Essay \"Childhood obesity\" PDF

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Childhood Obesity MHA 620 Health Policy Analyses January 28, 2013

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Problem Statement: A developing concern that needs to be addressed is the issue of childhood obesity and its tremendous increase over the past 3 decades. Obesity and poor health contributes to the occurrence of chronic disease in individuals, which is the leading cause of death in the United States. How do we combat this problem?

Background: From the years 1980 to 2008, the percentage of children ages 6 to 11 years who were

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obese went from 7% to almost 20%. The definition of obesity is having excess body fat. In adolescents aged 12 to 19, the percentage went from 5% to 18% during the same period. Over one third of children and adolescents were considered overweight or obese by the year 2008 (CDC). In the African American and Hispanic communities, the number is even higher at nearly 40% (“WAT-AAH; WAT-AAH!..,” 2013). Obese children suffer twice the risk of having three or more reported mental, medical, or developmental conditions than non-obese children. The risk was 1.3 times higher in overweight children compared to non-overweight children. Obese children have a greater reported tendency to have emotional and behavioral issues, poorer health, learning disabilities, asthma, allergies, and depression. They are also more likely to develop ADHD over their non-overweight peers, as well as developing bone, joint, and muscle problems, headaches, ear infections, conduct disorder and developmental delays. In addition, obese children tend to have higher rates of grade repetition, more missed school days and other school difficulties (“Asthma; childhood obesity..,” 2013). Obese children are at greater risk for developing sleep apnea, and social and psychological problems such as poor self-esteem and loneliness (“Centers for disease..,” 2012). Over half of 8 year-olds and up to 78% of adolescents between the ages of 9 and 14 years consume sugary soft drinks on a daily basis. A third of American teenagers drink at least three cans of soft drinks every day. Each 12 ounce soda on average contains 10 teaspoons of sugar. This is over the the allowed consumption rate set by the American Heart Association. With each can of 12 oz. soda on average containing 10 teaspoons of sugar, these consumption rates exceed the allowance set by the American Heart Association. Children between the ages 4-8 should not consume more than 3 teaspons of sugar in a day and 5-8 teaspons for adolescents (“WAT-AAH;

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WAT-AAH!..,” 2013). Obese children are more likely to have high cholesterol or high blood pressure which are risk factors for heart disease. 70% of obese children in a population-based sample of 5-17 yearolds had acquired at least one risk factor for cardiovascular disease. These children are more likely to have pre-diabetes. Pre-diabetes is a condition in which blood glucose levels are so high that diabetes may develop in the individual if not controlled. Obese children are more likely to become obese adults, which places them at risk for adult health problems. Some of these health problems are heart disease, type 2 diabetes, cancers, osteoarthritis and stroke. Obesity is one of the greatest risk factors contributing to the development of many types of cancers, such as breast cancer, colon cancer, cancer of the kidneys, ovarian cancer, prostate cancer, and many more (“Centers for disease..,” 2012). Overall, childhood obesity has become an epidemic in America and strict modifications must be enforced in order to improve the situation. Health care policies need to be developed in order to aid in finding a solution to this problem.

Landscape Identification: Health policy should be embraced as 'courses of action that affect services, organizations,

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institutions, and funding arrangements of the health system'. However, there may often be many obstacles in the way of accessing the numerous different and geographically widespread individuals, groups, and networks that may be involved in the policy processes. In practice, monitoring participant observation can be challenging (Walt, Shiffman, et al, 2008). Here are our stakeholders in changing health policy and their roles: Child Care Providers: Almost half of children in America under the age of 5 are enrolled in child care. Due to this fact, child care providers can play an essential part in teaching children about nutrition in their early stages. In the November/December 2012 issue of the Journal of Nutrition, Education and Behavior, a new study was released displaying that training child care providers on their role in promoting healthy eating for children was a great component in the fight to prevent childhood obesity. The study was done at Washington State University and was called the ENHANCE project. The study monitored 72 child care providers from 45 child care settings before and after a 3-hour wellness retreat. It focused on feeding relationships, child nutrition education, and family communication. This program allowed providers to gain skills and tools in order to successfully incorporate healthy eating promotion and obesity prevention in their child care settings. It was important to instill confidence in the child care providers regarding their ability to provide quality information. This encouraged providers to engage in more efforts and more communication with families about healthy eating and nutrition (“Child care providers..,” 2012). Early learning creates a foundation for better practicing habits in children. Health Advocates: With the support of adults, children will make healthier, more beneficial decisions. Some county health advocates have developed youth programs aimed at

