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Childhood Obesity : How can physical education help reduce the incidence?. Judith A. Flohr, Ph.D. Department of Kinesiology James Madison University flohrja@jmu.edu. Outline. Introduction Responsibility Obesity and Public Health
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Childhood Obesity : How can physical education help reduce the incidence? Judith A. Flohr, Ph.D. Department of Kinesiology James Madison University flohrja@jmu.edu
Outline • Introduction • Responsibility • Obesity and Public Health • Defining Obesity:When is a Child Considered Obese/Overweight? • Prevalence of Obesity • Consequences of Obesity • Prevention:The Importance of Physical Education • Managing Obesity/Overweight • Questions and Answers
ResponsibilityWho is “responsible” for the health and well being of children? University Faculty University Faculty Physical Education Teachers School Administrators State/Federal Legislators University Faculty Parents Health Care Providers
East Penn School District April 4, 2002 To the Parents/Guardian of “I am an overweight kid”; Beginning in the fall 2001 school nurses in cooperation with teachers and administrators have been screening students for signs and symptoms of overweight and/or obesity. Unfortunately, the results of the height and body weight measurements indicate that your child is obese. We want to assure you that the purpose of the screenings and this letter are to assist in appraising, protecting and promoting the health status of your child. We look forward to working with you to encourage and develop ways for your child to increase his/her activity and adopt good nutritional habits. Sincerely, George Ziolkowski, Director Pupil Personnel Services
Responsibility • Teachers • Maximize the child’s physical activity experiences • Before/After school programs • Recreational activities • Maximize physical activity during and after class • Emphasis should be on a child’s health • Homework • Effective use of class time • How?
Mission and Goals • Program • What is the mission of the program? • Fitness development? • Motor skill development? • Physical activity behavior? • Teacher • Professional goals • Personal health goals • Contribution to the mission of the program • Students • Setting goals • Environment, activities etc to help reach goals
Defining Obesity/Overweight • Body mass index Weight (kgs) Height (meters2) • Categories • Underweight = < 5th • Acceptable = 5th-85th • At Risk = 85th- 95th • Overweight = 95th
50th Percentile 5th 95th
Statistics • Twenty years ago, 5% of American kids were overweight; today 15% are, and another 15% are headed that way • In 1969 80% of kids played sports everyday;today 20% do • By 17, a child has spent 38% more time in front of the TV than in school.
Body Mass Index 4th graders in Virginia 16.4% (13) 14.1% (13) Percentage of Population Comprehensive Study of the Nutritional Status of Children (1998)
Body Mass Index 4th and 7th graders (Harrisonburg) 31% (14) 30% (14) % of population 13% N = 54 N=22 N=25 1996 4th graders
Body Mass Index 7th graders ( Harrisonburg) N=12 N=20 N=10 N=05 OB >95th Percentile OW >85th Percentile
Consequences of Childhood Obesity:Risk for Adulthood Obesity Percent who become obese adults 0-5 yrs 6-12 yrs 12-17 yrs
Consequences of Childhood Obesity • Overweight 5-10 year olds • 60% have 1 CVD risk factor • 25% have 2 or more • Obesity is a major risk factor for • Type II Diabetes, CVD and hypertension.
