Obesity and APE
Question…
What percentage of Americans are
overweight and obese?
…and Answer
John Hopkins University (meta-analysis)
66% of U.S. adults were overweight or obese
and 34.5% are obese in 2003-2004. Since then,
the rate has stabilized. (80% of AfricanAmerican women aged 40 years or over are
overweight; 50% are obese).
JAMA, 2006
Rates of overweight and obesity remain high
with 31.9% of children and adolescents aged 2
through 19 years at or above the 85th percentile
of the 2000 BMI-for-age growth charts.
…and Answer
http://calorielab.com/news/2008/07/02/fatt
est-states-2008/
http://www.cdc.gov/nccdphp/dnpa/obesity/t
rend/maps/index.htm
“Costs” of obesity
Physically, increased likelihood of:
Type-2 diabetes, heart disease, high blood
pressure, stroke, a few types of cancers, gall
stones, liver diseases, osteoarthritis, infertility,
colon cancer, hypertension, arthritis, sleep
disturbances, breathing problems, & physical
disability
Typically long-onset diseases of lifestyle
“Costs” of obesity
Economic
Obese patients add an estimated $75 billion a
year to the nation's medical bill (CDC, 1998)
Negative relationship between body weight
and wages for white females (Cawley, 2004)
“Costs” of obesity
Academic
Overweight children had significantly lower math and
reading test scores compared with non-overweight
children in kindergarten (Frost & Sullivan, 2004)
In other words, students that maintained a higher
level of physical activity maintained higher grades and
learned at a faster rate than those students who were
less physically active (Byrd, 2006)
Obese females are 50 percent less likely to attend
college than non-obese females (Crosnoe, 2008) –
University of Texas
“Costs” of obesity
Mental/Emotional
Lower self-esteem, less confidence in social
situations due to their appearance, poor body
image, more likely may have more absent/skip
school, more apt to try drugs and alcohol
(Hupper, 2006)
A body mass index, of 30 or higher -- was
associated with a 25 percent increase in the
likelihood of major depression, bipolar disorder
and panic disorder (Harrisson, 2008)
“Costs” of obesity
Obesity Increases Risks of Problems in Pregnancy
and Childbirth
 Infant death
 Infant birth defects
 Delivery by cesarean section
 Slow or difficult labor or delivery
 Diabetes and high blood pressure in pregnancy
 Infertility
 Menstrual problems
Percentage of Overweight U.S. Children and Adolescents is Soaring*
18
16
16
16
14
12
10
8
6
4
2
Ages 12-19
5
4
Ages 6-11
0
196370**
1971-74
1976-80
1988-94
19992002
* >95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts
**Data from 1963-65 for children 6-11 years of age and from 1966-70 for adolescents 12-17 years of age
Source: National Center for Health Statistics
“Costs” of obesity
70%
chance of being overweight
as adults
 Children who are overweight have a
 Childhood onset of type 2 diabetes
Children born in 2000 have a high risk of getting
diabetes in their lifetimes:
 33% of males
 39% of females
“Costs” of obesity
 61% of overweight 5- to 10-year-olds already had risk
factors for heart disease, and 26% had two or more risk
factors for the disease (Freedman, Dietz, Srinivasan, and
Berenson, 1999).
 Second leading cause of preventable death in the US
 Boys tend to be more active than girls; Affluent more
active than poor; White more active than non-white;
Higher education graduates more active than high school
graduates.
Q&A
How is being overweight or obese
defined?
Defining overweight and obese
Adults
BMI between 25 and 29.9 is considered
overweight, 30 or higher is considered
obese
Body fat percentage calculated by skin
calipers or bioelectrical impedence
• Interpreting body fat percentages (varies
but mostly consistent)
Defining overweight and obese
Children (2-20)
Can’t use adult formala for BMI due to child’s
age and growth
Must view resource:
http://www.cdc.gov/nccdphp/dnpa/healthyweight/ass
essing/bmi/childrens_BMI/about_childrens_BMI.htm
Calculators
Online but one at a time
• http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx
Old fashioned by hand but quicker than online
• Weight and height charts
• BMI-for-age charts for girls and boys
Q&A
What do you think the role of physical
educators is in helping to address the
obesity dilemma?
Work with a partner to craft several strategies
for reducing childhood obesity in your future
students.
