Download Childhood Obesity and Culture

Childhood Obesity and Culture
Aimee Dershowitz, Psy.D., HSPP
Who Am I?
• Aimee Dershowitz, Psy.D., HSPP
• Graduated from the University of Indianapolis
• Concentration in Health Psychology and Child and Adolescent Psychology
• Internship at Family Psychological Center in Harrison, AR
• Psychologist at Four County Counseling Center
“The increasing prevalence and severity of childhood obesity may reverse the modern era's steady increase in life expectancy, with today's youth on average living less healthy and ultimately shorter lives than their parents‐ the first such reversal in lifespan in modern history (Daniels, 2006).”
Definitions
• Overweight is classified as children having BMI values above the 85th percentile and below the 95th percentile for age and gender.
• Obesity is classified as above the 95th percentile for age and gender Statistics
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Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years.
The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012.
The percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.
In 2012, more than one third of children and adolescents were overweight or obese.
Statistic Continued
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One out of ten children worldwide is overweight or obese = 155 million children
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2‐3% (30‐45 million) of the population meeting criteria for obesity
In the United States 33.6% of individuals between the ages of 2 and 19 are overweight and 17.1% of children are at risk of becoming overweight
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12.4% of children aged 2 to 5 years are obese
17.0% of children aged 6 to 11 years are obese
17.6% of adolescents aged 12–19 years are obese
2003 Map
2005 Map
2007 Map
2009 Map
2011 Map
2013 Map
Statistic Related to Ethnicity
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20% of African‐American children are obese
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24% African‐American girls
19% of Hispanic‐American children are obese
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22% Hispanic‐American boys
16% of Caucasian‐American children
13% of Asian‐American children are obese
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10% Asian‐American boys
4% Asian‐American girls
26% Asian‐American children are overweight or obese
General Risk Factors
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Family history (particularly if parents are obese)
Low or high birth‐weight
Feeding a child solid food before 3 months old
Lower parental education level (biggest correlation among multiple studies)
A single, nonworking parent is correlated with increased obesity
More than 1 hour of screen time per day, especially if TV is in bedroom or if the child eats in front of the TV
Higher exposure to advertisements for high caloric foods
Regularly eating high caloric foods
Lack of exercise
Psychological factors
Socioeconomic factors
Poor family health habits
Lack of sleep (less than 8 hours)
Restriction of caloric intake
Risk Factors Due to Low SES
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Exhibit the highest percentages of overweight/obese children across ethnicities
Less access to more expensive, but healthier, foods
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Poorer neighborhoods have a disportionately higher ratio of fast food vendors to grocery stores
Increased sedentary behaviors
Often had different views about what is classified as “junk food” compared to their higher SES peers.
Many parents work long hours at one or more jobs, have multiple child‐care responsibilities (e.g., homework help, recreation, doctor visits, supervision), manage a household, care for aging parents, and try to meet their own personal needs, which leads to a preference for faster convenience foods over healtheir options.
Risk Factors in African American Culture
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The perceived ideal body size is larger for African‐Americans than Caucasian‐Americans, particularly for females
African‐American communities often lack access to affordable healthy foods and eat more high‐density caloric foods than income‐matched Caucasian peers.
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The presence and influence of media among African‐American households pose a significant challenge to healthy eating and regular physical activity among children.
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African‐American neighborhoods have a disportionately higher ratio of fast food vendors to grocery stores
prime time television aimed at African‐American audiences had twice the number of food commercials, with less than 7% focused on healthier foods.
African‐American children and adolescents watch an average of five hours and 54 minutes of television daily, often have a TV in their room, and eat in front of the TV more than same‐age peers
Environmental factors involving transportation, infrastructure, and safety limit African‐American children’s options for physical activity
African American (AA) mothers exhibit more food/meal monitoring, restriction practices, pressure to eat, and concern about their child’s weight
Risk Factors in Hispanic Culture
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Hispanic women tend to prefer a thinner shape for themselves, but a plumper figure for their children.
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Children’s weight status reflects parenting skills, and that having a ‘‘skinny’’ child is a sign of bad parenting and poor health
Hispanic mothers report using food as a parenting tool to shape children’s behaviors, using ‘‘bad’’ foods (e.g., sweets) to get children to eat ‘‘good’’ foods, pushing the child to eat more, deciding how much the child should eat, and worrying about their child’s overweight and overeating
Many Hispanic mothers of obese children believe their child to be healthy and are unconcerned about their child's weight, although these same parents are likely to believe that obese children in general should be taken to a nutritionist or physician for help with weight reduction
Higher proportions of Hispanics lack health insurance or transportation to health care providers, and even if they do have providers, they exhibit less utilization of the services due to different beliefs about the cause, course, and cure of an illness, the stigma attached to particular illnesses, and interactions between patients and providers
Hispanic parents are about twice as likely as non‐Hispanic whites to encourage children to finish the contents of the bottle and to prop the bottle up to maximize the amount fed.
