TAHAMAS for a better future

17-19 November 2016 Dubai, Unit ed Arab Emirates TAHAMAS for a better future Detecting weight and weight related health problems at early ages in order to prevent complications Dubai Nutrition Conference 17-19 Nov 2016 By Dima Bader M.Sc. Therapeutic Nutritionist- Jordan ement of chronic diseases

Table of Contents Introduction Driving Force; Studies (Global, Jordan and UAE) Tahamas - Key Note, Objective, Scope & Methodology Tahamas - Phase 1; Progress & Achievements Tahamas- Phase 2; In the Pipeline Automation- AnthroPlus Future Roadmap

WHO statement Introduction In 1995, around 200 million obese adults worldwide and another 18 million under-five children are classified as overweight. As of 2000, the number of obese adults has increased to over 300 million. In developing countries, it is estimated that over 115 million people suffer from obesity-related problems. WHO published the School Policy framework in 2007 to implement the global strategy on Diet, Physical activity & Health http://www.who.int/nutrition/topics/obesity/en/

Introduction The prevalence of overweight and obesity in childhood and adolescence is high. Excessive body fat at a young age is likely to persist into adulthood Obesity related problems is associated with physical and psychosocial comorbidities, as well as lower cognitive, school and later life achievement Lifestyle interventions can benefit cognitive function and school achievement in children of normal weight, as well as in overweight or obese children and adolescents http://www.ncbi.nlm.nih.gov/pubmed/24627300

Driving Force; Studies In A joint WHO and CDC study, it was revealed that 19% of children aged (6-12) years old suffer from overweight and 6% suffer from obesity. In a study conducted in Jordan in 2010, it was revealed that overweight and obesity comprise to 57.7% in males and 65.4% in females, aged above 15yearsold. Males Obesity 57.7% Females Obesity 65.4%

Driving Force; Studies A study in the UAE in 2016 investigated the prevalence of obesity in 44,942 students in RAK, where: ¼ of children (11 14 years) were either obese or extremely obese. 10% of boys and 3% of the girls (15 to 18 years) were extremely obese

Objective of the initiative Tahamas - Key Note is a Healthy nutrition initiative in Jordan designed to detect overweight and obesity among different segments of society, especially for school students. is an abbreviation in Arabic for "Right Nutrition - Physical activity No Obesity"

Tahamas Project- Objective Assessing the weight and height of students and compares them against the WHO growth charts (2007), to advise when required methods to be applied by schools and parents to improve the lifestyle and eating habits of their children. Coordinating healthy eating and physical activity policies and practices through a school health council and school health coordinator, via understanding the current status and assessing eating habits and physical activity patterns.

Tahamas Project- Methodology Assessment and Analysis of Data Nutritional Education Recommendations for Healthy Schools TARGET: Coherent strategy towards promoting healthy eating habits and activity patterns and using a systematic approach to develop, implement and monitor healthy eating and Physical activity policies to evaluate overall society healthy lifestyle

Tahamas Project- Why Schools The target group is school students in the age group (5-18 years): Number of students in school exceeds one million and three hundred thousand students (in Jordan) Students spend at least nine months per year at school, seven hours a day, consuming around two meals daily at schools. Eating habits and activity patterns may be affected by peers & school health scheme. It may be expensive for parents to take their children to dietitian but easier if the dietitian clinic comes to their school

Tahamas Project- Methodology Specialized team from the nutrition specialists assess the students through taking the physical measurements Compare measurements with the BMI/age, based on lists of the WHO Send the result reports individually to the student parents'.

Tahamas Project- Methodology Childhood obesity is defined as a BMI at or above 95 th percentile (above +1.64 z- score) for children of same age and gender

Tahamas Project- Methodology

Tahamas Project- Methodology Conduct the analysis of the results and present them to the school administration to discuss the set of proposed solutions and recommendations. Provide interactive discussion sessions for school students and their parents as well as the educational and administrative staff at the school in order to enhance the awareness in proper and healthy diet in the society

Tahamas Project- Phase 1 Progress & Achievements Project started in year 2015, with two awareness workshops conducted for school managers & administrators The team worked with 10 schools, a total of 5862 students were screened. Data acquired from school children was assessed against the WHO growth charts. Individualized cards were sent to every student parents indicating his/her weight chart results. Children with obesity were further assessed with scientifically approved body composition machines.

