Reducing Childhood Obesity with Education

The epidemic of childhood obesity has caught the attention of First Lady Michelle Obama and this is an indicator of how serious this problem is. As healthcare professionals it is incumbent to diagnose the overall problem and devise innovation policies and solutions to initiate effective damage control and preventative strategies. The development of structured and proven techniques is necessary to fight childhood obesity. The seriousness of this cannot be overstated, since addressing the problem effectively will help to determine the future health of this nation. The long-term implications of not successfully treating overweight children will compromise their quality of life, cause low self-esteem, and increase overall healthcare costs. Since the policing of additives to food such as preservatives, excess salt and sugar, sugar substitutes (high fructose corn syrup) and bad fats (partially hydrogenated oils) has not been as stringent as it should be, health care professionals are the first line of defense along with parents, teachers, and communities to prevent childhood obesity.

Identifying the Problem

Almost every American family can relate to obesity. The popular television show The Biggest Loser is a reminder that obesity is a significant problem for many. However, most do not need a television program to realize this as they can probably see this crisis in their immediate or extended family. Data from 2009 and 2010 indicates that one in three children are obese or overweight (Vine, 2013). Children as young as twelve months are overweight. A study of American children indicates that almost 19 percent of children between twelve and twenty-four months are obese. This concern is worldwide, of Finland’s population of two-year-old children, 11.3 percent of females and 6.3 percent of males are overweight or obese (Mustila, 2013). Another study shows that in United States “Obesity rates among the nation’s children have tripled in the past 30 years. As of 2008, over 30% of children aged 2 to 19 years had body mass indexes at or above the 85th percentile for their age” (McPherson, 2012, p. 37). This unfortunate trend can be the result of mothers being overweight or gaining excess weight during pregnancy. Smoking and drinking during pregnancy are also pre-indicators of obese infants. Parents may not want to acknowledge that their child is overweight. They sometimes erroneously assume that once they become older they will grow out of it. However misdirected eating and lifestyle habits are becoming more difficult to conquer.

Contributing to the problem of obesity in America is the food industry. The Food and Drug Administration and the U.S. Department of Agriculture oversee practices in food safety which is an enormous undertaking (Selected Federal Agencies with a Role in Food Safety, 2014). While this branch of government does its best to ensure that the food the public consumes is safe, much of the responsibility lies in the hands of specific food manufacturers. Problems such as salmonella contamination are usually not addressed until after an outbreak. A significant contributor to obesity is packaged foods. This includes shelf and frozen food items. A diet consisting of only packages foods usually not only increases weight, but also contributes to hypertension and diabetes because of the excess salt and sugar content not to mention the excessive amount of chemical preservatives and additives.

Obesity and its complications are reversible and preventable. One way to prevent childhood obesity is to understand that many factors contribute to it. These factors include the mother’s pregnancy, her susceptibility to diabetes and hypertension, too much weight gain and smoking. Infants that experience inconsistent sleep patterns, wrong types of first-foods, and gain too much weight during their first year are at risk of being overweight children. These are proven indicators that can lead to childhood obesity (Mustila, 2013). The prevention of pre-school obesity begins with prenatal care. Mothers who are obese and have diagnosed gestational diabetes mellitus (GDM) their children are at risk of being overweight. The identification of the root causes of childhood obesity is the first line of defense in preventing this epidemic.

Goals, Options and Solutions

Healthcare professionals are in a critical position to develop healthy habits in both mothers and their children. While arresting childhood obesity is the critical issue, educating and changing the mindset of parents is a key instrument. When parents are not informed about food choices this directly impacts their health and their children’s health and they will continue to make bad choices. A study in Finland advocates intervention during pregnancy (Mustila, 2013). This study focuses on mothers who were overweight during pregnancy and have or are at risk of having GDM. Since childhood obesity is difficult to reverse prevention is the best line of defense. As a result, in Finland a structured care plan for the mothers was initiated and facilitated by Primary Care Physicians (PCP) and nurses. The nurses played a significant role as they were the liaison between the patient, physician, physiotherapist, and dietician. Nurses performed home care follow-up with patients to encourage adherence to nutrition and physical activity interventions. This allowed the nurse to closely monitor the mother’s weight. The most obvious improvement was that GDM was in some cases minimized or prevented. This reduced the infant’s chances of becoming overweight. Childhood obesity is a very complex issue and the solutions are multiple, there is no single answer.

