Childhood Obesity Teaching Presentation

1. J E N N I F E R PA N Z A R E L L A R N , B S N
N U R S 5 6 5 : N U R S E A S E D U C AT O R
Childhood Obesity

2. Introduction
Click or copy and paste link
into your browser:
https://www.youtube.com/watch
?v=2Hd0qwxvgH4

3. Definition
• Weight gain is the imbalance between caloric intake
and energy expenditure.
• When the child is above the normal healthy
weight for his or her age and height.
• Obesity is determined using the
Body Mass Index (BMI).
http://www.cdc.gov/healthyweight/physical_activity/index.html

4. Overweight or Obese
Overweight:
Body Mass Index (BMI) at or above the 85th
percentile and below the 95th percentile
Obese:
Body Mass Index (BMI) at or above the 95th percentile
http://www.cdc.gov/obesity/childhood/defining.html

5. Body Mass Index
(BMI)
BMI Calculator:
https://nccd.cdc.gov/d
npabmi/Calculator.asp
x
How to calculate BMI:
Weight in kilograms divided by a
weight in meters
 Age specific
 Sex specific
 Inexpensive
 Not invasive
 Easy to perform
 High BMI is an indicator of high body fat
http://www.cdc.gov/healthyweight/physical_activity/index.html

6. QUESTION
How many children and adolescents aged 2-19 are affected
by childhood obesity in America?
a. 6 Million
b. 25 million
c. 12.7 million
d. 2 million

7. Statistics
• Tripled over the last 30 years
• One third (1 in 3) of children and adolescents are overweight or obese.
• Childhood obesity affects 12.7 million in the U.S.
• Higher prevalence in Hispanics (21.9%) and Non-Hispanic Blacks (19.5%)
• 17% of children and adolescents are overweight or obese
*CDC statistics are based on children and adolescents aged 2-19 between 2011-2014

8. New York State Otsego County
 17.6% children and adolescents
are overweight or obese
 16.4% children and adolescents
are overweight or obese
Statistics
The Healthy People 202o program goals aim to
reduce childhood obesity prevalence to
14.5% by 2020.

9. QUESTION
Childhood obesity increases the risk for:
a. Asthma
b. Diabetes
c. Cardiovascular disease
d. Depression
e. All of the above

10. Acute Health Concerns
 High Blood Pressure
 High Cholesterol
 Diabetes
 Asthma
 Sleep Apnea
 Joint discomfort
 Liver Disease
 Gallstones
 Gastro-esophageal reflux (GERD)
 Depression
 Low self-esteem

11. Chronic Health Concerns
 Adult Obesity
 Cardiovascular Disease
 Diabetes
 High Blood pressure
 Stroke
 Cancer
 Osteoarthritis
 Reproductive Problems
 Gallstones
 Sleep disorders
 Depression

12. QUESTION
What are the 3 major contributing factors associated
with Childhood Obesity?
a. Inactivity
b. Increased consumption of high-caloric foods (Food choices)
c. Genetics
d. Media use or Screen time

13. Contributing factors
Genetics
(or other organic causes)
Behavioral Environmental
*Minor role
• Not the major contributor
• Taken into consideration
• Medical causes should be ruled
out
*Important role
• Physical Inactivity
• Food choices
• Media use or screen time
• Eating patterns
• Social norms
• Cultural norms
• Family norms
• Parenting style
• Parents overweight or obese
*Influential role
• Daycare
• School
• After-school programs
• Community
• Home

14. 5-2-1-0 Lets go!
 Nationally recognized
 Reinforce healthful habits
 http://www.letsgo.org
Goals:
To increase physical activity
and healthful eating habits.

15. Lets Move!
Launched in 2010 by First Lady Michelle Obama
Initiatives Promotes Healthy Futures
http://www.letsmove.gov
Initiatives
1. Creating a healthy start for children
2. Empowering parents and caregivers
3. Providing healthy food in schools
4. Improving access to healthy, affordable foods
5. Increasing physical activity

16. Benefits of Family-based Interventions
Research finds that parental involvement
strongly influences a child’s behaviors.
 Integral change agent
 Parents are responsible for meal planning (Plan, Purchase, and Prepare)
 Parents are responsible for activity planning
 Parents are the primary role-models for their own children

17. Where do we start?

18. INCREASED SCREEN TIME
PHYSICAL INACTIVITY
POOR EATING HABITS
Contributing Factors Associated with
Childhood Obesity:

19. QUESTION
How many hours does the average school-age child
spend in front of a screen?
a. 2 hours
b. 7 hours
c. 4 hour
d. 9 hours

20. Screen Time
 29% of children under 1 years old watch TV about 90 minutes daily.
 64% of toddlers watch TV for about 2 hours daily.
 Preschoolers spend about 2.2 to 4.6 hours in front of a screen.
 School-age children spend about 7 hours daily in front of a screen.
www.commercialfreechildhood.org

