Running Head: COMMUNITY PROBLEM REPORT: CHILDHOOD OBESITY

Community Problem Report: Childhood Obesity Laurence Loiselle, Raul Vasquez Rascon & Ashley Raulston University of Texas at El Paso

CHILDHOOD OBESITY Abstract The United States of America is a large and diverse community, which has common goals and challenges. One of those challenges is the phenomenon of childhood obesity, which can be explored in a report. This community problem report is divided in three categories, each linked to a question on childhood obesity: the effects of childhood obesity on future generations, the epidemic resemblance of childhood obesity in a worldwide context, and the policies and legislature in place to decrease childhood obesity. Further research has to be conducted to acquire a better understanding of all the different facets of the phenomenon of childhood obesity. Introduction For decades, the American public has been bombarded with publicities promoting

teas, medications, workouts, and more, all promising miraculous weight loss. Although some people may argue that there is no need for all those products, some would agree that there is an enormous demand for a working weight loss program since childhood obesity has double over the course of 30 years (Childhood Obesity Facts, para. 1). As a matter of fact, a large number of studies have been conducted, with the goal of tracking, understanding and finding ways to decrease childhood obesity. To understand the extent of the phenomenon of childhood obesity, it is essential to discuss its effect on future generations, the policies related to decreasing obesity in children, and how it affects not only the U.S, but also the world population. How Will Childhood Obesity Effect Future Generations? According to the website Centers for Disease Control and Prevention (2013), Childhood obesity has more than doubled in children and tripled in adolescents in the past

CHILDHOOD OBESITY 30 years (Childhood Obesity Facts, para. 1). The possibility of health risks can occur immediately in childhood, and can have long-term effects once into adulthood. Even if the

symptoms of health issues are not present in childhood, they are more likely to be seen early in adults whom were overweight in childhood. Health risks have increased and become more severe in obese children. Daniels (2006), stated that Many health conditions once thought applicable only to adults are now being seen in children and with increasing frequency (p. 47-48). Such heath conditions include high blood pressure, early symptoms of hardening of the arteries, type 2 diabetes, nonalcoholic fatty liver disease, polycystic ovary disorder, and disordered breathing during sleep (Daniels, 2006). Childhood obesity can also increase the risk of heart disease and can accelerate the processes that lead to heart attacks and strokes in adulthood. With childrens bodies still developing, it is possible they will become prone to related obesity health risks in their young age. Childhood obesity may also have psychosocial effects into adulthood. An article that discusses the psychosocial effects of childhood obesity into adulthood is Childhood Weight Affects Adult Morbidity and Morality. Dietz (1998), stated Because children who are overweight may grow up to be more obese as adults, their risk of morbidity and morality in adulthood may be increased (p.413S). Psychosocial effects due to obesity represent the second major source of adult morbidity in childhood and in adolescence. Certain psychosocial effects, which are found in only women and not men, are completion of fewer years of education, higher rates of poverty, and lower rates of marriage and household income. (Dietz, 1998, p. 411S). Childhood obesity may be a result of many factors such as low self esteem, unhealthy eating choices, neglect, child abuse, and many more. Many consider it a controversial topic

CHILDHOOD OBESITY that may have different opinions. Psychological and physical abuses can affect children and cause harm to their bodies. According to Robinson (2012):

Obesity is linked to five of the 10 leading causes of death in the US. Diseases of the heart, cancer, stroke, diabetes and kidney diseases account for 59% of deaths. Obesity is also linked to sleep apnea, gallbladder disease, arthritis, binge-eating disorder and depression. Failing to prevent obesity may result in decreased life expectancy and increased health risks. Robinson (2012) states Over the next few decades, life expectancy for the average American could decline by as much as 5 years unless aggressive efforts are made to slow rising rates of obesity. Is childhood obesity concentrated to the US or is it a worldwide phenomenon? During the past decade, the American public has been overwhelmed with newspaper articles, pictures and campaigns with one common goal, to bring awareness to the phenomenon of childhood obesity. It is now common knowledge that Americans have to face the challenge of overcoming childhood obesity, but are they alone? According to the Harvard School of Public Health (2013), all five continents are concerned: it has become truly a global problema globesity epidemic, as some have called itaffecting countries rich and poor(par. 2). Although most countries are affected by this phenomenon, some are dealing with fast growing rates, anxious populations, and poor educational systems, making each case unique. One of the main concerns of the globalization of childhood obesity is that it is spreading to less industrialized areas and countries. As stated in Epidemic of Childhood Obesity Among Chinese Children and Effectiveness of School-Based Interventions, a study

