Obesity and APE

Question…



What percentage of Americans are overweight and obese?

…and Answer



John Hopkins University (meta-analysis)

 66% of U.S. adults were overweight or obese and 34.5% are obese in 2003-2004. Since then, the rate has stabilized. (80% of African American women aged 40 years or over are overweight; 50% are obese). 

JAMA, 2006

 Rates of overweight and obesity remain high with 31.9% of children and adolescents aged 2 through 19 years at or above the 85th percentile of the 2000 BMI-for-age growth charts.

…and Answer

 http://calorielab.com/news/2008/07/02/fatt est-states-2008/  http://www.cdc.gov/nccdphp/dnpa/obesity/t rend/maps/index.htm

“Costs” of obesity



Physically, increased likelihood of:

 Type-2 diabetes, heart disease, high blood pressure, stroke, a few types of cancers, gall stones, liver diseases, osteoarthritis, infertility, colon cancer, hypertension, arthritis, sleep disturbances, breathing problems, & physical disability  Typically long-onset diseases of lifestyle

“Costs” of obesity



Economic

 Obese patients add an estimated $75 billion a year to the nation's medical bill (CDC, 1998)  Negative relationship between body weight and wages for white females (Cawley, 2004)

“Costs” of obesity



Academic

 Overweight children had significantly lower math and reading test scores compared with non-overweight children in kindergarten (Frost & Sullivan, 2004)  In other words, students that maintained a higher level of physical activity maintained higher grades and learned at a faster rate than those students who were less physically active (Byrd, 2006)  Obese females are 50 percent less likely to attend college than non-obese females (Crosnoe, 2008) – University of Texas

“Costs” of obesity



Mental/Emotional

 Lower self-esteem, less confidence in social situations due to their appearance, poor body image, more likely may have more absent/skip school, more apt to try drugs and alcohol (Hupper, 2006)  A body mass index, of 30 or higher -- was associated with a 25 percent increase in the likelihood of major depression, bipolar disorder and panic disorder (Harrisson, 2008)

“Costs” of obesity

Obesity Increases Risks of Problems in Pregnancy and Childbirth  Infant death  Infant birth defects  Delivery by cesarean section  Slow or difficult labor or delivery  Diabetes and high blood pressure in pregnancy  Infertility  Menstrual problems

Percentage of Overweight U.S. Children and Adolescents is Soaring*

18 16 14 12 10 8 6 4 2 0 5 4 Ages 12-19

Ages 6-11

16 16 1963 70** 1971-74 1976-80 1988-94 1999 2002

* > 95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts **Data from 1963-65 for children 6-11 years of age and from 1966-70 for adolescents 12-17 years of age Source: National Center for Health Statistics

“Costs” of obesity

 Children who are overweight have a

70% chance of being overweight as adults

 Childhood onset of type 2 diabetes  Children born in 2000 have a high risk of getting diabetes in their lifetimes:  33% of males  39% of females

“Costs” of obesity

   61% of overweight 5- to 10-year-olds already had risk factors for heart disease, and 26% had two or more risk factors for the disease (Freedman, Dietz, Srinivasan, and Berenson, 1999).

Second leading cause of preventable death in the US Boys tend to be more active than girls; Affluent more active than poor; White more active than non-white; Higher education graduates more active than high school graduates.

Q&A



How is being overweight or obese defined?

Defining overweight and obese



Adults

 BMI between 25 and 29.9 is considered overweight, 30 or higher is considered obese  Body fat percentage calculated by skin calipers or bioelectrical impedence • Interpreting body fat percentages but mostly consistent) (varies

Defining overweight and obese



Children (2-20)

 Can’t use adult formala for BMI due to child’s age and growth  Must view resource:  http://www.cdc.gov/nccdphp/dnpa/healthyweight/ass essing/bmi/childrens_BMI/about_childrens_BMI.htm

 Calculators  Online but one at a time • http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx

 Old fashioned by hand but quicker than online • • Weight and height charts BMI-for-age charts for girls and boys

Q&A



What do you think the role of physical educators is in helping to address the obesity dilemma?

 Work with a partner to craft several strategies for reducing childhood obesity in your future students.

