School Nutrition Environment

And Adolescent Obesity A Training of Trainee Program

Presented at the Dallas Independent School District, Dallas, Texas

ByOnyema Madukauba Pascal

Doctoral Student of Public Health Walden University

To impart knowledge and skills

Clip art

Microsoft 2007

Learning Objectives 1

To motivate the school authorities

How?

Ban or restrict fast foods Clip art Microsoft 2007

Create an enabling environment for exercise

Learning Objectives 2

Overweight & Obesity have reached epidemic levels in the US (Ludwig, 2007). Clip art Clip art ( microsoft

2007)

Ludwig, D.S (2007, December).Childhood Obesity – The shape of things to come.

The New England Journal of Medicine.357(23):2325-2327.Retrieved from http://content.nejm.org/cgi/content/full/357/23/2325

Obesity A Major Concern

The incidence of adolescent obesity has more than tripled in the past 30 years (CDC,2009)

Texas is one of the states with the highest prevalence of obesity; ranking 15th among 50 States of the Federation as at 2007 (TDSHS, 2009)

Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.htmlTDSHS (2010). Obesity in Texas. Retrieved from http://www.dshs.state.tx.us/obesity/pdf/THIPolicyBrief06.pdf

Incidence and Prevalence

As at 2009, 1 out every 3 adolescents in the US is overweight and close to 25 % are obese( CDC,2009) Clip art (Microsoft 2007)

Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

Incidence and Prevalence

Coronary heart disease(CHD)

Type 2 diabetes

Cancers (endometrial, breast, and colon)

Hypertension(CDC, 2009).

Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

Major Health Implications

Direct medical costs

Indirect medical costs

More than 15% of the United States GDP

( Ludwig, 2007)

Ludwig, D.S (2007, December).Childhood Obesity – The shape of things to come. The New England Journal of Medicine.357(23):2325-2327.Retrieved from http://content.nejm.org/cgi/content/full/357/23/2325

Economic Implications

Discrimination

Stigmatization

Negative stereotyping

Clip art ( microsoft 2007) Griffiths, L.J., Wolke, D., Page, A.S., & Horwood, J.P. (2006). Obesity and

bullying: Different effects for boys and girls. Archives of Disease in Childhood, 91(2), 121-125.

Social Implications

Depression

Low self esteem

Negative body image

Inferiority complex

Sweeting, H.N,(2008). Gendered dimensions of obesity in childhood and adolescence. Nutrition Journal.7:1. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2265740pdf/1475-2891-7-1.pdf

Psychosocial Implications

Overconsumption of calories

Lack of Physical activity

TV watching / Adverts

Parental behaviors

Boone-Heinonen,J, Gordon-Larsen, P and Adair, L.S(2008,Dec). Obesogenic clusters: multidimensional adolescent obesity related behaviors in the U.S. Ann Behav Med. 36(3): 217–230. Retrieved from. http://www.ncbi.nlm.gov/PMC/articles/PMC2769258pdf/nihms.94416.pdf

Behavioral Risk Factors

Access to Vending machine

Proximity to fast food joints

Peer group sporting activities

Kleisser, C, Rosario, A.S, Mensink, G.B.M ,Prinz-Langenohl,R and Kurth, B.M (2009). Potential determinants of obesity among children andadolescentsin Germany: results from the cross-sectional KiGGS study. BMC Public Health. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2642815pdf/1471-2458-9-46.pdf

Environmental Risk factors

A holistic approach

Appropriate Intervention

Keeping with the objectives of school nutrition programs

Encouraging fruits and Vegetables

Encouraging sporting activity

Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity.

Retrieved from http://www.cdc.gov/obesity/causes/economics.html

Focus on Environment

• Schools

• Schools

• Parent Teacher Association

• Food vendors

• School Nutrition Association

Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb). Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2): 409–414. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf

Formation of Coalition

Image credit: nottingham.ac.uk

Working with US Department of Agriculture

Collaboration with the CDC

Pursuing the institute of medicine( IOM) nutrition standards

Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity.

Retrieved from http://www.cdc.gov/obesity/causes/economics.html

School Nutrition Program

Farm to School Programs

Turnkey nutrition education

Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

Vegetable and Fruits

Image from usda.gov

Engaging students during free plays.

Organizing sporting activities clip art ( Microsoft 2007) Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb). Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2): 409–414. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf

Sporting Activity

Banning or restricting vending machines

Creating more paths for Biking and walking

Reconstructing bus stops.

Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb). Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2): 409–414. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf

Environmental modifications

Financial implications

Adherence/ Sustainability

Parental influence

Newman, K.(2009).Parenting behaviors and adolescent obesity. Ph.D. dissertation,

The University of Alabama at Birmingham, United States -- Alabama. Retrieved from

http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com/pqdweb?did=1955643521&Fmt=2&clientId=70192&RQT=309&VName=PQD

Challenges

Knowledge has a bearing on attitude and practice

Collaboration with other stake holders is a plus

Prospects

Obesity is preventable

Now is the time to act

School nutrition environment is the target.

Conclusion

Boone-Heinonen,J, Gordon-Larsen, P and Adair, L.S(2008,Dec). Obesogenic clusters: multidimensional adolescent obesity related behaviors in the U.S. Ann Behav Med. 36(3): 217–230. Retrieved from.

http://www.ncbi.nlm.gov/PMC/articles/PMC2769258pdf/nihms.94416.pdf

Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

Griffiths, L.J., Wolke, D., Page, A.S., & Horwood, J.P. (2006). Obesity and bullying: Different effects for boys and girls. Archives of Disease in Childhood, 91(2), 121-125

References

Kleisser, C, Rosario, A.S, Mensink, G.B.M ,Prinz- Langenohl,R and Kurth, B.M (2009). Potential determinants of obesity among children and adolescentsin Germany: results from the cross-sectional KiGGS study. BMC Public Health. Retrieved from

http://www.ncbi.nlm.gov/PMC/articles/PMC2642815pdf/1471-2458-9-46.pdf

Ludwig, D.S (2007, December).Childhood Obesity – The shape of things to come. http://content.nejm.org/cgi/content/full/357/23/23251

References

Newman, K.(2009).Parenting behaviors and adolescent obesity. Ph.D. dissertation, The University of Alabama at Birmingham, United States -- Alabama. Retrieved from

http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com/pqdweb?did=1955643521&Fmt=2&clientId=70192&RQT=309&VName=PQD

Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb).

Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2):

409–414. Retrieved from

http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf

References

Sweeting, H.N,(2008). Gendered dimensions of obesity in childhood and adolescence.

Nutrition Journal.7:1. Retrieved from

http://www.ncbi.nlm.gov/PMC/articles/PMC2265740pdf/1475-2891-7-1.pdf  Scharoun-Lee, M, Kaufman,J.S, Popkin,B.M and Gordon-Larsen, P,(2009,Jan).

Obesity, Race/ethnicity and Life Course Socioeconomic Status across the

Transition from Adolescence to Adulthood. J Epidemiol Community Health. 63(2): 133–139. Retrieved from

http://www.ncbi.nlm.gov/pmc/articles/PMC2627789/pdf/nihms.73895.pdf

TDSHS (2010). Obesity in Texas. Retrieved from http://www.dshs.state.tx.us/obesity/pdf/THIPolicyBrief06.pdf

References