Childhood Obesity… Let’s “Step” Towards A Healthier Future!

Childhood Obesity…Let’s “Step” Towards A

Healthier Future!

Shelley FrancisDiabetes Community Consultant

Union of NB Indians

ANTEC 2010

Childhood Obesity…Sad FactsChildhood Obesity…Sad Facts

In Canada, over 26% of children and youth (1.6 million children) are considered overweight or obese

If this trend continues, 46 % of school-aged children will be overweight or obese by 2015

In 20 years, 70% of 35-44 year olds will be obese as compared to 57% who are currently obese

Aboriginal children are at higher risk due to genetic and lifestyle factors


55% Obesity rate in First Nation Communities (CMA, 2007)

Chronic disease rates are higher (and some are in epidemic proportions) among Canada’s Aboriginal population

Mental health issues are abundant among Aboriginal People – slowing our progress towards healthier communities


Unfortunately most obese children and youth do not outgrow their weight problem….in fact most people tend to gain weight as they age.

What is Childhood ObesityWhat is Childhood Obesity

Childhood Obesity is a medical condition that affects children and teenagers. It happens when too much fat is stored in the body, causing a weight that is not proportional to the child’s height.

The primary cause of CO is eating too much and not getting enough exercise

Risk Factors to Childhood ObesityRisk Factors to Childhood Obesity

Most children who are affected:

Consume food and drinks that are high in sugar and fat on a regular basis such as fast food, candy, baked goods, pop and other sugar-sweetened beverages

Are not physically active each day

Watch a lot of TV and play a lot of video games, computer use

Eat to help deal with stress or problems

Risk Factors to Childhood ObesityRisk Factors to Childhood Obesity

• Live in an environment where healthy eating and physical activity are not encouraged

• Come from a family of overweight people where genetics may be a factor, especially if healthy eating and physical activity are not a priority in the family

• Come from a low-income family who do not have the resources or time to make healthy eating and active living a priority

• Have a genetic disease or hormone disorder such as Prader-Willi syndrome or Cushing's syndrome

Long-term Obesity =Long-term Obesity =Long-term Health and Social Long-term Health and Social

Problems! Problems!

What Happened??What Happened?? Lack of physical activity programs in

schools and in the community Lack of grassroots stuff to do – or

unwillingness to do them Video and computer game access Lack of time at home – families are

VERY busy! Lack of knowledge of the importance

healthy eating Access to food is incredible and

convenient!!

Consequences of Consequences of Childhood ObesityChildhood Obesity

Chronic diseases: diabetes, heart disease, cancer Bone & joint dysfunction High blood pressure and elevated cholesterol Earlier than normal puberty or menstruation Liver problems – due to ongoing fat digestion Eating disorders such as bulimia and anorexia Respiratory problems such as asthma, shortness of

breath etc. Skin infections due to excessive perspiration trapped in

skin folds Sleep apnea Fatigue

Consequences of Consequences of Childhood ObesityChildhood Obesity

Negative body image Depression Teasing, bullying, social marginalization More likely to bully others Poor self-esteem and may feel socially isolated Increased risk for depression Poorer social skills High stress and anxiety May have behaviour and/or learning problems as a

result of psychological difficulties related to childhood obesity

ADI Diabetes Prevention &ADI Diabetes Prevention &Healthy Lifestyle Healthy Lifestyle School ProgramSchool Program

Community-based school program Vision…to create an awareness of the

growing incidence of Diabetes among Aboriginal People in Canada – and how to prevent it and other chronic diseases

Addresses healthy lifestyle issues such as nutrition and physical activity

Addresses the devastating childhood obesity epidemic facing our Youth

Health Promotion in Schools…Health Promotion in Schools…

School Food Policy Implementation

Nova Scotia (2006) – staged implementation began

New Brunswick (2007) – staged implementation began

Eel Ground School (2008) – full implementation began Sept. 2008

Eel Ground School Nutrition Eel Ground School Nutrition Policy ObjectivePolicy Objective

“This policy establishes the minimum requirements for healthy foods and regular physical activity in the Eel Ground School by setting standards for awareness of healthy foods, food options available in schools and sale of foods in and through the school system.”

Eel Ground School Eel Ground School Nutrition Policy Nutrition Policy

Awareness began 2003Planning through wellness committee

in summer of 2007Approval of Chief & Council and

education committeeStaged approach until Sept.2008,

then policy fully implementedBreakfast and Hot lunch programs

ADI School Screening ProgramADI School Screening Program

Began in 2004Eel Ground First Nation was first

school involved with screeningWith parental consent, each student

grades K-8 tested with blood sampleGenerally well-toleratedStudents screened annually

Screening ResultsScreening ResultsBlood Glucose TestingBlood Glucose Testing

INDICATORINDICATOR 20032003 20052005 20082008

%% %% %%

Impaired Glucose ToleranceImpaired Glucose Tolerance

(PC glucose >11.1 mmol/l)(PC glucose >11.1 mmol/l) 0%0% 0%0% 0%0%

Impaired Fasting GlucoseImpaired Fasting Glucose

(AC glucose > 5.7)(AC glucose > 5.7) 9%9% 5%5% 0%0%

Normal Blood GlucoseNormal Blood Glucose

(pre meal < 7 and post meal < (pre meal < 7 and post meal < 9 mmol/l)9 mmol/l)

91%91% 95%95% 100%100%

Screening ResultsScreening ResultsBody Mass Index (2005)Body Mass Index (2005)

