Growing Healthy Kids
Alarming Trends
The U.S. Surgeon General states that,
during the last 20 years, the number of
overweight children has doubled, and the
number of overweight adolescents has
tripled.
Source: Institute of Medicine, 2004
Overweight Defined by BMI
Body Mass Index (BMI) percentiles help
determine if a child’s weight is right for his
or her height.
 A BMI number is calculated for children and teens
using height and weight.

[weight (lb) / height (in)2] x 703

For children and teens, BMI is age and gender
specific and is often referred to as BMI-for-age.
Source: Centers for Disease Control and Prevention (CDC) Growth Chart Slides
BMI-Percentiles-for-Age
Example:
Chart for Boys 2 to 20 years
The BMI number is then
plotted on CDC’s BMIpercentile-for-age growth
charts (for either girls or
boys) to obtain a percentile
ranking.
BMI
Source: CDC Growth Chart Slides
BMI-for-Age …
What does it mean?
Weight Status
Category
Percentile range
Underweight
BMI-for-age = Less than the 5th
percentile
Healthy weight
BMI-for-age = 5th percentile to less
than the 85th percentile
At risk of overweight
BMI-for-age = 85th to less than the
95th percentile
Overweight
BMI-for-age = Equal to or greater
than the 95th percentile
A Snapshot of America

34% of all children and teens in the U.S. are
either overweight or at risk of overweight
Source: Pediatrics, 2006

In minority populations, 20% of children and
teens are overweight Source: Time, 2004

10% of pre-school children are overweight
Source: Department of Health and Human Services, 2002
Pennsylvania Statistics

18.2% of eighth graders are overweight

17.0% of eighth graders are at risk
of overweight
Source: Pennsylvania Department of Health
Perception versus Reality
Has our perception of “healthy” weight changed over the past 20 years?
These drawings show an average “healthy” weight child on the left and an
“overweight” child on the right.
Why does healthy weight
matter?

Immediate benefits may include:
•
•
•
•
More energy
Better ability to focus on tasks
Increased academic performance
More self-esteem and confidence
Healthy habits may lead to a lifetime of good
health
 Obese children have an 80% chance
of becoming obese adults

Source: American Academy of Adolescent and Child Psychiatry (AACAP), 2003
Heart Disease Risk Factor
Levels in Children
Percent of children, aged 5-10, with at least 1 heart
disease risk factor:
60%
Percent of overweight children, aged 5-10, with
2 or more heart disease risk factors:
25%
Source: Pediatrics, 2006
Type 2 Diabetes

Rates of type 2 Diabetes, formerly known as
“adult onset diabetes”, are increasing in youth.

Approximately 85% of children diagnosed with
type 2 diabetes are overweight or obese.

As the U.S. population becomes increasingly
overweight, researchers expect type 2 diabetes
to appear more frequently in younger children.
Source: American Diabetes Association
What has contributed to the
current health status of
children and teens?
Food
What are kids eating …
or not eating?
The Top 10
In 1999-2000 the top 10 items consumed by
boys and girls, aged 6-19, were:
1. Carbonated
beverages
2. Low-fat milk
3. Fruit drinks
4. Whole milk
5. Grain mixtures
(pizza, pasta)
Source: A Nation at Risk: Obesity in the United States
6. Meat mixtures
(hamburgers, etc.)
7. White potatoes
(French fries)
8. Sugars / sweets
9. Cakes / cookies
10. Non-citrus juices
Soda Consumption
Children who drank more than 12 ounces of
sweetened drinks …
 Gained
significantly more weight than children
who drank less than six ounces a day
 Drank
 Took
less milk
in 244 more calories/day
Source: Journal of Pediatrics, 2003
Carbohydrates

In 1994-95, intake of whole grains for children
was 1 serving or less

Between 1989-1995, the increase in
carbohydrates in children and teens came
from:
•
•
•
•
Pizza
Pasta
Mexican food
Soft drinks
Source: A Nation at Risk: Obesity in the United States
Fruits & Vegetables

Between 1994 and 1996, only 14% of children
ages 6-19 met the recommendations for daily
fruit intake, and only 20% ate enough
vegetables.

