Nemours: New efforts to reduce prevalence of overweight and obesity among Delaware's children

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The prevalence of overweight and obesity among Delaware children, ages 2-17, shows a flattening of the trajectory – no change- between 2006 and 2008.  Because overweight and obesity rates had previously been climbing rapidly, the leveling-off is cause for optimism reports Nemours in the March 2010 edition of Health Affairs, a peer-reviewed publication and the country's most respected health policy journal. The research was funded in part by the Robert Wood Johnson Foundation.

"Reversing the trend of overweight and obesity is a long-term prospect, but seeing the rates plateau in Delaware is quite promising," said Debbie I. Chang, MPH, Nemours, Vice President of Policy and Prevention and the lead author on the article. Nemours conducts the Delaware Survey of Children's Health to collect parent-reported information about the weight and behaviors of children aged 2-17.  

This leveling-off was seen in all Delaware counties and demographic subpopulations and mirrors the national trend supported by information released earlier by Centers for Disease Control and Prevention.  Since 1980, child obesity rates have increased dramatically across the nation. Being overweight has doubled for children and tripled for adolescents, raising their risks for developing type 2 diabetes, early heart disease, and other health conditions such as asthma as well as psychological problems, including lower self-esteem.

The article attributes this stabilization to the multi-sector and place-based approach Nemours and its many dedicated partners implement in child care, schools, primary care and in the broader community. These efforts are ultimately aimed at changing behaviors and reducing the prevalence of overweight and obesity among Delaware's children.

5-2-1-Almost None

The article shows a four-fold increase in awareness of Nemours' 5-2-1-Almost None "prescription for health" which encourages children to: eat at least five fruits and vegetables a day; limit screen time to no more than two hours a day; get at least one hour of daily physical activity, and drink almost no sugary beverages, like sodas and sports drinks. Children of parents who were familiar with the message showed a marked increase in physical activity in 2008 compared with 2006.

  • In 2006, 5% of parents heard of and could recall NHPS' 5-2-1-Almost None campaign.
  • In 2008, 19% of parents heard of and could recall NHPS' 5-2-1-Almost None campaign.

"There is a lot of work still to do," said Yvette Santiago, Director of Community and Government Affairs, Nemours Health & Prevention Services. "But it's clear that, when it comes to childhood obesity, our model of working collaboratively to reach into homes, schools, child care centers, and communities, is yielding results and being noticed at the national level."

Delaware child care policy has undergone significant change, leading the nation in regulations encouraging more physical activity and specifying limited consumption of foods high in fat, sugar, and sodium, in favor of more fruits and vegetables, whole grains and low fat dairy for kids in day care.

In other findings reported in the article, schools that participated in a pilot program to ensure that students get 150 minutes of physical activity during the school day saw results in student fitness levels. Based on the Fitnessgram assessment, students in the pilot group were one-and-a-half times more likely to be physically fit than children in a control group. Nemours has worked with school districts to develop meaningful wellness policies and with the state Department of Education to implement the Fitnessgram.  

"We have built important alliances in Delaware, between and among parents, schools, child care providers, policy makers, and the community of concerned citizens in the state. What we are doing in Delaware is a model for the nation and demonstrates what states can accomplish through a focused, multi-sector initiative," added Ms. Chang.

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