Preventing Childhood Obesity Health in the Balance (2005) / Chapter Skim
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From page 285... ...
The family is thus an appropriate and important target for interventions designed to prevent obesity in children through increasing physical activity levels and promoting healthful eating behaviors. In the United States in the 21st century, there are a great many pressures on parents and children that can adversely affect daily family life.
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From page 286... ...
For example, parents may feel pressured to contribute cookies or soft drinks to the classroom or child-care setting if the other children are bringing in similar foods and beverages. On the other hand, if new values about what constitutes appropriate food choices for children become normative, this can produce positive changes in individual families and in their children's daytime environments.
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From page 287... ...
and become involved in ensuring that opportunities are made available and expanded for all families. PROMOTING HEALTHFUL EATING BEHAVIORS For decades, scientists have suggested that there are critical periods in the brain development of animals and humans that may profoundly affect food intake and body weight (in particular, body fat)
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From page 288... ...
. Needless to say, women of child-bearing years should pursue a healthful lifestyle that emphasizes sound dietary and physical activity habits, and because of the importance of a healthy maternal body weight at conception and adequate weight gain during pregnancy, these goals should be embraced and nurtured by the entire family.
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From page 289... ...
. Breastfeeding is thought to promote the infant's ability to regulate energy intake, allowing him or her to eat in response to internal hunger and satiety cues—that is, to assume greater control in determining meal size (Fisher et al., 2000)
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From page 290... ...
that soft drinks and French fries are being fed to infants as young as 7 months of age (Fox et al., 2004)
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From page 291... ...
. Parents should promote healthful food choices among toddlers and young children by making a variety of nutritious, low-energy-dense foods, such as fruits and vegetables, available to them.
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From page 292... ...
, youth, and parents in choosing and providing a balanced diet. Parents should promote healthful food choices by school-age children and
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From page 293... ...
Coon and colleagues (2001) found that watching television during mealtime was associated with consumption of fewer fruits and vegetables and increased consumption of soft drinks, salty snacks, pizza, and red meat.
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However, methodological limitations prevent conclusions regarding whether reducing soft drink consumption led to the observed changes in obesity prevalence (French et al., 2004)
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From page 295... ...
Pressure and restriction tend to be used with different foods (pressure with perceived "healthful foods" that parents want to encourage; restriction with some snack foods that parents want to limit) , but a parent who uses one tactic is likely to use the other as well (Fisher et al., 2002)
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From page 296... ...
. Correlates of Physical Activity Developmental, Biological, and Psychosocial Correlates Children's gender and age are both important factors to consider in examining physical activity levels.
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From page 297... ...
The personal psychosocial factors that influence physical activity differ somewhat between children and adolescents. Intention to be physically active, preference for physical activity, positive beliefs about physical activity, enjoyment of physical activity, and enjoyment of physical education classes have been shown to be positively associated with physical activity in children (Stucky-Ropp and DiLorenzo, 1993; Pate et al., 1997; Trost et al., 1997, 1999; DiLorenzo et al., 1998; Sallis et al., 2000)
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From page 298... ...
Parental support can include a wide range of actions, from encouraging the child or adolescent to try or to continue a new activity, to providing transportation to an activity class, to purchasing sports equipment. Researchers have identified several family variables, including support for physical activity, mother's perception of barriers to physical activity, and parental modeling of physical activity, to be associated with physical activity levels in fifth- and sixth-grade boys and girls (Stucky-Ropp and DiLorenzo, 1993; DiLorenzo et al., 1998)
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From page 299... ...
. Most of these interventions were implemented as parts of multicomponent school-based studies such as the Child and Adolescent Trial for Cardiovascular Health (described in Chapter 7)
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From page 300... ...
. There are numerous ways in which parents can help to increase therr child's or adolescent's physical activity levels by supporting and engaging in a range of recreational or utilitarian (e.g., walking to the grocery store)
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From page 301... ...
. The 2003 Youth Risk Behavior Surveillance nationwide survey found that 38.2 percent of high school students reported watching television three hours or longer on an average school day; 67.2 percent of African-American students, 45.9 percent of Hispanic students, and 29.3 percent of white students reported three or more hours of television viewing (CDC, 2004c)
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From page 302... ...
In attempting to determine how television viewing may promote childhood obesity, studies have examined the advertising of foods (particularly high-calorie, high-fat, or high-sugar foods and beverages) , eating while watching television, decreased physical activity levels while viewing television, and the potential for physical activity that is lost due to time spent watching.
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From page 303... ...
This study demonstrates the validity of targeting decreased inactivity as a potentially effective strategy that is distinct from strategies seeking to increase physical activity. Of most direct relevance to recommendations for preventing obesity are experimental studies showing that reducing the amount of television viewing and other sedentary behaviors reduces weight gain and prevalence of obesity both among population-based samples of children and adolescents (Gortmaker et al., 1999; Robinson, 1999)
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From page 304... ...
This specific time limit is derived from the evidence provided by the two school-based prnmary prevention intervention studies that demonstrated reductions in body weight, body fat, and prevalence of obesity. The interventions in those trials set goals to limit television, videotape, and video game use to no more than seven hours per week (Robinson, 1999)
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From page 305... ...
When parents adopt a healthier lifestyle, they may foster the development of healthful behaviors and patterns in their children, in addition to positively affecting their own well-being. Researchers have provided evidence that modeling and enhanced familiarity have independent significant effects on food intake (Cullen et al., 2000, 2003)
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From page 306... ...
Researchers have compared the effects of different families' eating and activity patterns on their children. Families can be categorized as either "obesogenic," where physical activity is relatively low and energy and fat intakes are high, or nonobesogenic, where parents show higher levels of activity and lower energy intakes.
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From page 307... ...
Because of the variable timing of growth spurts, and the sometimes dramatic changes in body composition with age, continued monitoring of growth on an annual basis is warranted; if concerns arise about the child's growth trajectory, parents should then discuss these issues with a qualified health-care professional. Routine determination of children's BMI percentile, and regular communication between parents and health-care providers regarding their child's BMI-percentile history and current status, are crucial to increasing the knowledge base of parents regarding their child's growth pattern and weight status.
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From page 308... ...
To implement this recommendation parents can: · Choose exclusive breastfeeding as the method for feeding infants for the first four to six months of life · Provide healthful food and beverage choices for children by carefully considering nutrient quality and energy density · Assist and educate children in making healthful decisions regarding types of foods and beverages to consume, how often, and in what portion size · Encouu-age and support regular physical activity · Limit children's television viewing and other recreational screen time to less than two hours per day
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From page 309... ...
HOME 309 · Discuss weight status with their child's health-care provider and monitor age- and gender-specific BMI percentile · Serve as positive role models for their children regarding eating and physical activity behaviors REFERENCES AACAP (American Academy of Child and Adolescent P.~ chi at y)
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From page 310... ...
1996. Enetgy expendimte, television viewing and obesity.
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2002. Television viewing and television in bed oom associated with ovetweight risk among low-income preschool child en.
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1996. Television viewing as a cause of incteasing obesity among child en in the United States, 1986-1990.
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1994. Relanons between patental mealtime ptactices and child en's food intake.
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2004. Childten's food constmption d~ing television viewing.
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2003. Dance and reducing television viewing to prevent weight gain in African-American gi is: The Stanford GEMS pilot smdy.
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From page 316... ...
1997. The effects of a 2-yeat physical education prod am (SPARK)
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From page 317... ...
HOME 317 USDA (U.S. Department of Ag icolt~e)
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