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Affects of Nutrition and Weight Status in Children

Tatanya Swan

September 14, 2012

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Table of Contents

Abstract

Introduction

Theories and Construct

Message and Channels

Tactics and Evaluation

Conclusion

Abstract

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Over the past decade, the nutrition and weight status of child in the United States has become a public health concern. This has causes chronic health diseases to occur as children continue to develop. In the local community, change will be influenced by health professional, parents, school faculty, and health departments through the use of social cognitive theory and cultivation theory that assist in the development of specific, measurable, attainable, realistic and timely goals. The use of the new “My Plate” will be used as a visual aid for child to understand all the food groups that are essential to a balance diet such as fruits, vegetables, whole grains and low-fat dairy products (Neuman, 2011). The success of the plan will be evaluated within a three to six month period that allows the children to work toward their goals set for a healthier lifestyle and the cafeteria manager will also be evaluated based upon the changes made to the lunch menu.

Introduction

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In the United States, the overall health of a child’s nutrition and weight status is a

fundamental component that can affect his or her growth, development, and resistance to disease.

As a result, nutrition and weight is a public health concern for children across the US. The

overconsumption of foods high in calories, fats, cholesterol and sodium are the main reason for

the chronic health problems associated with poor nutrition and weight control. “Being

overweight during childhood and adolescence increases the risk of developing high cholesterol,

hypertension, respiratory ailments, orthopedic problems, depression and type 2 diabetes as a

youth. One disease of particular concern is Type 2 diabetes, which is linked to overweight and

obesity and has increased dramatically in children and adolescents, particularly in American

Indian, African American and Hispanic/Latino populations. The hospital costs alone associated

with childhood obesity were estimated at $127 million during 1997–1999 (in 2001 constant U.S.

dollars), up from $35 million during 1979–1981” (HHS, n.d.). In 1994-1996, the Food Guide

Pyramid servings recommended, children are only consuming 12 to 30 percent of dairy and 14 to

18 percent of fruit. In replace of milk, children are consuming three or more eight ounce servings

of soda per day and continue to increase at a fast pace (HHS, n.d.). However, the “My Plate”

design is now replacing the Food Guide Pyramid template which was complicated for a child to

decipher and now is illustrated as a typical eating plate split into four sections (Neuman, 2011).

The most common nutritional deficiency faced by children in the U.S. is iron deficiency

and is highest in low income families making children even more susceptible to the deficiency.

A child’s nutrition and weight status can be accessed through dietary measures, growth, physical

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activity, and blood evaluations. The Center for Disease Control and Prevention implemented the

Pediatric Nutrition Surveillance System (PedNSS) in order to monitor low income children

growth and blood assessed to evaluate common nutrition and weight problems such as

retardation, obesity, iron deficiency, and anemia (Parvanta et al., n.d.).

As a way to promote a healthier generation of children, the Healthy, Hunger-Free Kids

Act was approved by President Obama under the regulation of the United States Department of

Agriculture Food and Nutrition Service to assist with the improvement of nutritious school

lunches across the U.S (USDA, 2012). In order to influence healthier eating habits and increased

physical activity in the local community, public health communicates messages through health

seminars, health fairs, commercials, news broadcasts, podcasts, websites, and billboards.

Research over the years has shown that obesity is related to chronic diseases. Rosenbaum

(1989) discovered that 25% of children diagnosed with obesity are affected by the condition into

adulthood. The Public Health Service (1991) identified excess weight gain due to the influence

of factors including genetic make-up, environmental, cultural, psychological and socioeconomic

conditions. To intervene with high risk obese children, the PedNSS is used to pinpoint the set

population and implement an intervention plan.

