Question 1
1.) Current findings indicate that improved diet quality and increasing levels of physical activity are associated with a decreased prevalence of metabolic syndrome in youth. How would you target intervention strategies with adolescents? (Keep in mind it is unlikely you’ll see these clients on an individual clinical basis. More than likely this would be in some type of community group setting.)
posted by annie_weyhrauch @ 8:20 PM
33 comments
33 Comments:
It is more likely that you would be targeting groups of adolescents rather than individuals. I think that there are three main topics that would need to be addressed. These include: 1. Healthier options within each food group- they may have no idea that there are good fats, etc. 2. Portion sizes- it is safe to say that the majority probably have no idea what portion sizes actually look like. 3. Exercise- or ways to increase physical activity. These messages would be targeted at groups of adolescents and that could be done through school (that would ensure they were all getting exposed to it), or through other community and/or sports groups.
That's a tough one. I would begin by trying to create some motivation to make healthier choices. From there, I would promote fruits/veggies, whole grains vs. refined, and better fats. I might focus on breakfast and lunch ideas,since a lot of kids are left to make their own choices at those meals, while parents provide the evening meal (assuming we are only talking to the adolescents here). If they are going to get cafeteria food or fast food for lunch/breakfast, what are the best choices that still allow the kids to eat at the same places their friends do? I think the key here is to make things seem somewhat "easy", and still tasty. Physical activity, another important factor in preventing metabolic syndrome, would have to be discussed as well. I would explain the MANY benefits of exercise, and that it doesn't have to be a chore. I would encourage students to get involved with a sports team/club, or if that's not an option, simply walk. Get a pedometer and try for 10,000 steps a day. Walking/exercising for 10 minutes 3 times/day still offers many of the benefits that running 3 miles at a time does. Weight lifting is a great option...take a weight training class (you get credit!) to learn how, get some weights at home, etc....lean muscle mass burns more calories than fat, even at rest. Overall, I would focus on things that are somewhat easy to incorporate into their current schedule and don't require drastic changes but will result in health benefits now and in the future.
There are a variety of options for promoting healthy behaviors among adolescents. Kids need to be motivated to do something, so keeping a positive/fun attitude might help inspire them to make changes in their lives. I would start out maybe asking them what their favorite foods are and what a typical day is like for them. From there, I could give healthier food options and suggestions for changing their current diet. I could also promote joining a sports team, going for walks, spending less time on the computer, playing video games, or watching TV. I would explain all of the benefits of a healthy diet and exercise. I would try not to make it sound like a hard, dreaded plan, but an easy way of life. Making a poster board, or playing a trivia game with prizes might also help the kids connect the concepts. Also, I think somehow targeting the parents of these children would be extremely beneficial; explaining to them what to choose at the grocery store and how to cook/prepare foods. Parents could also be a huge influence on their children’s eating and exercise habits, as role models they could make better choices and hope that their kids might follow in their steps.
I definitely agree that keeping a positive attitude about lifestyle changes is very important, especially with this age group. Chances are that these teens are not really into caring much about their long-term health conditions (yet), so you would have to really appeal to them in other ways. I think as far as being able to reach these kids, heading into health or PE classes in your area and acting as a guest speaker every now and then (because what teacher wouldn’t love for you to do that?) would give you an opportunity to speak to this group, and then you just have to make sure that your message is more positive than negative and that it is encouraging minor changes over a longer time period, so that the end result is the same but they don’t feel like they’re making drastic life changes all at once.
Emily- I definitely think you have some good points about exercise. It can be really fun, and it doesn’t have to be grueling or take up a large portion of your day or any of those things, just encouraging kids to move more and watch their food choices might result in a large difference for some of these children who may have never thought that small changes could be so helpful in managing their long-term health conditions. And maybe one way to get to kids would be to discuss things with their PE teachers if you're not wanting to present straight to the kids, I don't know how your PE class was, but there was nothing about encouraging us to move during the whole day as much as it was just running laps and goofing off, etc. That's really a time when kids should be encouraged to move, not only during class, but all day long in small ways that can really add up!
