1. IOM APOP Texas CORD REDUCING CHILD OBESITY STEVEN H KELDER, PhD, MPH Beth Toby Grossman Distinguished Professor of Spirituality and Healing Co-Director, Michael & Susan Dell Center for Healthy Living

2. THANK YOU FOR INVITING ME!

4. PORTRAIT OF AN OVERWEIGHT CHILD

5. 5 75 percent of young Americans are ineligible to join the military. Obesity is the leading reason applicants fail to qualify for military service. Otherwise excellent recruits, some with generations of family military service, are turned away because they are obese.

7. HEALTH CONSEQUENCES

8. SCOPE AND SOCIETAL COSTS

9. NHANES AGE 12-20 Overweight is defined as 85-95 percentile Obese is defined between the 95% and 120% of 95 percentile Severely Obese is defined as greater than 120% of the 95 th percentile All34% White31% Black41% Hispanic42%

10. NHANES AGE 12-20 HOW MANY KIDS ARE WE TALKING ABOUT? Overweight is defined as 85-95 percentile Obese is defined between the 95% and 120% of 95 percentile Severely Obese is defined as greater than 120% of the 95 th percentile

11. No Data 10.7% - 13.8% 13.9% - 14.6% 14.7% - 15.7% 15.8% - 19.5% PERCENTAGE OF HIGH SCHOOL STUDENTS WHO WERE OVERWEIGHT,* 2011 * Students who were = 85th percentile but < 95th percentile for body mass index, based on sex- and age- specific reference data from the 2000 CDC growth charts. State Youth Risk Behavior Surveys, 2011

12. No Data 7.3% - 10.8% 10.9% - 11.9% 12.0% - 14.6% 14.7% - 17.0% PERCENTAGE OF HIGH SCHOOL STUDENTS WHO WERE OBESE,* 2011 * Students who were = 95th percentile for body mass index, based on sex- and age-specific reference data from the 2000 CDC growth charts. State Youth Risk Behavior Surveys, 2011

13. PHYSICAL ACIVITY AND HEALTH Activity Risk of Disease Prevention of Weight Gain Diabetes Mellitus Musculoskeletal Injury Functional Health Status CHD Stroke Osteoporosis

16. ADOPT POLICIES AND IMPLEMENT PRACTICES TO REDUCE OVERCONSUMPTION OF SUGAR-SWEETENED BEVERAGES. SSBs provide more calories and added sugars to American diets than any other food or beverage.

19. WE KNOW WHAT TO DO

20. ACCELERATING PROGRESS IN OBESITY PREVENTION

21. HBOS THE WEIGHT OF THE NATION Documentaries (4) for adult audience Short documentaries (12) on specific topics in obesity prevention Documentaries (3) for children and families Trade publication for general audiences Website (http://theweightofthenation.hbo.com/)http://theweightofthenation.hbo.com/ Social media (Facebook, Twitter, Youtube, and GetGlue) Screening kits with discussion guides Marketing efforts, including reaching families with children Written materials for school-age children and teachers (Scholastic, Inc.)

22. Briggs, M., et. al, (2010). Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: comprehensive school nutrition services. Journal of nutrition education and behavior, 42(6), 360- 71. Society for Nutrition Education. Kann, L., et. al, (2007). Health Education: Results from the School Health Policies and Programs Study 2006. The Journal of school health, 77(8), 408-34. doi:10.1111/j.1746-1561.2007.00228. 7600 food ads/year 153 F&N/ year HOW MUCH NUTRITION EDUCATION IS ENOUGH?

23. School Day Physical Education Recess & Breaks Classroom Before School After-school time After-school Programs Intramural Sports Extramural Sports ~6-7 hrs/d Active Commute To ~15 minutes Active Commute From ~15 minutes ~60 min/d ~2-3hrs /d WHOLE-OF-SCHOOL

24. CAN SCHOOL SUPPORT 60 MINUTES OR MORE OF PHYSICAL ACTIVITY PER DAY?

25. IF YOU BUILD IT THEY WILL COME…

26. GO NOODLE!

27. TE Sep, OctNov, DecJan, FebMar, Apr, May TEA 6-8 foundation curriculum Math English/ Reading Science Social Studies Activity break formats AerobicAnaerobicStretchingBreathing Delivery Type Peer Led Video LedTeacher Led TEA Foundation Curriculum: http://bit.ly/13fsUzj SCHOOL YEAR SCOPE AND SEQUENCE

28. 28 Physical activity improves academic achievement, including grades and standardized test scores. Physical activity impacts cognitive skills, including enhanced concentration, attention, and improved classroom behavior. Increasing physical education time does not reduce academic performance.

30. CATCH 2.0 EVIDENCE | COST-EFFECTIVE | SCALABLE | NATIONWIDE | RECOGNIZED| APPROVED

31. CATCH Preschool CEC Grades K-2 Grades 3-5 Grades 6-8 After School CKC Parks & Recreation CATCH FAMILY OF PROGRAMS

32. Campus Team – Program Champion Physical Education Nutrition Services Classroom Education Family Education After School Activity Breaks CATCH MODEL FOR SCHOOL HEALTH IMPLEMENTATION

33. A CATCH SCHOOL YEAR

34. Cafeteria supervisors post daily menus with GO, SLOW, and WHOA foods identified. GO, SLOW, WHOA Menu Signs

35. Randomized Control Trial El Paso replication study Travis County replication study Child Obesity Research & Demonstration project EVIDENCE

36. PASS & CATCH IMPROVES STANFORD MATH & READING SCORES * * * Murray (UTSPH), under review At Risk: adaptability, social skills, leadership, study skills, functional communication

37. First year investment ~ $10.00 per child Second year investment ~ $4.00 per child Childhood school-based programs such as CATCH are beneficial investments COST EFFECTIVENESS Sources: Brown et al., 2007; Cawley et al, 2010 Based on the published literature, the most cost-effective way to prevent obesity in youth is CATCH… – Harvard Economist, Cawley et al, 2010.