Childhood Obesity…
Let’s “Step” Towards A
Healthier Future!
Shelley Francis
Diabetes Community Consultant
Union of NB Indians
ANTEC 2010
Childhood Obesity…Sad Facts
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In Canada, over 26% of children and youth
(1.6 million children) are considered
overweight or obese
If this trend continues, 46 % of school-aged
children will be overweight or obese by 2015
In 20 years, 70% of 35-44 year olds will be
obese as compared to 57% who are currently
obese
Aboriginal children are at higher risk due to
genetic and lifestyle factors
Childhood Obesity…Sad Facts
55% Obesity rate in First Nation
Communities (CMA, 2007)
 Chronic disease rates are higher (and
some are in epidemic proportions)
among Canada’s Aboriginal population
 Mental health issues are abundant
among Aboriginal People – slowing our
progress towards healthier
communities
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Childhood Obesity…Sad Facts
Unfortunately most obese children and
youth do not outgrow their weight
problem….in fact most people tend to
gain weight as they age.
What is Childhood Obesity
Childhood Obesity is a medical
condition that affects children and
teenagers. It happens when too much
fat is stored in the body, causing a
weight that is not proportional to the
child’s height.
The primary cause of CO is eating too
much and not getting enough exercise
Risk Factors to Childhood Obesity
Most children who are affected:
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Consume food and drinks that are high in sugar and
fat on a regular basis such as fast food, candy,
baked goods, pop and other sugar-sweetened
beverages
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Are not physically active each day
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Watch a lot of TV and play a lot of video games,
computer use
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Eat to help deal with stress or problems
Risk Factors to Childhood Obesity
• Live in an environment where healthy eating and
physical activity are not encouraged
•
Come from a family of overweight people where
genetics may be a factor, especially if healthy eating
and physical activity are not a priority in the family
•
Come from a low-income family who do not have the
resources or time to make healthy eating and active
living a priority
•
Have a genetic disease or hormone disorder such as
Prader-Willi syndrome or Cushing's syndrome
Long-term Obesity =
Long-term Health and Social
Problems!
What Happened??
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Lack of physical activity programs in
schools and in the community
Lack of grassroots stuff to do – or
unwillingness to do them
Video and computer game access
Lack of time at home – families are
VERY busy!
Lack of knowledge of the importance
healthy eating
Access to food is incredible and
convenient!!
Consequences of
Childhood Obesity
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Chronic diseases: diabetes, heart disease, cancer
Bone & joint dysfunction
High blood pressure and elevated cholesterol
Earlier than normal puberty or menstruation
Liver problems – due to ongoing fat digestion
Eating disorders such as bulimia and anorexia
Respiratory problems such as asthma, shortness of
breath etc.
Skin infections due to excessive perspiration trapped in
skin folds
Sleep apnea
Fatigue
Consequences of
Childhood Obesity
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Negative body image
Depression
Teasing, bullying, social marginalization
More likely to bully others
Poor self-esteem and may feel socially isolated
Increased risk for depression
Poorer social skills
High stress and anxiety
May have behaviour and/or learning problems as a
result of psychological difficulties related to
childhood obesity
ADI Diabetes Prevention &
Healthy Lifestyle
School Program
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Community-based school program
Vision…to create an awareness of the
growing incidence of Diabetes among
Aboriginal People in Canada – and how to
prevent it and other chronic diseases
Addresses healthy lifestyle issues such
as nutrition and physical activity
Addresses the devastating childhood
obesity epidemic facing our Youth
Health Promotion in Schools…
School Food Policy Implementation
Nova Scotia (2006) – staged
implementation began
 New Brunswick (2007) – staged
implementation began
 Eel Ground School (2008) – full
implementation began Sept. 2008
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Eel Ground School Nutrition
Policy Objective
“This policy establishes the minimum
requirements for healthy foods and
regular physical activity in the Eel
Ground School by setting standards for
awareness of healthy foods, food
options available in schools and sale of
foods in and through the school
system.”
Eel Ground School
Nutrition Policy
Awareness began 2003
 Planning through wellness committee
in summer of 2007
 Approval of Chief & Council and
education committee
 Staged approach until Sept.2008,
then policy fully implemented
 Breakfast and Hot lunch programs
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ADI School Screening Program
Began in 2004
 Eel Ground First Nation was first
school involved with screening
 With parental consent, each student
grades K-8 tested with blood sample
 Generally well-tolerated
 Students screened annually
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Screening Results
Blood Glucose Testing
INDICATOR
2003
2005
2008
%
%
%
Impaired Glucose Tolerance
(PC glucose >11.1 mmol/l)
0%
0%
0%
Impaired Fasting Glucose
(AC glucose > 5.7)
9%
5%
0%
91%
95%
100%
Normal Blood Glucose
(pre meal < 7 and post meal <
9 mmol/l)
Screening Results
Body Mass Index (2005)
Indicator
# Students
%
BMI>95th
Percentile(=Obesity)
16
32%
BMI 85-95thPercentile
(Overweight - risk for
obesity)
13
27%
BMI 50-85thPercentile
9
18%
BMI 3-50th Percentile
11
22%
BMI<3rd Percentile
2
<1%
Screening for Type 2 Diabetes Risk
Factors in Children & Adolescents
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Identify children 10 years and greater who
are most at risk of developing Type 2
Diabetes in the future
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Parent Questionnaire and consent
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Initial screening for diabetes risk factors did
not involve any blood glucose testing,
avoiding unnecessary blood samples.
