Pediatric obesity, which has reached epidemic proportions in the United States in the past 10 years, translates directly into rising rates of adult obesity. This study assessed the impact of a school, family, community, and industry-based primary intervention project on the rates of overweight and obesity in a rural countywide cohort of children in grades kindergarten through 8. It included classroom education, student/ family wellness booklets, point source healthy menus, occupational health analyses, and community health fairs. A 5-year longitudinal analysis of grade-specific rates of overweight and obesity of the participating children showed that overweight and obesity rates increased for all cohorts. Key elements contribute to increasing rates of pediatric obesity. Inadequate penetration of education/information dissemination and lag time represent 2 explanations for the lack of obesity reduction during the program implementation period. Strategies for successful engagement of multiple groups are essential to effectively reverse the pediatric obesity epidemic.
National Health Examination Survey II (ages 6 through 11), III (ages 12 through 17), National Health and Nutrition Examination Surveys I, II, and III, and 1999-2000, NCHS, CDC. Hyattville, Md: National Centers for Health Statistics ; Atlanta, Ga: Centers for Disease Control and Prevention.
2.
Jackson Y., Dietz WH, Sanders C., et al. Summary of the 2000 Surgeon General's Listening Session: toward a national action plan on overweight and obesity. Obes Res . 2002;10:1299-1305.
3.
Krels NF, Jacobson MS; American Academy of PediatricsCommittee on Nutrition. Prevention of pediatric overweight and obesity. Pediatrics . 2003;112:424-430.
4.
Nestle M., Jacobson M.Halting the Obesity Epidemic: A Public Health Policy Approach.” Public Health Rep.2000;115:12-24.
Epstein LH, Paluch RA, Consalvi A., Riordan K., Scholl T.Effects of manipulating sedentary behavior on physical activity and food intake . J Pediatr.2002;140:334-339.
7.
Ludwig DS, Pereira MA, Kroenke CHDietary fiber, weight gain, and cardiovascular disease risk factors in young adults. JAMA.1999; 282:1539-1543.
8.
Ebbeling CB, Leidig M., Sinclair KB, Hansen JP, Ludwig DSA reduced glycemic load diet in the treatment of adolescent obesity. Arch Pediatr Adolesc Med.2003; 159:773-779.
9.
Bowman S. Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DSEffects of fast food consumption on energy intake and diet quality among children in a national household survey. Pediatrics. 2004;114:112-116.
10.
American Academy of PediatricsCommittee on School Health. Soft drinks in schools. Pediatrics. 2004;113: 152-154.
11.
Pereiva M., Jacobs DR Jr, Van Horn L., Slattery ML, Kartashov AI, Ludwig DSDairy consumption, obesity, and the insulin resistance syndrome in young adults . JAMA.2002;287:2081-2089.
12.
Rippe JM, Hess S.The role of physical activity in the prevention and management of obesity . J Am Diet Assoc.1998; 98(suppl II):531-538.
13.
Burdette H., Whitaker R.A national study of neighborhood safety, outdoor play, television viewing, and obesity in preschool children. Pediatrics. 2005;116:657-662.
14.
Gortmaker S., Cheung LW, Peterson KE, et al. Impact of a school based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving. Arch Pediatr Adolesc Med.1999;153:975-983.
15.
Paradis G., Levesque L., Macaulay AC, et al. Impact of a diabetes prevention program on body size, physical activity, and diet among Kanien'keha:ka (Mohawk) children 6 to 11 years old: 8-year results from the Kahnawake Schools Diabetes Prevention Project. Pediatrics. 2005;115: 333-339.
16.
Summerbell CD, Ashtol V., Campbell KJ, Edmunds L., Kelly S., Waters E.Interventions for treating obesity in children . Cochrane Database Syst Rev.2003;3:CD001872.
17.
Koplan JP, Liverman CT, Kraak VA, eds. Preventing Childhood Obesity: Health in the Balance. Washington, DC: Institute of Medicine; 2004.
18.
Beech BM, Klesges RC, Kumanyika SK, et al. Child-and parent-targeted interventions: the Memphis GEMS pilot study. Ethn Dis.2003;13(1 suppl 1):S40-S53.
19.
Davis S., Gomez Y., The Southwestern Cardiovascular Curriculum Project. Ann N Y Acad Sci.1993;699: 265-256.
20.
Fitzgibbon ML, Stolley MR, Dyer AR, VanHorn L, KauferChristoffel K. A community-based obesity prevention program for minority children: rationale and study design for Hip-Hop to Health Jr. Prev Med.2002;34:289-297.
21.
Tioga County, Pennsylvania State Health Data Center.1998Behavioral Health Risks of Pennasylvania adults. Available at: www.health.state.pa.us. Accessed Jan 23, 2007.
22.
Freedman DS , Dietz WH, Srinivasan S., Berensen CSThe relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics. 1999;103:1175-1182.
23.
Flynn MA, McNeil DA, Maloff B., et al. Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with `best practice' recommendations. Obes Rev. 2006;7 (suppl 1):7—66.
24.
Cable News Network (CNN).Child obesity grows faster in rural areas. March 14, 2005, from Center for Rural Pennsylvania Data 1999-2001 .
25.
Bao W., Srinivasan SR, Valdez R., Greenlund KJ, Wattigney WA, Berenson GSLongitudinal changes in cardiovascular risk from childhood to young adulthood in offspring of parents with coronary artery disease: The Bogalusa Heart Study . JAMA.1997;278:1749-1755.
26.
Swinbarn B. , Egger G.Preventive Strategies against weight gain and obesity. Obes Rev. 2002;3:289-301.
27.
Dietz WH, Gortmaker SLPreventing obesity in children and adolescents. Annu Rev ofPublic Health. 2001;22: 337-353.
28.
Meiselman HL , Hedderley D., Staddon SL, Pierson BJ, Symonds CREffect of effort on meal selection and meal acceptability in a student cafeteria. Appetite1994;23:43-55.
29.
Rideout VJ, Foehr UG, Roberts DF, et al. Kids and Media at the New Millennium: A Comprehensive National Analysis of Children's Media Use. Menlo Park, Calif: The Henry J. Kaiser Family Foundation, 1999.
30.
Robinson T.Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA.1999;282:1561-1567.
31.
Armstrong J. , Reilly J.; Child Health Information Team. Breast feeding and lowering the risk of childhood obesity. Lancet. 2002;359:2023-2024.