21. Screen Time
 Children are growing up connected
 Technology is everywhere
 Interactive
 Mobile
 There are benefits
 There are challenges and health concerns
The American Academy of Pediatrics (AAP) released a statement in November
2016 discussing the impact of media on cognitive, language, motor, social, and
emotional skills of children.
www.healthychildren.org/MediaUsePlan

22. Screen time and Childhood Obesity
 Increased screen use is associated with childhood obesity
 Screen time is linked to an elevated BMI
 Screen time is associated with consuming extra calories
 Screen time is associated with inactivity
 Bedroom TV’s are associated with elevated BMI
www.commercialfreechildhood.org

23. Screen time and Other Concerns
 Linked to irregular sleep patterns
 Linked to sleep disturbances
 Linked to delayed language skills
 Less time engaged in creative play to develop problem-solving skills
 Decreased interactions and decreased socializing
 Associated lower academic achievements and poor grades
 Associated with inactivity
 Associated with increased psychological difficulties
www.commercialfreechildhood.org

24. Screen Time and Media: AAP Recommendations
 Avoid digital media in children 18-24 months of age. If you choose to introduce digital media, choose high
quality programs and do it together!
 Limit screen time for children 2-5 years to co-viewing 1 hour per day high quality programs. Help
children understand and apply concepts to world around them!
 Avoid fast-paced and violent content.
 Do not leave televisions on when not in use.
 Do not use media to calm child.
 Monitor media and downloaded content.
 Make mealtimes media and screen free.
 No screens 1 hour before bed.
 Create unplugged spaces
 Use new technology in social and creative ways
 Do not substitute sleep, activity, play, reading or social interactions with media or screen use.
AAP: Media and Young Minds (2016)
http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/19/peds.2016-2591.full.pdf

25. Pros Cons
 Prevent Childhood obesity
 Tend to eat healthier
 More active
 Educational benefits
 What else?
 Developmental concerns
 Health concerns (Obesity)
 Behavioral concerns (Hyperactivity)
 What else?
Discussion: Media and Screen Use
What can you do to minimize media
and screen use in your family?

26. QUESTION
How many hours should a school-age child
engage in aerobic physical activity?
a. 1 hour
b. 2 hours
c. 30 minutes
d. 1 or more hours

27. Physical Activity
According to the CDC children and adolescents should engage in
60 minutes or more of physical activity daily.
• Aerobic Activity (moderate to vigorous)
• Muscle Strengthening
• Bone Strengthening
http://www.cdc.gov/physicalactivity/basics/children/what_counts.htm

28. Physical Activity
Examples
 What activities do
YOU enjoy?
 What activiites do your
CHILDREN enjoy?
 What activities will you
enjoy as a FAMILY?
Aerobic Activity
(moderate-vigorous)
• Hiking
• Running
• Walking
• Bicycle riding
• Jumping rope
• Swimming
• What else?
Muscle Strengthening
• Resistance exercises
• Push-ups
• Sit-ups
• Gymnastics
• Rock Climbing
• Weights
• What else?
Bone
Strengthening
• Hopping
• Skipping
• Running
• Basketball
• Volleyball
• tennis
• What else?
http://www.cdc.gov/physicalactivity/basics/children/what_counts.htm

29. Benefits Barriers
 Reduce risk for Childhood obesity
 Build strong bones and muscles
 Reduce depressive symptoms
 May improve academic skills
 Increased quantity of life
 What else?
 Time
 Motivation
 Fear
 Support
 Access
 What else?
Discussion: Physical Activity
How can you add physical activity to
your family routine?

30. Active Learning: Calendar
 Participates will break into 4 groups.
 Each group will fill in one week of physical activities on the calendar.
 Each group will complete 7 days (Sunday-Saturday)
 We will share the suggestions with the entire group
 Upon completion of the discussion the entire group will have one
month of physical activities that can be used at home.

31. Calendar Example
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Bike ride in
the park
Walk after
dinner
Family
Basketball
game at local
community
center
Swimming at
local pool
Family
exercise
night. Use a
video or
make your
own!
Rock
climbing at
local
community
center
Family
football game

32. QUESTION
What is the major factor impacting food choices today?
a. Availability
b. Color
c. Convenience
d. Taste

33. Healthy Eating Habits
• Healthy eating habits start early in life
• Advertising impacts the foods purchased
• Limited access to healthy and affordable foods
• Greater availability to high caloric foods
• Increased portion sizes
• Don’t skip breakfast
• Foods are chosen often based on convenience
https://www.cdc.gov/obesity/childhood/causes.html
http://www.cdc.gov/healthyschools/nutrition/facts.htm

