2. ChildhoodObesity:The New EpidemicPage 2
Abstract
The rise of obesity in the United States is alarming. The question is do we start with the adult
obesity first to conquer the epidemic? If obesity is in the children who are more likely to become
obese adults, should we learn what is causing the epidemic in them first? Childhood obesity
affects children during their learning years. If can combat the epidemic during the child’s
informative years and teach them how to combat it then we can combat the adulthood obesity
and the diseases that it causes. As an industrialized country with the so many natural resources
and the newest technology at our disposal, how are we becoming so ill from being overweight?
In the United States, there are approximately 12.7 million children and 78.6 million adults that
are overweight. The United States ranks ninth globally among non-industrialized and
industrialized countries and are ranked number one among the industrialized countries.
3. ChildhoodObesity:The New EpidemicPage 3
Discussion
Obesity has been on the rise for the past thirty years in the United States. This is an epidemic that
is causing other diseases to rise in numbers. “In the United States, we have approximately 78.6
million adults and 12.7 million children that are overweight or obese.” (cdc.gov). “The United
States is ranked 9th globally among non-industrialized and industrialized countries. The United
States is ranked number one among the industrialized countries.” (who.org). “Today,
Approximately 1 in 3 adults (34%) and 1 in 6 children and adolescents (16.2%) are obese.
Obesity – related conditions include heart disease, stroke, and Type 2 diabetes, which are among
the leading causes of death.” (HealthyPeople.gov). Are the prevention programs that the United
States implemented enough to stop this epidemic? This study will look at the programs for
prevention of obesity that the United States has already implemented.
Obesity is defined as a person having body mass index (BMI) greater than 30 kg/m2.
Extreme obesity is defined as a person having a BMI greater than 40 kg/m2. Obesity is “rapidly
becoming the leading cause of preventable death in the United States, with obesity- related
deaths projected to soon surpass deaths related to tobacco abuse.” (Hurt). “In analysis of the
leading causes of global mortality and burden of disease, obesity, and being overweight were
among the ten causes for each.” (Hurt). The Expert Committee of the American Medical
Association recently concluded that there is strong evidence that eating away from home,
specifically consumption of fast foods is a risk for childhood obesity.”(Hurt). The restaurants
have increased their portion sizes in the past twenty years. The NIH has defined portion “as the
amount of food that you choose to eat for a meal or snack.” (nhibi.nih.gov). the restaurant size
portion is enough to feed 2 or 3 servings per plate. The NIH has defined servings “as the
measured amount of food or drink.” (nhibi.nih.gov). Here are a few examples that the NIH has
charted which shows the increased calorie intake.
Comparison of Portions and Calories 20 Years Ago to Present Day
20 Years Ago Today
Portion Calories Portion Calories
Bagel 3'' diameter 140 6'' diameter 350
Cheeseburger 1 333 1 590
Spaghetti
w/meatballs
1 cup sauce
3 small
meatballs
500 2 cups sauce
3 large
meatballs
1,020
Soda 6.5 ounces 82 20 ounces 250
Blueberry
muffin
1.5 ounces 210 5 ounces 500
4. ChildhoodObesity:The New EpidemicPage 4
The CDC has noted the effects on childhood obesity may lead to the following health
problems:
Heart disease caused by high cholesterol or high blood pressure
Type 2 Diabetes
Asthma
Sleep Apnea
Social Discrimination
Hepatic Steatosis.
“In a population based sample of 5 – to 17 – year olds, almost 60% of overweight children had at
least one CVD risk factor while 25% of children had two or more CVD risk factors.”(cdc.gov).
“Type 2 Diabetes has begun to emerge as a health – related problem among children and
adolescents. The onset of diabetes in children and adolescents can result in advanced
complications such as CVD and Kidney failure.” (cdc.gov).
The Healthy People with the help of the CDC has shown the following prevalence of
obesity in the states and the United States territories. These numbers are alarming to the health
care providers wondering how they can help bring the numbers down and what is causing the
numbers to be raising.
No state had a prevalence of obesity less than 20%.
5 states and the District of Columbia had a prevalence of obesity between
20% and <25%.
23 states, Guam and Puerto Rico had a prevalence of obesity between
25% and <30%.
19 states had a prevalence of obesity between 30% and <35%.
