Obesity and children, Obesity and children, may we intervene with may we intervene with the local farm?the local farm?

Andrea Gibson, Ph.D. student Walden University

PH 8165-3 Instructor: Dr. Rebecca Heick

Fall Quarter, 2009

OBJECTIVESOBJECTIVES

Understand childhood obesityUnderstand childhood obesity Review Connecticut childhood Review Connecticut childhood

obesity data and determinantsobesity data and determinants Impact childhood obesity by Impact childhood obesity by

introducing a local farm “market” introducing a local farm “market” in our elementary schoolin our elementary school

Obesity Still a Major Obesity Still a Major Problem in the U.S. Problem in the U.S. In 2003-04, 17.1% of children and In 2003-04, 17.1% of children and adolescents 2-19 years of age (over 12 and a adolescents 2-19 years of age (over 12 and a half million) were overweighthalf million) were overweight

32.2% of adults (over 66 million) were obese. 32.2% of adults (over 66 million) were obese.

Almost 5% of adults were extremely obese.Almost 5% of adults were extremely obese.

Center of Disease Control, [CDC], (n.d.) Obesity still a major problem. Retrieved from http://www.cdc.gov/nchs/pressroom/06facts/obesity03_04.htm

Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood overweight to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study. Pediatrics 2001;108:712–718

Use of BMI to Screen for Use of BMI to Screen for Overweight and Obesity Overweight and Obesity in Childrenin Children

Overweight is defined as a BMI at Overweight is defined as a BMI at or above the 85th percentile and or above the 85th percentile and lower than the 95th percentile. lower than the 95th percentile.

Obesity is defined as a BMI at or Obesity is defined as a BMI at or above the 95th percentile for above the 95th percentile for children of the same age and sex. children of the same age and sex.

CDC, (n.d.). Defining childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood/defining.html

In Connecticut, more In Connecticut, more than half of adults (59%) than half of adults (59%) are obese or overweight are obese or overweight based on 2005-2007 based on 2005-2007 datadata

26% of Connecticut high 26% of Connecticut high school students are school students are obese and 12% are obese and 12% are overweightoverweight

Connecticut Department of Public Health (2008). 2007 Youth Risk Behavior Survey Results. Retrieved from http://www.ct.gov/dph/lib/dph/hisr/pdf/yrbs2007ct_summary_tables.pdfTrust for America’s Health. F as in fat: 2008, 10-11. (2008, Aug.). Retrieved from http://www.rwjf.org/files/research/081908.3424.fasinfat.pdf

A A caloriecalorie is defined as a unit of energy is defined as a unit of energy supplied by food. A calorie is a calorie supplied by food. A calorie is a calorie regardless of its source. Whether you're regardless of its source. Whether you're eating carbohydrates, fats, sugars, or eating carbohydrates, fats, sugars, or proteins, all of them contain calories. proteins, all of them contain calories.

Caloric balanceCaloric balance is like a scale. To remain in is like a scale. To remain in balance and maintain your body weight, the balance and maintain your body weight, the calories consumed (from foods) must be calories consumed (from foods) must be balanced by the calories used (in normal balanced by the calories used (in normal body functions, daily activities, and exercise). body functions, daily activities, and exercise).

CDC Overweight and Obestiy, (n.d. ) Retrieved from http://www.cdc.gov/obesity/causes/index.html

NPAO State Based ProgramNPAO State Based Program State health departments serve State health departments serve

as the leader in coordinating as the leader in coordinating statewide nutrition, physical statewide nutrition, physical activity, and obesity strategies.activity, and obesity strategies.

Funded in 23 StatesFunded in 23 States Connecticut is not NPAO fundedConnecticut is not NPAO funded

CDC, (n.d.). NPAO State Based Programs. Retrieved from http://www.cdc.gov/obesity/stateprograms/index.html

NPAO Goal:NPAO Goal:

The program goal is to prevent The program goal is to prevent and control obesity and other and control obesity and other chronic diseases through healthful chronic diseases through healthful eating and physical activity. eating and physical activity.

