background information

CIGNA HealthCare and the Healthy Kids Challenge have teamed up to set the standard for the way employers, health professionals, schools, and families work together to battle the childhood obesity crisis.

The Healthy Kids Challenge is a nationally recognized, award-winning program that addresses child nutrition and physical activity issues. Healthy Kids Challenge offers a multi-level approach of assistance to schools, organizations and communities.

Through its unprecedented collaboration with the Healthy Kids Challenge, CIGNA HealthCare has produced the Fit & Fun Families Employer Tool Kit, an information breakthrough to equip employers in providing employee wellness resources related to healthy eating and physical activity.

The foundation of this toolkit is built on guidelines recommended in the AMERICAN ACADEMY OF PEDIATRICS POLICY STATEMENT:  Prevention of Pediatric Overweight and Obesity, 2003 (2) The toolkit is also based on the recommendations by the U.S. Surgeon General and the National Center for Chronic Disease Prevention and Health Promotion.

• Families should be educated and empowered through anticipatory guidance to recognize the impact they have on their children's development of lifelong habits of physical activity and nutritious eating.
• Dietary practices should be fostered that encourage moderation rather than over consumption, emphasizing healthful choices rather than restrictive eating patterns.
• Regular physical activity should be consciously promoted, prioritized, and protected within families, schools, and communities.
• Optimal approaches to prevention need to combine dietary and physical activity interventions.

Rationale for the Seven Healthy Messages

5-A-Day the Tasty Way – Snack Attack – Breakfast GO POWER – Active Play EVERY DAY – Healthy Meals...Fast – Discovering Smart Servings – Drink Think

A sampling of studies and references that demonstrate the need for messages is provided on each of the seven Employer Tip Sheets.  Additional supporting studies and references (identified by subject below) include:

Prevention Programs: Centers for Disease Control recommends targeting specific health habits:  "To make the best use of scarce resources for prevention, public health agencies attempting to prevent chronic disease should use strategies that focus on highly prevalent risk factors that are modifiable through behavior change. Following are four behavior change strategies that meet this criterion. Each strategy can target one or more Healthy People 2010 objectives.

• Promote increases in physical activity. Exercise provides numerous health benefits and should be promoted to the most sedentary subgroups of the population.
• Promote breastfeeding. Breastfed children have less risk for acute diseases of infancy and early childhood and a reduced risk of developing childhood obesity.
• Increase fruit and vegetable consumption. Higher consumption of fruits and vegetables is associated with lower incidence of several chronic diseases, including cardiovascular disease and some cancers.
• Reduce screen-viewing time. A reduction in the length of time that children and adolescents watch television and are on the computer may reduce the risk for obesity among young people."

CDC:  Promoting Healthy Eating and Physical activity for a Healthier Nation; Promising Practices in Chronic Disease Prevention and Control: A Public Health Framework for Action, accessed 2/22/05   www.cdc.gov/nccdphp/promising_practices/promoting_ health/opportunities.htm

Overall Health Behavior Goals:  The Department of Health and Human Services (HHS) and the Department of Agriculture (USDA). Dietary Guidelines for Americans 2005, accessed 2/22/05 http://www.healthierus.gov/dietaryguidelines/index.html

National Center for Chronic Disease and Health Promotion.  Nutrition and Physical Activity: Are there recommendations for young people? Accessed 2/22/05  http://www.cdc.gov/nccdphp/dnpa/physical/recommendations/young.htm

5-A-Day:  Limited data exist on the fruit and vegetable consumption of preschoolers and children. In other age categories, only 20.4% 18-24 year-olds and 19.7% of 25-34 year-olds eat 5+ servings of fruits and vegetables per day (Centers for Disease Control, Behavior Risk Factor Surveillance System, 2003).

Snacks and TV Viewing:  Serving snacks to children while they are engaged in other activities such as watching television is associated with increased intake of high energy, low nutrient foods which may lead to unconscious overeating and unwanted weight gain. (Coon, K.A., J. Goldberg, B.L. Rogers, et al. Relationships between use of television during meals and children's food consumption patterns, Pediatrics 107: E7, 2001)

Breakfast:  "Breakfast: Waking Up to a Healthy Start" September 1998 Archives of Pediatric and Adolescent Medicine, Massachusetts General Hospital

• Children who increase their participation in school breakfast programs tend to show improvement on a wide range of measures of social and academic functioning.
• Increased school breakfast participation correlated with less tardiness and absence, higher math grades, and reductions in problems like depression, anxiety and hyperactivity.