3 states (Arkansas, Mississippi and West Virginia) had a prevalence of
obesity of 35% or greater.
The Midwest had the highest prevalence of obesity (30.7%), followed by
the South (30.6%), the Northeast (27.3%), and the West (25.7%).
Prevalence¶
of Self-Reported Obesity Among U.S. Adults by
State and Territory, BRFSS, 2014
¶Prevalence estimates reflect BRFSS methodological changes started
in 2011. These estimates should not be compared to prevalence
estimates before 2011.
Source: Behavorial Risk Factor Surveillance System, CDC.
5. ChildhoodObesity:The New EpidemicPage 5
*Sample size <50 or the relative standard error (dividing the standard
error by the prevalence) ≥ 30%.
Source: Behavorial Risk Factor Surveillance System, CDC.
*Sample size <50 or the relative standard error (dividing the standard error by the prevalence) ≥
30%.
6. ChildhoodObesity:The New EpidemicPage 6
CDC Tables
2013: Percent of students in grades 9-12 who are obese†
Location Type Location Value 95% CI Sample Size
National National 13.7 (12.6-14.9) 12,580
States
Alabama 17.1 (14.6-19.9) 1,499
Alaska 12.4 (10.5-14.6) 1,167
Arizona 10.7 (8.3-13.6) 1,520
8. ChildhoodObesity:The New EpidemicPage 8
Oklahoma 11.8 (10.0-14.0) 1,333
Rhode Island 10.7 (9.5-12.0) 2,304
South Carolina 13.9 (11.6-16.5) 1,555
South Dakota 11.9 (9.8-14.4) 1,272
Tennessee 16.9 (15.1-18.8) 1,831
Texas 15.7 (13.9-17.6) 3,039
Utah 6.4 (4.8-8.5) 2,136
Vermont 13.2 (11.3-15.4) 5,853
Virginia 12.0 (10.8-13.4) 6,483
West Virginia 15.6 (13.5-18.0) 1,561
Wisconsin 11.6 (9.7-13.9) 2,771
Wyoming 10.7 (9.4-12.2) 2,910
Footnotes
†
Obese is defined as body mass index (BMI)-for-age and sex ≥ 95th percentile based on the 2000 CDC
growth chart; BMI was calculated from self-reported weight and height (weight [kg]/ height [m²]).
Notes
National estimates from the national YRBSS survey. State estimates from the state YRBSS survey.
State estimates are not available when the state does not participate in the survey, the state does not
ask the question, or the state does not achieve a sufficient response rate to weight the data.
Data Source
Youth Risk Behavior Surveillance System
Suggested Citation
Nutrition, Physical Activity and Obesity Data, Trends and Maps web site. U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Chronic
Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity, Atlanta,
GA, 2015. Available at http://www.cdc.gov/nccdphp/DNPAO/index.html.
There are psychological stress that overweight or obese children and adolescents also
have a risk in having. They can develop low self – esteem which may interfere with their
education, social development, and social functioning. They are often bullied by their peers.
They may carry this low self – esteem into adulthood.
There are contributing factors that children are facing today. The healthier generation
campaign has listed 5 factors:
“Television and media: screen time is a major factor; marketing of
unhealthy foods: high in calories, sugars, salt, and fat and low nutrients
9. ChildhoodObesity:The New EpidemicPage 9
Limited access to healthy affordable foods: some people have less access
to stores and supermarkets especially in rural, low income neighborhoods,
and communities of color
Lack of daily physical activity
Increased portion sizes
Higher consumption of sugary beverages.” (healthiergeneration.org).
Considering that children have more access to video games and computers nowadays, they have
more stationary play time compare to the children of the 1970s and 1980s. The food corporations
played into this television time with creating the advertisements directed at the children and
adolescents. The children see the ads and persuade the parents into buying the product. The food
companies add the low – fat, low sugar, and no high fructose corn syrup onto the labels fooling
the consumers especially if the consumers do not understand how to read the labels. The sugary
beverages include many fruit juices and flavored water.
