Growing Healthy Growing Healthy KidsKids

Halifax Area School Halifax Area School Food Services Food Services PresentsPresents

Alarming Trends

The U.S. Surgeon General states that, during the last 20 years, the number of overweight children has doubled, and the number of overweight adolescents has tripled.

Source: Institute of Medicine, 2004

Overweight Defined by Overweight Defined by BMIBMI

Body Mass Index (BMI) percentiles help Body Mass Index (BMI) percentiles help determine if a child’s weight is right for his determine if a child’s weight is right for his or her height. or her height.

A BMI number is calculated for children and A BMI number is calculated for children and teens using height and weight.teens using height and weight.

[weight (lb) / height (in)[weight (lb) / height (in)22] x 703] x 703 For children and teens, BMI is age and For children and teens, BMI is age and

gender specific and is often referred to as gender specific and is often referred to as BMI-for-age.BMI-for-age.

Source: Centers for Disease Control and Prevention (CDC) Growth Chart Slides

The BMI number is then The BMI number is then plotted on CDC’s BMI-plotted on CDC’s BMI-percentile-for-age percentile-for-age growth charts (for either growth charts (for either girls or boys) to obtain a girls or boys) to obtain a percentile ranking.percentile ranking.

BMI-Percentiles-for-AgeExample: Chart for Boys 2 to 20 years

BMI

Source: CDC Growth Chart Slides

BMI-for-Age …What does it mean?

Weight Status Weight Status CategoryCategory

Percentile rangePercentile range

UnderweightUnderweight BMI-for-age = Less than the 5th BMI-for-age = Less than the 5th percentilepercentile

Healthy weightHealthy weight BMI-for-age = 5th percentile to BMI-for-age = 5th percentile to less than the 85th percentileless than the 85th percentile

At risk of overweightAt risk of overweight BMI-for-age = 85th to less than BMI-for-age = 85th to less than the 95th percentilethe 95th percentile

OverweightOverweight BMI-for-age = Equal to or BMI-for-age = Equal to or greater than the 95th greater than the 95th percentilepercentile

A Snapshot of America

34% of all children and teens in the U.S. are either overweight or at risk of overweight Source: Pediatrics, 2006

In minority populations, 20% of children and teens are overweight Source: Time, 2004

10% of pre-school children are overweightSource: Department of Health and Human Services, 2002

Pennsylvania Statistics

18.2% of eighth graders are overweight

17.0% of eighth graders are at risk of overweight

Source: Pennsylvania Department of Health

Perception versus RealityPerception versus Reality

Has our perception of “healthy” weight changed over the past 20 years?These drawings show an average “healthy” weight child on the left and an

“overweight” child on the right.

Why does healthy weight Why does healthy weight matter?matter?

Immediate benefits may include:Immediate benefits may include:• More energy More energy • Better ability to focus on tasksBetter ability to focus on tasks• Increased academic performanceIncreased academic performance• More self-esteem and confidenceMore self-esteem and confidence

Healthy habits may lead to a lifetime of Healthy habits may lead to a lifetime of good healthgood health

Obese children have an 80% chanceObese children have an 80% chanceof becoming obese adultsof becoming obese adults

Source: American Academy of Adolescent and Child Psychiatry (AACAP), 2003

Heart Disease Risk Factor Heart Disease Risk Factor Levels in ChildrenLevels in Children

Percent of children, aged 5-10, with at least 1 heart disease risk factor:Percent of children, aged 5-10, with at least 1 heart disease risk factor:

60%60%

Source: Pediatrics, 2006

Percent of overweight children, aged 5-10, Percent of overweight children, aged 5-10, withwith

2 or more heart disease risk factors:2 or more heart disease risk factors:

25%25%

Type 2 DiabetesType 2 Diabetes Rates of type 2 Diabetes, formerly known as Rates of type 2 Diabetes, formerly known as

“adult onset diabetes”, are increasing in youth. “adult onset diabetes”, are increasing in youth.

Approximately 85% of children diagnosed with Approximately 85% of children diagnosed with type 2 diabetes are overweight or obese.type 2 diabetes are overweight or obese.

As the U.S. population becomes increasingly As the U.S. population becomes increasingly overweight, researchers expect type 2 diabetes overweight, researchers expect type 2 diabetes to appear more frequently in younger children. to appear more frequently in younger children.

Source: American Diabetes Association

What has contributed to What has contributed to the current health status of the current health status of

children and teens?children and teens?

FoodFood

What are kids eating … or not eating?