As an initiative to help solve the obesity problem affecting children nutrition and physical

fitness, Michelle Obama, the first lady, is dedicated to the passing of the Childhood Nutrition

Reauthorization Bill as a way to ensure the children receive nutritional meals in school to remain

healthy. The Healthier US Schools Challenge is a program that requires schools to meet higher

standards around food served, nutritional information provided, and physical education. Child

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nutrition can be improved through the Healthier US Schools Challenge by increasing school

participation, application assistance, and reward. The improvement of school lunch and breakfast

will increase the number of children consuming healthier nutritional meals. As a monetary

incentive, the program is designed to compensate participating schools with funds for each level

of the program completed. In addition, the program support efforts to ensure doctors are

screening children for obesity and counseling parents on strategies for keeping children at a

healthy weight. By having a program geared to the promotion of healthier lifestyles teaches

children to eat quality meals full of vegetables and fruits and to reduce the amount of sweets

consumed on a daily basis, not to mention, the nutritional facts provided on food labels (White

House, 2010).

Theories and Construct

The two communication theories that apply to the promotion of proper nutritional habits

and weight control in children are social cognitive theory and cultivation theory. Social cognitive

theory (SCT) suggests that an individual’s behavior is mutually influenced by a person’s

thoughts and emotions as well as his or her environment. For example, a child’s decision to be

involved in or not to be involved in physical activity or over indulgence of fast foods can be

heavily influenced by advertisements on television, radio stations, magazines and newspapers. A

child who does not have a supportive and attentive parent is more likely to consume fatty food

high in calories and less likely to exercise. In addition, if the child lives in an area full of crime

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and violence, the chances of the child wanting to go outside and ride a bike, skate, skateboard, or

play sports are very low.

Cultivation Theory emphasizes the influence that television can have on individuals'

attitudes. The more television one watches, the more likely his or her attitude is created by the

images on the television, especially if the images are relevant (Lindquist, 2006). Therefore,

social cognitive theory and cultivation theory play a factor in the development of a child and the

influences of social media that help to persuade a child to either take part in physical activities

and eat a balance meal or overtime become obese with chronic illnesses.

According to Davies & Fitzgerald (2008) explained to be successful in preventing and

overcoming overweight and obesity on a wide scale, both individual and environmental

strategies must be combined in a variety of settings. Some environmental interventions

developed to address the problems of overweight and obesity include community gardens,

removal of fast food courts from schools, healthy food options in vending machines in

workplaces, marketing smaller portion sizes by the food industry, and policy based regulation of

advertising and promotional strategies. There is a role for the media in coverage and promotion

of all environmental strategies.

The benefit of weight loss in obese children is the prevention of diabetes, psychological

effects, possible cancer, hypertension, and cardiovascular disease. The psychological condition

can highly stigmatize conditions that may affect a child’s ability to gain acceptance amongst

peers and signs of low self-esteem that hinder educational achievements and possible

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employment in the future. Schiavo (2007) explained health communication programs can

highlight the cause and effect relationship between desirable outcomes and recommended

behaviors. It can also contribute to the development of tools and resources that will recommend

easy-to-achieve steps for recommended behaviors and set realistic expectations.

Message and Channels

Early in life, healthy nutritional behavior is vital to the promotion of healthy nutritional

weight. The primary goal of the plan is to overcome poor nutrition and obesity in children by

reinforcing healthy eating habits and increase physical activity. Although, a child may be

overweight and eat a poor diet, it is important that the child is mentored and influenced at home,

child care setting, schools, churches, and in the local community to make healthy decision about

his or her meal choices that does not inhibit the necessary caloric intake to support normal

growth and development. The use of the new “My Plate” can be used as a visual aid for child to

understand all the food groups that are essential to a balance diet such as fruits, vegetables,

whole grains and low-fat dairy products (Neuman, 2011). Studies have shown that families who

eat at least one meal together will typically increase the consumption of fruits and vegetables and

decrease the amount of fats and sugars eaten. University of Windsor and Western Ontario in

Canada evaluated over 1,200 children between the ages of 10 to 14and discovered that families

who eat together have a positive impact on their nutritional diet (Teja and Chunara, 2012). The

European Journal of Clinical Nutrition identified two thirds of the children “ate dinner with at

least one parent 6–7 days a week; some only 3–5 days a week and 15 per cent for 0–2 days a

week” (Teja and Chunara, 2012). The plan will assist in influencing the school board to