The people are afraid of diets or just basically the word “diet.” “Diet reflects the variety
of foods and beverages consumed over time and in settings such as worksites, schools,
restaurants, and the home.” (healthypeople.gov). The individuals need to have the knowledge
and the skills to make healthier choices in their diet. There are social factors that play into
influencing the individual’s diet:
Knowledge and attitude
Skill
Social support
Societal and cultural norms
Food assistance programs
Economic pricing systems
Individuals need to change the belief that dieting is bad. The individual needs to understand that
it is a lifestyle choice of being healthier. The individual needs to be educated that any food that is
bought prepackaged and prepared can be made at home with fresh ingredients and less fat,
chemicals, and sugar. Society needs to brace that it is okay for children and adolescents to eat
more vegetables and fruits than a snack cake. The parents need to be educated how to cook a
meal instead of popping a prepared meal into the microwave or stopping by that fast food
restaurant. Individuals need to get support from their families and friends. The parents need to be
changing the whole family lifestyle instead of that child facing it alone.
The economic price systems need to adjust the pricing to be more affordable. When an
individual is trying to afford food on a tight budget, it is hard to get all the recommended
nutrients. It is easier on the wallet when they can clip coupons and get special buys on the low
nutrient junk foods. Many individuals are living in what are considered food deserts. These are
low income areas that do not have grocery stores where the residents can go to shop for fresh
foods. The grocery stores closed up because they could not afford to stay open in these areas.
“The Congress in the Food, Conservation, and Energy Act of 2008 directed the USDA to
conduct a 1 year study to assess the extent of the problem of limited access, identifying
characteristics and causes, consider the effects of limited access on local populations, and outline
recommendations to address the problem. The USDA findings on the access to a supermarket or
grocery store is a problem for a small percentage of households. They found 3 pieces of evidence
to corroborate this conclusions:
2.3 million (2.2%) of all households live more than a mile from a
supermarket and do not have access to a vehicle. Additional 3.4
10. ChildhoodObesity:The New EpidemicPage 10
million (3.2%) of all households live between half a mile to 1 mile
and do not have access to a vehicle.
Area based measures of access show that 23.5 million people live
in low income areas (areas where more than 40% of the population
has income at or below 200 percent of Federal poverty thresholds)
that are more than 1 mile from a supermarket or large grocery
store. However, not all of these 23.5 million people have low
income. If estimates are restricted to consider only low – income
people in low – income areas, then 11.5 million people or 4.1 % of
the total population, live in low income areas more than 1 mile
from supermarket.
Data on time use and travel show that people living in low –
income areas with limited access spend significantly more time
(19.5 minutes) traveling to a grocery store than the national
average ( 15 minutes). However, 93% of those people who live in
low income areas with limited access traveled to the grocery store
in a vehicle they or another household member drove.
There is a key concern for people who live in these areas with limited access is that they rely on
small grocery stores or convenience stores. If they do carry healthy foods, then it is at higher
prices. People in low income households’ shop where food prices are lower when they can. The
data on SNAP benefit redemptions from 2008 show that 86 percent of SNAP benefits were
redeemed at supermarkets or large grocery stores. The same data show participants who did not
shop at supermarkets purchased less non-canned fruit, non-canned vegetables, and milk than
SNAP participants who shopped frequently at a supermarket.” (USDA.gov).These areas only
have convenience stores that only carry packaged foods, high sugary foods and beverages, and
few fresh items. The following table provided by HealthyPeople.com shows us what state has a
problem with obesity and low income children.
