School Lunches Weigh Heavily in Childhood Obesity

[Guest guest]

Obese sixth graders pack on the pounds in much the same manner as their

adult counterparts -- too much TV, poor dietary habits, and too little

physical

activity.<http://www.medpagetoday.com/Pediatrics/Obesity/24616?utm_content=Group\

CL & utm_medium=email & impressionId=1296543623705 & utm_campaign=DailyHeadlines & utm_s\

ource=mSpoke & userid=134896>

All three factors had significant associations with obesity in a cohort

study involving 1,003 sixth graders.

The strongest predictors of obesity were school-lunch consumption (OR 1.29,

1.02 to 1.64) and spending two or more hours in front of a TV or video game

within the past day (OR 1.19, 1.06 to 1.33), as reported recently in

the *American

Heart Journal*.

Moderate physical activity reduced the likelihood of obesity by 11% (OR

0.89, 0.82 to 0.90).

The unhealthy behaviors translated into an unfavorable metabolic profile,

including lipids, blood pressure, blood glucose, and heart rate.

" Opportunities to improve child health should emphasize programs that

increase physical activity, reduce recreational screen time, and improve

nutritional value of school lunches, " Kim A. Eagle, MD, of the University of

Michigan in Ann Arbor, and co-authors wrote in conclusion.

" Whether genetic or not, childhood obesity can be attacked. "

Current theories about the origin of obesity have generally placed most of

the blame for the condition on either behavioral factors or heredity and

genetically determined susceptibility. In an effort to inform on the issue,

the investigators developed a school-based intervention to improve the

health status of middle-school students in several towns in the southeast

part of Michigan.

The intervention had built-in research opportunities to examine possible

associations between the students' physical activity, food intake,

physiologic measures, and body mass index (BMI).

" We reasoned that if dietary patterns and physical activity were similar in

obese and nonobese students, this would argue for a stronger genetic basis

for obesity in our subjects, " the authors wrote in the introduction to their

report.

" We also hypothesized that obesity before adolescence is associated with

physiologic characteristics, including blood pressure, fitness, serum

glucose, and serum lipids, " the authors added.

The program, called Project Healthy Schools, has five principal goals:

increase intake of fruits and vegetables, reduce consumption of fatty foods

and fast food, reduce consumption of sugar-containing beverages, increase

physical activity, and reduce sedentary behaviors.

The intervention included a variety of educational materials and

modification of environmental factors in the schools, such as school

lunches, items stocked in campus vending machines, and substitution or

replacement of sugar-containing sodas with bottled water whenever possible.

Eagle and co-authors reported baseline data from the study: Students' mean

age was 11.5, and 150 (15%) of the children were obese, as defined by a BMI

≥95th percentile for age. Obese children were significantly taller (154.34

cm versus 149.40, *P*<0.001), significantly heavier (65.74 kg versus 42.00

kg [145 lbs versus 93], *P*<0.001), and had a significantly higher BMI

(27.47 versus 18.69, *P*<0.001).

Analysis of baseline physiologic characteristics showed that obese children

had significantly higher:

- Serum cholesterol, 180.10 versus 166.51 mg/dL, *P*<0.001

- LDL, 101.60 versus 89.18 mg/dL, *P*=0.004

- Triglycerides, 166.62 versus 117.42 mg/dL, *P*<0.001

- Mean systolic blood pressure, 118.48 versus 108.09 mm Hg, *P*<0.001

- Mean diastolic blood pressure, 70.42 versus 64.37 mm Hg, *P*<0.001

- Resting heart rate, 84.67 versus 69.69 bpm, *P*<0.001

- Recovery heart rate, 117.94 versus 100.84 bpm, *P*<0.001

Comparison of self-reported diet and beverage behaviors identified three

significant differences. Obese children were:

- Less likely to have consumed milk within the previous 24 hours (83.0%

versus 89.7%, *P*=0.020)

- More likely to consume school lunches on most days (45.1% versus 34.2%,

*P*=0.001)

- More likely to consume regular sodas/soft drinks daily or almost daily

(39.7% versus 30.4%, *P*=0.029)

Analysis of physical activity showed that obese students were significantly

less likely to have exercised for at least 20 minutes a day for five days in

the previous week (45.8% versus 55.6%, *P*=0.030). They were also less

likely to participate in school or organized sports (*P*=0.030, *P*=0.016,

respectively).

Obese students also were significantly more likely to say they engaged in

screen-related sedentary activities for at least two hours in the past day:

TV watching, 58.2% versus 41.8%, *P*<0.001; computer time, 34.5% versus

29.8%, *P*<0.001; and playing video games, 26.1% versus 17.5%, *P*=0.017.

*Primary source: *American Heart Journal

Source reference:

Eagle TF, et al " Health status and behavior among middle-school chiildren in

a midwest community: What are the underpinnings of childhood obesity? " *Am

Heart J*. 2010; 160:

1185-1189.<http://www.ahjonline.com/article/S0002-8703%2810%2900888-4/abstract%3\

Cbr%20/%3E>

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

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