School-Based Intervention Trials for Childhood Obesity Prevention

Introduction and Research Background

Background of the Research

In recent years, the number of children who are overweight or obese has climbed rapidly. The purpose of this paper is to examine the problems that overweight and obese children face—both physically and emotionally—and to explore how schools can intervene to lessen the prevalence of obesity in the United States.

One of the chief concerns regarding childhood obesity and weight gain is the amount of fast food that children consume (Gillman, et al, 2001). Over the last 20 years, fast food purchases in the United States have increased until they comprise 40% of the money spent on food in the average household (Gillman, et al, 2001).

Additional concerns have been raised about soda consumption and television viewing time among children. In 1972, children drank an average of 27 gallons of soda per child annually. By 1992, that number had risen to 44 gallons per child (Gillman, et al, 2001). Portion sizes are also increasing, and collectively these factors work against children's efforts to maintain a healthy weight (Gillman, et al, 2001). The prevalence of bicycle riding among children in the United States is decreasing. In contrast, other countries continue to use bicycles as a popular means of transportation. The Netherlands has 30% of trips made by bicycle, but the United States has only 1% (Gillman, et al, 2001).

Statement of the Problem

There does not appear to be an easy solution to childhood obesity (Epstein et al., 1995). Many parents are too busy to monitor exactly what their children eat, and family mealtimes are nonexistent in many households (Epstein, et al, 1995). More children now eat in front of the television or snack on high-calorie foods and fast food rather than home-cooked, nutritious meals (Epstein, et al, 1995).

Although some fast food businesses offer healthier options, most children prefer less healthy choices (Epstein, et al, 1995). Without parental supervision to ensure proper nutrition and exercise, many children spend their free time watching television with high-calorie snacks and soda (Epstein, et al, 1995).

Genetics plays a role in weight gain and obesity, but it is not impossible for individuals from obese families to remain thin (Epstein, et al, 1995). Obesity concerns extend beyond physical consequences. Neurological effects and other complications emerge in obese and overweight children (Epstein, et al, 1995). Many of these children experience clinical depression and often eat when feeling sad, which contributes to obesity and prevents healthy weight loss (Epstein, et al, 1995). Teaching children appropriate weight management strategies is essential for them to develop healthier bodies and improved self-image (Epstein, et al, 1995).

Rationale for the Study

When children lose weight, their resolve strengthens and interest in other activities often increases as they feel less restricted by their bodies (Mokdad et al., 1999). However, not all children successfully lose weight regardless of intervention methods, and these children may become overweight adults.

Many such individuals continue to feel poorly about themselves and may raise overweight children as well (Mokdad, et al, 1999). While some genetic component may exist—as obesity often runs in families—not everyone from obese families becomes obese themselves (Mokdad, et al, 1999). However, children with obese or overweight parents face greater struggle, as they lack the genetic predisposition to thinness and experience constant modeling of overeating (Mokdad, et al, 1999). They learn to perceive large portions and heavy eating as normal, failing to develop adequate nutrition knowledge (Mokdad, et al, 1999).

If these children were raised in families where healthy eating and maintenance of normal weight were standard, genetic factors might exert less influence and environmental factors would play a greater role in obesity outcomes (Mokdad, et al, 1999).

Obesity Theories

Despite disagreement about obesity's exact causes, there is widespread agreement that it is a serious problem that continues to worsen (Mokdad, et al, 1999). While genetics may play a role, this explanation seems unlikely given current evidence (Mokdad, et al, 1999). The rapid growth in overweight individuals over the past decade suggests environmental causes rather than genetic changes (Mokdad, et al, 1999). This is not to say genetics plays no role, but many overweight children lack genetic predisposition and are victims of sedentary lifestyles and overeating (Mokdad, et al, 1999).

Fast food, soda, and sedentary living are largely to blame (Mokdad, et al, 1999). Urban sprawl makes walking or biking to work infeasible in many areas, requiring people to drive several miles daily (Mokdad, et al, 1999). Children who previously walked to school often live too far away to do so. Even those living close to schools often do not walk because parents fear unsafe conditions (Mokdad, et al, 1999).

Many parents work long hours, creating latchkey children who lack close parental supervision (Mokdad, et al, 1999). Children who once played outdoors now remain inside watching television or playing video games while snacking (Mokdad, et al, 1999). While healthy household food makes this less problematic, many homes stock potato chips, candy, soda, and other foods unsuitable for daily childhood diets (Mokdad, et al, 1999).

Research Questions

Based on the information presented, four specific research questions guide this study:

• Which age groups profit best from prevention interventions?
• Regarding gender effects of prevention intervention, what can be done to improve effects in the less successful sex?
• Which approach of prevention is most effective and efficient—universal, selective, or targeted prevention?
• What are the best ways to include parents in these interventions, and does this improve effects?

Overview of the Study

Chapter One presents basic information including the problem statement and rationale. Chapter Two reviews relevant literature on childhood obesity and associated theories. Chapter Three details the methodology, ensuring clarity of analysis, limitations, and validity considerations. Chapter Four presents data analysis and results to test hypotheses. Chapter Five summarizes findings, presents conclusions, and recommends future research directions, addressing study limitations and possibilities for subsequent investigations.

There is a clear need for physical education and health education classes in schools. This paper discusses the importance of physical education in lowering childhood obesity rates.