Childhood Obesity in the US and Interventions that prove to reduce this epidemic
ASSIGNMENT INSTRUCTIONS (Module 4/2)
Childhood Obesity in the US and Interventions that prove to reduce this epidemic
**ASSIGNMENT INSTRUCTIONS: Discuss how childhood Obesity is an epidemic in the US, how the rates continues high, discuss how some subpopulations of children had a declines in obesity. Summarize the interventions these sites implemented (policies, initiatives,etc)that worked… and conclude discussing the huge impact that all these policies and initiatives would have on childhood obesity in the US if implemented consistently in all schools/daycare/communities in the US.
* All this information below is taken from this article: Ottley, P. G., Dawkins-Lyn, N., Harris, C., Dooyema, C., Jernigan, J., Kauh, T., . . . Young-Hyman, D. (2018). Will upload articles
**At the very end of this paper, you will find another article with some information that might help you as well. Because we need to use at least 2 references.
“Childhood obesity rates in the United States have been high over the past two decades, with ∼19% of children ages 2-19 years considered to have obesity.1,2However, in recent years, national data indicate that obesity rates have begun to stabilize among some subpopulations of children.3 These stabilizations suggest recent progress in impacting the childhood obesity epidemic.4 Numerous federal, state, and local programs and policies designed to reduce obesity have been implemented across the United States.”
A combinations of programs and policies that may be influencing obesity in children
A study examined the initiatives, policies, programs, and practices (hereafter called strategies) implemented in four municipalities that experienced declines in childhood obesity over the last decade.
Significant federal, state, and local investments have been made to address childhood obesity. Research suggests that effective approaches to reducing childhood obesity may be multilevel.6 Multilevel approaches aim to improve the nutrition and physical activity environments where children spend their time. The social ecological model (SEM) in Figure 1 illustrates how obesity prevention initiatives have been integrated across multiple levels.7-9 The model illustrates the potential impact at the community and organizational levels through local programs and policies as well as federal and state policies such as the Child Nutrition Reauthorization Act.
The study explore factors that operate at multiple levels that may have contributed to declines in childhood obesity reported by the four communities included in this study: Anchorage, Alaska; Granville County, North Carolina; New York, New York; and Philadelphia, Pennsylvania.
Comprehensive school wellness policies-nutrition
Two of the four sites adopted comprehensive school wellness policies that included nutrition guidelines for school meals and snacks and drinks from vending machines, and classroom nutrition education. In Philadelphia, the districtwide school wellness policy established coordinated school wellness councils, and it set standards for all foods available on school property during the school day. For example, the standards limited snacks' total fat content to 7 g or less per serving and sodium content to less than or equal to 360 mg per day; they offered only skim and 1% milk; and they banned the sale of candy during the school day. The wellness policy also required nutrition education that promoted fruit, vegetables, whole-grain products, low-fat and fat-free dairy products, healthy food preparation methods, health-enhancing nutrition practices, and caloric balance between food intake and energy expenditure.
Through executive order, New York City adopted comprehensive nutrition standards for all foods purchased and served by city agencies and their programs, including public schools and ECE centers, requiring agencies to comply with science-based standards for calorie, sugar, sodium, and fiber content for all meals and snacks purchased or prepared in city-funded programs.
Nutrition education
Almost all sites implemented nutrition education as a targeted strategy designed to raise awareness and teach children and parents/caregivers about healthful behaviors. In Granville, the Community Care Network clinics (healthcare setting) implemented a Health Check program that incorporated BMI screenings with education to providers and parents about childhood obesity. This expanded to include family referrals to nutrition education, including a referral to a nutritionist for any child found to be at risk for overweight or obesity. The nutrition education offered to parents included demonstrations about the amount of sugar in soda, meal planning, grocery store tours, and strategies for purchasing healthy items on a limited budget.
In Philadelphia, the EAT.RIGHT.NOW Nutrition Education Program (in the school setting), supported through SNAP ED funding, was designed to reach students in schools with a majority of low-income populations eligible for free or reduced-price lunch. In Alaska, 22 health and wellness education teachers were hired and trained to implement the health curriculum in grades 4-6 and to become the experts in the building on health and wellness topics.
Comprehensive school wellness policies-physical activity
Two sites had comprehensive school wellness policies with a physical activity component. Philadelphia implemented a physical education (PE) curriculum, including a physical fitness assessment, for each student. The policy also included using a fitness assessment tool for grades 3 through 12, and PE components related to movement, cooperation, fair play, and social skills; at least 50% of PE class time was required to be spent in moderate-to-vigorous physical activity. The policy did not, however, have a minute-based physical activity requirement. In the classroom, elementary students are given "movement breaks" for every 90 minutes of seat time, time is devoted in the elementary schedule for supervised and safe recess, and students are taught information and skills to understand the benefits of being physically active.
Alaska introduced a new health curriculum that taught nutrition and PE topics as well as others, and it was integrated with the PE curriculum that taught "lifelong" physical activity skills and values. Health, wellness, and PE time also were increased from 60 minutes per week of PE only to 90 minutes of PE and plus 30 minutes of health and wellness instruction per week in elementary schools.