Hispanic mothers do not utilize tummy‐time with their infants as much as other cultures
Risk Factors in Asian Culture
• Under‐control of eating and restriction of foods found to increase BMI (opposite of most other cultures)
• Correlation between increasing age and increasing BMI in Asian children, possibly due to a loosing of food restrictions as they age
Acculturation Factors
• Children who acculturate into American culture rather than maintain traditional customs exhibit a higher rate of obesity, due to an increase in sedentary behaviors (though not a decrease in physical activity)and high‐
caloric food intake
• Food insecurity (uncertainty of accessibility to nutritionally adequate foods) is characterized by household concern about ample food supply, which results in the substitution of quality foods with cheaper ones, overeating when food is available, and the reduction of quality and variety in diets.
Health Consequences
Mental Health Consequences
• Depression
• More peripheral and isolated interpersonal relationships rather than social relationships with a central network of other children
• Low self‐esteem
• Social discrimination and bullying
• Lower quality of life
Treatment
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The treatment must involve the whole family (including extended families within the Hispanic culture)
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Obesity runs in families
It is hard to change behavior when the child is constantly seeing models of poor eating and exercise behaviors
Behavioral techniques have been found to be effective to help change bad habits into good habits
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Stimulus control
Self‐rewarding and external rewards
The focus needs to be on a combination of diet, exercise, and psychoeducation.
A multidisciplinary approach is often helpful: pediatrician and nutritionist
Exercise can be fun if it is portrayed that way!!
Works Cited
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Bassett Jr., D. R. (2008). Physical activity of canadian and american children: A focus on youth in amish, mennonite, and modern cultures. Applied Physiology, Nutrition & Metabolism, 33(4), 831‐835. doi:10.1139/H08‐044 Brophy, S., Cooksey, R., Gravenor, M. B., Mistry, R., Thomas, N., Lyons, R. A., & Williams, R. (2009). Risk factors for childhood obesity at age 5: Analysis of the millennium cohort study. BMC Public Health, 9, 467‐473. doi:10.1186/1471‐2458‐9‐467 Bruss, M. B., Morris, J. R., Dannison, L. L., Orbe, M. P., Quitugua, J. A., & Palacios, R. T. (2005). Food, culture, and family: Exploring the coordinated management of meaning regarding childhood obesity. Health Communication, 18(2), 155‐175. doi:10.1207/s15327027hc1802_4 Burrows, T., Warren, J. M., & Collins, C. E. (2010). The impact of a child obesity treatment intervention on parent child‐feeding practices. International Journal of Pediatric Obesity, 5(1), 43‐50. doi:10.3109/17477160902957158 Buscemi, J., Beech, B., & Relyea, G. (2011). Predictors of obesity in latino children: Acculturation as a moderator of the relationship between food insecurity and body mass index percentile. Journal of Immigrant & Minority Health, 13(1), 149‐154. doi:10.1007/s10903‐009‐9263‐6 Cachelin, F. M., Thompson, D., & Phimphasone, P. (2013). Impact of asian american mothers’ feeding beliefs and practices on child obesity in a diverse community sample. Asian American Journal of Psychology, doi:10.1037/a0034897 Caprio, S. (2006). Treating child obesity and associated medical conditions. Future of Children, 16(1), 209‐224. Daniels, S. R. (2006). The consequences of childhood overweight and obesity. Future of Children, 16(1), 47‐67. The effect of family‐based multidisciplinary cognitive behavioral treatment in children with obesity: Study protocol for a randomized controlled trial. (2011). Trials, 12(1), 110‐121. doi:10.1186/1745‐6215‐12‐110 Green, J., Waters, E., Haikerwal, A., O'Neill, C., Raman, S., Booths, M. L., & Gibbons, K. (2003). Social, cultural and environmental influences on child activity and eating in australian migrant communities. Child: Care, Health & Development, 29(6), 441‐448. doi:10.1046/j.1365‐2214.2003.00363.x Gunnarsdottir, T., Njardvik, U., Olafsdottir, A. S., Craighead, L. W., & Bjarnason, R. (2011). The role of parental motivation in family‐based treatment for childhood obesity. Obesity (19307381), 19(8), 1654‐1662. doi:10.1038/oby.2011.59
