Childhood Overweight and Obesity in Massachusetts: Trends, Problems - - PowerPoint PPT Presentation

▶
childhood overweight and obesity in massachusetts trends
SMART_READER_LITE
LIVE PREVIEW

Childhood Overweight and Obesity in Massachusetts: Trends, Problems - - PowerPoint PPT Presentation

Oct 01, 2022 387 likes •822 views

Childhood Overweight and Obesity in Massachusetts: Trends, Problems & Solutions Jennifer Sacheck, PhD Tufts University Friedman School of Nutrition Science & Policy John Hancock Center on Physical Activity and Nutrition 1 What I Am Going

slide-1
SLIDE 1

1

Jennifer Sacheck, PhD

Tufts University Friedman School of Nutrition Science & Policy John Hancock Center on Physical Activity and Nutrition

Childhood Overweight and Obesity in Massachusetts: Trends, Problems & Solutions

slide-2
SLIDE 2

2

What I Am Going to Talk About…..

  • Often there are no “quick” answers with

science & sometimes the science is not “exact”

  • We can use “science” to guide “policy”

– Science spans biological sociological

  • Will not make “recommendations” but just

some “key suggestions”

slide-3
SLIDE 3

3

Childhood Obesity Prevalence & Trends

slide-4
SLIDE 4

4

1999-2007 Trends for Adolescent Overweight and Obesity in Massachusetts and the U.S

Youth Risk Behavior Survey, 1999-2007

****

2 4 6 8 10 12 14 16 18 20 1999 2001 2003 2005 2007

%

Obesity-US Obesity-MA Overweight-US Overweight-MA

slide-5
SLIDE 5

5

Obesity Prevalence by State in US Children Aged 10-17 yrs

National Survey of Children’s Health, 2003 Singh, J Comm Health, 2008

%’s #27

slide-6
SLIDE 6

6

Prevalence of Overweight by Grade & Gender in MA

30.4% 34.0% 33.1% 32.4% 33.4% 37.6% 38.0% 37.6% G rade 1 G rade 4 G rade 7 G rade 10 G irls Boys

Essential School Health Survey, 2007

slide-7
SLIDE 7

7

44.8% 24.1% 39.8% 22.9%

<100% F ederal P

  • verty Level (F

P L) >400 % F P L

Massachusetts United S tates

National Survey of Children’s Health, 2003

% Overweight or Obese Children by Family Income

slide-8
SLIDE 8

8

National Survey of Children’s Health, 2003

% of Overweight or Obese Hispanic Children

45.2% 37.7% 27.1% 29.5%

M assachusetts United States

Hispanic Non Hispanic

slide-9
SLIDE 9

9

Causes of Childhood Obesity

slide-10
SLIDE 10

10

Social Ecological Model of Obesity

Society Community Organizational Interpersonal Individual

slide-11
SLIDE 11

11

Rise in obesity….the inability to control our individual energy intake/expenditure vs. the environmental stimuli that influences intake/expenditure

slide-12
SLIDE 12

12

Determinants of Obesity

Educational priorities Built environment Advertising & gaming Food away from home Sedentary attractions Family structure Cultural values Maternal Environment Biology Psychology Purchasing Power Screen Time Free Play Social Influences Food availability BODY WEIGHT

slide-13
SLIDE 13

13

Energy “Gap”

  • It has been calculated that the energy gap

needed to produce weight gain is between 110 - 165 calories per day

– ~1 can of soda – 1 oz bag of chips – 1 ice cream bar

Wang et al, Pediatrics, 2006 Plachta-Danielzik et al, Obesity, 2008

slide-14
SLIDE 14

14

Closing the Energy “Gap”

  • ↓ TV viewing by 1.4 hours (106 kcal/hr)
  • Walk 1.9 hrs vs. sitting (30 kg boy)
  • ↑ PE from 1x 3x per week (+240

kcal/wk) Removed sodas from Boston high schools

– ↓ consumption =34 kcal/day

slide-15
SLIDE 15

15

Poor Nutrition

slide-16
SLIDE 16

16

Recommended Daily Servings vs. Reality (2-19 yrs)

2 4 6 8 10 12 Grains Who le Grains Vegetables F ruit D airy NHANES, 1999-2002 2.1 2.3 1.7 0.76 7.0

slide-17
SLIDE 17

17

Food Consumption of Massachusetts High School Students

Massachusetts Youth Risk Behavior Survey, 2001-2007

16% 18% 14% 19% 32% 12% 15% 33% 15% 15% 35% Ate 5+ fruit and vegetables per day Drank 3+ glasses of milk per day Ate breakfast everyday 2001 2003 2005 2007

slide-18
SLIDE 18

18

Food Consumption of Massachusetts Middle School Students

Massachusetts Youth Risk Behavior Survey, 2007

15% 41% 15% 40% 12% 40% Ate 5+ fruit and vegetables per day Drank 1+ glasses of soda per day 6th 7th 8th

slide-19
SLIDE 19

19

CDC National Immunization Study, 2007

Comparison of Breastfeeding Rates

73.8% 41.5% 20.9% 25.0% 50.0% 75.0% 23.8% 45.2% 77.6% E ver Breastfed Breastfed at 6 months Breastfed at 12 months

Healthy People 2010 G

  • als

National Massachusetts

slide-20
SLIDE 20

20

Lack of Physical Activity

slide-21
SLIDE 21

21

Physical Activity

  • 41% of students are

physically active (60 min/day)

  • 9th grade students

were more likely than 12th grade students to meet recommendations (60 min/day)