Obesity reduction target: increase Obesity reduction target: increase consumption of fruits and consumption of fruits and vegetablesvegetables

CDC, (2008). NPAO technical manual. Retrieved from http://www.cdc.gov/obesity/downloads/TA_Manual_1_31_08.pdf

Gallup Survey Says Gallup Survey Says Children Aware of Children Aware of Healthy Lifestyle (1995)Healthy Lifestyle (1995)

97% agreed that a balanced diet is "very 97% agreed that a balanced diet is "very important" for good health, and 98% important" for good health, and 98% said the same about physical activity. said the same about physical activity.

66% said they like eating "many 66% said they like eating "many different kinds of foods," while different kinds of foods," while 74%agreed that eating "a lot of bread, 74%agreed that eating "a lot of bread, cereal, and other grains is good for you." cereal, and other grains is good for you."

64% rated their own eating habits "good 64% rated their own eating habits "good to excellent," and 76% said the same to excellent," and 76% said the same about their parents' eating habits. about their parents' eating habits.

U.S. Gallup Survey, (1995). Children Aware of Healthy Lifestyle. Retrieved from http://cv8yh9th3f.search.serialssolutions.com.ezp.waldenulibrary.org/?genre=article&issn=03621332&title=FDA+Consumer&volume=29&issue=6&date=19950701&atitle=Gallup+survey+says+children+aware+of+healthy+lifestyle.&spage=4&pages=4-4&sid=EBSCO:Academic+Search+Premier&aulast=

State of Connecticut General Assembly

Childhood Obesity in Connecticut:A Preventable Crisis

Only one in five Connecticut high Only one in five Connecticut high school students (21.5%) eats the school students (21.5%) eats the recommended 5 or more daily recommended 5 or more daily servings of fruits and vegetables servings of fruits and vegetables

Connecticut Department of Health, (2007). Connecticut childhood obesity factsheet. Retrieved from http://www.cga.ct.gov/COC/PDFs/obesity/obesity_factsheet_012909.pdfConnecticut Department of Public Health (2008). 2007 Youth Risk Behavior Survey Results. Retrieved from http://www.ct.gov/dph/lib/dph/hisr/pdf/yrbs2007ct_summary_tables.pdf

Essex Elementary’s Strategic Profile Essex Elementary’s Strategic Profile suggests strong academic suggests strong academic performance and an overall performance and an overall expenditure of $8,406 per student expenditure of $8,406 per student in 2006-2007in 2006-2007

Essex Elementary Strategic Profile, (2008). Retrieved from http://www.reg4.k12.ct.us/stratprof/esstrategicprof.pdf

The most important determinants The most important determinants of fruit and vegetable of fruit and vegetable consumption in children age 6-12 consumption in children age 6-12 are:are:

Environmental (accessibility)Environmental (accessibility) Behavioral (parent and peer influence)Behavioral (parent and peer influence) Taste preferenceTaste preference Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory.

Englewood Cliffs, NJ: Prentice-HallBlanchette, L. & Brug, J. (2005). Determinants of fruit and vegetable consumption among 6-12 year old children and effective interventions to increase consumption. Journal of Human Nutrition and Dietetics, 18, 431-443

Most CT schools Most CT schools already have some already have some health programs health programs and services in and services in placeplace

Few have Few have coordinated the coordinated the elements into a elements into a cohesive and cohesive and coherent whole coherent whole planplan

Connecticut Department of Health (n.d.) Guidelines for a coordinated approach to school health. Retrieved from: http://www.sde.ct.gov/sde/cwp/view.asp?a=2678&q=320726&sdePNavCtr=|#45551

Fruits and VegetablesFruits and Vegetables

Contain essential vitamins, minerals, fiber and other Contain essential vitamins, minerals, fiber and other compounds that may help prevent chronic diseasescompounds that may help prevent chronic diseases

Low in calories per volume, low in energy densityLow in calories per volume, low in energy density

Substituting for higher energy dense foods such as Substituting for higher energy dense foods such as those high in fat and added sugars can be part of a those high in fat and added sugars can be part of a successful weight management strategysuccessful weight management strategy

C DC,( n.d.) Obesity: Halting the epidemic by making health easier. Retrieved from: http://www.cdc.gov/NCCdphp/publications/AAG/obesity.htm

CDC, (2008). NPAO technical manual. Retrieved from http://www.cdc.gov/obesity/downloads/TA_Manual_1_31_08.pdf

Why Choose CT Grown?Why Choose CT Grown?