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reactivate physical education courses consisting of 60 minutes of moderate to vigorous physical

activity each day along with nutritionally balance school lunches (Bellows & Roach, 2009). The

project goal is supported by two specific measurable objectives: modification of four obese

genetic protective factors related to childhood obesity (minutes engaged in physical activity,

servings of fruits and vegetables consumed, servings of sugar-sweetened and sugar-free

beverages consumed, and minutes engaged in screen time), and reification of five

maternal-mediated constructs of SCT (environment, expectations, emotional coping, self-

control, and self-efficacy) (Knowlden & Sharma, 2012). Adam Knowlden and Manoj Sharma

(2012) explained Social Cognitive Theory (SCT) is a robust theoretical framework for

addressing childhood obesity. SCT is a behavior change model rooted in reciprocal determinism,

a causal paradigm that states that human functioning is the product of a dynamic interplay of

behavioral, personal, and environmental factors.

The various communication media channels that have the greatest impact in benefiting

children nutrition and weight control in the public health system uses strategic disseminate of

health information through interpersonal channels such as counseling sessions, one-on-on

meeting with the child, peer education as support, and provider patient encounters. These

channels of communication are achieved through tactics such as health fairs promoted by

popular cartoon characters (Schiavo, 2007). The communication strategy used will help in the

persuasion of children pledging to give up saturated fat snacks and high fructose drinks. By

doing so, the children will adapt to the nutritional and physical changes faster which will assist

with developing personalities and diversities despite economic status, religious belief or gender.

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The existing barrier that may complicate the intervention of improving nutritional and

weight control in children is sedentary behavior and specifically television viewing (Schiavo,

2007). Since Sedentary behavior, and specifically television viewing, has replaced the time

children spend in physical activities that has contributed to the increase of calorie consumption

through excessive snacking and eating meals in front of the television. This has negatively

influenced children to choose high-calorie, low-nutrient foods through exposure to food

advertisements, and decrease children’s metabolic rate (Bellows & Roach, 2009). In order

address these concerns, the intervention will partner with gaming system companies such as WII,

X-BOX, Play Station to help implement addition products that allow the child to interact and

move to help increase metabolic rate.

Tactics and Evaluation

At the local level, the initiative to help improve nutrition and increased physical activity

will contribute to the changes being made amongst the local school board, health professional

and parents. In addition, at the state and federal level, the Dietary Guidelines set in place for

Americans will also be regulated to ensure that the food being distribution to children in schools

follows the guidelines set in place. The food being distributed in local grocery stores will focus

on strategic advertising methods that will help influence healthier food choices through in-store

coupons. By doing so, this will increase of availability to nutritional sources of food that is

affordable for the local community. The increase in the amount of time provided for physical

education and sports programs in local schools will help in the influence of healthier lifestyles

and promote the consumption of healthier meals both at home and at local fast food restaurants

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(RWJF, 2012). The 2012 Olympic Games contestants have promoted healthier meals at

McDonald restaurants across the world that are under 400 calories that proves that healthier

choices can be made at fast food restaurants (Tepper, 2012).

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The role of public health leader in managing a crisis situation such as the improvement of

nutritional and weight control in children is to effectively assess the crisis, pinpointing root

cause, implementation of a resolution and the ability to communicate a response that will be used

to alleviate the situation through a crisis communication team (CCT). The communication

response plan would be carried out based upon the seven steps such as activating the CCT,

gathering of information pertinent to the crisis, assessing the gravity, identifying key

stakeholders or partners, implementing a communication strategy to the local community,

developing external materials, and informing the local community through media

communication (Rowitz, 2006).

In order for the intervention be classified as effective in the improvement of nutrition and

weight control of children in the United States, the support from the local, state, and federal level

will be greatly needed to carry out the message to the local communities, school boards and

parents through the use of social and mass media communications, not to mention, the seminars

and advertisements used to broaden the knowledge and the resources given to the school, grocery

stores, and health professional to carry out the dream. The timeframe for results to be shown

from these initiatives will take approximately five years and schools will have to prove their

changes over the course of two to three years. Incentives and grants will be used to help

influence these changes.

