CHILDHOOD OBESITY

1. CHILDHOOD OBESITY TRENDS

2. OBJECTIVES • Become aware of child obesity problem • Inform what BMI is • Consider changes that can be made • Give ways to encourage classroom activities • Suggest ways to improve school health • Review Middleboro Wellness Plan • Tips for Parents

3. Heart disease is the leading cause of death in the United States. Overweight and obesity increase one's risk of developing heart disease. • By 8 yrs of age 40% of children have significant cardiac risk factors like high blood pressure, high cholesterol and/ or inactive lifestyles. • The percentage of overweight youth has more than doubled in the past 30 years. • Obesity is one of the most pressing health threats to families and children nationwide. • 1/3 of American children and adolescents are either obese or at risk of being obese. • Children who are overweight or obese increase their likelihood of developing heart disease, type 2 diabetes, stroke, asthma and a host of other serious health problems. • Numerous factors contribute to weight problems including heredity or family history, activity, and eating habits.

4. December 2008 NASN STUDY • Overweight and obesity are considered the “number one reason for peer rejection in America”. • Falkner & colleagues (2001) compared to nonobese peers 7th,9th & 11th graders were more likely to have negative social experiences, believe they were poor students, and expect to quit school. • Costs of illnesses related to childhood obesity have risen from $35 mil to $127 mil over the past 20 years. Claims to medicaid in North Carolina for management of chronic diseases related to obesity have already been affected. • As already stated physical and psychological consequences are more damaging.

5. Adopting heart healthy behaviors, such as following a healthy eating plan and participating in regular physical activity, can help individuals achieve or maintain a healthy weight. Even modest amounts of weight loss of approximately 10 percent of initial body weight can reduce high blood pressure, high blood cholesterol levels, and high blood glucose levels in overweight or obese individuals with high levels. Reducing these risk factors helps to prevent cardiovascular disease and/or reduce its severity in those with existing disease.

6. BMI What is BMI? Body Mass Index (BMI) is a number calculated from a child’s weight and height. BMI is a reliable indicator of body fatness for most children and teens. BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat, such as underwater weighing and dual energy x-ray absorptiometry (DXA).1 BMI can be considered an alternative for direct measures of body fat. Additionally, BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems. For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age.

7. WHAT IS BMI PERCENTILE After BMI is calculated for children and teens, the BMI number is plotted on the CDC BMI-for-age growth charts (for either girls or boys) to obtain a percentile ranking. Percentiles are the most commonly used indicator to assess the size and growth patterns of individual children in the United States. The percentile indicates the relative position of the child’s BMI number among children of the same sex and age. The growth charts show the weight status categories used with children and teens (underweight, healthy weight, at risk of overweight, and overweight).

8. Weight Status Category Percentile Range Underweight Less than the 5th percentile Healthy weight 5th percentile to less than the 85th percentile At risk of overweight 85th to less than the 95th percentile Overweight Equal to or greater than the 95th percentile BMI-for-age weight status categories and the corresponding percentiles are shown in the following table.

10. Tips for Teachers Just another thing to add to your already busy day!

11. There are many ways to celebrate at school. I have provided you with a hand-out that lists non-food ways to celebrate and healthy snack ideas. It is my desire that we could institute a new policy for the 2008-2009 school year. Examples of this would be: non-food ways ( active game chosen by students, special art project, donate a book to classroom) healthy snacks ( fruit tray, finger sandwiches, cheese cubes & crackers). Unfortunately getting parents onboard with no cupcakes/treats could be hard. Parents like to send sweets in because in some respects that is easier than being more creative.

12. Constructive Classroom Rewards: Classroom rewards can be an effective way to encourage positive behavior but schools should not only teach children to make healthy food choices but also provide an environment that fosters that. Somehow the connection between food and mood needs to be broken. Therefore a goal should be to separate food from rewards. (Handout of non food rewards) Examples: social rewards ( special attention, praise, or thanks) recognition ( sticker, photo, or note sent home) Privileges school supplies.

13. A School can increase physical activities • Teach academics through physical activity • Keep kids active at recess, before and after school. • Brain power breaks. • Reward students with physical activity opportunities – helps eliminate food rewards • Promotion of lifestyle physical activities to students & staff. ( take & display pictures of staff & students being active) • Engage students and families in physical activities

14. Activity websites • www.fitnessfinders.net • http://www.actionforhealthykids.org/gotuwc/ • www.creativewalking.com • www.opi.mt.gov/pdf/health/Mind&Body.pdf • http://teamnutrition.usda.gov/Resources/empoweringyouth.html • http:www.bam.gov • www.newenglanddairycouncil.org/wellness

15. We need to praise Food Services for the healthy changes that have already been made. Lynn Petrowski, our prior Food Services Director, did a wonderful job of making healthy changes within our lunch program. This has been well accepted at the lower levels but still causes complaints with upper levels due to likes & dislikes. We have an enhanced food base, follow the A-list for health foods and have limited the a la carte to all baked not fried foods. Nationwide there are now changes to whole grains, baked not fried snacks, and vending machines being removed from within schools. 55% of national schools are using skinless poultry, only 19% offer French fries, and 60% of elementary schools offer lettuce, vegetable or bean salads.

