Maintaining a Healthy Lifestyle

Eating healthy is crucial. If an individual does not eat properly, many issues can develop as a result. Understanding the importance of eating right is a task that many people in America have not practiced due to the quickness of fast food, the ease of tasty products on the market that is loaded with additives and preservatives, a lack of physical activity and minimal help from their primary care physicians and medical professionals. As a result of this disregard for maintaining a healthy lifestyle, obesity and overweight issues have plagued and continue to wreak havoc on America.

Assessment

There is a significant concern for the pandemic of obesity and diabetes. The evidence of pivotal weight management in the United States has continued to fluctuate over the years. Reaching and maintaining a healthy weight is an imperative factor in overall health and can help individuals control and potentially avert any ailments that may arise. It is essential to differentiate between being overweight and being obese. Overweight is having additional body weight from bone, fat, muscle or water. Obesity is having an elevated quantity of extra body fat. Body mass index is a functional gauge of weight. There are several factors that may contribute to a person's weight including environment, family history, genetics, metabolism, and general behavior. Metabolism is defined as the way the body changes food and oxygen into fuel that it uses on an everyday origin. It is also equally important to have an active balance when maintaining a fit weight. The amount of energy one receives from food or drinks needs to be balanced with the energy the body uses for breathing, digesting and overall physical activity. Denoted by energy IN, or the amount of energy received from food and drinks and energy OUT, stated to be physical activity, breathing, etc.; in order to maintain a healthy weight, the IN and OUT have to balance over a certain period of time ("Aim for a Healthy Weight," 2013). 

As weight is in direct proportion to the number of calories consumed and expended, maintaining weight often can pose a challenge. At the heart of maintaining a healthy weight is an appropriate diet. Diet reflects the diversity of foods and beverages consumed over a period of time in a variety of settings. There is statistical data noting the demographic characteristics of those with a healthier diet. Most Americans, though, need a diet enhancement when seeking to learn how to maintain a healthy weight. Currently, there are both physical and social determinants of diet. The physical determinant of diet composes one's capability to access healthy food by being informed of the right choices. Food marketing plays a heavy role in this, however. Social determinants include understanding and attitudes about food, the communal support to improve one's diet, economics in the ability to afford healthier options rather than fast food and the norms and practices of society ("Nutrition and Weight Status," 2012). These determinants appear to be consistent across all ethnicities in the United States. The obesity numbers are staggering within the United States, thus so are the health care costs. But health care costs set aside, when examining the statistics associated with obesity rates in America, there is a definite need in maintaining a healthy weight.

Statistics for obesity rates are: 'a third of American adults are overweight. Another third are obese. Combined, 68.8% of U.S. adults are either overweight or obese. Obesity is a contributing factor in five of the top 10 contributing factors of death: heart disease, cancer, stroke, and diabetes and kidney disease. Losing as little as 5-7% of a person's total weight lowers blood pressure, improves blood sugar levels and lowers diabetes by nearly 60% in people with prediabetes. In 2009, roughly 94% of schools served a lunch that failed to meet the federal standards for healthy school meals. 80% of the lunches served in those schools exceeded federal recommendations for total fat and saturated fat. 1 in 3 children born in the year 2000 will develop diabetes sometime in their lifetime" (Chou and Kane, 2012). The statistics go on and on unfortunately with the staggering amount of obesity and overweight facts within the United States.

Within the state of California, and according to the Los Angeles County Health Survey 2011, there are an estimated "1,616,000 obese individuals and 2,537,000 overweight people, ("Los Angeles County Health Survey, 2011). These statistics vary by demographic with those between the ages of 30-39 having "500,000 overweight individuals and 369,000 obese and between the ages of 40-49 having 515,000 overweight individuals and 363,000" ("Los Angeles County Health Survey, 2011). It is important to understand that these are statistics based on data that was collected by those who participated in the survey. It stands to reason what the numbers would have been if everyone within Los Angeles County had participated. 