The Top 10The Top 10

1.1. Carbonated Carbonated beveragesbeverages

2.2. Low-fat milk Low-fat milk3.3. Fruit drinks Fruit drinks4.4. Whole milk Whole milk5.5. Grain mixtures Grain mixtures

(pizza, pasta)(pizza, pasta)

6.6. Meat mixtures Meat mixtures (hamburgers, etc.)(hamburgers, etc.)

7.7. White potatoes White potatoes (French fries) (French fries)

8.8. Sugars / sweets Sugars / sweets9.9. Cakes / cookies Cakes / cookies10.10. Non-citrus juices Non-citrus juices

In 1999-2000 the top 10 items In 1999-2000 the top 10 items consumed by boys and girls, aged 6-19, consumed by boys and girls, aged 6-19,

were:were:

Source: A Nation at Risk: Obesity in the United States

Soda ConsumptionSoda Consumption

Children who drank more than 12 ounces of Children who drank more than 12 ounces of sweetened drinks …sweetened drinks … Gained significantly more weight than children Gained significantly more weight than children

who drank less than six ounces a day who drank less than six ounces a day Drank less milkDrank less milk Took in 244 more calories/dayTook in 244 more calories/day

Source: Journal of Pediatrics, 2003

CarbohydratesCarbohydrates In 1994-95, intake of whole grains for In 1994-95, intake of whole grains for

children was 1 serving or lesschildren was 1 serving or less

Between 1989-1995, the increase in Between 1989-1995, the increase in carbohydrates in children and teens carbohydrates in children and teens came from:came from:• PizzaPizza• PastaPasta• Mexican food Mexican food • Soft drinksSoft drinks

Source: A Nation at Risk: Obesity in the United States

Fruits & Vegetables Between 1994 and 1996, only 14% of Between 1994 and 1996, only 14% of

children ages 6-19 met the children ages 6-19 met the recommendations for daily fruit intake, recommendations for daily fruit intake, and only 20% ate enough vegetables. and only 20% ate enough vegetables.

Among high school students, only 23.6% Among high school students, only 23.6% of males and 20.3% of females eat five or of males and 20.3% of females eat five or more vegetables per day.more vegetables per day.

In 1980, about 50% of high school seniors In 1980, about 50% of high school seniors reported eating green vegetables reported eating green vegetables ““nearly every day.”nearly every day.”

Source: Robert Wood Johnson Foundation

VegetablesVegetablesOnly ¾ of children (all ages) report eating at Only ¾ of children (all ages) report eating at

least one vegetable every day…least one vegetable every day… Most popular vegetable is French fries!Most popular vegetable is French fries! Next is tomato products (spaghetti Next is tomato products (spaghetti

sauce)sauce) Lower is green beans, corn, and peasLower is green beans, corn, and peas Lowest is nutrient-packed dark green Lowest is nutrient-packed dark green

or deep yellow vegetablesor deep yellow vegetablesSource: United States Department of Agriculture

Eating OutEating Out On average, children ages 11-18 eat On average, children ages 11-18 eat at fast-food restaurants twice a at fast-food restaurants twice a weekweek Away-from-home foods eaten by Away-from-home foods eaten by children are higher in fat and children are higher in fat and saturated fat and lower in fiber and saturated fat and lower in fiber and calcium than those eaten at homecalcium than those eaten at home Children eat nearly twice as many calories Children eat nearly twice as many calories (770) (770) at restaurants as they do during a mealat restaurants as they do during a meal at home (420)at home (420)

Source: Robert Wood Johnson Foundation

Super Size It?Super Size It?

Portion sizes are Portion sizes are getting bigger and getting bigger and

bigger!bigger!

Calorie Difference: 525 calories

1,025 calories 2 cups of pasta with sauce and 3 large meatballs

20 Years Ago

Today

500 calories1 cup spaghetti with sauce and 3 small meatballs

Spaghetti and Meatballs

Calorie Difference: 165 Calories

250 Calories 20 ounces

85 Calories 6.5 ounces

SodaSoda

20 Years Ago

Today

140 calories 3-inch diameter

Calorie Difference: 210 calories

350 calories 6-inch diameter

BagelBagel 20 Years

AgoToday

210 calories 1.5 ounces

Calorie Difference: 290 calories

500 calories 4 ounces

Blueberry MuffinBlueberry Muffin

20 Years Ago

Today

Portion Size Influences Portion Size Influences Amount of Food EatenAmount of Food Eaten

Children 3-5 years old consumed 25% Children 3-5 years old consumed 25% more of an entrée and 15% more more of an entrée and 15% more calories at lunch when presented with calories at lunch when presented with portions that were double an age-portions that were double an age-appropriate standard size.appropriate standard size.

Source: American Journal of Clinical Nutrition, 2005

Adults ate more food when given Adults ate more food when given larger portions but rated hunger the larger portions but rated hunger the same as smaller size portions.same as smaller size portions.

Source: Journal of the American Dietetic Association, 2004

Physical ActivityPhysical Activity

How are kids spending their free time?

