Growing Healthy Kids

Growing Healthy Kids

Alarming Trends The U.S. Surgeon General states that, during the last 20 years, the number of overweight children has doubled, and the number of overweight adolescents has tripled. Source: Institute of Medicine, 2004

Overweight Defined by BMI • Body Mass Index (BMI) percentiles help determine if a child’s weight is right for his or her height. • A BMI number is calculated for children and teens using height and weight. [weight (lb) / height (in)2] x 703 • For children and teens, BMI is age and gender specific and is often referred to as BMI-for-age. Source: Centers for Disease Control and Prevention (CDC) Growth Chart Slides

BMI-Percentiles-for-Age Example: Chart for Boys 2 to 20 years The BMI number is then plotted on CDC’s BMI-percentile-for-age growth charts (for either girls or boys) to obtain a percentile ranking. BMI Source: CDC Growth Chart Slides

BMI-for-Age …What does it mean?

A Snapshot of America • 34% of all children and teens in the U.S. are either overweight or at risk of overweight Source: Pediatrics, 2006 • In minority populations, 20% of children and teens are overweightSource: Time, 2004 • 10% of pre-school children are overweight Source: Department of Health and Human Services, 2002

Pennsylvania Statistics • 18.2% of eighth graders are overweight • 17.0% of eighth graders are at risk of overweight Source: Pennsylvania Department of Health

Perception versus Reality Has our perception of “healthy” weight changed over the past 20 years? These drawings show an average “healthy” weight child on the left and an “overweight” child on the right.

Why does healthy weight matter? • Immediate benefits may include: • More energy • Better ability to focus on tasks • Increased academic performance • More self-esteem and confidence • Healthy habits may lead to a lifetime of good health • Obese children have an 80% chance of becoming obese adults Source: American Academy of Adolescent and Child Psychiatry (AACAP), 2003

Percent of children, aged 5-10, with at least 1 heart disease risk factor: 60% Heart Disease Risk Factor Levels in Children Percent of overweight children, aged 5-10, with 2 or more heart disease risk factors: 25% Source: Pediatrics, 2006

Type 2 Diabetes • Rates of type 2 Diabetes, formerly known as “adult onset diabetes”, are increasing in youth. • Approximately 85% of children diagnosed with type 2 diabetes are overweight or obese. • As the U.S. population becomes increasingly overweight, researchers expect type 2 diabetes to appear more frequently in younger children. Source: American Diabetes Association

What has contributed to the current health status of children and teens?

Food What are kids eating … or not eating?

1. Carbonated beverages 2. Low-fat milk 3. Fruit drinks 4. Whole milk 5. Grain mixtures (pizza, pasta) 6. Meat mixtures (hamburgers, etc.) 7. White potatoes (French fries) 8. Sugars / sweets 9. Cakes / cookies 10. Non-citrus juices The Top 10 In 1999-2000 the top 10 items consumed by boys and girls, aged 6-19, were: Source: A Nation at Risk: Obesity in the United States

Soda Consumption Children who drank more than 12 ounces of sweetened drinks … • Gained significantly more weight than children who drank less than six ounces a day • Drank less milk • Took in 244 more calories/day Source: Journal of Pediatrics, 2003

Carbohydrates • In 1994-95, intake of whole grains for children was 1 serving or less • Between 1989-1995, the increase in carbohydrates in children and teens came from: • Pizza • Pasta • Mexican food • Soft drinks Source: A Nation at Risk: Obesity in the United States

Fruits & Vegetables • Between 1994 and 1996, only 14% of children ages 6-19 met the recommendations for daily fruit intake, and only 20% ate enough vegetables. • Among high school students, only 23.6% of males and 20.3% of females eat five or more vegetables per day. • In 1980, about 50% of high school seniors reported eating green vegetables “nearly every day.” Source: Robert Wood Johnson Foundation

Vegetables Only ¾ of children (all ages) report eating at least one vegetable every day… • Most popular vegetable is French fries! • Next is tomato products (spaghetti sauce) • Lower is green beans, corn, and peas • Lowest is nutrient-packed dark green or deep yellow vegetables Source: United States Department of Agriculture

Eating Out • On average, children ages 11-18 eat at fast-food restaurants twice a week • Away-from-home foods eaten by children are higher in fat and saturated fat and lower in fiber and calcium than those eaten at home • Children eat nearly twice as many calories (770) at restaurants as they do during a meal at home (420) Source: Robert Wood Johnson Foundation

Super Size It? Portion sizes are getting bigger and bigger!

Spaghetti and Meatballs 20 Years Ago Today 500 calories 1 cup spaghetti with sauce and 3 small meatballs 1,025 calories 2 cups of pasta with sauce and 3 large meatballs Calorie Difference: 525 calories

Soda Today 20 Years Ago 85 Calories 6.5 ounces 250 Calories 20 ounces Calorie Difference: 165 Calories

Bagel 20 Years Ago Today 140 calories 3-inch diameter 350 calories 6-inch diameter Calorie Difference: 210 calories

Blueberry Muffin 20 Years Ago Today 500 calories 4 ounces 210 calories 1.5 ounces Calorie Difference: 290 calories

Portion Size Influences Amount of Food Eaten • Children 3-5 years old consumed 25% more of an entrée and 15% more calories at lunch when presented with portions that were double an age-appropriate standard size. Source: American Journal of Clinical Nutrition, 2005 • Adults ate more food when given larger portions but rated hunger the same as smaller size portions. Source: Journal of the American Dietetic Association, 2004

Physical Activity How are kids spending their free time?

