Title
of Health Intervention:
Avoiding the Pitfalls of Portion Size: Understanding
how much is on your child’s plate.
Health
Topic: Childhood obesity and the results of overindulging
and not understanding portion control
Intended
Audience:
The lesson is geared towards parents with young
children between the ages of 3-12. Parents have been told by their pediatrician
that their children are heading towards being overweight.
Procedures:
Set up tables, chairs, turn on the computer, pull up
PowerPoint for videos, set up portion displays, set out bring cards and chips,
and have handouts prepared.
Introduction:
Hello, my name is Tracy; I will be your health
educator today specializing in portion size and control. In the next half hour,
I will explain what childhood obesity is, how potion size is contributing to
obesity in children, talk about portion distortion and give tips on how to size
down out portions.
We live in a world where everything is SUPER SIZED
which in some instances can be great! SUPER SIZED televisions, SUPER SIZED
cars, and SUPER SIZED special movie effects, but one place that being
considered SUPER SIZED is not okay is when it comes to our children. This is what we are going to focus on over
the next 30 minutes. We are going to
learn how not to SUPER SIZE our children through using portion control.
Describe
portion control review bingo game
a. Hand out game cards
b. Explain directions of game
Background:
For the past decade and a half childhood obesity has
been on the rise and is continuing to grow. There are facts and statistics that
prove childhood obesity is a serious and rising problem, and change is
needed.
·
“Over the past thirty years, childhood
obesity has tripled” (Centers for Disease Control and prevention [CDC], 2011a).
·
“The percentage of children aged 6–11
years in the United States who were obese increased from 7% in 1980 to nearly
20% in 2008. Similarly, the percentage of adolescents aged 12–19 years who were
obese increased from 5% to 18% over the same period” (CDC, 2011a).
·
“Approximately 17% (or 12.5 million) of
children and adolescents aged 2—19 years are obese” (CDC, 2011b).
Risks
associated with obesity:
There are many health risk associated with childhood
obesity which can lead to health problems in adulthood.
·
“High blood pressure and high
cholesterol, which are risk factors for cardiovascular disease (CVD)” (CDC,
2012).
·
“In one study, 70% of obese children had
at least one CVD risk factor, and 39% had two or more” (CDC, 2012).
·
“Increased risk type 2 diabetes” (CDC,
2012).
·
“Breathing problems, such as sleep
apnea, and asthma” (CDC, 2012).
·
“Joint problems and musculoskeletal
discomfort” (CDC, 2012).
·
“Fatty liver disease, gallstones, and
heartburn” (CDC, 2012).
·
“Obese children and adolescents have a
greater risk of social and psychological problems, such as discrimination and
poor self-esteem, which can continue into adulthood” (CDC, 2012).
Health
risks later:
Children who are obese have a greater chance of
becoming as obese adult. Diseases and
health conditions associated with adult obesity include heart disease, sleep
apnea, and diabetes. Disease carried over from childhood can result in severe
cases in adulthood shortening a person’s life span (CDC, 2012).
Contributors:
Low
Physical Activity
Many children are living sedentary lifestyles.
Nowadays it seems the majority of time is spent in front of the television,
computer, playing video games, on our phones, and social networking. All these activities promote sedentary
lifestyles and in my opinion are contributing to the unhealthy lifestyle most
Americans are living and the rise in childhood obesity. These activities
contribute to snacking and filling up on junk, causing us to feel full so we’re
not hungry when it is time to eat a real meal (CDC, 2012).
·
“Eight- to eighteen-year-olds spend more
time with media than in any other activity besides sleeping—an average of more
than 7½ hours a day, seven days a week” (Rideout, Foehr & Roberts, 2010).
SIDE
NOTE: When I was a child I spent barely any time indoors.
My days consisted of riding bikes, climbing trees, and playing at the
playground until dark. I grew up in
Upstate New York and the winters were brutal, but on almost any given day I was
outside playing.
Poor
eating habits
Families are working longer hours, and more days to
maintain their standard of living which leaves them with little time and energy
to prepare home cooked meals. Families
today are also living in the world of extracurricular. Every minute of the day
is consumed with some activity outside of school that leaves them little time
to cook, so their options are quick meals and fast food.
·
“There are over 25,000 fast food chains
for Americans to choose from. The yearly total Americans spend on fast food is
over $140 billion a year” (The healthy eating guide, 2011).
Increased
portion sizes
Over the past few decades’ portion size have grown
causing an increase in the calories we consume. We are bombarded daily with
increased portions sizes at restaurants, grocery stores and special events,
such as movies and sport games.
Portion sizes of less healthy foods and beverages
have increased over time in restaurants, grocery stores, and vending machines.
·
“Research shows that children eat more
without realizing it if they are served larger portions. This can mean they are
consuming a lot of extra calories, especially when eating high-calorie foods”
(CDC, 2012).
Portion
Control:
There are many people who do not know what a healthy
portion is, but who can blame them? Over
the past few decades, our portions have changed drastically. We have become
accustomed to thinking larger portions are better and believe that what is
served to us is normal. Retraining our
brains to understand that larger isn’t always better is not an easy task. In order to have success when losing and
managing weight we need to change our portions, which is a critical component
to successful reducing childhood obesity (Kidshealth.org, n.d).
