Interim Study on Child Health Susan B. Sisson, PhD, RDN, CHES, FACSM - PowerPoint PPT Presentation

Interim Study on Child Health Susan B. Sisson, PhD, RDN, CHES, FACSM Associate Professor, Nutritional Sciences Assistant Dean for Research, College of Allied Health Director, Behavioral Nutrition and Physical Activity Laboratory University of Oklahoma Health Sciences Center Oklahoma City, OK, USA 1

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity • Children’s screen time www.mikepaulblog.com 2

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity • Children’s screen time www.mikepaulblog.com 3

What’s the Numbers? Prevalence of Overweight and Obesity • 23% of American preschoolers • 31% of low-income preschoolers in Oklahoma • 38% of preschoolers in our sample of child care centers in Oklahoma (Weedn et al. 2012; Weedn et al. 2013; Ogden et al. 2014; Sisson et al. 2016) 4

Children at Risk Ethnic disparities in obesity Hispanic 17.2 18.4 American Indian 16.3 16.4 African American 10.7 11.8 White 11.5 13.4 0 5 10 15 20 25 30 35 40 Female Male – American Indian 78% higher odds of obesity – Hispanic 62% higher odds of obesity (Weedn et al. 2012; Weedn et al. 2014) 5

Why Care? • Obese children were twice as likely to be obese adults • Overweight 5 year olds are 4 times as likely to be obese in middle school (Serdula et al. 1993 ; Cunningham et al . 2014; Cheung et al. 2016) 6

Lots of Children in Non-Parent Care • 65% of women are employed • Families with children under 6 years – 35% of both parents (in 2-parent homes) work – 75% of single parents work • 61% if children aged 0-6 years received regular child care outside the home • Those with full time working moms spend 38 hours/week in non-parent care (American Fact Finder [C23008]; Thorpe 2009 ; Interagency Forum on Child & Family Statistics; 7 Mulligan 2005)

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity • Children’s screen time www.mikepaulblog.com 8

Room for Improvement in Practices • 21% offer 100% fruit juice ≤1/week • 18% offer veggies other than potatoes, corn and green beans daily • 52% provide active play time ≥91 min/day • 57% report TV is rarely used • 43% have a written (and followed) physical activity policy (Sisson et al. 2012) 9

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity • Children’s screen time www.mikepaulblog.com 10

Child Care Environment and Obesity Dependent Variable Odds Ratio 95% Confidence p value Interval Total Environment 0.91 0.86, 0.97 0.004 Physical Activity 0.82 0.73, 0.93 0.002 Nutrition 0.90 0.80, 1.01 0.066 α = 0.05 (Sisson et al. 2016 ; Sisson et al. 2017) 11

CACFP Matters • Centers participating in CACFP provide healthier foods, staff behaviors, and are associated with lower overweight and obesity 12 (Ritchie et al. 2012; Korenman et al. 2013; Liu et al. 2016)

Importance of the Child Care Center • Provide access to high quality, nutritious foods • Ensure children are consuming those foods • Provide access to indoors and outdoors opportunities for active play • Engage children in structured physical activities • Develop an environment that promotes health-enhancing behaviors by staff, parents and children

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity • Children’s screen time www.mikepaulblog.com 14

What’s for Lunch? Kcals served: 510 ± 241 • Add what is in 16217 paper 2 Kcals consumed: 387 ± 239 5 A physically 4.5 Served Consumed 4 active 3.5 preschooler 3 2.5 needs 1200- 2 1.5 1600 kcals/day 1 0.5 0 Total fruit & Lean protein Low fat Dairy Whole grains Fried meat High fat high Sugar vegetables sugar sweetened condiments beverages (Sisson et al. 2017) 15

Where are Meals Falling Short Excess or deficient nutrients in 3-5 year olds in Oklahoman child care centers: • Protein exceeded daily recommended intake by 3.5-5 times Over- and under- consumption of vitamins and minerals • Protein (grams) Recommended and Served in Oklahoma Child Care Centers 20 16.9 15 15.1 10 6.3 5 4.3 0 1-3yo 4-8yo (Rasbold et al. 2015) 16 DRI Served

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity https://www.naturalproductsinsider.com/blogs/insider- law/2017/04/fda-examines-divergent-views-on-definition-of- • Children’s screen time hea.aspx 17

Inadequate Food Quantity and Quality in Oklahoma • Oklahoma is among the 10 states with the lowest food security 1 in 4 children are at risk of going to bed hungry Poverty rate among children is 22% • • Families resort to cheaper, unhealthier options Processed foods, high-fat, high-sugar • (USDA 2012-2014 ; Meal Gap 2014 Report ; 2014 US Census ) 18

Better Than What’s at Home Kcals Child Care: 333 ± 180 5 Kcals Home: 455 ± 175 4 Child Care Home 3 2 1 0 Total fruit & Low fat Dairy* Whole grains Fried meat High fat high Sugar sweetened vegetables* sugar beverages* condiments (Sisson et al. 2017) 19

CACFP Goals • More fresh fruits and vegetables • More whole grains • More variety in protein • Low-fat and unflavored dairy products • Less added sugar • Appropriate portions https://www.childcarenetwork.com/Get-Started/USDA-Meals 20

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity • Children’s screen time www.mikepaulblog.com 21

Child Care Environment 99 ± 70 minutes of 39 ± 45 Total 23.9 outdoor minutes of environment 43 time TV viewing 12.5 mean Nutrition scale 21.2 max possible 8 ± 12 91 ± 46 minutes of minutes of Physical activity 11.7 structured sedentary scale 21.8 activity time 0 20 40 60 (Sisson et al. 2016) 22

But the kids are so active? • 60 minute/day required outside time (OSDH) • 4.3 minutes/hour were spent in moderate-to- vigorous physical activity • 24 minutes of moderate-to-vigorous physical activity • 4300 steps/day (OKDHS 2009; Sisson et al., 2017) 23

Children’s Activity in OK Child Care Average 7.6 ± 1.6 hours of wear 365 minutes 100 Percent of Time in Child Care (6.1 hours) 90 80 70 60 50 27 minutes 40 30 35 minutes 17 minutes 10 minutes 20 10 0 Sedentary Light Moderate Vigorous Physical Activity Intensity

Physical Activity Guidelines • NASPE – 60 min and up to several hours of active play – Limited sitting • US Federal PA guidelines (>5 years) – 60 min or more/day moderate or vigorous • Canadian PA guidelines (early years) – 180 min or more/day any intensity – 60 min/day energetic play (NASPE 2010; Health.gov 2008; CSEP.ca. 2012) 25

Roadmap of Today’s Talk • Prevalence of overweight and obesity • Obesogenic practices in Child Care • Influence of Child Care • About the food served • Importance of healthy food in child care • Children’s physical activity • Children’s screen time www.mikepaulblog.com 26

Leisure Screen Time 32 hours/week (AAP 2016; Briefel et al. 2015) 27

We’ve reached the end of the road… Thank you for your participation! susan-sisson@ouhsc.edu 28