By Jonelle Agurs, ASN Intern

According to the National Health and Nutrition Examination Survey (NHANES), national reports indicate a steady increase in childhood obesity levels, in preschoolers up to four years of age. However, state-specific studies of data retrieved from the Pediatric Nutrition Surveillance System (PedNSS) tell a slightly different story: in 2011, nineteen U.S. states/territories reported a drop in obesity prevalence among low-income preschoolers up to 2.6%, with the greatest decline observed in the Virgin Islands. Although national obesity levels among this age group still range from 9.2-17.9%, we must acknowledge the sporadic, yet significant lapse in prevalence rates of this medical condition from state-to-state.

Childhood obesity is associated with a variety of physical complications, such as high blood pressure, diabetes, and asthma, which in turn, contribute to mental health setbacks that affect a child’s self-esteem and motivation to perform daily tasks. Obese preschoolers are five times as likely to become obese adults, as compared to their non-obese peers, and low-income households are particularly vulnerable to chronic obesity – inexpensive fast food options, that boast great taste, but have little nutritional value, are disproportionately marketed in low-income, minority communities. Using cross-promotion marketing tactics, 71% of food products use third-party licensed characters to appeal to adolescent audiences, but less than 20% meet nutritional guidelines set for children. A public health intervention at this impressionable stage of a child’s life is crucial in ensuring better health habits for a lifetime.

So, why do some states show significant improvements in obesity levels? It is most likely because these state and county agencies play a unique role in the success of their communities – a role that involves everyone from the enthusiastic teacher in a child’s preschool class, to the soccer coach in charge of physical education after school, to the local grocer who provides fresh fruits and vegetables for the community. Local and state initiatives, aimed to implement healthier food and recreational options for the communities they serve, have aligned their WIC programs with the Dietary Guidelines for Americans, which gives nutritional recommendations for consumers at every level.

In my home state of Maryland, for example, county health departments have already begun to equip families and healthcare providers with strategies to manage and prevent obesity in pediatric clients. In 2013, the Montgomery County Government initiated Be Active Montgomery! – a series of summer fitness events, in partner with Montgomery County schools, that promote physical fitness and family community building. In 2014, the Howard County Health Department in Columbia, MD issued a Childhood Obesity Prevention Toolkit to educate families on how to encourage healthy dietary/physical habits at home, and they also provided website access to a WIC Vendor Locator that would assist families in finding stores in their communities. I believe that local strategies such as these have contributed to the decrease in low-income pediatric obesity rates in Maryland from 2008-2011, despite the steady population increase.

Childhood obesity in America is one of those issues that is entangled in a web of possible causes. Food deserts in low-income communities promote consumption of quick-and-easy, fatty meal solutions. Highway expansion results in more vehicles per capita and an increase in traffic safety concerns for parents whose children walk and bike around the neighborhood. Public transportation, however useful, proves inconvenient for expectant, single mothers, who are incapable of transporting loads of groceries to their homes. All in all, the solution to the obesity epidemic in America may seem elusive; however health professionals should approach the situation with a modicum of hope that children will be our nation’s saving grace. Regardless of personal opinion, if the movers and shakers of this country made every effort to, literally, think of the children, perhaps we can redesign our environmental and socioeconomic constructs as a nation, to afford every child access to a proper community that promotes healthy living.

Hot Topics in Obesity will be discussed on Friday, December 5 during the fourth annual Advances and Controversies in Clinical Nutrition conference. Dr. William H. Dietz, Director of Redstone Global Center for Prevention and Wellness at GWU in Washington, DC, will give an address “What Explains the Reported Declines in Childhood Obesity?” Dr. Rebecca Puhl will address obesity and weight-related stigma during the same session. Read an interview with her.

The conference runs December 4-6 at the Gaylord National Resort & Convention Center in National Harbor, MD, and features a dynamic program with topics ranging from dietary supplements to nutrition and cancer. To learn more about this year’s conference, please visit the website.

References
1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6231a4.htm
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449228/
3. http://www.apa.org/pi/families/resources/newsletter/2012/07/childhood-obesity.aspx
4. http://www.ncbi.nlm.nih.gov/pubmed/19719889
5. http://journals.cambridge.org/download.php?file=%2FPHN%2FPHN13_03%2FS1368980009991339a.pdf&code=f5a13f391d3239a1ff41ae708a1ef5e1
6. http://www.howardcountymd.gov/displayprimary.aspx?id=4294969221
7. http://www.montgomerycountymd.gov/rec/bam/index.html
8. http://assets.thehcn.net/content/sites/montgomery/Final_Draft_Obesity_Action_P

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