IndicatorIndicator # Students# Students %%BMI>95BMI>95thth Percentile(=Obesity)Percentile(=Obesity)

1616 32%32%

BMI 85-95BMI 85-95ththPercentile Percentile

(Overweight - risk for (Overweight - risk for obesity)obesity)

1313 27%27%

BMI 50-85BMI 50-85ththPercentilePercentile 99 18%18%

BMI 3-50BMI 3-50thth Percentile Percentile 1111 22%22%

BMI<3BMI<3rdrd Percentile Percentile 22 <1%<1%

Screening for Type 2 Diabetes Risk Screening for Type 2 Diabetes Risk Factors in Children & AdolescentsFactors in Children & Adolescents

Identify children 10 years and greater who are most at risk of developing Type 2 Diabetes in the future

Parent Questionnaire and consent

Initial screening for diabetes risk factors did not involve any blood glucose testing, avoiding unnecessary blood samples.


Parent Consent and Questionnaire completed and sent back to school.

Children were screened for the following 3 risk factors: Aboriginal Descent, BMI>95%, 10 years of age or older

If all 3 risk factors were present…


…And they had one or more of the following risk factors, their risk would be assessed as high and further screening needed to be completed: Mother with Gestational Diabetes Family members with diabetes Acanthosis Nigricans High blood fats Hypertension Polycystic Ovary Disease

Screening for Type 2 Diabetes Screening for Type 2 Diabetes Risk Factors in Children & Risk Factors in Children &

Adolescents (2008)Adolescents (2008)

IndicatorIndicator # Students# Students %%BMI>95BMI>95thth

Percentile(=Obesity)Percentile(=Obesity)2525 42%42%

Elevated Blood Elevated Blood PressurePressure

99 15%15%

Mothers With Mothers With Gestational DiabetesGestational Diabetes 77 12%12%

Acanthosis NigricansAcanthosis Nigricans 33 9%9%

Health Promotion in Schools…Health Promotion in Schools…

Kindergarten ClassCanada Food Guide display at Miramichi Regional Hospital

Project OutcomesProject Outcomes Healthier learning environment for school Increased awareness of Diabetes epidemic Increased staff involvement in healthy lifestyles Ownership of the project by the students Enhanced communication and partnerships

between health programs on and off reserve Healthier children! Follow up

continues…..parents more involved Pride for the students, staff and community

ADI School Program PartnershipsADI School Program Partnerships

Community First Nation School Community Health Nurse/CHR Local businesses Provincial Health Department Regional Hospital Health Authority Pharmaceutical Industry University Faculty of Nursing & Kinesiology Brighter Futures Program FNIHB staff - Dental Therapist, Nutritionist, Physical

Activity Specialist etc.

Where Are We Going?Where Are We Going?

Continue with annual screening clinics Partner with helping organizations Continue to do classroom education with the

students Continue to support school staff in making

the school environment healthy Promotion of School Food Policy 4 Steps to better health in Children

4 Simple Steps to 4 Simple Steps to Better Health in ChildrenBetter Health in Children

ONE Hour of Physical Activity Per Day!

FIVE Fruits & Vegetables Per Day!

TWO Hours or Less of Screen Time Per Day!

ZERO Sugar Sweetened Beverages Per Day!

What Can Families Do?What Can Families Do? Be active as a family Involve children in household activities Be knowledgeable about health Eat meals together at home Teach your children basics – like cooking Lead by example Start early in your child’s life Don’t set child up for failure (junk foods in the

kitchen cupboards) Do not talk “diets” – focus on healthy lifestyles Be supportive, not critical!

What Can Communities Do?What Can Communities Do?

Limit sale of sugar sweetened beverages (SSB’s) at community events, municipal buildings, schools, public areas etc.

Offer food skills programs (cooking classes, healthy grocery shopping tours)

Support adoption of school food policies

Be an active community with walking trails, subsidized activity fees etc.)

Offer support through health programs

What Can Government Do?What Can Government Do?

Fund more treatment centres for obese and overweight children

Support research and evaluation of ongoing childhood obesity programs to improve services and accessibility

Improve access to affordable fruits and vegetables and healthy foods in general

Support ongoing and new initiatives such as Winteractive, Summeractive, CPNP, ADI, Headstart - ensure that these programs target the children and youth in preventing obesity and other chronic diseases

What Are What Are WeWe Going To Do?Going To Do?

Lobby Chiefs and Councils local and national governing bodies to support the cause

Educate School staff to enlist their support Become educated ourselves Ensure a constant presence wherever kids are Be there for students, families and staff Be role models for all community members Persistence is the key to success…

DON’T GIVE UP!!!

Children’s Pride &Children’s Pride &A Brighter Future are in Our A Brighter Future are in Our

Hands!Hands!

Questions?Questions?

Shelley Francis, BNRN, CDE Diabetes Community Consultant

Union of NB Indians(506) 458-9444

[email protected]

Ann Gottschall, RNMNDiabetes Community Consultant

Union of NS Indians(902) 863-8455

[email protected]

Questions?Questions?

Margie Gray BSc.RD Diabetes Community Consultant

MAWIW Council Inc. (506) 476-4014

[email protected]

Tara MacKinnon, PDt., CDEDiabetes Community Consultant

Confederacy of Mainland Mi’kmaq(902) 895-6385

[email protected]

Childhood Obesity… Let’s “Step” Towards A Healthier Future!

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