By Glenna Murdock, RN, contributor
March 25, 2010 - One out of every three children and adolescents, ages 2 to 19, are overweight or obese, according to a national survey, and 80 percent of children who were obese between 10 and 15 years of age were obese adults at age 25. These statistics underline the importance of beginning healthy food and exercise habits in early childhood.
The subject of obesity—particularly childhood obesity—has been at the forefront recently, especially following the announcement by First Lady Michelle Obama of a national goal to eradicate childhood obesity in one generation. To that end, in February she unveiled the Let’s Move campaign. The initiative centers on four mainstays: increased physical activity, more nutritional information, increased availability of healthy foods and personal responsibility. This ambitious project is a collaborative effort, with Mrs. Obama enlisting participation from the public and private sectors and the non-profit and for-profit arenas to brainstorm and offer solutions.
The Let’s Move campaign joins a number of existing programs that have been working to combat this nationwide problem, including one organized by school nurses. Since most children spend a large portion of their day at school, this is a key setting in which to address the problem.
“The school nurse has the capacity to reach large numbers of young people and families from diverse backgrounds,” said Shirley Schantz, RN, EdD, ARNP, director of nurse education, National Association of School Nurses (NASN). “School nurses are proactive about raising awareness regarding the problem of obesity and in assisting schools to make low- or no-cost changes that have a big impact.”
“Simple changes, such as cutting fruits and raw veggies into small pieces and putting them first in the food line make those items more attractive to students,” explained Schantz. “In many schools, the nurses have been able to affect policy changes such as the elimination of sugar-sweetened beverages from vending machines and banning food rewards. Instead of pizza parties, students are rewarded with extra recess time or other favorite activities."
Now in its fifth year, the NASN’s in-service training program, School Nurse Childhood Obesity Prevention Education (SCOPE) provides strategies for school nurses to assist students, families and the school community to address the challenges of obesity and overweight.
Renee Porter, RN, CPNP, ND, is the obesity nurse coordinator at The Children’s Hospital (TCH) in Aurora, Colo. The obesity clinic at this not-for-profit hospital serves a large percentage of patients who are covered by public health assistance. The clinic takes a team approach, with each patient receiving input from a dietician, psychologist, physician, and recreation and exercise therapists.
“Ours is a very individualized approach for each family,” Porter said. “For a sedentary family, for instance, we suggest specific activities for a snowy day, a rainy day, a sunny day. We may need to figure out why a family eats the way they do and then determine the changes they need to make. There are many aspects of the problem to address.”
“A hospital can’t do it alone,” Porter continued. “There needs to be collaborative efforts amongst many different groups. The community needs to take steps to provide safe areas for children to play and exercise. The schools must incorporate healthy foods and opportunities for exercise. Citizens need to get involved in grass roots efforts for the creation of legislative bills that support healthy lifestyles in some way.”
Mrs. Obama’s campaign has asked for the help of the mayors of America’s towns and cities, encouraging them to make their communities exercise-friendly. Some who have already made strides in their towns were recognized by the first lady on the day the Let’s Move campaign was announced. The mayor of a small Mississippi town established a soccer league in his town by leasing a parcel of land from a resident for $1 per year. The mayor of a city in Massachusetts described a part of his job as creating an atmosphere and opportunity for good health, referring to new walking paths and a recreation center.
The mayor of Oklahoma City, Okla., who was dismayed to see his city ranked number two on a list of America’s fattest cities, challenged his citizens to lose weight and established a Web site where they could sign up and keep track of their weight loss. Restaurants across the city began offering daily “Mayor’s Specials” and traffic picked up on the city’s walking paths. Over a period of two years, the city has collectively lost 540,000 pounds, including 40 lost by the mayor.
On the day Let’s Move debuted, President Obama signed a formal memorandum that established the country’s first national task force on childhood obesity. The task force is made up of representatives from the departments of the Interior, Health and Human Services, Agriculture and Education for the purpose of turning Mrs. Obama’s list of proposals into action.
Another step toward fighting childhood obesity is in the health care reform bill that was recently approved by the House of Representatives; it mandates that fast food chains prominently display the calorie count of each food they serve to help customers make healthier choices.
“Health care reform is not just about insurance and access to treatment,” said Michael Eriksen, director of the Institute of Public Health at Georgia State University. “It is about keeping people healthy, resulting in less demand on the health care system.”
Toolkits for Healthcare Professionals
The National Initiative for Children’s Healthcare Quality (NICHQ) and the teams from NICHQ’s learning collaborative, "Healthy Care for Healthy Kids: a Collaborative to Prevent, Identify and Manage Childhood Overweight," have developed a toolkit to assist clinicians in providing quality care for children who are overweight or at risk for becoming overweight. The toolkit can help primary care practice teams deliver coordinated, integrated and multidisciplinary services to prevent overweight and improve care for children who are already overweight or at risk.
The state of Maine also offers Keep ME Healthy, a toolkit developed by the Maine Youth Overweight Collaborative. These tools and resources, which have received national recognition by the NICHQ, provide practical support and guidance to health care practices, organizations and individuals to help improve care and outcomes for overweight and obese youth. Additional resources are available in the Let's Go! Childhood Obesity Resource Toolkit for Healthcare Professionals.
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