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‘Toxic’ environment
The term “toxic environment” has been used to describe the myriad factors — such as increased portion size, sugar-sweetened beverages, fast food, and decreased physical activity — responsible for overweight in children. The interaction of these factors, in the presence of genetic predisposition to obesity, can increase a child’s risk of becoming overweight.18 The rapid increase in excessive weight gain in the U.S. cannot be blamed solely on genetics, however. The interplay of environmental factors is the greatest component in this epidemic. Particularly evident is an energy imbalance in the form of increased energy intake (in the form of calories) or decreased energy output.18,19
Nurses can assume a leadership role in decreasing the menace of childhood overweight by focusing energies on providing patients and families with information that is realistic for their busy lives, considers ethnicity, and focuses on strengthening family bonds. Only through this approach can there be success in achieving the goal of healthy lifestyles for all children.
Patient resources for prevention and
treatment of childhood overweight |
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Unicare.com and the
American Dietetic Association
Site has many programs and tools to assist the reader in making healthy choices every day.
Resource available: Healthy Habits for Healthy Kids
A colorful, well-designed online tool to assist parents and health care professionals in helping children achieve and maintain a healthy weight. Excellent resource for parents and children. Current evidenced-based information.
Cost: FREE. Can download copies or order by mail.
Language: English and Spanish |
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American Dietetic Association
Serves the public by promoting optimal nutrition, health, and well-being, with tips of the day, monthly features, and multiple resources on the website.
Resource available: A 50-page pamphlet “If Your Child is Overweight: A Guide for Parents,” provides the latest nutritional information for helping 4- to 12-year-olds with overweight. Written in an easy-to-use, approachable format. Simple how-to instructions will help to guide the child to change eating patterns; family-centered tips for making nutritional, healthy changes; attainable goals for children to achieve in a positive and healthful manner; nutritional information parents need to know, including portion sizes and sample menus; the food guide pyramid adapted for kids; physical activity tips; calculating children’s BMI; charts for hunger and weekly goals; and options for eating out, school lunches, and dealing with special occasions.
Cost: $70 for a package of 10.
Language: English only |
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KidsHealth (Nemours Foundation)
KidsHealth is the largest and most visited site on the Internet, providing doctor-approved health information about children from before birth through adolescence. Provides families with accurate, up-to-date, and jargon-free health information they can use. Multiple topics for parents and children on nutrition and physical activity. Kid’s section of the site provides easy-to-read information in a fun format. Interactive games focusing on nutrition and physical activity for children. Cannot reproduce information, but nurses can direct families to this online resource.
Cost: Download information and free to print.
Language: English and Spanish |
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kidsnutrition.org
(USDA/ARS Children’s Nutrition Research Center
at Baylor College of Medicine)
Comprehensive reviews of topics ranging from helping kids develop healthy eating habits to nutrition for vegetarian teens. Links to many helpful sites on nutrition for children and information for parents and health care providers. Up-to-date information for parents on how to help the overweight child.
Cost: Information on sites and information on linked sites are free to download and print.
Language: English and Spanish |
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Healthy Eating and Activity Together (HEAT)
National Association of Pediatric Nurse Practitioners (NAPNAP)
The HEAT initiative is the only nursing organization program focused on prevention of childhood overweight. The goal of HEAT is to improve child health through relationship-based, culturallyappropriate interventions enhancing parent, child, and practitionereffectiveness in improving nutrition, eating, feeding, and physical activity.
Resources available later this year: Evidence-based, culturally appropriate clinical practice guidelines focused on optimal nutrition, feeding/eating, and physical activity to guide care.
Cost: To be determined.
Language: English and Spanish |
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Christina Calamaro, RN, MSN, CRNP, is chair of the school-age program for the National Association of Pediatric Nurse Practitioners’ HEAT initiative and a doctoral candidate at the University of Pennsylvania School of Nursing, Philadelphia.
References
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2. CDC. 2000 CDC Growth Charts. Atlanta: Center for Disease Control and Prevention: National Center for Health Statistics; 2000.
3. Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital & Health Statistics - Series 11: Data From the National Health Survey. 2002(246):1-190.
4. AAP. Prevention of Pediatric Overweight and Obesity: American Academy of Pediatrics Policy Statement; Organizational Principles to Guide and Define the Child Health Sytem and/or Improve the Health of All Children; Committee on Nutrition. Pediatr. 2003;112:424-430.
5. International Obesity Task Force website. Available at: www.iotf.org. Accessed
February 15, 2005.
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18. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360:473-482.
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20. Dietz WH. Overweight in childhood and adolescence. N Engl J Med. 2004;350(9):855-857.
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