childhood obesity and iowa schools

Weighty Issues:

Why and How Schools Should Be Involved

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Iowa

No Data <10% 10%–14%

Source: http://www.cdc.gov/



Iowa

No Data <10% 10%–14%




Iowa

No Data <10% 10%–14% 15%–19%




Iowa

No Data <10% 10%–14% 15%–19% ≥20




Iowa

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%




Iowa

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Iowa

Source: http://www.cdc.gov/brfss/

What About NE Iowa?

Iowa Allamakee

Clayton Fayette Howard Winneshiek

Overweight

37.3% 38.2 38.1 37.8 38.2 35.9

Obese 22.5% 23.2 23.2 22.8 23.0 21.5

Source: http://facits.idph.state.ia.us/facits/

One in two children (ages 6-19) in the U.S. is overweight (obese) or at risk of

overweight (overweight)

Children and Weight

Overweight/Obese Trends

0

5

10

15

20

25

6-11 year old girls

12-19 year old girls

6-11 year old boys

12-19 year old boysPerc

en

tag

e

JAMA 2002, 2004, 2006

What About Iowa Youth?

Source: Youth Risk Behavior Surveillance System, 2007

National Iowa

Obese Females9.6% 8.8%

Overweight Females 15.1% 10.6%

Obese Males16.3% 13.7%

Overweight Males 16.4% 16.2%

Obese Total 13.0% 11.3%

Overweight Total

15.8% 13.5%

What about NE Iowa?

Iowa Allamakee

Clayton Fayette

Overweight85-95%

17.5% 15.7% 19.8% 23.4%

Obese>95%

14.9% 15.7% 14.9% 12.9%

Source: Iowa WIC programhttp://www.idph.state.ia.us/wic/common/pdf/2007_pednss_county.pdf

Weighty Costs

• $40 billion spent on health clubs, diet soda, diet books and videos, artificial sweetener, weight loss centers and liquid diets

• Medical expenditures related to obesity – United States - $75 billion – Iowa - $783 million

• Weight-associated hospital costs for children more than tripled between 1979 and 1999

Excessive weight gain in childhood precedes adult obesity

and related problems.

Overweight children are 43.5 times more likely to have at least 3 cardiovascular risk

factors.

HEALTH HAZARDS AHEAD

Source: Nicklas (2001) Journal of the American College of Nutrition 20(6): 599-608

Children’s Eating Habits• 2% of kids meet all Food Guide Pyramid Recommendations

– 16% do not meet any recommendations– 40% meet only one or none

• More than – 84% of kids eat too much fat– 91% eat too much saturated fat

• Less than– 15% get enough fruits– 20% get enough vegetables– 30% get enough milk

Source: Munoz et al. (1997) Pediatrics 100(3):323-329

Children’s Eating Habits

• Over 50% of snacks eaten by American children are cookies, desserts, potato chips, salty snacks, candy and gum.

• Only 16% of snacks are fruits -- and only 1% of snacks are veggies.

• American children eat only half the recommended five daily servings of fruits and vegetables. (only about 1 in 5 kids get 5-A-Day)

• The most common vegetables eaten by children are French fries, ketchup and pizza sauce. (of the vegetables eaten by 6-11 year olds approximately 55 to 60% come from potatoes or tomatoes)

• Children have especially low intakes of nutrient rich dark green leafy and deep yellow veggies.

Media and marketing issues

• $2 billion in marketing towards children annually

• Average TV time = 526 commercials per day• Ronald McDonald is 2nd only to Santa Claus in

recognition• $ spent on fast food is greater than movies,

books, magazines, newspapers, videos and recorded music combined

Source: Food, Fun ‘n Fitness, Friesz 2002

Child Nutrition and WIC Reauthorization

Section 204 of P.L. 108-265June 30, 2004

Wellness policies

Nutrition guidelines selected by the local educational agency for all food available on each school campus under the local educational agency during the school day with the objectives of promoting student health and reducing childhood obesity.

• School meals guidelines meet the DGA, these nutrition guidelines are for foods available outside of the school meals programs.

Foods of Minimal Nutritional Value

• Criteria for food sold outside of meals in the food service area during mealtimes

• Restricts the sale of foods providing less than 5% of the RDI for eight specified nutrients

What’s in, what’s out?