When you chose CT Grown, you get the freshest, highest-quality When you chose CT Grown, you get the freshest, highest-quality products available.  products available. 

When you choose CT Grown, you fuel your local economy by keeping When you choose CT Grown, you fuel your local economy by keeping your money and jobs in the state.your money and jobs in the state.

When you choose CT Grown, you support your neighbor and preserve When you choose CT Grown, you support your neighbor and preserve open space which lowers the demand for municipal services and open space which lowers the demand for municipal services and reduces your taxes.reduces your taxes.

The average food on an American’s plate has traveled 1,500 miles and The average food on an American’s plate has traveled 1,500 miles and 14 days from its source, losing precious nutrients the entire time.14 days from its source, losing precious nutrients the entire time.

  

Connecticut Department of Agriculture,(n.d.). Farm to chef program. Retrieved from http://www.ct.gov/doag/cwp/view.asp?a=2778&q=330846

USDA offers USDA offers competitive Annual competitive Annual USDA GrantUSDA Grant Fresh fruits and vegetables, free Fresh fruits and vegetables, free

of charge to all children of charge to all children throughout the school daythroughout the school day

Nutrition education is requiredNutrition education is required

Connecticut State Department of EducationBureau of Health/Nutrition, Family Servicesand Adult Educationhttp://www.cga.ct.gov/COC/PDFs/obesity/forum/materials/fiore/Fiore_PowerPoint_11_7_08.pdf

Food, Conservation and Energy Act of 2008, Public Law 110-234

Colorado school introduced “The Market” Colorado school introduced “The Market” where fresh fruits and vegetables were where fresh fruits and vegetables were bought at bulk discountbought at bulk discount

Students may shop with box tops or school Students may shop with box tops or school coins, 20% of students are regular customerscoins, 20% of students are regular customers

CDCl ,NPAO State-based programs, (n.d.) Retrieved from http://www.cdc.gov/nccdphp/dnpa/obesity/state_programs/index.htm

What could we do in What could we do in Essex, CT to bring the Essex, CT to bring the farm to the school?farm to the school?

Bring in the farmer’s market that Pioneer Bring in the farmer’s market that Pioneer Elementary in Colorado pioneered?Elementary in Colorado pioneered?

Purchase produce using half the school’s ice Purchase produce using half the school’s ice cream budget (student’s buy ice cream at 50 cream budget (student’s buy ice cream at 50 cents per ice cream currently)?cents per ice cream currently)?

Compete with the existing school’s ice cream Compete with the existing school’s ice cream stand using with the power of nutrition stand using with the power of nutrition education?education?

Nutrition Education Nutrition Education and farmer’s market and farmer’s market launch:launch: 2 weeks ahead of the fruit-stand, 2-3 hours of 2 weeks ahead of the fruit-stand, 2-3 hours of

nutrition education per week per student and nutrition education per week per student and test baseline understanding test baseline understanding

Essay contest on “Why I need to eat fruits Essay contest on “Why I need to eat fruits and vegetables.” Winners are first customersand vegetables.” Winners are first customers

Launch farmer’s market- email, text, auto-Launch farmer’s market- email, text, auto-alert parents to send fruit stand money all alert parents to send fruit stand money all month (in place of ice cream money)month (in place of ice cream money)

Compare sales and nutrition attitude surveys Compare sales and nutrition attitude surveys from baselinefrom baseline

Continue with ongoing nutrition education 3-Continue with ongoing nutrition education 3-6 hours per month6 hours per month

Who can partner?Who can partner?