34. Healthy Eating
Fruits Grains Dairy Vegetables Protein Limit
• Whole fruits
(Meals, Snacks,
Dessert)
• Oatmeal
• Popcorn
• Brown Rice
• Fat-free milk
• Yogurt
• Soy milk
• Fresh, frozen
or canned
• Raw*
• Salads
• Sides
• Main dishes
• Seafood
• Beans
• Unsalted nuts
and seeds
• Soy products
• Eggs
• Lean meats
• poultry
• Cake
• Cookies
• Pastries
• Saturated
milk
• Fats
• Salt
• Half the plate should be fruits and vegetables (400g or 5 portions daily)
• Half your grains should be whole grains
• Move to low fat dairy products
• Vary your protein routine
• Drink and eat less sodium, saturated fat, and added sugars
https://choosemyplate-
prod.azureedge.net/sites/default/files/tentips/MyPlateMyWins.pdf

35. Healthful Eating
Mealtimes
Mealtime:https://choosemyplate-
prod.azureedge.net/sites/default/files/printablematerials/D
GTipsheet38BuildHealthyMealtimeHabits.pdf
 Go food shopping together
 Get creative in the kitchen
 Offer the same foods for everyone
 Kids kid involved in the mealtime process
 Do not reward with food
 Eat at the table
Role model healthful eating habits!

36. Healthful Eating
Snacks
Snacks:
https://choosemyplate-
prod.azureedge.net/sites/default/files/printablematerials/D
GTipSheet24MyPlateSnackTipsforParents.pdf
• Prepare in advance (slice veggies and store them)
• Mix it up!
• Snack on lean protein
• Offer whole-wheat breads and cereals
• Portion control
• Fruits are quick and easy
• Consider individually wrapped low fat cheese
• Drink low fat milk instead of sugary alternatives
• Drink water
Role model healthful eating habits!

37. Pros Cons (barriers)
 Prevent Childhood obesity
 Promote growth and development
 Increased energy
 Higher quality of life
 What else?
 Overweight or obese
 Energy imbalance
 Decreased health
 Decreased cognitive development
 Cost
 Time
 What else?
Discussion: Health Eating
How can you promote healthy eating
habits in your family?

38. Active Learning: Calendar
 Participates will break into 4 groups.
 Each group will fill in one week of snacks on the calendar.
 Each group will complete 7 days (Sunday-Saturday)
 We will share the suggestions with the entire group
 Upon completion of the discussion the entire group will have one month of
snacks that can be used at home.

39. Calendar Example
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Carrots,
Celery, and
Low-fat
Ranch
dressing
Cheese,
whole wheat
crackers, and
grapes
Apple slices,
and trail mix
(dried fruit,
whole grain
cereal, and
nuts)
Cucumbers
slices,
broccoli, and
low-fat ranch
dressing
Cheese
quesadilla's
with salsa
Apple slices,
celery sticks,
raisins, and
peanut butter
Whole wheat
blueberry
muffins and
strawberreis

40. Parental Role
Create a
healthy home
environment
 Engage children in physical activity
 Monitor media use and reduce screen time
 Make available healthy foods
 Use authority as a TOOL
Role-model healthful behaviors!
Click or copy and paste link into browser:
https://www.youtube.com/watch?v=3bxGV2NBSy8
Handout:
https://choosemyplate-
prod.azureedge.net/sites/default/files/tentips/DGTipsheet12BeAHealth
yRoleModel.pdf
*Based on LetsMove! initiatives

41. Benefits Barriers
 Decreased health risks
 Increased quality of life
 Increased quantity of life
 What else?
 Access to healthy foods
 Cost of healthy foods
 Access to community activities
 Cost of activities
 Time
 What else?
Discussion: Adopting a Healthy Lifestyle
What are 3 ways you can incorporate
healthy habits into the family routine?

42. Behavior Change
 Change happens
gradually
 Will not happen
Overnight
 Use support and
resources
 There will be
set-backs
Pre-contemplation Stage: Consider the change
Contemplation Stage: Consider pros and cons
Preparation Stage: Decide to make change
Action Stage: Take action!
Maintenance: Sustained lifestyle change
When Set-Backs occurs… get
back into action!
Make realistic mini-goals and focus on
SUCCESS!

43. Setting Realistic Goals
Motivations Family
Strengths
Barriers Actions Realistic
Mini-Goals
Support
Loose weight Enjoy outside
activities
Time
Energy
What else?
Plan and
prepare
healthy meals
and snacks
Plan time to
exercise
Keep a
calendar to
track progress
Physical Activity
goal:
Participate in pre-
planned activities
for 30 minutes 3x
week.
Screen Goal:
3 hours per day
Eating goal:
Will eat 2 servings
of fruits and
vegetables daily 4x
this week
FAMILY
After school
programs
Community
based
programs
Preparation Stage Action Stage Maintenance Stage

44. SUCCESS
 Track progress
 Reward Success (NOT with food!)
 Be flexible
 Make adjustments
 Change things up
 Keep it fresh
Have Fun!

