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Problem-Based Research Paper

Childhood Obesity

Delaware Technical Community College

NUR 340 Nursing Research

Veronica Franco

October 5, 2017

Childhood Obesity

Over the years, childhood obesity has become a serious issue for the United States. More

children are susceptible to developing other conditions such as diabetes, and hypertension

because of obesity. According to the Center for Disease Control and Prevention (CDC), today,

the number of children with childhood obesity is three times higher than that of 1970 and one in

five school children are considered obese (2017). As healthcare providers, it is important to

maintain and promote the safety of our patients and obesity can pose a threat to the health of

many. The pathway or standard or care that can aid in maintaining an appropriate nursing

practice is the Obesity Prevention and Management Pathway. According to the Childrens

Hospital of Philadelphia, this pathway aims at incrementing visits to healthcare providers starting

at 2 years old and following guidelines according to the childs Body Mass Index (BMI) (2017).

The article Combating obesity: Teaching children to eat right, explains the importance

of educating the younger population about proper nutrition in order to combat obesity (Cook, et

al., 2017). According to the article, the perfect medium for obesity is developed by the

individuals lifestyle, culture, and nutritional habits such as consuming foods high in sugar

(Cook, et al., 2017). Developing proper interventions in order to aid children in consuming

nutritious foods is necessary. The amount of children ages 6-11 whom have been diagnosed as

obese has increased from 6.5% to 19.6% since 1980 (Cook, et al., 2017). Obesity not only affects

the health of children but it creates an increased economic burden on healthcare

resources(Cook, et al., 2017).

Following the Healthy People 2020 goals in incorporating healthy lifestyles by providing

proper education to schools of all levels is important (Cook, et al., 2017). Certain initiatives have

been taken place in order to aid in the creation of balanced nutrition to the younger populations.

The National School Lunch Program provided by the government is able to provide free or

deduced meals to children depending on their economic level (Cook, et al., 2017). Other

initiatives that have been created include the Farm to school program, which, brings vegetables

and fruits from farms to schools, or community farms, which allow individuals to have access to

fresh produce (Cook, et al., 2017). Children and adults are able to participate and engage in

planting and harvesting fruits and vegetables. Many of these programs offer education about

proper nutritious meals to families.

The article The potential and reality of physical education in controlling overweight and

obesity provides information about the impact of childrens activity on their reduction of

obesity (Kahan & McKenzie, pg.653, 2015). Overweight and obesity has increased significantly

over the years and children are more vulnerable in developing conditions such as type two

diabetes and metabolic syndrome (Kahan & Mckenzie, 2015). Engaging children in physical

activity is essential in incrementing their wellbeing. According to the article, the US Department

of Health and Human Services (USDHHS) advises that children should exercise for an average

of 60 minutes per day (Kahan & Mckenzie, 2015). Schools play an integral part in engaging

children in such activities. Involving children in physical education (PE) classes is a mandatory

rule to schools all throughout the nation (Kahan & McKenzie, 2015). Unfortunately, the amount

of time children should be engaged in physical activity has not been established nationwide.

Only only 19 states have provided the exact number of minutes that the children in the schools

have engaged in exercise (Kahan & Mckenzie, 2015). It is important that energy expenditure

(EE) should be greater than the amount of food consumed in order for weight management to

occur (Kahan & Mckenzie, 2015).

The studys result showed that EE differ from state to state (Kahan & Mckenzie, 2015).

According to Kahan & McKenzie, the states of Alabama, Florida, Louisiana, and New Jersey,

showed a yearly EE of 1,466,758, which was 5 times higher than that of the state of Hawaii

(2015). Students, who exercised according to the guidelines established by the National

association for Sport and Physical Education (NASPE), were able to generate an EE of 35,000-

90,000 greater than those who did not engage in any type of exercises and only received class

instructions (Kahan & Mckenzie, 2015). The study proved that implementing physical activity

among school children increases the amount of EE and in turn aid in the management of

overweight and obesity.

The article is able to meet the guidelines of a quantitative study. The purpose of the study

was to examine the effects that school activity has on the reduction of childhood obesity (Kahan

& Mckenzie, 2015). The independent variable identified is the amount of physical activity and

the dependent or outcome variable is obesity through energy expedited (Salerno & Young,

2013). The study conducted was a descriptive non-experimental since the researchers collected

the data but did not apply any interventions, and was not a randomized controlled trial (Salermo

