WHAT - PowerPoint PPT Presentation

Loading...

PPT – WHAT PowerPoint presentation | free to download - id: 46f952-ZjhkY



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

WHAT

Description:

WHAT S UP DOC? School Health and Wellness A Pediatrician s Perspective Claire LeBlanc MD, FRCPC, Dip Sport Medicine University of Alberta Global Obesity Epidemic1 ... – PowerPoint PPT presentation

Number of Views:74
Avg rating:3.0/5.0
Slides: 27
Provided by: Cheo1
Learn more at: http://achsc.org
Category:
Tags: what | nutrition | sport

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: WHAT


1
WHATS UP DOC? School Health and Wellness A
Pediatricians Perspective
  • Claire LeBlanc
  • MD, FRCPC, Dip Sport Medicine
  • University of Alberta

2
Global Obesity Epidemic1
  • More than 400 million adults were obese in 2005
    worldwide
  • Chronic diseases associated with obesity account
    for 60 of the 58 million deaths/year2
  • Cardiovascular disease, diabetes, some cancers,
    chronic respiratory diseases

1http//www.who.int/mediacentre/factsheets/fs311/e
n/index.html 2 Preventing Chronic Diseases a
Vital Investment Geneva, World Health
Organization 2005
3
2003 Obesity Trends Canadian Adults
P.T. Katzmarzyk, Unpublished Results. Data
from Statistics Canada. Health Indicators, June,
2004
4
Children not Immune3
  • In 2005 at least 20 million children under five
    years old were overweight globally1
  • Up to 80 of obese youth continue this trend into
    adulthood
  • ? Risk for chronic disease and premature
    mortality

3 LeBlanc CMA, Gomez J et al. Pediatrics
,20061171834-1842
5
Prevalence of Overweight Obesity4 Canadian
Children 2004 (2-17yrs)
4 Shields M. Statistics Canada 2005 82-620-MWE
6
Provincial Overweight Obesity 20044 (children
aged 2-17)
50
PREVALENCE
0
BC
MN
NB
NS
NF
AL
SK
ON
QU
PEI
4 Shields M. Statistics Canada 2005 82-620-MWE
7
What are Some Co-morbidities of Obesity in Youth?3
  • Type 2 diabetes
  • Obstructive sleep apnea
  • Nonalcoholic Fatty liver (NAFLD)
  • Polycystic ovary syndrome
  • Hypertension
  • Hyperlipidemia
  • Focal segmental glomerulosclerosis
  • Orthopedic complications
  • Depression/anxiety
  • Poor self-esteem, and lower health-related
    quality of life

3 LeBlanc CMA, Gomez J et al. Pediatrics
,20061171834-1842
8
Why are Kids Overweight?
  • Excessive juice pop
  • Low fruit/veggies
  • Low cereal fiber
  • Absence of family meal
  • Fast-foods ? fat and energy
  • Mega-meals5

5 Newman C. National Geographic 2004206(2) 46-60
9
Why are Kids Overweight?
  • Too much TV watching
  • Strongly linked to obesity4
  • Inadequate physical activity (PA) levels6
  • Canadian 5-17 year olds average 11,356 steps/day
    by pedometer
  • Need 12,000 -16,500 steps/day 90 min
    mod-vigorous PA/day

6 CANPLAY Physical Activity Monitor 2005.
www.cflri.ca/eng/statistics/surveys/pam2005.php
10
Why Not Active Enough?
  • ? PA DAILY at home
  • TV, computer/video games
  • Unsafe environments
  • ? Recreational facilities
  • Inactive parents
  • ? PA DAILY at school
  • 17 Canadian schools (Elementary ? High) have
    daily PE by PE specialists7

7 Cameron C. Opportunities for PA in Canadian
Schools Trends from 2001-2006. www.cflri.ca

11
Benefits of Healthy Nutrition
  • Malnourished children have8
  • ? Physical activity endurance
  • ? Cognitive function school performance
  • Greater frequency of ADHD
  • Omitting breakfast can interfere with learning
    even in well-nourished children
  • School breakfast programs9
  • ? School attendance
  • ? Math test scores
  • Optimal growth development
  • Obesity prevention

8Fanjiang G Curr Opin Clin Nutr Metab Care. 2007
May10(3)342-7 9Powell, CA. Am J Clin Nutr
1998688739.
12
Benefits of Physical Activity
  • Aerobic PA ? Wt (obese kids)9
  • Diet exercise better than either alone10
  • Lifestyle PA better than calisthenics or
    programmed aerobic exercise11
  • Improved co-morbidities
  • Insulin resistance fatty liver dyslipidemias
  • ? Self esteem ? anxiety depression12
  • May improve or not worsen academics13

9Owens S. Med Sci Sports Exerc.
199931(1)143-148 10Epstein LH. J Consult Clin
Psychol. 198452(3)429-437 11Epstein LH. Behav
Ther 198516345-356 12Kirkcaldy BD. Soc
Psychiatry Psychiatr Epidemiol 200237544-550 13
Trudeau F, Shephard RJ. International J of
Behavioral Nutrition Physical Activity
20085101-41
13
Behaviour Must ChangeBut How?
  • Historically strategies to ? obesity focus on
    individual behaviour change BUT
  • Since 1950, US Federal agencies issued gt 37
    versions of guides encouraging Americans to ?
    energy intake ? PA.YET
  • Obesity rates are still rising