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Once the intervention is launched, the changes incorporated amongst the local

community will be evaluated based upon food inspectors, fitness trainers, and local health

department assessment of the food be distributed in schools and the average BMI of the children.

If the assessment, identifies that little to no changes have been made from the time the

intervention was started, then the school will have to development an action plan that will bring

about change within the next three to six months. After the three to six month, if no changes have

been made, the incentives and grants will be discontinued and food inspectors and fitness trainers

will have to be brought in to assist in the creation of a new approach to increase nutritional meals

and physical activity. Once the new nutritional approach and exercise regimen is used, the

children will most likely demonstrate social and behavior changes through increase desire to

make new friends, desire to take part school sports, and increased self –esteem.

The S.M.A.R.T (Specific, Measurable, Attainable, Realistic and Timely) goal setting

approach guides a child and his or her parent through the process of identifying obtainable goals.

A child may agree to a specific goal such as refraining from “Happy Meals” from McDonald and

replace it with a healthy and nutritional sandwich from Subway. The child can develop a

measurable goal such as going outside to ride his or her bike for an hour three times a week after

school. In order to maintain a healthy and fulfilling diet, the child can replace sweets with health

whole grain snacks, fruits, and vegetables which will be attainable and realistic for a young child.

The timeframe for achieving the goal should be care and manageable such as a three month

period including weekly weight assessment (Colorado Association, 2011).

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Within three to six months, the school cafeteria manager will revise the school lunch

menu including a reduction of high sodium meals and high saturated fats. The meals that are

served will be prepared with natural ingredients and have 0 grams of Trans fat. In order to ensure

the accessibility of natural ingredients, the school cafeteria manager will create a contract with

various state farm distributers that can deliver large quantities of items for approximately a

month at a time. Since the natural items such as milk, meats, fruits, vegetables, and herbs will be

purchased in bulk the cost of the items are significantly reduced. When working with natural

ingredients the incorporation of various fruits, vegetables, and herbs will make any child’s

school lunch delicious and appealing to any child, despite a picky appetite. By having a school

wide meeting with the children and providing a survey of their favorite meals will provide

cafeteria managers with specific areas of improvement for certain meal such as turkey burger

instead of a beef hand burger. These goals within the school will be measurable based upon

school nurse evaluations of children and the overall reduction of weight in obese children at the

end of the six month period.

Conclusion

In conclusion, childhood nutrition and weight status is fundamental component

that affects the growth, development, and resistance to disease. Due to the overconsumption of

food high in saturated fats, nutrition and weight control in children has become a public health

concern in schools. As a way to promote a healthier generation of children, the Healthy, Hunger-

Free Kids Act was approved by President Obama under the regulation of the United States

Department of Agriculture Food and Nutrition Service to assist with the improvement of

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nutritious school lunches across the U.S (USDA, 2012). In order to influence healthier eating

habits and increased physical activity in the local community, public health officials

communicate messages through health seminars, health fairs, commercials, news broadcasts,

podcasts, websites, and billboards. The communication theories that apply to the promotion of

nutritional foods and weight control are social cognitive theory and cultivation theory that help in

the change of social and behavioral problems. The visual aid that assist in the influence of

healthier meals for children is the “My Plate” that helps children understand the four food groups

in a simply fashion (Neuman, 2011). The S.M.A.R.T (Specific, Measurable, Attainable,

Realistic and Timely) goal setting approach guides both the child and the cafeteria managers in

making decisions that are obtainable within a three to six month period. The positive influences

made on the minds of impressionable child at a young age help in the decision making process

for choosing nutritional foods and increasing physical activity that promote healthier lifestyles as

each child continues to grow. As the local community partner with schools, parents, teachers,

heath professionals, and health departments the resources obtained through various

communication methods will help in the development of a more informed and knowledgeable

society. Overtime, the decisions made will help in the reduction of chronic diseases that may

develop within children.

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