Daniel Clark MD/PhD/MPH/RN/BS/GED/Promotoro/ CHW and Kuei Lee

Daniel Clark MD/PhD/MPH/RN/BS/GED/Promo

toro/CHW and Kuei Lee

Childhood Obesity• Increasing in prevalence

(1976-1980 vs 2003-2006)– 6-11 yrs old: from 6.5% to 17.0%– 12-19 yrs old: from 5.0% to 17.6%

• 1 of 10 key health indicators for Healthy People 2010

• 15% of American children are overweight

• Inactivity and poor diet cause 300,000 deaths/year in U.S.

• Obesity-related diseases cost over $100 billion/year in U.S.

Kuei

Source: http://www.cdc.gov/obesity/childhood/prevalence.html

http://www.sph.uth.tmc.edu/catch/cns.htm

Dan

School-Based Interventions• 3 Basic Approaches:

(1) Nutrition- Guidelines- Price Interventions- Product regulation

(2) Physical Activity(3) Environmental

- Community and Family Interventions

Source: http://www.cdc.gov/obesity/childhood/prevalence.html

School-Based Interventions

• Meta-analysis• “Do School Based Food and Nutrition Policies

Improve Diet and Reduce Obesity?”

• Published and unpublished literature

• U.S. and Europe

• 18 studies met inclusion criteria

Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.

School-Based Nutrition Interventions: Meta-Analysis

Nutritional guidelines• Decreased total and saturated fat• Increased fruit & vegetable

availability• Improved students’ dietary intake

Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.

School-Based Nutrition Interventions: Meta-Analysis

Price Interventions• Increased fruit & vegetable

sales

• No negative effect on profits

Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.

School-Based Nutrition Interventions: Meta-Analysis

Product regulation• Decreased sale of foods with

minimal nutritional value• Unintended negative

consequences

Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.

Physical Inactivity• Independent risk factor for CHD

• 30% CV deaths

• 30% DM deaths

• 60% of cancer deaths

Source: Stone et. al., Am J Prev Med 1998;15(4).

CATCH PROGRAM• First initiated as a research study involving the University of California at San Diego, University of Minnesota, Tulane University and the University of Texas Health Science Center – Houston

• Purpose: to develop an elementary school-based program to reduce the risk factors related to cardiovascular disease.

• Four Components:

1.Eat Smart school nutrition program2.K-5 and 6-8 Classroom curriculum3.Physical Education Program4.Family Programs

CATCH: Eat Smart

CATCH: Eat Smart

CATCH: Classroom Curriculum

CATCH Activities and Games

CATCH: Family Activities

CATCH: Family Activities

CATCH: Follow Up from 1991-1997

Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704

CATCH: Follow Up from 1991-1997

Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704

CATCH: Follow Up from 1991-1997

Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704

CATCH: Follow Up from 1991-1997

Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704

CATCH: Follow Up from 1991-1997

Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704

CATCH: Follow Up Conclusions

• Intervention group demonstrated significantly healthier behaviorsas compared to the control group.

• Behavioral differences between both groups persisted for 3 years after intervention.

• The difference between experimental and control groups, though still statistically different over time, are narrowing over time.

• More research needs to be done to develop the best modalities formaintaining intervention effects beyond elementary school level.

• Programs to alter environments for elementary, middle, junior, and high schools are warranted.

Acknowledgements

LaredoLaredo• Roger PeralesRoger Perales• Kelsey VaughnKelsey Vaughn• Sylvia ArellanoSylvia Arellano• All the SpeakersAll the Speakers• La Bestia BlancaLa Bestia Blanca

HarlingenHarlingen • Pat BortoniPat Bortoni• Noe GarzaNoe Garza• Beatriz TapiaBeatriz Tapia

Questions?