SUPERSIZING
Our Children
The Childhood
Obesity Epidemic
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AND INFO HERE
Objectives
• Describe prevalence and contributing factors of
overweight and obesity in infants and children.
• List possible consequences of being overweight as a
young child.
• Describe the role of the child care environment and
of child care staff in helping to prevent overweight
in children.
• List ways in which the child care facility can help
children eat healthier and get more activity.
Obesity in America
Obesity is Caused by
Long-Term Energy Imbalance
Fat
Stores
BMI Chart created by Vertex42.com. Used with permission.
Obesity Trends* Among U.S. Adults
BRFSS 1990, 2000, 2010
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2000
1990
2010
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
 Based upon BMI measurements:
 69% of the US adult population is
overweight
 More than one third of adults (35.7%) are
considered obese
SOURCE: http://www.cdc.gov/obesity/data/adult.html
Obesity Trends for Maine (1990-2012)
Source: America’s Health Rankings Report, The United Health Foundation,
http://www.americashealthrankings.org/ME/Obesity
• Only about 14% of U.S. adults eat the
recommended servings of fruits and vegetables
each day.
• More than 60% of American adults do not get
the recommended amount of physical activity to
provide health benefits.
• Nationally, 25% of all adults are not active at all.
SOURCES: Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health
Econ. 2012; 31:219-30. AND Wang CY, McPherson K, Marsh T, Gortmaker S, Brown M. Health and economic burden of
the projected obesity trends in the USA and the UK. Lancet. 2011; 378:815-25.
The Estimated Cost…
• Adults:
– Obesity accounted for 21% of medical spending – or $190
Billion – in 2005
– It’s estimated by 2030 obesity-related medical costs could go
up by $48 to $66 billion a year in the U.S.
• Children:
– 1979 to 1999 saw a tripling of annual costs, rising from $35
million to $127 million.
– The annual cost nearly doubled from 2001 to 2005 due to
hospitalizations relating to obesity (from $125.9 million to
$237.6 million.
SOURCES: Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health
Econ. 2012; 31:219-30. AND Wang CY, McPherson K, Marsh T, Gortmaker S, Brown M. Health and economic burden of
the projected obesity trends in the USA and the UK. Lancet. 2011; 378:815-25.
What Factors Affect Obesity?
• Biology
~Genes
• Behaviors
~Diet
~Physical activity
• Environments
~Social
~Physical
Focus on what we can change!
Why the Increase In Obesity?
• Rising obesity rates
result from
increases in caloric
intake and/or
decreases in caloric
expenditure
• The rise in obesity
rates in the last
decade could be
explained by as
little as an average
net increase of 100
calories per day.
FOODS
Calories
2 Oreo cookies
106
4 Hershey’s Kisses
100
8 fl oz Coca-Cola
162
1 Tbsp ranch dressing
90
2 slices white bread
130
SOURCE: www.calorieking.com
ACTIVITIES
Calories
Walking 1 mile
96
Biking 4 miles (@10 mph)
102
Jogging 1 mile (@5 mph)
120
SOURCE: www.healthyheart.org/nutrition/caloricostofexercise.htm
Changes in Caloric Intake from 1970 to 2000
• Adults
– Men: 2,450 to 2,618 kcal/day (+7% )
– Women: 1,542 to 1,877 kcal/day (+22% )
• Children
– Boys: 2,550 to 2,800 kcal/day (+10%)
– Girls: 1,780 to 1,900 kcal/day (+7%)
In the past decade intakes have remained fairly stable.
Help, the Environment is
Making US Fat!
Brainstorm
What factors in
the environment
make it hard for
us to eat smart
and move more?
Ideas?
Urban Sprawl and Time Spent in Cars
Street Connectivity and Mixed Use
Poor Access to Recreational Facilities
Lack of Parks and Green Spaces
Are children from rural areas, like
much of Maine, more or less active?
• Higher percentages of rural children have
been identified as obese compared to
urban children.
• It may be harder for rural children to
participate in after-school activities such as
sports; transportation may be one of the
reasons why
• Rural children may spend MORE time being
inactive as well
Source: Center for Rural Affairs 2009
Density of Fast Food Restaurants
Eating Away from Home
Contributes to Portion Distortion
FRENCH FRIES
30 Years Ago
210 Calories
2.4 ounces
Today
610 Calories
6.9 ounces
Calorie Difference: 400 Calories
Presence of Convenience Stores and
Absence of Grocery Stores
Prices Matter
School and Work
• Poor food choices in cafeteria or vending
machines
• Minimal PA opportunities, even in schools
• School or work environments that don’t support
or encourage healthy eating or PA
– Time limitations
– Difficult to bring food from home
• Technology that makes work easier,
but reduces PA
Home – Food Environment
• Availability and accessibility of fruits & veggies
and healthy snacks
• Family meals, especially for children
• Family traditions (walks after dinner; playing
with the kids)
Adults control what
enters the home!
