Childhood Obesity in America - Essay Example

 Childhood Obesity in America Introduction The prevalence of obesity among children has been rising at an astounding rate, nearly doubling over past three decades (Cawley 2). The negative health consequences of obesity in children and adolescents are indisputable (Cawley 2). As the obesity epidemic continues to affect our nation's children, it is imperative that prevention be addressed as opposed to treating a problematic disease. Nutrition education may be one of the best ways to prevent childhood overweight. Classification and Prevalence Currently in the U.S., 37.2% of children ages 6-11 and 34.3% of adolescents (ages 12-19) are considered overweight or at risk for overweight (Ogden et al. 1551). These figures have more than doubled since the late 1970's and continue to rise. Trends in overweight of children show greater prevalence of overweight or at risk for overweight in certain ethnic groups and states where higher populations of these groups reside. Mexican American children tend to have a higher prevalence of overweight than any other ethnicity, with 42.9% considered at risk for overweight or overweight and 22.5% overweight. African American children have the second highest prevalence with 40% at risk for overweight or overweight and 22% overweight (Ogden et al. 1551). Underweight, overweight, and at risk for overweight in children is measured by calculating the body mass index or BMI. Children at risk for overweight are classified as having a BMI-for-age greater than the 85th percentile, but less than the 95th percentile. Overweight children are classified as having a BMI-for-age greater than or equal to the 95th percentile (Centers for Disease Control and Prevention 1). Public Health Cost Along with overweight in children come several other complications such as asthma, diabetes, hypertension, orthopedic complications, psychosocial effects, and sleep apnea. These complications cause health risks, and require billions of dollars in health care annually. In the year 2008, the annual national expenditures related to obesity increased to $85.7 billion (Finkelstein cited in Cawley 18). Furthermore, overweight children often remain overweight as adults. Their risk for certain chronic diseases in adulthood such as diabetes and coronary artery disease may increase. The overall economic and public health costs associated with childhood obesity persisting into adulthood are staggering. Hospital discharges over the past twenty years with obesity as a component of the diagnosis have increased significantly. Wang and Dietz in their study using the national Hospital Discharge Survey, 1979-1999, reported that the length of hospital stay for patients with obesity diagnosed, either primary or secondary, was longer than that for overall discharges. In fact, the length of stay for obesity-related diagnoses increased while the average stay for other diagnosis decreased. The authors further stated that when obesity is the primary diagnosis, the average length of stay was twice as long as those listing obesity as a secondary diagnosis (Wang & Dietz 2- 5). These facts reflect the impact of the increasing severity of obesity's cost on society. Possible Solutions As incidence of childhood overweight and chronic diseases increase, many researchers have tested different approaches to reduce the risk of children becoming overweight. Some researchers have worked with parents and others with school systems to implement interventions. Various researchers have recommended that childhood nutrition education begin with adults who are just considering parenthood (Bourdeaudhuij 436). Some researchers have focused on families. It is imperative that nutrition education begins early in life because children's eating habits start developing then. In the past, family focused interventions were thought to be beneficial because there was the potential to reach each family member directly or indirectly through educating only certain members, such as mothers or caregivers (Bourdeaudhuij, Brug, Vandelanotte, & Oost 436). However, several family-based interventions did not prove to be as beneficial as what was anticipated because one family member is not usually strong enough to influence food choices of the entire family (Bourdeaudhuij et al., 436). De Bourdeaudhuij, Brug, Vandelanotte, and Van Oost conducted a study to determine if a family-based intervention to reduce dietary fat intake would have better results than an individual intervention. They recruited students between the ages of 15-18 who volunteered to participate with one parent and also students who participated as individuals. The participants were asked to fill out a questionnaire about their dietary fat intake, and then, they received feedback concerning their answers. The participants in all groups reported positive intentions to reduce their fat intake based on the feedback they received. However, there was no significant change in their eating behaviors. De Bourdeaudhuij et al. suggested that participation of all family members would produce more effective results (Bourdeaudhuij et al., 436). Another family-based intervention conducted by Stolley and Fitzgibbon focused on dietary intake and physical activity of African-American mothers and daughters. The intervention group was educated on low fat, low calorie diets and increasing physical activity for 11 weekly one-hour sessions. Upon completion of the intervention, there was no significant change in BMI between the control and intervention groups (Stolley & Fitzgibbon, 152). Family-based interventions focus on a small number of participants from each family. If all members of a family are asked to participate, as De Bourdeaudhiuj et al. suggested, the response rates have been shown to be as low as 10% (Bourdeaudhuij et al., 436). Therefore, other approaches such as school-based interventions have been pursued in hopes of achieving more positive results. Effectiveness of School- Based Interventions Across the nation, the school environment is becoming a recommended focus for nutrition education. Because children are required to attend school, they may be considered as a captive audience during the school day, as opposed to interventions requiring children to attend before or after school or even on the weekends. Elementary children spend up to seven hours a day at school, and significant portion of the daily calories for children come from school meals (Gortmaker et al., 413 -417). Much research has been conducted on obesity prevention and weight reduction in children and adolescents, and results have shown positive outcomes in reducing weight and increasing nutrition knowledge. Gortmaker et al. reported reduced obesity in 11-12 year old young girls after an intervention of two school years that incorporated lessons related to physical activity, reducing sedentary behavior, and nutrition education. According to BMI and triceps skinfold measurements, obesity was reduced among girls in the intervention group (Gortmaker et al., 413 -417). Auld, Romaniello, Heimendinger, Hambidge and