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Childhood Obesity Media Project

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Title: Childhood Obesity Media Project


1
Childhood Obesity Media Project
(University at Buffalo, 2006)
  • By Lindsay Howard, Christine Achterholt, Amanda
    Radersma, and Jojo Agtarap

2
Table of Contents
  • Purpose of Kit
  • Childhood Obesity Defined
  • Health Effects Diabetes Type II
  • Hypertension
  • Orthopedic Complications
  • Psychosocial Effects and Stigma
  • Respiratory
  • Body Mass Index
  • BMI-For-Age
  • BMI-For-Age Charts
  • At Risk Quiz
  • Fast Food Facts
  • Scary Fast Food Facts
  • Fast Food Facts
  • Tips
  • Healthy Foods
  • Canadas Food Guide
  • Tips for Parents
  • 5 Strategies for Healthy Eating
  • Frequently Asked Questions
  • Sample Letter
  • Definitions
  • Obesity Brochure
  • References

3
Purpose of the Obesity Tool Kit
  • This tool was developed for nurses with the
    intent that they (as well as other healthcare
    professionals) will use it as a tool for
    childhood obesity education in various settings.
  • The entire tool kit or
  • portions there of are
  • accessible for viewing,
  • printing, and other uses
  • as necessary or
  • when desired.

(Webweaver, 2006)
4
Childhood Obesity Defined
  • The prevalence of obesity has been increasing
    at an alarming rate over the past two decades.
    The National Center for Health Statistics (2002)
    had estimated that sixteen percent of children
    ages six to nineteen years of age are overweight.
    With the increasing growth of childhood obesity
    in North America, the medical community is now
    paying attention to this epidemic since early
    2000. About 15.5 percent of adolescents (ages 12
    to 19) and 15.3 percent of children (ages 6 to
    11) are obese (National Center for Health
    Statistics, 2002). The increase in obesity among
    North American youths over the past two decades
    is dramatic, as shown in the tables below.

5
(American Obesity Association,
2002)
6
Health Effects Diabetes (Type 2)
  • Type 2 diabetes accounted for two to four percent
    of all childhood diabetes before 1992, but
    skyrocketed to 16 percent by 1994. The parallel
    increase of obesity in children and adolescents
    is reported to be the most significant factor for
    the rise in diabetes. (American Obesity
    Association, 2002)
  • Obese children and adolescents are reported to be
    12.6 times more likely than non-obese to have
    high fasting blood insulin levels, a risk factor
    for type 2 diabetes. (American Obesity
    Association, 2002)
  • An inactive person risks a lipid profile
    consisting of raised concentrations of
    low-density lipoprotein (LDL) cholesterol and
    triglycerides, and reduced concentrations of
    protective high-density lipoprotein (HDL)
    cholesterol (Hambrecht Gielen, 2005)

(Childrens Physician, 2005)
7
Hypertension
  • Persistently elevated blood pressure levels have
    been found to occur about nine times more
    frequently among obese children and adolescents
    (ages five to 18) than in non-obese.
  • Obese children and adolescents are reported to be
    2.4 times more likely to have high diastolic
    blood pressure and 4.5 times more likely to have
    high systolic blood pressure than their non-obese
    peers (American Obesity Association, 2002).

(BBC Health, 2006)
8
Orthopedic Complications
  • Engaging in little activity increases
    adolescents risk of developing both mechanical
    and metabolic health related issues. Obese teens
    are at risk for joint disease in their lower
    limbs due to the excess weight the body has to
    handle.
  • Growing youth, bone and cartilage in the process
    of development are not strong enough to bear
    excess weight. As a result, a variety of
    orthopedic complications occur in children and
    adolescents with obesity. In young children,
    excess weight can lead to bowing and overgrowth
    of leg bones.
  • Obese teens are at risk for joint disease in
    their lower limbs due to the excess weight the
    body has to handle. The associated diseases
    includes bilateral tibia vara, which results in
    knee pain, slipped upper femoral epiphyses, which
    causes hip pain, and pes planus, which is caused
    by poor foot arches.

(Seacoast Orthopedics Sports
Medicine, n.d.)
(Loke, 2002).
9
Psychosocial Effects Stigma
  • Black, Goldstein, Mason (1992) note that 19.3
    of obese individuals had a depressive disorder,
    with 10 presenting with bipolar disorder.
  • Obese adolescents have feelings of low
    self-esteem, social isolation, rejection and
    depression. They may also feel a strong sense of
    failure (Marmitt, 1991).

