lectures Flashcards

1
Q

BMI (Body Mass Index)

A

a number calculated from a person’s weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems. Obesity = 30 or higher in adults

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2
Q

Facts Quiz (4)

A
  1. more than 2/3 of US adults are obese or overweight. 2. gender gap is closing in regards to adult obesity rates. 3. obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death (not to mention orthopedic problems, mental health problems, etc) 4. adult obesity rates vary significantly for women in different racial and ethnic groups
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3
Q

Why care about childhood obesity? (2)

A
  1. obese children are more likely to become obese adults 2. if children are overweight, obesity in adulthood is likely to be more severe
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4
Q

Is childhood obesity a social justice problem?

A

Yes, it is unethical for public health community to not take action

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5
Q

Obesity Definition

A

the abnormal or excessive accumulation of fat in adipose tissue to the extent that health may be impaired

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6
Q

Childhood Obesity Definition

A

a serious medical condition that affects children and adolescents. It occurs when a child is well above the normal weight for his or her age and height. Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once confined to adults, such as diabetes, high blood pressure, and high cholesterol. Childhood obesity can also lead to poor self-esteem and depression

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7
Q

Issue with measurement

A

Classification of obesity to a single measure is difficult

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8
Q

Individual-level effect on childhood obesity

A

Complex since children (young children) have less control over their behaviors than older children and adults, thus there are many environmental influences (caregivers and their behaviors, peers) that must be considered

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9
Q

When designing interventions, what is important to consider about children?

A

the cognitive level, as well as the ability of outside entities to influence them (marketing)

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10
Q

When are times of intensive growth? (4)

A

Also called critical periods. Development of obesity can occur during 1. gestation 2. early infancy 3. adiposity rebound (the time in early childhood when body fat begins to increase), and 4. puberty

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11
Q

Facts about family dinner (2)

A
  1. away-from-home dining contributes to the obesity problem, as these foods tend to be higher in fat and saturated fat and lower in fiber 2. frequency of family dinner has been associated with healthier meals
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12
Q

Influence of Parental Activity (5)

A
  1. interventions directed at families and or parents have a potential for benefit in children, without necessarily targeting the child 2. parents are role modeling 3. shared physical activity 4. they have the same genetic influences 5. increased access
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13
Q

Adiposity Rebound (3)

A
  1. child’s BMI increases during the first year of life. After that, BMI gradually decreases until it reaches its lowest point around 6years of age, then increases again 2. age of the lowest point BMI is at the start of of Adiposity Rebound 3. children who experience early age of AR are at risk of being overweight
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14
Q

mother’s factors (6)

A
  1. pre-pregnancy maternal weight 2. pregnancy weight gain 3. pregnancy glucose tolerance 4. toxic exposures in pregnancy 5. breastfeeding initiation, maintenance 6. feeding practices
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15
Q

child’s factors (4)

A
  1. birth weight 2. weight gain in the early months and years 3. duration of breastfeeding 4. night feedings
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16
Q

Low birth weight babies

A

babies that are small for gestational age (SGA) are prone to develop obesity. Led to the concept of prenatal developmental programming as key to later obesity

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17
Q

High birth weight babies

A

as birth weight rises, child and young adult BMI rises

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18
Q

Gestational Diabetes Mellitis (GDM)

A

GDM raises risk of high birth weight (LGA), and LGA babies and babies of mother with GDM are at high risk for childhood obesity

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19
Q

Types of toxic exposures in pregnancy (6)

A
  1. smoking 2. endocrine disrupting chemicals 3. glucocorticoids, other hormones 4.some plastics 5. some pesticides 6. low protein diet
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20
Q

proposed mechanisms during development (2)

A
  1. disruption of processes controlling eating, activity, metabolism, and fat formation
  2. during critical developmental windows - the formation of appetite and satiety centers in brain
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21
Q

Effects of breastfeeding (3)

A
  1. duration of breastfeeding is inversely related to pediatric overweight 2. exclusive breastfeeding has a stronger protective effect that breastfeeding combined with formula feeding 3. protective effects may extend into adulthood
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22
Q

Why is breastfeeding so influential? Possible explanations (3)

A
  1. child can decide when finished feeding 2. insulin response greater with formula-fed infants (higher insulin levels = more fat tissue and weight gain) 3. leptin (hormone that inhibits appetite and controls fat) may be influenced by breastfeeding
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23
Q

mental health effects of childhood obesity (6)

A
  1. obese children were rated more negatively, across racial groups 2. obese adolescents report more victimization than do overweight adolescents 3. more likely to report suicidal ideation than those who were not teased 4. may impact interpersonal relations (friendships, dating) 5. can result in unhealthy eating behaviors 6. greater levels of general stress
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24
Q

How does the Degree of teasing relate to mental health?

A

Positively related to weight concerns, loneliness, lower confidence in physical appearance, and higher preference for isolative activities

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25
Q

Attitudes toward overweight

A

Female adolescents viewed an overweight peer more positively when her obesity could be attributed to a medical reason (thyroid condition), otherwise individual was seen as self-indulgent, lacking self-discipline and less popular

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26
Q

Parental Bias

A

parents themselves may also be the ones to stigmatize their children. This perceived parental responsibility combined with obstacles encountered in helping their child achieve successful weight loss may create an atmosphere of frustration and anger in the household–Stop blaming the parents!