In examining the survey by demographics, the majority of those who were overweight of all ethnicities were Latinos having "1,191,000 overweight and 929,000 obese and Caucasian (white) being the second-largest ethnicity to be affected by the obese and overweight epidemic with 740,000 stating they were overweight and 391,000 obese ("Los Angeles County Health Survey, 2011). Within Glendale, CA, "the obese numbers accounted for 21% of the overall Los Angeles County statistics in the survey, while 35.1% accounted for the entire overweight individual category. The survey did not indicate a substantial difference in the amount of overweight and obese men versus women. Men were accounted in having 1,532,000 individuals overweight and 792,000 obese; while women were stated to have 1,005,000 overweight and 824,000 obese. Individuals were assessed along with the federal poverty level in the survey as well and the numbers varied with 1,044,000 people overweight and 520,000 obese individuals being at 300% or above the FPL ("Los Angeles County Health Survey, 2011). The numbers varied from there with regard to be above the federal poverty level. A sizeable link to health inequality was not significantly noted in the survey. An interpretation of the fact that Latinos were the highest among those that were obese and/or overweight can be explored, however.

While the Los Angeles County Survey stated that Latinos, were the highest affected by obesity and overweight issues; "the CDC reported Latinos as the minority group with the second-highest obesity prevalence in adults. Additionally, the Office of Minority Health in 2007, reported adult Latinos 18 years of age and over to be 1.2 times more likely to be overweight than non-Hispanic whites. Childhood and adolescent overweight and obesity rates show sharply increasing trends that surpass the rates for adults. A more staggering pattern emerges for those between the ages of 12-19. Over a certain amount of time, statistical data assessed noted a percentage increase in the number of overweight adolescents from 5% to about 18%. With Latinos being projected to represent 24.4% of the total U.S. population by 2050, representing nearly half of the general popular. According to the U.S. Census as of July 1, 2008, an estimated 47 million Hispanics represent 15% of the U.S. population, including Puerto Rico. Latinos are experiencing an increase in obesity prevalence. As reported by the Department of Health and Human Services' Office of Minority Health in 2007, Latinos were 1.1 times more likely to be obese than non-Hispanic whites. Between 2003-2006, Mexican American women were 30% more likely to be overweight than non-Hispanic white women. According to the U.S. Census, 67% of Hispanics have a high school degree or less schooling and earn an annual per capita income of $15,916," ("Hispanic Obesity: An American Crisis," 2010) making for a task ahead of helping individuals of all ethnicities maintain a healthy weight. A correlation can also be noted between income and obesity rates when analyzing Latinos.  There are organizations committed to bringing forth progress in the realm of nutrition to combat obesity and overweight issues, not solely among those within Glendale, CA but as a whole in the United States. 

Diagnosis/Outcomes Identification

Two of the largest organizations that are determined to tackle the pandemic are the Centers for Disease Control and Prevention and the American Heart Association. That is not to say that other organizations such as World Health Organization and NCCOR, the National Collaborative on Childhood Obesity Research are not equally committed to bringing a definite change in the way Americans eat on a daily basis. Given all of the information available, the question becomes, are there any health concerns not being address despite the many organizations that are currently seeking to combat the problem.

In analyzing the various organizations, this does not appear to be the case. In fact, all of the aforementioned organizations emphasize the importance of keeping a healthy diet, a health plan, and thus, weight. While some are more thorough than others in their recommendations and suggestions, they are doing their part in informing the general public in the United States about the importance of maintaining a healthy diet. 

Each organization stresses that "a healthy lifestyle involves many choices and emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products, lean meats, poultry, fish, beans, eggs and nuts as well as ensuring that foods that are eaten are low in saturated fats, trans fats, cholesterol, salt, and added sugars" ("Healthy Weight - it's not a diet, it's a lifestyle! " 2012). There is a reason to believe that the problem can be tackled through several different plans that will inevitably alter the landscape of nutrition within America.

