness or educates people about the effects of bad eating habits. With the continuity of
bad eating habits in the community especially in minors there will be a significant increase in
the number of obese children compared to previous years. Adults would be overweight and
suffer from obesity related illnesses like diabetes, hypertension. A study was completed by
the use of scanner data from supermarkets. These were studied and comparisons were made
between the sales of snacks before and after the program were run to help reduce
consumption of snacks in school going children. The also carried out an experiment by the
use of questionnaires which contained a food checklist for measuring the rate of consumption
of various foods on the checklist. The use of promotions for increasing the consumption of
fruits in schools has made a significant impact as the consumption of snacks has reduced.
Supermarkets had a drop-in sale of snacks after the program was implemented. With the
creation of awareness and education on the negative effects of junk food you find that
behaviors are changed so as eating habits. Healthier diets are sort after as a measure to
prevent negative outcomes that come with bad eating habits. Once the community has gained
knowledge of health consequences, they are likely to promote and enforce programs that
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 11

sensitize more people around the community and in turn cause a ripple effect around the
country then world.
My second proposed solution is related to fast food. A number of studies have been
completed to be able to find out the direct effects of fast-food consumption and the increase
of obesity. The goal of such studies is to educate people on the significance of good eating
habits and nutrition. This study proposes creation of more aware community of the health
benefits of dieting. The community in the long term would suffer from illnesses related to
obesity such as hypertension, obesity in adult’s strokes diabetes and many more. These will
be on the rise if continued use of fast foods was not controlled by sensitization or education
of the community of the negative effects. A study used questionnaires filled in by parents on
the frequency of consumption of fast foods. Collection of body mass index of children of
specific ages from relevant institutions e.g., hospitals and clinics. By reviewing data from
records held by regulatory authorities. Eating of fast foods directly result to mass gain and
diseases like diabetes. The consumption of fast food per week led to an increase in weight at
a higher level. Fast food consumption led to complications in motor functions due to obesity.
They have a benefit as community awareness, sensitization and education has decreased the
levels of consumption of fast foods and also led to the improvements of nutritional contents
in establishments that offer food. As the community is educated changes in eating habits are
enforced in younger generations which in turn led to a better future for coming generations
The third solution is about observing diet. The study proposes having a good diet for
the children since studies have determined the relationship between diets and changes in
people’s weight in the community to be positively related. The study therefore proposes
creation of awareness on the health impacts of unhealthy diets. The study also proposes the
government and relevant bodies to sensitize and educate the community on benefits of
healthy diets. The consumption of fast foods has led to an increase of overweight children
and adults in the community. An increase in weight related illnesses. The decrease in the
number of fast-food establishments after regulations were put in place. Fast food places have
decreased in regions highly affected due to the new regulations put in place. There has been a
drop in the intake of soft drinks in the US. The community has embraced guidelines set to
regulate fast food establishments. All areas are showing a reduction of consumption of fast
foods. There has been a change in eating habits in the community. Attitudes have also
changed about healthy diets
My last solution is based on the effects of strategies like food deprivation on the
health of the community that suffers from fast food related effects like obesity. The study
proposes reducing the amount of diet related illnesses in the community through sensitization
programs and measures. The increase of fast-food consumption would have negative health
effects on the community. Without the control of fast-food establishment practices on dieting.
The community will continue to suffer health risks related to obesity. The implementation of
regulatory measures in food consumption will benefit communities by reduction of diet
related illnesses. People with food insufficiencies have poor eating diets they consume more
calories in junk food and lack nutritional balance. It was found that when diets are followed
calorie consumption reduces with the knowledge and sensitization on nutrition and its effects.
Illnesses related to obesity have gone lower with this kind of intervention according to a
number of studies. The deprivation of food intake moderates the effect of obesity related
illnesses. Food regulated people suffer less from health risks. Findings help in education and
add to literature in public libraries.
USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 12

References
Zimmerman, M. 2009. Air shows deliver adrenaline without bleeding family budgets. Los
Angeles Times. May 23, 2009.
Crompton, J.L. 2006. Economic impact studies: instruments for political shenanigans?
Journal of Travel Research. 45: 67-82
Tedstone, A., Targett, V., & Allen, R. (2015). Public Health England: Sugar reduction the
evidence for action. Accessed 18th Jan 2022 from
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/470179/Sugar_reduction_The_evidence_for_action.pdf

Falbe, J., Thompson, H. R., Becker, C. M., Rojas, N., McCulloch, C. E., & Madsen, K. A.
(2016). Impact of the Berkeley excise tax on sugar-sweetened beverage
consumption. American journal of public health, 106(10), 1865-1871. Accessed 18th Jan 2022
from https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2016.303362?rfr_dat=cr_pub
%3Dpubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org

Storcksdieck genannt Bonsmann, S., & Wills, J. M. (2012). Nutrition labeling to prevent
obesity: reviewing the evidence from Europe. Current Obesity Reports, 1-7. Accessed 18th
Jan 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410024/

Enterprises, M. (2017). US weight loss market worth $66 billion. Webwire. com, 4. Accessed
18th Jan 2022 from https://www.webwire.com/ViewPressRel.asp?aId=209054

Wolpert, S. (2007). Dieting does not work, UCLA researchers report. UCLA Newsroom, 3.
Accessed 18th Jan 2022 from https://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-
UCLA-Researchers-7832

Wellman, N. S., & Friedberg, B. (2002). Causes and consequences of adult obesity: health,
social and economic impacts in the United States. Asia Pacific journal of clinical
nutrition, 11, S705-S709. Accessed 18th Jan 2022 from
https://www.cdc.gov/obesity/adult/causes.html

Shanoor, S., Shah, A, and Schneider, E. (2018). The US HAS Two Opioid Epidemics: The
Federal Response Should Consider Both. Accessed 18th Jan 2022 from
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https://www.commonwealthfund.org/blog/2018/us-has-two-opioid-epidemics-federal-
response-should-consider-both

CDC, (2022). Tobacco- Related Mortality. Accessed 18th Jan 2022 from
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Appendices
Appendix 1: UK sugar intake compared to the recommended maximum of 5% energy

Source: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/470179/Sugar_reduction_The_evidence_for_action.pdf

Appendix 2: Contributors to sugar intake in the UK – children aged 4 to 18 years

USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 14

Source: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/470179/Sugar_reduction_The_evidence_for_action.pdf

Appendix 3: Contributors to sugar intake in the UK – adults aged 19 to 64 years

USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 15

Source: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/470179/Sugar_reduction_The_evidence_for_action.pdf
Running head: USA CHILDHOOD OBESITY INTERVENTION PORTFOLIO 16

Appendix 4: Summary of marketing and promotional activity to encourage sales of high sugar foods and drinks