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Amber France
Concordia University
Childhood Obesity: A Growing Problem in the Childhood Obesity: A Growing Problem in the United StatesUnited States
IntroductionIntroduction• Rates have tripled over the past 30 years (Ogden & Carroll, 2010)
• Due to an increase in high calorie, high sugar, high fat foods and sedentary lifestyle
• Complex issue with multiple influential factors: (Karnik & Kanekar, 2012)
• Genetics
• Behavioral
• Environmental
BiostatisticsBiostatistics
• Obesity rate research examines:
• BMI
• Location and socioeconomic status to determine prevalence
• Physical activity
• Nutrition
• Collection of data through surveys:
• National Survey for Children’s Health (NSCH)
• National Health and Nutrition Examination Survey (NHANES)
• NHANES Youth Fitness Survey
(CDC, 2013)
EpidemiologyEpidemiology
Obesity Rates Based on Age Obesity Rates Based on Race & Gender
(Ogden & Carroll, 2010)
Socioeconomic StatusSocioeconomic Status• Rates increase with (CDC, 2011)
• Decrease in household education
• Family below 400% poverty
• Children >2 hours screen time per day
• Less than a bachelor’s degree
• Less likely to breastfeed through at least 3 months• Study in New York public elementary school
(Thorpe, List, Marx, May, Helgerson, & Frieden, 2004)
• 43% had BMI >85th percentile
• 1 in 4 children obese
• 31% Hispanic children
• 23% black children
• 16% white children
• 14% Asian children
Examining BMI ChartsExamining BMI Charts• Study to identify predictors of severe obesity
• Data obtained through interviews with children, parents, childcare, early-education providers, and teachers
• Questions pertaining to child’s nutrition, physical activity, health care, & experiences
• Looked at parental characteristics (maternal weight, behaviors, and MD counseling)
• Results:
• Crossing 85th percentile prior to kindergarten increased risk
• At 9 months: double risk
• 2-4 years: 8x more likely to be obese by kindergarten
• Major contributors:
• Formula feeding
• Early introduction to solids
• Lack of health care
• Poor nutritional behaviors
(Flores & Lin, 2013)
Maternal InfluencesMaternal Influences
• Maternal obesity triples odds of childhood obesity
• Younger maternal age increases risk
• Smoking
• Profession or level of education
• Not breastfeeding exclusively for the first 6 months of life (Reilly et al, 2005)
(Flores & Lin, 2013)
BiomedicalBiomedical• Obesity:
• Chronic energy imbalance resulting in fat accumulation
• Associated with chronic disease such as diabetes, hypertension, heart disease, and cancer
• Influences on obesity
• Genetics
• Environment
(CDC, 2011)
GeneticsGenetics• Not solely to blame
• Variants in genes cause decrease sensitivity to satiety
• Multiple genes play a factor & operate under multiple mechanisms such as (Farooqi & O’Rahilly, 2007)
• Energy intake
• Dividing nutrients between fat & lean muscle
• Thrifty Genotype
• Gene that helps survive during famines now coupled with todays environment & behaviors being challenged
(CDC, 2012)
Environmental InfluencesEnvironmental Influences• Abundant availability of low cost energy dense foods
• Sedentary lifestyle
• Increase in automobiles
• Lack of safe sidewalks
• Building structures & designs
• “Obesogenic Environment” (Bouchard, 2007)
• Large portion sizes
• High fat, sugar, and caloric diets
• TV, video games, computer use
(Farooqi & O’Rahilly, 2007)
Social and Environmental FactorsSocial and Environmental Factors• Obesity is a public health crisis
• Poor diet & physical activity 2nd leading cause of death in US
• Factors:
• Behavioral
• Environmental
• Social
• Parental
• School-based
• Community
(Karnik & Kanekar, 2012)
Behavioral FactorsBehavioral Factors• Contributors:
• High fat, sugar, and caloric diets provided to children
• Sedentary lifestyle
• Leads to:
• Consuming more calories
• Burning less energy
• Weight gain and obesity
(Karnik & Kanekar, 2012)
Environmental & Social FactorsEnvironmental & Social Factors• Food intake & physical activity influenced by surroundings
• Influences
• Parents are most influential to lifestyle choices
• Children spend most of their day in school
• Community offers affordable and accessible healthy options
(Karnik & Kanekar, 2012)
