The importance of healthy nutrition in school Heather O’Gorman, MPH student Walden University PUBH 6126-6 Instructor: Robert Marino Summer, 2011 Welcome, San Diego Unified School Board of Education, and thank you for joining me for this presentation regarding the health and nutrition of your students. My name is Heather O’Gorman, and I am a Master’s in Public Health student at Walden University.

Agenda Define obesity Significance of obesity Causes Nutrition guidelines How school nutrition plays a part What’s Next? Today I would like to stress the importance of improving the school nutrition environment. Read through agenda.

Objectives Describe and define obesity Recognize the importance of improving the school nutrition program Implement healthy changes By the end of this presentation, you will be able to…

Childhood Obesity Definition BMI over 30 in adults At or above 95th percentile To start off today, I wanted to talk a little bit about childhood obesity, which has been an increasing problem for public health in the last 3 decades. According to CDC (2011), body mass index (BMI) is a calculation obtained using weight and height in order to determine risk factors due to weight, and a BMI of 30 or greater is considered obese; however, in children obesity is measured by using a percentile that relates to age and sex, with a child being in the obese category if they are at or above the 95th percentile for other children their age and sex. Centers for Disease Control and Prevention (CDC) (2011). Basics about childhood obesity Retrieved from http://www.cdc.gov/obesity/childhood/basics.html

Childhood Obesity Childhood obesity has become a growing epidemic Worldwide 22 million kids under 5 are obese China had an increase of 17% for girls and 25% for boys in childhood obesity from 1985-2000 Developing countries are also seeing a rise Read first sentence: Looking worldwide there are increasing numbers of young children suffering from obesity, and those numbers continue to rise. Raj, M. & Kumar, K. (2010). Obesity in children and adolescents. Indian Journal of Medical Research, Vol.132, Pp 598-607. Retrieved from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=3&hid=119&sid=77d5bda4-ac57-4ca1-8504-3ab766e460ca%40sessionmgr104

Childhood obesity United States 25% of all children are overweight 11% of all children are obese The United States have seen massive trends towards childhood obesity. The image represents the rate of overweight and obese children per state in 2007. As you can see, the United States has a very high rate of obese and overweight children, with only 3 states having a rate from 20-25%. Dehghan, M., Akhtar-Danesh, N., & Merchant, A.T. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal, 4: 24. DOI:10.1186/1475-2891-4-24 *Image from National Conference of Legislatures, retrieved from http://www.ncsl.org/?tabid=13877

Childhood Obesity United States Cont. Obesity rates tripled in the last three years for children ages 6-11 (Rahman, Cushing, & Jackson, 2011) In San Diego, 11% of high school student are obese (CDC, 2009) Read slides: These numbers reflect the importance of implementing change. Centers for Disease Control and Prevention (CDC) (2009). The obesity epidemic and San Diego students. Retrieved from http://www.cdc.gov/healthyyouth/yrbs/pdf/obesity/sandiego_obesity_combo.pdf Rahman, T., Cushing, R.A., & Jackson, R.J. (2011). Contributions of built environment to childhood obesity. Mount Sinai Journal of Medicine, Vol. 78, Pp49–57. DOI:10.1002/msj.20235

Childhood Obesity Significance Overweight and obese children are twice as likely to remain so into adulthood Obesity leads to increased risks of: Diabetes Heart disease Cancer Poor psychological health Children that continue down the path of poor eating and exercise habits generally stay obese into adulthood. Some studies have shown that even if an overweight adolescent loses weight as an adult, there is still an increased risk of these diseases (McBride, 2010). McBride, D. (2010). Childhood obesity. Practice Nurse, Vol.39, Pp.40-45. Retrieved from http://ezp.waldenulibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=51884776&site=ehost-live&scope=site

Childhood Obesity Causes Genetics Calories consumed are greater than calories burned Poor nutrition Lack of physical activity There are many factors that contribute to childhood obesity. Genes have been shown to play a part in obesity, but for today we will focus on the behavior and environmental causes. Obesity takes place when the calories consumed are greater than the body burns. The body uses a specific amount of calories (or energy) each day just to function, so if a person consumes more calories than needed, they become stored as fat. The trick is a balance between healthy nutrition and physical activity. For today’s presentation, we will talk about how nutrition plays a part, and the importance of implementing healthy nutrition initiatives. Dehghan, M., Akhtar-Danesh, N., & Merchant, A.T. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal, 4: 24. DOI:10.1186/1475-2891-4-24

Healthy Nutrition In 2011, the MyPlate was created to replace the MyPyramid According to the USDA, the new MyPlate really focuses on enjoying food, but watching portion sizes. It recommends that half the plate should be fruits and vegetables, at least half of consumed grains should be whole grains, and switching to fat-free or low-fat milk. In addition to that, a larger focus has been set on reducing sodium and drinking water instead of drinks filled with sugar. United States Department of Agriculture (USDA) (2011). ChooseMyPlate.gov. Retrieved from http://www.choosemyplate.gov/