Favorite Activities

Watching TV - 3 hours, 51 minutes Using the computer - 1 hour, 2 minutes Video games - 49 minutes Reading – 43 minutes

A survey of young people ages 8 – 18 showed their daily activities accounted for the following hours:

Source: Robert Wood Johnson Foundation

TelevisionTelevision Obesity levels increase as the amount of Obesity levels increase as the amount of

time spent watching TV increases, time spent watching TV increases, especially among female children and especially among female children and teens. teens. Source: Archives of Pediatric and Adult Medicine

Kids who have a TV in their bedroom Kids who have a TV in their bedroom watch about 1.5 hours more per day than watch about 1.5 hours more per day than those who do not.those who do not.Source: Kaiser Family Foundation

Screen TimeScreen Time The typical American child spends The typical American child spends about 44.5 hours per week using about 44.5 hours per week using media outside of school.media outside of school. Boys spend an average of 1 hour and 12 Boys spend an average of 1 hour and 12

minutes playing video games daily, while minutes playing video games daily, while girls average 25 minutes a day.girls average 25 minutes a day.

Kids who have a computer in their Kids who have a computer in their bedroom use it about 45 minutes more bedroom use it about 45 minutes more per day than those who do not.per day than those who do not.

Source: Robert Wood Johnson Foundation

Physical ActivityPhysical Activity

Physical activity declines steadily during Physical activity declines steadily during adolescence.adolescence.

Source: CDC, 1997

Only 25% of high school students Only 25% of high school students participate in at least 30 minutes of participate in at least 30 minutes of moderate physical activity on five or moderate physical activity on five or more days of the week.more days of the week.Source: Institute of Medicine

50% of children ages 12-21 rarely or never exercise.Source: CDC

The Future of our Children

“Children today have a shorter life expectancy than their parents for the first time in 100 years.”

How can we combat this How can we combat this “overweight epidemic?”“overweight epidemic?”

Prevention is the key!Prevention is the key!

Habits such as healthy Habits such as healthy eating and physical activity eating and physical activity MUST be established in MUST be established in childhood AND practiced childhood AND practiced throughout a lifetime.throughout a lifetime.

It takes everyone working It takes everyone working togethertogether

"You can't educate a child "You can't educate a child who isn't healthy, and you who isn't healthy, and you can't keep a child healthy can't keep a child healthy who isn't educated."who isn't educated."      Source: Former U.S. Surgeon General Joycelyn EldersSource: Former U.S. Surgeon General Joycelyn Elders

The Role of SchoolsThe Role of Schools““Schools not only teach our children Schools not only teach our children to read and write, but also to take to read and write, but also to take care of their bodies and minds. care of their bodies and minds. Schools are really ideal places to Schools are really ideal places to promote good health because most promote good health because most young people are in school five days young people are in school five days a week during most of the school a week during most of the school year.”year.”

Source: Former U.S. Secretary of Health and Human Services Tommy G. Thompson, 2001

What is a StudentWhat is a Student Wellness Policy? Wellness Policy?

The Child Nutrition and The Child Nutrition and WIC Reauthorization WIC Reauthorization Act of 2004 requires Act of 2004 requires implementation of local implementation of local school wellness policies school wellness policies that address healthy that address healthy eating and physical eating and physical activity.activity.

All schools participating All schools participating in the federal school in the federal school lunch and/or breakfast lunch and/or breakfast program must comply.program must comply.

Measurable goals Measurable goals must be established must be established for: for: • Nutrition guidelines Nutrition guidelines • Nutrition education Nutrition education • Physical educationPhysical education• Physical activityPhysical activity• Other school-based Other school-based

activities related to activities related to healthy eating and healthy eating and physical activityphysical activity

Source: Child Nutrition and WIC Reauthorization Act

Nutrition EducationNutrition Education The goal of nutrition education is to teach, The goal of nutrition education is to teach,

encourage, and support healthy eating encourage, and support healthy eating among students.among students.

Promoting student health and nutrition Promoting student health and nutrition enhances readiness for learning and enhances readiness for learning and increases student achievement.increases student achievement.

Nutrition GuidelinesNutrition Guidelines In order to develop lifelong healthy eating In order to develop lifelong healthy eating patterns, children need to be introduced to patterns, children need to be introduced to

a variety of nutritious foods in a positive a variety of nutritious foods in a positive manner. manner.

Foods available in district schools during Foods available in district schools during the school day shall be offered to students the school day shall be offered to students with consideration for promoting student with consideration for promoting student health and reducing childhood obesity. health and reducing childhood obesity.

The Goal of The Goal of Physical EducationPhysical Education

Physical activity is critical to the development Physical activity is critical to the development and maintenance of good health. and maintenance of good health.

The goal of physical education is to develop The goal of physical education is to develop physically educated individuals who have the physically educated individuals who have the knowledge, skills, and confidence to enjoy a knowledge, skills, and confidence to enjoy a lifetime of healthful physical activity.lifetime of healthful physical activity.

