Daniel Clark MD/PhD/MPH/RN/BS/GED/Promotoro/CHW and Kuei Lee

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• Daniel Clark MD/PhD/MPH/RN/BS/GED/Promotoro/CHW
  and Kuei Lee

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Childhood Obesity

• Increasing in prevalence (1976-1980 vs 2003-2006)
• 6-11 yrs old from 6.5 to 17.0
• 12-19 yrs old from 5.0 to 17.6
• 1 of 10 key health indicators for Healthy People
  2010
• 15 of American children are overweight
• Inactivity and poor diet cause 300,000
  deaths/year in U.S.
• Obesity-related diseases cost over 100
  billion/year in U.S.

Kuei
Dan
Source http//www.cdc.gov/obesity/childhood/preva
lence.html http//www.sph.uth.tmc.edu/catch/cns.h
tm
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School-Based Interventions

• 3 Basic Approaches
• Nutrition
• - Guidelines
• - Price Interventions
• - Product regulation
• Physical Activity
• Environmental
• - Community and Family Interventions

Source http//www.cdc.gov/obesity/childhood/preva
lence.html
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School-Based Interventions

• Meta-analysis
• Do School Based Food and Nutrition Policies
  Improve Diet and Reduce Obesity?
• Published and unpublished literature
• U.S. and Europe
• 18 studies met inclusion criteria

Source Jaime, Patricia C. Lock, Karen. Do
School Based Food and Nutrition Policies Improve
Diet and Reduce Obesity? Preventive Medicine,
Vol. 48, 1 2009 p. 45-53.
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School-Based Nutrition Interventions
Meta-Analysis

• Nutritional guidelines
• Decreased total and saturated fat
• Increased fruit vegetable availability
• Improved students dietary intake

Source Jaime, Patricia C. Lock, Karen. Do
School Based Food and Nutrition Policies Improve
Diet and Reduce Obesity? Preventive Medicine,
Vol. 48, 1 2009 p. 45-53.
6
School-Based Nutrition Interventions
Meta-Analysis

• Price Interventions
• Increased fruit vegetable sales
• No negative effect on profits

Source Jaime, Patricia C. Lock, Karen. Do
School Based Food and Nutrition Policies Improve
Diet and Reduce Obesity? Preventive Medicine,
Vol. 48, 1 2009 p. 45-53.
7
School-Based Nutrition Interventions
Meta-Analysis

• Product regulation
• Decreased sale of foods with minimal nutritional
  value
• Unintended negative consequences

Source Jaime, Patricia C. Lock, Karen. Do
School Based Food and Nutrition Policies Improve
Diet and Reduce Obesity? Preventive Medicine,
Vol. 48, 1 2009 p. 45-53.
8

• Physical Inactivity
• Independent risk factor for CHD
• 30 CV deaths
• 30 DM deaths
• 60 of cancer deaths

Source Stone et. al., Am J Prev Med 199815(4).
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CATCH PROGRAM

• First initiated as a research study involving
  the University of
• California at San Diego, University of
  Minnesota, Tulane University
• and the University of Texas Health Science
  Center Houston
• Purpose to develop an elementary school-based
  program to
• reduce the risk factors related to
  cardiovascular disease.
• Four Components
• Eat Smart school nutrition program
• K-5 and 6-8 Classroom curriculum
• Physical Education Program
• Family Programs

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CATCH Eat Smart
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CATCH Eat Smart
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CATCH Classroom Curriculum
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CATCH Activities and Games
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CATCH Family Activities
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CATCH Family Activities
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CATCH Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med.
1999153695-704
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CATCH Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med.
1999153695-704
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CATCH Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med.
1999153695-704
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CATCH Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med.
1999153695-704
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CATCH Follow Up from 1991-1997
Nader et al. Arch Pediatr Adolesc Med.
1999153695-704
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CATCH Follow Up Conclusions

• Intervention group demonstrated significantly
  healthier behaviors
• as compared to the control group.
• Behavioral differences between both groups
  persisted for 3 years
• after intervention.
• The difference between experimental and control
  groups, though
• still statistically different over time, are
  narrowing over time.
• More research needs to be done to develop the
  best modalities for
• maintaining intervention effects beyond
  elementary school level.
• Programs to alter environments for elementary,
  middle, junior, and
• high schools are warranted.

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Acknowledgements

• Laredo
• Roger Perales
• Kelsey Vaughn
• Sylvia Arellano
• All the Speakers
• La Bestia Blanca

• Harlingen
• Pat Bortoni
• Noe Garza
• Beatriz Tapia

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Questions?