CHILDHOOD OBESITY led by Lee and Keung (2013) on childhood obesity in less populated areas of Asia: Obesity prevalence among children is rising in virtually all countries with rapid acceleration in countries with brisk economic development such as China (p.37). Keung and Lees (2013) results demonstrate an increase in the amount of overweight and obese children in some administrative regions of China, in this case, Macao. Some of the explanations given by the authors for the increase of childhood obesity in midsized cities were the diet transition taken

by Chinese families and the increase in gross domestic product (GDP) (Lee & Keung, 2013). Although the GDP and the diet of the Chinese population are two important factors, it cannot be inferred that they are the sole reasons accounting for the increase of childhood obesity. Many more factors have to be taken into consideration; one of which is the education system in which children evolve. Nutrition plays an essential role in maintaining a healthy weight; with that in mind, it could be argued that the art of picking nutritious aliments should be taught in school. Some American education systems are already taking a step in the right direction by making a semester of health class in high school mandatory, but some European countries are taking it a step farther. A report written by Kate Hill (2013) on a French PhD students study of the Australian way of instructing children how to treat meal time, revealed that the frame of an education system can influence how the children approach eating. The report explored the French and Australian regular school day and how there structure influenced the eating habits of children. Some changes made by the French government to help reduce childhood obesity through the education system were to forbid candy, and give more time for children to eat so they would not be eating often, quickly and mindlessly(As cited in Hill, 2013, par. 15). The point was that children should learn to care for their alimentation, by allowing more time for

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them to eat, they will inevitably pay attention to what is on their plate (As cited in Hill, 2013, par. 17). The studys underlying purpose was to evaluate how easily the French program could be implemented in the Australian school system. A similar study could be done to evaluate if the French system is implementable in the United States. Such structure showed to be effective in decreasing the childhood obesity rates in France. Changing an entire system is costly, especially in a country as large as the US. With that in mind, other options can be considered before opting for the most drastic one. As proposed by the World Health Organization (2013) on their webpage about the European problematic of obesity, countries have to join forces to monitor the progress of not only obesity, but also overweight children. Before changing the entire structure of their education programs, twenty-one European countries have combined information, which was collected according to a common agreed protocol containing core items (World Health Organization, 2013, par. 5). The European countries participating in the sharing of data are part of the Childhood Obesity Surveillance Initiative. The main purpose of this group, aside from collecting information, is to track the epidemic trends of childhood obesity and to compare its effect on other European regions (World Health Organization, 2013, par.1). Such large gathering of information is valuable when governments undergo the thought process leading to policy making. What are the current policies for food regulation? Children and adolescents are facing health issues that are directly connected with being overweight. In their article titled Taxing soft drinks and restricting access to vending machines to curb child obesity, Fletcher, Frisvold and Tefft (2010) expose that obesity rates in North America have risen exponentially during the last four decades, with schools and a

CHILDHOOD OBESITY vast majority of building complexes having vending machines and providing with access to fast foods and soft drinks in an easier manner, caloric surplus is not difficult to attain, thus provoking excess bodyweight on individuals.

Dietary habits and the economic situation lived in is a convincing factor in whether or not an infant may develop excess adipose tissue in its body According to Kumanyika et al. (2002), geographical location is also a figure which can contribute to the issue at hand so is, that obesity is considered a non-communicable disease (Kumanyika et al., 2002) and might become the number one cause of death worldwide in what is only hardly a number of years from this current time. Children that are obese or overweight have the tendency of continuing to be obese during their adult life and the risk rate for this group to develop non-transmissible diseases such as diabetes and cardiovascular diseases is considerably higher. Obesity and the diseases linked to obesity are preventable. Although genetics and a sedentary lifestyle are variables that cause the accumulation of energy physiologically, food choices made by choice of taste, economic accessibility or lack of thereof, convenience and awareness of how nutritious is an important factor in the matter of immoderate weight gain. According to Drewnowski and Darmon (2005) in their article named, The economics of obesity: dietary energy density and energy cost; The average American spends less than $8.00/d on food and beverages, with low-income families spending as little as $25 per person per week, this is an indication of monetary perception as a variable in the structure of the person or family diet. Outcomes to this issue have been formulated and proposed by governmental bodies and public health authorities, one that has received attention and been discussed is increasing the taxes in soft drinks, especially at public schools. Since schools are an essential part in the

CHILDHOOD OBESITY solution to this epidemic, many states in the United States raised the tax of soft drinks, even naming the proposal in certain case as an obesity tax with the purpose of reducing the

consumption of sugar beverages amongst the alumni (M. Fletcher et al., 2010). However, the proposal is complicated to be completely implemented since other political interests arise and stop the initiative from fully developing and work. In his article Sharing solutions for childhood obesity, Ernie Hood (2005) talks about implementing fitness programs into schools such as long distance runs and sports competitions to help reverse the children obesity epidemic, the promotion of general wellness into the scholarly programs is the priority that is managed by Hood and it is efficient in theory as it is in practice. The primary or universal prevention of obesity should not be centered solely on the obesity as it is. In his article Child obesity prevention, J. Colomer (2005) talks about obesity treatment should be a political and public health objective, with the purpose of bettering the overall eating behaviors of the community, reducing the risks of chronic diseases and working towards improving the physical and dietary habits of the population as a whole. According to Colomer (2005) policies that involve intervention to a scholarly level are a key element in the primary intervention methods to solve the issue. Multifaceted programs that promote physical activity and diet changing and that center on the sedentary behavior can contribute to the reduction of the obesity in schools and especially young children (p. 13). Most factors associated with children obesity are related to the lifestyle carried by the individual. For this reason, educating children about dietary habits and its benefits is necessary for them to maintain a healthy weight. Involving the youth into physical activity and monitoring eating patterns as well as health related issues is an attainable outcome to the

CHILDHOOD OBESITY matter. This behavior forms part of a clinically healthy lifestyle that are recommended to be carried since the premature stages of childhood. The objective is to promote and model a positive attitude towards diet and physical activity without focusing on a bodyweight index to avoid adverse eating disorders (Colomer, 2005).

