Hello I'm Dr. John Iskander. Welcome to CDC beyond the data I'm here today with
Captain Heidi Blank CDC's chief for obesity prevention and control
welcome Heidi thanks for having me at today's Grand Rounds session we focused
on childhood obesity prevention what can you tell our audience about the scope of
this problem and and how we define it obesity is a disorder of excess body fat
and in adults and children we use a measure called body mass index or BMI
and it's actually a simple equation of weight divided by height squared so as a
screening measure in the doctor's office or in schools or in other settings it's
pretty simple to actually identify children who are have obesity or at risk
for obesity unfortunately in today's country we have about one in five
children already struggling with obesity so that's obviously clearly a population
health issue I think some of our audience may be familiar with some of
the eventual complications such as type 2 diabetes but there's really a much
longer list of risks of obesity could you just kind of take us quickly sort of
head to toe on that so in childhood when children have obesity they already are
at risk for a number of acute conditions some of these are structural like bone
problems or sleep apnea there's also mental health issues with children
including bullying and stigmatization we see increased absenteeism from school if
obesity continues and is persistent and it goes into adulthood as you mentioned
type-2 diabetes is a large concern of obesity but also cardiovascular disease
and we now have 13 cancers that are causally linked to obesity yeah so that
certainly is something that I think is many of our audience are likely unaware
of and I think that that's very sobering what do we know about the the need to
really intervene during childhood and particularly earlier in childhood in
terms of maybe maybe our population is just sort of going to go grow out of
this problem yes so I been to a lot of places in the communities
across America and I hear from a lot of parents who think their children are
just going through a stage that they're going to grow out of this but
unfortunately we have a bulk of evidence and data from from our national surveys
as well as modeling exercises that they really show children are on a trajectory
toward obesity so we used to think obesity was an adult onset disease we're
now seeing children as young as two three and four having obesity again
again very sobering now a lot of the focus in our session was on the early
childhood education or what we'll refer to as the childcare setting so why is
that setting important for obesity prevention and what can parents and
child care providers do to have an impact in that setting so we know that a
large number of our children spend their days outside the home so over 60% of our
toddlers are in child care for over 30 hours a week so although parents and
aunts and uncles and grandparents are very important in the household setting
our child care providers really are that first line of defense and first line of
healthy habits during that school week we have a lot of children who are
benefitting from high-quality child care for school readiness and early literacy
but we really need to make sure too that those healthy habits are established
during that child care day and so what are some of those targets which are not
only targets for child care what are some of those targets in terms of
physical activity and healthy nutrition so we know that obesity is not a simple
disease there are many factors that cause obesity so the science is evolving
but we know that better foods so those that are lower in calorie and high
nutrients so things like fruits and vegetables getting adequate physical
activity reducing screen time or sedentary time but also stress
management and sleep are really important in children a lot of
initiatives these days use something like a 10 5 to10 approach so 10 hours of
sleep 5 fruits and vegetables less than 2 hours of screen time one hour of
physical activity and zero sugary drinks mmm that's that's that's really a great
a great way to remember that because I think that that applies across a pretty
wide range of age as well so clearly there's a lot of
impact that the childcare providers can have that that parents can have outside
of the outside of the school day as well obviously as kids age they continue to
spend a lot of time in in in school settings
um CDC does have some school guidelines and although they're not solely focused
on obesity prevention I think they're there they're relevant could you just
hit for our audience some of the high points of those guidelines yes so the
school health guidelines really provide a comprehensive set of standards and
best practices that that schools can really aim for so some of it are around
the areas that we talked about but it also includes nutrition education
nutrition services and that nutrition environment so that includes the school
day the after school the campus so again ensuring healthier foods drinking water
availability physical activity throughout the school day so in some
times that can be actually kind of active recess in addition to some
activity breaks during that school day are as part of lessons also we are
related to food service directors and and the healthy school guidelines really
do fit into this whole child whole community model so really trying to
think about the parents the community and the child and how that really fits
together in our society right certainly we want we want act we'd not only want
active and healthy children we want active and healthy parents and families
and communities as well and and certainly we had speakers at Grand
Rounds who really addressed different aspects of all of that so you gave us
some really fairly sobering statistics earlier about the the current amount of
childhood obesity and and some of the complications that might ensue and and
some of the kind of trajectories that were on I think there is though some
basis for four for optimism in in some of the data about from from child care
settings could you kind of walk us through that and maybe talk a little bit
about what has led to some of those positive outcomes
so the CDC has a partnership with the USDA the United States Department of
Agriculture and we've released a report that shows among the low income children
in our in our population those were probably the most vulnerable for obesity
so the two to four year olds actually we've seen a decrease in obesity since
2010 so this is really exciting it's a very large data set so it provides some
robustness around our data and our estimates I mean this really gives us
hope that that society communities families are starting to move in the
right direction and so is it is it likely that approaches like that 10 5
to10 approach are could those be some of the underlying factors beyond these
improvements so yeah so we've done some analyses along with with partners to
look at at least four communities that found childhood obesity declines and
that's helped us kind of provide some information of why we think that WIC
population why that data is showing that decline some of the things that we're
seeing some changes in in the right direction include many more child care
providers and many more child care settings that are meeting best practices
so again around breastfeeding supports for moms healthy nutrition and snacks
especially infant feeding we're seeing a lot of early infant weight gain among
American children this really includes things like in early introduction of
foods moms not being able to really meet their breastfeeding intent so early
formula feeding and so in in parenting styles and so child care providers are
really working with parents to ensure that that parents have that best
knowledge and that the child care providers are doing the right thing
and so we're seeing so we're seeing things like state policies that are
supporting the child care center we're seeing that in schools as well so if you
layer on kind of you know state policies and state initiatives district or school
level and child care provider level positive movements and then and then the
community at large so we're seeing park and recreation facilities offering
programs improving their bending really getting kids and multi generations
involved and so it really takes all those layers to make a difference
because we go through our days in many key settings again we leave our houses
we go to these places whether it's work sites for parents or the childcare in
the school so it's really taking these levels of policy change environmental
change and individual habits and we think all that it's kind of coming
together to really change this so that's really really important I think we have
also had some examples presented of linking childcare with farmers markets
for example which I thought was a good example of a community linkage so I
think almost everyone in our audience will have some role either as a parent
teacher a school administrator a school board member just an interested or
engaged community member where are some places they can go to find more
resources in addition to our own CD site which has obesity and has nutrition
physical activity strategies many of our states and local communities have
community coalition's some of these are healthy eating active living type
coalitions we also have school wellness and PTA membership and so many folks who
are interested in this really can get involved we're happy to put folks in in
contact with a number of our organizations at the state and
territorial level as well well and on on that note of really everybody being able
to have some some role in this I'd like to again thank you very much and for
your work and for speaking with us today thank you I'm dr. John Iskander please
join us next time for beyond the data
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