While the Finland study focused on prevention, reversing the trend of obesity is a public health issue. Health care professionals (HCPs) are in a unique position to encourage lifestyle changes in mothers and children. They interact with patients on a daily basis and can combine their medical knowledge to communicate with patients in a meaningful way. To reverse obesity involves not only HCPs but the entire community. This includes public education representatives, social service organizations and individual families. Unfortunately, there are multiple obstacles to preventing and reversing obesity. The availability of inexpensive unhealthy food is one; lunches in many urban and inner-city public schools are unhealthy and many do not include fresh fruit or vegetables. Additionally, lack of knowledge about healthy eating and knowing how to critically read food labels is also a hindrance. The food industry, especially manufacturers of packaged and frozen foods send mixed messages to consumers. Food items may be promoted as low fat, but they may also have excess salt and sugar and numerous unhealthy additives and preservatives.

However, HCPs are in a position to enact change by educating their patients. One of the most difficult challenges is encouraging parents to make the necessary lifestyle adjustments for themselves and their children. Parents are responsible for their children’s diet. However, a study among HCPs revealed some basic reasons for obesity in their patients is too much fast-food, watching too much television and having sedentary lifestyles (Spivack, 2010). Though these are known causes it is not known if HCPs address eating habits of children in their first year of life. The challenge for HCPs is communicating the seriousness of the problem to parents in such a way that it will result in lifestyle changes. A reinforcement of this message from educational institutions, community centers, and from governmental agencies will help.

First Lady Michelle Obama has initiated the “Let’s Move” initiative as her response childhood obesity. In 2011, President Obama assigned a task force to study obesity and to come up with solutions on how to reduce it to 5%, as it was before 1970 (Summary of Recommendations, 2010). The result was a list of recommendations such as pre-pregnancy nutrition education, HCPs encouraging breastfeeding, research into chemicals prone to cause obesity, and recommending less time on digital media are a few from an extensive list. HCPs play a significant role in implementing these recommendations along with current federal and local agencies.

Educating families is the most obvious line of defense to childhood obesity. The strategically situated professionals to initiate the education rest with primary care physicians and nurses. Healthcare professionals interact with their patients at the beginning of life and at the end of it. Although the task is daunting, if support from public and private institutions is aggressive then the goal of realizing reduced obesity in children will be attainable.

References

McPherson, M. M. (2012). Educating health care professionals in advocacy for childhood obesity prevention in their communities: integrating public health and primary care in the Be Our Voice project. American Journal Of Public Health, 102(8), 37-43. doi:10.2105/AJPH.2012.300833

Mustila, T. R. (2013). Pragmatic controlled trial to prevent childhood obesity in maternity and child health care clinics: pregnancy and infant weight outcomes (the VACOPP Study). BMC Pediatrics, 1380. doi:10.1186/1471-2431-13-80

Selected Federal Agencies with a Role in Food Safety. (2014, March 19). Retrieved from Foodsafety.gov: http://www.foodsafety.gov/about/federal/

Spivack, J. S. (2010). Primary care providers' knowledge, practices, and perceived barriers to the treatment and prevention of childhood obesity. Obesity, 1341-1347. doi:10.1038/oby.2009.410

Summary of Recommendations. (2010, May). Retrieved from Let's Move: http://www.letsmove.gov/sites/letsmove.gov/files/TFCO_Table_of_Contents.pdf

Vine, M. H. (2013). Expanding the role of primary care in the prevention and treatment of childhood obesity: a review of clinic- and community-based recommendations and interventions. Journal Of Obesity. doi:10.1155/2013/172035