Michelle Obama has used her influential position to create such a program to work to fight, and end childhood obesity through her Lets Move! campaign, which she launched on February 9, 2010 (Learn the Facts, para. 1, n.d.). She is attempting to help treat obesity and also to help prevent obesity in future generations. Michelle Obama has a website Lets Move in which she gives helpful information to support healthy choices to parents, providing healthier food choices in schools, and making sure children are physically active throughout the day whether in school or at home (Learn the Facts, para. 9, n.d.). She has contributed to initiatives that determine which snacks will be available in school vending machines, opting for a greater number of healthier snacks (Robinson, 2012). Michelle Obama has also contributed to the healthier lunches and the installation of salad bars in schools. Although it has only begun Robinson (2012) states, It is too soon to determine whether her campaign will alter the health of the nation for future generations or we will ultimately see the first decline in life expectancy in US recorded history. Conclusion In conclusion, more studies have been dedicated to understanding the phenomenon of childhood obesity, not only in the U.S., but also around the world, encouraging the political scene to push for more policies. All of these new regulations have for goal to decrease the rate of growth of childhood obesity, which would reduce the chances of passing obesity on to the next generation, since obese children are more likely to become obese adults. At last,

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more aspects of the phenomenon of childhood obesity need to be study to determine whether or not; it is becoming the most important community problem in the United States.

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Childhood Obesity Facts. (July 10, 2013). Centers for Disease Control Prevention. Retrieved October 20, 2013 from www.cdc.gov/healthyyouth/obesity/facts.htm Colomer, J., & Grupo PrevInfad, J. (2005). Retrieved from http://www.pap.es/files/1116434-pdf/447.pdf Daniels, R. S. (2006). The Consequences of Childhood Overweight and Obesity. The Future of Children, 16(1), 47-67. Retrieved from http://www.jstor.org/stable/3556550?seq=1 Dietz, H. W. (1998) Childhood Weight Affects Adult Morbidity and Morality. Journal of Nutrition 128(2), 4115-4145. Retrieved from jn.nutrition.org/content/12812/4115.full Drewnowski, A., & Darmon, N. (2005). The economics of obesity: dietary energy density and energy cost. The american journal of clinical nutrition, 82(1), 265S-273S. Retrieved from http://ajcn.nutrition.org/content/82/1/265S.full Earnie, H. (2005, August). Sharing solutions for childhood obesity. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1280362/ Eckel, R., & Krauss, R. (1998). American heart association call to action: obesity as a major risk factor for coronary heart disease. Circulation, doi: 10.1161/01.CIR.97.21.2099 Harvard School of Public Health. (2013). Globalization. Retrieved from https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/globalizationand-obesity/ Hill, Kate. (2013). Australia's overweight kids can learn from French, research shows. ABC South East SA. Retrieved from http://www.abc.net.au/local/stories/2013/10/15/3869564.htm?site=southeastsa 1161/01.CIR.97.21.2099

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Kumanyika. , Jeffery, R. W., Morabia, A., Ritenbaugh, C., Antipatis, V. J., Antipatis, V. J., & Antipatis, V. J. (2002). Obesity prevention: the case for action.International journal of obesity, 26, 425436. Retrieved from http://www.bvsde.paho.org/texcom/cd050644/kumanyik.pdf Learn the Facts. (n.d.). In Lets Move. Retrieved from http://www.letsmove.gov/learnfacts/epidemic-childhood-obesity Lee, A., Ho, M. M., & Keung, V. W. (2011). Epidemic of Childhood Obesity Among Chinese Children and Effectiveness of School-Based Interventions. International Journal Of Pediatric Obesity, 6(2Part2), e252-e256. doi:10.3109/17477166.2011.575150 M. Fletcher, J., Frisvold, D., & Tefft, N. (2010, May ).Taxing soft drinks and restricting access to vending machines to curb child obesity. Retrieved from http://lahealthaction.org/library/taxingsoftdrinks.pdf Robinson, A. (2012, March). Childhood Obesity How Michelle Obama Helped To Fight It. AND Magazine. Retrieved from www.andmagazine.com/content/phoenix/ 11987.html World Health Organization. (2013). WHO European Childhood Obesity Surveillance Initiative (COSI). Retrieved from http://www.euro.who.int/en/health-topics/diseaseprevention/nutrition/activities/monitoring-and-surveillance/who-european-childhoodobesity-surveillance-initiative-cosi