45. Lets Review!
1. Identify chronic health concerns related to childhood obesity.
1. Identify two ways to increase physical activity
1. Identify two ways to encourage healthy eating habits.
1. Identify two ways to role model healthful behaviors to their children.

46. We can do it
Together!

47. References
Clarke, J., Fletcher, B., Lancashire, E., Pallan, M., & Adab, P. (2013). The views of stakeholders on the role of the primary
school in preventing
childhood obesity: a qualitative systematic review. Obesity Reviews, 14(12), 975-988. doi:10.1111/obr.12058
Davison, K, Jurkowski, J., Li, K., Kranz, S. and Lawson, H. (2013). A childhood obesity intervention developed by families for
family: results from a pilot study. International Journal of Behavioral Nutrition and Physical Activity. 10;3. Pp. 2-11. DOI:
10.1186/1479-5868-10-3
Find Your Healthy Eating Style and Maintain it for a Lifetime. (2016). United States Department of Agriculture (USDA).
Retrieved from:https://choosemyplate-prod.azureedge.net/sites/default/files/tentips/MyPlateMyWins.pdf
Healthy Diet. (2015). World Health Organization (WHO). Retrieved from:
http://www.who.int/mediacentre/factsheets/fs394/en/

48. Healthy Weight. (2015). Centers for Disease Control and Prevention (CDC). Retrieved from:
http://www.cdc.gov/healthyweight/physical_activity/index.html
Karnik, S., & Kanekar, A. (2012). Childhood Obesity: A Global Public Health Crisis. International Journal of Preventive
Medicine. 3(1): 1–7.
Lindsay, A., Sussner, K., Kim, J., and Gortmaker, S. (2006). The Role of Parents in Preventing Childood Obesity. Future of
Children. 16(1): 169-
186. Retrieved from: http://www.futureofchildren.org/publications/docs/16_01_08.pdf
Matthews, T. and Hamilton, B. (2016). Mean Age of Mothers is on the Rise: United States, 2000-2014. NCHS data brief, no.
232. Centers for Disease Control and Prevention (CDC). Retrieved from:
http://www.cdc.gov/nchs/products/databriefs/db232.htm
Media and Young Minds (2016). Council On Communications and Media. Pediatrics. DOI: 10.1542/peds. 2016-2591.
Retrieved from: http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/19/peds.2016-
2591.full.pdf
Nutrition, Physical Activity, and Obesity. (2014 May). Leading Health Indicators. Healthy People 2020. Retrieved from:
https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Nutrition-Physical-Activity-and-Obesity
Ogdon, C., Carroll, M., Fryar, C., and Flegal, K. (2015). Prevalence of Obesity Among Adult and Youth: Untied States, 2011-
2014. NCHS Data brief. US. Department of Health and Human Resources and Centers for Disease
Control and Prevention and National Center for Health Statistics. Retrieved from:
http://www.cdc.gov/nchs/data/databriefs/db219.pdf

49. Overweight and Obesity. (2015). Centers for Disease Control and Prevention (CDC). Retrieved from:
http://www.cdc.gov/obesity/childhood/defining.html
Nutrition. (2016). Centers for Disease Control and Prevention (CDC). Retrieved from:
https://www.cdc.gov/nutrition/index.html
Physical Activity. (2015). Centers for Disease Control and Prevention (CDC). Retrieved from:
http://www.cdc.gov/physicalactivity/index.html
Prevalance. (2014). Childhood Overweight. Obesity Society. Retrieved from: http://www.obesity.org/resources/facts-about-
obesity/childhood-overweight
Raychaudhuri, M., and Sanyal, D. (2012). Childhood obesity: Determinants, evaluation, and prevention. Indian Journal of
Endocrinology and Metabolism. 16: 192-194. Retrieved from: https://dx.doi.org/10.4103%2F2230-8210.104037
Selected Research On Screen Time and Children. (n.d.). Campaign for a Commercial-Free Childhood. Retrieved from:
http://www.screenfree.org/wp-content/uploads/2014/01/screentimefs.pdf
Sorg, M., Yehle, K., Coddington,J., and Ahmed,A. (2013). Implementing family-based childhood obesity interventions. The
Nurse Practitioner. Vol. 38. No. 9. Pp. 14-21.
What Are the Health Risks of Overweight and Obesity? (2012). Explore Overweight and Obesity. National Heart, Lung, and
Blood Institute (NIH)>
Retrieved from: https://www.nhlbi.nih.gov/health/health-topics/topics/obe/risks