Past Monthly Health Topics
Previous Articles:
- Celebrate National Public Health Week: 5 day, 5 essential articles about living a healthy lifestyle!
- Tips for Parents – Ideas to Help Children Maintain a Healthy Weight
- 12 Ways to Be Healthy this Holiday Season
- Overweight & Obesity in Cooper County School Age Children 2009 - 2010
- Health Benefits of Fruits and Vegetables
- Whole Grains for Healthy Meals
- Eating For Health
- The History Of Vitamin D
Overweight & Obesity in Cooper County School Age Children
2009 - 2010
Download this article: Overweight & Obesity in Cooper County School Age Children
OVERVIEW
The Cooper County Public Health Center and the Cooper County School Nurses have formed a collaborative group call the School Health Coalition. We have been meeting for the past five years. Our primary objective is to address priority health issues that effect our communities -especially the health of our children.
Community Assessment
- Our 2008 Community Assessment identified Heart Disease, Cancer & Diabetes as the three leading causes of morbidity (disease) and mortality (death) in Cooper County.
- Obesity is a major risk factor for developing all three of these diseases
Public Health
- According to the American Heart Association, “childhood and adolescent overweight is one of the most important current public health concerns.”
National Institute of Child Health Data
- Approximately 198,000 of 639,000 Missouri Children, ages 10-17 years, are considered overweight or obese according to BMI for age standards (31%).
- Nearly half of Missouri children in poor families are overweight or obese (48.2%). The prevalence rate for poor children is more than double the rate for children in higher-income families (21.6%).
- The prevalence of overweight and obesity is almost one in two (48.8%) for black children in Missouri, ranking MO 21/23 states with reliable estimates for this subgroup.
- MO children are slightly more likely than their counterparts to be physically active for at least 4 days per week, but also more likely to spend 2 hours or more in front of the TV or computer screen.
NICH –Women, Infants & Children (WIC) Program Data
- According to the 2006 Pediatric Nutrition Surveillance System (PedNSS), which assesses weight status of children from low-income families participating in WIC, 30.2% of low-income children ages 2 to 5 years in Missouri are overweight or obese.
- Missouri’s state rank for overweight or obese children is 34 (one is best).
Childhood Overweight Rates
- Rate tripled between 1980 and 2000.
- Definitions of overweight use some variant of Body Mass Index (BMI).
Body Mass Index -BMI
- BMI is a number calculated from a child’s height and weight (Based on their age & sex)
- Considered a reliable indicator of body fatness for most children and teens (not a direct measure but correlates to direct measures of body fat (i.e. underwater weighing or dual energy X-ray absorptiometry (DXA).
- Accepted alternative –an inexpensive and easy to perform screening tool for weight categories that may lead to health problems.
BMI Percentile
- After BMI is calculated for children and teens, the BMI number is plotted on the CDC BMI-for-age growth charts (for either boys or girls) to obtain a percentile ranking
- Percentiles are the most commonly used indicator to assess the size and growth patterns for children over the age of two.
- Percentile indicates the relative position of the child’s BMI number among children of the same sex and age.
Why Consider Age & Sex of the Child?
- The normal amount of body fat changes with the age of the child.
- The normal amount of body fat differs between boys and girls.
BMI-for-age Weight Status Categories & Percentiles
Weight Status Category BMI PercentileRange Under-Weight Less than 5th Percentile Healthy Weight 5th to less than 85th Percentile Over-Weight 85th to less than the 95th Percentile Obese Equal to or greater than the 95th Percentile BMI Charts
Identifying the Extent of the Problem
- The Cooper County School Nurses agreed to share their health assessment data with us so that we could present, to you, a clearer picture of the extent of the problem.
- Participating Schools: David Barton LSE, Bunceton, Pilot Grove, Otterville, and Prairie Home.
- Boonslick Vo-Tech LPN students and MU Sinclair School of Nursing students assisted the schools with the height and weight measurements.
WHY SHOULD WE BE CONCERNED?
- Obesity present in adolescence has been shown to be associated with increased overall mortality (death) and specifically with increased risk of co-morbid diseases, especially CVD and diabetes.
- Current data suggests that the observed association between adult obesity and overweight in adolescence make childhood and adolescence the critical periods for targeting prevention efforts. (Overweight children & adolescents are likely to be overweight into adulthood.)