Hambidge conducted a study that incorporated nutrition education into other subjects such as math and science as well as in the school cafeteria. Nutrition education was provided by classroom teachers and special resource teachers. These researchers reported an overall increase in knowledge of the Food Guide Pyramid and a more positive attitude towards school lunches. Children increased their fruit and vegetable consumption by 1/4th of a serving after the intervention and were able to add foods to meals to increase their fruit and vegetable intake. (Auld et al., 403 -405). Sharing Nutritional Awareness through Curriculum for Kids or Project SNACK was another successful school-based intervention (Javid 1). Javid (p. 1) implemented nutrition education into language arts, science, social studies, math, and art classes of kindergarten through sixth graders. Their results showed increased ability to classify healthy foods in the food groups and identify nutritious snacks and foods that create a well-balanced meal. Javid also showed that upon completion of the intervention, pre- and posttests of students showed significantly positive results in knowledge gained (Javid 1). Another study by Blom-Hoffman, Kelleher, Power, and Leff was conducted to evaluate the implementation of a multi-component nutrition education program. His team targeted African American kindergarteners and first graders in an under-resourced public school. The program included classroom applications, behavioral components at lunchtime, and a brief family educational component to keep parents informed. The results of the knowledge-based component were favorable. There was a statistically significant difference in nutrition knowledge between the experimental group and the control group post intervention (Blom-Hoffman et al., 55 -60). The Coordinated Approaches to Children's Health (CATCH) Eat Smart Program was an intervention designed to help reduce the risk of cardiovascular disease in elementary school children, grades 3-5 (Osganian et al. 419). The trial was implemented over a period of 4 years in a total of 96 elementary schools across the nation. The initial goal was to target nutrients that contribute to cardiovascular disease, such as total fat, saturated fat, cholesterol, and sodium and reduce the dietary amounts in children's intake. The program included classroom education as well as physical education components and school food service interventions. Overall, the results were successful. The CATCH intervention groups reduced total fat content in children's meals from 38.7% of total calories to 31 % of total calories. The saturated fat content of meals was reduced as well from 14.8% of total calories to 10.4% of total calories (Osganian et al., 425-426). This study was successful in lowering the amounts of total fat and saturated fat in meals offered to children so the meals were able to meet the USDA's guidelines for the School Meal Initiative (Osganian et al., 429). Another success of this study was that the children in the CATCH intervention schools had lower consumptions of fat and saturated fat when compared to the control schools (Osganian et al., 430). These are examples of successful school-based nutrition education interventions. The studies discussed were chosen based on their positive results. When compared to the unsuccessful family-based intervention studies, the positive impact on children's nutrition attitudes and health is obvious. The success of school-based nutrition education has been undeniable and with the positive results that have been recorded, it is imperative that teachers take a proactive role to educate children about nutrition. Despite successful outcomes of nutrition education in classrooms, many states do not require nutrition education for children, and when most interventions concluded, no further classroom nutrition education was continued. Conclusion The obesity epidemic is expanding and is beginning to affect our nations' youth. It has been shown that children with excess weight tend to have increased risk of becoming overweight as adults. This sets the stage for a cycle of self-destruction that leads American children toward much increased prevalence and severity of adult obesity in the future. With the current nutritional trends in children's daily intake, it is apparent that action must be taken to help modify children's diets. As research begins to identify current behaviors and trends, nutrition education curricula can be developed to address such issues. Before putting nutrition education curricula into action in schools, barriers to nutrition education should be identified, teachers should receive nutrition education, and health-conscious attitudes of teachers should be promoted. Work Cited Auld, G., Romaniello, C., Heimendinger, J., Hambridge, C., & Hambridge, M. “Outcomes from a school-based nutrition education program alternating special resource teachers and classroom teachers.” Journal of School Health, , 69, (1999), 403-408. Blom-Hoffman, J., Kelleher, C., Power, T. J., & Leff, S. S. “Promoting healthy food consumption among young children: Evaluation of a multi-component nutrition education program.” Journal of School Psychology, 42 , (2004), 45-60. Bourdeaudhuij, I. D., Brug, J., Vandelanotte, C., & Oost, P. V. “Differences in impact between a family- versus an individual-based tailored intervention to reduce fat intake.” Health Education Research, 17, (2002), 435-449. Cawley, J. The Medical Care Costs of Obesity: An Instrumental Variables Approach. National Bureau of Economic Research, 2010. Retrieved from http://www.nber.org/papers/w16467.pdf?new_window=1 Centers for Disease Control and Prevention. About BMI for Children and Teen. Retrieved, from Centers for Disease Control and Prevention, 2011. Web site: http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html Gortmaker, S. L., Peterson, K. E., Wiecha, J., Sobol, A. M., Dixit, S., Fox, M. K., & Laird, N. “Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health.” Archives of Pediatric & Adolescent Medicine, 153, (1999), 409-418. Javid, S. Nutrition Education in the Classroom: Project SNACK (Sharing Nutritional Awareness through Curriculum for Kids, K-6). San Diego Department of Education: San Diego, CA, 1981. Information extracted from http://trove.nla.gov.au/work/153557459 Ogden, C. L., Flegal, K. M., Carroll, M. D., & Johnson, C. L. “Prevalence of Overweight and Obesity in the United States, 1999-2004”, Journal of the American Medical Association, 288, (2006), 1549-1555. Osganian, S. K., Hoelscher, D. M., Zive, M., Mitchell, P. D., Snyder, P., & Webber, L. S. “Maintenance of effects of the Eat Smart School Food Service Program: Results from the CATCH-ON study.” Health Education & Behavior, 30, (2003), 418-433. Stolley, M. R. & Fitzgibbon, M. L. “Effects of an obesity prevention program on the eating behavior of African American mothers and daughters.” Health Education & Behavior, 24, (1997), 152-164. Wang, G., & Dietz, W. “Economic burden of obesity in youths aged 7 to 17 years: 1979–1999.” Pediatrics, 10, (2002), E81, 1-6. Read More