Favorite Activities A survey of young people ages 8 – 18 showed their daily activities accounted for the following hours: • Watching TV - 3 hours, 51 minutes • Using the computer - 1 hour, 2 minutes • Video games - 49 minutes • Reading – 43 minutes Source: Robert Wood Johnson Foundation

Television • Obesity levels increase as the amount of time spent watching TV increases, especially among female children and teens. Source: Archives of Pediatric and Adult Medicine • Kids who have a TV in their bedroom watch about 1.5 hours more per day than those who do not. Source: Kaiser Family Foundation

Screen Time • The typical American child spends about 44.5 hours per week using media outside of school. • Boys spend an average of 1 hour and 12 minutes playing video games daily, while girls average 25 minutes a day. • Kids who have a computer in their bedroom use it about 45 minutes more per day than those who do not. Source: Robert Wood Johnson Foundation

Physical Activity • Physical activity declines steadily during adolescence. Source: CDC, 1997 • Only 25% of high school students participate in at least 30 minutes of moderate physical activity on five or more days of the week. Source: Institute of Medicine • 50% of children ages 12-21 rarely or never exercise. Source: CDC

The Future of our Children “Children today have a shorter life expectancy than their parents for the first time in 100 years.”

How can we combat this “overweight epidemic?” • Prevention is the key! • Habits such as healthy eating and physical activity MUST be established in childhood AND practiced throughout a lifetime.

It takes everyone working together "You can't educate a child who isn't healthy, and you can't keep a child healthy who isn't educated." Source: Former U.S. Surgeon General Joycelyn Elders

The Role of Schools “Schools not only teach our children to read and write, but also to take care of their bodies and minds. Schools are really ideal places to promote good health because most young people are in school five days a week during most of the school year.” Source: Former U.S. Secretary of Health and Human Services Tommy G. Thompson, 2001

The Child Nutrition and WIC Reauthorization Act of 2004 requires implementation of local school wellness policies that address healthy eating and physical activity. All schools participating in the federal school lunch and/or breakfast program must comply. Measurable goals must be established for: Nutrition guidelines Nutrition education Physical education Physical activity Other school-based activities related to healthy eating and physical activity What is a Student Wellness Policy? Source: Child Nutrition and WIC Reauthorization Act

Nutrition Education • The goal of nutrition education is to teach, encourage, and support healthy eating among students. • Promoting student health and nutrition enhances readiness for learning and increases student achievement.

Nutrition Guidelines • In order to develop lifelong healthy eating patterns, children need to be introduced to a variety of nutritious foods in a positive manner. • Foods available in district schools during the school day shall be offered to students with consideration for promoting student health and reducing childhood obesity.

The Goal of Physical Education • Physical activity is critical to the development and maintenance of good health. • The goal of physical education is to develop physically educated individuals who have the knowledge, skills, and confidence to enjoy a lifetime of healthful physical activity. Source: National Association for Sport and Physical Activity

Provides a variety of physical activities that make a physical education class fun and enjoyable Creates maximum opportunities for students of all abilities to be successful Assists students in setting and achieving personal health-related fitness goals Prepares and encourages students to practice skills and be active for a lifetime Today’s PE Class To achieve a quality physical education program, a certified physical education teacher: Source: National Association of State Boards of Education, December 2004

Beyond the Gym The goal of a comprehensive school physical activity program is to provide a physical and social environment that encourages safe and enjoyable activities that are developmentally appropriate and designed to promote optimal health.

Physical Activity • Physical activity, broadly defined, includes exercise, sport, dance, as well as other movement forms. • Opportunities may include: • Recess and/or activity breaks • Intramural sport programs and/or physical activity clubs • Interscholastic sports • Walk/bike-to-school programs • Incentive programs for students and/or families Source: National Association of State Boards of Education, December 2004

Integration is Key to Success An effective coordinated school wellness program integrates the cafeteria, classroom and gym to reinforce positive healthy behaviors throughout the day and makes clear that good health and learning go hand in hand. Source: CATCH Texas

School-Based Activities • Signs posted in the cafeteria to promote healthful eating choices • Home assignments for the family • Parent newsletters • Promotional activities, campaigns and/or programs • Role modeling of healthy behaviors by teachers, food service staff and administrators • Student taste-testing

What can be done outside of school?

Use MyPyramid and “Go, Slow Whoa” food lists to make healthy food choices Adjust portions Start the day with breakfast Serve a rainbow of fruits & veggies every day Serve low-fat milk with meals and water with snacks Steer clear of sugary drinks and fruit juices Read food labels Save fast food for a once or twice a week treat Plan and make family meals together Be a role model Simple Steps for Healthful Family Eating

Fit Families = Happy Families • Encourage children to be physically active for at least 60 minutes every day • Limit TV, video games, and computer time to 1-2 hours a day combined • Play with your children and plan activity time for your entire family • Give gifts that promote fitness • Plan parties with active themes such as skating • Be a role model

Nutrition: www.mypyramid.gov www.nhlbi.nih.gov/health/public/heart/obesity/wecan/ www.fns.usda.gov/eatsmartplayhard/ www.dolesuperkids.com Physical Activity: http://www.presidentschallenge.org www.tvturnoff.org http://www.bam.gov/index.htm http://verbnow.com Body Mass Index www.cdc.gov/growthcharts . For More Information…

Acknowledgments WellSpan’s Community Health Improvement department developed this presentation and authorizes its use by school district personnel. Any other uses or copying is strictly prohibited. For more information, contact: Community Health Improvement at 717-851-3222. This presentation has been adapted from materials produced by the Center for Health Promotion and Prevention Research, University of Texas-Houston School of Public Health. For additional information about the CATCH Texas program, visit www.catchtexas.org

Growing Healthy Kids