Com m unities Role in Childhood Obesity Prevention: Nutrition and - - PowerPoint PPT Presentation

▶
com m unities role in childhood obesity prevention
SMART_READER_LITE
LIVE PREVIEW

Com m unities Role in Childhood Obesity Prevention: Nutrition and - - PowerPoint PPT Presentation

Oct 21, 2023 148 likes •343 views

Com m unities Role in Childhood Obesity Prevention: Nutrition and Physical Activity Lorrene Ritchie, PhD, RD Biennial Childhood Obesity Conference July 17, 2019 2 Nutrition and Physical Activity Outcom es Medium -Term Outcom es Medium

slide-1
SLIDE 1

Com m unities’ Role in Childhood Obesity Prevention: Nutrition and Physical Activity

Lorrene Ritchie, PhD, RD Biennial Childhood Obesity Conference July 17, 2019

slide-2
SLIDE 2
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

2

Ritchie et al. Am J Prev Med 2015;49:647-652. Pate et al. Am J Prev Med 2015;49:653-659.

Nutrition and Physical Activity Outcom es

Predictor Community Programs & Policies Long- Term Outcom e BMI Medium -Term Outcom es Medium -Term Outcom es Nutrition

  • added sugar
  • sugary drinks
  • energy-dense

foods

  • fast food
  • eating with TV
  • fruits & vegetables
  • whole grains
  • fiber
  • lower-fat milk
  • breakfast
  • dinner with family

Physical Activity

  • Total PA
  • Moderate-to-vigorous PA
  • Neighborhood attributes
slide-3
SLIDE 3

Nutrition

slide-4
SLIDE 4
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

4

HCS National Recom m ended

Total added sugar 19.0 18.5 < 10 tsp/ day Sugar from SSBs 7.0 7.0 ~ 0 tsp/ day Energy-dense foods 2.0 1.3 Minimal times/ day Fruit & vegetables 2.5 2.1 2.5 - 5.5 cup/ day Whole grains 0.7 0.7 2.5 - 4 oz/ day Fiber 15.5 14.1 25 – 38 g/ day Usually 1% / non-fat milk 26.8 30.9 ~ 100% Breakfast 6.2 4.4 ~ 7 days/ week Fast food restaurant 1.0 1.7 < 1 days/ week Dinner with family 5.0 5.1 ~ 7 days/ week Eating with TV 39.2 39.5 ~ 0%

Nutrition: HCS vs Nationally

slide-5
SLIDE 5
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

5

DOSE

More I ntense

  • Duration longer
  • Reach more children
  • Strategy more policy,

systems, or environmental

HOW

More Strategies

  • I nform ation
  • Services
  • Access
  • Consequences
  • Policy/ system s

W HAT

More Behaviors

  • Fruit & vegetables
  • W hole grains
  • Sugary drinks
  • W ater
  • Energy-dense

snacks/ sw eets

  • Fat
  • Calories
  • Breakfast
  • Fast food

Characteristics of Com m unity Efforts

slide-6
SLIDE 6
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

6

W HAT

Behavior

  • Fruit & vegetables (69% )
  • Energy-dense snacks/ sweets (44% )
  • Whole grains (40% )
  • Sugary drinks (39% )
  • Water (32% )
  • Fat (29% )
  • Fast food (27% )
  • Breakfast (21% )
  • Calories (18% )

HOW

Environm ental Strategy

  • ↑ Availability of healthier (49% )
  • ↓ Availability of less healthy (20% )
  • ↑ Affordability of healthier (7% )
  • ↑ Procurement from local farms (6% )
  • ↓ Portion sizes (2% )
  • ↓ Advertisement of less healthy (1% )
  • ↑ Supermarkets/ food retail (1% )

W hat and How are Com m unities Engaged

Webb et al. Pediatr Obes 2018;13 Suppl 1:103-112.

