Nutrition Task Force
Community Resources
and
The Growth Screening Program
Workshop
School Nursing in 2005
Monday, January 17, 2005
12:00 PM to 3:00 PM
Washington County Health
Partners, Inc.
• Not-for-profit, 501(c) 3 organization
• Dedicated to the enhancement of the health and
well-being of Washington County residents.
• Assesses the county’s health status periodically
• Works through volunteer task forces and programs
to address identified health issues
• Currently 7 task forces and 2 programs
Nutrition Task Force
Nutrition Task Force Background
• Created in July 2004
• Focus on promoting and supporting healthy
lifestyles for all children and the adults that impact
their homes, schools, and neighborhoods.
• Healthy lifestyles defined as living actively, eating
in healthy ways, and encouraging positive body
image and self esteem.
Nutrition Task Force
Task Force Members
•American Cancer Society, Kathleen Row
•Burgettstown School District, Jan Marietta, RN
•Canonsburg General Hospital, Sandy Hoffman, RN
•Community Action Southwest WIC Program, Judy Holtz, RD
•Family Health Council, Nancy Pauli
•Gateway Health Plan, Connie Osborne
•Highmark Corporation, Lynne Marchese
•Monongahela Valley Hospital, Debbie Hutcheson, RD, MS, CDE and Linda Kolano, RD, LDN
•PA Educational Network for Eating Disorders, Anita Sinicrope Maier, MSW and Jen Sylves
•Pediatric Associates of Washington, Fran Sylvers, CRNP
•Penn State Cooperative Extension, Carolyn Wissenbach
•Pennsylvania Department of Health, Maureen Smith, RN, BSN
•Private Registered Dietitian, Lea Ann Ostergaard, MS, RD, LDN
•Retired Medical Doctor, Jon S. Adler, MD
•University of Pittsburgh Graduate School of Public Health, Ravi Sharma, PhD and Katie Hindes, MPH
•UPMC for you, Carol Kelley
•The Washington Hospital Teen Outreach, Karen McFedries
Nutrition Task Force
Outline of Workshop
• Coordinated School Health Program Overview
• Growth Screening Progam and Available
Resources
• Eating Disorder Sensitivity/Screening
• Hands-on Learning (small group break out)
– Anthropometric measurements
– NutStat Program
• Action Plan Brainstorming
Nutrition Task Force
Objectives
1.
2.
3.
4.
5.
6.
To understand the concept of a Coordinated School Health
Program
To be aware of available resources for the growth screening
program
To recognize signs and symptoms of eating disorders and
those at risk for development
To understand how to implement the Growth Screening
Program with sensitivity to issues surrounding eating
disorders
To understand how implementation of the Growth Screening
Program could affect negatively affect eating disorder
behaviors
To understand how to work with NutStat Program
Nutrition Task Force
Coordinated School Health
Program Overview
The American Cancer Society is the
nationwide community-based voluntary
health organization dedicated to eliminating
cancer as a major health problem by
preventing cancer, saving lives and
diminishing suffering from cancer through
research, education, advocacy, and service.
Causes of Cancer: A Review of the Evidence
Estimated Percentage of Total Cancer Deaths
Attributable to Established Causes of Cancer
Tobacco
Adult Diet/Obesity
Sedentary lifestyle
Occupational factors
Family history of cancer
Viruses/other biologic agents
Prenatal factors/growth
Reproductive factors
Alcohol
Socioeconomic status
Environmental pollution
30
30
5
3
2
Ionizing/ultra-violet radiation
Rx drugs/medical procedures
1
Salt/additives/contaminants
0
5
10
15
20
25
30
Source: Harvard Report on Cancer Prevention, Cancer Causes and Control, November/December, 1996
35
ACS Serves as a Resource and
Advocate
• Materials
• Information sharing
• Training opportunities
American Cancer Society
1-888-227-5445
www.cancer.org
Procedures for the Growth Screening Program
for Pennsylvania’s School-age Population
Growth Screening Program
• Pennsylvania will be one of the first states in the nation to track
physical growth among the entire K-12 population on an annual
basis.
.
• Screening for the upcoming school year is voluntary; mandatory
tiered implementation will start in the '05-'06 school year and
will expand three additional grades each year thereafter. By the
'08-'09 school year, all grades will be screened.
New Screening Procedure
New Screen Procedure
• Measure height
• Measure weight
• Determine Body Mass Index (BMI)
• Graph BMI on 2000 CDC growth charts
• Provide information to parents
Why Worry About Pediatric Obesity?