PE Solutions to Obesity

CDC on High Quality PE Programs      Modify the curriculum to increase both moderate and vigorous bouts of activity Increase the time allotted to physical education across all levels Switch to more active games &/or modified existing games and rules to enhance activity for all participants Reduce wait, transition, and management time in a lesson while increasing activity time Use smaller sided games which promote student interaction with the content/equipment to be mastered Active Youth recommends teacher focus on…  Address the INTERESTS of students (what are they likely to participate in?)

PE Solutions to Obesity

Hershey Foods Corp Report:  Modify the school nutrition programs.

 Does the cafeteria offer healthy breakfast and lunch options? ($) Better yet, just healthy food?

 Are there healthy snacks and drinks in the vending machines?

 Most interventions increase activity (both intensity and duration) during class but many reported no change in out-of-school activity.

 Future programs need to aggressively promote out-of-school activity.  Attempt more coordinated and comprehensive interventions involving schools, communities, and home settings.

PE Solutions to Obesity

Involving the Classroom Teachers  Incorporate brief periods of stretching or activity in the classroom  Energizers  Provide nutrition lesson plans because many classroom teachers are not trained in health education  Post information such as posters or models around the classroom

PE Solutions to Obesity

  After school activities Suggestions:  Make it Fun!!

    Offer choices that appeal to a variety of student interests Include time for homework Target “at risk” population Provide mix of competitive & non-competitive activities GET PAID!!

 Steps  Who’s interested, in what?

      Scheduling: days/week, # of weeks, session length Promotion of club to students and staff Permissions/transportation Equipment Planning each session (KISS) Funding…who’s getting paid and what plus equipment

PE Solutions to Obesity

 Extending PE Ideas  http://www.ccsu.edu/physedhltfit/faculty/cummiskey/ext endingPE/extendingPE.html

PE Solutions to Obesity

 Specialized classes for students identified through testing as overweight or obese  Optional class: AM fitness club composed of fun activities to keep students moving. Parents sent a letter inviting them to attend • Could also be after school (may conflict with intramurals or coaching) • NASPE forum example  Required class: scheduled based upon BMI results • Modify the class specifically to obese children based on their needs and incorporate frequent body fat analyses, nutritional counseling, etc…  Biggest loser competition  Build an IPEP when appropriate

PE Solutions to Obesity

  Miscellaneous Strategies (Poole & other sources) Technology  Use pedometers, heart rate monitors, & other technologies to measure personal fitness.

 Fitzpatrick – March Madness Walk Off  Wii fitness Organize & participate in Jump Rope for Heart, Million Jump Day, field trips, ACES (all children exercising simultaneously), family nights, Fitnessgram awards for most improved, active lifestyle award, Walk to School and get extra PE, etc.

PE Solutions to Obesity

Miscellaneous Strategies cont.    Make frequent references to local physical activity resources  Bulletin board of how to get involved in the community (hiking trails, ultimate frisbee clubs, karate centers, etc) Collect fitnessgram assessment data on children from 4th – 12th grade. Grade on the absolute score or improvement.  What are the fitnessgram components? To calculate body fat, use bioelectrical impedance (Omron Body Fat Analyzer) or BMI Decorate the “naked gym” with the food pyramid, wellness scale, benefits of physical activity, bar graph of yards walked to burn off a big mac vs a grilled chicken sandwich, etc (Involve the art classes and make it interdisciplinary project)

Community & Obesity

   Encourage greater walking and riding to school (making activity part of daily commute)  “Walking School Bus” where volunteers coordinate walking routes to school ( www.walkingschoolbus.org

).