Karlie,
That's a good point about gym class. As I recall, no one ever told me why I should exercise, etc., they just made me do it. What's up with that?
Karlie- I really like your idea about going into PE classes and talking to the adolescents. Maybe even talking with the PE teacher about incorporating weekly nutrition lessons and topics in addition to the daily activity would be great. It is hard to get teens to think/care about their future and their health, but I don't think it would hurt to try. Teens health is so important to their future and suggesting gradual changes to them across time is crutial.
Targeting intervention strategies with adolescents could easily be done in a group community setting. I would definitely want to include a discussion on controlling saturated fat and trans-fatty acids in their diets. I would bring in products that they have in their vending machines and let them know which ones are the highest in trans and saturated fat. I would also give them healthy alternatives to those snacks. Another topic I would discuss is increasing their use of omega-3 and omega-6 fatty acids. I would make sure they knew which foods contained these fats. Other topics I would include consist of increasing their fiber, whole grains, fruits, and vegetables. Again, I wouldn't just tell them this I would give them recipes, snack ideas, and examples of sac lunches that incorporate my health suggestions. Finally, increasing physical activity would be an important part in all of this. Possible community settings could be in the classroom, guest speaker at school clubs, or being a guest speaker in a physical education class.
Sam- Good point on trying to get them to spend less time on technology and more time outdoors. Joining a sports team would be a great motivator to get them to exercise. Another good idea would be to take the dog for a walk each day or have a family bike trip rather than watching television at night.
This would definitely be a challenge for a dietitian, as we know that adolescents can be defiant and not be open to the ideas of others in general. However, teaching them the knowledge and importance of preventing CVD, DM, and metabolic syndrome is something that is almost necessary today. I would target this age group by providing games and other activities that would teach them the importance of, for example, proper portion sizes, fruits and vegetables, lean protein, less cholesterol and saturated fat, etc. There would have to be some sort of motivation to then take the ideas they learned from various teaching activities I created and turn them into practice. I would definitely encourage participation in school sports and extracurricular activities to keep them moving. Most people do not realize just how important physical activity is in overall health. Also, I would bring in some ideas for healthy breakfasts/lunches and have the students make the foods in a hands-on activity. Additionally, I would have various foods they would see in their cafeteria and compare them nutritionally with one another. A good thing to keep in mind would also be targeting the parents of these adolescents. As we know, most eating behaviors are learned from our family. Parents may need some education as well.
Emily--
I agree with you that it would be beneficial to focus on breakfast and lunch choices, since a lot of kids are on their own for these meals. School breakfast/lunch and the same meals at home can differ greatly. Just like our activity next month at Distric 87, we will need to show students that healthy choices can be made at home as well as at school.
I think the key to reaching any group is to focus on what they already do and make realistic suggestions for small changes. Since this is in a group setting, it would obviously have to be very general but understanding the group as a whole will hopefully impact at least a handful of them. Certain aspects are most likely out of their control, such as meals eaten at home--if their parents eat out for dinner 5 nights a week, it is not realistic to tell the child not to do this. Emphasizing healthier options (at fast food restaurants, the cafeteria, or breakfast and snack items they have on their own time) and proper portion sizes are important. It may be very important to involve parents or have the children share handouts/information with their parents. As for physical activity, I would encourage them to be active for 30 minutes a day doing something they enjoy. Perhaps watching one less TV show and doing indoor/outdoor exercises depending on the weather.
Emily-
You make a great point that it is important to explain WHY exercise is important. I don't think I was ever really explained why exercise was important when I was in school. Given that these children are going to be overweight and fairly inactive, it may be helpful to explain (in a simplified way they can understand) that it would simply make them feel better. Involving their family by sending home activity logs may increase their chances of regular activity when they set aside time to go on walks/bike rides together.
I would target interventions for adolescents around the school environment. If there were physical education classes I would try to work with those teachers to get students more active during that class.
I would also look at the school menu and talk to the food service manager to see if some previously untried healthy foods could be added to the menu on a trial basis to see if students respond well to them.
