Embed Size (px)
Citation preview
Trends in Childhood Obesity Current Data and A Call to Sustained Action
Presentation to the Essex-Passaic Wellness Coalition
Uche Akobundu, PhD, RD
Hunger-Free Communities Program Director
Introduction
Goal
• To provide an overview of federal, state and local trends in childhood obesity, determinants of overweight/obesity in children and practical recommendations for action
Introduction
Overview
– Federal, state and local trends in childhood obesity
– Social, environmental and policy-based determinants
– Effectiveness of available interventions
– Future research needs / action steps for community members
About the United Way of Passaic County
How We Work
5
Community Impact HEALTH
Did you know?
• 32,000 Passaic County
households are food insecure.
• Those most at risk for “food
insecurity” include the
un/underemployed, people
with disabilities, single parents
with children and people with
language barriers.
• Food insecurity increases risk
of poor health in adults and
children.
You can LIVE UNITED by
supporting these initiatives:
Hunger Free Communities
• Leads the Passaic County
Food Policy Council
• Promotes a community-wide
plan to end hunger by
addressing food availability,
affordability, & accessibility,
and consumer education and
advocacy.
• Provides grant funding for
innovative programs to
advance food access.
Trends in Childhood Obesity
Current Data and Opportunities for Action
Uche Akobundu, PhD, RD
Hunger-Free Communities Program Director
Childhood Obesity
• Childhood obesity has more than doubled in children and tripled in adolescents in the past 30 years. – The percentage of children aged 6–11 years in the United States who
were obese increased from 7% in 1980 to nearly 18% in 2010.
– Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to 18% over the same period.
– Obesity rates are high among preschool children in the United States. Approximately one child in eight aged 2–5 years is obese.
• In 2010, more than one third of children and adolescents were overweight or obese.
Source: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of
Adolescent and School Health and National Center for Chronic Disease Prevention and Health
Promotion, Division of Population Health. http://www.cdc.gov/healthyyouth/obesity/facts.htm
Childhood Obesity
• Overweight and obesity describe ranges of weights higher than what health professionals note are healthy for a given height. – Overweight and obesity are caused by a variety of factors,
including genetics, overeating, and lack of adequate physical activity.
• Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Obesity is defined as having excess body fat.
Source: Centers for Disease Control and Prevention, 2013.
http://www.cdc.gov/healthyyouth/obesity/facts.htm
Childhood Obesity Trends
Trends In Child - Adolescent Overweight By Age: Center for
Disease Control & Prevention
Percentage of Overweight 2- to 4-year-old Children
(Enrolled in WIC), by Year,
New Jersey and U.S., 2000-2005
New Jersey State Health Assessment Data. CDC Pediatric Nutrition Surveillance
System (PedNSS), New Jersey. http://www4.state.nj.us/dhss-
shad/indicator/view/OveWICChi.UT_US.html
Prevalence of obesity among low-income,
preschool-aged children
Source: Vital Signs: Obesity Among Low-Income, Preschool-Aged Children — United States, 2008–2011. Morbidity and Mortality Weekly Report.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6231a4.htm?s_cid=mm6231a4_w
Source: 2011 Pediatric Nutrition Surveillance System, United States
Decreases and increases*† in obesity§
prevalence from 2008 to 2011 among low-income
preschool-aged children
Obesity in New Jersey
• Obesity the region has been rising steadily for the past decade.
• We can extrapolate that these rates are beginning to flat-line, in line with recent data that suggests a flattening of obesity in adults are across the nation.
• Almost one quarter (23.8%) of adults in New Jersey are obese, compared with 19% in 2002. National Center for Chronic Disease Prevention and Health Promotion.
State Nutrition, Physical Activity and Obesity profile – New Jersey.
http://www.cdc.gov/obesity/stateprograms/fundedstates/new_jersey.html.
NJ County-Level Obesity Data
Source: New Jersey State Health Assessment Data.
Local Data on Children
• There is limited local data on childhood obesity and overweight by county, however Rutgers University data is available for selected municipalities
Overall, one in
ten students
(10.9%) was
reported to be
obese in 2011.
Obesity Trends: NJ Adolescents
Source: Argawal, M. The Status of Nutrition, Physical Activity and Obesity in
New Jersey. Rutgers Center on State Health Policy, 2012.
http://www.state.nj.us/health/fhs/shapingnj/library/ObesityReport_v6_Final.pdf
Obesity Trends: NJ Adolescents
Source: Argawal, M. The Status of
Nutrition, Physical Activity and Obesity
in New Jersey. Rutgers Center on
State Health Policy, 2012.
http://www.state.nj.us/health/fhs/shapin
gnj/library/ObesityReport_v6_Final.pdf
NJ is among the
states with the
lowest rates of
obese 10- – 17-
year olds
Source: F is for Fat 2013. Trust for America's Health and the Robert
Wood Johnson Foundation. http://fasinfat.org/files/fasinfat2013.pdf
How Did We Get Here?
