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  • 1. Obesity and Type 2 Diabetes in Children A presentation to initiate awareness and advocacy for an international health epidemic Developed by Jeanne Fenn, RN, BC, MEd, CDE Cecilia Rosales, MD, MS Claire Logue
  • 2. The purpose of this presentation is to:
    • Explain the obesity and type 2 diabetes crisis
    • Discuss methods of curbing this epidemic
    • Encourage participation within your family, school, and/or community in developing a healthier lifestyle
  • 3. What is Obesity?
    • A condition resulting from excessive storage of fat in the body. (Best measured by BMI)
  • 4. What is BMI?
    • BMI (Body Mass Index) is the ratio of weight in kilograms to square of height in meters. BMI correlates with more accurate measures of body fatness.
    • Pediatrics:
      • At risk: BMI between 85 th – 95 th percentile for age and sex
      • Overweight/Obese: BMI at or above the 95 th percentile for age and sex
      • American Academy of Pediatrics; Prevention of Pediatric Overweight and Obesity, 2003
  • 5. Example Calculation
    • Weight (lb) ÷ Height (in) ÷ Height (in) x 703 = BMI
    • Ex:13 year old boy, wt;146 pounds, ht; 64 in
    • 146 ÷ 64 ÷ 64 x 703 = 25
    • BMI of 25 per growth chart = 95%
    • This young man is overweight/obese
      • http://www.cdc.gov/growth charts
  • 6. Examples of Children At Risk By Mayo Clinic Staff
  • 7. The prevalence of childhood overweight and obesity has doubled in the past 20 years. American children are less physically active as a group than were previous generations. American Academy of Pediatrics Policy Statement: Prevention of Pediatric Overweight and Obesity, 2003
  • 8. What are common medical problems in obese children?
    • Type 2 diabetes
    • Heart disease
    • Mental health; depression, low self-esteem
    • Pulmonary or Respiratory problems
  • 9.  
  • 10. How Does Arizona Fare?
    • The number of overweight/obese adults has increased from 44.7% (1994) to 56% (2001)
    • Currently it is estimated that 58% of Arizonans are overweight/obese
    • 34% of children enrolled in Headstart programs are overweight.
  • 11. Trends in Prevalence of Overweight* in US Boys 12-17 Years Old *BMI at or above sex- and age-specific 95th percentile CDC, National Center for Health Statistics. 1998. Prevalence (%)
  • 12. Trends in Prevalence of Overweight* in US Girls 12-17 Years Old Prevalence (%) *BMI at or above sex- and age-specific 95th percentile CDC, National Center for Health Statistics. 1998.
  • 13. U. S. Obesity Rates: Past 20 Years
    • Today’s obese children could be the 1 st generation of Americans with a life expectancy less than their parents!
            • Richard Carmona MD, US Surgeon General
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  • 28. Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% ≥20
  • 29. Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% ≥20
  • 30. Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
  • 31. Source: Behavioral Risk Factor Surveillance System, CDC No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) Obesity Trends* Among U.S. Adults BRFSS, 2002
  • 32. 2002 Obesity Trends* Among U.S. Adults BRFSS, 1991-2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) 1991 1995
  • 33. Children Then….
  • 34. Children Now……. From Childhood & Adolescent Obesity and Type 2 Diabetes by Francine Kaufman MD
  • 35. Factors Related to the Onset of Obesity
    • Altered dietary intake
    • Decreased physical activity
    • Increased inactivity
  • 36. Altered dietary intake
    • Nutritional content
    • Portion size
  • 37. Decreased physical activity
    • Not as much participation in physical activities; walking, active play, recess
  • 38. Increased inactivity Look at time spent watching TV, playing electronic games
  • 39. Enrollment in daily physical education classes From the Surgeon General's Report on Physical Activity and Health, 1996
  • 40. Percentage of High School Students Who Reported Not Being Enrolled in Physical Education Class, 1999                                                                                                                    CDC, Youth Risk Behavior Surveillance System
  • 41. The Burden of Obesity (Adapted from American Obesity Association source, 2002)
  • 42. Prevention is the Key!
    • Tommy Thompson, Secretary of Health & Human Services
    • Dr. Richard Carmona, U.S. Surgeon General
    • Center for Disease Control (CDC)
    • American Academy of Pediatrics (AAP)
    • American Diabetes Association (ADA)
  • 43. Why Target Children?
    • Prevention is more cost effective than cure
    • Children can be reached through schools
    • Effects of chronic disease accumulate over time; so need long-term changes
      • We need to begin awareness at an early age
    • E. Sanchez, MD, MPH
  • 44. Why Should Schools Care About Health?
    • As a society, we value good health.
    • Good health is necessary for effective learning
    • Healthy students become healthy, productive citizens
    • Schools are the one place where the majority of our nations youth can be found
    • E. Sanchez, MD, MPH
  • 45. How Do You Initiate Change?
    • Environmental/Policy
      • Obtain baseline assessments
      • Make physical activity and nutrition a priority in schools
      • Fund preventative programs and services in community
      • Develop a comprehensive approach
  • 46. How Do You Initiate Change?
    • Community Action:
      • Utilize local data/community input to assess your needs
      • Increase awareness of obesity problem in culturally appropriate ways
      • Develop partnerships for community-wide healthy lifestyle actions
  • 47. How Do You Initiate Change?
    • Schools can provide:
      • Quality daily P.E. classes
      • Nutrition awareness campaign
      • Parent education/awareness campaign
      • Psychosocial education/intervention
      • School nutrition policy
  • 48. What Can We Do In Our School?
    • Ask for support from the school board and superintendent
    • Incorporate students, parents, teachers in providing strategies and ideas
    • Look at your school practices
    • Focus on health and activity, not weight
    • HAVE FUN!!!
  • 49. Governor Napolitano’s Call to Action Reports January 30, 2004
    • SELECTED REQUESTS:
    • Keep recess sacred, not used as a punishment
    • Daily P. E. classes
    • Provide healthy vending machine choices
    • Educate students about marketing ploys for unhealthy snacks
    • Age appropriate nutrition education
    • Omit unhealthy fundraisers/limit candy rewards for good behavior
  • 50. Behavior Change Strategies
    • Increase physical activity:
      • Provide exercise choices to children
      • Encourage age appropriate and creative exercises
      • Start with 30 minutes of moderate activity per day
      • Make it fun!
  • 51. Behavior Change Strategies
    • Increase awareness of food choices:
      • Moderate food portions
      • “ 5 a day” Vegetables and Fruits
    • Limit inactivity
      • American Academy of Pediatrics recommends limiting TV viewing to 1-2 hrs/day
  • 52. CDC’s Guidelines for Promoting Lifelong Physical Activity
    • Physical activity of moderate intensity for 5 days of the week
      • Walking 2 mi X30’
      • Running 11/2 mi X 15’
      • Bicycling 5 mi X30’ / 4 mi X 15’
      • Basketball X 15-20’
  • 53. A Pound of Prevention ….…
    • Life-long healthful eating
    • Daily physical activity throughout life
    • All things in moderation
    • TIP: Everyone needs to do these things, whether they are obese, overweight, or normal weight.
  • 54.  
  • 55. What are your views?