LIVE HEALTHY. Disclosure. Learning Objectives. University of Texas Health Science Center at San Antonio, Texas. Pediatrics Grand Rounds 28 June 2013

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LIVE HEALTHY Empowering Youth to Make Healthful Choices Disclosure Angie Mock has no relevant financial relationships with commercial interests to disclose. 1 Learning Objectives At the end of this presentation, the participant will be able to: 1. Compare obesity trends by state from 1985 present with a specific emphasis on Texas 2. Define the overall Framework for Preventing obesity 3. Educate patient and patient families on evidence-based Boys & Girls Programs that empower youth to make healthful choices. Our Healthy Lifestyles Vision Boys & Girls Clubs of America envisions our Movement as a catalyst for change, empowering our youth to make healthful choices for life. By charging members to Live Healthy through regular physical fitness, eating well and practicing sound decision-making skills, our youth will be well on their way to becoming successful adults. LIVE HEALTHY Where every member Is engaged in physical activity for at least 60 minutes daily. Increases their knowledge of healthy habits and good nutrition. Commits themselves to practicing healthy habits. Abstains from substance abuse and other risky behavior. Interacts positively with peers, adults and form positive family relationships. The Need to Build Healthy Lifestyles is Evident Nearly 33 percent of American children aged 2 to 19 years are overweight or obese. In 1960, only 4 percent of children were obese. Only 30 percent of students attend daily physical education classes. Approximately 12 percent of students did not eat for 24 or more hours to try and lose or keep from gaining weight within a 30 day period. Almost 25 percent of students surveyed stated that over the course of the past week they did not participate in any physical activity (enough to increase their heart rate and make them breathe hard) for more than 60 minutes. 1

The Need to Build Healthy Lifestyles is Evident Obese children are more at risk for developing lifethreatening conditions and chronic illnesses, such as: Type 2 diabetes Hypertension High cholesterol Kidney failure Impaired vision Sleep apnea Menstrual abnormalities Some cancers Setting the Context Problems of overweight and obesity are vexing Cause is multi-factorial Solutions depend of your view of causality What will solutions require of us? A magic bullet? Profound and pervasive changes in lifestyle, the food supply, and physical activity levels Sustainability of efforts is essential Framework for Preventing Obesity Home and Family School Community Club Genetics Psychosocial Other Personal Factors Social Norms and Values Sectors of Influence Behavioral Settings Individual Factors Food and Physical Beverage Intake Activity Food and Beverage Industry Agriculture Education Media Government Public Health Systems Healthcare Industry Land Use and Transportation Leisure and Recreation Energy Intake Energy Expenditure Energy Balance Prevention of Overweight and Obesity Among Children and Adolescents 10 BRFSS, 1985 BRFSS, 1986 2

BRFSS, 1987 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) BRFSS, 1988 BRFSS, 1989 BRFSS, 1990 BRFSS, 1991 BRFSS, 1992 15% 19% 15% 19% 3

BRFSS, 1993 BRFSS, 1994 15% 19% 15% 19% BRFSS, 1995 BRFSS, 1996 15% 19% 15% 19% BRFSS, 1997 BRFSS, 1998 15% 19% 20% 15% 19% 20% 4

BRFSS, 1999 BRFSS, 2000 15% 19% 20% 15% 19% 20% BRFSS, 2001 BRFSS, 2002 15% 19% 20% 24% 25% 15% 19% 20% 24% 25% BRFSS, 2003 BRFSS, 2004 15% 19% 20% 24% 25% 15% 19% 20% 24% 25% 5

BRFSS, 2005 BRFSS, 2006 BRFSS, 2007 BRFSS, 2008 BRFSS, 2008 BRFSS, 2009 6

BRFSS, 2010 Obesity: Solutions Interventions and strategies include: Increase consumption of fruits and vegetables Increase physical activity Increased consumption of water with meals/activities Reduce consumption of high-energy-dense foods Decrease television viewing Change individual knowledge, skills, and attitudes Change practices Change behavior Change health conditions Change environment Partnership/MetLife Foundation Study 12 to 17 year olds abuse prescription drugs more than they abuse ecstasy, crack/cocaine, heroin, and methamphetamine combined 60% of teens who have abused prescription painkillers did so before age 15 There are as many new abusers age 12 to 17 of prescription drugs as there are of marijuana Teen Smoking and Drug Trends Teen smoking rates have remained stable with 25% of teens reporting smoking cigarettes in the past month. Teen inhalant use remains steady at 10 percent for past year use. Steroid and heroin use among teens remains low at 5 percent for lifetime use. Teen Pregnancy Preventing teen childbearing could save the United States about $9 billion per year Compared to women 20 to 21 years, mothers aged 19 and younger, are more likely to drop out of high school and remain single parents. The children of teen mothers are more likely to have lower cognitive proficiency at kindergarten, exhibit behavior problems, have chronic medical conditions, rely more heavily on publicly provided health care, be incarcerated at some time during adolescence until their early 30s. 7

Empowering Youth to Make Healthful Choices Live Healthy Programs High Engagement Demonstrated commitment to leading Attain a healthier lifestyle. Healthy Lifestyles Youth acquire and maintain life-long attributes of good decisionmaking, healthy habits and meaningful relationships. (e.g. Peer led activities such as SMART Moves, Daily Challenges) Moderate Engagement Members develop habits and decisionmaking skills that embrace a healthy Knowledge of Healthy Lifestyles lifestyle. Youth have increased knowledge of good decision-making skills Improved knowledge of healthy habits Increased knowledge of resistance skills Participation in Healthy Lifestyles Activities Baseline Engagement All youth learn the importance of Emphasize the importance of healthy lifestyles messaging in Club programs and activities healthy habits and resistance Engagement of ALL youth in at least 60 minutes of daily physical activity to risky behaviors Increase participation of youth in nutrition related activities Engagement of ALL youth in programming that deters the use of substance abuse and other risky behaviors Youth Driven Staff Driven There are some simple steps Clubs should put in place to help create healthy lifestyles for members. ALL Club members should participate in the following: The Triple Play Daily Challenges Triple Play Healthy Habits and SMART Moves/SMART Girls Key Elements of Impact Culture of Health & Wellness Family/Community Engagement Live Healthy Principles There are some simple principles Clubs should employ to create healthy lifestyles for members: Ensure 60 minutes of daily physical activity Ensure youth participate p in nutrition-related activities Increase health and physical activity by improving the built environment Implement standards around Club vending Provide balance to Club celebrations Encourage parents to get involved in member s fitness. Live Healthy Contact Information Boys & Girls Clubs of America Wayne B. Moss Senior Director Sports, Fitness & Recreation 404.487.5761 wmoss@bgca.org Boys & Girls Clubs of San Antonio Angie Mock CEO 210.436.0686 amock@begreatsa.org 8