Child Obesity

Preventing Childhood Obesity through Parent Education

Enerolisa Paredes

NUR 408: Trends and Issues in Nursing and Health Care

Instructor: Professor Mary Joseph

June 14, 2017

Child Obesity

Preventing Childhood Obesity through Parent Education

Childhood obesity has been a big concern in many countries all around the world.

According to the Center for Disease Control (CDC), body mass index (BMI) is a measure used

to determine childhood overweight and obesity. Overweight is defined as a BMI at or above the

85th percentile and below the 95th percentile for children and teens of the same age and sex.

Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same

age and sex. The CDC has stated that child obesity has more than doubled in children and

quadrupled in adolescents in the past 30 years (Odgen et al., 806-814)". The statistics are not

only limited to this side of the hemisphere. In the European region, roughly 23% of women and

20% of men are obese and 30-70 % are overweight, making today a pandemic (The Lancet,

2006). Obesity has been associated with chronic health diseases such as heart disease, type II

diabetes, asthma, sleep apnea, and it can lead to social discrimination. Childhood obesity can be

treated by properly educating parents, but not all parents have the monetary means to provide a

healthy diet. Giving parents the appropriate tools is the key for preventing obesity among

children and developing healthy individuals.

The Food and Nutrition Service defines Nutrition education as any combination of

educational strategies designed to facilitate voluntary adoption of food choices and other food

and nutrition related behaviors conducive to health and well being. It also states that multiple

venues for nutrition education could be used involving activities at the individual, family and

community levels. The influence that the environment has on the individual needs to be also

taken into account. The behavior and interaction that they have with people that they live, work,

learn and play with has an effect on the dietary practices that will be followed. Because of this,

the community utilizes strategic activities and government projects such as Lets Move. The goal

2
Child Obesity

was to help children and parents obtain and maintain newly adapted nutritional and behavioral

practices. Despite this efforts parents still claim that they do not have the monetary means to

provide a healthy diet. But to be precise, what does a healthy diet mean? Healthy eating

encompasses a variety of foods that give you the sufficient nutrients you need in order to

maintain your health. These include protein, carbohydrates, fat, water, vitamins, and minerals.

These basic nutrients can be found on vegetables, fruits, grains and meats. These ingredients can

be purchased independently in the supermarket or farmers market at low cost. Experimenting and

adventuring into preparing meals at home using unprocessed food, the better you will feel, and

the more money you save.

Educating parents has presented as the hardest task. Eating habits have a cultural base,

the acquisition of a preference to particular foods that can be detrimental to their health, come

from generations after generations of the preparation of certain meals. There is also stigma,

beliefs and impressions of nutrition that can be erroneous but that originated by an authoritative

figure. Therefore, they remain in the germ line for generations to come. As a consequence,

numerous amount of research has been conducted to show how educating parents is key in

preventing childhood obesity. In a research conducted by Moria Golan, she emphasized the

need of making changes at home and in family environments, so that weight loss is maintained.

She reported a significant reduction in weight when the parent is the main focus, as opposed to

when the obese child is the main target. In the following years, there was a reported 2.9%

increase in weight in those kids that did not have the support of their parents (Golan, 66-76).

In another research in which the parents were the main target, parents received group sessions

and the child had no involvement in the process, children showed a 14.6% weight loss. It is

3
Child Obesity

highly encouraged that parents assume a leadership role rather than an authoritarian style (Golan

& Crow, 357-361). Addressing child obesity through parents is most beneficial.

Obesity is caused by bad eating habits, lack of exercise and poor parents education about

nutrition. By utilizing parents as the means for successful weight and exercise management, the

possibility of decreasing childhood obesity is possible. In a research conducted by Epstein et al

(1994), a significant amount of weight loss was observed in children where parents were

involved and included other variables such as activity level, family and peer influences. Epstein

et al, demonstrated that adding behavioral techniques, self-monitoring of energy intake and

weight, praise, and stimulus control for nutrition education, significantly improved the reduction

in percentage of overweight compare to nutrition education alone reported that when parents

and children were targeted together for weight loss, children in the child and parent group

achieved a greater decrease in the percentage overweight after 5 and 10 years than children in the

none specific control group, whereas in the child only group showed increases in percentage

overweight (Epstein, et al 373-83).

Parents influence childrens eating habits and activities by serving as role models. They

make food choices for the family. In a one year longitudinal study conducted by M. Golan et al.

(1998), they examined the overweight reduction and changes in eating-related behavior on two

groups, the first group with the parents as the exclusive agents of change, the other with the

conventional approach in which children are responsible for their own weight loss. Significant

differences were found between the two groups in the exposure to food stimuli and changes in

eating habits (eating while standing watching TV, reading or doing homework, eating following

stress and eating between meals). The model demonstrated how an environment in which the

obese child helped by the parents contributed to developing better eating and higher activity

4
Child Obesity

habits. By trying to establish this norm, the family as a whole benefits from the overall

education that the parents receive and becomes the new root of good eating behavior and better

health in subsequent generations.

Parental education status and knowledge about nutrition is one of the most valuable tools

in order to reduce childhood obesity, despite socioeconomically status (SES). In a study

conducted by Zarnowiecki et al. (2011), they recruited 192 children and their parents to

investigate how parental nutrition knowledge and attitudes around food predicted young

childrens knowledge of healthy foods, controlling for other influences such as socio-economic

status (SES) and parents education levels in a cross-sectional study. The study indicates that

parents can transfer knowledge about healthy foods to their young children despite SES and

educational background. In this manner, parents nutrition knowledge can result in

improvements in children nutrition knowledge regardless of SES. Young children and their

parents are important targets of obesity prevention because in the early years of life children gain

knowledge about food, dietary preferences and eating habits that may undergo through life

(Campbell, KJ & Hesketh, KD, 1272-1280). It is at home that children, shaped by their parents,

have their earliest experience with food and eating. From this experience a child obtains their

knowledge of nutrition. There are many factors that determine home food environment

including food availability, parent role modeling, feeding rules, conversations about food and

food preparation skills. Parents attitudes and knowledge about nutrition can dictate the food

preferences and eating habits of their child. This knowledge seems to be partial and parents are

not always able to make wise decisions when dealing with family diet. To further promote the

role of parental education in childhood obesity more studies are needed. In the meantime, we

need to encourage low educated parents to gain more knowledge about healthy eating lifestyles.