(Care for Kids, 2006)
10
Respiratory
(Mount Sinai School of
Medicine, n.d)
(Sleeplabs, n.d)
  • Prevalence of obesity is reported to be
    significantly higher in children and adolescents
    with moderate to severe asthma compared to their
    peer group.
  • Sleep apnea, the absence of breathing during
    sleep, occurs in about seven percent of children
    with obesity. For obese children, obstructive
    sleep apnea makes sleeping difficult, since the
    excessive fat in the neck causes the partial
    obstruction of the upper airways during sleep.
    The poor quality of sleep often results in lapses
    in concentration and memory, as well as daytime
    somnolence.

(Loke, 2002)
11
Body Mass Index (BMI)
  • Body Mass Index
  • (BMI) is a mathematical
  • formula used to assess
  • relative body weight.
  • The measure correlates
  • highly with body fat. It
  • is calculated as weight in
  • kilograms divided by the
  • square of the height in
  • meters (kg/m2) (American
  • Heart Association AHA,
  • 2006).
  • BMI weight (kg) / height2
  • (meters2) (AHA, 2006)
  • To convert pounds to kilograms, divide
  • the amount in pounds by 2.2 to give
  • you the amount in kilograms.

(Health Network, 2005)
12
BMI-for-Age
  • BMI for Children and Teens is sometimes referred
    to as "BMI-for-age (Center For Disease Control
    and Prevention CDCP, 2005).
  • BMI is used differently with children than it is
    with adults. In children and teens, body mass
    index is used to assess underweight, overweight,
    and risk for overweight. Children's body fatness
    changes over the years as they grow (CDCP, 2005).
  • BMI-for-age is plotted on gender specific growth
    charts. These charts are used for children and
    teens two to 20 years of age (CDCP, 2005).
  • Healthcare professionals use the following
    established percentile cutoff points to identify
    underweight and overweight in children (CDCP,
    2005)
  • Underweight is BMI-for-age Normal is BMI-for-age 5th percentile to percentileAt risk of overweight is BMI-for-age
    85th percentile to is BMI-for-age 95th percentile (CDCP, 2005).
  • The same calculation that is used with adults is
    used with, but the age of the child is also taken
    into consideration. (See following slide for age
    and sex specific charts)

(RuthK, 2006)
13
BMI-For-Age Charts
Boys
Girls
(CDCP, 2005)
14
At Risk for Obesity Quiz
  • 1) How much "screen time" (TV, video, computer
    games) does your child get each day?
  • Less than one hour -1 point
  • One to two hours 0 points
  • Two to three hours 1 point
  • More than three hours 2 points
  • 2) How many servings of fruits and vegetables
    (excluding fruit juice) does your child consume
    each day?
  • Five or more servings 0 points
  • Three to five servings 1 point
  • Less than three servings 2 points
  • 3) How much physical activity does your child get
    each day?
  • Less than 30 minutes 2 points
  • 30 to 60 minutes 0 points
  • More than 60 minutes -1 point
  • 5) Is water your child's primary beverage
    throughout the day, with low-fat or skim milk at
    meal times?
  • Most occasions 0 points
  • Sometimes 1 point
  • Hardly ever 2 points
  • 6) My child snacks predominantly on high-fat
    foods.
  • Most of the time 2 points
  • Some of the time 1 point
  • Hardly ever 0 points
  • 7) Food is not used to reward positive behavior
    in our family.
  • True 0 points
  • False 1 point
  • 8) My child participates on community or school
    sports teams or is involved in activities such as
    dance classes or tennis lessons.

(USA Today, 2003)
15
Quiz Continued.
  • 9) Regular physical activities are part of our
    family life.
  • True 0 points
  • False 1 point
  • 10) Do the child's parents maintain a healthy
    weight?
  • Yes, both parents maintain a healthy weight 0
    points
  • No, either the mother or father is overweight
    1 point
  • No, both parents are overweight 2 points
  • Scoring
  • -2 to 2 points Your child is at low risk of
    becoming overweight or obese. Continue to
    encourage your child to be active and eat
    healthy.
  • 3 to 7 points Your child is at moderate risk.
    Look for ways to increase opportunities for
    physical activity and focus on providing a
    balanced and healthy diet for your child.
  • 8 to 12 points Your child is at moderately high
    risk. Limit his or her screen time and help your
    child achieve the national guideline of one hour
    of physical activity each day. Look for ways to
    incorporate physical activity into your family
    life or identify organizations that your child
    can join that will provide opportunities for
    regular physical activity. In addition, examine
    your family's meal and snack patterns. Try
    replacing high-fat snacks with servings of fruits
    and vegetables.
  • 13 to 16 points Your child is at high risk.
    Carefully examine your child's eating and
    exercise habits.

