Childhood Obesity

There are more than one billion people affected by obesity in the world. In fact, the second-leading cause of death is from the effects of obesity (Miller, Rosenbloom, & Silverstein, 2004). Worldwide, there are over 22 million children under the age of 5 who are considered obese or overweight based on their body mass index (BMI) (Miller, Rosenbloom & Silverstein, 2004). Emphasis needs to be placed on prevention of obesity, rather than correction of the problem. Three nursing strategies that can be implemented to help reduce this trend are educating children on health lunch and drink choices while they are at school, promoting increased physical activity and working with the media to reduce junk food advertising.
Statistics show the number of overweight children in North America could reach 50% in the next 4 years (The Associated Press, 2006). Obesity results in high blood pressure, higher insulin levels, increased heart rate and cardiac output, and a high level of low-density lipoprotein cholesterol (LDL) (Davis, Kolar, Morthington, Davis, & Moll, 2002). These factors contribute to the development of diabetes, heart disease and strokes at an earlier age than children of normal weight (The Associated Press, 2006). Overweight children also have higher rates of infertility (Dehghan, Danesh, & Merchant, 2005). Due to these health trends, this generation may have a shorter life expectancy than their parents (The Associated Press, 2006). There are several contributing factors to the problem of obese children. One factor is a movement toward a more sedentary lifestyle. This results from increased television viewing and playing computer games. There is also a decreased sense of safety, resulting in fewer children walking to school each year and to other activities due to safety concerns. More parents are working and have their children stay inside while they are gone. Working parents also lack time to cook nutritional meals and have higher rates of fast food consumption. By addressing these contributing factors, nurses can help to reduce the rates of childhood obesity.
One nursing strategy is to educate children and parents on healthy food and drink choices. School and public health nurses have an opportunity to do this with school age children, especially since children eat one to two meals while at school. Nurses can go into classrooms and teach children how to make nutritional food choices through demonstration, visual aids and class discussion. Nurses can place educational emphasis on improving nutrition, the importance of exercise, preventing obesity and discouraging unhealthy lifestyle practices like smoking, alcohol and drug use to school age children (Davis et al, 2002). This will encourage children to make healthier lifestyle choices, decreasing obesity levels which will result in lower levels of cardiovascular disease and diabetes. Schools can provide healthy lunch option, such as fruits, vegetables, and whole-grain foods, which will help to encourage positive practice for making nutritional meal choices (Davis et al, 2002). Soda machines can be replaced with water and milk machines (Laing, 2002). In order to get parents involved, a child’s weight problem can be addressed on a report card. Studies have shown that parents who received health and fitness report cards for their children were more likely to address the weight problem and encourage health activities (Dehghan, Danesh, & Merchant, 2005).
While eating a healthy diet is essential to reducing childhood obesity, other lifestyle choices must also be made to correct the overweight trend. Another nursing strategy that can be implemented to help reduce increasing childhood obesity is to promote increased levels of physical activity. This can be accomplished through several different avenues. Since a sense of safety is vital for children and parents to participate in outdoor activities, nurses need to work with the local government to create safe play areas for children. Parks and ply zones that will be monitored for safety can be created in neighborhoods. These areas need to be easily accessible to children and need to promote play, exercise and physical recreation (Laing, 2002). Nurses can also work with parents and children to increase participation in sports activities. Children would be involved in regular physical exercise during which they receive positive support from their peers (Davis, et al, 2002). Schools can develop physical education programs that are longer in time and emphasize cardiovascular health (Dehghan, Danesh, & Merchant, 2005). With decreased caloric intake, the metabolism will slow down so physical activity is vital to promoting weight loss among obese children. Physical activity will also help increase insulin sensitivity and increase cardiovascular fitness (Miller, Rosenbloom, & Silverstein, 2004).
A third and final nursing strategy for reducing childhood obesity is to work with the media and marketing groups to promote healthy lifestyle choices and reduce junk food advertising. By using toys, music and easily identifiable characters, fast food chains promote their products to children (Miller, Rosenbloom, & Silverstein, 2004). Snacks, fast foot and other junk food products are most heavily advertised during children’s television programs (Laing, 2002). Nurses need to work with the media to change the advertising emphasis to healthy food and lifestyle choices. Making healthy food choices easy to identify for both parents and children while grocery shopping is another way nurses can work with marketing companies to reduce childhood obesity. Packaging can be changed to include easy to read nutritional information. Characters can be created and associated with nutritional food products (Dehghan, Danesh, & Merchant, 2005)
The number of overweight children is growing worldwide. This trend poses several health risks such as cardiovascular disease, diabetes, hypertension, and infertility. If this trend is not corrected soon, the lifespan of this generation and those to follow will shorten. Nurses can focus on strategies such as educating parents and children on healthy food choices, promoting physical activities through the creation of safe play areas and organized physical activity, and reducing the marketing of poor nutritional foots to children in order to help reduce this growing problem. These strategies will promote healthy lifestyles in children and reduce the percentage of overweight children which will help them to live longer and healthier lives.