Among high school students, only 23.6% of
males and 20.3% of females eat five or more
vegetables per day.

In 1980, about 50% of high school seniors
reported eating green vegetables
“nearly every day.”
Source: Robert Wood Johnson Foundation
Vegetables
Only ¾ of children (all ages) report eating at least
one vegetable every day…
 Most
popular vegetable is French fries!
 Next is tomato products (spaghetti sauce)
 Lower is green beans, corn, and peas
 Lowest is nutrient-packed dark green
or deep yellow vegetables
Source: United States Department of Agriculture
Eating Out
 On average, children ages 11-18 eat
at fast-food restaurants twice a
week
 Away-from-home foods eaten by
children are higher in fat and
saturated fat and lower in fiber and
calcium than those eaten at home
 Children eat nearly twice as many calories (770)
at restaurants as they do during a meal
at home (420)
Source: Robert Wood Johnson Foundation
Super Size It?
Portion sizes are
getting bigger and
bigger!
Spaghetti and Meatballs
20 Years Ago
500 calories
1 cup spaghetti with
sauce and 3 small
meatballs
Today
1,025 calories
2 cups of pasta with
sauce and 3 large
meatballs
Calorie Difference: 525 calories
Soda
20 Years Ago
85 Calories
6.5 ounces
Today
250 Calories
20 ounces
Calorie Difference: 165 Calories
Bagel
20 Years Ago
140 calories
3-inch diameter
Today
350 calories
6-inch diameter
Calorie Difference: 210 calories
Blueberry Muffin
20 Years Ago
210 calories
1.5 ounces
Today
500 calories
4 ounces
Calorie Difference: 290 calories
Portion Size Influences
Amount of Food Eaten

Children 3-5 years old consumed 25%
more of an entrée and 15% more calories
at lunch when presented with portions
that were double an age-appropriate
standard size.
Source: American Journal of Clinical Nutrition, 2005

Adults ate more food when given larger
portions but rated hunger the same as
smaller size portions.
Source: Journal of the American Dietetic Association, 2004
Physical Activity
How are kids spending
their free time?
Favorite Activities
A survey of young people ages 8 –
18 showed their daily activities
accounted for the following hours:
Watching TV - 3 hours, 51 minutes
 Using the computer - 1 hour, 2 minutes
 Video games - 49 minutes
 Reading – 43 minutes

Source: Robert Wood Johnson Foundation
Television
 Obesity levels increase as the amount of time
spent watching TV increases, especially among
female children and teens.
Source: Archives of Pediatric and Adult Medicine
 Kids who have a TV in their bedroom watch
about 1.5 hours more per day than those who
do not.
Source: Kaiser Family Foundation
Screen Time
 The typical American child spends
about 44.5 hours per week using
media outside of school.
 Boys spend an average of 1 hour and 12
minutes playing video games daily, while girls
average 25 minutes a day.
 Kids who have a computer in their bedroom
use it about 45 minutes more per day than
those who do not.
Source: Robert Wood Johnson Foundation
Physical Activity
 Physical activity declines steadily during
adolescence.
Source: CDC, 1997

Only 25% of high school students participate in
at least 30 minutes of moderate physical
activity on five or more days of the week.
Source: Institute of Medicine

50% of children ages 12-21 rarely
or never exercise.
Source: CDC
The Future of our Children
“Children today have a shorter
life expectancy than their
parents for the first time in
100 years.”
How can we combat this
“overweight epidemic?”

Prevention is the key!

Habits such as healthy eating
and physical activity MUST be
established in childhood AND
practiced throughout a lifetime.
It takes everyone working
together
"You can't educate a child who
isn't healthy, and you can't keep
a child healthy who isn't
educated."
Source: Former U.S. Surgeon General Joycelyn Elders
The Role of Schools
“Schools not only teach our children to
read and write, but also to take care of
their bodies and minds. Schools are really
ideal places to promote good health
because most young people are in school
five days a week during most of the school
year.”
Source: Former U.S. Secretary of Health and Human Services
Tommy G. Thompson, 2001
What is a Student
Wellness Policy?


