Louisiana has one of the highest rates of childhood obesity in the country. In the 2016–17 National Survey of Children’s Health, 19.1 percent of Louisiana children ages 10 to 17 were obese, much higher than the national average of 15.8 percent.
Fighting the high rate of childhood obesity in Louisiana and across the United States is key to preventing many of the deadliest and most destructive diseases affecting communities today and in the future. A report from the U.S. Centers for Disease Control and Prevention (CDC) states that obese children are more likely than children of normal weight to have high blood pressure, high cholesterol, and other cardiovascular risks. Obese children are also at greater risk of Type 2 diabetes, asthma and other respiratory problems, and bone and joint pain.
The two most effective factors in preventing childhood obesity are a nutritious diet and regular exercise. Ensuring children have access to healthy foods is particularly challenging in Louisiana because so many families live far from farmers markets and other sources of fresh, nutritious foods. The CDC reports that as of 2017, there were 1.7 farmers markets per 100,000 Louisiana residents, compared to 2.7 per 100,000 residents nationwide. Also, only 26.1 percent of middle schools and high schools in Louisiana had salad bars as of 2016, compared to a national average of 44.8 percent.
The health of the public depends on the ability of communities to create environments in which all of their members are able to live a healthy life. The struggle to ensure that children living in Louisiana have access to nutritious foods and the opportunity to lead active lives requires a concerted effort by families, community groups, public agencies, healthcare providers, educators, and private industry.
There are no simple answers to the problem of childhood obesity, yet many relatively easy steps are available that can help parents and children turn the tide against the growing crisis of obesity in children. This guide examines the state of childhood obesity in Louisiana, the ongoing efforts to combat the problem, and strategies and techniques that families and communities in the state can adopt to help the children of Louisiana be as healthy as they can be.
According to the CDC, a child or adult is considered obese if the person has a body mass index (BMI) that is at or above the 95th percentile. An adult or child is deemed to be overweight when their BMI is at or above the 85th percentile but below the 95th percentile. Based on this standard, one in three children in Louisiana is obese or overweight, according to research published in the Journal of the American Medical Association.
In a 2017 paper published in the Journal of General Internal Medicine, researchers determined that obesity raises a person’s annual medical costs by an average of $3,508 in 2010 dollars. Since the CDC has concluded that preschoolers who are obese or overweight are five times more likely than preschoolers of normal weight to become obese or overweight adults, reducing obesity in children will help rein in ever-expanding healthcare costs for the entire population.
These and other statistics highlight the many benefits that will accrue to communities in Louisiana and across the country as childhood obesity decreases.
The CDC’s Division of Nutrition, Physical Activity, and Obesity highlights the greater prevalence of childhood obesity in Louisiana than is present in most other states.
- Louisiana students in grades nine through 12 whose body mass index (BMI) places them at or above the 95th percentile (the level considered obese): 17 percent
- Louisiana students in grades nine through 12 whose BMI places them at or above the 85th percentile but below the 95th percentile (the level considered overweight): 18.2 percent
- Louisiana families participating in the U.S. Department of Agriculture Food and Nutrition Service’s Special Supplemental Nutrition Assistance for Women, Infants, and Children (WIC) as of April 2019: 101,304
- Children ages 2 to 4 participating in WIC in Louisiana as of 2014 who were obese: 13.2 percent
- Children ages 2 to 4 participating in WIC in Louisiana as of 2014 who were overweight: 15.2 percent
- Change in WIC participation by Louisiana families since April 2018: 7.6 percent decline
Figures from the CDC’s profile of nutrition, physical activity, and obesity in Louisiana and the 2017 Youth Risk Behavior Survey show the work yet to be done to ensure children and families in the state understand the importance of a nutritious diet and have ready access to healthy foods:
- High school students in Louisiana who ate no vegetables in the seven days prior to the survey: 16.5 percent
- High school students in the state who drank three or more sugary sodas a day on one or more of the seven days prior to the survey: 12 percent
The CDC’s 2017 Youth Risk Behavior Survey, “The Obesity Epidemic and United States Students,” reports on the health of U.S. high school students:
- High school students at or above the 95th percentile in body mass index (BMI), which is the threshold for “obesity”: 14.8 percent
- High school students at or above the 85th percentile in BMI (the threshold for “overweight”) but below the 95th percentile in BMI: 15.6 percent
- Did not eat any vegetables in the seven days prior to the survey: 7.2 percent
- Drank soda three or more times a day on one or more of the seven days prior to the survey: 7.1 percent
- Did not eat breakfast on one or more of the seven days prior to the survey: 14.1 percent
- Were not physically active for at least one hour total in each of the previous seven days: 15.4 percent
- Used a computer or played video games for three hours or longer on an average school day: 43 percent
The CDC’s National Center for Health Statistics reports on obesity by age, sex, and ethnicity. The incidence of obesity in children ages 2 to 19 in the most recent report of 2015-2016 includes the following statistics:
- Adolescents (ages 12 to 19) whose BMI places them in the “obese” category: 20.6 percent
- School-aged children (6 to 11) who are obese: 18.4 percent
- Preschool-aged children (2 to 5) who are obese: 13.9 percent
- Non-Hispanic African American children (ages 2 to 19) who are obese: 22 percent
- Hispanic children (ages 2 to 19) who are obese: 25.8 percent
- Non-Hispanic white children (ages 2 to 19) who are obese: 14.1 percent
- Non-Hispanic Asian children (ages 2 to 19) who are obese: 11 percent
The World Health Organization emphasizes the importance of starting young as the most effective way to combat childhood obesity. Infants and children who are obese have a much greater risk of becoming obese adolescents and adults. In turn, obese adults have higher rates of heart disease, Type 2 diabetes, and osteoarthritis and other serious bone and muscle problems. Obesity also increases the risk of colon cancer, breast cancer, and other forms of cancer.