Tahamas Project - Phase 1 Progress & Achievements Presentation to every school with the results (i.e. obesity, overweight, underweight). Organize a health club at school to start helping the children Educational materials about healthy eating patterns were distributed to schools and children. Awareness lectures for parents, children and school staff Media coverage to attain the attention and the compassion of the local community

Tahamas Project Results - Phase 1 Summary by Numbers Ext. underweight underweight Normal weight Overweight Obese Total no. of screened students= 5862 BMI/Age assessment 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Obese Overweight Normal weight underweight Ext. underweight >14-18 years 24% 30% 37% 9% 0% >11-14 years 23% 37% 32% 7% 1% 6-11 years 22% 21% 46% 10% 1%

Tahamas Project- Phase 1 Summary by Numbers 15% 13% BMI/Age assessment- Males 6-11 years >11-14 years >14-18 years 17% 17% 16% 17% 24% 12% 12% 3% 4.00% 4% 0.30% Males Males Males Males Males Obese Overweight Normal weight Underweight Ext underweight BMI/Age assessment- Females 6-11 years >11-14 years >14-18 years 22% 12% 15% 9% 20% 10% 22% 6% 10% 9% 3.00% 6% 0.70% 0.80% 0% Females Females Females Females Females Obese Overweight Normal weight Underweight Ext underweight

Tahamas Project- Phase 1 Summary by Numbers underweight 9% Average BMI/ Age Assessment Obese 23% Ext. underweight 1% Normal weight 38% Overweight 29%

Tahamas Project- Phase 1 Summary by Numbers Obesity/ Gender Comparison Obese Males Obese Females Overweight / Gender Comparison Overweight Males Overweight Females 15% 10% 13% 10% 12% 17% 20% 17% 9% 12% 12% 9% >14-18 years >11-14 years 6-11 years >14-18 years >11-14 years 6-11 years

Tahamas Project - Phase 2 In the pipeline Expand the implementation on a larger scale and cover a wide spectrum of the schools, from both public & private sectors. Strong school and community engagement to maximize healthy eating and physical activity opportunities for students. Target to cover around 100,000 students of age range (5-18 years)

Tahamas Project - Phase 2 Automation- AnthroPlus WHO AnthroPlus for Personal Computers Manual Weight for age Height for age BMI for age Software for assessing growth of the world's children and adolescents WHO AnrthoPlus Indicators Let's move it baby!

Modules: Tahamas Project - Phase 2 Automation- AnthroPlus Anthropometric calculator (AC) Individual assessment (IA) Nutritional survey (NS) Each module has specific functions, i.e. to assess an individual's nutritional status, follow a child's growth from birth to 19 years, and conduct nutritional surveys covering the same age group.

Anthropometric Calculator Calculated age is derived based on date of birth (DoB) and date of visit (D

Individual Assessment Total number of visits Active list with example children List of visits (1 row = 1 visit) with selected visit highlighte

Tahamas Project - Phase 2 Automation- AnthroPlus Nutrition Survey

Tahamas Project - Phase 2 Automation- AnthroPlus

Tahamas Project- Future Roadmap Brand the school with a new slogan i.e. Friends of Healthy Nutrition school with a Nutrition Club within Participate in setting regulations of food types permitted to be sold in the school canteens or food allowed to be brought from home.

Tahamas Project- Future Roadmap Activate the role of the school radio broadcast whereby a slot/segment is dedicated to educate the students about the Nutrition club and associated nutrition tips to fight overweight and obesity. Establish a website/ embed a module into the existing school website that can host all nutritional information pertaining to obesity

More of Achievements Tahamas Project- Future Roadmap Set an annual planner for the Nutrition club with means to disseminate the healthy nutrition messages. Conduct specialized training sessions to selected members of the teaching staff. Avail the school yards and activity areas to the students after school hours and during public holidays and weekends to assist in promoting for exercise and physical activity Training the students on preparing simple and healthy snack recipes such as school sandwich and illustrating the various healthy options

More of Achievements Tahamas Project- Future Roadmap Adopt the routine annual/ semiannual testing to investigate the student status of obesity/overweight as a preventive measure. Consider contracting a nutrition specialist to conduct regular visits and assist in controlling and managing any overweight/ obesity case with the students. Creating a platform for students families to be integrated into regular school based activity on regular basis and involve the parents in the social media channels

References World Health Organization (WHO) The WHO Child Growth Standard. http://www.who.int/childgrowth/en/ Khader Y, Irshaidat O, Khasawneh M, Amarin Z, Alomari M, Batieha A. Overweight and obesity among school children in Jordan: prevalence and associated factors. Matern Child Health J. 2009;13(3):424 431. [PubMed] http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3278864 http://www.ncbi.nlm.nih.gov/pubmed/24627300 http://onlinelibrary.wiley.com/doi/10.1002/osp4.37/full http://jaoa.org/article.aspx?articleid=2093529

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