The article mentions that "weight control should be recommended as the first line intervention to decrease metabolic syndrome in adolescents." If seeing the child on a one-on-one basis, I would review a typical day's eating and make suggestions for weight loss based on the information given. From here, I would urge the child and parent to come in for a follow up for further suggestions and motivation while making changes. Studies have shown patients who come for follow up appointments have a higher success rate. If the children were present in a group setting, the approach would change dramatically. In group settings, a broader variety of weight loss techniques would have to be presented in order to reach potential problems that all of the patients may be going through. The main topics would have to be healthy eating, with emphais on increasing fruits and vegetables, and the importance of physical activity. If these classes were set up on a weekly or monthly basis, you may be able to dive a little deeper into topics each session. Again, the theme here is the more times you can see a patient the more successful they will be. During each group setting, I would also remind everyone present that there are always individual sessions with a dietitian available to recieve more personal, in depth suggestions.
Karlie & Emily,
I completely agree about starting intervention early in school during PE class. My sister is in junior high, and I must say that gym class has really changed since I was in junior high. They really do provide education as to the importance of physical activity to stay healthy. They are even being weighed on bioelectrical impedence scales to test their body fat. Now we know that all body fat tests are not completely accurate from the class we went to, but at least it is a start. I think emphasis is greater on educating kids on the importance of activity, but there are still some flaws in the system. It is just nice to see we are gradually making improvements!
Lauren
In the community group setting, there is a program, “ShapeDown” for children, teens, and their parents. I am a big advocator for family involvement. Studies have shown that family approach is most effective on child obesity programs and long lasting healthy results. This program teaches parents and their children and/or teens how to take care of their health. They learn about food, exercise, and to express their feelings. (This is to avoid emotional eating; which may have lead to eating disorders later). Each participant is given a book to help (according to their goal level), in the booklet there are stories to help motivate and help overweight child understand the importance of food and exercise. The parents learn how to communicate and help their child be happy with their body and learn how to life an active healthy life.
It is important to determine if you are going to talk to this entire adolescent group all at once, or not; the article said ages in this study ranged from 12-19. There is a substantial difference in motivating a 12 year old to eat better, and teaching a 19 year old college freshmen how to increase their physical activity. I think it is most important that the interventions are age appropriate. For the younger adolescents, teaching them what "good" foods are would be a good, age appropriate intervention. Often times they arent aware of how food can affect their bodies. With the older age groups however, it is important like Emily said, to motivate the individuals to choose the foods that they are aware of that provide the health benefits.
Like we are doing for national nutrition month, going into the community and/or school setting, and providing information to the general student population would be beneficial in targeting our population of adolescents.
Sam, I agree that getting the parents involved is an important part of childrens eating and exercise habbits. I know that many of my eating habits have come from my parents (good and bad). Encouraging parents to get involved and be role models for their children will make a significant difference in their childs habbits.
I would want to start off by trying to change some of the stigmatisms that are around healthy lifestyles. First being that healthy food tastes bad. Having healthy foods at the intervention and showing kids that healthy foods do taste good. Second that physical activity has to running or something strenuous like that. Show them that walking the dog, taking the stairs, playing out side are all acceptable forms of physical activity. I think too many times kids see on TV the "big time" athletes and think that the workouts they do are the only acceptable forms of physical activity. So, basically getting them to stop thinking "I am not an athlete, I can't be that active I won't even try." And to start thinking, "Any form of activity is healthy."
Tori McRoberts
Heather,
I think that community programs are great! The problem is that if they aren't advertised properly parents don't know about them. I think that schools could do more to help make parents aware of programs that are available in the community. (I know sometimes funding isn't in the budget for the program.)
Tori McRoberts
Giving them a reason for eating healthy and exercising would have to be the most important part of implementing intervention strategies with adolescents. Educating them on the many benefits of eating healthy and exercising regularly may serve as motivation for them. Find what interests the children have and focus on their more active interests to get them moving. It may help to set goals for them to achieve. If they have something to strive for they are more likely to participate in the ideas that you have given them. Ask what foods are their favorites and find healthy alternatives to that they can try as an alternative. Teaching them about portion control could be a good way to educate them on how many calories they are actually eating.