slide-7
SLIDE 7
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

7

More I ntense: Higher Reach, Duration, Strength

  • ↑ lower-fat milk

More Strategies & Restricting Availability of Less Healthy

  • ↓ added sugar
  • ↓ sugary drinks
  • ↓ energy-dense

More Behaviors & Targeting Less Healthy

  • ↑ fruit/ vegetables
  • ↑ fiber

Associations of Com m unity Efforts over Past 6 years w ith Nutrition Outcom es

Ritchie et al. Pediatr Obes 2018;13 Suppl 1:14-26. Webb et al. Pediatr Obes 2018;13 Suppl 1:103-112.

slide-8
SLIDE 8
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

8

  • Appears to take several years of sustained efforts for

communities to reap benefits: no quick fix

  • Different features of community efforts are important;

there is no “single” or “simple” solution

  • Increase intensity: broader reach, longer duration,

multiple strategy

  • More effort needed to change some behaviors, such as

eating from a fast food restaurant, eating dinner with family, and eating while watching TV

Lessons Learned on Nutrition

slide-9
SLIDE 9
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

9

  • Simultaneously target multiple behaviors: don’t just

focus on promoting more fruit, vegetables and whole grain – also limit less healthy options such as sugary drinks, sweets and fast food

  • Giving information and enhancing skills should

accompany change to food environments

  • Environment changes that show promise: restricting

the availability of unhealthy foods, and reducing portion sizes

Lessons Learned on Nutrition

slide-10
SLIDE 10
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

10 10

Place Matters

Woodward-Lopez et al. Community characteristics modify the relationship between obesity prevention efforts and dietary

  • utcomes in children in the Healthy Communities Study. Ped Ob

(i i )

W HAT ( behavior) HOW ( strategy)

More Healthy

  • South
  • Rural

Less Healthy

  • West

Less Healthy

  • South
  • Low-income
  • High African

American

More Healthy

  • Northeast
  • West
  • Higher-income
  • High Hispanic
slide-11
SLIDE 11
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

11 11

Lessons Learned on Nutrition Different considerations may be needed for childhood obesity prevention efforts

  • Particularly in southern U.S. and rural

communities

  • To a lesser extent, depending on community

income and race/ ethnicity

slide-12
SLIDE 12

Physical Activity

slide-13
SLIDE 13
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

13 13

Less PA in Girls, especially as Get Older

Age (years) MVPA in past 7 days

slide-14
SLIDE 14
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

14 14

Associations of Com m unity Efforts over Past 6 years w ith Physical Activity

Ritchie et al.. Pediatr Obes 2018;13 Suppl 1:14-26

  • An index reflecting the 6-year history of the number of

behavior change strategies used was positively associated with children’s moderate-to-vigorous physical activity

  • This association was attenuated with adjustment for

demographic factors

  • Moderation analyses found that the association was positive

among non-Hispanic, but not Hispanic, children

slide-15
SLIDE 15
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

15 15

Neighborhood Attributes in Relation to PA

Street Segment Near Child’s Home (Windshield Survey)

  • Burned, boarded up, or abandoned residential units
  • Litter
  • Quality and condition of residential units
  • Busy thoroughfare
  • Side street/cul-de-sac/dead end/one-way
  • Sidewalks
slide-16
SLIDE 16
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

16 16

Neighborhood Attributes in relation to PA

Youth with no litter on their street reported significantly lower neighborhood-based PA Youth living on a side street, cul-de-sac, dead-end,

  • r one-way street reported greater neighborhood-

based PA

slide-17
SLIDE 17
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

17 17

Lessons Learned on Physical Activity Community programs and policies to promote physical activity in children may be more successful if they are sustained for several years and employ multiple behavior change strategies Specific street quality attributes are associated with physical activity in youth

slide-18
SLIDE 18
  • Click to edit Master text styles

– Second level

  • Third level

– Fourth level » Fifth level

18 18

Strengths & Lim itations

  • Range of nutrition and physical activity measures
  • First study to characterize naturally occurring

community efforts in relation to child nutrition and physical activity outcomes

+

  • Large number of comparisons
  • Self-report of child nutrition and physical activity
slide-19
SLIDE 19

Thank you!

For more info: Lritchie@ucanr.edu