Childhood Obesity :
How can physical education help reduce
the incidence?
Judith A. Flohr, Ph.D.
Department of Kinesiology
James Madison University
flohrja@jmu.edu
Outline
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Introduction
Responsibility
Obesity and Public Health
Defining Obesity:When is a Child Considered
Obese/Overweight?
Prevalence of Obesity
Consequences of Obesity
Prevention:The Importance of Physical
Education
Managing Obesity/Overweight
Questions and Answers
Responsibility
Who is “responsible” for the health and well being of
children?
University Physical
Faculty
Education
Teachers
School
Administrators
University
Faculty
State/Federal
Legislators
University
Faculty
Parents
Health Care
Providers
East Penn School District
April 4, 2002
To the Parents/Guardian of “I am an overweight kid”;
Beginning in the fall 2001 school nurses in cooperation with
teachers and administrators have been screening students for signs
and symptoms of overweight and/or obesity. Unfortunately, the results
of the height and body weight measurements indicate that your child is
obese. We want to assure you that the purpose of the screenings and
this letter are to assist in appraising, protecting and promoting the
health status of your child.
We look forward to working with you to encourage and
develop ways for your child to increase his/her activity and adopt good
nutritional habits.
Sincerely,
George Ziolkowski, Director
Pupil Personnel Services
Responsibility
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Teachers
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Maximize the child’s physical activity experiences
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Maximize physical activity during and after class
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Before/After school programs
Recreational activities
Emphasis should be on a child’s health
Homework
Effective use of class time
How?
Mission and Goals
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Program
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What is the mission of the program?
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Teacher
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Fitness development?
Motor skill development?
Physical activity behavior?
Professional goals
Personal health goals
Contribution to the mission of the program
Students
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Setting goals
Environment, activities etc to help reach goals
Defining Obesity/Overweight
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Body mass index
Weight (kgs)
Height (meters2)
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Categories
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Underweight = < 5th
Acceptable = 5th-85th
At Risk = 85th- 95th
Overweight = 95th
50th Percentile
5th
95th
Statistics
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Twenty years ago, 5% of American kids
were overweight; today 15% are, and
another 15% are headed that way
In 1969 80% of kids played sports
everyday;today 20% do
By 17, a child has spent 38% more time
in front of the TV than in school.
Body Mass Index 4th graders in Virginia
Percentage of Population
40
35
30
25
16.4%
(13)
20
14.1%
(13)
15
10
< 50th
> 50th
> 85th
> 95th
5
0
Boys
Girls
Comprehensive Study of the Nutritional Status of Children (1998)
Body Mass Index 4th and 7th graders (Harrisonburg)
% of population
60%
50%
40%
30%
31%
(14)
13%
30%
(14)
N = 54
N=22
N=25
Boys'01
Girls'01
20%
10%
0%
1991
1996
4th graders
OB
OW
Body Mass Index 7th graders ( Harrisonburg)
60%
50%
40%
30%
20%
10%
0%
Boys 12 yr
OB >95th Percentile
OW >85th Percentile
N=12
Girls 12 yr
N=20
Boys 13 yr
N=10
Girls 13 yr
N=05
Percent who become
obese adults
Consequences of Childhood Obesity:
Risk for Adulthood Obesity
80
70
60
50
40
30
20
10
0
Preschool
0-5 yrs
SchoolAge
Adolescence
6-12 yrs
12-17 yrs
Consequences of Childhood Obesity
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Overweight 5-10 year olds
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60% have 1 CVD risk factor
25% have 2 or more
Obesity is a major risk factor for
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Type II Diabetes, CVD and hypertension.
Consequences of Childhood Obesity
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Overweight schoolchildren are:
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2 time as likely to have elevated total
cholesterol
12 times as likely to have  fasting insulin
Consequences of Childhood Obesity
Hyperinsulinemia Syndrome X
Obese adolescents
 25% impaired glucose
tolerance
 .4% silent Type II
Diabetes
Prevention of Obesity:
Etiology of Obesity
Cultural
30%
(environment,
Other
lifestyle)
45%
Genetic
25%
Prevention:Etiology of Obesity
High Energy
Intake
Low Energy
Expenditure
Genetic &
Parental
Influences
Prevention:Etiology of Childhood Obesity
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Low birth weight
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Pregnancy
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Induces a “natural” catch-up in growth 0-2 years of
age.
Catch-up may increase the risk for obesity later in
life
Overweight mother may = overweight child
Breast Feeding
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Critical periods,
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Oscai, Larry
Prevention:Etiology of Childhood Obesity
Parental Effects
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Obesity in parents is a
strong risk factor
(environmental ?