Source: National Association for Sport and Physical Activity

Today’s PE ClassToday’s PE Class

Provides a variety of Provides a variety of physical activities physical activities that make a that make a physical education physical education class fun and class fun and enjoyableenjoyable

Creates maximum Creates maximum opportunities for opportunities for students of all students of all abilities to be abilities to be successfulsuccessful

Assists students in Assists students in setting and achieving setting and achieving personal health-personal health-related fitness goalsrelated fitness goals

Prepares and Prepares and

encourages students encourages students to practice skills and to practice skills and be active for a be active for a lifetimelifetime

To achieve a quality physical education To achieve a quality physical education program, a certified physical education program, a certified physical education teacher:teacher:

Source: National Association of State Boards of Education, December 2004

Beyond the GymBeyond the Gym

The goal of a comprehensive school The goal of a comprehensive school physical activity program is to physical activity program is to provide a physical and social provide a physical and social environment that encourages safe environment that encourages safe and enjoyable activities that are and enjoyable activities that are developmentally appropriate and developmentally appropriate and designed to promote optimal health.designed to promote optimal health.

Physical ActivityPhysical Activity Physical activity, broadly defined, includes Physical activity, broadly defined, includes

exercise, sport, dance, as well as other exercise, sport, dance, as well as other movement forms.movement forms.

Opportunities may include:Opportunities may include:• Recess and/or activity breaksRecess and/or activity breaks• Intramural sport programs and/or physical Intramural sport programs and/or physical

activity clubsactivity clubs• Interscholastic sports Interscholastic sports • Walk/bike-to-school programsWalk/bike-to-school programs• Incentive programs for students Incentive programs for students and/or familiesand/or families

Source: National Association of State Boards of Education, December 2004

Integration is Key to Integration is Key to SuccessSuccess

An effective coordinated school An effective coordinated school wellness program integrates the wellness program integrates the cafeteria, classroom and gym to cafeteria, classroom and gym to reinforce positive healthy behaviors reinforce positive healthy behaviors throughout the day and makes clear throughout the day and makes clear that good health and learning go that good health and learning go hand in hand.hand in hand.

Source: CATCH Texas

School-Based ActivitiesSchool-Based Activities Signs posted in the cafeteria to Signs posted in the cafeteria to promote healthful eating choicespromote healthful eating choices Home assignments for the familyHome assignments for the family Parent newslettersParent newsletters Promotional activities, campaigns Promotional activities, campaigns

and/or programsand/or programs Role modeling of healthy behaviors by Role modeling of healthy behaviors by

teachers, food service staff and teachers, food service staff and administratorsadministrators

Student taste-testingStudent taste-testing

What can be done outside of school?

Simple Steps for Simple Steps for Healthful Family EatingHealthful Family Eating

Use MyPyramid and “Go, Slow Whoa” food lists to make healthy food choices

Adjust portions Start the day with

breakfast Serve a rainbow of fruits &

veggies every day Serve low-fat milk with

meals and water with snacks

Steer clear of sugary drinks and fruit juices

Read food labels Save fast food for a once or

twice a week treat Plan and make family

meals together Be a role model

Fit Families = Happy Fit Families = Happy FamiliesFamilies

Encourage children to be physically active for at least 60 minutes every day

Limit TV, video games, and computer time to 1-2 hours a day combined

Play with your children and plan activity time for your entire family Give gifts that promote fitness Plan parties with active themes

such as skating Be a role model

For More Information…For More Information…Nutrition:Nutrition: www.mypyramid.govwww.mypyramid.gov www.nhlbi.nih.gov/health/public/heart/obesity/wecan/www.nhlbi.nih.gov/health/public/heart/obesity/wecan/ www.fns.usda.gov/eatsmartplayhard/www.fns.usda.gov/eatsmartplayhard/ www.dolesuperkids.comwww.dolesuperkids.com

Physical Activity:Physical Activity: http://www.presidentschallenge.orghttp://www.presidentschallenge.org www.tvturnoff.orgwww.tvturnoff.org http://www.bam.gov/index.htm http://www.bam.gov/index.htm http://verbnow.comhttp://verbnow.com

Body Mass IndexBody Mass Index www.cdc.gov/growthchartswww.cdc.gov/growthcharts

..

AcknowledgmentsWellSpan’s Community Health Improvement department developed this presentation and authorizes its use by school district personnel. Any other uses or copying is strictly prohibited.

For more information, contact: Community Health Improvement at 717-851-3222.

This presentation has been adapted from materials produced by the Center for Health Promotion and Prevention Research, University of Texas-Houston School of Public Health. For additional information about the CATCH Texas program, visit www.catchtexas.orgwww.catchtexas.org