(USA Today, 2003)
16
Fast Food Facts
(McDonalds, 2006)
(My Campus Dining, n.d.)
  • In a recent study, children who ate fast food
    (compared to those who
  • did not) were found to have the following
    intakes
  • Higher level of calorie intake
  • More fat and saturated fat
  • More total carbohydrates
  • More added sugars
  • More sweetened beverages
  • Less milk, fiber, vegetables
  • Eating fast food on a frequent basis does not
    provide the
  • recommended nutrient intake for optimal growth
    and development of
  • children. An increase in the reliance on fast
    food restaurants may be
  • contributing to the increased prevalence of
    overweight children.
  • (Asche, 2005)

17
Scary Fast Food Facts
  • McDonald's feeds more than 46 million people a
    day - more than the entire population of Spain.
  • French fries are the most eaten vegetable in
    America.
  • The average child sees 10,000 TV advertisements
    per year.
  • McDonald's operates more than 30,000 restaurants
    in more then 100 countries on 6 continents.
  • Only seven items on McDonald's entire menu
    contain no sugar.
  • McDonald's distributes more toys per year than
    Toys-R-Us.
  • (Supersize Me, n.d.)

18
Fast Food Facts
  • Due to increases in drive-thru restaurants and
    the demands of everyday life parents are more
    likely to buy meals for their children from fast
    food restaurants (Statistics Canada, 2003)
  • According to Statistics Canada (2004), 1/3 of
    children aged 14-18 interview in a study had
    consumed something prepared by a fast-food outlet
    the day before their interview.
  • The food prepared in the fast-food outlets ranged
    from pizza, hamburgers to hot dogs and 25 had a
    regular soda.
  • Harrison Marske report that with an average of
    10.65 food advertisements an hour being shown on
    TV children aged 6-11 see about 11000 food
    advertisements every year (University of
    Michigan, n.d.)

(University of Michigan, n.d.)
19
Tips on How to Reduce Reliance on Fast Foods
  • Be aware of the negative health effects of
    regular use of fast foods.
  • Make informed decisions about fast food by asking
    for nutrition information about menu offerings.
  • Value good nutrition and make it a family
    priority.
  • Plan ahead. Plan simple meals for week nights.
    Always include a fruit and a vegetable.
  • Prepare main dish items on the weekend that can
    be frozen for a quick meal later in the week.
  • Utilize a crock pot to start a meal before you go
    to work so it will be ready when you get home.
  • Visit the following websites for nutritional
    information and tips on healthier eating,
  • http//www.bddiabetes.com/us/download/13a_fastfo
    odguide.pdf
  • or
  • http//www.fraserhealth.ca/NR/rdonlyres/etq23spst
    vxkh4bjfyhbglgru6zfhmkmdi6ohoykjsgrofgn2z7s4izripm
    dletbjj6sdznsjietwn/HealthierFoods.pdf
  • (Asche, 2005)

20
Fast Food Facts Nutritional Information Sheets
  • http//www.wendys.com/food/pdf/us/nutrition.pdf
  • http//www.mcdonalds.ca/pdfs/Food_FactsNutrition_e
    n.pdf
  • http//www.bk.com/Nutrition/PDFs/brochure.pdf
  • http//www.arbys.com/nutrition/printable.php?type
    nutrition
  • http//www.yum.com/nutrition/documents/kfc_nutriti
    on.pdf

21
Are Healthy Foods Affordable?
  • The average monthly cost to feed the average
    family of four in 2005 is 654, up from last
    year by 3.5.
  • The largest barrier for healthy eating is
    inadequate income. Poverty is associated with
    lower food expenditures and lower quality diets.
    Low income families consume fewer fruits,
    vegetables and milk products than higher income
    families in Canada.
  • Families on income assistance living and buying
    food in BC would need to spend 31 to 44 of
    their income on food, compared to the average
    B.C. family that spends 15 of their income on
    food.