2011: Percent of low-income children aged 2 to less than 5 years who are
obese†
Location Type Location Value Sample Size
National National 14.4 3,480,880
States
Alabama 14.2 67,403
Arizona 14.5 86,763
Arkansas 14.2 42,626
California 16.8 262,637
Colorado 10.0 27,529
Connecticut 15.9 27,793
District of Columbia 13.2 6,978
11. ChildhoodObesity:The New EpidemicPage 11
Florida 13.2 241,168
Georgia 13.2 138,941
Hawaii 9.2 17,879
Idaho 11.5 22,272
Illinois 14.8 133,471
Indiana 14.3 73,424
Iowa 14.5 34,420
Kansas 12.8 37,523
Kentucky 15.5 33,224
Louisiana 12.7 53,803
Maryland 15.4 65,020
Massachusetts 16.4 61,551
Michigan 13.3 116,006
Minnesota 12.7 70,589
Mississippi 14.0 47,872
Missouri 12.9 67,853
Montana 11.7 10,720
Nebraska 14.3 22,201
Nevada 12.8 33,582
New Hampshire 14.6 8,249
New Jersey 16.5 78,420
New Mexico 11.4 30,345
New York 14.4 230,903
North Carolina 15.4 103,874
North Dakota 13.2 6,693
Ohio 12.4 121,932
Oregon 14.9 54,316
12. ChildhoodObesity:The New EpidemicPage 12
Pennsylvania 12.3 120,182
Rhode Island 16.6 12,697
South Dakota 15.3 10,351
Tennessee 14.3 69,662
Texas 14.9 447,015
Utah 9.0 23,235
Vermont 12.9 6,179
Virginia 15.6 58,833
Washington 14.1 106,647
West Virginia 14.0 22,653
Wisconsin 14.0 58,885
Territories
Puerto Rico 18.0 89,879
Virgin Islands 11.1 2,578
Tribes
Cheyenne River Sioux Tribe-SD 20.7 406
Choctaw-MS 21.2 471
Inter Tribal Council of Arizona 24.0 6,146
Navajo Nation 18.4 5,749
Rosebud Sioux Tribe–SD 22.5 710
Standing Rock Sioux Tribe–ND 23.0 465
Three Affiliated Tribes–ND 31.8 157
Footnotes
†
Obese is defined as body mass index (BMI)-for-age and sex ≥ 95th percentile based on the 2000 CDC
growth chart; BMI was calculated from measured weight and height (weight [kg]/ height [m²]).
Subjects with unknown or errors in their record were excluded.
^
Data not available because sample size is insufficient or data not reported.
Notes
Low-income is defined as U.S. children who attend federally-funded maternal and child health and
nutrition programs, including the Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC), Early and Periodic Screening, Diagnosis, and Title V Maternal and Child Health (MCH)
Program.
National includes all contributors in a given year. Contributors can change from year to year.
Estimates for states, tribes, or territories are not available in a given year if the group did not
participate in the system, did not ask the relevant question, or the sample size is not sufficient in that
year.
13. ChildhoodObesity:The New EpidemicPage 13
2004-2011 trends by race/ethnicity are affected by the juncture at which contributors implemented
the 1997 Office of Management and Budget standards for race/ethnicity data collection and reporting.
These standards permitted the reporting of multiple races for the first time and affected how ethnicity
data (Hispanic/non-Hispanic) were reported.
Besides changing the individual’s idea about diets and foods, we need to change the idea
of exercise. Exercise plays an important role in changing the lifestyle of people in general. We
need the parents to go and be active with their child/children with no television or computer
screen involved. We need to let the parents know that job, housework, friends, or checking social
media or email can wait until after 30 minutes of physical activity and dinner time with the
family. “Probably the most important role for exercise and increased physical activity in
individuals with obesity is the recidivism after weight loss from dieting and the maintenance of
lean body mass is reduced.” (Hurt). Individuals need to learn and understand that obesity can be
changed by lifestyle choices. The lifestyle choices are choices that stay with a person, but often
diets only last until the individual hits the desired weight and starts feeling better, or when the
person gives up due to no social support, hits a level spot, and/or gets tired of it.
Individuals need to learn “what constitutes good nutrition as opposed to harmful food
choices is often not clearly understood by the general public.” (Hurt). “The current food rich
environment, in which unhealthy choices are readily available, makes achieving and maintaining
the goal of eating healthily difficult.” (Allom). In the cities and towns, there are fast food or
diners next to the schools. The adolescents have to fall into peer pressure of buying that value
meal of cheeseburger and fries instead of buying that salad. It is cheaper for the person to get a
value meal compared to that salad. “The accessibility of food and the presence of cues in the
environment, such as the sight, smell and palatability of food has been found powerfully
influence eating behavior.” (Allom). The easy access to all food rather than the lack of access to
specific healthy foods, may be more important factor in explaining the increase in obesity. The
key factor here is the environment. “In the last 20 years, the percentage of calories attributable to
fast food consumption has increased from 3% to 12% of total calories consumed in the United
States.” (Block). The amount of spending in the United States on fast foods has risen from $6
billion to $110 billion over the last 30 years. Even though there has been a decrease in the fat
content (as a percentage of total calories) of the average American’s diet, Americans are
consuming more calories. “The USDA reported an increase in the average daily food energy
intake from 1,854 calories to 2,002 calories between 1977 – 1978 and 1994 – 1996. In 1995,
“away – from – home” foods provided 34 % of total caloric intake and 38 % of total fat intake
compared to 18 % comparison for both categories in 1977 – 1978. Fast food is a major
component of the “away – from – home” category, accounting for 12 % of total caloric intake for
Americans in 1995 compared to only 3 % in 1977 – 1978.” (Block).The smell of cooked meat
and French fries over power the smell of fresh fruits and vegetables. We eat with our eyes and
noise before our mouth. The healthier foods need to be more pleasing to our senses over the bad
foods.
