Nutrition and Obesity Prevention

1. Nutrition and Obesity Prevention Pamela Oliphant, RD (209) 277-2116 (T, Wed, Th) atcrd1@gmail.com

2. Overweight or Obese • Overweight- BMI at or above 85th percentile and lower than 95th percentile. • Obese-BMI at or above the 95th percentile. • California in group of highest obesity rate. • 1 in 7 low income preschool children are obese-may be stabilizing. (1,2,4)

3. 17% of 2-19 year-olds are obese-more than doubled in 1 generation.If overweight at < 8 years obesity in adulthood is more severe.80% of overweight at 10-15 years-obese as adults at 25 years. (2,3)

4. Consequences of Overweight/Obesity • Psychosocial risks- social discrimination can lead to decreased self-esteem and can hinder academic and social functioning. • Cardiovascular Disease (CVD) risks-obese children found to have risk factors for CVD-elevated cholesterol, elevated blood pressure, abnormal glucose tolerance. • 70% obese children with 1 CVD risk factor, 39% with 2 or > risk factors. (5)

5. Additional Health Risks • Asthma • Fatty Liver • Sleep Apnea-cessation of breathing 10 seconds or >, can occur in 7% obese children • Type 2 Diabetes-increased reporting past 2 decades (5)

6. Contributing Factors • Genetic- may need to exist with environmental and behavioral factors to have effect on weight • Behavioral • Environmental (6)

7. Behavioral Factors • Energy intake Increased eating out Increased portions High Kcal Beverages • Physical activity Decreased at home and school. (6,7)

8. Behavioral Factors Cont. • Sedentary Behavior 3 hours/day media Decreased activity- decrease in metabolic rate Increased snacking/eating in front of TV Influences of ads on un- healthy food choices

9. Environmental Factors • Role models within home (sleep, pregnancy, breastfeeding, eating together, cooking together, gardening, activity, portioning). • Role models within child care/school 80% of 5 years or younger are in child care 40 or more hours weekly. . Community-lack of sidewalks, lack of safe bike paths and parks, lack of fresh fruits/veggies in local markets. (6,8)

10. What Can We Do • Proper role modeling for parents/children to include nutrition messaging that works- emphasis on increasing fruits/veggies in diet, portions, and decreasing high kcal beverages. • Education classes/classroom involvement • Gardening • Eating out • Portion control * • Healthy weight classes/individual instruction • Physical activity/Family activities * • Beverages, healthy meal/snack prep. with kids * (Kids Eat Right-eatright.org, Calif. Dairy Council)

11. Head Start Nutrition and Wellness Policy

14. Nutrition Messaging for Parents Role Model Messages Cooking/Eating Together Messages Cook together. Eat together. Talk to each other. Make mealtime a family time. Make meals and memories together. It’s a lesson they’ll use for life. (8) • They learn from watching you. Eat fruits and veggies and your kids will too. • They take their lead from you. Eat fruits and veggies and your kids will too. (8)

15. Division of Feeding Responsibility Messages • Let them learn by serving themselves. Let your kids serve themselves at dinner. Teach them to take small amounts at first. Tell them they can get more if they’re still hungry. • Sometimes new foods take time. Kids don’t always take to new foods right away. Offer new fruits and veggies many times. Give them a taste at first and be patient with them. • Patience works better than pressure. Offer your children new foods. Then, let them choose how much to eat. Kids are more likely to enjoy a food when eating it is their own choice. It also helps them learn to be independent. (8)

16. Choose a partner and practice nutrition messaging for parents-1 is educator 1 is parent-switch Scenario- Preschool child is a picky eater and won’t eat vegetables From conversation with parent you learn they don’t eat veggies themselves, and they rarely eat together. Use 1 message from each of the categories to council the parent on how to improve vegetable intake/improve diet quality. ** OHSMS Protocol-Nutr. Svs. 2D-How often do you communicate with parents about quantity and consumption of foods at home and school?

17. Nutrition Messaging for Children • Modeling healthy eating • (protocol 4c OHSMS) • Family style • Shared conversation • Sit/share food • Portion control * • Time • How are children encouraged to try new foods? • Make It Fun/OK to play • Talk about color, • shape, texture, • flavor, health bene- • fits of foods • *Use CACFP meal pattern • Modeling healthy activity • Do you move or stand/sit while children are outside? • Books/songs with movement-do you do with kids? • Send ideas home with kids to increase family activity.

18. Partner up; 1 teacher, 1 preschooler- then switch • Scenario: • Lunchtime with introduction of new food • (fruit or veggie). • Messaging to include positive discussion • of food item (color, texture, what it may • resemble, health benefits) and proper • portioning assistance.

19. 1) Centers for Disease Control and Prevention. Defining Childhood Overweight and Obesity. cdc.gov. March 3, 2011.2) Centers for Disease Control and Prevention. Trends in Childhood Obesity. cdc.gov. August 20, 2010.3) Centers for Disease Control and Prevention. Childhood Overweight and Obesity. cdc.gov. March 3, 2011.4) Centers for Disease Control and Prevention. Geographic Patterns of Obesity Prevalence Among Low-Income, Preschool-Age Children. cdc.gov. January 6, 2011.5) Centers for Disease Control and Prevention. Consequences. cdc.gov. March 3,2011.6) Centers for Disease Control and Prevention. Contributing Factors. cdc.gov. March 3, 2011.7) Kavey, R. How Sweet It Is: Sugar-Sweetened Beverage Consumption, Obesity, and Cardio- vascular Risk in Childhood. Amer. Dietetic Assoc. 2010;110;10;1456-1460.

20. 8) White, A, Wilson, J, Burns, A, Blum-Kemelor, D, Singh, A, Race, P, Soto, V, Lockett, A. Use of Qualitative Re- search to Inform Development of Nutrition Messages for Low-income Mothers of Preschool Children. Journal of Nutrition Education and Behavior. Vol. 43, 19-27. January 2011.