Youth Initiatives Cristina S. Barroso, DrPH University of Texas School of Public Health, Brownsville Regional Campus Presented at the Texas Association of School Based Health Centers 14 th Annual Child & Adolescent Conference February 12, 2010

Children Born Today have a Lower Life Expectancy than their Parents  1 in 3 will develop diabetes  3/5 if African American  ½ if Hispanic  > ½ if Native American

Obesity by the Numbers  National Health and Nutrition Examination Survey (NHANES )  9.5% of infants & toddlers ≥ 95 th percentile  16.9% of children & adolescents ≥ 95 th percentile  11.9% of children & adolescents ≥ 97 th percentile Ogden et al., 2010 BMI = body mass index [weight (kg)/height (m) 2 ]

Impact of Childhood Obesity on Adult Obesity  One out of four obese adults were overweight children  Onset ≤ 8 years – more severely obese as adults (BMI = 41.7 vs. 34.0)  One-half of adults with BMI ≥ 40 were obese as children Freedman et al., 2001

Obesity is caused by long-term positive energy balance Fat Stores ~ 600 calories per day

A Framework for Obesity Prevention

Toxic Environment  Availability & affordability of high fat/high carbohydrate food (fast food, soft drinks)  Large portion sizes  Marketing to children  Fewer family meals  TV, computers, video games  Safety issue  Decrease in physical education Schwartz MB & Brownell KD, 2007

Dollars Spent on U.S. Food Advertising in 2005  Food, beverages, candy $7,313,200,000  Restaurants & fast food $5,061,000,000 Advertising Age, 2006

NO SINGLE INTERVENTION WILL REVERSE THE CURRENT TRENDS IN OBESITY

Legislation & Policy  Passage of Senate Bill 19 9/1/2001  Daily PE (30 min/d or 135 m/week) 4 th grade  School Health Advisory Councils 4 th grade  Coordinated School Health Programs (CSHPs) 4 th grade (9/1/2007)  Texas Public School Nutrition Policy all grades (8/2004)  Passage of Senate Bill 42 9/1/2005  CSHP: 6-8 th grade ( school year)

New Legislation – Senate Bill 530 ( ) (Amends Sections and , Education Code)  K-5: 30 minutes/day  6-8: 30 minutes/day for minimum of 4 semesters  Physical Fitness assessment (Fitnessgram), grades  Pacer  Strength & flexibility  SHAC should determine importance of daily recess for elementary school students  SHAC should evaluate CSHP

4 th Grade Prevalence of Obesity* by Health Service Region in Texas, SPAN , *Obesity is > 95th Percentile for BMI by Age/Sex

Texas Senate Bill 42 (SB42) Awareness of & adherence to SB42 in a representative sample of public middle schools Impact of SB42 (along Texas-Mexico border): – Frequency of school PE class – Quality of school PE – Prevalence of child self-reported physical activity & child overweight

Are You Aware that SB42 Requires…? , Key Informants

How Did You Become Aware of SB42…? , Key Informants

What type of PE Class Schedule is Followed? , Key Informants

How Many Minutes per Class? , Key Informants

How Many Days per Week? , Key Informants

Self-Reported Structured Physical Activity of 8 th Grade Border Students, &

Self-Reported Structured Physical Activity of 8 th Grade Border Students, and (±0.0005) (±0.05)(±0.15) *p<0.001; difference between border districts and border districts

The Rio Grande Valley Solution

Coordinated Approach To Child Health (CATCH)

Does CATCH Work?  Reduced total fat and saturated fat content of school lunches  Increased moderate-to-vigorous physical activity (MVPA) during PE classes  Improved students’ self-reported eating and physical activity behaviors  Effects persisted over three years without continued intervention Luepker et al., 1996; Nader et al.,1999

CATCH Characters