” OBESITY PROMOTION AND PREVENTION THROUGH PHYSICAL EXERCISE AND DIET EDUCATION “

THE RESEARCH PROPOSAL IS ATTACHED HERE .

THE RESEARCH PROPOSAL . TITLE IS : ” OBESITY PROMOTION AND PREVENTION THROUGH PHYSICAL EXERCISE AND DIET EDUCATION ”

THIS CLINICAL GUIDELINE AS EDUCATIONAL TOOL WILL BE DIRECT TO THE PARENTS AND EDUCATORS IN SCHOOLS ( PEDIATRIC AND ADOLESCENT AGES ) SO NEEDS TO INCLUDE: CAUSES , CONSEQUENCES ,RISK FACTORS AND RECOMMENDATION TO MAKE CHANGES IN LIFE STYLE ADOPTING HEALTHY HABITS .

Obesity: Promotion and Prevention Through Physical Exercise and Diet Education
Ana G Mendez University System
NURS SC & RESEARCH PROCESS
NURS 502
Prof: Juan Carlos Ramirez
Author: Enrique Funcia
April 2,2017

Table of Contents
Abstract 3
Introduction 4
Background Study 4
Problem Statement 5
Objectives of the study 5
Picot Question 5
Hypotheses 6
Literature Review 7
Study Significance 9
Action plan 9
Development of Clinical Guideline Plan 9
Body Mass Index to Determine Obesity 10
Engagement in Physical Activities 10
Enhanced School Based Physical Exercises 10
Diet Therapy 11
Wheeling Walks 11
Methodology 11
Defining the Purpose or Objectives of the Guideline 11
Establishment of a Relevant Clinical Question 12
School Based Education Program 12
Forming Community Groups 12
Review of Literature 12
Recommendations 13
Ethical Consideration 13
Recommendation 13
Conclusion 13
References 15

Abstract

In developed countries, obesity occurrence in children is rising. Childhood obesity and overweight has substantial psychological and physical health consequences.There has been concern on the rising numbers of obesity cases and overweight starting very early in life. Increased obesity worldwide has been linked with changes in patterns in feeding and also on physical activities (Hassapidou et al., 2015). Encouraging the young children on observing healthy diets and increased durations of physical exercise can be effective in reducing obesity in children. Young school going children however skip school to attend medical checkups therefore affecting the economic productivity. Overweight and obese young children are at danger of getting morbidities such as diabetes and cardiovascular diseases. The aim of the research proposal is to develop a clinical educative guideline that would assist in promoting physical activities and diet in an effort to reducing obesity. The clinical guideline action plan shall however discuss various education strategies that could greatly help in treating obesity. The methodology will also include various steps as well as having a thorough search of literature from the medical databases such as the PubMed, APA and CINAHL. Effective recommendations will then be provided upon successful completion of the action plan.

Introduction
Background Study
In developed countries, obesity in childhood has reached epidemic levels(Lachat et al., 2013). However, obesity incidence in children is rising in developing countries as well. Additionally, childhood obesity and overweight has substantial psychological and physical health consequences.(Kanazawa, 2013). In United States, the incidence of obesity among the young generation or rather the children is increasing dramatically as well as the world at large(Patki et al., 2014). Nevertheless, other diseases related to increased weight cardiovascular, hypertension and diabetes have also been on the rise(Reinehr, 2014).
According toKobel et al (2017), obesity in childhood has been associated with cases of heart diseases and premature death among this population. However, the increased obesity worldwide has been linked with changes in patterns in feeding and also on physical activities. Khanal et al (2015) found that higher risks of obesity and overweight has been associated with fast foods and beverages that induces overweight. Additionally, unhealthy consumption patterns are more often combined to with little physical activities(Gebremichael & Chere, 2015).
There has been concern on the rising numbers of obesity cases and overweight starting very early in life(Lohse et al., 2017). However, development of effective interventions that check development of long term chronic diseases should be assessed thus reducing healthy problems in adulthood. Arguably, the development, survival and protection of children is critical to ensure healthy citizens in future. Improving economic development can only be realized if only children
optimum development is guaranteed(Collins & Fulton, 2015). Encouraging the young children on observing healthy diets and increased durations of physical exercise can be effective in reducing obesity in children(Lazorick et al., 2016).

Problem Statement
Obesity among the young children is an important public health concern. However, obesity in childhood have been associated with higher risks of developing cardiovascular diseases in adulthood and other chronic illnesses such as diabetes and hypertension. Arguably, obesity in children have been associated with negative impact on the economy as more funds are reserved to manage many conditions associated with increased obesity and overweight. Young school going children however skip school to attend medical checkups therefore affecting the economic productivity.
Objectives of the study
a. To develop an appropriate clinical guideline plan to help in treatment and prevention of obesity in community.
b. To evaluate the effectiveness of improved physical education on preventing obesity in children.