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27
Q

Epigenetics Definition

A

the development and maintenance of an organism is orchestrated by a set of chemical reactions that switch parts of the genome off and on at strategic times and locations. Epigenetics is the study of these reactions and the factors that influence them

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28
Q

Why is Fetal and early childhood nutrition key?

A

body compensates for under or hypernutrition and tries to predict later life environment

29
Q

Influence of Mealtimes

A

mealtimes allow for monitoring behavior (especially adolescents); protective against the development of eating behaviors in pre-teens and bulimia in female college students; more fruits and veg. consumption in adolescents

30
Q

Food Insecure Households

A

Lack consistent access to adequate food for active healthy living for all household members throughout the year

31
Q

TV-viewing and eating

A

TV watching and eating reduce consumption of fruits and vegetables, adults are more likely to overeat in front of TV, many families watch TV during meals, concern about exposure to food marketing

32
Q

Physical Activity Differences by Gender

A

Girls have been shown to be more physically active when there is a safe place to play nearby. Girls also have been shown to need social support form parents and peers for physical activity

33
Q

Active Living Research

A
  1. Kids are very active during recess if the playground is painted with designs for recreation and games. 2. Parks paved with trails are more likely to be used for physical activity than those without. 3. walking to and from public transit satisfies the daily physical activity recommendation for 29% of transit users 4. children are 2x more likely to walk to their destination if they live near parks, schools and shops
34
Q

CDC’s Recommendation Strategies for Obesity Prevention

A
  1. require PE in schools 2. reduce screen time in public service venues 3. improve access to outdoor recreational facilities 4. enhance infrastructure supporting bicycling 5. enhance infrastructure supporting walking 6. enhance personal safety 7. enhance traffic safety 8. participate in community coalitions or partnerships to address obesity
35
Q

Individual Assessment Items to Study

A

Policy, Systems, and Environmental Change (PSE) strategies. Key for childhood obesity prevention. Sometimes environmental policy changes; sometimes policy changes first require environmental changes (especially at the local level to build a movement). Example of a policy related to physical activity? Example of an environmental change related to physical activity?

36
Q

What is the Farm Bill?

A

the primary agricultural and food policy tool of the federal government. The comprehensive omnibus bill is passed every 5 years or so by the United States Congress and deals with both agriculture and all other affairs - intended to protect our food and farming systems from the forces of weather, price fluctuations and global economy

37
Q

Menu Labeling

A

chain restaurants with 20 or more outlets are required to list calories and other nutrition information on menus and menu boards. Vending machines included.

38
Q

Fresh Food Financing Initiative

A

grant and loan program to encourage supermarket development in underserved neighborhoods throughout the state.

39
Q

Healthy Food Financing Initiative

A

supports projects that increase access to healthy, affordable food in communities that currently lack these options. Through a range of programs at the USDA, HHS, the Healthy Food Financing Initiative will expand the availability of nutritious food, including developing and equipping grocery stores, small retailers, corner stores, and farmers markets selling healthy food. Using the census tract as a unit of analysis, they will give funding priority to food deserts

40
Q

Examples of State Policy Initiatives

A
  1. EBT and farmers markets - IL passed legislation to facilitate EBT machines at famers markets. 2. Breastfeeding promotion - Hospital Infant Feeding Acts; resolutions; protection against discrimination. 3. Local food promotion - makes financial assistance available to deliver New York State grown foods to food service markets, including restaurants, schools and colleges and others especially in underserved urban and other communities
41
Q

Food Policy Councils

A

FPCs are related food advisory councils or coalitions, who support and advise citizens and officials in developing policies and programs to improve regional, state, or local food systems. FPCs aim to identify and propose solutions, and increase consumer access to and the availability of affordable, healthy foods. They are commissioned by the state, or local governments

42
Q

Local Policy Initiatives Examples

A

Tax incentives for healthy corner stores. Low- or no-cost incentives include: bid preferences, density bonuses, exemptions, streamlined processes. Some types of incentives will cost the local gov’t money through direct spending, loss in tax revenue, or staff time for example - grants, subsidies, loans, tax credits, exemptions, abatements, permitting free reductions and waivers, recognition programs that require extra staff time, paid advertising, and rewards

43
Q

Institutional Food Policies

A

placement of foods in prominent locations increases the rate at which they’re purchased; purchase leads to consumption and consumption of foods high in sugar, fat, and salt increases the risks of chronic diseases.

44
Q

Policy is…

A

A definite course of action adopted for the sake of expediency, facility, etc, or a course of action adopted and pursued by a government, ruler, political party, etc, or an action or procedure conforming to or considered with reference to prudence or expediency

45
Q

Pre-emption Definition

A

Pre-emption occurs when, by legislative or regulatory action, a “higher” level of government (state or federal) eliminates or reduces the authority of a “lower” level over a given issue” –so federal law pre-empts state law and state law pre-empts local law

46
Q

Local control benefits

A

provides greater accountability because local legislators interact with their constituents on a daily basis. Local policy makers can craft laws addressing the unique needs of their communities, which fosters innovation and allows diverse communities to adopt appropriate protections for themselves rather than accept a one-size-fits-all top-down standard

47
Q

What is a Health Policy?