Are school facilities open for use after school hours? Partnerships among businesses and other organizations can support programs that are accessible to all children and adolescents in the community  Negotiated a deal with local fitness centers for students who score poorly on fitnessgram assessment 

May require an out of school practicum experience for students who are overweight or obese

Families Solutions to Obesity

  Send home bi or tri-yearly results on the fitnessgram assessment. This could be a double-sided newsletter, fitnessgram results on one side and wellness information on the other (nutrition, exercise, and Send home letters to overweight or obese students inviting them to a Wellness Workshop sponsored by the PE Staff (rotate speaker). Have fun activities (rock climbing, volleyball, etc) as well as a lecture on wellness and physical activity. Some topics might include:  Limit out-of-school “screen time” (TV, videogames, computer)      Encouragement encourage them to participate in physical activity, participate in physical activity with them, watch them play or compete, volunteer, and provide transportation to physical activity and sports events Be a role model by communicating positive and consistent messages (walk instead of drive a car, use the stairs, move the yard for exercise) Organize physical activities themselves with friends and family members Portion control, food preparation Basic nutrition information like you would teach in health class

Health Professional Solutions & Obesity

   Guest speakers and field trips  Reinforce the importance of physical activity among physically active children and adolescents Establish partnerships with communities (e.g., child care facilities, schools, recreation centers) to raise awareness about the benefits of physical activity for children and adolescents, be positive role models, and serve as advocates for high-quality physical education programs ( Kentucky Hospital System) Ask health care professionals to sponsor and support prevention activities (currently 97% of health spending in devoted to care and 3% prevention)

Child Nutrition and WIC Reauthorization Act

Signed by President Bush on June 30, 2004.

Section 204 of this Act requires each district participating in the USDA School Meal Program to have established a local school wellness policy by the school year beginning July 2006.

 Physical and health educators are the most knowledgeable teachers in schools to plan and implement such a policy



Wellness Policy must include the following:

1a. Nutrition education goals 1b. Physical activity goals 1c. Other school-based activities 2. Nutrition guidelines/standards 3. Assurances that USDA school meals guidelines are being met 4. Plan for measuring implementation – Designation of 1 or more people to ensure wellness policy is being met at all school buildings

REQUIRED Areas to Consider in a School Wellness Policy

   Nutrition Education Physical Education & Physical Activity Other School Based Activities  Health Education  Family/Home Involvement  Technology  Interdisciplinary connections to wellness  Brain Primers (Energizers)  Intramural/After School  School Nurse  Wellness Adventures  Eating Environment

Resources for School Wellness Policy

 http://www.ccsu.edu/physedhltfit/faculty/cummiskey/conf erences/presentations.htm

 Action for Healthy Kids  www.actionforhealthykids.org

 Team Nutrition  www.fns.usda.gov/tn/healthy/wellnesspolicy.html

  National Alliance for Nutrtion and Activity  www.schoolwellnesspolicies.org/ Making it Happen – School Nutrition Success Stories  www.fns.usda.gov/tn/resources/makingithappen.html

 School Nutrition Association  www.asfsa.org/childnutrition/fsoperations/policies/index.asp

Benefits to Normal BMI (various sources)  Action for Healthy Kids reported  Physical activity is consistently related to higher levels of  self-esteem and lower levels of anxiety and stress.

A strong relationship has been reported between fitness  Overweight and obese children are more often absent, victims poorer on academic achievement tests.  More healthy children make more healthy adults and in turn, more healthy children.

Benefits to Normal BMI cont.

 Prevents high blood pressure  Relieves stress  Raises HDL (“good”) cholesterol  Reduces the risk of diabetes and some cancers  Improves psychological well-being (greater self  Increases lean muscle mass  Reduces symptoms of depression and anxiety and improve mood  Improves cardiorespiratory fitness

You’ve Got Support

    81 percent of teachers and 85 percent of parents favor grade level 94 percent of teachers and 89 percent of parents favor developing new "lifestyle" approaches to physical education, focusing on activities children can continue to participate in after they've left school 87 percent of teachers and 88 percent of parents believe school boards should not eliminate physical education for budgetary reasons 87 percent of teachers and 77 percent of parents believe schools should not eliminate physical education classes to focus on meeting stricter academic standards

Don’t Underestimate the Power of Your EXAMPLE!

Adult’s Physical Activity Pyramid

Children’s Physical Activity Pyramid

In conclusion, tackling the obesity problem in the US will require a comprehensive solution involving families, communities, and schools. Your efforts will make a difference!

Resources not listed already

 http://kidshealth.org/parent/nutrition_fit/nut rition/overweight_obesity.html