Elementary school principalElementary school principal Region 4 school administrationRegion 4 school administration TeachersTeachers School nursesSchool nurses ParentsParents Community dieticiansCommunity dieticians Local farmersLocal farmers

Provide outcomes to the Provide outcomes to the Connecticut State Health Connecticut State Health Department and Board of Department and Board of EducationEducation

Leverage success based on sales Leverage success based on sales and qualitative change in and qualitative change in nutrition education and attitudesnutrition education and attitudes

Evaluate: Look at best sellers and Evaluate: Look at best sellers and stock the items but add new stock the items but add new choices in sync with the growing choices in sync with the growing seasonseason

Farm to School.orgFarm to School.org

Teaches students the path from Teaches students the path from farm to forkfarm to fork

Farm to School.org., (n.d.). Retrieved from http://www.farmtoschool.org/aboutus.php

Thank YouThank You

Further Reading:Further Reading:

Sharma, M., (2005). School-based interventions Sharma, M., (2005). School-based interventions for childhood and adolescent obesity. for childhood and adolescent obesity. ObesityObesity

ReviewsReviews, 7, 261-269, 7, 261-269

Students Succeed with School Meals, (n.d.). Students Succeed with School Meals, (n.d.). Retrieved from Retrieved from http://www.nutritionnc.com/ResourcesForSchools/pdf/schoolMealsPromoKit/EatSmartMoreMoreMessagesforKids/eatsmartandmovemoremessages.pdf

References:References:

Bandura, A. (1986). Bandura, A. (1986). Social foundations of thought and action: A social cognitive theorySocial foundations of thought and action: A social cognitive theory . . Englewood Cliffs, NJ: Prentice-HallEnglewood Cliffs, NJ: Prentice-Hall

Blanchette, L. & Brug, J. (2005). Determinants of fruit and vegetable consumption among 6-12 Blanchette, L. & Brug, J. (2005). Determinants of fruit and vegetable consumption among 6-12 year old children and effective interventions to increase consumption. year old children and effective interventions to increase consumption. Journal of Human Journal of Human Nutrition and Dietetics,Nutrition and Dietetics, 18, 431-443 18, 431-443

Center of Disease Control, (n.d.). Defining childhood overweight and obesity. Retrieved from Center of Disease Control, (n.d.). Defining childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood/defining.htmlhttp://www.cdc.gov/obesity/childhood/defining.html

Center of Disease Control, (n.d.). NPAO State Based Programs. Retrieved from Center of Disease Control, (n.d.). NPAO State Based Programs. Retrieved from http://www.cdc.gov/obesity/stateprograms/index.htmlhttp://www.cdc.gov/obesity/stateprograms/index.html

Center of Disease Control, (n.d.) NPAO State-based programs,Colorado. Retrieved from Center of Disease Control, (n.d.) NPAO State-based programs,Colorado. Retrieved from http://www.cdc.gov/nccdphp/dnpa/obesity/state_programs/index.htmhttp://www.cdc.gov/nccdphp/dnpa/obesity/state_programs/index.htm

Center of Disease Control, (2008). NPAO technical manual. Retrieved from Center of Disease Control, (2008). NPAO technical manual. Retrieved from http://www.cdc.gov/obesity/downloads/TA_Manual_1_31_08.pdfhttp://www.cdc.gov/obesity/downloads/TA_Manual_1_31_08.pdf

Center of Disease Control, (n.d.) Obesity: Halting the epidemic by making health easier. Retrieved from:Center of Disease Control, (n.d.) Obesity: Halting the epidemic by making health easier. Retrieved from: http://www.cdc.gov/NCCdphp/publications/AAG/obesity.htmhttp://www.cdc.gov/NCCdphp/publications/AAG/obesity.htm

Center of Disease Control, (n.d.) Obesity still a major problem. Retrieved from Center of Disease Control, (n.d.) Obesity still a major problem. Retrieved from http://www.cdc.gov/nchs/pressroom/06facts/obesity03_04.htmhttp://www.cdc.gov/nchs/pressroom/06facts/obesity03_04.htm

Center of Disease Control, (n.d). Overweight and Obestiy. Retrieved from Center of Disease Control, (n.d). Overweight and Obestiy. Retrieved from http://www.cdc.gov/obesity/causes/index.htmlhttp://www.cdc.gov/obesity/causes/index.html

Connecticut Department of Agriculture,(n.d.). Farm to chef program. Retrieved from Connecticut Department of Agriculture,(n.d.). Farm to chef program. Retrieved from http://www.ct.gov/doag/cwp/view.asp?a=2778&q=330846http://www.ct.gov/doag/cwp/view.asp?a=2778&q=330846

