Sunday, November 25, 2007

Childhood Obesity: An Avoidable Crisis

Childhood obesity is reaching epidemic proportions in the United States. Studies on childhood obesity have concluded that as many as 31% of pre-schoolers are obese according to the Surgeon General’s standards (Hodges 2003).

As educators and health promoters, nurses have a responsibility to educate families about childhood obesity. Parents and children need to be taught about proper nutrition and the need for physical activity as well as the potentially harmful effects of sedentary activities such as excessive TV watching, video game play, and computer usage. As part of the education process, nurses should also assist families in formulating a plan to combat obesity.
Studies have shown that adults who become obese in childhood continue on to become obese adults 77% of the time (Hodges 2003). Serious health problems are linked to obesity including diabetes, cardiovascular complications, and various orthopedic problems. The problem of obesity is further compounded in children and adolescents, who are subject to psychosocial complications such as rejection by peers, low self esteem, and depression.
A key role of nurses is to educate. Education opportunities exist in a variety of settings. Children’s healthcare appointments, community organizations, health fairs and childcare centers all provide for educational opportunities. It is important for nurses to consider parental knowledge of obesity when caring for overweight and obese children, or when attempting to prevent obesity. A major defense against obesity is education of parents and children about the importance of good food choices. Children’s eating habits are not only impacted by the food choices available to them, but also by children’s tendencies to emulate their parents eating habits (Cedarquist 2006). If parents chose low nutritional value snacks, the child most likely will too (Hodges 2003). To nurses, this means educating parents regarding nutritional needs for themselves and their children. One avenue for nutrition education is during well-child check ups. Well-child check ups provide nurses with an opportunity for direct teaching. Another effective tool for parental education is written information such as brochures to be distributed at health fairs and other community based functions. Nutrition education helps to ensure children receive the nutrients needed to promote healthy growth, while limiting excess calories that have little to no nutritional value, which leads to excess fat storage. Nurses may encourage parents to allow their children’s involvement in meal planning and preparation. This gives children an understanding of what constitutes a healthy meal or snack, while allowing the child to be an active participant in the family’s health (Deville-Almond, 2005). While, imperative, food choices only address one factor in childhood obesity. A sedentary lifestyle also plays a major role in obesity.Document1
Another leading cause of Childhood obesity is the time children spend watching television, playing video games, or using the computer. A 2000 study showed that up to 80 percent of TV ads aired during peak children’s programming times were for fast foods, unhealthy snack foods and candy (Larimore, et al., 2005). The American Diabetic Association found that school age children consumed roughly 20 percent of their daily caloric intake while watching TV or playing video games (Larimore, et al., 2005). During scheduled well-child check-ups, nurses should alert parents to the abundance of “junk food” ads children are exposed to during TV watching. As well as encouraging parents to watch what children are viewing on TV (including the ads), and knowing what children are snacking on during this time, nurses may suggest parents set limits on TV time. Limitations may include only watching TV, playing video games or computer use after chores, homework and dinner is finished or limiting TV and/or computer time to only an hour or so each day. By aiding parents in identifying the amount of time their children spend in sedentary activities, nurses can segue into education about the importance of physical activity.
Physical inactivity is a chief contributor to childhood obesity. Similar to the way eating habits are established, children tend to imitate the lifestyle habits of their parents. According to a study by Perusse, Tremblay, Leblanc, and Bouchard about habitual physical activity and exercise participation, evidence was found to support the theory that children model their physical activity habits after those of their parents (Hodges 2003). Another study found that only 5% of parents who participated in the study believed that increasing their child’s activity level would be effective in controlling weight (Myers 2000). In light of this evidence, nurses must educate parents about the importance of physical activity. Activity education, as with dietary education can be done during well child check-ups and through written information to be distributed through community based organization such and the YMCA and after school programs.
Childhood obesity is a growing problem. Each year the number of obese children rises, along with the medical problems specifically linked to obesity. Obesity is, however, preventable. As educators and health promoters, nurses have a responsibility to educate families about childhood obesity and its associated health risks and complications, as well as to assist families in formulating a strategy to combat it. By taking steps to educate families of the importance of proper nutrition, an active, healthy lifestyle, and allotted time set aside for more sedentary activities, childhood obesity can be curbed.