16. Study says ads trick children's taste buds Wrapping affects their preferences By Lindsey Tanner, Associated Press  |  August 7, 2007 Even carrots, milk, and apple juice tasted better to the children when they were wrapped in the familiar packaging of the Golden Arches “You see a McDonald's label and kids start salivating," said Diane Levin, a childhood development specialist who campaigns against advertising to children The study will probably stir more debate over the movement to restrict ads to children. It comes less than a month after 11 major food and drink companies, including McDonald's, announced new curbs on marketing to children under 12

17. Entire school activity ideas • A walking club for staff and or students. • A mock relay to correspond to the Boston Marathon. • Bulletin board showing staff & students being active. • Would like volunteers who might be interesting in doing something like this.

18. THE MIDDLEBORO WELLNESS POLICY PROCEDURAL GUIDELINES

19. Set Nutrition Education Goals –encourage students to make lifelong healthy food choices. • Set Physical Activity Goals – help students to understand the short and long term benefits of a physically active & healthy lifestyle. • Establish nutrition standards for all food available in school setting. • Set goals for school based activities to promote wellness. • Set goals for measurement & evaluation.

20. It is very important that parents are a role model for their children. Behavior is learned from observation. We can either be a good or bad example. It helps to examine your own behavior. Please think about the following questions in order to examine your own eating habits.Do you snack all day long?Do you eat in front of the TV?Do you eat whenever you are bored or under stress?Do you eat dessert at every meal?Do you skip breakfast?Do you have soda rather than milk or water with your meals?Do you diet all the time and have a fear of food?These are behaviors your kids may pick-up on, which can affect their eating habits now and in the future. Therefore, think about your own eating regimen to support your child’s positive food choices. 1.

21. Ways to be a role model would be: • never skip meals • limit junk food in the house • eat and prepare food with your children • try new foods but don’t force children to try • turn off the TV while eating • be active yourself.

22. WHAT ARE HEALTHY FOODSWe should never label foods as either GOOD or BAD.This can restrict eating or lead to negative attitudes toward food. Healthy foods are those that are nutrient-rich or have a large amount of key vitamins and minerals for their calories. It is critical to make each calorie count; especially when weight may be an issue. You don’t have to give up your favorite foods to eat a healthy diet just try to have your core choices nutrient-rich and round out with other foods. Colorful fruits and vegetables have more nutrients, lean meats, beans, low fat and fat free dairy and nuts are examples of ideal foods.A website that is a good family guide to healthy eating is: www.nutritionexploration.org

23. Be that positive role model Plan & cook meals together Offer kid-size servings Give your child a good start with breakfast Encourage drinking low fat milk & water Plan afternoon snacks Pay attention to hunger cues Avoid skipping meals Restrictive diets are usually not best for kids WAYS TO ENCOURAGE BETTER EATING HABITS FOR YOUR CHILD

24. HELP YOUR CHILD BECOME MORE ACTIVE • Boundaries- set time limits on TV, video games & computers • Play- encourage daily after school activities: play outdoors, ride a bike, walk the dog, toss a ball • Family time- adopt a lifestyle that includes regular physical activity: walk after dinner, games that incorporate movement • Encourage- provide opportunities to experience different activities & let them choose what they like • Enjoy- make sure the activity is not viewed as punishment

25. I have a survey for the families which might give them an indication of how their food choices measure up.

26. If you pack a lunch for school, what foods do you send? • ___ Sandwich ___leftovers ___cookies ___chips • ___ granola bar ___ yogurt ___ veggies ___ fruit other ________ • IN YOUR HOME SURVEY • What snack foods do you have in your home? (Check all that apply.) • ___ cookies ___ chips ___ granola bars ___yogurt • ___ fruit ___ veggies ___bagels other ______________ IN YOUR HOME SURVEY 1.        What snack foods do you have in your home? (Check all that apply. ___ cookies ___ chips ___ granola bars ___yogurt ___ fruit ___ veggies ___bagels other ______________ 2.        If you pack a lunch for school, what foods do you send? ___ Sandwich ___leftovers ___cookies ___chips ___ granola bar ___ yogurt ___ veggies ___ fruit other ________ 3.        What is there to drink in your house? (Check all that apply.) ___ water ___ soda ___ fruit drink ___ 100% fruit juice (orange, apple, etc) ___ 1% milk ___ whole milk ___ fat-free milk 4.        How many times does your family eat out during the week? ___ every day ___ 4 times a week ___ 2 times a week ___ Once a week ___ rarely 5.        Do you have sports equipment (bike, balls, roller blades, etc.) at home? ___ Yes ___ No, Explain __________________________________ 6.        Are the adults in the home physically active? ___ All the time ___ Sometimes, explain ______________________ ___ Never • Are the adults in the home physically active? • ___ All the time ___ Sometimes, explain ______________________ • ___ Never

27. THANK YOU You do a lot in your days and I appreciate your attention as we work together to fight this “growing” problem.