A

decisions, plans, and actions that are undertaken to achieve specific health care goals within a society

48
Q

Healthy Kids Outdoors Act

A

Legislation that would authorize the Secretary of the Interior to carry out programs and activities that connect Americans, especially children, youth, and families, with the outdoors

49
Q

Redfields to Greenfields

A

a research effort analyzing the effects of acquiring financially distressed properties (real estate “in the red”) in major US cities and converting them into green space (public parks and adjacent land banked for future sustainable development)

50
Q

Health Impact Assessments (HIA)

A

a systematic process that uses an array of data sources and analytic methods, and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. HIA provides recommendations on monitoring and managing those effects

51
Q

Marketing to children

A

Current food and beverage marketing practices puts children’s long-term health at risk. If America’s children and youth are to develop eating habits that help them avoid early onset of diet-related chronic diseases, they have to reduce their intake of high-calorie, low-nutrient snacks, fast foods, and sweetened drinks, which make up a high proportion of the products marketed to them

52
Q

Developmental considerations

A

By age 2, children recognize brand logos on product packages and by preschool, children can recall brand names seen on TV. Preschoolers had higher preference for foods in McDonald’s packaging than same food in plain packaging. Children younger than 7 or 8 do not possess the cognitive abilities to understand that advertising presents a biased point of view

53
Q

Hedonic Hunger

A

the drive to eat palatable foods in the absence of energy needed. Eating for pleasure

54
Q

Social Cognitive Theory on Marketing to kids

A

food advertising can prime or automatically activate, increased food consumption in children and young adults…these effects are not mediated by hunger, advertising awareness, or mood

55
Q

Cultivation theory on TV

A

a social theory which examines the long-term effects of television. The primary proposition of cultivation theory states that the more time people spend “living” in the television world, the more likely they are to believe social reality portrayed on television

56
Q

Product Tie-ins

A

Sponge Bob and other familiar characters on packaging attracts children and helps sell foods

57
Q

Advergames

A

children spend a substantial amount of time on their computers, surfing the web, listening to music and playing games. Fast food restaurants such as McDonald’s designed “advergames” which are online games children can play while receiving subtle advertising from companies

58
Q

Viral Videos

A

the popularity of video-sharing websites such as YouTube, give fast food restaurants a way to create video marketing campaigns to advertise their products. They’re usually laced with an element of humor or surprise

59
Q

In-school marketing

A

food and beverage marketing appears in many places throughout schools including posters, vending machines, in-school TV ads, school newspapers, textbook covers, sports equipment, scoreboards, buses, scholarships, incentive programs and more

60
Q

Advertising to Children

A

Until about 11 or 12, children generally lack effective understanding of advertising tactics. There is a precedent for regulation of child-directed advertisements therefore the government can regulate food advertising to children because cognitive research shows that it is misleading

61
Q

Counter-marketing

A

Kidz Bite Back Initiative - the initiative uses a comprehensive approach by integrating five companies into one effort that targets two audiences of children ages 9-11 and parents. The counter-marketing strategies are confrontational and directed toward the deceptive marketing practices of the fast food, soft drink, and junk food companies, as well as the television networks and video game companies. The Kidz Bite Back campaign is the only elementary-school-based grassroots effort in the nation formed by counter-marketing campaigns.

62
Q

Social marketing

A

system application of marketing, along with other concepts and techniques, to achieve specific behavioral goals for social good

63
Q

Fast food regulation

A

December 2001, restaurants may include a toy with a meal if the food and drink combined contained fewer than 600 calories, and if less than 35% of the calories come from fat, however McDonald’s is getting around the law by charging a small fee for the toy

64
Q

Special Topic #1 SSB’s

A

consensus that we need to address SSBs. There is evidence that SSBs are linked to obesity, including childhood obesity. Different strategies on how to do it: education, pricing, accessibility (hospitals banning SSBs)

65
Q

Special Topic #2 Obesity and Violence

A

perception of neighborhood safety may be associated with OW status among urban adolescents in certain racial/ethnic groups

66
Q

Special Topic #3 Other Biological and chemical concerns

A

Endocrine disruptors increases body weight with age, antibiotics associated with increased body mass if exposed during the first 6 months of life and consistently from 10-38 months, Genetically modified foods and HFCS also related to weight gain

67
Q

Special Topic #4 Is obesity a communicable or non-communicable disease?

A

hypothesis about adenovirus - 36 (Ad-36), the suspect pathogen

68
Q

Special Topic #5 Obesity: a global pandemic

A

65% of the world’s population live in countries where overweight and obesity kills more people than underweight

69
Q

Special Topic #6 Breastfeeding and Obesity prevention

A

every study has limitations, and more research is needed. some are finding no association, others have.