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making healthy actually fun for children. Fitness instructor Laura Farrell is a supporter by hosting a 10-week Fit Kids exercise program at Crest Pier Recreation Center every Fall and Winter in Washington, U.S.. She has been providing this program since 2007. The classes are geared towards children ages 8 through 12 and are one-hour long, once a week, ending in a 10 minute nutrition lesson. Some topics have been on the importance of portion control, identifying and choosing healthier snacks, and becoming more aware of “mindless eating”. The classes are fun and fast-paced and the keep the children moving. The 2012 Spirit of Women National Award winner in the Community Hero in Action category, Annmarie Chelius is also on a mission to inspiring kids to live healthier lives, however, her main focus is on what they are eating. She is a chef educator with the Atlantic Cape Community College's Academy of Culinary Arts and she also volunteers with the “Chefs Move! To School” program which is part of First Lady Michelle Obama's Lets Move! children's health campaign. Every few months, Chelius volunteers her time at the Ocean City Intermediate School by hosting hands-on healthy cooking demonstrations. She also writes and performs original rap songs with healthy messages for the children. She explains that getting the children engaged in healthy activities is the key to success. They already know what is healthy and what is not. All they need is encouragement and ways to make health fun (Lala, 2012). Educators: Teachers can create innovative, easy solutions to help kids and adults better understand the food they consume and how it impacts their lives. They have a role in educating kids on how to eat and live healthfully. HealthTeacher is the interactive leader in youth health. There are games, apps, and educational resources to make health fun for children. HealthTeacher's research-based products are designed to get kids more active and to

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develop healthy behaviors that can be sustained throughout their lives. It has reached over 6 million kids through its fast-growing network of 11,000+ schools. HealthTeacher's interactive products are used by teachers and kids to address important children's health issues, including physical activity, nutrition, and social and emotional well-being (“HealthTeacher..,” 2012). City and State Officials: The U.S. Conference of Mayors received a grant of $300,000 dollars from the Robert Wood Johnson Foundation to help communities increase children's access to affordable healthy foods and create opportunities for physical activity. The grant was awarded through Leadership for Health Communities, a program that seeks to help local and state leaders to successfully eliminate the childhood obesity epidemic. They work to eliminate any barriers to active lifestyles and healthier eating in schools and communities. The U.S. Conference of Mayors Food Policy Task Force works to increase access to quality affordable healthy foods in American cities. The U.S. Conference of Mayors strive to increase availability of healthy and locally grown food in these cities. In Philadelphia alone, efforts have aided in successfully decreasing the rate of childhood obesity by 5 percent. The U.S. Conference of Mayors will be joining five other national policy-maker associations in working with Leadership for Healthy Communities on this initiative (“The U.S. Conference..,” 2013).

Option 1: Incorporate health-related curriculums into classes. Make healthy foods more accessible in every community (Mandate for fast food restaurants to provide healthy food

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alernatives for reasonable prices) The average child is exposed to over 40,000 fast food advertisements every year. These ads influence the food choices that children make, especially considering the fact that food is more than likely consumed in excess while watching television. The food that is advertised are extremely unhealthy, high in fats, sugars and calories. Children are steadily consuming fast food more and more now than ever because it is quick and convenient. Not only are the foods high in fats, sugars and calories but the portion sizes are out of control. State officials should create a mandate for fast food restaurants to provide healthy food alternatives for reasonable prices. Fruits, grains, low-fat, and low-calorie snacks and meals should be on menus. Children are not purposely making attempts to become obese by consuming more and more fast foods. It is the convenience of the fast foods that makes them appealling. However, given better options at their favorite restaurants could make a significant difference. Schools may not have the funds to add health education courses. It would be most costefficient to simply incorporate health learning curriculums into classes already in session. Curriculums should include instructions in nutrition, information on local exercise classes provided in the community, individual and group counseling, and training children in eating control techniques. Parents should also get involved in the process. Parents play an essential role in planning meals and designing proper physical activities for their children, as well as providing healthy food choices. Children are encouraged to get involved in their own meal planning as well. They should become active participants in the planning of their physical activities that will be fun for them, as

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well as beneficial to their overall health (Green, Riley, & Hargrove, 2012).

Option 2: Promote activity by adding an exercise program in the middle of the school day, provided by community health advocates (funded by Leadership for Health Communities

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for example) whom will also educate students on nutrition. Health advocates within the community are ready and willing to provide fitness and health instruction for children in order to combat the childhood obesity epidemic. One already given example was with Laura Farrall and her 10-week Fit Kids exercise program at Crest Pier Recreation Center in Wildwood Crest, Washington given every year, fall and winter seasons, since 2007. The main focus is to get children moving again . In addition to high-caloric intake, their lifestyles have become exceedingly sedentary. Laura Farrall's fitness classes last for 10 weeks, however a typical school semester is at least 20 weeks. If state officials can provide funding for these types of programs then community health advocates will surely participate. At the end of each class, a nutrition lesson is given which includes topics regarding portion control and healthy snacking (Lala, 2012). Hiring health advocates to provide these exercise programs will not be as costly as hiring separate health education teachers and adding on health education classes. College students looking for volunteer work, retired educators, and others may be valuable resources in jump-starting the programs in every community. Currently, only 3.8 percent of elementary schools in the U.S. provide physical education programs, 7.9 percent of middle schools, and 2.1 percent of high schools. The minimum required time for physical activity for youth is 150 minutes or 2 and a half hours per week (Green, Riley, & Hargrove, 2012). Children are not receiving nearly as much time performing vigorous physical activities as they should.