Connecticut Department of Health, (2007). Connecticut childhood obesity factsheet. Retrieved fromConnecticut Department of Health, (2007). Connecticut childhood obesity factsheet. Retrieved from http://www.cga.ct.gov/COC/PDFs/obesity/obesity_factsheet_012909.pdfhttp://www.cga.ct.gov/COC/PDFs/obesity/obesity_factsheet_012909.pdf

References continuedReferences continued

Connecticut Department of Public Health (2008). 2007 Youth Risk Behavior Survey Results.Connecticut Department of Public Health (2008). 2007 Youth Risk Behavior Survey Results. Retrieved from http://www.ct.gov/dph/lib/dph/hisr/pdf/yrbs2007ct_summary_tables.pdfRetrieved from http://www.ct.gov/dph/lib/dph/hisr/pdf/yrbs2007ct_summary_tables.pdf

Connecticut Department of Health (n.d.) Guidelines for a coordinated approach to school health. Connecticut Department of Health (n.d.) Guidelines for a coordinated approach to school health. Retrieved from: Retrieved from: http://www.sde.ct.gov/sde/cwp/view.asp?a=2678&q=320726&sdePNavCtrhttp://www.sde.ct.gov/sde/cwp/view.asp?a=2678&q=320726&sdePNavCtr

Connecticut State Department of Education Bureau of Health/Nutrition, Family ServicesConnecticut State Department of Education Bureau of Health/Nutrition, Family Services and Adult Education. Retrieved from and Adult Education. Retrieved from http://www.cga.ct.gov/COC/PDFs/obesity/forum/materials/fiore/Fiore_PowerPoint_11_7_08.pdfhttp://www.cga.ct.gov/COC/PDFs/obesity/forum/materials/fiore/Fiore_PowerPoint_11_7_08.pdf

D. Martin (personal communication, April 12, 2009D. Martin (personal communication, April 12, 2009))

Essex Elementary Strategic Profile, (2008). Retrieved fromEssex Elementary Strategic Profile, (2008). Retrieved from http://www.reg4.k12.ct.us/stratprof/esstrategicprof.pdfhttp://www.reg4.k12.ct.us/stratprof/esstrategicprof.pdf

Farm to School.org., (n.d.). Retrieved from http://www.farmtoschool.org/aboutus.phpFarm to School.org., (n.d.). Retrieved from http://www.farmtoschool.org/aboutus.php

Food, Conservation and Energy Act of 2008, Public Law 110-234Food, Conservation and Energy Act of 2008, Public Law 110-234

Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood overweight to coronary heart Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood overweight to coronary heart disease risk disease risk

factors in adulthood: The Bogalusa Heart Study. factors in adulthood: The Bogalusa Heart Study. PediatricsPediatrics 2001;108:712–718 2001;108:712–718..

Trust for America’s Health. Trust for America’s Health. F as in fat: 2008F as in fat: 2008, 10-11. (2008, Aug.). Retrieved from, 10-11. (2008, Aug.). Retrieved from http://www.rwjf.org/files/research/081908.3424.fasinfat.pdf (Jan. 28, 2009).http://www.rwjf.org/files/research/081908.3424.fasinfat.pdf (Jan. 28, 2009).

U.S. Gallup Survey, (1995). Children Aware of Healthy Lifestyle. Retrieved from U.S. Gallup Survey, (1995). Children Aware of Healthy Lifestyle. Retrieved from http://cv8yh9th3f.search.serialssolutions.com.ezp.waldenulibrary.org/?http://cv8yh9th3f.search.serialssolutions.com.ezp.waldenulibrary.org/?genre=article&issn=03621332&title=FDA+Consumer&volume=29&issue=6&date=19950701&atitle=Gallup+survey+saygenre=article&issn=03621332&title=FDA+Consumer&volume=29&issue=6&date=19950701&atitle=Gallup+survey+says+children+aware+of+healthy+lifestyle.&spage=4&pages=4-4&sid=EBSCO:Academic+Search+Premier&aulast=s+children+aware+of+healthy+lifestyle.&spage=4&pages=4-4&sid=EBSCO:Academic+Search+Premier&aulast=