Confirming the importance of addressing childhood obesity at a young age is research reported in the New England Journal of Medicine that found 5-year-olds who are overweight are four times more likely to be overweight at 14 years old than 5-year-olds of normal weight. The journal Acta Pharmacologica Sinica published a report that found the increased risk of disease for obese children extends into adulthood, making them more likely to suffer ailments that include arterial hypertension, fatty liver disease, and cardiovascular disease.
These are among the health risks to obese children that the CDC has identified:
- Elevated cholesterol levels
- Asthma, sleep apnea, and other respiratory problems
- Joint pain and muscle aches
- Heartburn (gastroesophageal reflux)
- Anxiety and depression
- Low self-esteem
- Difficulty socializing
Healthy eating and daily physical activity are two habits that pay dividends now and well into the future — for children and adults alike. The sites listed here provide useful information and describe simple, straightforward techniques for ensuring that children and families make eating healthy and staying active a big part of their daily routine.
Like many human activities, people tend to fall into a pattern of eating that they repeat regularly. The U.S. Department of Health and Human Services’ Dietary Guidelines 2015-2020 indicate that three-fourths of the U.S. population eat too few vegetables, fruits, dairy, and healthy oils, while greater than half consume too much added sugar, saturated fat, and salt. The guidelines recommend that people adopt new, healthier eating patterns over time as the best way to reach and maintain a normal weight and to ensure they receive the nutrients they need to help prevent chronic illnesses.
The most effective way to replace unhealthy eating patterns with more nutritious alternatives is to start with small healthy food choices at one meal or snack each day, then expanding to two or three such choices over the course of a day or week, and gradually choosing the healthy alternative at nearly every opportunity. The Healthy U.S.-Style Eating Pattern is one of three Food Patterns devised by the U.S. Department of Agriculture to ensure people consume “nutrient-dense” foods in the appropriate amount. It is based on the foods and serving sizes people in the U.S. are accustomed to, but it is presented at 12 different calorie levels based on age, sex, weight, height, and physical activity level.
For example, the guidelines’ Daily Nutritional Goals for children ages 1 to 3 are based on 1,000 calories consumed each day, 13 grams of protein, and between 30 percent and 40 percent of total calories from fat. Conversely, the recommended diets for teenage males (ages 14 to 18) call for 2,200, 2,800, or 3,200 calories consumed per day based on height and weight; 52 grams of protein; and 25 percent to 35 percent of total calories from fat. For children of all ages, the guidelines suggest keeping intake of added sugars and saturated fat at less than 10 percent of total calories.
Along with a healthy diet, the best way to prevent chronic illness is by staying active. The CDC states the matter very clearly: regular physical activity could prevent one of every 10 premature deaths, one of eight cases of breast cancer and colorectal cancer, one in 12 cases of diabetes, and one in 15 cases of heart disease. For children, staying active for at least one hour each day offers a range of benefits:
- Less likely to suffer from depression
- Better aerobic capacity and muscle strength
- Improved academic performance and attentiveness (from regular physical activity at school)
Physical activity guidelines published by the U.S. Department of Health and Human Services for Active Children and Adolescents call for preschool children (ages 3 to 5) to be active throughout the day. The activities may include participating in spontaneous “active play” as well as structured activities that involve throwing, jumping, and riding a bicycle or tricycle, and it is recommended they be done for at least three hours each day at a range of intensity levels (light, moderate, vigorous).
For school-aged children and adolescents (ages 6 to 17), the guidelines recommend at least one hour of physical activity each day at moderate or vigorous intensity. The activities should focus on improving aerobic capacity and strengthening bones and muscles. Free play and unstructured activities often are sufficient to meet the guidelines for young children, who tend to be highly active by nature. As they reach adolescence, however, children’s activity patterns change, so structured activities may be more effective in helping them stay physically active on a daily basis. The guidelines note that girls in particular tend to reduce their level of physical activity when they reach adolescence.
Many public and private organizations have joined the fight against childhood obesity, offering information and other educational assistance to families and communities with the goal of instilling healthy eating and physical activity habits from a very early age.
