Obesity is an ongoing epidemic in all areas of the world and among adolescents is rising at alarming rates, in fact tripling over the last 20 years and infects 1 in 5 children/adolescents in the United States (Daly et al., 2016; CDC, 2020). Obesity does not discriminate as it occurs in both areas of low and high economic status and stems from adolescence through adulthood (Anabwani, 2015). This chronic disease carries with it high risks of type-two diabetes as well as cardiovascular disease and other co-morbidities into adulthood. Obesity in adolescence may cause sleep related issues, poor self-esteem, poor body image and social withdrawal leading to mental health issues (Anabwani, 2015). According to Daly et al, (2016) there are ways to combat obesity at younger ages to prevent or delay the progression of obesity, ranging from surgery to medications but ultimately looking at dietary habits and physical activity as the most promising of the three at this age.
The costs associated with the growing epidemic are nothing to ignore and according to Harvard University (2020), there was an estimate that the U.S. spent $190 billion dollars in one year on obesity-related health care expenses. These included both direct and indirect accrued costs with direct costs attributed to outpatient/inpatient medical services and indirect costs due to lost work, insurance cost increases and lower wages which are historically prevalent in obese and overweight populations (Harvard University, 2020).
In Anne Arundel County, MD., overweight status for children and adolescents (ages 2-19) are 15.1% of the population and the obesity rates are 17.3% of the population according to the Anne Arundel County Department of Health, 2020. Adolescents have the opportunity to be on their own more often, allowing them the independence to choose what foods and beverages they will or will not consume. Lack of nutrition education, peer influence, environment, marketing and mass media are some of the factors that will lead them to choose processed and ultra-processed foods, not realizing the importance and benefit of providing their growing bodies with nutrient dense foods that positively contribute to their developmental growth (ALjaraedah, et al. 2019). The indulgence of saturated fat and trans-fat foods, along with excess consumption of sugars, will continue to increase the obesity epidemic that runs rampant among the adolescent population world-wide and in Anne Arundel County (ALjaraedah et al. 2019). Larson et al. 2016 states that these energy dense snacks replace fruits and vegetables, depriving adolescents of the very nutrients needed for accelerated growth and development during this time in their lives.
The International Olympic Committee (2015) has stated that measuring energy intake and expenditure for adolescents is very difficult to do. Carbohydrate needs along with fat and protein intake should fall within the dietary guidelines for adolescent athletes and the committee points out that protein supplements do not need to be taken, the key to nutritional success for athletes is a well-balanced, nutrient dense diet (Bergeron, et al., 2015). Unfortunately, it is noted that both coaches and athletes (elite and non-elite) do not have an understanding of what a nutritionally balanced diet looks like and impacts overall performance cognitively, psychologically and physiologically which leads to lower performance outcomes, possible development of eating disorders (ED), disordered eating (DE), Female Athlete Triad and higher rates of injury with longer recovery times (Bergeron, et al., 2015).
Increasing nutritional knowledge in exemplar programs such as Tufts University’s “Healthy Kids Out of School” and also the C3 (Choice, Control and Change) program have been proven effective against combating the youth obesity epidemic. Increasing the awareness of a balanced diet to adolescents with assistance from non-profit organizations, the private business sector, local community businesses, schools, community stakeholders as well as coaches and athletic community organizations, will not only support the athlete’s health and well-being but the ability for the community to thrive in the future. By focusing on the four core capacities of personal agency (forethought, intentionality, self-efficacy and self-regulation of behavior through self-assessment and goal-setting) C3 and “Healthy Kids Out of School” were able to strengthen these areas through motivational activities and skill building (Contento & Swartz Rose, 2010; Tufts University, 2020). These programs with the support of stakeholders are fighting against the childhood/adolescent obesity epidemic and advocating for a healthier, younger generation (Tufts University, 2020; Contento & Swartz Rose, 2010).
Inquiry based activities that were utilized in the C3 program as well as a guided process of goal setting would be incorporated into the curriculum for the BBSC’s Healthy Athlete’s Program. The reason that these two teaching methods are important to the program’s success are stated by Contento et al. (2011), “…focusing on the scientific method rather than a set of facts to be learned, to help youth develop a rationale and increased motivation for taking action, and behavioral theory to provide skills for how to take action.” Considering the C3 program’s efforts support a curricular framework for the BBSC’s Healthy Athlete’s program, the Healthy Kids Out of School Program supplies a framework that will, as stated by Economos et al. (2018), “…integrate the principles of the organizations culture, while leveraging their existing policies and communication channels.” This is an opportunity to take what is learned, bring in the coaches and possibly even the parents/guardians and create an environment of high engagement and involvement through competition. This will enable the athletes to earn incentives for reaching different milestones supporting better nutrition practices, reinforcing positive behaviors and increasing self-efficacy.