• Fruitaides• French fries• Ice cream candy

bars• Cookies• Chips• Snack cakes• Doughnuts

• Seltzer water• Caramel corn• Popsicles• Jelly beans• Chewing gum• Lollipops• Cotton candy• Breath mints

Legislative activity

• Child Nutrition Promotion and School Lunch Protection Act (federal)– Updates Foods of Minimal Nutritional Value

and establishes federal-level nutrition standards

• Healthy Kids Act (state)– Establishes state-level nutrition standards

Institute of Medicine Nutrition Report

• Standards for Foods in Schools– Congress directive– April 25, 2007– Foods should be consistent with the Dietary

Guidelines for Americans 2005

IOM Report – Tier 1 foods

• Available to all students throughout the day

• Must provide 1 serving of fruit, vegetable, whole grain or nonfat/low-fat dairy

• < 200 calories

• < 35% total calories from fat• < 10% total calories from sat. fat• < 0.5 gm trans fat • < 35% calories from total sugars• < 200 mg sodium

IOM Report - Tier 2 foods

• Available ONLY to high school students AFTER school

• Do NOT provide a serving of fruit, vegetable, whole grain or nonfat/low-fat dairy

• < 200 calories• Same fat, sugar, sodium criteria as Tier 1

School Foods Report Card

• Iowa received an ‘F’ • Based on food/beverage policy outside

of the school lunch program– Beverage nutrition standards– Food nutrition standards– Grade level(s) impacted– Coverage of school day time– Location in school impacted

Institute of Medicine 9/14/06

• School boards, administrators, and staff should elevate the priority that is placed on creating and sustaining a healthy school environment and advance school policies and program that support this priority.

• Schools and school districts should conduct self-assessments to enhance and sustain a healthy school environment, and mechanisms for examining links between changes in the school environment and behavioral and health outcomes should be explored.

Should schools be in the health business?

Mean scale scores in English–language arts by fitness standards achieved.

311

316

322

327

333

342

355

300

306

314

320

326

336

350

304

309

317

322

329

339

352

290

300

310

320

330

340

350

360

0 1 2 3 4 5 6

Overall PFT Score

CS

T E

LA

Sc

ale

Sc

ore

Grade 5 Grade 7 Grade 9

300

308

316

322

330

342

361

294

300

308

315

322

334

350

317319

324

330

336

346

358

280

290

300

310

320

330

340

350

360

370

0 1 2 3 4 5 6

Overall PFT Score

CS

T M

ath

Sc

ale

Sc

ore

Grade 5 Grade 7 Grade 9 Students Who Took CST Geometry

Mean scale scores in mathematics by fitness standards achieved.

Nutrition: Breakfast Studies

• Iowa Breakfast Study (1960’s)• Maryland Breakfast Study (2001)• Minnesota (1998)

– Tardiness and absences– Suspensions – Test Scores – Attention and Behavior

Nutrition: Florida (1990)

• 12 weeks • Students were required to:

– Eat a nutritious breakfast each morning

– Limit sugar intake

– Eat nutritious snacks

– Eat more fruits, vegetables, whole-grain and protein-rich foods

– Attend nutrition education classes 2 to 3 times/week

Nutrition Outcomes (Florida 1990)

Wide Range Achievement Test (WRAT) scores

Classroom behavior

Nutrition quiz scores

Making it Happen

• ↓ Lunchroom discipline problems (183 vs 36)• ↓ After-lunch referrals to the principal

(96 vs 22)• ↑ Attentiveness/behavior after lunch ↑ 10 minutes of

instruction time (30 hours per year)• 12 of 13 reporting fiscal impact reported improved

or same bottom line

Success Stories– Establish nutrition standards for

competitive foods– Influence food and beverage contracts– Make more healthful foods and

beverages available– Adopt marketing techniques to promote

healthful choices– Limit student access to competitive foods– Use fundraising activities and rewards

that support student health

. . . and justice for all

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Many materials can be made available in alternative formats for ADA clients. To file a complaint of discrimination, write USDA, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue, SW, Washington, DC 20250-9410 or call 202-720-5964.

Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, in cooperation with the U.S. Department of Agriculture. Stanley R. Johnson, director, Cooperative Extension Service, Iowa State University of Science and Technology, Ames, Iowa.

Prepared by: • Ruth Litchfield, Nutrition Extension Specialist, ISU

Contributions by:• Barbara Anderson, Extension Field Specialist,

Wapello Co.• Pat Anderson, Extension Field Specialist, West

Pottawattamie Co.• Patricia Steiner, Extension Field Specialist, Des

Moines Co.

childhood obesity and iowa schools

Education

person iowa source

adults brfss

lbs overweight

obesity trends

weighty issues