Earlier Onset of Co-Morbid Diseases
- Diseases are likely to occur in the third and fourth decades of life (30’s & 40’s) instead of the fifth and sixth decade of life (50’s & 60’s)
Conditions Related to Overweight During Childhood & Adolescence
| Cardiovascular Diseases | Metabolic Diseases | Pulmonary Disease | Psychological Disorders |
| Dyslipidemia | Type2 Diabetes | Sleep Apnea | Depression |
| Hypertension | Metabolic Syndrome | Asthma (Exacerbation) | Poor Quality of Life |
| Left Ventricular Hypertrophy | Retinopathy | ||
| Atherosclerosis | Neuropathy |
Metabolic Syndrome
- Cluster of traits including:
- Hyperinsulinemia, obesity, hypertension, and hyperlipidemia
- Occurs in 30% to 50% of overweight children
- Each half-unit increase in BMI is associated with ~ 50% increased risk of developing metabolic syndrome among overweight children and adolescents.
Primary Cause of Metabolic Syndrome
- Obesity leads to excess insulin production.
- Excess insulin is associated with an increase in blood pressure and elevated cholesterol levels –which lead to inflammation and atherosclerosis that damages blood vessels and leads to CVD
- Insulin Resistance (pre-diabetes) –leads to type 2 diabetes (pancreas is still producing insulin, but the transport proteins in the cells can’t use it to move circulating glucose from the bloodstream into the cell –hyperglycemia (High blood sugar)
Increased Left Ventricular Mass(Enlarged Heart)
- Left Ventricle –(lower left chamber of the heart) is responsible for pumping oxygenated blood from the lung/heart to the rest of the body.
- It has the major work-load of the heart muscle. When a person is obese, the heart has to work harder to pump blood to the extra adipose tissue –increased workload leads to enlarged heart.
- Strong independent predictor of CHD, stroke, and sudden death in adults.
WHY IS THIS EPIDEMIC HAPPENING?
- Weight gain occurs when people eat too much food and get too little physical activity.
- Societal and community changes have accompanied the rise in obesity.
- People eat differently.
- Some Americans have less access to stores and markets that provide healthy affordable food such as fruits and vegetables, especially in rural, minority and lower-income neighborhoods.
- Restaurants, snack shop, and vending machines provide food that is often higher in calories and fat than food made at home.
- There is too much sugar in our diet. Six out of 10 adults drink at least one sugary drink per day.
- It is often easier and cheaper to get less healthy foods and beverages.
- Foods high in sugar, fat, and salt are highly advertised and marketed.
- Many communities are built in ways that make it difficult or unsafe to be physically active:
- Access to parks and recreation centers may be difficult or lacking and public transportation may not be available.
- Safe routes for walking or biking to school, work, or play may not exist.
- Too few students get quality, daily physical education in school.
GOALS OF PREVENTION
- Prevent children with normal BMI from becoming at risk of overweight (BMI >85%)
- Primary prevention –aimed at preventing at-risk-of overweight (BMI>85th%) from becoming overweight (BMI >95th%).
- Secondary prevention –aimed at treatment of overweight children to normalize weight and reduce co-morbid diseases (medical interventions).
Prevention Strategies Implemented in Schools –Wellness Policies
- Classroom curricula on nutrition
- Physical education curricula
- Changes in school meals, vending machines, and concession stands
- Before & after school programs
School strategies alone are not enough to change overweight/obesity rates if there is not consistent lifestyle changes outside the school setting.
Behavior Modification
- Increase fruit & vegetable consumption -‘5 to 9 a day’.
- Increase fiber-containing whole grain products
- Switch from whole milk & dairy products to 1% and fat-free products
- Use mono-unsaturated oils (extra virgin olive oil).
- Eat family meals at home (shown to decrease the amount of fat and calories consumed.
- Increase daily physical activity (1hr./day)
- Limit sedentary time (TV viewing <2hrs./day).
Good Nutrition & Physical Activity
- Contributes to:
- Improved academic performance
- Attendance rates
- Improved behavior
- Healthy weight for life-long health & well-being
What Can We Do As a Community?
- Create and maintain safe neighborhoods for physical activity and improve access to parks, playgrounds, and walking trails
- Advocate for quality physical education in schools and childcare facilities.
- Advocate for improved nutrition policies at schools
- Encourage breastfeeding through peer-to-peer support programs
- Support programs that bring local fruits and vegetables to schools, businesses, and communities.
Avoid Mixed Messages in Advertising
COOPER COUNTY HEALTHY LIFESTYLE INITIATIVE
We have to decide as a community:
- What are our strengths and weaknesses?
- Where our opportunities for improvement?
- Who are our partners?
- What are we willing to do?
Download this article: Overweight & Obesity in Cooper County School Age Children