Healthier children inevitably become healthier adults. Supplying a foundation for health education and exercise plans, saves lives in the long run. Americans will not be as susceptible to

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chronic illness and injury. Preventive health services are less expensive than treatments and procedures given after an illness or injury has already entered into it's late stages. Eventually, these foundational programs combating childhood obesity will drive down U.S. health care costs significantly.

Option 3: Change out sugary snacks and sodas from school vending machines, provide healthier foods in cafeterias, and promote “active gaming” in schools

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Vending machines in schools that contain unhealthy foods and drinks should be replaced with healthy items. The portion and ounce sizes should contained to a healthy limit. There must be support from parents, children, teachers and administrators to create a healthy environment for our youth. Schools may hold contracts with vendors to have their machines in their schools. However, contracts can either be altered if possible or waited out. New contracts should be made with vendors who are willing to supply healthy snacks and drinks for students. It takes community effort and structure in order to create significant change. Every one must participate in order to make positive changes. Salad bars should be placed in schools. Fresh fruits and vegetables should be readily available and presented in a more appealing display than the unhealthy food items. Children overall are very aware of what is and is not healthy. The major issue is that healthy items are not always available, not always affordable, and not as conveniently packaged. It is easier to get a simple candy bar from a machine than it is to pack an appropriate serving of grapes in a lunch baggie. Healthy granola and whole grain bars should be supplied in vending machines and school cafeterias (Green, Riley, & Hargrove, 2012). Active gaming increases children's physical activity by using technology. It is becoming ever popular and welcomed by many physical educators. Virtual bikes, rhythmic dance machines, virtual sporting games, balance boards, martial arts simulators, and other active gaming equipment are being provided by teachers in several American schools. They motivate physical activity amongst students in a more appealing way according to their generation. For proper instruction, the National Association for Sport and Physical Education has developed an informational paper with a how-to on implementing technology in physical

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education classrooms. The NASPE encourages the use of active gaming and feels that it can be a very effective tool for increasing physical activity in schools. Programs need to be developed to appeal to the current youth generation so that they do not get bored. Some feel that the active gaming programs may be too expensive and not feasible for many schools to adopt. However, there are several reasonably priced active gaming alternatives. Possibly, initial investment in the basic equipment can be considered expensive, but the types of games played can be continuously changed. This will provide a substantial return on the initial investment. Taking small steps over time towards the goal of creating a fully functioning active gaming room in every school is surely feasible for now (Hansen & Stephen, 2012).

Descriptive Table of Options Option 1

Option 2

Option 3

Childhood Obesity Incorporate health learning curriculums into classes already in session

14 Health advocates get involvedbeing college student volunteers, retired educators/instructors, or anyone who wishes to be of assistance, in order to keep down costs

Vending machines will be adjusted to supply convenient healthy items in replace for sugary, high fat, high calorie snacks

State officials step in to create a Community health advocates mandate for local fast food help teach a physical restaurants to present reasonably education course priced healthier alternative food items on their menus

Visually appealling healthy alternative foods will be provided in school cafeterias

Administrators encourage parents to get involved in the educational process, and meal and physical fitness planning

“Active gaming”-Using technology to promote physical activity in schools

Incorporate a short nutrition lesson at the end of each class each day

Recommendation: Option 3: Change out sugary snacks and sodas from school vending machines, provide

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healthier foods in cafeterias, and promote “active gaming” in schools Healthy vending machine: The challenge that majority of schools face is funding constraints. Many schools rely on revenue from their vending machines in order to supplement school budgets and pay for school needs and materials. There is a rightful fear that replacing unhealthy snacks in vending machines to more healthier options will cause them to lose those vending profits. There was a study done in four Ontario high schools that showed that students restrained from purchasing healthier snack choices in vending machines mainly because of 1)lack of variety and 2)a preference for more natural healthy food choices such as, yogurt, fruits, and vegetables. A possible solution to that would be providing a cold vending system, though they are more expensive, students will purchase the healthy food items, and therefore profits will be made (Callaghan, Mandich, He, 2010). However, the innovative YoNaturals of San Diego has been a successful market leader in replacing junk food vending machines with healthier ones. Their vending machines dispense natural and organic snacks and report growing success despite the present poor economy. They are profiting from the cultural shift from unhealthy to healthy eating, even amongst young people. They are able to use technology to track which healthy snacks are more popular than others, and quickly replenish those more popular items. So far, San Diego schools are comfortable with the YoNaturals vending machine transition and report that the nutritious items seem just as popular as the less nutritious snacks (“YoNaturals..,” 2010).

School cafeterias: The cafeteria appears to be the best setting for promoting healthy eating and nutritious foods due to the fact that not all students use vending machines as regularly as we may

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