Picot Question
In children, does education on observing healthy diet and physical education help in reducing the occurrence of obesity?
Hypotheses
H1- There is significant correlation between physical education and observing healthy diets in preventing obesity in children.
H0- There is no correlation between healthy diets and physical education on preventing obesity in children.

Literature Review
According toVaida (2013), obesity was declared a global epidemic by the World Health Organization in 2003 and with considerable health care concerns. In developing countries, obesity among the young children childhood has reached epidemic levels(Reinehr, 2014). In United States, approximately 24 % of children especially the school going population are overweight and a value of about 11% obese cases(Kanazawa, 2013). Arguably, nearly 75% of these children grow to become obesity in their adulthood. According to the survey by the Nutritional Examination Survey and National Health obesity and overweight prevalence among the youth is about 15% and the figure have tripled since 1970(Dudala et al., 2015). Nevertheless, the leading cause of death worldwide are non- communicable diseases.
Jones-Taylor (2015) found that overweight and obese young population are at danger of gettingmorbidities such as diabetes as well as cardiovascular diseases. However, obese children are at risk of developing obesity in adulthood. Obesity in children is an indication of metabolic diseases(Hassapidou et al., 2015). Such as diabetes. Additionally, obesity in children has been linked to premature deaths and cardiovascular diseases in old age(Guinhouya, 2012). Nevertheless, obesity in childhood has been found to cause considerable disabilities in adults. Additionally, obesity and overweight is strongly linked to many chronic diseases negative social development and lower esteem. The risks of slowed cognitive development in children are associated obesity cases.
Overweight and obesity definition has changed over time. Excess of body fats is used to describe overweight in human beings. However, Body Mass Index is mostly used in determining adiposity in adolescents and young children(BA et al., 2004). BMI values differs with gender and age.In pediatric population overweight is described on the Body Mass index (BMI)with the ones with a figure greater than 85th percentile and the ones with those with a figure greater than 95 defined as being obese(Dehghan et al., 2013). Assessments by the Centre for Diseases control and Prevention in the United States indicates that if the existing rates of obesity persists, one in every three newborns will develop diabetes.
Physical activities and proper nourishment in reducing diseases and deaths have from chronic diseases have been well-known. Approximately 300,000 to approximately 600,000 deaths cases annually associated to limited physical activities and poor diet and are also major causes of incapacities that including stroke and diabetes(Reilly, 2013). Inactivates and poor diet were responsible about 15% of deaths in United States(Gebremichael & Chere, 2015). In 2000, 23% of chronic deaths were reported to be associated with sedentary lifestyle. Healthy People 2010 found that nearly 705 of Americans do not consume sufficient fruits and approximately more than half of these individuals do not eat vegetables(Lachat et al., 2013). However, approximately 64% were found to consume a lot of saturated fat. Nevertheless, majority of subgroups in the population were considered to have too much fat in their diets with minimum incorporation of elements such as calcium and fruits.
Daily physical activities are critical for maintaining a healthy lifestyle. Arguably, physically inactive individuals are more likely to develop coronary diseases than individuals who participate in consistent physical activities. However, individuals with other risks aspects of coronary disorders such as hypertension and obesity may benefit regular physical actions(Reilly, 2013). There are substantial economic burden that are associated to obesity, poor diet and physical in activities. However, these aspects are associated with stroke and cancer that involves consumption of considerable amount of domestic funds with loss of productivity, illness and cases of premature death. Vaida (2013) found that the cost of managing the patients with obesity were estimated to be around $ 100 billion in 2005. Additionally, obesity and poor physical activities accounted for approximately 9.4% of medical expenditures of 2005 in United States(Kanazawa, 2013). Youth and children spends most of their time in schools and therefore a need to have time for the physical education. In United States, Healthy people proposes increased number of hours for regular exercise(Yamaguchi & Mitsuishi, 2014).
According toBlanck & Collins (2013), there is a need to promote physical education in the communities and also in schools. However, interventions aimed at promoting healthy living in young children must start early. Nevertheless, there are higher risk factors that are found among the young people that is sometimes carried in their later life. Additionally, sustainable and effective programs of promoting good health combines both the physical activity and nutritional aspect.
Study Significance
The results that will be obtained in this research work will help in improving the public health sector and the community on appropriate measures that can be observed on ensuring a health population that will be productive in future. However, the research will help the health stake holders to avert the negative effects that results from poor lifestyles and thus able to enhance growth of economy as funds that would be used in managing obesity will be put into other positive use. These interventions will enhance productivity of school going children as will reduce cases of school absenteeism.
Action plan
Development of Clinical Guideline Plan
Incidences of obesity in the United States has been increasing at an alarming rate and thus has resulted to increased mortality and morbidity rates (Yamaguchi & Mitsuishi, 2014). Prevalence have been to both children and adults. It’s estimated that one in every three children is either obese or overweight (Lachat et al., 2013). As a result, there is great need to develop an educative intervention that would help in preventing and controlling the condition. The aim of the research proposal is to develop a clinical educative guideline that would assist in promoting physical activities and diet in an effort to reducing obesity. The guideline will involve various steps that help in reducing the risks of obesity.