Our
lesson today is learning how to develop "portion control."
Portion
distortion is very real and many Americans suffer
from this. We believe that if we eat
much junk food we will be overweight when in reality it is the size of the
portions we eat of any type of food. We are living in a super-sized society
which is contributing to our children growing up obese (KidsHealth.org, n.d.).
Questions
we need to ask ourselves:
How do I plan for healthy eating?
How do I move my children away from the idea that
"bigger is always better"?
Well, first we need to familiarize ourselves with
portion size.
·
Show portion size chart (PowerPoint).
As children we develop eating habits, such as likes,
aversions, and portion sizes. Eating
healthy not only calls for eating healthy foods but controlling the amount of
food we eat, portion control. When preparing a meal for our children, the U.S.
Department of Agriculture (USDA) provides portion guidelines for adults and
children. An adult serving should be cut buy one half to a third when preparing
a plate for a child. For example, a 3 oz. piece of chicken is the size of a
deck of cards so a child’s serving should be 1 ½ ounces (WebMD, 2012).
It is challenging to understand portion sizes, but
to make it easier equate food to the size of different objects. Here are a few examples to help you visual
the serving sizes of some foods. The palm of a women’s hand hold about 3oz
which is a serving size of chicken. A cup of rice or pasta should be about the
size of a tennis ball. I have a take-home handout titled “Portion size guide” to
help you (WebMD, 2012).
Describe
portion control
·
Show YouTube videos
o
How to Determine a Serving Size for
Dummies (1.56) (PowerPoint)
o
How to Determine a Serving Size without
Measuring For Dummies (.56) (PowerPoint)
·
Use visual aids to show portion size
o
Hand out portion size guide
sheets/wallet
·
Discuss different portion sizes
o
Hand out portion size food containers
·
Hand out “What’s on your plate” information
Talk
about portion control tips
If anyone has bingo stop and review the key points.
Tips
Before
Eating, Divide the Plate
Fruits and veggies should fill one side of your
plate and the other side should have equal portions of protein and starch. For
example, pork chops and rice or chicken and potatoes are not complete meals if
fruits and vegetables are missing (Choosemyplate.gov, 2011).
Serve
Good-For-You Foods Family-Style
Share your meals (Mayo Clinic, 2009).
Before placing food on your plate decide what you
are going to eat and place appropriate size portions on your plate (Mayo
Clinic, 2009).
Do not put all the food on the table, out of sight
out of mind (Mayo Clinic, 2009).
Learn
Serving Sizes
Weigh out your food to make sure you have the
correct portions. Once you’re comfortable you will be able to measure out food without
the assistance of a scale (Mayo Clinic, 2009).
Learn to identify serving sizes this allows for
better control over the portions of food you eat (WebMD, n.d.).
Don’t
clean your plate
Let children decide when they’re finished; don’t
make them clean their plates; let them stop when they are full (NIDDK, 2012).
Eating
out
Split a meal (Choosemyplate.gov, 2011).
Substitute vegetables for french fries and order off
the kid’s menu for children they do not need an adult size meal (NIDDK, 2012).
Before you start eating, request a to go carton and
put half immediately into the carton (Mayo Clinic, 2009).
At
home
Make an effort to get everyone at the table to eat
together (NIDDK, 2012).
Use a small plate for your meals, using a large
plate can encourage a person to fill their plate causing them to eat more than
what they would have if they used a small plate (NIDDK, 2012).
Repackage goodies like cookies and chips into small
bags to control overeating. This way you can control portion size (Mayo Clinic,
2009).
Television can cause a distraction during mealtime
so turn off the television to control mindless eating (NIDDK, 2012).
Use an individual bowl to snack from instead of
snaking out of the bag this way you can keep track of how many portions you are
eating (Mayo Clinic, 2009).
Think
Before You Drink
Stock your house with liquid options, such as water,
low or fat free milk, or 100% juice. Children can have ½ to 1 cup of 100% fruit
or vegetable each day. Eliminate your
home of sugary and high calories drinks (Choosemyplate.org, 2011).
Evaluation
I will check for understanding of my lesson and to evaluate
the participant’s progress during the lesson and after I will use class observation,
answer & question session, and class discussion (bingo review) and a
questionnaire.
Anticipated Problem(s) and Solution(s)
·
Additional
participants attend the lesson then what were anticipated.
o
Have
additional copies of bingo cards, worksheets, handouts and additional chairs.
·
Forget
flash drive with PowerPoint information, videos, and graphics.
o
Send
PowerPoint to e-mail account and make a hardcopy of notes.
·
Conference
room is locked.
o
Call
ahead to make sure door is unlocked and that night staff (janitors) know we
will be holding a class.
·
Parents
many bring children with them if they have no other option.
o
Have
another person on hand to help with children. Bring books and a few toys to
have a play area set up for the children.
Objectives
Process Objectives
Participants
will be able to list during the lesson the main causes contributing to
childhood obesity to the members at their table (Cognitive).
