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The Obesity Epidemic: Implications for Public Schools: The Obesity Epidemic: Implications for Public Schools Josephine Connolly, MS, RD, Clinical Assist. Prof, Stony Brook University

The obesity epidemic is ...: The obesity epidemic is ... a social problem affects children’s health and ability to learn has economic implications a sociological problem is largely produced secondary to social structures

Obesity and Nutrition – Implications for Learning: 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

Nutritional Status & Cognitive Function: Nutritional Status & Cognitive Function Poor nutritional status affects cognitive development Low iron, zinc and protein intakes Low omega-3 polyunsaturated fat intake 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 2001 107(6):1381-1386

Slide5: Year Pounds per Person A 30% Increase www.cspinet.org

Slide6: Sugar Content of Popular Foods FOOD TSP “% Daily Value” Snickers bar, 2.1 oz. 5¾ 58 TastyKake Honey Bun, 3¼ oz. 6 60 Lowfat fruit-flavored yogurt, 8 oz. 7 70 Pepsi, 12 oz. 10¼ 103 Pancake syrup, ¼ cup 10¼ 103 Hostess Lemon Fruit Pie, 4½ oz. 11½ 115 Strawberry Passion Awareness Fruitopia, 20 oz. 17¾ 178 Sources: Manufacturers, USDA, CSPI analyses and/or estimates. Center for Science in the Public Interest, August, 1999

Sleep Apnea in Children: 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.

In General...: 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)

Obesity Trends* Among U.S. AdultsBRFSS, 1985: Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1986: Obesity Trends* Among U.S. Adults BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1987: Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1988: Obesity Trends* Among U.S. Adults BRFSS, 1988 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1989: Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1990: Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1991: Obesity Trends* Among U.S. Adults BRFSS, 1991 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1992: Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1993: Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1994: Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1995: Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1996: Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1997: Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1998: Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 1999: Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 2000: Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 2001: 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)

Slide26: 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

Factors Contributing to Development of Obesity : Factors Contributing to Development of Obesity Individual Responsibility Environmental Issues

Societal Web Influencing the Prevalence of Obesity: Societal Web Influencing the Prevalence of Obesity National Regional Community School Home Media/ Advertising Food Industry Transportation Urbanization Education Food & Nutrition Recommendations Individual Public Transportation Public Safety Health Care Local Agriculture Culture 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: Fat & Sugar Adds up Easily Recommended Sugar Max = 45 g Recommended Fat Max = 60 g 288 g 97 g

Cost of Obesity: 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

Where Can We Go From Here?: Where Can We Go From Here? Awareness campaigns Faculty and staff Community and parent level Student level Education programs Social learning theory – goal is to change behavior Policy development & implementation Evaluation Process Impact Outcome

Policy Topics: 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

Resource: Resource http://www.stonybrook.edu/heartlinks/