Interim Study on Child Health Susan B. Sisson, PhD, RDN, CHES, FACSM - - PowerPoint PPT Presentation

Interim Study on Child Health

Susan B. Sisson, PhD, RDN, CHES, FACSM Associate Professor, Nutritional Sciences Assistant Dean for Research, College of Allied Health Director, Behavioral Nutrition and Physical Activity Laboratory University of Oklahoma Health Sciences Center Oklahoma City, OK, USA

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Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

www.mikepaulblog.com

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Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

www.mikepaulblog.com

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What’s the Numbers? Prevalence of Overweight and Obesity

• 23% of American

preschoolers

• 31% of low-income

preschoolers in Oklahoma

• 38% of preschoolers in
• ur sample of child care

centers in Oklahoma

(Weedn et al. 2012; Weedn et al. 2013; Ogden et al. 2014; Sisson et al. 2016)

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Children at Risk

– American Indian 78% higher odds of obesity – Hispanic 62% higher odds of obesity

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(Weedn et al. 2012; Weedn et al. 2014)

11.5 10.7 16.3 17.2 13.4 11.8 16.4 18.4

5 10 15 20 25 30 35 40 White African American American Indian Hispanic

Ethnic disparities in obesity

Female Male

Why Care?

• Obese children were

twice as likely to be

• bese adults
• Overweight 5 year olds

are 4 times as likely to be obese in middle school

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(Serdula et al. 1993 ; Cunningham et al . 2014; Cheung et al. 2016)

Lots of Children in Non-Parent Care

• 65% of women are employed
• Families with children under 6 years

– 35% of both parents (in 2-parent homes) work – 75% of single parents work

• 61% if children aged 0-6 years received regular

child care outside the home

• Those with full time working moms spend 38

hours/week in non-parent care

(American Fact Finder [C23008]; Thorpe 2009 ; Interagency Forum on Child & Family Statistics; Mulligan 2005)

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Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

www.mikepaulblog.com

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Room for Improvement in Practices

• 21% offer 100% fruit juice ≤1/week
• 18% offer veggies other than potatoes, corn

and green beans daily

• 52% provide active play time ≥91 min/day
• 57% report TV is rarely used
• 43% have a written (and followed) physical

activity policy

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(Sisson et al. 2012)

Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

www.mikepaulblog.com

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Child Care Environment and Obesity

Dependent Variable Odds Ratio 95% Confidence Interval p value Total Environment 0.91 0.86, 0.97 0.004 Physical Activity 0.82 0.73, 0.93 0.002 Nutrition 0.90 0.80, 1.01 0.066 α = 0.05

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(Sisson et al. 2016 ; Sisson et al. 2017)

CACFP Matters

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(Ritchie et al. 2012; Korenman et al. 2013; Liu et al. 2016)

• Centers participating in CACFP provide

healthier foods, staff behaviors, and are associated with lower overweight and obesity

Importance of the Child Care Center

• Provide access to high quality, nutritious foods
• Ensure children are consuming those foods
• Provide access to indoors and outdoors
• pportunities for active play
• Engage children in structured physical

activities

• Develop an environment that promotes

health-enhancing behaviors by staff, parents and children

Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

www.mikepaulblog.com

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What’s for Lunch?

• Add what is in 16217 paper 2

(Sisson et al. 2017)

Kcals served: 510 ± 241 Kcals consumed: 387 ± 239

0.5 1 1.5 2 2.5 3 3.5 4 4.5 5

Total fruit & vegetables Lean protein Low fat Dairy Whole grains Fried meat High fat high sugar condiments Sugar sweetened beverages

Served Consumed

A physically active preschooler needs 1200- 1600 kcals/day

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Where are Meals Falling Short

Excess or deficient nutrients in 3-5 year olds in Oklahoman child care centers:

• Protein exceeded daily recommended intake by 3.5-5 times
• Over- and under- consumption of vitamins and minerals

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(Rasbold et al. 2015)

5 10 15 20 1-3yo 4-8yo 4.3 6.3 15.1 16.9

Protein (grams) Recommended and Served in Oklahoma Child Care Centers

DRI Served

Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

https://www.naturalproductsinsider.com/blogs/insider- law/2017/04/fda-examines-divergent-views-on-definition-of- hea.aspx

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Inadequate Food Quantity and Quality in Oklahoma

• Oklahoma is among the 10 states with the lowest

food security

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1 in 4 children are at risk

• f going to bed hungry
• Poverty rate among children is 22%
• Families resort to cheaper, unhealthier options
• Processed foods, high-fat, high-sugar

(USDA 2012-2014 ; Meal Gap 2014 Report ; 2014 US Census )

Better Than What’s at Home

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1 2 3 4 5

Total fruit & vegetables* Low fat Dairy* Whole grains Fried meat High fat high sugar condiments Sugar sweetened beverages*

Child Care Home

(Sisson et al. 2017)

Kcals Child Care: 333 ± 180 Kcals Home: 455 ± 175

CACFP Goals

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• More fresh fruits and

vegetables

• More whole grains
• More variety in

protein

• Low-fat and

unflavored dairy products

• Less added sugar
• Appropriate portions

https://www.childcarenetwork.com/Get-Started/USDA-Meals

Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

www.mikepaulblog.com

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Child Care Environment

(Sisson et al. 2016)

21.8 21.2 43 11.7 12.5 23.9

20 40 60

Physical activity scale Nutrition scale Total environment

mean max possible

39 ± 45 minutes of TV viewing 99 ± 70 minutes of

• utdoor

time 91 ± 46 minutes of sedentary time 8 ± 12 minutes of structured activity

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But the kids are so active?

• 60 minute/day required outside time (OSDH)
• 4.3 minutes/hour were spent in moderate-to-

vigorous physical activity

• 24 minutes of moderate-to-vigorous physical

activity

• 4300 steps/day

(OKDHS 2009; Sisson et al., 2017)

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Children’s Activity in OK Child Care

10 20 30 40 50 60 70 80 90 100 Sedentary Light Moderate Vigorous

Percent of Time in Child Care Physical Activity Intensity

365 minutes (6.1 hours) 35 minutes 17 minutes 10 minutes 27 minutes

Average 7.6 ± 1.6 hours of wear

Physical Activity Guidelines

• NASPE

– 60 min and up to several hours of active play – Limited sitting

• US Federal PA guidelines (>5 years)

– 60 min or more/day moderate or vigorous

• Canadian PA guidelines (early years)

– 180 min or more/day any intensity – 60 min/day energetic play

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(NASPE 2010; Health.gov 2008; CSEP.ca. 2012)

Roadmap of Today’s Talk

• Prevalence of overweight

and obesity

• Obesogenic practices in

Child Care

• Influence of Child Care
• About the food served
• Importance of healthy food

in child care

• Children’s physical activity
• Children’s screen time

www.mikepaulblog.com

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Leisure Screen Time

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(AAP 2016; Briefel et al. 2015)

32 hours/week

We’ve reached the end of the road… Thank you for your participation!

susan-sisson@ouhsc.edu

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