Works Cited Continued
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Hassink, S. G. (2010). Evidence for effective obesity treatment: Pediatricians on the right track! Pediatrics, 125(2), 387‐388. doi:10.1542/peds.2009‐3308 Huang, T. T., & Horlick, M. N. (2007). Trends in childhood obesity research: A brief analysis of NIH‐supported efforts. Journal of Law, Medicine & Ethics, 35(1), 148‐153. Kelly, K. P., & Kirschenbaum, D. S. (2011). Immersion treatment of childhood and adolescent obesity: The first review of a promising intervention. Obesity Reviews, 12(1), 37‐49. doi:10.1111/j.1467‐789X.2009.00710.x Klesges, L. M., Williams, N. A., Davis, K. S., Buscemi, J., & Kitzmann, K. M. (2012). External validity reporting in behavioral treatment of childhood obesity: A systematic review. American Journal of Preventive Medicine, 42(2), 185‐192. doi:10.1016/j.amepre.2011.10.014 Kumanyika, S., & Grier, S. (2006). Targeting interventions for ethnic minority and low‐income populations. Future of Children, 16(1), 187‐207. Lindsay, A. C., Sussner, K. M., Greaney, M. L., & Peterson, K. E. (2011). Latina mothers' beliefs and practices related to weight status, feeding, and the development of child overweight. Public Health Nursing, 28(2), 107‐118. doi:10.1111/j.1525‐1446.2010.00906.x Lindsay, A. C., Sussner, K. M., Kim, J., & Gortmaker, S. (2006). The role of parents in preventing childhood obesity. Future of Children, 16(1), 169‐186. Lobstein, T., Baur, L., & Uauy, R. (2004). Obesity in children and young people: A crisis in public health. Obesity Reviews, 5, 4‐85. Long, J. M., Mareno, N., Shabo, R., & Wilson, A. H. (2012). Overweight and obesity among white, black, and mexican american children: Implications for when to intervene. Journal for Specialists in Pediatric Nursing, 17(1), 41‐50. doi:10.1111/j.1744‐6155.2011.00309.x Lopez, K. N., & Knudson, J. D. (2012). Obesity: From the agricultural revolution to the contemporary pediatric epidemic. Congenital Heart Disease, 7(2), 189‐199. doi:10.1111/j.1747‐0803.2011.00618.x
Works Cited Continued
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Newby, P. K. (2007). Are dietary intakes and eating behaviors related to childhood obesity? A comprehensive review of the evidence. Journal of Law, Medicine & Ethics, 35(1), 35‐60. NFL. (2012). Play 60. Retrieved, 2012, Retrieved from http://www.nflrush.com/play60
Ogden, C. L., Lamb, M. M., Carroll, M. D., Flegal, K. M., & National Center for, H. S. (2010). Obesity and socioeconomic status in children and adolescents: United states, 2005‐2008. NCHS data brief. number 51. ().National Center for Health Statistics. Peterson, K. E., & Fox, M. K. (2007). Addressing the epidemic of childhood obesity through school‐based interventions: What has been done and where do we go from here? Journal of Law, Medicine & Ethics, 35(1), 113‐130. Rawlins, E., Baker, G., Maynard, M., & Harding, S. (2013). Perceptions of healthy eating and physical activity in an ethnically diverse sample of young children and their parents: The DEAL prevention of obesity study. Journal of Human Nutrition & Dietetics, 26(2), 132‐144. doi:10.1111/j.1365‐277X.2012.01280.x Renzaho, A. M. N., Swinburn, B., & Burns, C. (2008). Maintenance of traditional cultural orientation is associated with lower rates of obesity and sedentary behaviours among african migrant children to australia. International Journal of Obesity, 32(4), 594‐600. doi:10.1038/ijo.2008.2 Rosas, L., Guendelman, S., Harley, K., Fernald, L., Neufeld, L., Mejia, F., & Eskenazi, B. (2011). Factors associated with overweight and obesity among children of mexican descent: Results of a binational study. Journal of Immigrant & Minority Health, 13(1), 169‐180. doi:10.1007/s10903‐010‐9332‐x Ru‐Jye Chuang, Sharma, S., Skala, K., & Evans, A. (2013). Ethnic differences in the home environment and physical activity behaviors among low‐income, minority preschoolers in texas. American Journal of Health Promotion, 27(4), 270‐278. doi:10.4278/ajhp.110427‐QUAN‐171 Sealy, Y. M. (2010). Parents' food choices: Obesity among minority parents and children. Journal of Community Health Nursing, 27(1), 1‐11. doi:10.1080/07370010903466072 Spruijt‐Metz, D. (2011). Etiology, treatment, and prevention of obesity in childhood and adolescence: A decade in review. Journal of Research on Adolescence (Blackwell Publishing Limited), 21(1), 129‐152. doi:10.1111/j.1532‐
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