What you should do to prevent childhood obesity

1. Prevention of childhood
obesity

3. Why you should listen?
 Your child is gaining weight at a faster rate
than children of same age?
 Family history of heart disease and diabetes?
 You want to improve your child’s and family’s
nutrition?
 You want to improve amount of activity or
screen time?

5. Question
How many children and adolescents aged 2-19 are
affected by childhood obesity in America?
a. 2 Million
b. 6 million
c. 12 million
d. 25 million

6. Obesity Facts
• Childhood obesity affects 12.7 million in the U.S.
• Tripled over the past 30 years
• One third of children and adolescents are overweight or
obese.
*CDC statistics are based on children and
adolescents aged 2-19 between 2011-2014

8. Prevalence increases with age
8.9% of children aged 2-5 years
17.5% of children aged 6-11 years
20.5% of adolescents 12-19 years
 All ethnic groups
 All socioeconomic classes

9. Definitions
 Body mass index (BMI) :
Calculation used by pediatricians using a child’s
weight relative to height as an initial step to
evaluate their weight status
Overweight:
BMI between 85-95th percentile for age and
gender
Obese:
BMI above 95th percentile for age and gender

11. Risk Factors
 Risk factors for childhood obesity can begin
before a child is even born.
 Parents' obesity
 Mother smoking during pregnancy.
 An infant who is never breastfed, doesn't sleep
enough.

12. Environmental Factors
 4 fold risk if watch TV > 5 hrs vs 2 hrs
 Inactive
 Snacking

13. Question
 Childhood obesity increases the risk for:
a. Asthma
b. Diabetes
c. Cardiovascular disease
d. Depression
e. Obesity in adulthood
f. All of the above

14. Acute and Chronic Health
Concerns
 High Blood Pressure
 High Cholesterol
 Diabetes
 Asthma
 Sleep Apnea
 Skin infections (fungi trapped in skin folds)
 Joint discomfort
 Liver disease
 Gallstones
 Menstrual abnormalities
 Gastro-esophageal reflux (GERD)
 Stroke
 Cancer

15. Disordered eating
 Obsession with excess pounds
 Distorted body image
 Unusual diets, skipping meal, eliminate food
groups
 Eating disorders (e.g. bulimia, anorexia)

16. Mental Health Concerns
 Higher rates of:
Attention deficit hyperactivity disorder
Conduct disorder
Depression
Anxiety
Mood disorders

17. Lower quality of life
Lower physical
and
Social functioning

18. Increased problems in schools
 Increased absences
 Repeating grade
 Behavior problems

19. Question
What are the 3 major contributing factors to obesity?
a. Inactivity
b. Increased consumption of high-caloric foods (Food
choices)
c. Genetics
d. Media use or Screen time

20. Contributing factors

22. My child and I deserve the blame
for this weight problem?

23. My child’s weight problem needs a
quick fix?

24. My child will grow into the excess
pounds that he has?

25. My child seem overweight
according to growth charts, but, our
entire family is big-bonned so I
don’t think he has a weight
problem at all.

26. actually needs to eat more food to
stay healthy

28. Question
What is the major factor impacting food choices today?
a. Availability
b. Color
c. Convenience
d. Taste
e. Cost

29. Childproof your home
 Just like putting knifes and other sharps,
matches out of reach

30. Choices from the 5 major food
groups
 Grains: whole grain breads, oatmeal, brown
rice, pasta, potatoes
 Dairy products: milk, yogurt, cheese
 Vegetables: beets, broccoli, carrots, green
beans, peas, spinach
 Fruits: bananas, apples, pears, strawberries
 Meat/protein: lean cuts of beef, skinless
poultry, fish, eggs, peanut butter, beans,
reduced fat deli meats, tofu

31. What about Low-fat Milk?
 Whole cows milk after 1 y/o
 Limit to 32 oz/day
 If your child is/at risk for being overweight, use
2% reduced fat milk
 Do not give 1% or nonfat (skim milk) before 2
y/o

32. Guidelines emphasize..
 Vegetables: Choose a variety from dark green,
red, yellow, orange
 Fruits: Choose whole fruits when possible
 Grains: Make half of them whole grains
 Dairy: Choose fat-free or low-fat
 Protein: Choose from a variety of sources (sea
food, lean meats, eggs, beans, nuts, seeds, soy
products)
 Oils: Canola, corn, olive, peanut, safflower,
soybean, sunflower should replace solid fats

33. Make small changes..
 Try one vegetable per week
 Cut down on sugary beverages and substitute
water
 Eat at least one meal together as a family

34. Make small changes..
 Bring healthier snacks to family/friend
gatherings
 Trade one snack food each shopping trip for
more fruits and vegetables
 Split meals to control portions when eating at a
restaurant

35. Choose right snacks
 Plan snacks ahead of time
 Some healthier options for desserts and
snacks:
Fruit, low-fat/frozen yoghurt, low-fat oatmeal
cookies, cucumber slices, frozen banana,
unsalted pretzels, baked tortilla chips, baked
potato chips, frozen fruit bars, fresh
strawberries, air-popped popcorn, low-fat
cheese, crackers, sugar-free cereals,
homemade granola

36. ChooseMyPlate.gov

37. Food Shopping
 Plan ahead
 Shop at a market that you are familiar
 First shop at along the outer borders where
fresh fruits, vegetables..
 Invite the older child to shop and learn about
nutrition labels and be an active participant in
healthy options
 Check it out before checkout

38. Once you are in kitchen..
 Trim all visible fat
 Remove skin from chicken
 Use broiling, roasting, steaming more
 Include children in cooking appropriate to their
age

