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Sample Essay Paper on Nutrition and Weight Status: Combating Obesity among Children

Nutrition and Weight Status: Combating Obesity among Children

“Healthy People 2020” is a government’s preventive initiative aimed at promoting health among citizens. Its overarching goals include; achievement of health equity, elimination of disparities, improvement of health across all groups, creation of supportive physical and social environments for good health, attainment of higher quality lives free from preventable diseases, injuries, and disabilities, reduction of premature deaths, and promotion of healthy development, quality of life, and healthy behaviors across all stages of life. “Nutrition and weight status” represents one of the important areas of focus in the initiative. Nutrition and weight status are considered essential across all groups and at all stages of life to ensure progress towards the objectives outlined in the Healthy People 2020 initiative. For instance, Feingold et al. (2018) observe that obesity is a significant risk factor for chronic diseases. The role of obesity as a risk factor for chronic disease confirms the need to address its rising prevalence to avoid future escalations.

Educating children on the significance of nutrition and weight status is essential for empowering them to change their behaviors and choices in ways that can improve their health in the long term. Essentially, obesity increases the risk of chronic conditions such as poor cardiovascular health and diabetes, resulting in a heavy burden on healthcare resources, and warranting concerted efforts on all fronts and at all levels, that is, individual, community, and government policy, among others, to combat it. Children are especially vulnerable to obesity and its effects owing to their impulsiveness and lack of adequate awareness and knowledge about the effects of poor diet choices and physical inactivity. As such, it is imperative for children to be informed about this matter.

Act

One of the acts aimed at promoting health and combating obesity among children is the Healthy, Hunger Free Kids Act (HHFKA), 2010. The legislation is a federal statute that represents a part of the reauthorization for the financing of child nutrition, particularly in schools. It was the brain child of former First Lady Michelle Obama in her initiative, Let’s Move! It sets nutrition standards for schools and has empowered the U.S. Department of Agriculture to alter the breakfast and lunch programs in schools through improvement of critical nutrition and protection from hunger for many children across the U.S. The Bill set standards for food that children buy during lunch in school, including from vending machines, offers resources for schools and communities to produce and use fresh produce from local farms, as well as for federally subsidized school lunches.

As part of these provisions, the Act set a minimum for vegetable, fruit, and whole-grain servings, as well as a maximum for sugar, fat, and sodium content in the school lunches. It also set minimum standards for wellness policies in schools (USDA, 2013). The Act plays a significant role in the effort to combat obesity among children through promotion of healthier meals away from home when guardians and parents do not choose the foods that their children consume. The HHFKA continues to be effected today, despite some political opposition from various quarters (Schwartz & Wootan, 2019). The Act is essential because it promotes children’s awareness of the need to prevent obesity through better decision-making on foods consumed and related lifestyle choices, including physical activity, for improved wellness.

Prevalence/Epidemiology and Organizations

Childhood obesity is a significant problem in American society. In 2019, the Centers for Disease Control and Prevention (CDC) reported a prevalence of obesity of 18.5% among adolescents and children aged between 2 and 19 years. Statistics have illustrated that about 13.7 million adolescents and children in the country were obese as of 2019 (CDC, 2019). This prevalence increased with age, with observations of prevalence rates of 13.9%, 18.4%, and 20.6% among 2-5, 6-11, and 12-19-year olds respectively (CDC, 2019). CDC research illustrates further that obesity prevalence among children decreased with a higher level of education of the head of a household, and that the prevalence is higher among minority communities, particularly Hispanics and non-Hispanic Blacks.

The mechanism of childhood obesity development is still unclear. However, there are various speculations associated with the condition and research has shown that childhood obesity is a function of several factors including environmental factors, the cultural environment, and lifestyle choices. Environmental factors are characterized by phenomena such as nutritional transitions, which influence the availability of foods within the community. Other environmental factors include government policies within which children are brought up, school policies, parental work-life balance and demographics, each of which contributes to the development of unique eating habits (Karki, Shrestha & Subedi, 2019). Cultural factors are the consumption patterns embodied by different ethnic entities. For instance, the Hispanic communities consider children with higher weights to be healthy, and children are more likely to be fed excessively in order to attain the perceived acceptable weight based on community standards (Karki et al., 2019). Such factors not only result in childhood obesity but also promote the evolution of childhood obesity into adulthood. The lifestyle choices include practices such as sedentary lifestyle. The combination of these factors is escalated by genetics, which also plays a significant role as a risk factor for obesity.