It would definitely be important to discuss what types of foods they are eating at home and what they eat while in school. I would focus on convienence items, such as sodas, vending machine items and fast foods items. These types of foods really attract kids. I would discuss portion sizing with them as well. Most kids have no idea what a proper portion size would look like for certain foods. Parental support is very important in this situation as well. By talking about healthier food options with the parents and children, you would increase the chance of change within the household. Another great resource would be the school system. Find out what foods are being served at lunch and what vending machine items are available. By changing items at school, we can affect an entire population of students.
Emily,
You made a great point about discussing breakfast and lunch options. Physical activity is a very important part of the intervention and your suggestions are great, especially joining a team activity. Team activities can get children more physically active and help them make friends.
If I were meeting with a group of adolescents I would adress healthy eating options, including easy and healthful snacks, the importance of eating breakfast as well as fruits and vegetables. Next I would encourage participation in community events. If I were connected to a community center it would be easy to give a list of upcoming events, otherwise I would make sure to have a good idea of local hangouts and suggest possibly joining a community sports team.
Katherine McCullah
Colin,
I think it's a very good idea to give the kids a good reason to change their behavior. They may think it isn't worth their time or effort and may not see the immediate benefits. However, we know that healthful eating and physical activity are beneficial to overall health of everyone.
Katherine McCullah
Whether in a school or community setting I think the target audience should not only be the child but the parents because they are an intricate part in changing the behavior. Educational materials for the parents with tips to get their children to eat more fruits and vegetables and less fats would be my focus. I would also want to talk to the parents about having healthier foods in the house, better choices for snacks and trying to prepare more meals at home. Including the kids in the meal preparation could be fun for the adolescent and it would be educational for them to learn what goes into meal preparation. If they help make something they will more than likely want to try what they helped create. And it would be good family time too. The kids should be given information about the options their schools have and how they can be a part of making better meal choices. Also I would emphasize the importance of activity and how eating better foods may give them more energy to participate and simply feel better. Susan
Carrie
I agree you have to tailor each session to an age group. Yes the schools we are going to in March are a perfect example. The material has to be basic enough for everyone to understand yet interesting enough to hold their attention. I also agree with you Emily get the kids moving!! If they do any kind of activity it will be beneficial--dancing running, walking, playing catch, whatever. Just get them out of the classroom for a some time and allow there bodies and brains some fun activity! Susan
First and foremost, I think that it would be important to not only have children attend the classes, but also invite their parents. Children are not primarily the ones going to the grocery stores or choosing where to eat, so it is important that you bring parents in to learn as well as children. I believe that if you promote healthy eating young, it will become a habit for life, so I am encouraging teaching younger children. In order to teach a class to promote healthy eating, I would first not be restricting any foods. Humans definitely crave what they cannot have, so restricting is just asking for them to break the rules. Next, I would promote interactive learning habits at my class, like grocery store visits, reading nutrition fact labels, and looking up ingredients in specific foods. I think hands on learning is the best way. Also, I would have cooking classes that promote healthy snacking and meal ideas and ways to control portion sizes. When both children and parents see that eating healthy can be fun, they will be more movitated to eat healthy.
I think the "ShapeDown" program that Heather described sounds great, but I'm sure many people have never heard of it (myself included). With this though, Tori made a great point that maybe there just is not enough in the budget to bring these programs to their full potential. Unlike many other programs, this program sounds fantastic in that it addresses the problem with emotional eating, which is too often overlooked for the amount of influence it has on eating habits and behavior.
Sam-
I like how you said that you need to keep the kids motivated. This may be hard in the beginning but by making things fun and challenging hopefully the kids would stay motivated!
Lauren
That is interesting that in middle school they are already weighing students with electrical impedence scales. I had heard about it and like you; think that there are flaws in having young adolescents weighing themselves. I wonder how many complexes that will cause in students. The next step is fine tuning what the school districts, administrators, parents and legislature will want to do with the numbers from the children.
heather
Tori,
I really liked how you brought up the concept that kids think all "healthy" foods tastes bad. I think it is important to show the family and the children that healthy food can be just as good with the right cooking methods and seasonings. I think that this is a very important intervention strategy in order to promote the healthy food aspect not only to the children, but also to the parents!
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