Cedarquist, C. (2006). Helping your overweight child-family involvement is key. New york beacon. 13(13)15. Retrieved January 7, 2007 from Proquest data base.

DeVille-Almond, J. (2005) Tackling childhood obesity: Jane Deville-Almond shows how nurses in primary care can use the latest research to tailor the advice they give parents. Primary Healthcare. 15(8), 20-22. Retrieved October 31, 2006 from Expanded Academic ASAP database.

Hodges, E. (2005). A primer on early childhood obesity and parental influence. Pediatric nursing. 29(1), 13-17. Retrieved October 20, 2006 from proquest database.

Larimore, W., MD., Flynt, S., MPH, LD., Halliday, S. (2005) Supersized kids. New York: Warner Books.

Intervention 1: Parent Education

Disadvantage 1: Perception of the obese child

An effective tool against childhood obesity is parental education. Parents however, may reject the idea that their child is obese, or that obesity poses a real health risk to their child. Data provided by the federally funded nutrition program for women, infants, and children (WIC) shows that in Arlington, Virginia 21 % of the population served by this program were obese (Myers Vargas 2000). After identifying the obese clients, WIC nutritionists, health care nurses and clinicians began an intensive teaching intervention targeted specifically at these clients. After intensive intervention efforts aimed at educating parents, the data concluded that only a very small number of children had achieved the expected outcome of reduced body weight into a healthy range. In many cases the failure was directly linked to the parent’s perception of their obese child as not being obese, or the parent’s cultural belief that a fat child is a healthy child (Myers Vargas 2000).

Disadvantage 2: Nutrition
Obese children may be linked to the types of foods provided to them by their parents. Because of this, parental education about proper nutrition is an important tool in battling childhood obesity. However, in many cases, the problem may not lie with parental knowledge deficit of proper nutrition as greatly as with a lack of resources to purchase fresh fruits and vegetables, and protein rich foods such as meat, poultry or fish. The results of one survey suggested that Americans who eat the most fruits and vegetables are the least likely to be overweight (Larimore, Flynt 2005).

Intervention 2: Child Education

Disadvantage 1: Physical Activity

Physical activity is a great way to reduce obesity in children as well as adults. One article stated that while children understand the relationship between weight loss and physical activity, they fail to see any other benefits from physical activity (Deville-Almond 2005). Children no longer see physical activity as a means of socialization or recreation. Children tend to focus more on computer use, video games and television as means of socialization and recreation (Jerum, Melnyk 2001).

Disadvantage 2: Good Food Choices

Often times, parents rely on the public school system to provide their children with at least one nutritious meal throughout the day. Unfortunately, this is not always the case. One 2000 report found that “competitive foods” meaning, fast food style foods, were sold in 74% of middle schools, and 43% of elementary schools (Morantz, Torrey 2004). Regular school meals must follow USDA dietary guidelines; whereas competitive foods sold in lunchroom cafeterias do not to follow such guidelines (Morantz, Torrey 2004). The introduction of competitive foods into the public school lunch system has made nutritious foods for some children obsolete, as they now have a choice between healthy food and fast food at school.

Reference List

Deville-Almond, J. (2005) Tackling Childhood obesity: Jane Deville-Almond shows how nurses in primary care can use the latest research to tailor the advice they give parents. Primary Healthcare. 15(8), 20-22. Retrieved October 31, 2006 from Expanded Academic ASAP database.

Larimore, W., MD., Flynt, S., MPH, LD., Halliday, S. (2005) Supersized kids. New York: Warner Books.

Morantz, C., Torrey, B. (2004) Recommendations to reduce obesity in children and adolescents. American Family Physician. 70(12), 2377-2378. Retrieved October 21, 2006 from Proquest database.

Myers, S., Vargas, Z. (2000) Parental perceptions of the preschool obese child. Pediatric Nursing. 26(1), 23-34. Retrieved November 29, 2006 from proquest database.


Anonymous said...

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Mary said...


This is the assistant editor for which is a medical publication offering hospital news, information and reviews. We also cover a wide variety of medical issues, one of which being Children's Health and the importance of choosing the right hospital. You will notice articles on this topic under Children's tab. If possible I would like to be included within your blog roll, offering our information as a resource to your readers. Please let me know if this addition can be made.

Please email me back with your URL in subject line to take a step ahead and to avoid spam.

Thank you
Mary Miller,