‘BACK TO SCHOOL BLITZ’

1. ‘BACK TO SCHOOL BLITZ’ Screening Children for Body Mass Index, Diabetes and Nutrition Information

2. About the Blitz • The main goal was to screen 100% of children who live in the Garden River First Nation for obesity as well as the onset of diabetes • In order to do this effectively, the screening tool used was aimed to focus on four main categories: risk factors, lifestyle patterns, nutritional patterns and a blood glucose test • Input was received on the screening tool from an expert in Paediatric Endocrinology, Dr. Elizabeth Sellers, Winnipeg Children’s Hospital • Dr. Sellers is renowned for her research in diabetes and its association in aboriginal children

3. Background Info on Participants • Two groups were screened (2010 & 2011) • Total participants 2010: 192 • Total participants 2011: 75 • High risk* participants 2010: 34 • High risk* participants 2011: 31 • Average age from 2010: 9.6 • Average age from 2011: 10.2

4. Background Info on Participants Cont’d • Total number of participants (both groups): 267 • Total NOT high risk: 202 (75.7%) • Total high risk*: 65 (24.3%) * High risk participants were rated based on 3 categories: BMI score >95th percentile, family history of diabetes and/or presence of acanthosis nigricans

5. Nutritional Patterns Total Nutritional Intake

6. Nutritional Patterns • On average, only 29.6% of participants received adequate nutritional intake (according to Canada’s Food Guide) • High risk participants had a greater level of inadequate intake (75.5%) than those not at high risk (68.6%)

7. Nutritional Patterns (Fruit, Vegetable & Milk Intake) Total Nutritional Intake

8. Nutritional Patterns Cont’d • When broken down further, it is evident that the main issue is fruits and vegetables • Both fruit and vegetable intake was well under the recommended amount according to the Canada Food Guide (90.8% inadequate for both) • On the other hand, the consumption of milk products proved the opposite • 70.2% of participants received an adequate amount of milk products per day

9. BMI Statistics: Percentage of Participants Over and Under the 95th Percentile as outlined in the RNAO Nursing Best Practice Guidelines Program “Primary Prevention of Childhood Obesity” being under 95 percentile is best

10. BMI Statistics • Overall, approximately ¼ of the population screened recorded a BMI that was greater than the 95th percentile (as outlined in the RNAO Nursing Best Practice Guidelines Program “Primary Prevention of Childhood Obesity”) • The average score for high risk participants was significantly higher than those of the not high risk group (28.4 : 18.4) • When comparing 2011 and 2010 results, there was a higher percentage of participants over the 95th percentile (41.3% : 31.8%), however this is a result of targeting high risk children from 2010 and bringing them in to be re-screened • Including both high risk groups (2010 & 2011), a total of 23 scored a BMI over 30 and a total of 3 scored a BMI over 40 • In addition, of the participants brought back a second time, only 2 had recorded a lower BMI than the previous year. Two reported ++ emotional response to higher BMI

11. Risk Factors in High Risk Group • 3 main risk factors were assessed from the high risk group • BMI over 95th percentile= 65 (100%) of high risk group • Family History of diabetes (mainly in mother/ maternal grandmother)=47 (72.3%) • Presence of acanthosis nigricans (describe) = 4 (6.2%) PARTICIPANTS RISK FACTOR

12. Referrals In High Risk Group PARTICIPANTS TYPE OF REFERRAL

13. Referral Statistics • In total, 30 (46.2%) high risk participants were referred to either the registered dietician or physiotherapist • 17 (26.2%) participants were either deferred, refused a referral or did not show up at their scheduled appointment • 18 (27.6%) participants did not receive a referral • In 2011, 13 children from 2010’s screening that were considered high risk were brought back and reassessed • Only 2 of the 13 (15.4%) scored a lower BMI than the previous year • In 2011, a referral was attempted to be made for every high risk participant (however some deferred, refused or did not show up for their appointment)

14. 2011 Referrals 2010 Referrals

15. Sugar Test • As a total, the average blood glucose of both groups (2010 & 2011) was 5.8 mmol/L • Average of the high risk population was 6.0 mmol/L

16. Lifestyle Factors • “Children aged 5-11 and youth aged 12-17 should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily” (Public Health Agency of Canada, 2011). • In total, it was found that 19.9% of the population screened were meeting the physical activity requirement of 60 minutes per day • 34.8% recorded less than 60 minutes of activity per day and 45.3% did not record or specify the duration or frequency of physical activity per day

17. Lifestyle Factors Cont’d • When broken down further, we found that and even greater percent (44.6%) of high risk children reported less than 60 minutes of exercise per day, whereas only 16.9% obtained the required amount • 38.5% of this population did not specify duration or frequency of daily activity (could be due to various reasons)

18. Physical Activity Levels Number of Participants