1 / 36

Non-family Environmental Issues that Influence How Pediatricians Address Obesity with Families

Non-family Environmental Issues that Influence How Pediatricians Address Obesity with Families. William H. Dietz, MD, PhD Director of the Division of Nutrition and Physical Activity CDC. Factors Related to the Onset of Obesity. Altered dietary intake Decreased physical activity

wenda
Download Presentation

Non-family Environmental Issues that Influence How Pediatricians Address Obesity with Families

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Non-family Environmental Issues that Influence How Pediatricians Address Obesity with Families William H. Dietz, MD, PhD Director of the Division of Nutrition and Physical Activity CDC

  2. Factors Related to the Onset of Obesity • Altered dietary intake • Decreased physical activity • Increased inactivity

  3. Shifts in Food Practices in the United States • Fast food consumption • Reduced frequency of family meals • Restrained eating, meal skipping • Consumption of soft drinks-increased from 27 to 44 gal/y from 1972-1992 • 30,000 products in supermarkets • Increased portion size

  4. Factors Related to the Onset of Obesity • Altered dietary intake • Decreased physical activity • Increased inactivity

  5. Daily Physical Education Classes in School (9-12th graders) Year 1991 1999 % 42% 29% Source: YRBS

  6. Disconnected Network/ Connected Network Source: Frank Speilberg

  7. Factors Related to the Onset of Obesity • Altered dietary intake • Decreased physical activity • Increased inactivity

  8. Daily Television Viewing by Children and Youth by Hours Source: Kids and Media at the New Millennium, Kaiser Family Foundation, 1999

  9. (0-1) (1-2) (2-3) (3-4) (4-5) (>5) Prevalence of Obesity by Hours of TV per Day:NHES Youth Aged 12-17 in 1967-70 and NLSY Youth Aged 10-15 in 1990 TV Hours Per Day (Youth Report)

  10. CDC Funded States for Nutrition & Physical Activityto Prevent Obesity and Other Chronic Diseases Basic Implementation Capacity Building

  11. STEPS Awardees Representing 41 Communities State-coordinated Small Cities/Rural Communities Tribes/Tribal Entities Large Cities/Urban Communities Santa Clara County, CA Dekalb County, GA Hillsborough County, FL Intertribal Council of Michigan Cherokee Nation Health Services Group (Oklahoma) Southeast Alaska Regional Consortium Seattle-King County, WA Salinas-Monterey County, CA Austin-Travis County, TX New Orleans, LA St. Petersburg-Pinellas County, FL Boston, MA Philadelphia, PA San Antonio, TX Cleveland, OH WA – 4 counties AZ – 3 counties CO – 4 counties NY – 4 counties AL – 2 areas MN – 4 areas PA – 3 counties

  12. Behavior Change Strategies • Increase physical activity • Reduce television viewing in children and adolescents • Promote breastfeeding

  13. Promising Interventions • Increase fruit and vegetable consumption • Reduce soft drink consumption • Reduce portion size

  14. Intervention Sites to Prevent or Treat Obesity • Medical Settings • School • Work Site • Community

  15. Chronic Care Model Environment Medical System Patient Self-Management Family School Worksite Community Information Systems Decision Support Delivery System Design Self Management Support

  16. Intervention Sites to Prevent or Treat Obesity • Medical Settings • School • Work Site • Community

  17. School-based Approaches to Prevent or Treat Obesity • Physical education classes • Walk to school programs • Media curricula and TV turnoffs • Competitive foods and pouring contracts • Comprehensive school-based interventions

  18. Effective Interventions to Promote Physical Activity • Informational • Community-wide education • Point of decision prompts • Behavioral and social • School-based PE • Non-family social support • Individually adapted behavior change • Environmental and policy • Enhanced access with outreach • Urban design and land use

  19. School-based Approaches to Prevent or Treat Obesity • Physical education classes • Walk to school programs • Media curricula and TV turnoffs • Competitive foods and pouring contracts • Comprehensive school-based interventions

  20. Increase daily physical activity of children • Improve pedestrian safety • Educate and empower communities to create safe routes to school

  21. School-based Approaches to Treat or Prevent Obesity • Physical education classes • Walk to school programs • Media curricula and TV turnoffs • Competitive foods and pouring contracts • Comprehensive school-based interventions

  22. Effects of an 18-Lesson Elementary School Curriculum on Hours Spent Using Television, Videotapes, and Video Games n = 192 third- and fourth-grade students; self-reported data Source: Robinson TN. JAMA 1999;282:1561-7

  23. Effects of an 18-Lesson Elementary School Media Use Reduction Curriculum on Body Mass index p=.002; n = 192 third- and fourth-grade students Source: Robinson TN. JAMA 1999;282:1561-7

  24. School-based Approaches to Treat or Prevent Obesity • Physical education classes • Walk to school programs • Media curricula and TV turnoffs • Competitive foods and pouring contracts • Comprehensive school-based interventions

  25. Baseline Intervention Follow-up Effects of Increased Choices and Reduced Price on Fruit and Vegetable Consumption Fruits (#/day) Vegetables (lbs/day) Jeffery et al, Prev Med 1994; 23:788

  26. School-based Approaches to Treat or Prevent Obesity • Physical education classes • Walk to school programs • Media curricula and TV turnoffs • Competitive foods and pouring contracts • Comprehensive school-based interventions

  27. Intervention Sites to Prevent or Treat Obesity • Medical Settings • School • Work Site • Community

  28. Community-based Approaches • Communications • Community programs • Environmental change

  29. General Market Tween TV Ad: “Swing” (click camera to view video – broadband recommended)

  30. Community-based Approaches • Communications • Community programs • Environmental change

  31. Changes in the Physical Environment to Promote Physical Activity ChangeEffect Sidewalks Increased safety Traffic calming Increased safety On street parking Increased safety Grid design Increased connectivity Increased density Decreased distance Mixed use Decreased distance

  32. 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 Adult per Capita Cigarette Consumption and Major Environmental and Policy Changes in the US 1900-1990 Thousands per year Fairness Doctrine messages on radio and television Nonsmoker’s rights movement begins First Medical reports linking smoking and cancer US Surgeon General’s first report Broadcast advertising ban Federal cigarette tax doubles End of WW II Great Depression Year

  33. Role of the Pediatrician in Childhood Obesity Prevention and treatment - reimbursement - effective strategies for primary care Partnerships and coalitions Communication Advocacy

  34. Division of Nutrition and Physical Activity and VERB Websites • cdc.gov/nccdphp/dnpa • cdc.gov/nccdphp/dash • cdc.gov/youthcampaign • VERBnow.com • VERBparents.com • healthierus.gov/steps

More Related