Active Play:  Overall, 26% of US children watched 4 or more hours of television per day and 67% watched at least 2 hours per day.  Non-Hispanic black children had the highest rates of watching 4 or more hours of television per day (42%).   Boys and girls who watch 4 or more hours of television each day had greater body fat (P .001) and had a greater body mass index (P .001) than those who watched less than 2 hours per day. National Health and Nutrition Examination Survey III.

A study of individuals aged 15 and older without physical limitations found that the average annual direct medical costs were $1,019 for those who are regularly physically active and $1,349 for those who reported being inactive.  "Higher Direct Medical Costs Associated With Physical Inactivity." The Physician and Sportsmedicine 28(10). Oct 2000.

Fast Meals at Home vs. Fast Food:  "Eating at Fast-food Restaurants More than Twice Per Week is Associated with More Weight Gain and Insulin Resistance in Otherwise Healthy Young Adults."  National Heart, Blood, and Lung Institute Press Release, Thursday, December 30, 2004, accessed 2/22/05, http://www.nih.gov/news/pr/dec2004/nhlbi-30.htm

Food Portions and Body Weight:  McConahy KL, Smiciklas-Wright H, Birch LL, Mitchell DC, Picciano MF. Food portions are positively related to energy intake and body weight in early childhood. J Pediatr 2002;140:340-347.

Beverage Consumption:  Frequent beverage and snack consumption are likely contributors to the increasing obesity epidemic.  Energy density and beverage consumption in American Adults 1999-2001. Nielsen, S., and B. Popkin. Obesity Research. 719-P, 12(supplement): A183, 2004.

Why We Built the Kit

“Because of the increasing rates of obesity, unhealthy eating habits, and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents.”
U.S. Surgeon General Richard Carmona

Why Focus on Creating Fun & Fit Families?
Obesity is one of the most serious health threats our country faces today, threatening the health, productivity and wellbeing of our nation ­ and your business.

Behind smoking, obesity is the largest preventable cause of disease and premature death in the U.S. And the Centers for Disease Control warns that it could soon surpass smoking if trends continue as they are.

That’s not surprising when you consider that today in the U.S. 65% of adults – 2 out of every 3 adults – is overweight or obese. And more than 9 million children are considered overweight or obese.

And whether folks are just 20 pounds overweight, or severely obese, the health risks as a result of excess weight are real and serious, contributing to a host of diseases and chronic health conditions, including:

A Nation in Crisis
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Obesity has reached near epidemic proportions in our country. And the dramatic rise of childhood obesity has caused some to call it the health crisis of our generation.

And while obesity is clearly a national epidemic, the severity of the problem varies by region. As the map indicates, the problem is most severe in the Southeastern United States.

And childhood obesity is currently on a trajectory to double every 20 years – only adding fuel to the fire.

Why Business Should Care
As the prevalence of overweight and obese workers grows, so do the costs to care for these people.

In fact, according to the U.S. Surgeon General report on Obesity in America, 9% of the nation’s health care expenditures – $123 billion dollars a year – are due to obesity and overweight.

That’s not surprising when you consider that obese individuals spend 36% more on health care services and 77% more on medications than individuals with normal weight.

And for employers, the costs are compounded by the disability and lost productivity that results from obesity-related disabilities ­ with disability costs for overweight and obese folks averaging in excess of $8700 per claimant, per year.

What We’re Doing to Help
CIGNA has teamed up with Healthy Kids Challenge to provide educational materials and tools to support the multiple influencers in a child’s life:

• Teachers
• School Nurses
• School Food Service
• Physical Education Instructors
• Pediatricians
• Family Practitioners
• Parents & Families
• Businesses & Cummunity

What You Can Do to Help

• Implement the Fit & Fun Families program at your worksite.
• Sponsor a Healthy Kids Challenge school in your community.
• Make a tax-deductible donation to Healthy Kids Challenge.

CIGNA, Healthy Kids Challenge and You
Together we can help improve the health outlook for today’s employees and families – and tomorrow’s workforce.

Sources:
1 – Centers for Disease Control; 2 – National Center for Health Statistics, 1999–2000; 3 – Surgeon General, Obesity in America, National Health Policy Forum, July 2003 Barbara Moore, Shape Up America.

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