14
INDIVIDUAL
POPULATION
Energy Expenditure
I
T
Y
OBESE OR UNDERWT
O
P
R
E
V
Food intake Nutrient density
A
L
E
Kumanyika Ann Rev Pub Health 200122293-308
15
Comprehensive School Health Policy
  • NEW FOCUS - DEVELOP PUBLIC POLICY
  • Create healthy behavioural norms
  • Shape environment where healthy choices can reach
    entire populations
  • School environments reach large populations of
    children who are
  • Vulnerable to marketing
  • Unable to make fully informed decisions without
    guidance
  • World Health Organization (Through Public Health
    Agency of Canada) is developing a School Policy
    Framework
  • Implement WHO Global Strategy on Diet, PA
    Health
  • Promote healthy active living for staff
    students
  • Policies evidence based

http//www.who.int/dietphysicalactivity/en/index.
html
16
Effective School Programs
  • 13 Effective PA programs14
  • 12 Randomized Control Trials (RCT)
  • 11 school-based
  • All increased PA
  • 6 ? fitness measures
  • 3 ? obesity measures
  • Most were late elementary high school
  • 6 Effective programs to ? sedentary activity14
  • 6 RCT 4 School-based trials
  • 5 ? Screen time
  • 2 Improved obesity measures
  • Planet Health (2 yr) grade 6-7 students15
  • Robinsons grade 34 RCT16

14LeBlanc CMA. CMAJ 2007176(8)chapter 22
15Gortmaker SL. Planet Health. Arch Pediatr
Adolesc Med 1999153409-18 16Robinson TN.
JAMA 19992821561-7
17
Effective School Programs
  • Wellness, Academics You17
  • 1013 4th 5th graders ? PA veggies fruit
  • ? BMI ?PA ? fruit veggies
  • Fitkids 18 schools RCT after school program18
  • Grades 3,4,5
  • Healthy snacks, 80 min/day PA
  • Improved body fat fitness
  • Summers off ? returned to baseline
  • 16 Effective multifaceted programs9
  • All RCT
  • 7 trials gt 1 year duration
  • 3 increased PA
  • 5 increased fitness
  • 11 improved food intake
  • 7 improved obesity measures

17Spiegel SA. Obesity (Silver Spring). 2006
Jan14(1)88-96 18Gutin B. Int J Pediatr Obes.
20083 Suppl 13-9
18
Research Summary
  • Schools are pivotal settings to promote healthy
    active living
  • Multifaceted programs implemented in multiple
    settings targeting behaviour change rather than
    isolated knowledge acquisition appear to work
    best
  • Dedicated PE with a variety of aerobic activities
  • Active recreation before, after and during school
  • Healthy food and drinks in cafeteria, vending
    machines
  • Parental and family involvement important

19
WHO Suggests
  • Set up a School/District Wellness Committee
  • Develop implement policy
  • PA, food, curriculum, school health services
  • Monitor evaluate
  • Process, output outcome indicators
  • Involve stakeholders EARLY

20
STAKEHOLDERS
21
Schools Everyone Benefits from an Active Living
Workplace
  • Trustees, Superintendents
  • Develop policy
  • Influential, secure resources, support staff,
    bridge with external groups
  • Principals
  • Leaders promote maintain wellness programs for
    staff students
  • Teachers (Key implementers)
  • Require PE training, curriculum aligned with
    academic mandates, support from principal,
    sufficient time resources
  • Students (Key recipients)
  • Should have a say in policy/programs

22
Parents Extended Family
  • School health program can influence family
    behaviour at home
  • Students change parent behaviour
  • Parents can set a good example
  • Family can help with active living homework
    assignments
  • Family can encourage take part in safe active
    transportation
  • Walking school bus
  • Family can support school health policy and
    programs
  • PTA
  • Family can lobby decision-makers to support
    health promotion in schools

23
Health Professionals MDs
  • Provide families with office-based healthy
    lifestyle counseling
  • Time? Sufficient?
  • MD can set a good example
  • Support active school community
  • Sit on school/district wellness committee
  • Provide help with advocacy, research, monitoring,
    evaluation
  • Physicians can provide knowledge translation
  • MDs, health organizations, general public
  • Community wide education Media
  • Letters to or meetings with key decision makers

Dr. P. Nieman Marathon runner
24
Education Health United We Stand
  • Canadian Council on Learning 2008
  • 6/10 Canadian adults have insufficient literacy
    skills to manage their health
  • Those with low health literacy 2.5 x likely to
    have fair-poor health
  • MDs consulted most (74) for health-related
    information because of credibility
  • Need more training in using simple language
  • Media family/friends consulted next (67) but
    less credible schools way down on list
  • Opportunity for MDs to learn from schools on
    messaging schools to learn from MDs on
    health-related matters

http//www.ccl-cca.ca/CCL/Reports/LessonsInLearni
ng/LinL20080306HowLowLiteracy
25
Next Steps
  • Alberta School districts health regions showing
  • Best practice examples
  • Workshops
  • Listen, learn, offer help
  • Create feasible action plans for your region
  • Network of MD champions
  • NEW MODEL
  • Local ? Region ? Province

26
Alberta Will be Canadas BEST Province When We
Work Together
About PowerShow.com