Sunday, July 13, 2014

Influential Environments

My position is that both entities must shoulder the responsibility to create healthy diet and exercise environments for children, but the greater burden of responsibility rests on the parents. Proactive efforts made to address obesity in childhood should occur at multiple levels, including national advertising campaigns, community service announcements and programs, restaurant menus, school programs, family education, and the family's implementation of healthy choices in the home (Janicke, Sallinen, & Plume, 2008). I believe parents are the primary stake holders in their children's health, and the home environment has the potential to be an extremely negative (or positive) force in how children learn to eat and participate in healthy lifestyles.

Lifestyle and food consumption habits begin several years before the child enters school; and like many habits, eating routines start as early as birth (Lumeng, 2005). Lumeng (2005) found that the percentage of overweight children between the ages of 6 months and 2 years has increased from 7-12% between 1976 and 2000. The number of overweight children aged between the ages of 2-5 has doubled in the ten years between 1990 and 2000 (Lumeng, 2005). Children under the age of three, who are overweight do not have a greater chance of being overweight later in childhood than children at that age who are not overweight. However, when a child is overweight after the age of 3, they are 8 times more likely to be overweight in young adulthood than a 3 year old child of average weight. Satter (1992) describes the 'feeding relationship' that exists between a baby/child and the mother, and the quality of this relationship has a profound influence on the child's lifelong eating habits.

                              Strategies to Promote Diet and Exercise

Since obesity is a public health concern that poses problems for children and adults, especially for lower income families, I suggest a family education, such as the Expanded Food and Nutrition Education Program that emphasizes teaching families to make healthy food choices and reducing sedentary behaviors, since these lifestyle changes have been shown to reduce obesity. Educating parents, and involving them in children's weight reduction programs produces the best outcomes, especially when children are younger than 13 (Raynor, 2008). For children older than 13, however, involving the parent and child may be the most beneficial (Raynor, 2008). In any event, the education of parents is essential. Without their support, it may be difficult for children to maintain a change in diet. Family-based treatments for childhood obesity have been successful, and even simply limiting fast food consumption has made significant differences for families (Epstein, Valoski, Rena, & McCurley, 1994).

Schools should be held responsible for their part in influencing children and adolescents at school. Offering more time spent in physical education, and more health-related classes, and a drastic change in the lunch service program and changing the contents of vending machines accessed by students are all strategies that should be considered by school districts.

Children's behaviors are more likely to change when the consequences for their behaviors remain consistent across environments (Janicke, Sallinen & Plume, 2008). If schools and parents were reasonably similar in expectations related to diet and exercise, it is likely that children and adolescents would have a better chance of developing a healthy lifestyle and reducing their risk of overweight and obesity. This would take educated parents working in association with educated school systems, which would be a monumental undertaking.

Epstein, L. H.,Valoski, A., Wing, R. R., & McCurley, J. (1994). Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology, 13(5), 373–3 83.

Jelalian, E., & Hart, C. N. (2009). Pediatric obesity. In M. C. Roberts & R. G. Steele (Eds.), Handbook of pediatric psychology (4 ed., pp. 446–463). New York, NY: Guilford.

Lumeng, J. (2005). What can we do to prevent childhood obesity? Zero to Three, 25(3), 13-19.

Janicke, D. M., Sallinen, B. J., & Plume, J. C. W. (2008). Obesity prevention programs for school-aged children and adolescents. In E. Jelalian & R. G. Steele (Eds.), Handbook of childhood and adolescent obesity (pp. 331–350). New York, NY: Springer.

Raynor, H. A. (2008). Evidence-based treatments for childhood obesity. In E. Jelalian & R. G. Steele (Eds.), Handbook of childhood and adolescent obesity (pp. 201–220). New York, NY: Springer.

Satter, E. (1992). The feeding relationship. Zero to Three, 12(5), 1-9.

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