Body Mass Index to Determine Obesity.
Excess weight is the leading cause of obesity and thus enhancing educational campaigns to lose weight would greatly reduce the risk of obesity. The educative guidelines will provide knowledge that can be used to measure the BMI of individuals to determine whether they are at a risk of getting obesity or not.
Engagement in Physical Activities.
The clinical guidelines will advocate for increased physical activities for all obese children. Studies have stated that engaging in a moderate exercises for 150 minutes per week or a vigorous physical activity for a period of 90minutes a week greatly reduces the body mass index (Gebremichael & Chere, 2015).
Enhanced School Based Physical Exercises
In schools, the guideline shall encourage the introduction of physical education lesson in that will require all the children to take part. Increased exercises promotes fitness and thus have been found to promote children’s cardiorespiratory and bone health and thus preventing them from getting other diseases related to obesity (Guinhouya, 2012). The guideline therefore will recommend physical activities as a treatment strategy of obesity. The researcher will also advocate for frequent use of pedometer to enhance physical activities
Diet Therapy
Obesity is a health condition highly contributed by sedentary lifestyle (Hassapidou et al., 2015). The researcher will advocate for proper selection of diet to prevent and treat obesity cases. Obese patients will be advised to take food with low fat contents and reduced calories. Consumption of food that would greatly reduce the calories and fats simultaneously will highly be advocated for by the researcher. The guideline will emphasize on the need to take whole grains, vegetables and fruits as the perfect diet.
Wheeling Walks
In order to cater for the elderly in promoting physical activities, the guidelines will necessitate the introduction of a wheeling walk for those with insufficient ability to walk due to low speed gait and reduce surface grip. Such efforts shall require the obese adults to at least have a 30 minutes moderate physical activity.
Methodology
Clinical guideline plan will however follow various steps for it to be appropriate and practical.
Defining the Purpose or Objectives of the Guideline.
This will be the first step towards the preparation of the action plan. The researchers will require to develop appropriate objectives that would provide positive results as far as prevention and treatment of obesity is concerned. Several reviews from journals and article will act as a guide to providing proper and achievable objectives.
Establishment of a Relevant Clinical Question
In this step, the researchers will greatly focus on the need to develop an educative action plan that would assist in managing incidences of obesity in adults and children. The question will also be addressing the entire society on the need to embrace such a program.
School Based Education Program
The educative program will be inclusive thus the researchers will also guide in the formulation of a physical education lesson in the surrounding schools to enable children to increase exercises while at school. The teachers in these schools will also play a big role in this step.
Forming Community Groups
Education programs shall be conducted in different localities in the society. The researchers will be focused in forming interested groups of obese patients both adults and children that will take part in the initial educational awareness meeting.
Review of Literature
For the researchers to obtain reliable and consistent information worth to prepare the educative clinical guideline, various searches shall be performed. A number of randomized control trials and systematic review articles will be searched from various medical data bases. Three databases will be utilized include, American Psychological Association, PubMed and CINAHL shall frequently be visited to search for relevant articles that promote for physical activities and proper diet in treatment of obesity. The Boolean operators and/ or will also be highly utilized to assist in obtaining the articles.
Recommendations
After a thorough review of the searched articles, proper recommendations will be made. The recommendations will need to be reliable and therefore researchers will clearly scrutinize the applicability of the selected articles.
Ethical Consideration
Any research which involves human participant’s increases concern on legal and social matters and thus the researcher will need to have an approval from the institute review board. In addition since it will be a clinical research, they will also need to enhance confidentiality of the guideline as per the rules in the HIPAA. The formulated guidelines will be stored electronically and thus a password will be required as this will improve the security of the plan.
Recommendation
Since determining of obesity or overweight among children might be a complex issue, its recommended that researchers may focus on future intervention plans such as customizing on lifestyle and environmental factors in order to be closer to the needs of community.
Conclusion
Obesity and overweight among children have significant effect on psychological health and physical appearance. Psychological disorders however, increasingly occurs in obese children. In addition, other risk factors such as digestive diseases and cardiovascular disorders are more likely to be inherent among young overweight children. To control this, increased physical activities and reduced over consumption of calories are likely to reduce obesity among children.
Moreover, effective strategies can be implemented to target physical activities, diet and built environment which can be well initiated at schools and in their homes.

References
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Collins, J. L., & Fulton, J. E. (2015). Taking Steps to a Healthier Nation: Increasing Physical Activity through Walking. Journal of Physical Activity and Health, 12(s1), S1-S2. doi:10.1123/jpah.2015-0309
Dehghan, M., Akhtar–Danesh, N., & Merchant, A. (2013). Childhood Obesity, Prevalence and Prevention. Childhood Obesity, 319-335. doi:10.1201/b16340-19
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