NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University The Obesity Epidemic: Implications for Public Schools Josephine Connolly, MS,

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Presentation transcript:

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University The Obesity Epidemic: Implications for Public Schools Josephine Connolly, MS, RD, Clinical Assist. Prof, Stony Brook University

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University The obesity epidemic is... ¤ a social problem F affects children’s health and ability to learn  has economic implications ¤ a sociological problem F is largely produced secondary to social structures

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity and Nutrition – Implications for Learning ¤ micronutrient deficiencies ¤ blood sugar changes and behavior ¤ dieting practices - skipping meals ¤ sleep apnea ¤ consequences of taking medication for diabetes, high blood pressure or high cholesterol

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Nutritional Status & Cognitive Function ¤ Poor nutritional status affects cognitive development F Low iron, zinc and protein intakes F Low omega-3 polyunsaturated fat intake F Iron deficiency associated with lower scores on standardized math tests ¤ Foods associated with obesity (sweetened beverages and candy, chips and sweets) not high in micronutrients…. Some obese children may also be poorly nourished ¤ Obesity associated with inappropriate dieting practices among children, i.e. skipping meals Halterman, J.S. Pediatrics (6):

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Year Pounds per Person A 30% Increase

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Sugar Content of Popular Foods FOODTSP“% Daily Value” Snickers bar, 2.1 oz.5¾58 TastyKake Honey Bun, 3¼ oz.660 Lowfat fruit-flavored yogurt, 8 oz.770 Pepsi, 12 oz.10¼103 Pancake syrup, ¼ cup10¼103 Hostess Lemon Fruit Pie, 4½ oz.11½115 Strawberry Passion Awareness Fruitopia, 20 oz.17¾178 Sources: Manufacturers, USDA, CSPI analyses and/or estimates. Center for Science in the Public Interest, August, 1999

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Sleep Apnea in Children ¤ Childhood sleep disordered breathing or sleep apnea associated with poor school performance ¤ Obesity increases risk for sleep disordered breathing in children >8 years old ¤ Chervin, et al., School performance, race and other correlates of sleep-disordered breathing in children., Sleep Medicine, 2003:4(1);21-27.

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University In General... ¤ Headaches, stomach upsets and general malaise likely associated with nutritional status ¤ “Studies continue to confirm that when children’s and adolescents’ basic nutritional and fitness needs are met, they learn better.” (David Satcher, Surgeon General Oct 2002)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1986 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1987 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1988 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1989 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1990 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1991 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1992 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1993 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1994 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1996 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1997 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1998 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 1999 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Obesity Trends* Among U.S. Adults BRFSS, 2000 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Source: Behavioral Risk Factor Surveillance System, CDC No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) Obesity Trends* Among U.S. Adults BRFSS, 2002

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Factors Contributing to Development of Obesity Individual Responsibility Environmental Issues

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Societal Web Influencing the Prevalence of Obesity National Regional CommunitySchoolHome Media/ Advertising Food Industry Transportation Urbanization Education Food & Nutrition Recommendations Individual Public Transportation Public Safety Health Care Local Agriculture Culture Fund Raising Food as Reward % Free and Reduced Physical Education/ Athletic Programs Vending A la carte Amount of Cooking Frequency of Fast or Convenience Foods Activity Level # TVs Snacking Habits Calorie Intake Nutrient Composition Type & Level of Physical Activity Genetics

Fat & Sugar Adds up Easily Time7:00 am10:00 am Noon2:00 pm4:00 pm5:00 pm6:30 pm MealBreak- fast RewardLunchB-day Party MD Check up DinnerFund- raiser Food Drink waffles syrup Juice candythrew out sandwich; juice drink & cookies Cup- cake; juice drink lollipopMcDs ¼ pounder cheese, md fries lg coke Candy Sugar grams Fat grams Recommended Sugar Max = 45 g Recommended Fat Max = 60 g 288 g 97 g

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Cost of Obesity ¤ U.S. obesity-attributable adult medical expenditures = $75 billion (2003) dollars ¤ NY State = $ 6,080,000,000 (2nd highest) ¤ About half financed by Medicare/Medicaid ¤ Suspected implication – decreased state funds for other issues, i.e. education Finkelstein, EA, Obesity Research, January 2004

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Where Can We Go From Here?  Awareness campaigns F Faculty and staff F Community and parent level F Student level  Education programs F Social learning theory – goal is to change behavior ¤ Policy development & implementation ¤ Evaluation F Process F Impact F Outcome Goal - create a healthy culture conducive to learning

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Policy Topics ¤ Nutrition education curriculum incorporated into the physical education program ¤ Prohibition of the use of food as a reward ¤ Establishment of uniform nutrition standards for all foods and beverages in the School District (including vending, school stores and fundraisers) ¤ Move towards non-food related fundraising activities

NYSDOH Healthy Heart Program Dept. Family Medicine Stony Brook University Resource