Working with Anne Arundel County Parks and Recreation, Broadneck Baseball Softball Club, Anne Arundel Community College, Anne Arundel County Public Libraries and Anne Arundel County Public Schools the “BBSC’s Healthy Athlete Program” will assist with combating this epidemic. Facilitating the construction of a “nutrition backpack” full of sound nutrition knowledge and practices, such as increasing self-efficacy and raising awareness to what a balanced meal looks like along with adequate portion sizes, will allow personal choice to guide these highly influential adolescents down a path of “good” nutrition choices with confidence. These tools will be critical when in peer social situations, different environments (restaurants, grocery stores, 7-11’s, school cafeteria) and with repeated exposure to social media and marketing influences (Brown, 2016). Besides these benefits, the BBSC program will provide, “…strategies that can improve the athlete’s health both in the short and long term to become socially and economically productive adults” (Bhutta, 2017). Focusing on these constructs along with proper nutrition will produce athletes and community members that will have both the mind and muscle power to be successful in all facets of life.
References
ALjaraedah, T., Takruri, H.R., & Tayyem, R.F. (2019). Dietary practices and nutrient intake among adolescents: A general review. Obesity Medicine, 16:1-6. Doi: 10.1016/j.obmed.2019.100145.
Anabwani, G. (September 1, 2015). Nutrition issues in adolescence. Nestle Nutrition Institute. Retrieved from https://www.nestlenutrition-institute.org/country/za/news/article/2015/09/01/nutrition-issues-in-adolescence
Anne Arundel County Department of Health. (2020). Overweight and obesity in children, 2013. Statistics & Reports. Retrieved from https://aahealth.org/overweight-and-obesity-in-children-april-2013/
Bergeron, M.F., Mountjoy,M., Armstrong, N., Chia, M., Cote, J., Emery, C.A., Faigenbaum, A., Hall Jr., G., Kreimler, S., Leglise, M., Malina, R.M., Pensgaard, A.M., Sanchez, A., Soligard, T., Sundgot-Borgen., van Mechelen, Weissensteiner, J.R., & Engebretsen, L. (2015). International Olympic Committee consensus statement on youth athletic development. Sports Medicine, 49, 843-851. DOI 10.1136/bjsports-2015-094962
Bhutta, Z.A., Lassi, Z.S., Bergeron, G., Koletzko, B., Salam, R., Diaz, A., McLean, M., Black, R.E., De-Regil, L.M., Christian, P., Prentice, A.M. Klein, J.D. Keenan, W., & Hanson, M. (2017). Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: Priorities for implementation and research. New York Academy of Sciences, 1393, 61-71. DOI: 10.1111.nyas.13352
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Daly, P., Pace, T. Berg, J., Menon, U., & Szalacha,L.A. (2016). A mindful eating intervention: A theory-guided randomized anti-obesity feasibility study with adolescent Latino females. Complementary Theories in Medicine, 28:22-28. Doi: 10.1016/j.ctim.2016.07.006
Economos, C.D. Anzman-Frasca, S., Koomos, A.H., Bakun, P.J., Brown, C.M., Brown, D., Folta, S.C., Fullerton, K.J., Sacheck, J.M., Sharma, S., & Nelson, M.E. (2018). Dissemination of healthy kids out of school principles for obesity prevention: A RE-AIM analysis. Preventative Medicine, 119, 37-43. DOI 10.1016/j.ypmed.2018.12.007
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Larson, N., Miller, J.M., Watts, A.W., Story, M.T. & Nuemark-Sztainer, D.R. (2016). Adolescent snacking behaviors are associated with dietary intake and weight status. The Journal of Nutrition, 146:1338-1355. Doi: 10.3945/jn.116.230334
Tufts University. (2020). Healthy kids out of school. Child Obesity180, Reverse the Trend. Retrieved from https://childobesity180.org/initiatives/healthy-kids-out-of-school