Meeting PA Recommendations by Grade

49% 36% Meet PA R ecommendations 9th 12th

Meeting PA Recommendations by Gender

50% 32% Meet PA R ecommendations Males Females

Massachusetts Youth Risk Behavior Survey, 2007

slide-22
SLIDE 22

22

10 20 30 40 50 60 70 80 90 100 1993 1995 1997 1999 2001 2003 2005 2007 % US MA

Youth Risk Behavior Survey, 1993-2007

Adolescents Who Attend PE Class in an Average Week

slide-23
SLIDE 23

23

TV & Screen Time

  • High School

– 30% reported 3+ hrs/day of non-school related computer usage – 28% reported 3+ hrs/day of TV viewing

  • Middle School

– 18% reported 3+ hrs/day of Internet use on an average school day

Massachusetts Youth Risk Behavior Survey, 2007

slide-24
SLIDE 24

24

Costs & Consequences

slide-25
SLIDE 25

25

Consequences

Biological and Social Health

  • Overweight and obese children are more likely

to become obese adults

  • ↑ rates of diabetes and cardiovascular disease
  • Sleeping problems, social stigmas, teasing

Productivity

  • Greater levels of school absenteeism

decreased academic performance?

slide-26
SLIDE 26

26

MA Childhood Diabetes Prevalence

Insulin Pump Care 1 2 3 4 5 S Y 3 S Y 4 S Y 5 S Y 6 S Y 7 Blood Glucose Testing 10 20 30 40 50 60 S Y 1 S Y 3 S Y 5 S Y 7

Procedures Per 1,000 Students Per Month

MA ESHS, 2006-2007

slide-27
SLIDE 27

27

Costs

  • State medical expenses associated with obesity:

– Massachusetts 4.7% ($283 per capita)

  • Decrease of just 5% prevalence of overweight

and obesity and an increase in physical activity would save Massachusetts $9.6 billion over four years

  • Per child medical expenditures for overweight &
  • bese children are ~$200 more than for healthy

weight children

slide-28
SLIDE 28

28

Activism to Stop the Epidemic Bills & Initiatives Proposed Enacted Policy Combating the Obesity Epidemic

Integrating Science and Policy

New Scientific Evidence

slide-29
SLIDE 29

29

Policy: Individual vs. Society

Individual Society

Values

slide-30
SLIDE 30

30

POLICY SOLUTIONS Individual vs. Society

Individual Society Short-term Long-term

slide-31
SLIDE 31

31

Massachusetts Policy & Program Landscape

slide-32
SLIDE 32

32

MA Department of Public Health Initiatives

  • Statewide Taskforce on Obesity (2008): Formed to

both complement and coordinate several groups around the state to fight obesity

  • Workplace Wellness Initiative (2008): Conceptual

framework for worksite wellness initiatives

  • Wellness Grants (2007): Awarded $1 million in grants

across the state to support healthy eating and increased physical activity

slide-33
SLIDE 33

33

Other MA Initiatives

  • Jump Up & Go!
  • Growing Up Healthy
  • MA Action For Healthy Kids
  • Project Bread: Better Breakfast & Better

Summer Meals

  • Farm to School Project
slide-34
SLIDE 34

34

Massachusetts Legislative Environment

slide-35
SLIDE 35

35

School Wellness Policies

Only 30% of MA school wellness policies meet minimum federal requirements

– Only 70% of the policies included plans for evaluation and communication of those findings to school administration

slide-36
SLIDE 36

36

2007 Obesity-Related Standards in Schools & State Initiatives

Type of Legislation Massachusetts

Nutritional Standards for School Meals

X

Nutritional Standards for Competitive Foods Limited Access to Competitive Foods Physical Education Requirements

X

BMI or Health Information Collected

X

Non-invasive screening for diabetes Health Education Requirements

X

Trans Fat Restrictions

X

Snack Taxes Trust for America’s Health, 2007

slide-37
SLIDE 37

37

Most Promising Nutrition Policy Options

  • 2. Changes in nutritional standards at schools
  • limit access to junk foods in cafeterias and vending

machines

  • 1. ↑ Participation of schools in school breakfast

programs

  • 3. Regulation of marketing of foods to children
  • 4. Zoning changes in the built environment around

access to healthy and affordable food

  • 5. ↑ Promotion and public acceptance of breast-

feeding

slide-38
SLIDE 38

38

Most Promising Physical Activity Policy Options

  • 2. Administration of annual fitness testing in

schools

  • 1. Increased physical education and recess time

in schools

  • 3. Increase walkability and cyclability of built

environment

– design attractive sidewalk networks – create schoolyards, playgrounds, and trails that are safe and accessible – convert areas to be bike-friendly within communities to promote active living

slide-39
SLIDE 39

39

Most Promising Universal Approaches

  • Collect Data
  • Recognize that we have a problem
  • Life course approach
  • Teaching of health professionals about “prevention”
  • Increase business and organization care for health of

employees

  • Parents serve as “role models” for healthy lifestyle

behaviors

– ↑ healthy foods in the home – ↓ screen time – Promote safe, outdoor play

slide-40
SLIDE 40

40

Need For A Coordinated Strategy

School Administrators Program Managers Legislators Academics Healthcare Champions Improved Community Health

slide-41
SLIDE 41

41

Acknowledgements

  • Valerie Clark, MS, RD, Tufts University
  • Caitlin Westfall, Tufts Univesity
  • Stewart Landers, MDPH and others
  • Dr. Carol Goodenow, MDOE
  • Dr. Michael Doonan & Susan Houghton,

Brandeis University

  • Harvard Pilgrim Healthcare Foundation
slide-42
SLIDE 42

42

Thank You