Consequences of Childhood Obesity • Overweight schoolchildren are: • 2 time as likely to have elevated total cholesterol • 12 times as likely to have fasting insulin
Consequences of Childhood ObesityHyperinsulinemia Syndrome X Obese adolescents • 25% impaired glucose tolerance • .4% silent Type II Diabetes
Prevention of Obesity:Etiology of Obesity Cultural 30% Other (environment, lifestyle) 45% Genetic 25%
Prevention:Etiology of Obesity High Energy Intake Low Energy Expenditure Genetic & Parental Influences
Prevention:Etiology of Childhood Obesity • Low birth weight • Induces a “natural” catch-up in growth 0-2 years of age. • Catch-up may increase the risk for obesity later in life • Pregnancy • Overweight mother may = overweight child • Breast Feeding • Critical periods, • Oscai, Larry
Prevention:Etiology of Childhood ObesityParental Effects • Obesity in parents is a strong risk factor (environmental ? Genetic?) • Risk high if: • If thin child < 3 yrs has a parent or two parents, risk = 30-60% • In older children body weight stronger predictor of risk for obesity
Prevention:EtiologyEnvironmental Factors • High fat diet, soft drinks • Low level of habitual physical activity • Television viewing • Video Games • Physical Education
Prevention:Physical Education Daily participation in physical educationby high school students Percent Source CDC NYRBS, 1995
Prevention:Physical EducationPhysical Education Goes Down, Weight Goes Up %
The Importance of Physical Education • Middle School • Pedometer (measures steps) • Total on a PE day • Girls = 10,484 ± 2896 • Boys = 11,554 ± 4619 • Steps in PE • Girls 2063 ± 867 • Boys 2220 ± 1221 • 21% of daily total was from PE
The Importance of Physical Education 11,555 ± 4619 10,484 ± 2896 Steps 2220± 1221 2063± 867
The Importance of Physical Education Percent 21% 21%
The Importance of Physical Education • Approximately 2000 steps/mile • Walk one mile at 3 mph pace (3.5 METS) • Assume a body weight of 54 kgs. (119 lbs.) • Approximate caloric cost of PE = 100 kcals • PE = 500 kcals/week • 18/36 weeks with no PE 9,000 kcal surplus • 2.5 lbs/school year
“Overweight children and adolescents may be at a disadvantage physically, as well as socially and economically.” (Troiano, 1995, p.1090)
Prevention is vital! “Attempts to increase physical activity for children and adolescents may provide a promising avenue in this effort.” (Troiano, 1995, p.1090)
Managing Overweight & Obese Children • Non-Drug • Multidisciplinary Approach • Diet • Behavior Modification • Exercise • Limit • High fat snacks • Sweet beverages • Fast foods
Managing Overweight & Obese Children • Parents • Should not express criticism , if they do could increase risk of eating disorders • Encourage healthy diets and exercise
Managing Overweight & Obese Children • Parents should • Limit • TV • Video games • Computer use
Managing Overweight & Obese ChildrenPhysical Education • Body Composition • Caloric Expenditure • Muscle Development • Bone Development
Cardiovascular Endurance The ability of the heart, lungs and blood vessels to deliver oxygen to the working muscle for extended periods of time. Maintain an elevated (> 120-130 bpm) for at least 30 min most (5-6) days of the week Vigorous activity > 130 bpm at least 3 days/week How? Managing Overweight & Obese ChildrenPhysical Education PLAY
Muscular Strength The ability of a muscle to exert maximum force against resistance. Role in Metabolism Role in “Aerobic Ability” Engage major muscle groups in “resistance” activities Rope Surgical tubing Dyna/Therabands Milk jugs Bungee cords without hook Managing Overweight & Obese ChildrenPhysical Education
Muscular Strength Avoid maximal weights 8-10 RM Damage to “growth plate”-plastic swords Ligament damage-gum Avoid severe muscular fatigue Increase reps before resistance 1-2 sets of 8-10 different exercises Rest between sets 1-2 minutes Limit strength training to 1-2 sessions per week. Push-ups Pull-ups Managing Overweight & Obese ChildrenPhysical Education
Managing Overweight & Obese ChildrenPhysical Education • Muscular Endurance • The ability of a muscle to exert sub maximal force repeatedly over a period of time (> 30 repetitions) • How-Activities similar to muscular strength, lower resistance • Multi-joint vs. single joint
Managing Overweight & Obese ChildrenPhysical Education • Flexibility • Ability of a joint to move freely through a full range of motion. • When • Chewing Gum
ACTION • The Nation must take action to assist Americans in balancing healthful eating with regular physical activity. Individuals and groups across all settings must work in concert to: • Ensure daily, quality physical education in all school grades. Such education can develop the knowledge, attitudes, skills, behaviors, and confidence needed to be physically active for life. The Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity (2001)