Planning

Given the preponderance of evidence and research surrounding obesity and overweight rates as well as the importance of maintaining a healthy lifestyle, the nursing field plays a crucial role in helping the rates decrease. Despite numerous efforts to combat obesity and overweight issues, the consequence of research examining treatment programs across the nation designates that these programs have had a modest impact on the epidemic. “A review of diet modification programs conducted by Huon, Wardle, and Szabo (1999) found only 13 studies that were designed to diminish the threat, especially among children and young adult” (The, 2006). There is growing confirmation that supports the role that parents play in promoting healthy eating practices to their children, but also to nurses being promoters of wise choices. Parent awareness of health and illness and overall understanding of obesity-related conditions may also influence health-related behavior in the home. Research shows that up to 80% of parents do not know that their child is overweight because of a lack of facts and understanding about the epidemic. Despite the magnitude of primary care provider contribution in obesity prevention and in moving the population towards better eating habits and lifestyle changes, research has also indicated that such efforts have gone unnoticed or rather have failed (The, 2006). Nurses must continue to inform their patients to the best of their abilities about the serious health risks associated with obesity and being overweight.

A typical recommended action of a nurse to the patient about the risks of obesity and being overweight is as follows: "(1) Complete an assessment on the patient such as a health factor checklist and BMI calculation; (2) Discuss with child or adolescent his/her perceptions and the overall understanding of his/her health status; (3) Assess food preferences and habits (i.e. likes, dislikes, cultural practices); (4) Ask about any previous attempts to control weight (i.e. what was tried, what worked, what did not, any challenges); (5) Question if the child, teen or individual is doing any physical activity or if they will consider it; (6) Recommend several informative intervention techniques and state that an evaluation of the outcomes will be assessed" ("Nursing Practice Guideline for Care of a Child/Adolescent who is Obese or Overweight," n.d.). This will be immeasurably helpful when nurses such as myself see patients. It is important that the nursing profession take a proactive role in alleviating the problem of obesity and being overweight in society. 

Two programs that will be suggested to tackle the problem of horrible eating habits within the United States are Supertracker and Go-Slow-Whoa. Supertracker “helps individuals plan, analyze and track their diet and physical activity. Supertracker provides a food-a-pedia, weight manager, goal setters and reports" ("Supertracker," 2013) so the individual can track his/her physical activity. There are a multitude amount of physical activities that a nurse can recommend that include jogging, running, walking or jumping rope. The exercise does not have to be overly strenuous at the onset of the patient beginning their adventure to lose weight and prevent anybody complications. 

Go, Slow, Whoa is geared more towards young children and adolescent teens and getting them to understand the importance of maintaining a healthy diet. The thought process behind this is if children understand the importance of eating right, they will. Foods are classified as go foods or healthy ones; slow foods, which are those foods that they can eat but not on a daily basis and whoa foods, which are ones that they should refrain from eating ("Go, Slow, Whoa," 2013).  Go, Slow, Whoa denotes a char of specifics that can be provided to the patient/individual to help them attain their achievable weight. Each of these programs will be beneficial for a nurse to recommend to their patients in an effort to help them maintain a healthy weight.  "More importantly, as new and innovative policy and environmental interventions to support diet and physical activity are implemented, it will be important to identify which are most effective," ("Nutrition and Weight Status," 2012). It is reasonable for nurses to suggest timelines of when they expect to see that various changes in their patients.  

Evaluation

Research studies have stated that because health care professionals often drop the proverbial ball after suggesting dietary changes, it will be essential for nurses to check in on their patients. Supertracker provides reports for individuals to track their progress, therefore, nurses may ask if the patient will send them to the report or even bring it into the office on their next visit.  It is also equally important for the nurses to inform the patients that their intention is the key. They must set goals for themselves in order for those to be achieved. A reasonable timeframe for checking in with the patient is on a monthly basis. In doing this, changes will be evident on some level, either on an energetic basis with the patient or physical evidence, or even a combination thereof.  Nurses may even opt to work with registered dieticians and nutritionists to ensure the individuals are on track with their weight loss and maintaining the proper weight for their age and body mass index. 

Nurses will have to participate with organizations to understand and assess the parameters by which America's overall weight is being maintained and that obesity rates are declining. One such organization is Healthy People 2020, which has been providing goals for improving the health of all Americans for over three decades. 