Healthy Nutrition Foods to limit Sodium Saturated fats Cholesterol Processed sugar Sodium is a nutrient that bodies need, but many children consume much more than is needed. Too much sodium in ones diet can increase the risk of developing high blood pressure. It is recommended that children under 8 stay below 1,200 mg, and adolescence should not consume more than 2300 mg/day, which is actually just one teaspoon of salt. According to USDA & HHS (2010), the average American ages 2 and older have an intake of about 3400/day. Many of the foods served in the school lunch program may contain high amounts of sodium, such as pizza, pasta, white yeasty bread, pre-packaged foods, and mixed chicken dishes. School lunch meals currently contain up to 1600mg, which is over 15% of the recommended daily value of sodium. Although fats are necessary for many functions in the body, saturated fats are not needed. These fats increase the calorie levels in foods, and are found in foods such as pizza, full fat cheese, sausage, and bacon. Eating foods high in saturated fat can raise blood cholesterol levels, which increases risks of heart disease. Cholesterol is only found in animal products, so in order to keep a healthy cholesterol level it is important to limit meat intake, and eat more fruits and vegetables. Foods that have added sugars generally do not have the health benefits that whole, unprocessed foods do, and added sugar really increases the amount of calories in a food item. According to the USDA & HHS (2010), calories from sugar and solid fats equal about 35%, or 800 calories, per day of the average American diet, and they do not offer any necessary nutrients. By offering healthier, fresh, whole food alternatives, it will be easier to reduce the consumption of these unhealthy foods. .S. Department of Agriculture (USDA) & U.S. Department of Health and Human Services (HHS) (2010). 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010. Retrieved from http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf

School Nutrition Survey results from high school students 35% ate at least 2 servings of fruit per day 14% ate at least 3 servings of vegetables per day 18% drank at least 1 soda each day As you can see from these numbers, only a small percentage of high school students are getting the proper nutrition. When thinking about the fact that children spend a significant amount of time at school, it is important that they have healthy options for snacks and lunch. Centers for Disease Control and Prevention (CDC) (2009). The obesity epidemic and San Diego students. Retrieved from http://www.cdc.gov/healthyyouth/yrbs/pdf/obesity/sandiego_obesity_combo.pdf

School Nutrition Last CDC survey of San Diego high schools in 2008 None of students were required to take more than 1 health education courses 83% of schools did not offer fruits or vegetables in school stores, snack machines, or during events where food was offered 22% offered unhealthy foods and beverages outside the lunch program 43% used the School Health Index to assess nutrition policies This is the most recent data from the CDC, with the next study being conducted in 2012. Hopefully with the steps that have already been taken, and the small steps that you can take now, these numbers will change in the next survey. Centers for Disease Control and Prevention (CDC) (2009). The obesity epidemic and San Diego students. Retrieved from http://www.cdc.gov/healthyyouth/yrbs/pdf/obesity/sandiego_obesity_combo.pdf

What’s Next? Follow through on new dietary guidelines USDA Proposed School Lunch and Breakfast Guidelines Work together with parents Implement nutrition education classes Children Parents There have been a lot of changes with school nutrition programs, but the work is not done. The USDA has given proposed recommendations that they hope to have completed over the next 10 years. It is important that schools step up and implement changes so that these necessary changes can be made before then. It is also important to get parents involved in this. At this time, there are more healthy choices being offered in school, but it is also important that the children learn good eating habits and follow through at home. If you recall from earlier, 22 million children under 5 worldwide are obese, stressing the importance of getting the parents on board with helping fight obesity. Offering nutrition education classes for both the children and parents may help build an alliance that can help lower the prevalence of obesity.

References Centers for Disease Control and Prevention (CDC) (2011). Basics about childhood obesity Retrieved from http://www.cdc.gov/obesity/childhood/basics.html Centers for Disease Control and Prevention (CDC) (2009). The obesity epidemic and San Diego students. Retrieved from http://www.cdc.gov/healthyyouth/yrbs/pdf/obesity/sandiego_obesity_combo.pdf Dehghan, M., Akhtar-Danesh, N., & Merchant, A.T. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal, 4: 24. DOI:10.1186/1475-2891-4-24 McBride, D. (2010). Childhood obesity. Practice Nurse, Vol.39, Pp.40-45. Retrieved from http://ezp.waldenulibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=51884776&site=ehost-live&scope=site National Conference of State Legislatures (2007). Childhood overweight and obesity trends. Retrieved from http://www.ncsl.org/?tabid=13877

References Rahman, T., Cushing, R.A., & Jackson, R.J. (2011). Contributions of built environment to childhood obesity. Mount Sinai Journal of Medicine, Vol. 78, Pp49–57. DOI:10.1002/msj.20235 Raj, M. & Kumar, K. (2010). Obesity in children and adolescents. Indian Journal of Medical Research, Vol.132, Pp 598-607. Retrieved from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=3&hid=119&sid=77d5bda4-ac57-4ca1-8504-3ab766e460ca%40sessionmgr104 United States Department of Agriculture (USDA) (2011). ChooseMyPlate.gov. Retrieved from http://www.choosemyplate.gov/ U.S. Department of Agriculture (USDA) & U.S. Department of Health and Human Services (HHS) (2010). 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010. Retrieved from http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf

Additional Resources Dietary Guidelines for Americans http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf San Diego Childhood Obesity Initiative http://ourcommunityourkids.org/ UC Davis Center for Nutrition in Schools http://cns.ucdavis.edu/ School Nutrition Association http://www.asfsa.org/ Here are some additional websites that you may find helpful.

Thank you! Thank you very much for attending this presentation. I hope that you have all gained insight on this growing epidemic and the steps that we can take to help fight it.