Parental InfluenceParental Influence• Most influential factor
• Parents responsible for child’s lifestyle
• Interventions:
• Education with parents begin during pregnancy
• Intrapersonal & interpersonal level of influence (Schneider, 2011, pg. 234)
• Child gain knowledge, attitude, & skills to eat healthy & by physically active
(Karnik & Kanekar, 2012)
School-Based InfluenceSchool-Based Influence• Children spend most of their day in school
• Interventions to influence at the institutional level:(Schneider, 2011, pg. 234)
• School lunch programs
• Decrease sugary beverages
• Increase fruit, vegetable, & water
• Physical education classes
• Mandatory classes with moderate to vigorous activities
• Health education classes
• Educate on healthy lifestyles
(Karnik & Kanekar, 2012)
Community InfluenceCommunity Influence• Supports and encourages healthy lifestyles by
• Offering healthy foods at social events
• Imparting healthy messages
• Educational programs on healthy lifestyles
• Ex: walk to school day
• Billboards, media, & entertainment aimed towards healthy lifestyles
• Safe play areas and sidewalks
• Decrease in vending machines
(Karnik & Kanekar, 2012)
Educating Behavior ChangeEducating Behavior Change• Use the health belief model
• Individual feels vulnerable to the threat
• Perceived severity of the threat
• Perceived barriers to taking action to reduce risk
• Perceived effectiveness of taking action
• Important to educate both the parents and the children
• Parents must be involved to make the biggest impact
(Schneider, 2011, pg. 231)
Conclusions and Future StudyConclusions and Future Study• Obesity is a growing problem
• Parents, schools, community, & government all play a role in the lifestyle choices a child makes
• Education is needed for all to make the biggest impact
• Children need to be surrounded with healthy choices
• Instilling lifelong healthy habits will be passed down to each generation stopping this epidemic
• Further research needed on influential exposures during pregnancy
ReferencesReferencesBouchard, C. (2007). The biological predisposition to obesity: beyond the thrifty genotype scenario. International Journal of Obesity,31, 1337-1339. Retrieved from http://www.nature.com/ijo/journal/v31/n9/full/0803610a.html
Centers for Disease Control and Prevention. (2012) Genomics and Health. Retrieved from http://www.cdc.gov/genomics/resources/diseases/obesity/index.htm
Centers for Disease Control and Prevention. (2011) Health, United States, 2011 With Special Feature on Socioeconomic Status and Health. Retrieved from http://www.cdc.gov/nchs/data/hus/hus11.pdf
Centers for Disease Control and Prevention. (2011) Obesity and Genetics. Retrieved from http://www.cdc.gov/features/obesity/
Farooqi, I.S., and O’Rahilly, S. (2007). Genetic Factors in Human Obesity. International Association for the Study of Obesity, 8(1, 37-40. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2007.00315.x/pdf
Flores, G., & Lin, H. (2013). Factors Predicting Severe Childhood Obesity in Kindergartners. International Journal of Obesity, 37. Retrieved from http://www.nature.com/ijo/journal/v37/n1/pdf/ijo2012168a.pdf
Karnik, S., & Kanekar, A. (2012) Childhood Obesity: A Global Public Health Crisis. International Journal of Preventative Medicine, 3(1)1-7. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278864/
ReferencesReferencesNational Health and Nutrition Examination Survey. (2013). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/nchs/nhanes.htm
Ogden, C.,& Carroll, M. (2010). Prevalence of Obesity Among Children and Adolsecents: United States, Trends 1963-1965 Through 2007-2008. Center for Disease Control. Retrieved from
http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_ 07_08.htm
Reilly, J.J., Armstrong, J., Dorosty, A.R., Emmett, P.M., Ness, A., Rogers, I., … Sherriff, A. (2005). Early Life Risk Factors for Obesity in Childhood: Cohort Study. BMJ Online First, 330. Retrieved from http://www.bmj.com/content/330/7504/1357.pdf%2Bhtml
Schneider, M-J. (2011). Introduction to Public Health (3rd Edition ed.). Sudbury, MA: Jones & Bartlett Learning.
Thorpe, L.E., List, D.G., Marx, T., May, L., Helgerson, S.D., & Frieden, T.R. (2004). American Journal of Public Health, 94(9). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448480/pdf/0941496.pdf