Childhood Overweight:Nutrition and Physical Activity Interventions

Susan Algert

Surgeon General’s Call to Decrease Overweight & Obesity

• Approx. 300,000 deaths a year currently are associated with obesity and overweight

• The total direct and indirect costs attributed to overweight and obesity amounted to $117 billion in the year 2000.

The Problem

• In 1999, an estimated 61 % of U.S. adults were overweight, along with 13 percent of children and adolescents

• Obesity among adults has doubled since 1980, while overweight among adolescents has tripled

The Problem

• Only 3 % of Americans meet four of the five federal Food Guide Pyramid recommendations for intakes of grains, fruits, vegetables, dairy products and meats.

• More than 60% of Americans fail to meet federal recommendations for 30 minutes of moderate activity five days a week.

• 40% of adults engage in no physical activity

California

• Approximately 18% of 4th & 5th graders were “at risk” for being overweight, and 14% were overweight

• Approximately ¼ of teens are at risk for obesity and 7% were overweight

• Low income children consistently higher rates of overweight

Costs to society

• Obesity may account for as much as 6.8% of health care costs in the U.S, roughly 100 billion a year

• Obesity is associated with a 36% increase in inpatient and outpatient expenditures

• Strong association with reduced physical health related quality of life

Communication, Action Research and Evaluation(CARE)• Change perception of obesity so that health

is main concern and not personal appearance

• Direct research toward prevention and treatment and toward ethnic/racial/ income health disparities

• Ensure daily, quality physical education in schools

CARE

• Healthy food choices in schools

• Community facilities available for physical activity

• Reduce time spent watching t.v. and in sedentary behaviors

Components of Fitness

• Strength

• Flexibility

• Aerobic conditioning

• Endurance

Energy Systems of Physical Activity

• ATP

• Creatine Phosphate

Glucose Use

• Muscles use glucose and their own glycogen stores during exercise

• When glycogen is depleted muscles become fatigued

• Diet and intensity of activity affect glycogen use

• Moderate aerobic activity can use fatty acids and conserve glycogen

Fat use during physical activity

• Energy from breakdown of fat can come only from aerobic metabolism

• Training affects fat use

• Sustained moderate activities such as walking use body fat stores as major fuel source

Protein Use

• Not a major fuel source for physical activity

• Synthesis of body proteins is suppressed during activity

• Contributes no more than 10% of fuel used during activity

• Carbohydrate rich diet spares protein from being broken down

Fluids

• Water is most important nutrient

• Water loss of 1-2% can reduce a person’s capacity to do muscular work

• Recommendation is for 1-1.5 ml/kcal or ½ cup per 100 kcal expended

• Electrolytes replaced by regular diet

Physical Activity for Children

Sports teams

Lessons

Exercising in a park, sports facility or school

Healthy Diet for Children

• Fat?

• Sugar?

• Whole grains, fruits and vegetables