5
Child Obesity

The more the parents take an active in role in participating with their children, the better

the results. Many parents believe that their children need a diet to lose weight. However, we

have to make them understand that diet is not the solution, eating healthy and doing exercise is

the solution. As soon as they understand this they increase their knowledge about healthy eating

habits and promoting the importance of exercise.

Moreover, preventing disease and promoting healthy lifestyles are standards of nursing

practice. Nurses can help parents and children by providing nutritional advice and, through

weight management programs, offer strategies for decreasing caloric intake and increasing

physical activity. Nurses should always have a whole-family approach because it is challenging

for obese children to alter their dietary or physical habits if their families do not support them.

They should work with all members of the multidisciplinary team in addressing childhood

obesity, as it is a major health issue with long-term morbidities. Nurses advocate on behalf of the

American child by supporting different strategy suggestions, for example, subsidizing for school

health programs, requiring government nutritious norms on all food served in schools and

formation of recreational places in underserved regions to give opportunities to increase physical

activities (Rabbitt, A., & Coyne, I., 2012). This health provider can also help parents see the

importance of changing their eating habits and increasing physical activities to be role models for

their children.

The health of human beings will mostly depend on the childhood upbringing in relation

to healthy eating and if they are active enough in the physical activities. Parents with the help of

health care team can develop a strategy ensuring their children are active and look for food

choices to maintain healthy eating habits as well. Parents have a difficult but crucial role in

shaping their childrens lifestyle when it comes to healthy eating, they are responsible for feeding

6
Child Obesity

them. The only people that can change the eating patterns of children are parents. If we are going

to see any changes, then it is parental behavior that will need to be change. The nutritional

knowledge must be available to them so that increased physical activity and exercise become an

important part of a childs life.

Reference

7
Child Obesity

Ball, G. D., Ambler, K. A., Keaschuk, R. A., Rosychuk, R. J., Holt, N. L., Spence, J. C., Newton,
A. S. (2012). Parents as Agents of Change (PAC) in pediatric weight management: The
protocol for the PAC randomized clinical trial. BMC Pediatrics BMC Pediatrics, 12(1),
114. doi:10.1186/1471-2431-12-114.
Campbell, K. J., Crawford, D. A., & Ball, K. (2006). Family food environment and dietary
behaviors likely to promote fatness in 56 year-old children. International Journal of
Obesity, 30(8), 1272-1280. doi:10.1038/sj.ijo.0803266
Chaparro, M., & Koupil, I. (2014). The impact of parental educational trajectories on their adult
offspring's overweight/obesity status: A study of three generations of Swedish men and
women. Social Science & Medicine, 120, 199-207. doi:10.1016/j.socscimed.2014.09.024
Epstein, Leonard H., Alice Valoski, Rena R. Wing, and James Mccurley. "Ten-year Outcomes of
Behavioral Family-based Treatment for Childhood Obesity." Health Psychology 13.5
(1994): 373-83. Web.
Fernndez-Alvira, J. M., Velde, S. J., Bourdeaudhuij, I. D., Bere, E., Manios, Y., Kovacs, E., . . .
Moreno, L. A. (2013). Parental education associations with childrens body composition:
International Journal of Behavioral Nutrition, 10(1), 80. doi:10.1186/1479-5868-10-80
Golan, M., Fainaru, M., & Weizman, A. (1998). Role of behaviour modification in the treatment
of childhood obesity with the parents as the exclusive agents of change. International
Journal of Obesity, 22(12), 1217-1224. doi:10.1038/sj.ijo.0800749
Golan, M., & Weizman, A. (2001). Familial Approach To The Treatment Of Childhood
Obesity: Conceptual Model. Journal of Nutrition Education, 33(2), 102-107.
doi:10.1016/s1499-4046(06)60173-5
Golan, M., & Crow, S. (2004). Targeting Parents Exclusively in the Treatment of Childhood
Obesity: Long-Term Results. Obesity Research, 12(2), 357-361.
doi:10.1038/oby.2004.45
Golan, Moria. "Parents as Agents of Change in Childhood Obesity from Research to Practice."
International Journal of Pediatric Obesity 1.2 (2006): 66-76. Web.
Lamerz, A., Kuepper-Nybelen, J., Wehle, C., Bruning, N., Trost-Brinkhues, G., Brenner, H., . . .
Herpertz-Dahlmann, B. (2005). Social class, parental education, and obesity prevalence
in a study of six-year-old children in Germany. International Journal of Obesity, 29(4),
373-380. doi:10.1038/sj.ijo.0802914
Lancet, The. "Curbing the Obesity Epidemic." The Lancet 367.9522 (2006): 1549. Web.
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the
United States, 2011-2012. Journal of the American Medical Association
2014;311(8):806-814.
Rabbitt, A., & Coyne, I. (2012). Childhood obesity: nurses role in addressing the epidemic.
British Journal of Nursing, 21(12), 731-735. doi:10.12968/bjon.2012.21.12.731
Sobko, T., Svensson, V., Ek, A., Ekstedt, M., Karlsson, H., Johansson, E., . . . Marcus, C. (2011).
A randomised controlled trial for overweight and obese parents to prevent childhood