(Swiss Info, 2006)
(The Cost of Eating in BC, 2005)
22
Are Healthy Foods Affordable?
  • Low income families are more likely to eat an
    unbalanced diet, be physically inactive and
    overweight or obese. Unless the root cause of
    food insecurity is addressed povertyit will be
    difficult to achieve the provincial governments
    2010 health targets.
  • 36 of children use the food bank.

(Health Canada, 2002)
(The Cost of Eating in BC, 2005)
23
Canadas Food Guide
(Funny and Jokes, 2005)
24
Canadas Food Guide
(Red Apple, 2006)
  • The amount of food your body needs every day from
    each of the four food groups depends on your age,
    body size, activity level, whether you are male
    or female and if you are pregnant or
    breast-feeding. The Food Guide gives a lower and
    higher number of servings for each food group.
    Children would require a smaller serving size
    than a teenager or adult. (Health Canada, 2006)
  • View a printable version of Health Canadas Food
    Guide at
  • http//www.hc-sc.gc.ca/fn-an/food-guide-aliment/f
    g_rainbow-arc_en_ciel_ga_e.html

(Health Canada, 2006)
25
Tips for Parents
  • Children cant obtain all the nutrients a day
    through three meals alone, they need smaller
    portions of food more frequently.
  • Dont ban childrens snacks, plan them most
    children snack on prepackaged food which are high
    in calories and low in nutrients. provide healthy
    snack choices so children will learn to make
    healthy food choices in the future.
  • Children will typically grab whatever is close
    and easy. Try to have vegetables and fruits cut
    up and ready to eat.
  • Fruit juice is not a healthy choice, although
    they may contain nutrients, they are often high
    in calories and lead to weight gain and tooth
    decay. Juice also lacks the fiber that actual
    fruit has.
  • Children should drink no more than two 6 ounce
    servings of fruit juice a day .
  • Healthy snack choices include microwave popcorn,
    low or fat free milk, cheese and yogurt, low
    sugar/ whole grain breads and cereals.
  • Read nutrition labels. Sometimes foods that say
    low fat are high in sugar.
  • Limit the amount of television your children
    watch. This will help your child be more active
    and lessen the number of advertisements featuring
    unhealthy high-calorie foods.
  • Be a role model for your kids! If you are eating
    healthy so will they.

(Yolo, 2006)
(NAAR, 2005)
(Clerccenter, n.d.)
(Mayo Clinic, 2006)
26
Five Strategies for Healthy Eating
(Eton Digital, 2005)
  • Eat meals as a family.
  • Stock up on a variety of healthy foods and
    snacks This makes it easy for children to make
    healthy choices.
  • Be a role model to your children by eating
    healthy this is the best way to encourage
    healthy eating.

(Kids Health, 2006)
(Parisi, n.d.)
27
Five Strategies for Healthy Eating
(Eton Digital, 2005)
  • 4) Do not battle over foods do not bribe,
    bargain, reward or use food to show your love. Do
    not force your children to clean their plate as
    doing so teaches children to ignore their
    feelings of fullness.
  • 5) Get your children involved Children will
    enjoy making decisions about what to make for
    dinner etctalk to them about how to make a
    healthy meal and allow them to shop with you. You
    can help them create healthy habits.

(Kids Health, 2006)
(Health Care for Child Care, 2006)
28
Frequently Asked Questions
(The Chicago Book, 2006)
(Dakota Flax,2005)
(Frequently Asked Questions, n.d.)
29
  • 1) My child is overweight. What treatment options
    are available?
  • Children may have a genetic predisposition to
    obesity, being more common in children when one
    parent is obese and much more common when both
    parents are obese. Decreased activity levels in
    children, combined with the availability of
    palatable, high fat foods, is leading to the
    increase in childhood obesity. Currently, the
    treatment of childhood obesity primarily involves
    attempts at increasing exercise, decreasing the
    fat content of childrens diets, and behavioral
    changes.