Epidemic
• 27% of children age 5-10 have 1 or more heart
disease risk factor
• 1 in 3 children born in the year 2000 will develop
Type II Diabetes (based on current trends)
• Obesity is now the most prevalent nutritional disease
of children and adolescents in the United States.
Conseq
Consequences
of Obesity in Children
in Children
•
Cardiovascular health hypercholesterolemia,
dyslipidemia, hypertension
(metabolic syndrome)
•
Mental health depression,
low self-esteem
Pulmonary -asthma,
obstructive sleep apnea
•
Orthopedic - slipped
capital femoral epiphysis
Endocrine system hyperinsulinism, insulin
resistance, impaired glucose
tolerance, type 2 diabetes
mellitus, and menstrual
irregularity
•
•
•
Gastrointestinal /
Hepatic - nonalcoholic
hepatic steatosis, cholecystitis
Percentage of Overweight Children and Youth
Percentage
of Overweight
Who Become
Obese AdultsChildren
& Youth Who Become Obese Adults
80
80
70
50
Percentage
60
50
Preschool
School-age
Adolescent
40
30
20
20
10
0
Percentage
Age Group
National Institute for Health Care Management, Nov 2003
BMI-for-Age Cutoffs in Children
and Youth
>95th percentile
Overweight
85th to <95th percentile
Risk for Overweight
<5th percentile
Underweight
Categorizing Weight in
Categorizing Weight in Adults and Youth
Adults and Youth
Category
Adults (21+ years)
Youth (2-20 years)
Underweight
BMI < 18.5
< 5th BMI-for-age
percentile
Normal weight
BMI ≥ 18.5 – 24.9
BMI-for-age >5th
percentile to < 85th
percentile
At risk of overweight
Not Typically Used in
Adults
BMI-for-age ≥ 85th
percentile to < 95th
percentile
Overweight
BMI ≥ 25-29.9
BMI-for-age ≥ 95th
percentile
Obesity
BMI ≥ 30-39.9
Not Used in Youth
Extreme Obesity
BMI ≥ 40
Not Used in Youth
National Institute for Health Care Management, Nov 2003
Body Mass Index (BMI)
Body Mass
Index
(BMI)
Advantages
Advantages
•
Best single measure for obesity in children
•
Highest correlation with skinfold thickness
•
Simple and useful measure
•
Track growth from childhood, through adolescence, to adulthood
•
Performed reliably and easily
•
Recommended by AAP, WHO, AMA
Body
Mass
Index
(BMI)
Body Mass Index (BMI)
Limitations
Limitations
•
Screening tool ONLY….. not diagnostic
•
Individual assessment, skinfold measurements, family history, physical
examination, metabolic findings
•
Influenced by pubertal status
•
Not specific for children with special health care needs
•
Does not differentiate between central adiposity and peripheral adiposity
•
Lean muscle mass vs. fat tissue mass.
•
Sensitive to minor changes in weight and height
Key Messages
Key Messages
•
•
•
The prevalence of childhood overweight and obesity is
increasing at an alarming rate in the United States as well as in
other developed and developing countries.
BMI is currently the best tool we have to assess adiposity in
children and adolescents.
Surveillance data for BMI can serve to assess nutritional status
of populations, monitor changes over time, promote
epidemiological research, screen and refer individuals at risk,
and develop and evaluate programs and policies.
Available Resources
• Growth Screening Program
–
–
–
–
–
–
–
–
–
–
–
•
•
•
•
•
Sample parent letters (pre-screening and results)
Health Care Resources Brochure
Parent nutrition and physical activity resource list
Parent BMI brochure and insert
School nurse informational resource list
Floppy disk (Electronic copies of above items)
Nutrition and physical activity brochures
CD ROM (Copy of NutStat Program)
NutStat step-by-step instructions
Growth screening charts
BMI wheels
Eating disorder screening/sensitivity training materials
List of task force members and resources offered
Coordinated school health program brochure and “Model Program”
Community Action Southwest brochure
Preventing Childhood Overweight and Obesity: Parents Can Make a Difference-ProjectPA Kit
Nutrition Task Force
Hands-on Learning
Two break out groups
(need to rotate each):
1. Digital and balance beam scale and
stadiometer
2. Laptop with Nutstat Program
Nutrition Task Force
Action Plan
Brainstorming Session
Nutrition Task Force
Thank you!
Contact: Washington County Health Partners, Inc.
190 North Main Street, Suite 208
Washington, PA 15301
(P) 724-222-6511
(F) 724-222-6685
(E) info@wchpinc.org