This assessment illustrates the importance of education and awareness in the effort to combat obesity among children. Obesity is the outcome of imbalance between the quantities of calories consumed and the energy expended per unit of time in an individual’s life. Awareness of the need to control the quantities of food consumed, make healthy food choices, and choose positive lifestyles with adequate levels of physical activity is essential in the effort to combat obesity effectively. Since children have deficient capacities to understand the consequences of their choices and actions, and to control their impulses, action is required at the household and community levels to protect them from the harmful effects of some diets and lifestyles through creation and maintenance of environments that support good nutrition and weight status.

Organizations and stakeholders at the community, national, and international levels play important roles in this effort. These include; schools and healthcare organizations and personnel at the community level, the CDC and the government at the national level, and international organizations such as the World Health Organization. The focus of these stakeholders’ efforts on public education, awareness campaigns, and policy-making based on practical research is necessary to promote positive changes in lifestyles and dietary choices. As part of the environmental factors, government policies can promote or reduce the vulnerability of obesity among children. Practices such as taxing unhealthy foods and limiting access to the junk food can help curb childhood obesity. This indicates the need for the government to collaborate with school districts towards the establishment of practices that foster better health management. It is thus expected that with the implementation of the HHFK Act, the prevalence of childhood obesity will reduce.

Legislators and Stakeholders involved in Policy Development/Dissemination

Senator Blanche Lincoln introduced the HHFKA in the Senate in 2010. Lincoln was the chairperson of the Agricultural Committee in the Senate. As noted earlier, the Bill related closely with Michelle Obama’s initiative, Let’s Move! The principal aim of this initiative was to combat obesity among children, which was aligned with the public health goal of reducing the prevalence of obesity and control chronic diseases such as obesity and cardiovascular diseases. The U.S. Department of Agriculture was responsible for enforcing the standards in the act, while its implementation occurred in school settings across the U.S.

Role of Advanced Practice Registered Nurse in the Policy

Advanced Practice Registered Nurses (APRN) have critical leadership, advocacy, and educator roles in public health. These roles involve the application of their training at an advanced level of nursing practice to promote public health. APRNs' roles as leaders in nursing settings mandates them to engage and collaborate with governments and policymakers to represent the health needs of communities and their members such that developed and enforced policies are effective in meeting health needs and promoting the achievement of public health goals. In this context, they could engage policymakers and the government to improve the policy and its implementation for better promotion of children’s health and wellbeing.

APRNs also have the training and mandate to educate communities and their members on issues of public health. In this context, they could visit schools and educate students and partner with school administrations to enable competent and effective implementation of the policy for better children’s health. They could also provide guidance to patients who visit healthcare facilities and their families to foster better selection of diets within the family context. Public education could also be achieved by collaborating with community based organizations that frequently get into contact with community members.

The APRN can also strengthen the healthcare workforce as part of his/her strategies to enhance adherence to the act. This professional is automatically a potential nurse leader and should be able to possess significant knowledge of obesity as well as on the implementation of the requirements of the HHFK. According to Woo, Lee and Tam (2017), regulatory policies developed by the government mostly lack coherent professional boundaries for advanced nursing practice. While the lack of such boundaries can be a cause of confusion among APRNs, they are usually given greater autonomy and responsibilities compared to other nurses by their roles as nurse leaders. The professionalism of APRNs should see them acting as healthcare leaders in initiating the implementation of the policy both within the healthcare facility and among the general public. This policy therefore expands the scope of the leadership responsibilities of the APRN.

