2. Overview
• Socioeconomics & obesity
• Environmental factors
• Weight Management Program
– working with the entire family
• Women’s unique roles impacting childhood
obesity
3. A Framework to Prevent &
Control Overweight & Obesity
Food & Beverage Industry
SOCIAL NORMS & VALUES Agriculture
Education
Media
SECTORS OF INFLUENCE Government
Public Health Systems
Home & Family Healthcare Industry
School BEHAVIORAL SETTINGS Business & Workers
Community Land Use & Transportation
Work Site Leisure & Recreation
Healthcare Community & Faith-based
INDIVIDUAL Organizations
Genetics FACTORS Foundations & Other Funders
Psychosocial
Other Personal Factors
Food and Physical
Beverage Intake Activity
Energy Intake Energy Expenditure
Adapted from Preventing Childhood Obesity,
ENERGY BALANCE Institute of Medicine, 2005
4. County-level Estimates of Obesity among Adults aged ≥ 20 years:
United States 2008
Age-adjusted percent
0 - 19.4
19.5 - 23.8
23.9 - 27.0
27.1 - 30.7
> 30.8
www.cdc.gov/diabetes
6. Socioeconomics of Obesity
Women & Poverty
• In 2010, 17 million women lived in poverty
• Single mothers account for >40% of those living in
poverty
• Low income families more likely to live in areas
with:
o Fewer recreational opportunities
o Reduced access to healthy foods
2010 Census Data-National Women’s Law Center. Accessed Sept 9, 2012
Lindsay,AC, et al. The Future of Children, Volume 16, Number 1, Spring 2006, pp. 169-186
7. Socioeconomics of Obesity
Poverty & Obesity
• A lower income and poverty is associated with
higher Body Mass Index (BMI)
• Lower Activity is associated with higher BMI
• Low fruit and vegetable intake is associated with
higher BMI
8. Environmental Factors:
Physical Activity
• Communities not bike or walk friendly
• Limited Access to recreation facilities
• Safety Concerns
• Less daily physical activity in schools
• Increased attraction to sedentary behaviors
9. A Family Connection
• Parental obesity is one of the strongest risk
factors for childhood obesity
• Parents provide the genes and the family
environment
– Parenting style
– Food availability
– Physical activity
KL Whitaker, et al . Am J Clin Nutr. May 2010
Stang J, et al. J Am Diet Assoc.2011 Sep;111(9):1301-5.
10. Like Mother, Like Daughter….
• Children’s food preferences are more strongly
correlated with the mother
• Mother’s food decisions influence daughter’s
food choices
• Mother’s who are preoccupied with dieting
may influence daughter’s habits
• Stronger association with maternal weight
– Especially with daughters
1. Keery et al. Psychosom Res. 2006 July; 61 (1) : 105-111
2. Cutting et al. Am J Clin Nutr. 1999;69:608–13.
12. Family Based Interventions
• Counsel the mother as the family health
leader
• Family Based versus Parent Only
– Parent only interventions
Janicke, DM, et al. Arch Pediatr Adolesc Med. 2008;162(12):1119-1125
13. Advice to mothers in
our program:
1. Model healthy behaviors
2. Create opportunities for your child to make
healthy food and physical activity choices
3. 5-4-2-1- almost none
4. Make it a family affair
Notas do Editor
Lower-cost foods make up a greaterproportion of the diet of lower-incomeindividuals (23). In U.S. Department ofAgriculture (USDA) studies, female recipientsof food assistance had more energydensediets, consumed fewer vegetablesand fruit, and were more likely to beobese. Healthy Eating Index scores are inverselyassociated with body weight andpositively associated with education andincome (24). DIABETES CARE, VOLUME 31, NUMBER 11, NOVEMBER 2008, Influence of Race, Ethnicity, and Culture onChildhood Obesity: Implications forPrevention and TreatmentA consensus statement of Shaping America’s Health and the ObesitySocietySONIA CAPRIO, MD1STEPHEN R. DANIELS, MD, PHD2ADAM DREWNOWSKI, PHD3,4FRANCINE R. KAUFMAN, MD5,6
Comparing maternal and paternal intergenerational transmission ofobesity risk in a large population-based sample1–4Katriina L Whitaker, Martin J Jarvis, Rebecca J Beeken, David Boniface, and Jane Wardle First published April 7, 2010, doi: 10.3945/ajcn.2009.28838 Am J ClinNutr May 2010 ajcn.28838 J Am Diet Assoc. 2011 Sep;111(9):1301-5.Parenting style and child feeding practices: potential mitigating factors in the etiology of childhood obesity.Stang J, Loth KA.
Importance of making a difference for moms, even if goal is to reach the kids – women are key in preventing obesity from a family systems perspective – new research….