Participants
will show a willingness to take personal action to improve portion control
habits at home by following guidelines presented in class in a post evaluation
questionnaire a month later (Affective).
Participants
will engage in conversation with class and teacher during the lesson showing an
understanding of the material presented by listing the key points of the lesson
(Psychomotor).
Outcome Objectives
80%
of the participants will be able to identify the cause of childhood obesity
(Cognitive).
75%
of the participants will agree to use portion control guidelines when preparing
their children’s meals (Affective).
80%
of participants will be able to demonstrate their understanding of portion size
through a question and answer period (psychomotor).
Goal
The
goal of the program is to provide families with background knowledge of obesity
and how portion control can help them and their children can live health lives
through eating appropriate sized meals.
·
Increase
knowledge of obesity.
·
Change
attitudes towards potion size and eating healthy.
·
Encourage
healthy eating behaviors.
·
Increase
self-efficacy in order to develop portion control habits.
Guiding Health Education Theory or Model
Health
Behavior Model
The
Health Behavior Model was developed as a guiding framework to explain why a
person decides not to change or maintain a health habit , as well as, what
makes a person decide to change and maintain their new health behaviors. The
constructs of the model include perceived susceptibility, perceived severity,
perceived benefits, perceived barriers, cues to action and self-efficacy. In
order for people to change their behavior they need to understand how where
they fit among these constructs. Once they have knowledge of how each of these
constructs affects them they can begin to change their behaviors and have the
confidence to maintain these health behaviors (Glanz, Rimer & Viswanath,
2008). Obtaining and preparing the proper foods can be a perceived barrier
creating a potential negative effect on their health action. According to John
& Ziebland (2004) there are external and internal factors which create food
barriers for families. A few examples of external food barriers are high prices
of fruits and vegetable and time to properly grocery shop. A few internal
barriers are health habits and food preference. A strong predictor of whether
or not food will be eaten is the taste of a food (John & Ziebland, 2004).
The main purpose of this lesson is to change eating behaviors
which will include breaking down food barriers, such as food selection, as well
as, increasing their self-efficacy to shop and prepare for foods that will
create a well-balanced meal.
Setting 8 round tables
• Nighttime 6:30 -7:00
• Thursday night
• Conference room
• Two display tables
• Overhead projector
and computer
• 8 Tables and Chairs
Estimated Time
• Introduction (5min)
• Explanation and
handout of game (5min)
• Background
information (5min)
• Discussion of visual
aids (pass them around) (5 min)
• Question and answer
(10 min)
• Review (5min)
Materials
Needed
• Computer
• Handouts (what does
a serving size look like)
• Visual aids (portion
control items, my plate handout, bingo game)
• 8 tables, 32 chairs
• Bingo chips
• Plastic containers
• Food portions
• Take home kids coloring
sheet
Reference
page
Center for Disease Control and Prevention. (2011a). Childhood obesity facts. Retrieved from
http://www.cdc.gov/ healthyyouth/ obesity/facts.htm
Center for Disease Control and Prevention. (2011b). Obesity rates among all children in the United
States. Retrieved from http://www.cdc.gov/obesity/ childhood/data.html
Center for Disease Control and Prevention. (2012). Overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood/basics.html
Choosemyplate.gov. (2011). Build a health meal. Retrieved from http://www.choosemy
plate.gov/food-groups/downloads/TenTips/DGTipsheet7 BuildAHealthyMeal.pdf
Glanz, K., Rimer, B., & Viswanath, K. (2008).
The health belief model. In Champion, V., & Skinner, C. (Eds.), Health
Behavior and Health Education: Theory, research, and practice (pp. 45-62). San
Francisco, CA: Jossey-Bass
Jeyanthi, J., & Ziebland, S. (2004). Reported
barriers to eating more fruit and vegetables before and after participation in
a randomized controlled trial: a qualitative study. Health Education Research, 19(2), 165-174. doi: 10.1093/her/cyg016
Retrieved from http://her.oxford journals.org/content/19/2/165.full.pdf+html
Kidshealth.org (n.d.).Portion distortion. Retrieved from http://kidshealth.org/parent/ nutrition_center/healthy_eating/portions.html#
Mayo Clinic. (2009). Nutrition and healthy eating. Retrieved from http://www.mayoclinic.com/
health/portion-control/MY01101
National Insititute of Diabetes and Digestive and
Kidney Diseases [NIDDK]. (2012). How can
I control portions at home. Retrieved from http://win.niddk.nih.gov/publications
/just_enough.htm#f
Rideout, V., Foehr, U., & Roberts, D. (2010). Generation M2 media in the lives of
8to18year olds. A Kaiser family foundation study. Retrieved from http://www.kff.org/entmedia/
upload/8010.pdf
The Healthy Eating Guide. (2011). Health eating statistics: American’s obesity
crisis. Retrieved from http://www.thehealthyeatingguide.com/healthyeatingstatistics.html
WebMD. (2012). Portion
size guide. Retrieved from http://www.webmd.com/diet/printable/ portion-control-size-guide