Genetic?)
Risk high if:
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If thin child < 3 yrs has
a parent or two parents,
risk = 30-60%
In older children body
weight stronger
predictor of risk for
obesity
Prevention:Etiology
Environmental Factors
High fat diet, soft drinks
 Low level of habitual
physical activity
 Television viewing
 Video Games
 Physical Education
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Prevention:Physical Education
Percent
Daily participation in physical education
by high school students
50
45
40
35
30
25
20
15
10
5
0
Boys
Girls
1985
1991
1993
1995
Source CDC NYRBS, 1995
Prevention:Physical Education
Physical Education Goes Down, Weight Goes Up
45
40
%
35
30
25
PE
% Overweight
20
15
10
5
0
1985
1990
1991
1993
1995
1997
The Importance of Physical Education
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Middle School
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Pedometer (measures steps)
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Total on a PE day
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Steps in PE
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Girls = 10,484 ± 2896
Boys = 11,554 ± 4619
Girls 2063 ± 867
Boys 2220 ± 1221
21% of daily total was from PE
The Importance of Physical Education
11,555
± 4619
10,484
± 2896
12000
Steps
10000
8000
PE
Total
6000
4000
2063± 867
2220± 1221
2000
0
Girls
Boys
Percent
The Importance of Physical Education
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Non PE
PE
21%
21%
Girls
Boys
The Importance of Physical Education
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Approximately 2000 steps/mile
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Walk one mile at 3 mph pace (3.5 METS)
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Assume a body weight of 54 kgs. (119 lbs.)
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Approximate caloric cost of PE = 100 kcals
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PE = 500 kcals/week
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18/36 weeks with no PE 9,000 kcal surplus
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2.5 lbs/school year
“Overweight children and adolescents may be at a
disadvantage physically, as well as socially and
economically.” (Troiano, 1995, p.1090)
Prevention is vital!
“Attempts to increase physical activity
for children and adolescents may
provide a promising avenue in this
effort.”
(Troiano, 1995, p.1090)
Managing Overweight & Obese Children
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Non-Drug
Multidisciplinary Approach
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Diet
Behavior Modification
Exercise
Limit
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High fat snacks
Sweet beverages
Fast foods
Managing Overweight & Obese Children
 Parents
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Should not express criticism , if they do
could increase risk of eating disorders
Encourage healthy diets and exercise
Managing Overweight & Obese Children
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Parents should
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Limit
TV
 Video games
 Computer use
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Managing Overweight & Obese Children
Physical Education
 Body Composition
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Caloric Expenditure
Muscle Development
Bone Development
Managing Overweight & Obese Children
Physical Education
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Cardiovascular
Endurance
The ability of the heart,
lungs and blood vessels to
deliver oxygen to the
working muscle for
extended periods of time.
 Maintain an elevated
(> 120-130 bpm) for at least
30 min most (5-6) days of
the week
 Vigorous activity > 130
bpm at least 3 days/week
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How?
Managing Overweight & Obese Children
Physical Education
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Muscular Strength
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The ability of a muscle to exert
maximum force against resistance.
Role in Metabolism
Role in “Aerobic Ability”
Engage major muscle groups in
“resistance” activities
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Rope
Surgical tubing
Dyna/Therabands
Milk jugs
Bungee cords without hook
Managing Overweight & Obese Children
Physical Education
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Muscular Strength
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Avoid maximal
weights
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8-10 RM
Damage to “growth
plate”-plastic swords
Ligament damagegum
Avoid severe
muscular fatigue
Increase reps before
resistance
1-2 sets of 8-10
different exercises
 Rest between sets
1-2 minutes
 Limit strength
training to 1-2
sessions per week.
Push-ups
Pull-ups
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Managing Overweight & Obese Children
Physical Education
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Muscular Endurance
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The ability of a muscle to exert sub
maximal force repeatedly over a period of
time (> 30 repetitions)
How-Activities similar to muscular
strength, lower resistance
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Multi-joint vs. single joint
Managing Overweight & Obese Children
Physical Education
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Flexibility
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Ability of a joint to move freely through a
full range of motion.
When
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Chewing Gum
ACTION
The Nation must take action to assist Americans in balancing healthful eating
with regular physical activity. Individuals and groups across all settings must
work in concert to:
•Ensure daily, quality physical education in all
school grades. Such education can develop the
knowledge, attitudes, skills, behaviors, and
confidence needed to be physically active for life.
The Surgeon General's Call To Action To Prevent
and Decrease Overweight and Obesity (2001)
http://www.vahealth.org/nutrition/sac/CNSCPreport.pdf