39. Healthy Eating
• Half the plate should be fruits and
vegetables
• Decrease sodium, saturated fat,
and sugar intake
• Do not skip breakfast
 Offer the same foods for everyone
 Do not reward or punish with food
 Offer appropriate size portion

40.  Plan ahead for those times
 Sit together as much
 Fix breakfast the night before
 Keep things simple
 Turn the trips to the fast food restaurants to
once-in-a-while experience

41. Limit or completely avoid sugary
drinks

42. Schedule the meals and snacks
instead of allowing grazing

43. Turn off the TV during meals
Limit unconscious eating

44. Physical Activity, Sedentary
Behavior, and Sleep

45. Question
How many hours does the average school-age child
spend in front of a screen?
a. 2 hours
b. 4 hours
c. 7 hour
d. 9 hours

46. Question
How many hours should a school-age child engage in
aerobic physical activity?
a. 30 minutes
b. 1 hour
c. 1 or more hours
d. 2 hours

47. Physical Activity
According to the CDC children and adolescents should
engage in
60 minutes or more of physical activity daily.
• Aerobic Activity
• Muscle Strengthening
• Bone Strengthening

48. Physical Activity= Better Health
 Stronger bones and joints
 Greater muscle strength
 Decrease in body fat
 Improved flexibility
 Healthier cardiovascular system
 Reduced likelihood of developing diabetes
 More energy, less stress
 Self confidence, self esteem
 Better concentration at school

49. What activity should you
choose?
 Your child, NOT YOU, should be the person
making the choice
 Anything that involves movement qualifies for
physical activity
 Free play can be a powerful form of
 AAP recommends only free play, rather than
team sports up to age of 6 years

50. Pre-school aged child
 Make sure some balls and play equipment are
available whenever your child goes outside
 Let him decide on what he wants to do:
- Playing with supervision on backyard, joining
a gymnastic program, installing a sandbox,
having toys
, hide-and-go seek together, visit to zoo

51. Give options, do not insist!
 “If you weren’t watching TV, what could you be
doing instead? Could you jump rope? Play
tennis? Go in-line skating? Go for a walk?”
 “Here are a few activities you could do this
afternoon. You could swim, go bowling with
your brother, go for a walk with me, play with
your soccer ball in back yard.”
 Do no say “ It is time for walk on the treadmill!”

52. Activity must be fun!
 Some children may feel self-conscious or
embarrassed about participating in group play
 Plan with a special friend, or sibling with him
he feels comfortable
 Activity must be fun whether or not he is
successful
 If feeling unsafe about playing outside, after
school programs, YMCA, Boys & Girls club..

54. Turning Family Time Into Active
Time
 Going to the park for a bike,
 going to the zoo,
 spending time gardening,
 play catch in the backyard
 Wash the car together
 Fly a kite as a family
 Family walk in the evening around
neighbourhood

55. Screen Time
 29% of children under 1 years old watch TV about 90
minutes daily.
 64% of toddlers watch TV for about 2 hours daily
 Preschoolers spend about 2.2 to 4.6 hours in front of a
screen.
 School-age children spend about 7 hours daily in front
of a screen.

56. Screen Time
The American Academy of Pediatrics (AAP) released a
statement in November 2016 discussing the impact of
media on cognitive, language, motor, social, and emotional
skills of children.
www.healthychildren.org/MediaUsePlan

57. Screen time and other concerns
 Irregular sleep patterns
 Sleep disturbances
 Delayed language skills
 Less time engaged in creative play to develop
problem-solving skills
 Decreased interactions and decreased socializing
 Lower academic achievements and poor grades
 Increased psychological difficulties

58. Screen Time and Media:
AAP Recommendations
 Avoid digital media in children 18-24 months of age.
If you choose to introduce digital media, choose high
quality programs and do it together!
 Limit screen time for children 2-5 years to co-
viewing 1 hour per day high quality programs. Help
children understand and apply concepts to world
around them!

59. Screen Time andMedia: AAP
Recommendations
 Avoid fast-paced and violent content.
 Do not leave televisions on when not in use.
 Do not use media to calm child.
 Monitor media and downloaded content.
 Make mealtimes media and screen free.

60. Screen Time andMedia: AAP
Recommendations
 No screens 1 hour before bed.
 Create unplugged spaces
 Use new technology in social and creative ways
 Do not substitute sleep, activity, play, reading or
social interactions with media or screen use.
AAP: Media and Young Minds (2016)
http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/19/peds.2
016-2591.full.pdf

61. Importance of Sleep
 Lack of sleep increases the risk for obesity
 Birth to 4 months: 14 to 15 h (including naps)
 4-12 months: 12 to 16 hours
 1 to 2 years : 11-14 hours
 3 -5 years: 10-13 hours
 6-12 years: 9-12 hours
 13 to 18 years: 8-10 hours

62. Tips on sleep
 Bedtime routine
 Giving a bath, reading a book, singing songs,
etc..
 Keep a track
 Minimize changes in bed time and wake up
time by helping school aged children
 Keep screens out of bedroom
 Turn off the TV for 30 min-1 h before sleep to
prevent sleep problems

63. Your role as a parent
 Developing a consistent approach
 Put health first
 You are the agent for change!
 Customize approaches for your Family
 Power of a family
 Structured eating
 Keep focused on the goal

64. What’s your parenting style?
 Asses your strengths and challenges
 Your family background
 Family interactions
 Emotions and Food
 Managing setbacks and detours
 Conquering Obstacles
 Sneaking food
 Your child’s hunger
 Vacations, holidays, family gatherings

65. SUCCESS
Monitor progress
Reward Success (NOT with food!)
Make adjustments
Change things up
Keep it fresh
Have fun!