(Galeria Karola Krenskiego, n.d)
(Abacus Design, n.d.)
30
  • 2) What are some of the factors that contribute
    to childhood obesity?
  • There are many factors that contribute to
    childhood obesity including technological
    advancement, lack of parental oversight,
    decreased physical activity, inadequate school
    lunch programs and easy access to fast-food.
  • A) Physical Inactivity and Safety Concerns
  • Kids today, in general, exercise less than kids
    from previous generations. With increasing levels
    of violence in society, parents have greater
    safety concerns about letting children play
    outside. Parents are reluctant to let their
    children even walk alone to play with their
    friends. Many children go straight from school
    to home, where they must stay inside until their
    parents get home. They have time to watch TV,
    play video games and snack.
  • B) Easy Access of High-Calorie Foods
  • In addition to physical inactivity, easy access
    to high-calorie foods significantly contributes
    to children gaining weight. Many school lunch
    programs offer unhealthy choices, but even the
    programs that offer healthy foods are not helping
    kids stay at a healthy weight kids often refuse
    to eat the healthy food. Additionally, the
    availability of vending machine snacks can easily
    undo any benefits healthy school lunch programs
    promote. Schools are reluctant to remove vending
    machines because of the revenue they generate.

(Abacus Design, n.d)
(State Transit Authority, n.d.)
(Abacus Design, n.d.)
31
  • 3) What methods do you recommend for weight
    reduction?
  • The general recommendations are usually dietary
    alterations with behavior modification and
    exercise. Methods such as, weight reduction
    programs and treatment and screening of
    underlying eating disorders are interventions
    that can be utilized. 
  • 4) How do I figure out what a healthy weight is
    for my child?
  • It is difficult to figure out the ideal weight
    for a child, because children grow so quickly.
    One way to estimate a healthy weight is to
    consult a doctor. Comparing your childs weight
    to standard weights of other children by age is
    another alternative measure that can be used.
  • 5) At what age should I start monitoring my
    childs weight?
  • Although it is usually not recommended to
    closely monitor your childs weight, it is a good
    idea to monitor for signs and symptoms that your
    child could become overweight as early as age 2.
    Children may show signs of being overweight by
    late infancy.

(Small Indulgence,2006)
(Engineering Electronics, 2003)
(Abacus Design, n.d.)
32
Sample Letter
  • Dear Community Leaders,
  • The issue of childhood obesity has risen in
    recent years to become one of the greatest health
    crises impacting the future of our children.
    Childhood obesity is now considered an epidemic
    that affects one in three children, and the
    crisis is growing (Cowley, 2000). According a
    recent statistic the health crisis affects ten to
    fifteen percent of youth today with the numbers
    tripling in the past twenty years (Childhood
    Obesity Foundation, 2006). Childhood obesity is
    known to be caused by such factors as sedentary
    lifestyles and poor eating habits. Obesity is
    linked to problems such as depression, social
    isolation and decreased self-esteem as well as an
    increased risk for the development of chronic
    illnesses such as type II diabetes and heart
    disease.
  • As a community we must take a stand to prevent
    and change the way obesity is affecting our
    children and their future. We need to work
    together to increase peoples awareness of the
    magnitude of the problem and join forces to
    develop strategies for change. Prevention,
    promotion, and management are key to our
    childrens health and their future. Families,
    parents, teachers, health professionals and
    governments must join together to fight the
    obesity epidemic.
  • For more information on how you can help..(add
    contact information)
  • Sincerely,

Letter Click on Letter to left to download
a printable copy of this letter
33
Definitions
  • Body Mass Index a mathematical formula used to
    assess relative body weight. The measure
    correlates highly with body fat. It is calculated
    as weight in kilograms divided by the square of
    the height in meters (kg/m2) (American Heart
    Association, 2006).
  • Chronic Illness a long-lasting or recurrent
    condition that usually lasts longer than three
    months (Wikipedia, 2006). Examples related to
    childhood obesity include heart disease, type 2
    diabetes and hypertension.
  • Epidemic a disease that appears as new cases in
    a given human population, during a given period,
    at a rate that substantially exceeds what is
    "expected", based on recent experience
    (Wikipedia, n.d.)
  • Health According to the World Health
    Organization "health is a state of complete
    physical, mental and social well-being and not
    merely the absence of disease or infirmity. It
    also ncludes the ability to lead a "socially and
    economically productive life" (Wikipedia, n.d.,
    para. 2).

