Nutrition Task Force

1. Nutrition Task Force Community Resources and The Growth Screening Program Workshop School Nursing in 2005 Monday, January 17, 2005 12:00 PM to 3:00 PM

2. Washington County Health Partners, Inc. • Not-for-profit, 501(c) 3 organization • Dedicated to the enhancement of the health and well-being of Washington County residents. • Assesses the county’s health status periodically • Works through volunteer task forces and programs to address identified health issues • Currently 7 task forces and 2 programs Nutrition Task Force

3. Nutrition Task Force Background • Created in July 2004 • Focus on promoting and supporting healthy lifestyles for all children and the adults that impact their homes, schools, and neighborhoods. • Healthy lifestyles defined as living actively, eating in healthy ways, and encouraging positive body image and self esteem. Nutrition Task Force

4. Task Force Members • American Cancer Society, Kathleen Row • Burgettstown School District, Jan Marietta, RN • Canonsburg General Hospital, Sandy Hoffman, RN • Community Action Southwest WIC Program, Judy Holtz, RD • Family Health Council, Nancy Pauli • Gateway Health Plan, Connie Osborne • Highmark Corporation, Lynne Marchese • Monongahela Valley Hospital, Debbie Hutcheson, RD, MS, CDE and Linda Kolano, RD, LDN • PA Educational Network for Eating Disorders, Anita Sinicrope Maier, MSW and Jen Sylves • Pediatric Associates of Washington, Fran Sylvers, CRNP • Penn State Cooperative Extension, Carolyn Wissenbach • Pennsylvania Department of Health, Maureen Smith, RN, BSN • Private Registered Dietitian, Lea Ann Ostergaard, MS, RD, LDN • Retired Medical Doctor, Jon S. Adler, MD • University of Pittsburgh Graduate School of Public Health, Ravi Sharma, PhD and Katie Hindes, MPH • UPMC for you, Carol Kelley • The Washington Hospital Teen Outreach, Karen McFedries Nutrition Task Force

5. Outline of Workshop • Coordinated School Health Program Overview • Growth Screening Progam and Available Resources • Eating Disorder Sensitivity/Screening • Hands-on Learning (small group break out) • Anthropometric measurements • NutStat Program • Action Plan Brainstorming Nutrition Task Force

6. Objectives • To understand the concept of a Coordinated School Health Program • To be aware of available resources for the growth screening program • To recognize signs and symptoms of eating disorders and those at risk for development • To understand how to implement the Growth Screening Program with sensitivity to issues surrounding eating disorders • To understand how implementation of the Growth Screening Program could affect negatively affect eating disorder behaviors • To understand how to work with NutStat Program Nutrition Task Force

7. Coordinated School Health Program Overview The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer through research, education, advocacy, and service.

8. Causes of Cancer: A Review of the EvidenceEstimated Percentage of Total Cancer Deaths Attributable to Established Causes of Cancer 30 30 5 3 2 0 5 10 15 20 25 30 35 1 Tobacco Adult Diet/Obesity Sedentary lifestyle Occupational factors Family history of cancer Viruses/other biologic agents Prenatal factors/growth Reproductive factors Alcohol Socioeconomic status Environmental pollution Ionizing/ultra-violet radiation Rx drugs/medical procedures Salt/additives/contaminants Source: Harvard Report on Cancer Prevention, Cancer Causes and Control, November/December, 1996

11. ACS Serves as a Resource and Advocate • Materials • Information sharing • Training opportunities

12. American Cancer Society 1-888-227-5445www.cancer.org

13. Procedures for the Growth Screening Program for Pennsylvania’s School-age Population

14. Growth Screening Program • Pennsylvania will be one of the first states in the nation to track physical growth among the entire K-12 population on an annual basis. . • Screening for the upcoming school year is voluntary; mandatory tiered implementation will start in the '05-'06 school year and will expand three additional grades each year thereafter. By the '08-'09 school year, all grades will be screened.

15. New Screening Procedure New Screen Procedure • Measure height • Measure weight • Determine Body Mass Index (BMI) • Graph BMI on 2000 CDC growth charts • Provide information to parents

16. Epidemic Why Worry About Pediatric Obesity? • 27% of children age 5-10 have 1 or more heart disease risk factor • 1 in 3 children born in the year 2000 will develop Type II Diabetes (based on current trends) • Obesity is now the most prevalent nutritional disease of children and adolescents in the United States.

17. Cardiovascular health-hypercholesterolemia, dyslipidemia, hypertension (metabolic syndrome) Endocrine system -hyperinsulinism, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, and menstrual irregularity Mental healthdepression, low self-esteem Pulmonary-asthma, obstructive sleep apnea Orthopedic- slipped capital femoral epiphysis Gastrointestinal / Hepatic- nonalcoholic hepatic steatosis, cholecystitis Consequences of Obesity in Children Conseqin Children

18. Percentage of Overweight Children and Youth Who Become Obese Adults Percentage of Overweight Children & Youth Who Become Obese Adults National Institute for Health Care Management, Nov 2003

19. BMI-for-Age Cutoffs in Children and Youth

20. Categorizing Weight in Adults and Youth Categorizing Weight in Adults and Youth National Institute for Health Care Management, Nov 2003

21. Best single measure for obesity in children Highest correlation with skinfold thickness Simple and useful measure Track growth from childhood, through adolescence, to adulthood Performed reliably and easily Recommended by AAP, WHO, AMA Body Mass Index (BMI) Advantages Body Mass Index (BMI)Advantages

22. Screening tool ONLY….. not diagnostic Individual assessment, skinfold measurements, family history, physical examination, metabolic findings Influenced by pubertal status Not specific for children with special health care needs Does not differentiate between central adiposity and peripheral adiposity Lean muscle mass vs. fat tissue mass. Sensitive to minor changes in weight and height Body Mass Index (BMI) Limitations Body Mass Index (BMI)Limitations

23. Key Messages Key Messages • The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States as well as in other developed and developing countries. • BMI is currently the best tool we have to assess adiposity in children and adolescents. • Surveillance data for BMI can serve to assess nutritional status of populations, monitor changes over time, promote epidemiological research, screen and refer individuals at risk, and develop and evaluate programs and policies.

24. Available Resources • Growth Screening Program • Sample parent letters (pre-screening and results) • Health Care Resources Brochure • Parent nutrition and physical activity resource list • Parent BMI brochure and insert • School nurse informational resource list • Floppy disk (Electronic copies of above items) • Nutrition and physical activity brochures • CD ROM (Copy of NutStat Program) • NutStat step-by-step instructions • Growth screening charts • BMI wheels • Eating disorder screening/sensitivity training materials • List of task force members and resources offered • Coordinated school health program brochure and “Model Program” • Community Action Southwest brochure • Preventing Childhood Overweight and Obesity: Parents Can Make a Difference--ProjectPA Kit Nutrition Task Force

25. Hands-on Learning Two break out groups (need to rotate each): • Digital and balance beam scale and stadiometer • Laptop with Nutstat Program Nutrition Task Force

26. Action Plan Brainstorming Session Nutrition Task Force

27. Thank you! Contact: Washington County Health Partners, Inc. 190 North Main Street, Suite 208 Washington, PA 15301 (P) 724-222-6511 (F) 724-222-6685 (E) info@wchpinc.org