Selected Determinants of Childhood Obesity • Food Behaviors
• Over-consumption of sugar and salty foods/not getting recommended amounts of fruits & vegetables
• Lack of exercise
• Food Environment – Disparities in availability of and access to healthy food retail – Highly prevalent junk food marketing
• Physical Activity Behavior – Almost all children do not meet the guidelines for being physically active for 60 minutes each
day
• Changes in Society – American household structure, including delayed marriage, increased divorce, and women's
movement into paid labor force
• Access to nutrition education – Diet-related health literacy is challenged by information-rich environment
• Physical Activity Environment – Traffic, crime level, pleasantness of neighborhoods and parks condition of sidewalks are most
commonly reported barriers.
Source: F is for Fat 2013. Trust for America's Health and the Robert
Wood Johnson Foundation. http://fasinfat.org/files/fasinfat2013.pdf
Selected Determinants of Childhood Obesity
• Economic Constraints – Health insurance, transportation access, ability to purchase/access to health supportive
activities
• Limited Time – Long working hours, increased car time
• Schools – Marketing of foods, availability of low nutrition foods and beverages, curriculum
changes (health education and physical education)
• Community Design – Driver-centered, limited public transportation, retail/employment centers separate
from housing
• Marketing and Advertising – Junk food marketing to children, popularity of fad dieting/extreme weight loss
programs
Source: F is for Fat 2013. Trust for America's Health and the Robert
Wood Johnson Foundation. http://fasinfat.org/files/fasinfat2013.pdf
There is Hope!
What is Going Well
• Dietary intake of children
• Number of children (HS students) meeting physical activity guidelines
• Menu labeling environment
• Parental knowledge, awareness and demand for healthy foods and environments
What is Going Well
• Number of children eating a healthy diet is improving
Center for Nutrition Policy and Promotion. Diet Quality of Children Age 2-
17 Years as Measured by the Healthy Eating Index-2010.
But there is cause for concern…
Childhood Obesity
The trend for childhood obesity is that it s decreasing
Effective Treatment of Obesity
Evidence suggests that the key components of a successful treatment program include:
• Modify diet (i.e., traffic light diet)
• Limit sedentary behavior to no more than 2 hours per day Gradually increase physical activity to 60 minutes of moderate intensity activity per day
• Weight maintenance (not weight loss)
• Use behavioral techniques to increase and maintain motivation for lifestyle change (pros and cons of change, identify and overcome barriers, goal-setting, develop coping strategies)
Future Intervention/Research Needs
• High-quality evidence on successful, generalizable treatment programs is limited.
– Research as present is mixed due to variety of studies, protocols, populations studies and outcomes
• More research is needed to determine the effect of pediatric obesity treatment on behavioral, physiological, and psychosocial outcomes.
– The effect of improvements in cardiovascular and metabolic health on the long-term co-morbidities associated with childhood obesity has not been studied.
• The cost effectiveness of obesity treatments should be determined since they may appear to be expensive.
– Research that quantifies the Return on Investment presented by such interventions can facilitate policy change.
Action Steps: Community Groups
• To continue the downward trend in obesity, continued communitywide action is needed. Community members can help prevent obesity in young children by: – Creating partnerships with civic leaders and child-care providers to
make changes that promote healthy eating and active living;
– Making it easier for families with children to buy healthy, affordable foods and beverages in their neighborhood; and
– Providing opportunities for children to play safely through access to community parks and other recreation areas.
– Creating ‘buzz’ around the topic of childhood obesity – make it a local issue
– Leverage local resources to engage the community in action steps towards creating a healthy food environment
School meals matter!
12.5 Million eat Breakfast
31 Million eat Lunch
Interventions
Targeted at
Childcare and
School Settings
Physical activity in
and around
schools!
Camden, Newark, Trenton, & Vineland
Essex, Morris, Passaic, Sussex, &
Union Counties
Local Organizations Making a Difference
Hudson Institute. Better-For-
You-Foods. Its Just Good
Business. Obesity Solutions
Initiatives, 2011.
Interventions
Targeted at
Business
Community
Department of
Health,
Rockland
County, NY
Department of
Health and
Mental Hygiene,
New York City,
NY
Camden, Newark, Trenton, & Vineland
Local Organizations Making a Difference
Take Home Messages
• Childhood obesity in the US and New Jersey is high but the rate of increase is slowing.
• Changes to our social, environmental, family life, food shopping and dietary patterns all contributed to rising rates.
• However, there is hope and there are many efforts at the state, regional and local levels that provide great models for addressing childhood obesity in the community.
• There are many practical actions local groups can take to also make a difference to the health of children in the community.
Public Health
Matters!
Improvements our
built and social
environment &
policies can
impact our health!
VS
39
Thank You!
Uche Akobundu, PhD, RD
Hunger-Free Communities Program Director
United Way of Passaic County
Paterson, NJ
(973) 279-8900
