Daniel Clark MD/PhD/MPH/RN/BS/GED/Promotoro/ CHW and Kuei Lee
Daniel Clark MD/PhD/MPH/RN/BS/GED/Promo
toro/CHW and Kuei Lee
Childhood Obesity• Increasing in prevalence
(1976-1980 vs 2003-2006)– 6-11 yrs old: from 6.5% to 17.0%– 12-19 yrs old: from 5.0% to 17.6%
• 1 of 10 key health indicators for Healthy People 2010
• 15% of American children are overweight
• Inactivity and poor diet cause 300,000 deaths/year in U.S.
• Obesity-related diseases cost over $100 billion/year in U.S.
Kuei
Source: http://www.cdc.gov/obesity/childhood/prevalence.html
http://www.sph.uth.tmc.edu/catch/cns.htm
Dan
School-Based Interventions• 3 Basic Approaches:
(1) Nutrition- Guidelines- Price Interventions- Product regulation
(2) Physical Activity(3) Environmental
- Community and Family Interventions
Source: http://www.cdc.gov/obesity/childhood/prevalence.html
School-Based Interventions
• Meta-analysis• “Do School Based Food and Nutrition Policies
Improve Diet and Reduce Obesity?”
• Published and unpublished literature
• U.S. and Europe
• 18 studies met inclusion criteria
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
School-Based Nutrition Interventions: Meta-Analysis
Nutritional guidelines• Decreased total and saturated fat• Increased fruit & vegetable
availability• Improved students’ dietary intake
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
School-Based Nutrition Interventions: Meta-Analysis
Price Interventions• Increased fruit & vegetable
sales
• No negative effect on profits
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
School-Based Nutrition Interventions: Meta-Analysis
Product regulation• Decreased sale of foods with
minimal nutritional value• Unintended negative
consequences
Source: Jaime, Patricia C. & Lock, Karen. “Do School Based Food and Nutrition Policies Improve Diet and Reduce Obesity?” Preventive Medicine, Vol. 48, 1; 2009; p. 45-53.
Physical Inactivity• Independent risk factor for CHD
• 30% CV deaths
• 30% DM deaths
• 60% of cancer deaths
Source: Stone et. al., Am J Prev Med 1998;15(4).
CATCH PROGRAM• First initiated as a research study involving the University of California at San Diego, University of Minnesota, Tulane University and the University of Texas Health Science Center – Houston
• Purpose: to develop an elementary school-based program to reduce the risk factors related to cardiovascular disease.
• Four Components:
1.Eat Smart school nutrition program2.K-5 and 6-8 Classroom curriculum3.Physical Education Program4.Family Programs
CATCH: Eat Smart
CATCH: Eat Smart
CATCH: Classroom Curriculum
CATCH Activities and Games
CATCH: Family Activities
CATCH: Family Activities
CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
CATCH: Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med. 1999;153:695-704
CATCH: Follow Up Conclusions
• Intervention group demonstrated significantly healthier behaviorsas compared to the control group.
• Behavioral differences between both groups persisted for 3 years after intervention.
• The difference between experimental and control groups, though still statistically different over time, are narrowing over time.
• More research needs to be done to develop the best modalities formaintaining intervention effects beyond elementary school level.
• Programs to alter environments for elementary, middle, junior, and high schools are warranted.
Acknowledgements
LaredoLaredo• Roger PeralesRoger Perales• Kelsey VaughnKelsey Vaughn• Sylvia ArellanoSylvia Arellano• All the SpeakersAll the Speakers• La Bestia BlancaLa Bestia Blanca
HarlingenHarlingen • Pat BortoniPat Bortoni• Noe GarzaNoe Garza• Beatriz TapiaBeatriz Tapia
Questions?