- State of Obesity is a collaboration of Trust for America’s Health and the Robert Wood Johnson Foundation intended to raise awareness about the dangers posed by the current “obesity epidemic.” Along with reports on the results of recent obesity research, the site encourages state governments to implement strong policies promoting nutrition and physical activity for all residents. Of particular note are the site’s overviews of state policies on early childhood health, school health programs, and health initiatives at the community and neighborhood level.
- The World Health Organization’s Commission on Ending Childhood Obesity provides reports on the marketing of foods and nonalcoholic beverages to children, population-based approaches to preventing childhood obesity, and a school policy framework for promoting healthy diets and physical activity.
- The National Survey of Children’s Health is sponsored by the Data Resource Center for Child & Adolescent Health. It is intended to highlight “intersecting aspects of children’s lives,” such as the availability of quality health care, family relationships, and the characteristics of their school, neighborhood, and community, all of which affect the physical and mental health of children. Among the resources offered by the survey are content maps covering Child and Family Health Measures and Title V Maternal and Child Health Services Block Grant Measures from the most-recent 2016-2017 survey.
Parents aren’t always aware of the health risks their children face as a result of poor nutrition or lack of physical activity. These services help families, educators, and healthcare providers determine the specific needs of their children in terms of eating a healthy diet and staying in good physical shape.
- The CDC’s BMI Percentile Calculator for Child and Teen determines the BMI percentile of children ages 2 to 19 based on growth charts. Enter the child’s age, sex, height, and weight to calculate a rough estimate of the child’s BMI percentile. (The CDC notes that the BMI calculator is not intended to substitute for the advice of a medical professional.)
- The Kids Count Data Center is a service of the Annie E. Casey Foundation that generates visualizations of data related to childhood health and other aspects of children’s lives, including nutrition, immunizations, exercise levels, mental health, and other demographic data.
- The second edition of the CDC’s Physical Activity Guidelines for Americans includes recommendations for preschool children (ages 3 to 5) and for children and adolescents ages 6 to 17. The guides encourage preschool children to engage in a variety of activities all day long to promote physical development. For children and adolescence, the guidelines recommend spending at least one hour each day on moderate-to-vigorous physical activity by engaging in a sport or other exercise the child enjoys doing.
In addition to the CDC’s program to combat childhood obesity, other sources for helpful information and advice are provided by public agencies and nonprofit organizations.
- The U.S. Department of Agriculture’s Food Buying Guide for Child Nutrition Programs is an interactive tool for creating virtual shopping lists and comparing the nutritional value of various foods. In addition to searching for information about specific foods, visitors to the site can create lists of favorite foods, use a tool that automatically creates a shopping list based on Child Nutrition Program guidelines, and download a Food Buying Guide. (Note that some of the site’s resources are accessible only after completing a free registration process.)
- The Louisiana Action Guide on Fruits and Vegetables was created by the CDC to instruct healthcare providers and public policymakers on specific techniques that can be applied to reduce the incidence of childhood obesity in the state. Among the guide’s recommendations are to align the state’s Early Care and Education licensing regulations with the federal standards for serving fruits and vegetables and to increase the number of school districts that participate in farm to school programs.
Louisiana’s State Health Assessments and State Health Improvement Plan are the glue that binds efforts throughout the state’s 64 parishes to reverse recent increases in childhood obesity rates. The plan was created with the participation of hundreds of nonprofit organizations, healthcare providers, private businesses, and public officials. The Implementation Plan of the Health Improvement Plan uses a five-level “social ecological model” of health promotion, from innermost to outermost: individual, interpersonal, organizational, community, policy.
The nonprofit Obesity Action Coalition (OAC) features a list of Louisiana state offices that promote the fight against obesity. Among the agencies are the Governor’s Council on Physical Fitness and Sports and the Louisiana Council on Obesity Prevention & Management. The OAC provides a wealth of information on childhood obesity, including facts about the stigma of childhood obesity, the correct way to measure a child’s weight in BMI-for-age percentiles, and a range of downloadable guides, brochures, and other public education resources.
When communities invest in health, they are investing in the future. Knowing how to choose nutritious food options and appreciating the importance of regular physical activity can’t happen too early. Patterns related to eating and staying active arise in preschool or earlier, and they persist into adolescence and adulthood. Parents, schools, and the children themselves must be educated about the benefits of a healthy diet and regular vigorous activity. Communities must ensure that it is easy for children and families to acquire fruit, vegetables, and other fresh foods as part of a balanced, three-meal-a-day diet. They must also work to provide safe access to parks and other areas where children can play and exercise.
By expending time and resources now to reduce and ultimately eliminate childhood obesity, Louisianans will make a huge improvement to the health and well-being of our children, grandchildren, and generations to come. Learn how Tulane University’s Online Master of Public Health program prepares graduates for taking lead roles in the state’s efforts to ensure all children in Louisiana benefit from a nutritious diet and ample room and opportunity to do what kids love to do: get physical.