PE Solutions to Obesity
CDC on High Quality PE Programs
 Modify the curriculum to increase both moderate and
vigorous bouts of activity
 Increase the time allotted to physical education across all
levels
 Switch to more active games &/or modified existing games
and rules to enhance activity for all participants
 Reduce wait, transition, and management time in a lesson
while increasing activity time
 Use smaller sided games which promote student
interaction with the content/equipment to be mastered
Active Youth recommends teacher focus on…
 Address the INTERESTS of students (what are they
likely to participate in?)
PE Solutions to Obesity
Hershey Foods Corp Report:
Modify the school nutrition programs.
Does the cafeteria offer healthy breakfast and
lunch options? ($) Better yet, just healthy food?
Are there healthy snacks and drinks in the
vending machines?
Most interventions increase activity (both
intensity and duration) during class but many
reported no change in out-of-school activity.
Future programs need to aggressively promote
out-of-school activity.
Attempt more coordinated and comprehensive
interventions involving schools, communities, and
home settings.
PE Solutions to Obesity
Involving the Classroom Teachers
Incorporate brief periods of stretching
or activity in the classroom
Energizers
Provide nutrition lesson plans because
many classroom teachers are not
trained in health education
Post information such as posters or
models around the classroom
PE Solutions to Obesity
After school activities
 Suggestions:
 Make it Fun!!
 Offer choices that appeal to a variety of student interests
 Include time for homework
 Target “at risk” population
 Provide mix of competitive & non-competitive activities
 GET PAID!!
 Steps
 Who’s interested, in what?
 Scheduling: days/week, # of weeks, session length
 Promotion of club to students and staff
 Permissions/transportation
 Equipment
 Planning each session (KISS)
 Funding…who’s getting paid and what plus equipment
PE Solutions to Obesity
 Extending PE Ideas
 http://www.ccsu.edu/physedhltfit/faculty/cummiskey/ext
endingPE/extendingPE.html
PE Solutions to Obesity
Specialized classes for students identified
through testing as overweight or obese
 Optional class: AM fitness club composed of fun
activities to keep students moving. Parents sent a
letter inviting them to attend
• Could also be after school (may conflict with intramurals or
coaching)
• NASPE forum example
 Required class: scheduled based upon BMI results
• Modify the class specifically to obese children based on
their needs and incorporate frequent body fat analyses,
nutritional counseling, etc…
Biggest loser competition
Build an IPEP when appropriate
PE Solutions to Obesity
Miscellaneous Strategies (Poole & other sources)
 Technology
 Use pedometers, heart rate monitors, & other technologies to
measure personal fitness.
 Fitzpatrick – March Madness Walk Off
 Wii fitness
 Organize & participate in Jump Rope for Heart,
Million Jump Day, field trips, ACES (all children
exercising simultaneously), family nights,
Fitnessgram awards for most improved, active
lifestyle award, Walk to School and get extra PE, etc.
PE Solutions to Obesity
Miscellaneous Strategies cont.
 Make frequent references to local physical activity
resources
 Bulletin board of how to get involved in the community
(hiking trails, ultimate frisbee clubs, karate centers, etc)
 Collect fitnessgram assessment data on children from 4th
– 12th grade. Grade on the absolute score or
improvement.
 What are the fitnessgram components? To calculate body
fat, use bioelectrical impedance (Omron Body Fat Analyzer)
or BMI
 Decorate the “naked gym” with the food pyramid,
wellness scale, benefits of physical activity, bar graph of
yards walked to burn off a big mac vs a grilled chicken
sandwich, etc (Involve the art classes and make it
interdisciplinary project)
Community & Obesity
 Encourage greater walking and riding to school (making
activity part of daily commute)
“Walking School Bus” where volunteers coordinate
walking routes to school (www.walkingschoolbus.org).
 Are school facilities open for use after school hours?
 Partnerships among businesses and other organizations
can support programs that are accessible to all children and
adolescents in the community
 Negotiated a deal with local fitness centers for students who
score poorly on fitnessgram assessment
 May require an out of school practicum experience for
students who are overweight or obese
Families Solutions to Obesity
 Send home bi or tri-yearly results on the fitnessgram assessment.
This could be a double-sided newsletter, fitnessgram results on one
side and wellness information on the other (nutrition, exercise, and
weight training
 Send home letters to overweight or obese students inviting them to a
Wellness Workshop sponsored by the PE Staff (rotate speaker).
