Childhood Obesity Reduction by School Based Programs

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Abstract. Childhood obesity has become one of the most common health problems facing children in America. Results from the Third National Health and Nutrition Examination Survey reveal that ethnic minority children in the United States are at particular risk for development of cardiovascular disease due to their disproportionate levels of obesity. In treating childhood obesity among ethnic minorities, practitioners need to be mindful of the cultural norms surrounding body size. Additional concerns that must be addressed include the effects of target marketing of unhealthy foods toward ethnic minorities and environmental deterrents to outside physical activities, to name a few. Strategies given to address the problem of childhood obesity among ethnic minorities include, increasing the child's physical activity, reducing television viewing and the adoption and maintenance of healthy lifestyle practices for the entire family. Key Words: Childhood Obesity; Ethnic Minorities; Children; Overweight; Culture **********

According to the Third National Health and Nutrition Examinations Survey (NHANES III), obesity is now an epidemic in the United States. An estimated 97 million adults in the US and one in five children between the ages of 6 and 17 is overweight. In the thirty years since NHANES I was conducted, the number of children in the United States who are overweight has more than doubled (Winkleby, Robinson, Sunquist, and Kramer, 1999; Strass & Knight, 1999). Once obesity develops, it is difficult to treat, and obese children are more likely to become obese adults (Power, Lake, & Cole, 1997; Serdula, Ivery, Coates, Freeman, Williamson, & Byers, 1993). Obesity has been positively identified as a major determinant of adverse serum lipid and lipoproteins and blood pressure levels, even in children (Berensen, Srinivasan, Wattigney, and Hersha, 1993; Aristimuno, Foster, Vouis, Srinivasan, & Berensan 1984). According to Berensan, et al, because obesity begins in childhood, it is important to determine the level at which obesity begins to influence cardiovascular risk. In childhood, obesity is associated with high blood pressure levels, higher insulin levels, increased heart rate and cardiac output, and high level of very low-density lipoprotein cholesterol (HDL). These factors have all been observed to have a major impact on the future development of cardiovascular disease (Lauer, Bunts, Clark, & Mahoney, 1991; Webber, Osganian, Luepker, Feldman, Stone, Elder, Perry, Nader, Parcel, Broyles, & McKinlay, 1995; and Moussa, S. Kaik, Selwanes, Yaghy, & Bin-Othman, 1994, McMurray, Harrell, Levine, & Gansky, 1995). Cultural Variations in Obese Children

Among African American and Mexican American girls, the early onset of obesity and high insulin levels may be precursors of the higher incidence of diabetes mellitus seen in these groups in adulthood (Berensen, et al, 1993, Alexander, Sherman, & Clark, 1991). Culturally, attitudes toward obesity are found to be more lenient in African American communities (Kumanyika, Wilson, & Guilford-Davenport, 1993; Davis, Northington, & Kolar, 2000). Data from CATCH, the Child and Adolescent Trial for Cardiovascular Health, of the National Heart, Lung, and Blood Institute which sponsored multicenter school-based intervention programs, revealed several significant differences along cultural lines in the children. The CATCH population consisted of 3,530 Anglo-American children, 674 African-American children, and 708 Latino children, in the third grade in the states of California, Louisiana, Minnesota, and Texas. HDL cholesterol levels were highest in African-American (55.5 mg/dl) compared with 50.7 mg/dl for Anglo Americans and 51.3 mg/dl (p
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