Effect of Policy on Clinical Practice

The effect of HHFKA on clinical practice relates to the effort to utilize community outreach and policy-making approaches to achieve public health goals. The Act indicates the need for more proactive preventive interventions at the community level rather than the passive treatment-dependent models of public health. The proactive intervention healthcare model can be achieved through public education and contributions to policy-making, to achieve public health objectives. It signals the need for clinical practice to incorporate active partnerships and actions at the community level for more effective achievement of public health goals. These models involve the empowerment of communities and their members with knowledge and environmental structures that can control preventable health conditions and diseases. Inter-professional teams combining the skills and efforts of nurses, nurse leaders, local government leaders, school administrations, community leaders, and local community members are essential in ensuring the success of these efforts and promote the health of children.

Policy Application in an Inter-professional Team

The application of the HHFK Act also has significant effects on the multidisciplinary team. The management of obesity requires the conceited efforts of a multidisciplinary team comprising of healthcare professionals, including physicians, nutritionists, educators, and even physical therapists. With the implementation of the policy and its reported success however, the pressure on the multidisciplinary team towards the prevention or reduction of obesity reduces. For instance, children have been reported to choose healthier meals following the introduction of the act. The choice of healthier meals is an indication of increasing awareness of the needs and benefits of those healthier food choices, which implies that it becomes easier for the multidisciplinary team to guide children and their parents on healthy choices.

The act has also increased cooperation not only among the interdisciplinary team in healthcare but also across several industries. Teachers and school administrations have been included in the fight against obesity, unlike the traditional approach in which the burden of educating the public on health issues was solely with the healthcare fraternity. The distribution of roles across industries makes it possible for collaboration and communication to occur between the healthcare and the education sectors.

The contributions of dietetics to the multidisciplinary teams have also been expanded by the implementation of the policy. Hayes, Contento and Weekly (2018) suggest that following the implementation of the act, there has been deliberate action by the government towards ensuring that each school has dietetics professionals to help the school administrations address the nutrition requirements of the children. Several dietetics internships are being provided through school rotations, and this improves the overall interaction between the children and healthcare professionals within the school set-up. Such a program not only enhances the participation of the nutritionists in the multidisciplinary team, but also expands the extent of inclusion of the healthcare sector in the care for the target population, unlike the traditional model where nutrition-related services were confined to the hospital environment. Service to the children and adolescent population has thus improved with respect to the delivery of nutrition care.

Conclusion

The Healthy, Hunger Free Kids Act (HHFKA) of 2010 presented in the paper as a suitable policy to address the concerns and objectives of the “nutrition and weight status” topic under the Healthy People 2020 initiative, with a specific focus on children and adolescents. Implementation of the policy promises to address the problem of unhealthy food and beverage choices among children in the school setting. This focus is essential owing to the increasingly significant problem of obesity among 2-19-year-olds in the U.S. The Act signals the need for proactive interventions at the community level to achieve public health objectives through the roles of public education, policy-making, advocacy, and leadership in advanced nursing settings.

References

Centers for Disease Control and Prevention (CDC) (2019). Childhood obesity facts. CDC. Retrieved from: https://www.cdc.gov/obesity/data/childhood.html

Feingold, K., Anawalt, B., Boyce, A., et al. (2018). Clinical problems caused by obesity. South Dartmouth, MA: MD Text.com Inc. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK278973/

Hayes, D., Contento, I. R., & Weekly, C. (2018). Position of the academy of nutrition and dietetics, society for nutrition education and behavior, and school nutrition association: comprehensive nutrition programs and services in schools. Journal of the Academy of Nutrition and Dietetics, 118(5), 913-919. Retrieved from https://jandonline.org/article/S2212-2672(18)30295-8/fulltext

Karki, A., Shrestha, A., & Subedi, N. (2019). Prevalence and associated factors of childhood overweight/obesity among primary school children in urban Nepal. BMC Public Health, 19(1055). Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7406-9

Schwartz, C., & Wootan, M. (2019). How a public health goal became a national law. Nutrition Today 54(2): 67-77.

Woo, B. F. Y., Lee, J. X. Y., & Tam, W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15(63). Retrieved from https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-017-0237-9

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