34
Definitions
  • Overweight having more body fat than is typical
    or required for the normal functioning of the
    body (Wikipedia, n.d.)
  • Physical Exercise is the performance of some
    activity in order to develop or maintain physical
    fitness and overall health. Frequent and regular
    physical exercise is an important component in
    the prevention of some of the diseases of
    affluence such as heart disease, cardiovascular
    disease, Type 2 diabetes and obesity (Wikipedia,
    n.d., para 1).
  • Prevalence can be defined by either of the
    following
  • the total number of cases of a given disease in
    a specified population at a specified time and/or
  • the ratio of the number of cases of a disease
    present in a statistical population at a
    specified time and the number of individuals in
    the population at that specified time(Wikipedia,
    n.d., para 1).
  • Sedentary Lifestyle a type of lifestyle most
    commonly found in modern (particularly Western)
    cultures. It is characterized by sitting or
    remaining inactive for most of the day (for
    example, in an office or at home). It is believed
    to be a factor in obesity and other disorders,
    primarily heart disease (Wikipedia, n.d., para.
    2).

35
Obesity Brochure





  • Childhood Obesity
  • A Growing Epidemic
  • obesitybrochure.pdf

(University at Buffalo, 2006)
Designed By Kwantlen University College Nursing
Students 2006
Brochure Click on Brochure to left to
download a printable copy
36
References
  • Abacus Design. (n.d.) Frequently Asked Questions.
    Retrieved November 3, 2006, from
    www.abacusdesign.com.au/frequently-asked-ques...
  • American Heart Association. (2006). Glossary.
    Retrieved Match 16, 2006, from http//www.american
    heart.org/presenter.jhtml?identifier1158
  • American Obesity Association (2002) Childhood
    Obesity. Retrieved November 3, 2006, from
    http//obesity1.tempdomainname.com/subs/childhood/
    prevalence.shtml
  • http//obesity1.tempdomainname.com/subs/fast
    facts/obesity_youth.shtml
  • Asche, K. (2005). Fast foods may increase
    childhood obesity rates. Retrieved November 3,
    2006, from http//www.extension.umn.edu/
    extension news/2005/fast food.html
  • BBC Health. (2006). Condition Hypertension.
    Retrieved November 3, 2006, from
    www.bbc.co.uk/.../conditions/hypertension1.shtml
  • BC Community Nutritionist Council School
    Advisory Committee. (n.d.). Healthier foods How
    to make fun-fast-food healthier for students.
    Retrieved November 5, 2006, from
    http//www.fraserhealth.ca/NR/rdonlyres/etq23spstv
    xkh 4bjfyhbglgru6zfhmkmdi6ohoykjsgrofgn2z7s4izripm
    dletbjj6sdznsjietwn/HealthierFoods.pdf
  • Black, D.W., Goldstein, R.B., Mason, E.E.
    (1992). Prevalence of mental disorder in 88
    morbidly obese bariatric clinic patients. America
    Journal of Psychiatry, 149, 227-234.

37
References
  • Canadian Institutes of Health Research. (2003).
    Obesity in Canada identifying policy priorities.
    Institute of Nutrition, Metabolism and Diabetes
    (INMD) http//www.cihrirsc.gc.ca/e/21597.html14
  • Center for Disease Control and Prevention.
    (2005). BMI-Body Mass Index BMI for Children and
    Teens. Retrieved March 16, 2006, from
    http//www.cdc.gov/ nccdphp/dnpa/bmi/bmi-for-age.h
    tm
  • Childhood Obesity Foundation. (2006).
    Identifying, evaluating and promoting best
    practices for childhood obesity. Retrieved
    September 24, 2006, from http//www.cofbc.ca
  • Clerccenter. (n.d.). Retrieved November 6, 2006,
    from http//clerccenter.gallau det.edu/products/im
    ages/otherphotos/ODY_5.gif
  • Cowley, G. (2000). Generation XXL Childhood
    obesity now threatens one in three kids with
    long-term health problems and the crisis is
    growing. Newsweek, 136(1), 40-44. Retrieved
    September 25, 2006, from CINAHL database.
  • Dairy Queen. (2006). Nutrition facts. Retrieved
    November 3, 2006, from http//www.dairyqueen.com/N
    R/rdonlyres/F4C25FBA-C782-4E3B-8D18-F30A041B3BF0/0
    /DQLtdBrzrGrllChllNtrtnFcts2006.pdf

38
References
  • Dakota Flax. (2005). Frequently asked questions
    and answers. Retrieved, November 3, 2006, from
    www.dakotaflax.com/faq.html
  • Demasi, B. Keith, R. (2006). Timely
    information Human nutrition, diet health.
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