School obesity programs may promote worrisome eating behaviors and physical activity in kids

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School obesity programs may promote worrisome eating behaviors and physical activity in kids

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Volume 14
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Issue 2
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In recent years, childhood obesity has consistently ranked among the top concerns that parents and the public have regarding the health of children in the U.S. There have been a variety of prevention efforts, many of them school-based, aimed at childhood nutrition and obesity.

Meanwhile, there has also been a steady increase in the prevalence of eating disorders, especially among children and pre-teens. Reasons for this increase are not clear, but there is concern that interventions to prevent obesity—however well-intentioned—may play a role.

In September 2011, the C.S. Mott Children’s Hospital National Poll on Children’s Health asked parents about obesity prevention programs in their children’s schools and about food-related behaviors and physical activity that may be worrisome.

School-Based Interventions

Parents of children age 6 to 14 report a variety of interventions aimed at obesity prevention at their children’s schools:

  • 37% say height/weight measurements are taken at school
  • 40% report incentives for children to increase physical activity
  • 42% say there is nutrition education in school
  • 59% say there are limits on sweets or “junk food” in the classroom

Overall, 82% of parents report at least one of these obesity prevention programs in their children’s schools.In addition, 7% of parents say that their children have been made to feel bad at school about what or how much they were eating.  

Worrisome Behaviors

Overall, 30% of parents report at least one worrisome behavior in their children that could be associated with the development of eating disorders (Figure 1).

School programs that provide incentives for children to increase physical activity are associated with an increase in parents’ reporting their children have too much physical activity. Parents that report incentive programs at their children’s school are more likely to say their children are “too physically active” (11%) compared with parents who do not report incentives for physical activity at their child’s school (4%). Otherwise, we did not find school-based obesity-prevention programs to be associated with the other worrisome eating and physical activity behaviors among children that parents reported.

Potentially Worrisome Behaviors

Parents’ report of other behaviors in their children that are potentially worrisome for the development of eating disorders were also quite common.  These include:

  • Worried about weight, 17%
  • Worried about body image or shape, 16%
  • Avoiding sweets or junk food, 10%
  • Sudden interest in vegetarianism, 3%

There was no association between school-based programs and these ‘potentially worrisome’ behaviors.

Parent report of worrisome behaviors in children age 6-14

Highlights

  • 82% of parents report at least one school-based intervention aimed at preventing childhood obesity within their children’s schools.
  • 30% of parents of children age 6-14 report worrisome eating behaviors and physical activity in their children.
  • 7% of parents say that their children have been made to feel bad at school about what or how much they were eating.

Implications 

Given the lifelong health risks that result from childhood obesity, school-based obesity prevention initiatives make good sense. At the same time, the rising prevalence of eating disorders—and the trend of seeing these disorders more often among younger children—raises concerns that some obesity prevention initiatives may inadvertently promote an unhealthy anxiety about eating or weight among certain children.

The level of worrisome eating and activity behaviors in this Poll (nearly 1 of every 3 households with kids) underscores how important it is for parents to be aware of and discuss nutrition messages presented to their children. Parents should also be alert to sudden changes in their children’s eating behaviors, and to the possibility of food- or weight-related teasing or bullying.

In this study, we found only one worrisome weight-related behavior to be associated with school-based nutrition interventions:  Where there were school-based incentives for physical activity, more parents reported their kids to be “too physically active.”  Our study was not designed to quantify the actual level of physical activity nor to understand what aspects of “too much” activity parents found most worrisome.

Overall, further study is required to determine whether school nutrition interventions are associated with an increased risk of disordered eating in school-age children.  Nevertheless, the twin dilemmas of obesity and eating disorders will continue to challenge parents, schools, and healthcare providers to present a carefully balanced view of healthy eating behaviors and physical activity.

Download infographic:NPCH-EatingBehaviors.jpg

Data Source & Methods

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc. (KN), for C.S. Mott Children’s Hospital via a method used in many published studies.  The survey was administered in September 2011 to a randomly selected, stratified group of parents age 18 and older (n=976) with a child age 6-14 from the KN standing panel that closely resembles the U.S. population.  The sample was subsequently weighted to reflect population figures from the Census Bureau.  The survey completion rate was 58% among parent panel members contacted to participate.  The margin of error is ± 1 to 5 percentage points.

Findings from the C.S. Mott Children's Hospital National Poll on Children's Health do not represent the opinions of the investigators or the opinions of the University of Michigan.  The University of Michigan reserves all rights over this material.

Citation

Davis MM, Rosen DS, Christner J, Singer DC, Butchart AT, Kauffman AD, Clark SJ. School obesity programs may promote worrisome eating behaviors and physical activity in kids. C.S. Mott Children’s Hospital National Poll on Children’s Health, University of Michigan. Vol 14, Issue 2, January 2012. Available at: http://mottpoll.org/reports-surveys/school-obesity-programs-may-promote-worrisome-eating-behaviors-and-physical-activity.

Contributing Faculty
David Rosen, MD, MPH
Jennifer Christner, MD
Poll Questions (PDF)