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School Nutrition Environment And Adolescent Obesity

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  1. School Nutrition Environment And Adolescent Obesity A Training of Trainee Program Presented at the Dallas Independent School District, Dallas, Texas By Onyema Madukauba Pascal Doctoral Student of Public Health Walden University

  2. Learning Objectives 1 • To impart knowledge and skills Clip art Microsoft 2007

  3. Learning Objectives 2 • To motivate the school authorities • How? • Ban or restrict fast foods Clip art Microsoft 2007 • Create an enabling environment for exercise

  4. Obesity A Major Concern Overweight & Obesity have reached epidemic levels in the US (Ludwig, 2007). Clip art Clip art ( microsoft 2007) Ludwig, D.S (2007, December).Childhood Obesity – The shape of things to come. The New England Journal of Medicine.357(23):2325-2327.Retrieved from http://content.nejm.org/cgi/content/full/357/23/2325

  5. Incidence and Prevalence • The incidence of adolescent obesity has more than tripled in the past 30 years (CDC,2009) • Texas is one of the states with the highest prevalence of obesity; ranking 15th among 50 States of the Federation as at 2007 (TDSHS, 2009) Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html TDSHS (2010). Obesity in Texas. Retrieved from http://www.dshs.state.tx.us/obesity/pdf/THIPolicyBrief06.pdf

  6. Incidence and Prevalence • As at 2009, 1 out every 3 adolescents in the US is overweight and close to 25 % are obese ( CDC,2009) Clip art (Microsoft 2007) Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

  7. Major Health Implications • Coronary heart disease(CHD) • Type 2 diabetes • Cancers (endometrial, breast, and colon) • Hypertension(CDC, 2009). Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

  8. Economic Implications • Direct medical costs • Indirect medical costs • More than 15% of the United States GDP ( Ludwig, 2007) Ludwig, D.S (2007, December).Childhood Obesity – The shape of things to come. The New England Journal of Medicine.357(23):2325-2327.Retrieved from http://content.nejm.org/cgi/content/full/357/23/2325

  9. Social Implications • Discrimination • Stigmatization • Negative stereotyping Clip art ( microsoft 2007) Griffiths, L.J., Wolke, D., Page, A.S., & Horwood, J.P. (2006). Obesity and bullying: Different effects for boys and girls. Archives of Disease in Childhood, 91(2), 121-125.

  10. Psychosocial Implications • Depression • Low self esteem • Negative body image • Inferiority complex Sweeting, H.N,(2008). Gendered dimensions of obesity in childhood and adolescence. Nutrition Journal.7:1. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2265740pdf/1475-2891-7-1.pdf

  11. Behavioral Risk Factors • Overconsumption of calories • Lack of Physical activity • TV watching / Adverts • Parental behaviors Boone-Heinonen,J, Gordon-Larsen, P and Adair, L.S(2008,Dec).Obesogenic clusters: multidimensional adolescent obesity related behaviors in the U.S. Ann Behav Med. 36(3): 217–230. Retrieved from. http://www.ncbi.nlm.gov/PMC/articles/PMC2769258pdf/nihms.94416.pdf

  12. Environmental Risk factors • Access to Vending machine • Proximity to fast food joints • Peer group sporting activities Kleisser, C, Rosario, A.S, Mensink, G.B.M ,Prinz-Langenohl,R and Kurth, B.M (2009). Potential determinants of obesity among children andadolescentsin Germany: results from the cross-sectional KiGGS study. BMC Public Health. Retrieved from • http://www.ncbi.nlm.gov/PMC/articles/PMC2642815pdf/1471-2458-9-46.pdf

  13. Appropriate Intervention • A holistic approach

  14. Focus on Environment • Keeping with the objectives of school nutrition programs • Encouraging fruits and Vegetables • Encouraging sporting activity Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

  15. Formation of Coalition • Schools • Schools • Parent Teacher Association • Food vendors • School Nutrition Association Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb). Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2): 409–414. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf Image credit: nottingham.ac.uk

  16. School Nutrition Program • Working with US Department of Agriculture • Collaboration with the CDC • Pursuing the institute of medicine( IOM) nutrition standards Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html

  17. Vegetable and Fruits • Farm to School Programs • Turnkey nutrition education Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html Image from usda.gov

  18. Sporting Activity • Engaging students during • free plays. • Organizing sporting activities clip art ( Microsoft 2007) Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb). • Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2): 409–414. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf

  19. Environmental modifications • Banning or restricting vending machines • Creating more paths for Biking and walking • Reconstructing bus stops. Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb). Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2): 409–414. Retrieved from • http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf

  20. Challenges • Financial implications • Adherence/ Sustainability • Parental influence Newman, K.(2009).Parenting behaviors and adolescent obesity. Ph.D. dissertation, The University of Alabama at Birmingham, United States -- Alabama. Retrieved from http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com/pqdweb?did=1955643521&Fmt=2&clientId=70192&RQT=309&VName=PQD

  21. Prospects • Knowledge has a bearing on attitude and practice • Collaboration with other stake holders is a plus

  22. Conclusion • Obesity is preventable • Now is the time to act • School nutrition environment is the target.

  23. References • Boone-Heinonen,J, Gordon-Larsen, P and Adair, L.S(2008,Dec).Obesogenic clusters: multidimensional adolescent obesity related behaviors in the U.S. Ann Behav Med. 36(3): 217–230. Retrieved from. http://www.ncbi.nlm.gov/PMC/articles/PMC2769258pdf/nihms.94416.pdf Center for Disease Control and Prevention (CDC) (2009). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/causes/economics.html Griffiths, L.J., Wolke, D., Page, A.S., & Horwood, J.P. (2006). Obesity and bullying: Different effects for boys and girls. Archives of Disease in Childhood, 91(2), 121-125

  24. References • Kleisser, C, Rosario, A.S, Mensink, G.B.M ,Prinz- Langenohl,R and Kurth, B.M (2009). Potential determinants of obesity among children and adolescentsin Germany: results from the cross-sectional KiGGS study. BMC Public Health. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2642815pdf/1471-2458-9-46.pdf • Ludwig, D.S (2007, December).Childhood Obesity – The shape of things to come. http://content.nejm.org/cgi/content/full/357/23/23251

  25. References • Newman, K.(2009).Parenting behaviors and adolescent obesity. Ph.D. dissertation, The University of Alabama at Birmingham, United States -- Alabama. Retrieved from http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com/pqdweb?did=1955643521&Fmt=2&clientId=70192&RQT=309&VName=PQD • Pietiläinen, K.H, Kaprio,J, Borg, P, Plasqui,G,Yki- Järvinen, H,Kujala, U.M, et al, (2008,Feb). Physical inactivity and obesity: A vicious circle. Obesity (Silver spring)16(2): 409–414. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2249563pdf/nihms.26744.pdf

  26. References • Sweeting, H.N,(2008). Gendered dimensions of obesity in childhood and adolescence. Nutrition Journal.7:1. Retrieved from http://www.ncbi.nlm.gov/PMC/articles/PMC2265740pdf/1475-2891-7-1.pdf • Scharoun-Lee, M, Kaufman,J.S, Popkin,B.M and Gordon-Larsen, P,(2009,Jan). Obesity, Race/ethnicity and Life Course Socioeconomic Status across the Transition from Adolescence to Adulthood. J Epidemiol Community Health. 63(2): 133–139. Retrieved from http://www.ncbi.nlm.gov/pmc/articles/PMC2627789/pdf/nihms.73895.pdf • TDSHS (2010). Obesity in Texas. Retrieved from http://www.dshs.state.tx.us/obesity/pdf/THIPolicyBrief06.pdf