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Childhood Obesity: A Family Affair
Tami Ross, RD, CDE
Patti Geil, MS, RD, FADA, CDE [email protected]
Generation XXL: A Profile
• Tall for age (above 50%tile)
• Began gaining weight between ages 3-5 years
• Frequent fast food consumer
• Drinks most of his/her calories
• May skip one or more meals each day, then starts to graze
• Watches four or more hours of TV each day
Generation XXL: The Facts
• Prevalence of childhood obesity and overweight has doubled in the past 20 years in the United States
• 15.3% of 6-11 year olds are at or above 95%tile for BMI
• 15.5% of 12-19 year olds are at or above 95%tile for BMI
• Higher rates of obesity and overweight in minority and economically disadvantaged children
Generation XXL: The Consequences• Hypertension and
CVD
• Type 2 diabetes
• Hepatic disease
• Airway disorders
• Back, hip and knee strain
• Dyslipidemia
• 70% chance of becoming overweight adults
• Depression, low self-esteem, lack of self-confidence
Factors Associated with Childhood Obesity Genetics
Family influence
Nutrition
Physical activity
Other variables
Obesity’s Genetic Link –
It’s a Family Affair Neither parent obese: ~10% chance of having an obese
child
One parent obese: ~50% chance of having an obese child
Both parents obese: ~66% chance of having an obese child
Other factors – high birth weight– maternal diabetes– early menarche
Family Factors That Influence Weight
Role models Food environment Demise of family meal time Reinforce dietary behaviors $ocioeconomic status
Healthy Habits for Healthy Kids
www.wellpoint.com
Newton’s First Law of Thermodynamics
Energy is neither created or destroyed.
Calories in (food) = Calories out (activity) + weight gainCalories in = Calories out Weight maintenanceCalories in < Calories out Weight lossCalories in > Calories out Weight gain
3500 calories = 1 pound
.15% daily caloric excess = obesity within 5 years
Nutrition Factors Four “Kid” Food Groups Forgetting Fruits & Vegetables Unbalanced Food Pyramid Bypassing Breakfast Grazing Clean Plate Club Dashboard Dining Portion Distortion Food, Food Everywhere Self-regulation of Intake
Portion Distortion
1960’s fries: 210 calories
2003 super size fries: 610 calories
1916 cola bottle size: 6 ½ ounces
2003 cola bottle size: 20 ounces
Common Nutrition “Blind” Spots
Liquid calories4 cans soda/day = ~600 calories which
could promote 1 #/week weight gain
Snacks
Caloric density
Physical Activity Factors
Increasing urbanization - only 10% of children walk to school
Modern technology
Screen time
Screen Time and Obesity
Of U.S. children 8-16 years old, more than 25% watch at least 4 hours of TV per day.
Children who watch 4+ hours of TV/day have significantly greater BMI than those watching < 2hours/day.
TV in the bedroom is a strong predictor of overweight.
The CDC recently recalculated Americans’ activities –
KY had the lowest percentage of people achieving the minimum physical activity recommendations of 30 min./day, 4 days/wk.
Other Variables Associated with Childhood Obesity
Smoking
Alcohol use
Early sexual experimentation
15-20% of America’s teens are either overweight or at risk.
www.ActionForHealthyKids.org
Prevention is the key
1. Check BMI once a year.2. Breastfeed babies.3. Begin the day with breakfast.4. Encourage healthy habits at school & away from
home.5. Make moderation the motto.6. Factor in family mealtime.7. Count liquid calories.8. Don’t join the clean plate club.9. Keep kid portions kid-sized.10. Cut screen time & devise an after-school action play.11. Get moving.
Family Interventions: It’s a Family Affair
Provide & encourage healthy food and beverages
Be a positive role model Teach balance, variety, &
moderation One family meal/day Avoid using food for rewards, bribes,
or comfort
Nutrition Interventions:Target the common offenders
Eliminate concentrated sources of empty calories.
64 oz. Big Gulp regular soda = 750 calories
Aim to reduce fat consumption.
Nutrition Interventions:Target the common offenders
Begin every day with breakfast.
Eat 3 meals/day and reduce grazing.– Snack calories do count! – Keep snacks healthy:
• Fresh fruit• Raw vegetables w/ low fat dip• Graham crackers w/ low fat hot chocolate• Low sugar cereal w/ low fat milk• Pretzels & salsa• Fruit sorbet• Low fat yogurt• Animal crackers• Light microwave popcorn
Nutrition Interventions:Target the common offenders
Don’t join the clean plate club.
Get in touch with hunger.
Reduce fast-food frequency.
Choose kid-size portions, not super-size portions.
Portion size check-up
1 tsp. – thumb tip ½ cup – medium handful 1 cup – size of fist ½ cup pasta or rice – tennis ball or ice cream scoop 1 slice bread – computer disk; size of palm of hand &
halfway up fingers 1 medium fruit – tennis ball ½ cup vegetables – light bulb 2-3 oz meat – deck of cards, cassette tape, bar of soap,
size and thickness of palm of hand 2 Tbs. peanut butter – ping pong ball
Nutrition Interventions:Target the common offenders
Work toward 5-9 fruits & vegetables/day.½ cup cooked vegetables or vegetable juice1 cup raw vegetables½ cup cut fruit1 medium fruit
Get the food pyramid back in balance.
Kids Food Pyramid
www.pork4kids.com/images/kidpyramid.pdf
Physical Activity Interventions
Kids need at least 30 minutes of moderate to vigorous physical activity most days of the week, muscle strengthening exercise at least twice a week, & lifestyle fitness activity every day.
Physical Activity Interventions
Make activity part of the child’s daily routine.
Expose children to a variety of physical activities.
Buy a pedometer.
Build activity into the family routine.
Physical Activity Interventions
Cut screen time to no more than 2 hours/day.
Get moving in front of the tube.
Take screen breaks.
Track Progress & Provide Rewards
Food & activity log
Focus on the positive
Reward positive changes
What Else Can We Do?
Check blood glucose
Check blood pressure
Check for sleep disturbances
Other interventions – Medication & Surgery
Home is where the HEALTH is!
Resources
American Diabetes Association, 2003 www,diabetes.org www.amazon.com
Success Stories!!
