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Addressing Childhood Obesity

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Kent Thompson

on 3 April 2013

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Transcript of Addressing Childhood Obesity

Addressing Childhood Obesity Prevention through School Gardens and Farm to School Programs Dr. Judith Weber, PhD, RD & Rachel Schichtl, MS, RD
Childhood Obesity Prevention Research Program
Arkansas Children’s Hospital Research Institute
Department of Pediatrics, UAMS Background School
Gardens Farm
School Garden
Cafeteria Summary In Arkansas:
Approximately 21% of children and adolescents ages 6-19 years are obese (≥ 95th percentile), and a combined 38% are overweight or obese (≥ 85th percentile)
Highest prevalences are found in Hispanic boys (31% ≥ 95th, 50% ≥ 85th) and African American girls (26% ≥ 95th, 45% ≥ 85th) and Hispanic girls (24% ≥ 95th, 44% ≥ 85th)

Arkansas Center for Health Improvement, Year Seven Assessment of Childhood and Adolescent Obesity in Arkansas (Fall 2009-Spring 2010), Little Rock, AR: ACHI, December 2010 Background: Child Health Trends Nationally:
Approximately 19% of children and adolescents ages 6-19 years are obese (≥ 95th percentile), and a combined 35% are overweight or obese (≥ 85th percentile)
Highest prevalences are found in Hispanic boys (27% ≥ 95th; 43% ≥ 85th) and African American girls (26% ≥ 95th; 43% ≥ 85th)

Ogden CL., Carrol MD., Curtin LR., Lamb MM., Flegal KM., Prevalence of High Body Mass Index in US Children and Adolescents, 2007-2008, JAMA. 2010;303(3):242-249. Background: Child Health Trends Obese children and adolescents are at greater risk for health problems:
CVD: High BP, High Cholesterol, Abnormal Glucose Tolerance
Psychosocial: Low self-esteem, Depression
Asthma, Hepatic Steatosis, Sleep Apnea, Type 2 Diabetes
Adult Obesity
80% of children overweight at age 10-15 are obese at age 25
If overweight before 8 yrs, adult obesity is more severe Background: Child Health Trends Fruit and Vegetable Intake (YRBS 2009)
< 23% consumed fruits and vegetables ≥ 5 times per day
< 14% consumed vegetables 3 times per day
~29% consumed 1 regular soda ≥ 1 time per day during the 7 days prior to the survey

Physical Activity (YRBS 2009)
< 19% were physically active at least 60 minutes per day on each of the 7 days prior to the survey~33% of students watched TV 3 or more hours per day on an average school day

Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance- United States. Surveillance Summaries, 2009. MMWR 2010;59. Background: Child Health Trends Evidence Limitations Why
Gardens? Targeted
Behaviors Targeted
Behavior School
Prevalence DGS
Example Increase in willingness to taste
Increase in preferences
Increase in intake
Increase in physical activity (very small sample)
Increase in confidence to prepare
Increase in identity From 13 studies - 7 Positive Lack of rigor in current school garden literature Small sample sizes (n<400); convenience samples
Usually no control groups
Small size gardens
Minimal documentation of physical activity
Mainly limited to elementary schools
Focus primarily on knowledge, willingness to taste/try new F/V
Brief exposures (e.g. 12 weeks or less)
Lack of curricular materials Academic/Curricular Considerations: Academic support is the most frequently cited reason for having a school garden (85%)
However, greatest barriers to using the garden
for instruction are:
Lack of time (88%)
Lack of curricular materials specifically linked to the relevant academic standards (74%) School Garden Programs Increase children’s access to, and variety of, fresh fruits and vegetables (FV)
Increase children’s intake of FV
Increase opportunities for physical activity (PA)
Integrate with core curriculum to impact academic achievement
Provide a physical and emotional place for at-risk kids to “fit in” Dietary Intake Increased FV (amount and variety)
Decrease foods high in fats and added sugars Physical Activity Increase number of minutes spent in light, moderate, and vigorous PA
Increase number of minutes spent in cardiovascular (CV), bone strengthening, and muscle strengthening (PA) “Places” where children live: Home
State Social risk factors: Race/ethnicity
Income level
Household composition
Delinquency issues School Garden Facts Fact 1
Fact 2 Design
Goals Intervention
Component Curriculum
Component Preliminary
Results Sufficiently large sample size; >6 schools
Pair-matched control schools
Large size garden plus greenhouse
Focus on key risk behaviors: fruit/vegetable intake and physical activity
Expand to middle school
Full academic year
Aligned to state frameworks in core subjects To increase fruit and vegetable intake
To increase physical activity Primary Goals Maintain or reduce body weight
Maintain or reduce body mass index (BMI)
Maintain or reduce body fat
Improve academic achievement
Increase school bonding (attachment)
Reduce social risk behaviors (fighting, absenteeism, bullying) Secondary Goals Coming Soon! Intervention Component Coming Soon! Results Preliminary
Data Evidence Limitations /
Barriers Why
School Farm
Facts AFRI
Example What is it?
What is local? Goals Ongoing
Activities Farm
Capacity Barriers How
Addressing AFRI
Example Taste
Tests Farm to School programs connect schools to local farmers by serving local produce in school cafeterias and providing agriculture, health, and nutrition education opportunities. What is Farm to School? Varies from 50-100 miles to state wide to regional
May be associated with such factors as
Grown on a small-scale farm
Directly sold by farmer
Sustainably grown
Current operating definition for AR:
From anywhere in Arkansas or surrounding states for districts that are close to the border What is Local? What is Farm to School? Coming Soon! Evidence Coming Soon! Limitations/Barriers Economic
School Meals Why Farm to School? Number of programs incrase from <10 in 1998 to >1,100 by 2007
Programs located in 50 states in >12,000 schools serving K-12 students
Total annual sale for farmers range from $8,000-55,000 (2004-2006 data) Farm to School Facts Coming Soon! Goals CND Survey
HS Ongoing Activities 95% of schools process fruits and vegetables from ‘as purchased’ to ‘edible portions’.
44% of districts have capacity to increase processing of fresh fruits and vegetables. Farm to School Capacity 83 Districts identified at least one locally grown product they would like to purchase
These districts serve a combined 142,495 students per day
1 serving per week for 1 school year:
= 4.9 million servings per year! Market Potential for Farm to School in Arkansas Lists of local vendors and produce products they offer
Regulatory information
Food safety training related to fresh produce
Information on how to order from local producers
Examples of farm to school programs from around the country
Tips on seasonal menu planning
Training to process fresh produce
Quantity recipes for local fruits and vegetables
Marketing techniques to expanding the palate of students
Information on forming a purchasing cooperative What Information Would Help Child Nutrition Staff Market Maker
Policies and legislation
Checklist How Addressing? Feature garden produce on a salad bar
Purchase seed with school meals money
Get students involved in growing produce, planning recipes
Food Safety Checklist Available Garden to Cafeteria Options Taste Tests Marshall Taste Test Results Little Rock Taste Test Results ADE CNU Supports Farm to School ACHRI Childhood Obesity Prevention Research Program
The Arkansas Grow Healthy Study
Monthly Newsletter – sign-up sheet or email Andrew Carberry
ADE CNU Farm to School Webpage
Under construction, Benefits, First steps, FAQ’s, Links up so far Where to Find Us The National Farm to School Network www.farmtoschool.org
USDA Farm to School http://www.fns.usda.gov/cnd/f2s/
Farm to School: A Selected and Annotated Bibliography http://www.nal.usda.gov/afsic/pubs/srb1102.shtml Where to Find Information
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