Healthy People 2020 "has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors; empower individuals toward making informed health decisions and to measure the impact of prevention activities and combatting cultural beliefs in regards to weight. Healthy People 2020's mission is to identify nationwide health improvement priorities, increase public awareness and understanding of the determinants of health, disease and disability and the opportunities for progress, provide measurable objectives and goals that are applicable at the national, state and local levels, engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge and identify critical research, evaluation and data collection needs" ("About Healthy People," 2012, para. 1-6). Another organization that nurses should work with in addition to Healthy People is the Center for Disease Control and Prevention. The CDC's Division of Nutrition, Physical Activity and Obesity continually works to "implement policy and environmental strategies to make healthy eating and active living accessible and affordable for everyone. It is the primary online communication channel for all disease data and statistics providing a plethora of information for individuals interested in health issues, public health professionals, researchers and scientists, and health care providers" ("Obesity and Overweight," 2012). It will be important for those in the nursing field to work in conjunction with organizations such as this to ensure that Americans are maintaining a healthy weight in addition to their own follow-ups from the aforementioned programs that should be implemented in all doctor's offices and medical clinics worldwide as a metric for helping obese and overweight individuals. 

Conclusion

The United States is considered to be the fattest nation in the world. America is the land of excess and it is commonplace to overeat on a regular basis. One might think that in today's economy, that obesity levels might be declining, but the reverse is true. The fact is obesity levels in America are on the rise. Overweight and obesity issues continue to plague America and the onus is on the medical professional along with parents to minimize the issues that have resulting from these problems. Nurses have to educate individuals and patients on the importance of maintaining a healthy diet. This is essential to ridding America of the proverbial appetite for unhealthy products or foods that do not aid in maintaining a healthy lifestyle. With a myriad of fat and calorie-laden foods that run rampant at restaurants and eateries across America, the question becomes how can obesity and overweight issues effectively be minimized. Continued education coupled with the intention of the individual/patient is key factors. An exercise is also a significant tool that can alleviate much of the obesity and overweight issues in this country. If these are practiced each and every day, America will be on their way to better diets, lifestyles and combating the obesity and overweight pandemic.

(Appendix omitted for preview. Available via download). 

References

About Healthy People. (2012, December 17). Department of Health and Human Services. Retrieved from http://www.healthypeople.gov/2020/about/default.aspx

Aim for a Healthy Weight. (2013). National Health, Lung and Blood Institute. Retrieved from http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/index.htm

Chou, J., & Kane, J. (2012, May 8). Obesity in America: By the numbers. PBS. Retrieved from http://www.pbs.org/newshour/rundown/2012/05/obesity-in-america-by-the-numbers-1.html

Go, Slow, Whoa, 2013. (2013). The Nemours Foundation. Retrieved from http://kidshealth.org/kid/stay_healthy/food/go_slow_whoa.html

Healthy Weight - it's not a diet, it's a lifestyle! (2012, October 25). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/healthyweight/healthy_eating

Hispanic Obesity: An American Crisis [Policy Brief]. (2010). NHCSL Hispanic Obesity Institute. Retrieved from http://www.nhcsl.org/Hispanic-Obesity-An-American-Crisis.pdf

Los Angeles County Health Survey [Excel Spreadsheet]. (2011). County of Los Angeles Public Health. Retrieved from http://publichealth.lacounty.gov/ha/LACHSDataTopics2011.htm

Nursing Practice Guideline for Care of a Child/Adolescent who is Obese or Overweight [PDF]. (n.d.). The State of Connecticut. Retrieved from http://www.ct.gov/dcf/lib/dcf/nurses/pdf/nursing_guidelines_for_care_of_the_obese_or_overweight_child_(2).pdf

Nutrition and Weight Status. (2012, September 6). U.S. Department of Health and Human Services. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=29

Overweight and Obesity. (2012, December 21). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/obesity/

Supertracker. (2013). USDA. Retrieved from https://www.supertracker.usda.gov/default.aspx

The, B. C. (2006). TAKE ACTION!: A Nurse Practicioner Practice Guide for Prevention of Childhood Obesity [Project]. Retrieved from http://www.nursing.arizona.edu/Library/The_BC.pdf

U.S. Census Bureau. (2011). Retrieved from http://www.census.gov/#