Food Environments
The Centers for Disease Control and Prevention (CDC) reported that over the last three decades obesity has nearly tripled in children aged 2- 12(Control., 2015), and therefore referred to as the childhood obesity epidemic. Researchers posit that obesity among children and adolescents is typically due to sedentary lifestyles and unhealthy eating both of which are influenced by socioeconomic climate(Carroll-Scott et al., 2013; Van Hulst, Gauvin, Kestens, & Barnett, 2013). Consequentially, obesity disproportionately affects minority, low-income populations(Rendall, Weden, Fernandes, & Vaynman, 2012). See Figure 1.
Figure 1: Children and Adolescent Obesity Rates by Race(Obesity, 2014; Rendall et al., 2012)
Diet-related diseases are one of the leading causes of death in the United States(Keith, Fontaine, Pajewski, Mehta, & Allison, 2011). Such diseases include heart disease, cancer, and stroke, as well as contributing conditions, particularly obesity and diabetes(Keith et al., 2011). Additional health conditions that are associated with overweight/obese children include sleep apnea, gallbladder disease, elevated liver enzymes, polycystic ovarian disease, and orthopedic problems(Ul-Haq, Mackay, Fenwick, & Pell, 2013). The majority of diet-related diseases disproportionately affect urban, low-income, and minority youth populations, further compromising their well-being (Carroll-Scott et al., 2013; Rendall et al., 2012; Ul-Haq et al., 2013). Such diseases were at one time specific to adults and are now appearing earlier on in life. (Keith et al., 2011).
Affluence and environmental settings are the most significant environmental factors that are responsible for rising overweight and obese children & adolescents (Carroll-Scott et al., 2013; Brief, 2012;Van Hulst et al., 2013). Low-income neighborhoods lack safe parks to participate in physical exercise(Carroll-Scott et al.,2013) Among immigrant communities over 85% of those aged 13-16 do not reach the federally recommended amount of physical activity. Underserved communities have a decreased access to healthy food options (See Figure 2), making it nearly impossible to maintain a health diet to prevent obesity and related illnesses (Carroll-Scott et al., 2013; Brief, 2012; Rendall et al., 2012; Van Hulst et al. 2013).
Figure 2: Lack of Access to Healthy Food Options Low vs. High Income Neighborhoods (Brown, 2012)
Unhealthy Meals & Food Environments
Young children aged 2 to 3 require the consumptions of 1000–1,400 calories daily(Rathus, 2015), the Mayo Clinic suggest a balanced diet including which includes variety of protein sources (ie; seafood, lean meats, nuts), fruits, vegetables, whole grains, and dairy products (Rathus, 2015). A study comparing the nutrient the quality of fast food kids meals revealed that only 3% of meal options met the nutrient guidelines criteria from the National School Lunch Program (O'Donnell, Hoerr, Mendoza, & Goh, 2008)(NSLP) (O'Donnell et al., 2008). Meals had significantly higher fat and sugar intakes than evidenced-based recommendations on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity Committee(O'Donnell et al., 2008). Healthy options included some milk and fruit these typically did not have the necessary amounts of iron, vitamin A, and calcium (listed in the NSLP criteria).
Lastly, the school food environment is of particular importance to those children and adolescents living in impoverished areas; this a critical component to modifying their food consumption. Approximately 19%-50% of a students caloric intake is consumed at school, and many lower income individuals participate in the free meal programs. Furthermore, the presence of vending machines and snack bars that offer unhealthy food items at a low-cost contribute to the rise in weight among students as well. To effectively address this problem the public health policy surrounding childhood and adolescent obesity must address the underlying societal, cultural and environmental factors that influence one's ability to maintain healthy lifestyles.
References:
Brown, K. (2012). Healthy Food. Retrieved from Web: http://www.ct.gov/dph/lib/dph/hems/nutrition/pdf/yale_rudd_center_access_to_healthy_foods_report_2008.pdf
Carroll-Scott, A., Gilstad-Hayden, K., Rosenthal, L., Peters, S. M., McCaslin, C., Joyce, R., & Ickovics, J. R. (2013). Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: the role of built, socioeconomic, and social environments. Social science & medicine, 95, 106-114.
Control., C. F. D. (2015). Combatting Childhood Obesity. Web Retrieved from http://www.cdc.gov/features/preventchildhoodobesity/.
Keith, S. W., Fontaine, K. R., Pajewski, N. M., Mehta, T., & Allison, D. B. (2011). Use of self-reported height and weight biases the body mass index-mortality association. Int J Obes (Lond), 35(3), 401-408. doi:10.1038/ijo.2010.148
O'Donnell, S. I., Hoerr, S. L., Mendoza, J. A., & Goh, E. T. (2008). Nutrient quality of fast food kids meals. The American journal of clinical nutrition, 88(5), 1388-1395.
Obesity, T. S. o. (2014). Combatting Childhood Obesity. Retrieved from Web: http://stateofobesity.org/disparities/
Rathus, S. A. (2015). HDEV: Cengage Learning.
Rendall, M. S., Weden, M. M., Fernandes, M., & Vaynman, I. (2012). Hispanic and black US children's paths to high adolescent obesity prevalence. Pediatric obesity, 7(6), 423-435.
Ul-Haq, Z., Mackay, D. F., Fenwick, E., & Pell, J. P. (2013). Meta-analysis of the association between body mass index and health-related quality of life among children and adolescents, assessed using the pediatric quality of life inventory index. The Journal of pediatrics, 162(2), 280-286. e281.
Van Hulst, A., Gauvin, L., Kestens, Y., & Barnett, T. (2013). Neighborhood built and social environment characteristics: a multilevel analysis of associations with obesity among children and their parents. International Journal of Obesity, 37(10), 1328-1335.