The Child Nutrition and
WIC Reauthorization Act
of 2004 requires
implementation of local
school wellness policies
that address healthy
eating and physical
activity.
All schools participating in
the federal school lunch
and/or breakfast program
must comply.
Source: Child Nutrition and WIC Reauthorization Act

Measurable goals must be
established for:
•
•
•
•
•
Nutrition guidelines
Nutrition education
Physical education
Physical activity
Other school-based
activities related to
healthy eating and
physical activity
Nutrition Education

The goal of nutrition education is to teach,
encourage, and support healthy eating among
students.

Promoting student health and nutrition enhances
readiness for learning and increases student
achievement.
Nutrition Guidelines

In order to develop lifelong healthy eating
patterns, children need to be introduced to a
variety of nutritious foods in a positive manner.

Foods available in district schools during the
school day shall be offered to students with
consideration for promoting student
health and reducing childhood obesity.
The Goal of
Physical Education

Physical activity is critical to the development
and maintenance of good health.

The goal of physical education is to develop
physically educated individuals who have the
knowledge, skills, and confidence to enjoy a
lifetime of healthful physical activity.
Source: National Association for Sport and Physical Activity
Today’s PE Class
To achieve a quality physical education program, a
certified physical education teacher:

Provides a variety of
physical activities that
make a physical
education class fun and
enjoyable

Assists students in setting
and achieving personal
health-related fitness
goals

Creates maximum
opportunities for
students of all abilities
to be successful

Prepares and encourages
students to practice skills
and be active for a
lifetime
Source: National Association of State Boards of Education, December 2004
Beyond the Gym
The goal of a comprehensive school
physical activity program is to provide a
physical and social environment that
encourages safe and enjoyable activities
that are developmentally appropriate and
designed to promote optimal health.
Physical Activity

Physical activity, broadly defined, includes
exercise, sport, dance, as well as other
movement forms.

Opportunities may include:
•
•
•
•
•
Recess and/or activity breaks
Intramural sport programs and/or physical activity
clubs
Interscholastic sports
Walk/bike-to-school programs
Incentive programs for students
and/or families
Source: National Association of State Boards of Education, December 2004
Integration is Key to Success
An effective coordinated school wellness
program integrates the cafeteria,
classroom and gym to reinforce positive
healthy behaviors throughout the day and
makes clear that good health and learning
go hand in hand.
Source: CATCH Texas
School-Based Activities
 Signs
posted in the cafeteria to
promote healthful eating choices
 Home assignments for the family
 Parent newsletters
 Promotional activities, campaigns
and/or programs
 Role modeling of healthy behaviors by
teachers, food service staff and administrators
 Student taste-testing
What can be done
outside of school?
Simple Steps for
Healthful Family Eating

Use MyPyramid and “Go, Slow
Whoa” food lists to make
healthy food choices

Steer clear of sugary drinks
and fruit juices

Read food labels

Save fast food for a once or
twice a week treat

Adjust portions

Start the day with breakfast

Serve a rainbow of fruits &
veggies every day

Plan and make family meals
together

Serve low-fat milk with meals
and water with snacks

Be a role model
Fit Families = Happy Families

Encourage children to be physically active for at least 60
minutes every day

Limit TV, video games, and computer time to
1-2 hours a day combined

Play with your children and plan activity time
for your entire family

Give gifts that promote fitness

Plan parties with active themes
such as skating

Be a role model
For More Information…
Nutrition:




www.mypyramid.gov
www.nhlbi.nih.gov/health/public/heart/obesity/wecan/
www.fns.usda.gov/eatsmartplayhard/
www.dolesuperkids.com
Physical Activity:




http://www.presidentschallenge.org
www.tvturnoff.org
http://www.bam.gov/index.htm
http://verbnow.com
Body Mass Index

.
www.cdc.gov/growthcharts
Acknowledgments
WellSpan’s Community Health Improvement department
developed this presentation and authorizes its use by
school district personnel. Any other uses or copying is
strictly prohibited.
For more information, contact:
Community Health Improvement at 717-851-3222.
This presentation has been adapted from materials produced by the Center for Health Promotion and
Prevention Research, University of Texas-Houston School of Public Health. For additional information about
the CATCH Texas program, visit www.catchtexas.org