The learning behavior of choosing the healthier choices are taught at young ages. The
young children who help the parents in the kitchen are often the adolescents who chooses the
healthier foods. Children are easier to adapt to learning new ideas than adolescents and adults.
Children like to play in the dirt and food, so it is easier to teach them about planting the herbs,
vegetables, and fruit trees while teaching them how to make a fresh salad or entrée of vegetables
14. ChildhoodObesity:The New EpidemicPage 14
that appeal to their eyes. If the children learn where the types of foods come from and how to
prepare it to be healthy, we teaching them a lifetime skill and a healthy lifestyle at the same time
that will last their lifespan.
Obesity affects all races, genders, and economic levels but in different ways. The United
States Department of Health and Human Services did a National Health and Nutrition
Examination Survey between 2005 – 2008. The survey showed:
“Among men, obesity, prevalence is generally similar at all income levels,
however non – Hispanic black and Mexican-American men those with
higher income are more likely to be obese than those with low income
Higher income women are less likely to be obese than low income
women, but most obese are not low income
There is no significant trend between obesity and education among men.
Among women, however, there is a trend, those with college degrees are
less likely to be obese compared with less educated women
Between 1998-1994 and 2007-2008 the prevalence of obesity increased in
adults at all income and education levels.” (DHHS.gov)
There are barriers that we need to change, so we can have a decrease in this epidemic.
We need to change how powerful lobbyist representing the unhealthy foods and beverages
manufacturers can influence the government officials. “The misinformed constituents – the
pervasive fears and misconceptions in many schools and altering school vending practices.”
(Dodson). These barriers are stopping the progress of the healthy lifestyle. Many organic food
companies are small in operation and cannot afford what the large food corporations can when it
comes to lobbying. The schools need to adapt the ideas of where children and adolescents can
grow fruits and vegetables depending where their schools are located on the school property or
rooftop. The schools then could implicate a program where the students could plant and work
with the plants for them to eat at lunch or have a home economics class to prepare the food. This
would cut the school the budget in some areas but increase it in others. The children can take this
learning tool home and teach their parents how to do it. The schools could also work with the co-
op farms in the area to bring in more fresh meats, fruits, and vegetables to serve the students at
lunchtime. The small farmers in the community could help implement the new program.
These are some areas that need to be addressed as the epidemic keeps increasing. The
changes in the healthcare system are discussed, plans should be offered that directly affect these
changes. This epidemic has cost an estimated $ 147 billion dollars. We need to figure out how to
improve the current prevention programs. We need to figure out how to get the individuals more
informed about the epidemic. The knowledge needs to be taught to all individuals about the
healthy lifestyle.
15. ChildhoodObesity:The New EpidemicPage 15
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Staff
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16. ChildhoodObesity:The New EpidemicPage 16
References
http://nccd.cdc.gov/NPAO_DTM/LocationSummary.aspx?statecode=70.
http://www.cdc.gov/healthyweight/prevention/index.html.
http://www.cdc.gov/nutrition/data-statistics/index.html.
http://www.in.gov/isdh/20060.htm.
http://www.who.int/topics/obesity/en/.
http://obesity.procon.org/view.resource.php?resourceID=004371.
https://www.healthiergeneration.org.
www.ncbi.nlm.nih.gov/pubmed/17498510.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3033553/.
www.nhlbi.nih.gov/about/org/oei/.
www.USDA.gov
Block, J., Scribner, R., DeSalvo, K. (2004). Fast Food, Race/Ethnicity, and Income A
Geographic Analysis. American Journal of Preventive Medicine.
.