Classroom-based physical activity
Two of the four sites used non-PE classroom-based activities to increase physical activity, integrating fitness breaks with the core academic curriculum. In New York City, the Move to Improve program was developed in partnership with the Department of Education and counted toward the 120 minutes of PE per week mandated by the state. The program trained school teachers and directors to implement the specific curriculum and incorporate physical activity in theclassroom. Students participated in moderate physical activity for 8 to 12 weeks with five program goals ranging from 30 minutes per day for 4 days to 60 minutes per day for 7 days. As mentioned earlier, Philadelphia trained teachers and provided elementary students with "movement breaks" for every 90 minutes of seat time.
Physical activity health education
One of the four sites offered health education in the healthcare setting to parents, reminding them to reduce sedentary behaviors and increase moderate-to-vigorous physical activity per day for their children. Through the Healthcare Referral Program from the Granville-Vance Health Department, providers and case managers gave "prescriptions" to parents reminding them that children should have 2 hours or less of TV or video games, and 1 hour or more of moderate-to-vigorous activity per day.
Facilitators of Nutrition and Physical Activity-Targeted Strategies
Many of the nutrition strategies were enhanced by federal guidelines and policies such as the 2007 federal requirements for the Child and Adult Care Food Act, the reauthorization of the Federal Child Nutrition and Women, Infants and Children (WIC) Act in 2004, and Healthy, Hunger-Free Kids Act.19 In all sites, the physical activity requirements could not be implemented without endorsement and participation from teachers and school administrators. Across strategies, state or city officials (e.g., governors, mayors) as well as leaders in the departments of health (e.g., directors, program managers) and education (e.g., superintendents, principals) were reported as instrumental and served as champions in supporting these efforts. In addition, partnerships across multiple sectors as reported by all sites (e.g., education, health, community, and faith-based organizations) led to promoting healthy lifestyles and environments. The strategies implemented across various sectors, settings, and levels were described by some respondents as a "layering effect" which, according to those respondents, improved the chances for reducing obesity rates.
#2 ARTICLE: Rosettie, K. L., ⨯, R. M., Cudhea, F., Peñalvo, J.,L., ⨯, M. O., Pearson-Stuttard, J., . . . Mozaffarian, D. (2018).
Diets of American youth are suboptimal, contributing to obesity in childhood and type 2 diabetes and cardiovascular disease (CVD) later in life [1–3]. According to the Institute of Medicine, schools are an essential setting for policies aimed at improving the diets of children and adolescents (hereafter referred to as children) [4]. Children consume over one-third of their daily food in school [4]; and childhood represents a crucial formative period given that long-term dietary preferences form early in life and that both dietary habits and obesity tend to track into adulthood
Two promising school food environment policies include provision of fresh fruits and vegetables (F&V) and competitive food restrictions on sugar-sweetened beverages (SSBs) [6–9]. Increasing F&V and reducing SSBs could be beneficial to health in childhood and later in life, especially related to adiposity and cardiometabolic disease (CMD) [10,11]. F&V provision in schools involves the distribution of free or subsidized fresh fruits and vegetables to students, often as snacks offered outside of school meals [12–14]. SSB restriction includes limiting the availability, portion sizes, or sales of SSBs in schools [15–17]. Based on the promise of such policies, in 2008 the Fresh Fruit and Vegetable Program (FFVP) was expanded nationally for elementary schools with the highest low-income enrollments to provide free fresh F&V to students outside usual school meals [18]. In 2010 the Healthy, Hunger-Free Kids Act (HHFKA) introduced Smart Snack Standards in schools receiving federal meal funding. Among other standards including age-appropriate portion sizes, the HHFKA focused on restricting SSBs in public schools, with full implementation planned for 2016 [19].
Our findings, based on nationally representative data and estimates from intervention studies of school policies and dietary habits, provide estimates of thepotential impact of national implementation of F&V provision and SSB restriction policies on diet and BMI in children and CMD mortality in adults. To our knowledge, this is the first analysis to quantify these potential effects. Our results suggest that these policies would produce moderate but meaningful changes in diet over 1–2 years, with small corresponding changes in childhood BMI. If implemented across elementary, middle, and high schools, our results further suggest that 22,383 CMD deaths/year, or about 3% of the total national burden, would be averted in adults.
Rosettie, K. L., ⨯, R. M., Cudhea, F., Peñalvo, J.,L., ⨯, M. O., Pearson-Stuttard, J., . . . Mozaffarian, D. (2018).
***Please use my references. If you add any new reference, it must be from scholarly peer review articles, nothing from .com, or other online books,etc.
*** Avoid starting any sentence with “This, these, it” a
*** try to avoid “as well as” as much as possible
**Please don’t forget to back up all the paper with citations!
Thank you!
CITATIONS
Rosettie, K. L., ⨯, R. M., Cudhea, F., Peñalvo, J.,L., ⨯, M. O., Pearson-Stuttard, J., . . . Mozaffarian, D. (2018). Comparative risk assessment of school food environment policies and childhood diets, childhood obesity, and future cardiometabolic mortality in the united states. PLoS One, 13(7), 1-16. DOI:10.1371/journal.pone.0200378
Ottley, P. G., Dawkins-Lyn, N., Harris, C., Dooyema, C., Jernigan, J., Kauh, T., . . . Young-Hyman, D. (2018). Childhood obesity declines project: An exploratory study of strategies identified in communities reporting declines. Childhood Obesity, 14, S-12-S-21. DOI:10.1089/chi.2018.0020