References
Davis, S., Kolar, K., Northington, L., Davis, M., & Moll, G. (December 2002). Childhood Obesity Reduction by School Based Programs. Association of Black Nursing Faculty Journal. Retrieved January 16, 2008 from http://findarticles.com/p/articles/mi_m0MJT/is_6_13/ai_95915535/pg_1
Dehghan, M., Akhtar-Danesh, N., & Merchant, A. (September 2005). Childhood Obesity: Prevalence and Prevention. Nutrition Journal, 4. Retrieved October 14, 2007, from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1208949
Laing, P., RN. (2002) Childhood Obesity: A Public Health Threat. Pediatric Nursing Journal, 14(10), 14-16.
Miller, J. Rosenbloom, A., & Silverstein, J. (September 2004). Childhood Obesity. JCEM, 89(9):4211-4218. Retrieved January 16, 2008, from http://jcem.endojournals.org/cgi/reprint/89/9/4211
The Associated Press. (March 7, 2006). Study: Childhood Obesity Expected to Soar. Retrieved September 28, 2007, from http://www.msnbc.msn.com/id/11694799/

Intervention #1
Nurses need to educated children and parents on healthy food and drink choices
Disadvantage #1
A problem that arises with nurses educating children and their parents is the lack of motivation on the client’s end toward learning and change. They are either comfortable in their lifestyle, don’t seen the future health concerns, or are too busy with work and other time limitations to take the time to correct their knowledge deficit (St.Onge, Keller, and Heymsfield, 2003). Studies have shown that homes with two parents working are more likely to consume fast food due to the convenience rather than prepare meals for nutritional value (St.Onge, Keller, and Heymsfield, 2003). Once families can be educated on and realize the importance of nutritional meals and are taught the skills needed to implement proper nutrition choices they will overcome this barrier.
Disadvantage #2
Another disadvantage for nurses trying to educate children and their parents is the lack of reimbursement by either insurance companies or other healthcare corporations for their time and resources used. Studies have shown that clinics specializing in pediatric obesity were rarely reimbursed for their expenses by insurance companies. Healthcare workers are not given any incentives to go out into the community and provide education and resources for preventing childhood obesity through proper nutrition (Story, Neumark, Sherwood, Holt, Sofka, Trowbridge, & Barlow, 2002). If insurance companies can see the importance of obesity prevention in children and the long term health benefits for the children, they may start to reimburse and invest in nutritional education for children and their families.
Intervention #2
Nurses need to focus on promoting physical activity for children by working with the community to develop safe play areas and parks.
Disadvantage #1
Socioeconomic status could prevent nurses from working to develop safe play areas for children. Low-income neighborhoods may not have the community involvement or resources needed to develop safe and monitored play areas. Since unsafe communities lead to children not being able to play outdoors, it will be more challenging to ensure children’s safety while playing in these neighborhoods (Laing, 2002).
Disadvantage # 2
If a community is already thoroughly developed, it may be difficult to gain support for the building of parks and walking trails (Dehghan, Danesh, & Merchant, 2005). Losing business and profit-generating areas for physical activity promotion may not be welcome by a community. These parks and trails also need to be placed near neighborhoods for easy access if they are to be used regularly. This may prove to be a difficult task in existing communities.
References
Dehghan, M., Akhtar-Danesh, N., & Merchant, A. (September 2005). Childhood Obesity: Prevalence and Prevention. Nutrition Journal, 4. Retrieved October 14, 2007, from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1208949
Laing, P., RN. (2002) Childhood Obesity: A Public Health Threat. Pediatric Nursing Journal, 14(10), 14-16.
St. Onge, M., Keller, K., & Heymsfield, S. (2003). Changes in Childhood Food Consumption Patterns: A Cause for Concern In Light of Increasing Body Weights. American Journal of Clinical Nutrition, 78, 1068-1073.
Story, M., Neumark, D., Sherwood, N., Holt, K., Sofka, D., Trowbridge, F., & Barlow, S. (2002). Management of Child and Adolescent Obesity: Attitudes, Barriers, Skills, and Training Needs Among Health Care Professionals. Pediatrics, 110, 210-214.