Screening for Type 2 Diabetes Risk
Factors in Children & Adolescents
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Parent Consent and Questionnaire
completed and sent back to school.
Children were screened for the following 3
risk factors:
 Aboriginal Descent,
 BMI>95%,
 10 years of age or older
If all 3 risk factors were
present…
Screening for Type 2 Diabetes Risk
Factors in Children & Adolescents
…And they had one or more of the following risk
factors, their risk would be assessed as high and
further screening needed to be completed:
 Mother with Gestational Diabetes
 Family members with diabetes
 Acanthosis Nigricans
 High blood fats
 Hypertension
 Polycystic Ovary Disease
Screening for Type 2 Diabetes
Risk Factors in Children &
Adolescents (2008)
Indicator
# Students
%
BMI>95th
Percentile(=Obesity)
25
42%
Elevated Blood
Pressure
9
15%
Mothers With
Gestational Diabetes
7
12%
Acanthosis Nigricans
3
9%
Health Promotion in Schools…
Kindergarten Class
Canada Food Guide
display at Miramichi
Regional Hospital
Project Outcomes
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Healthier learning environment for school
Increased awareness of Diabetes epidemic
Increased staff involvement in healthy lifestyles
Ownership of the project by the students
Enhanced communication and partnerships
between health programs on and off reserve
Healthier children! Follow up
continues…..parents more involved
Pride for the students, staff and community
ADI School Program Partnerships
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Community First Nation School
Community Health Nurse/CHR
Local businesses
Provincial Health Department
Regional Hospital Health Authority
Pharmaceutical Industry
University Faculty of Nursing & Kinesiology
Brighter Futures Program
FNIHB staff - Dental Therapist, Nutritionist, Physical
Activity Specialist etc.
Where Are We Going?
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Continue with annual screening clinics
Partner with helping organizations
Continue to do classroom education with the
students
Continue to support school staff in making
the school environment healthy
Promotion of School Food Policy
4 Steps to better health in Children
4 Simple Steps to
Better Health in Children
FIVE Fruits & Vegetables Per Day!
TWO Hours or Less of Screen Time Per Day!
ONE Hour of Physical Activity Per Day!
ZERO Sugar Sweetened Beverages Per Day!
What Can Families Do?
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Be active as a family
Involve children in household activities
Be knowledgeable about health
Eat meals together at home
Teach your children basics – like cooking
Lead by example
Start early in your child’s life
Don’t set child up for failure (junk foods in the
kitchen cupboards)
Do not talk “diets” – focus on healthy lifestyles
Be supportive, not critical!
What Can Communities Do?
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Limit sale of sugar sweetened beverages
(SSB’s) at community events, municipal
buildings, schools, public areas etc.
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Offer food skills programs (cooking classes,
healthy grocery shopping tours)
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Support adoption of school food policies
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Be an active community with walking trails,
subsidized activity fees etc.)
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Offer support through health programs
What Can Government Do?
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Fund more treatment centres for obese and
overweight children
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Support research and evaluation of ongoing
childhood obesity programs to improve
services and accessibility
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Improve access to affordable fruits and
vegetables and healthy foods in general
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Support ongoing and new initiatives such as
Winteractive, Summeractive, CPNP, ADI,
Headstart - ensure that these programs
target the children and youth in preventing
obesity and other chronic diseases
What Are We
Going To Do?
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Lobby Chiefs and Councils local and national
governing bodies to support the cause
Educate School staff to enlist their support
Become educated ourselves
Ensure a constant presence wherever kids are
Be there for students, families and staff
Be role models for all community members
Persistence is the key to success…
DON’T GIVE UP!!!
Children’s Pride &
A Brighter Future are in Our
Hands!
Questions?
Shelley Francis, BNRN, CDE
Diabetes Community Consultant
Union of NB Indians
(506) 458-9444
shelley@unbi.org
Ann Gottschall, RNMN
Diabetes Community Consultant
Union of NS Indians
(902) 863-8455
ann.gottschall@ns.sympatico.ca
Questions?
Margie Gray BSc.RD
Diabetes Community Consultant
MAWIW Council Inc.
(506) 476-4014
margieg@nb.sympatico.ca
Tara MacKinnon, PDt., CDE
Diabetes Community Consultant
Confederacy of Mainland Mi’kmaq
(902) 895-6385
adi@cmmns.com