Home – Media Use
• Media importance in home
(use of TV at meals, video
games, etc)
• Number and location of TVs
– Particularly access to media
in the bedroom
• TV watching:
– Decreased movement
– Increased calories and
cravings
Home – Outdoor Play Time
• Free play outdoors is
important
– Increased fitness levels
– Decreased stress
– Stronger immune systems
– Better test scores
– More creativity
– Happier demeanor
Overweight and Children
Childhood Obesity
• Weight
categories for
children are
determined by
growth charts
Obesity in Children
16%
14%
12%
10%
8%
6%
4%
2%
0%
1971-1974
1988-1994
Total
Boys
1999-2000
Girls
2003-2004
Overweight Infants?
• In 2003-2004, NHANES
estimated 9.5% percent
of infants and children
less than 2 years of age
were obese.
SOURCE: The 2003-2004 National Health and Nutrition
Examination Survey (NHANES),
Should We Be Concerned?
• Overweight is now the most common
nutritional disease of children.
• Preschool children who are overweight are
almost 5x more likely to be overweight as
young adults
• Carrying extra body weight is a risk factor
for many chronic conditions and health
problems.
Brainstorm
What are the
health risks to
overweight or
obese children?
Ideas
?
Health Risks of Obesity
• Heart Disease
 Total cholesterol
 Serum triglycerides
 Blood pressure
•
•
•
•
•
Breathing Problems
Type 2 Diabetes
Musculoskeletal Problems
Fatty Liver
Weight Discrimination
Contributors to Child Obesity
• Food choices
• Physical activity
• Eating patterns
Contributors to Childhood Obesity
• Obese parents
• Parenting style
• Parents with poor
health behaviors
Contributors to Childhood Obesity
• Diabetes during
pregnancy
• Low-birth weight
• Excessive weight gain in
pregnancy
• Formula feeding
• Demographic Factors
THE CHILD CARE ENVIRONMENT
The Child Care Environment
• Nearly 28% of children
(infants to age 5 years)
are
in some kind of
organized child care.
• 55% of 3-6 year olds
are in early care and
education programs.
• Child care setting is an ideal setting for
promoting early development of
healthy behaviors
What Can We Do?
• Focus on what we can change!
–
–
–
–
Nutrition
Physical activity
Feeding interactions
Role Modeling!
Brainstorm
• What can YOU do
to help prevent
obesity in
preschoolers?
Ideas
?
Use a Consistent Message
Implement the
Strategies for Success
Implement the Strategies for Success
Provide healthy choices for
snacks and celebrations;
limit unhealthy choices.
Implement the Strategies for Success
Provide water and low fat
milk; limit or eliminate
sugary beverages.
Implement the Strategies for Success
Provide non-food rewards.
Implement the Strategies for Success
Provide opportunities for
children to get physical
activity every day.
Implement the Strategies for Success
Limit recreational
screen time.
*Keep TV/Computer out of the
bedroom. No screen time under
the age of 2.
Implement the Strategies for Success
Participate in local, state, and
national initiatives that
promote healthy eating and
active living.
Implement the Strategies for Success
Engage community partners
to help support and promote
healthy eating and active
living at your site.
Implement the Strategies for Success
Partner with and educate
families in adopting and
maintaining a lifestyle that
supports healthy eating
and active living.
Implement the Strategies for Success
Implement a staff wellness
program that includes
healthy eating and
active living.
Implement the Strategies for Success
Collaborate with Food and
Nutrition Programs to offer
healthy food and
beverage options.
Implement the Strategies for Success
1) Provide healthy choices for snacks and celebrations; limit unhealthy choices.
2) Provide water and low fat milk; limit or eliminate sugary beverages.
3) Provide non-food rewards.
4) Provide opportunities for children to get physical activity every day.
5) Limit recreational screen time.
*Keep TV/Computer out of the bedroom. No screen time under the age of 2.
6) Participate in local, state, and national initiatives that promote healthy eating
and active living.
7) Engage community partners to help support and promote healthy eating and
active living at your site.
8) Partner with and educate families in adopting and maintaining a lifestyle that
supports healthy eating and active living.
9) Implement a staff wellness program that includes healthy eating and active
living.
10) Collaborate with Food and Nutrition Programs to offer healthy
food and beverage options.
YOU CAN MAKE A DIFFERENCE!
Child care providers are
advocates for healthy
children!!
Summary
• Obesity is increasing in America, especially among
children.
– More than 1 in 4 preschoolers are overweight or obese.
• Childhood obesity increases kid’s risk for health
problems later in life.
• Obesity is more than just a personal decision!!
• Child care providers can help keep kids healthy.
• The 5210 message encourages healthy choices for
children and their families.
Making Changes at YOUR Child Care
• List three ways you can help the children at your facility
reach one of the
behaviors every day.
• Pick one of the 5 priority strategies and list 3 ways you can
work on implementing this strategy at your child care
program right now.
• BONUS: Challenge all the teachers at your facility to think
of a 5210 Goes to Childcare motto or catchphrase for your
program. Then, let the kids vote on the best one!
Thank you!!
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