Lower-cost foods make up a greaterproportion of the diet of lower-incomeindividuals (23). In U.S. Department ofAgriculture (USDA) studies, female recipientsof food assistance had more energydensediets, consumed fewer vegetablesand fruit, and were more likely to beobese. Healthy Eating Index scores are inverselyassociated with body weight andpositively associated with education andincome (24). DIABETES CARE, VOLUME 31, NUMBER 11, NOVEMBER 2008, Influence of Race, Ethnicity, and Culture onChildhood Obesity: Implications forPrevention and TreatmentA consensus statement of Shaping America’s Health and the ObesitySocietySONIA CAPRIO, MD1STEPHEN R. DANIELS, MD, PHD2ADAM DREWNOWSKI, PHD3,4FRANCINE R. KAUFMAN, MD5,6
Comparing maternal and paternal intergenerational transmission ofobesity risk in a large population-based sample1–4Katriina L Whitaker, Martin J Jarvis, Rebecca J Beeken, David Boniface, and Jane Wardle First published April 7, 2010, doi: 10.3945/ajcn.2009.28838 Am J ClinNutr May 2010 ajcn.28838 J Am Diet Assoc. 2011 Sep;111(9):1301-5.Parenting style and child feeding practices: potential mitigating factors in the etiology of childhood obesity.Stang J, Loth KA.
Importance of making a difference for moms, even if goal is to reach the kids – women are key in preventing obesity from a family systems perspective – new research….
Obesity and Women presentation by Michelle Rimer, MS, MPH, RD, LDN
Michelle Rimer, MS, MPH, RD, LDN Solmaz Institute on Obesity Hickory, NC
Overview• Socioeconomics & obesity• Environmental factors• Weight Management Program – working with the entire family• Women’s unique roles impacting childhood obesity
A Framework to Prevent & Control Overweight & Obesity Food & Beverage Industry SOCIAL NORMS & VALUES Agriculture Education Media SECTORS OF INFLUENCE Government Public Health Systems Home & Family Healthcare Industry School BEHAVIORAL SETTINGS Business & Workers Community Land Use & Transportation Work Site Leisure & Recreation Healthcare Community & Faith-based INDIVIDUAL Organizations Genetics FACTORS Foundations & Other Funders PsychosocialOther Personal Factors Food and Physical Beverage Intake Activity Energy Intake Energy Expenditure Adapted from Preventing Childhood Obesity, ENERGY BALANCE Institute of Medicine, 2005
County-level Estimates of Obesity among Adults aged ≥ 20 years: United States 2008 Age-adjusted percent 0 - 19.4 19.5 - 23.8 23.9 - 27.0 27.1 - 30.7 > 30.8www.cdc.gov/diabetes
County level estimates of Poverty United States 2008
Socioeconomics of Obesity Women & Poverty • In 2010, 17 million women lived in poverty • Single mothers account for >40% of those living in poverty • Low income families more likely to live in areas with: o Fewer recreational opportunities o Reduced access to healthy foods2010 Census Data-National Women’s Law Center. Accessed Sept 9, 2012Lindsay,AC, et al. The Future of Children, Volume 16, Number 1, Spring 2006, pp. 169-186
Socioeconomics of Obesity Poverty & Obesity• A lower income and poverty is associated with higher Body Mass Index (BMI)• Lower Activity is associated with higher BMI• Low fruit and vegetable intake is associated with higher BMI
Environmental Factors: Physical Activity• Communities not bike or walk friendly• Limited Access to recreation facilities• Safety Concerns• Less daily physical activity in schools• Increased attraction to sedentary behaviors
A Family Connection• Parental obesity is one of the strongest risk factors for childhood obesity• Parents provide the genes and the family environment – Parenting style – Food availability – Physical activityKL Whitaker, et al . Am J Clin Nutr. May 2010Stang J, et al. J Am Diet Assoc.2011 Sep;111(9):1301-5.
Like Mother, Like Daughter…. • Children’s food preferences are more strongly correlated with the mother • Mother’s food decisions influence daughter’s food choices • Mother’s who are preoccupied with dieting may influence daughter’s habits • Stronger association with maternal weight – Especially with daughters1. Keery et al. Psychosom Res. 2006 July; 61 (1) : 105-1112. Cutting et al. Am J Clin Nutr. 1999;69:608–13.
Family Based Interventions• Counsel the mother as the family health leader• Family Based versus Parent Only – Parent only interventionsJanicke, DM, et al. Arch Pediatr Adolesc Med. 2008;162(12):1119-1125
Advice to mothers in our program:1. Model healthy behaviors2. Create opportunities for your child to make healthy food and physical activity choices3. 5-4-2-1- almost none4. Make it a family affair