& Young, 2013). The purposive sample in the research article included both boys and girls

between the ages of 6 through 15 (Kahan & Mckenzie, 2015). The researchers used the

guidelines from NASPE and those of 19 states in order to determine EE from school physical

activity (Kahan & Mckenzie, 2015). They used several formulas and calculations to determine

the amount of EE while taking the frequency and duration, PA intensity during lessons, class

size, and childrens body mass into consideration (Kahan & Mckenzie, pg.654, 2015). The

article provided tables explaining the yearly EE from all school levels, and figures explaining

how EE was calculated and different numerical and analytical data was provided throughout the


One study that aids in learning the importance of childhood obesity control is A

systematic review and meta-analysis of the effect of lifestyle modification on metabolic control

in overweight children (Lien, et al., 2017). Maintaining a healthy and balanced life is an

essential component of the standard of care. Consuming appropriate servings of fruits and

vegetables while engaging in physical activities is essential. The study included eight randomly

controlled trials with a population of 3,923 children whose aim was to determine whether

lifestyle changes could aid in maintaining an appropriate Fasting Plasma Glucose (FPG) and aid

in preventing type 2 diabetes (Lien, et al., 2017). The children who were engaged in improving

their lifestyle, showed a lower FPG, BMI, and insulin levels compared to those who didnt

include any type of lifestyle modifications (Lien, et al., 2017).

Another study entitled Effects of a multidisciplinary weight loss intervention in

overweight and obese children and adolescents aimed at determining how helping children

change their lifestyle could affect their weight (Mameli, et al., 2017). The study included 864

children between the ages of 2 and 18 years of age who agreed to monitor their BMI while

following a specific weight management intervention (Mameli, et al., 2017). During the process

of lifestyle remodeling, children were offered nutritional, medical, and psychological guidance

from experts (Mameli, et al., 2017). The result of the study confirmed that improving ones

lifestyle could aid in controlling weight. More than 80% of the patients showed a reduction of

their BMI, 18% of the patients changed from an obese to an overweight status, and 13.1%

returned to a normal BMI levels (Minami, et al., 2017).

Family plays an important role in engaging children in healthy habits. Another study

named Effects of an intensive lifestyle intervention to treat overweight/obese children and

adolescents, aims at determining the effects of following a specific diet on children who are

overweight (Ranucci, et al., 2017). The study examined results of 74 children in relation to their

adherence to a Mediterranean diet, which involves consuming more fruits, vegetables, healthy

fats, and less red meat. They examined the childs waist to height ratio and BMI in relation to the

diet and physical activities (Ranucci, et al., 2017). The results of the study showed a great

reduction in the childrens weight, BMI, waist circumference, and level of fat (Ranucci, et al.,


All of the studies summarized above, contribute to the importance of monitoring children

and engaging them in a healthy and balanced diet. The Obesity Prevention and Management

Pathway aim at managing and reducing overweight and obese childrens risk for developing

comorbidities (Childrens Hospital of Philadelphia, 2017). It is important to educate children and

their parents and ensure that they are maintaining a proper lifestyle and share the best practices in

order to better treat our pediatric population. As for future research intervention, it is important

to conduct research on the different parenting styles and determine how children education plays

a role in obesity. It is important to include multicultural studies in order to determine what

groups are at greater risk for developing obesity.



Centers for Disease Control and Prevention (2017, January 25). Childhood obesity facts. Retrieved from

Cook, S., Gerber, S., Heines, K., Martin, C., Reeder, B., Schmidt, S., & ... Wimsatt, S. (2017).

Combating Obesity: Teaching Children to Eat Right. Kentucky Nurse, 65(2), 10-11. Retrieved

from CINAHL with Full Text Database

Kahan, D., & McKenzie, T. L. (2015). The Potential and Reality of Physical Education in Controlling

Overweight and Obesity. American Journal Of Public Health, 105(4), 653-659.


Lien, A. S., Tsai, J., Lee, J., Wu, M., Jiang, Y., & Yen, H. (2017). A systematic review and meta-

analysis of the effect of lifestyle modification on metabolic control in overweight children.

Evidence-Based Complementary & Alternative Medicine (Ecam), 1-12.


Mameli, C., Krakauer, J. C., Krakauer, N. Y., Bosetti, A., Ferrari, C. M., Schneider, L., & ... Zuccotti, G.

V. (2017). Effects of a multidisciplinary weight loss intervention in overweight and obese

children and adolescents: 11 years of experience. Plos ONE, 12(7), 1-10.


Ranucci, C., Pippi, R., Buratta, L., Aiello, C., Gianfredi, V., Piana, N., & ... Mazzeschi, C. (2017).

Effects of an Intensive Lifestyle Intervention to Treat Overweight/Obese Children and

Adolescents. Biomed Research International, 1-11. doi:10.1155/2017/8573725

Salerno, E., Young, A. (2013). Making a difference with nursing research. Upper Saddle River, New

Jersey: Pearson