Have fun activities (rock climbing, volleyball, etc) as well as a lecture
on wellness and physical activity. Some topics might include:
 Limit out-of-school “screen time” (TV, videogames, computer)
 Encouragement - encourage them to participate in physical activity,
participate in physical activity with them, watch them play or
compete, volunteer, and provide transportation to physical activity
and sports events
 Be a role model by communicating positive and consistent messages (walk
instead of drive a car, use the stairs, move the yard for exercise)
 Organize physical activities themselves with friends and family members
 Portion control, food preparation
 Basic nutrition information like you would teach in health class
Health Professional Solutions & Obesity
 Guest speakers and field trips
 Reinforce the importance of physical activity among
physically active children and adolescents
 Establish partnerships with communities (e.g., child
care facilities, schools, recreation centers) to raise
awareness about the benefits of physical activity for
children and adolescents, be positive role models, and
serve as advocates for high-quality physical education
programs (Kentucky Hospital System)
 Ask health care professionals to sponsor and support
prevention activities (currently 97% of health
spending in devoted to care and 3% prevention)
Child Nutrition and WIC
Reauthorization Act
Signed by President Bush on June 30, 2004.
Section 204 of this Act requires each
district participating in the USDA School
Meal Program to have established a local
school wellness policy by the school year
beginning July 2006.
Physical
and health educators are the most
knowledgeable teachers in schools to plan and
implement such a policy

Wellness Policy must include the following:
1a. Nutrition education goals
1b. Physical activity goals
1c. Other school-based activities
2. Nutrition guidelines/standards
3. Assurances that USDA school meals guidelines
are being met
4. Plan for measuring implementation
–Designation
of 1 or more people to ensure
wellness policy is being met at all school buildings
REQUIRED Areas to Consider in a School
Wellness Policy
 Nutrition Education
 Physical Education &
Physical Activity
 Other School Based
Activities
Health Education
Family/Home
Involvement
Technology
Interdisciplinary
connections to
wellness
Brain Primers
(Energizers)
Intramural/After
School
School Nurse
Wellness Adventures
Eating Environment
Resources for School Wellness
Policy
 http://www.ccsu.edu/physedhltfit/faculty/cummiskey/conf
erences/presentations.htm
 Action for Healthy Kids
 www.actionforhealthykids.org
 Team Nutrition
 www.fns.usda.gov/tn/healthy/wellnesspolicy.html
 National Alliance for Nutrtion and Activity
 www.schoolwellnesspolicies.org/
 Making it Happen – School Nutrition Success Stories
 www.fns.usda.gov/tn/resources/makingithappen.html
 School Nutrition Association
 www.asfsa.org/childnutrition/fsoperations/policies/index.asp
Benefits to Normal BMI (various sources)
Action for Healthy Kids reported
 Physical activity is consistently related to higher levels of
self-esteem and lower levels of anxiety and stress.
 A strong relationship has been reported between fitness
scores and academic achievement (www.cahperd.org) –
California AHPERD.
 Overweight and obese children are more often absent, victims
of bullying, exhibit greater behavior problems, and perform
poorer on academic achievement tests.
 More healthy children make more healthy adults and in turn,
more healthy children.
Benefits to Normal BMI cont.
Prevents high blood pressure
Relieves stress
Raises HDL (“good”) cholesterol
Reduces the risk of diabetes and some cancers
Improves psychological well-being (greater selfconfidence and self-esteem)
Increases lean muscle mass
Reduces symptoms of depression and anxiety and
improve mood
Improves cardiorespiratory fitness
You’ve Got Support
 81 percent of teachers and 85 percent of parents favor
requiring students to take physical education every day at every
grade level
 94 percent of teachers and 89 percent of parents favor
developing new "lifestyle" approaches to physical education,
focusing on activities children can continue to participate in
after they've left school
 87 percent of teachers and 88 percent of parents believe school
boards should not eliminate physical education for budgetary
reasons
 87 percent of teachers and 77 percent of parents believe
schools should not eliminate physical education classes to focus
on meeting stricter academic standards
Don’t Underestimate
the Power of
Your EXAMPLE!
Adult’s Physical
Activity Pyramid
Children’s Physical
Activity Pyramid
In conclusion, tackling the obesity problem
in the US will require a comprehensive
solution involving families, communities,
and schools. Your efforts will make a
difference!
Resources not listed already
http://kidshealth.org/parent/nutrition_fit/nut
rition/overweight_obesity.html