1. CATCH School & Family Health Education Deanna M. Hoelscher, PhD, RD, LD, CNS Director, Michael & Susan Dell Center for Advancement of Healthy Living University of Texas School of Public Health, Austin Regional Campus Steven H. Kelder, PhD, MPH Co-Director, Michael & Susan Dell Center for Advancement of Healthy Living University of Texas School of Public Health, Austin Regional Campus

2. Trends in U.S. Youth Obesity 1 1 Obesity is > 95th Percentile for BMI by Age/Sex Sources: Ogden et al., 2006; Ogden et al., 2008 HP 2010 Goal

3. Relationship Between Weight Gain in Adulthood and Risk of Type 2 Diabetes Mellitus Relative Risk Weight Change (kg) Willett et al. N Engl J Med 1999;341:427. Men Women -10 -5 0 5 10 15 20

4. Increase in Healthcare Costs Among Obese Compared with Lean (BMI <25 kg/m2) Patients* Increase in Cost Compared with Lean Subjects (%) BMI 30-34 kg/m 2 BMI > 35 kg/m 2 Quesenberry CP Jr et al. Arch Intern Med . 1998;158:466-472. *HMO Setting: Northern California Kaiser Permanente. Healthcare visits Pharmacy Laboratory tests All outpatient services All inpatient services Total healthcare

5. Tracking of physiologic variables % Remaining +- one quintile Source: Kelder et al, Preventive Medicine (in press) 2002

6. Effective Obesity Prevention: CATCH & Community

7. Coordinated Approach To Child Health (CATCH) Classroom Curriculum Physical Education School Food Service Family

14. WHOA Highest fat and sugar SLOW Higher in fat and sugar, more highly processed GO Lowest in fat, no added sugar, whole grains, fruits & veggies skim whole

18. Moderate to Vigorous PA (Percent of Lesson Time) Healthy People 2010 Objective 1.9 Semester

19. CATCH Dietary Outcomes 3 Years Post-Intervention (8th Grade) Dietary Fat, % of Energy School Grade CATCH Source: Nader et al., 1999

20. El Paso CATCH replication. Risk of Overweight or Obesity in Girls ( > 85 th % BMI) * * Source: Coleman et al., 2005; * Significantly higher than 3 rd grade (baseline). 11%, 3 year effect size

21. Pass & CATCH improves Stanford math scores * * * Murray (UTSPH), unpublished At Risk : adaptability, social skills, leadership, study skills, functional communication

22. A Public Health Approach to Obesity Prevention Intervention Efficacy Public Health Impact!! Population Reach X

25. Percentage of PE class time 3 rd , 4 th , and 5 th grade students engaged in MVPA (n = ~103 class observations). Travis County CATCH Project. a, b b, c [a: p = .023; b: p = <.001; c: p = .001.] HP 2010 Goal

28. Trends in Prevalence of Youth Overweight 1 United States Compared to Texas 1 Overweight is > 95th Percentile for BMI by Age/Sex Sources: Hoelscher et al., 2004; Ogden et al., 2006; SPAN, 2004-2005 HP 2010 Goal

29. Efficacy X Reach = Public Health Impact *Obesity is > 95th Percentile for BMI by Age/Sex 2000-2002 2004-2005 4th Grade Prevalence of Overweight* by Health Service Region, SPAN, 2000-2002 to 2004-2005

35. State = 169 schools R10 = 10 schools R11 = 8 schools

38. Reported PE and Recess Min per Week 135 min per week PE days - log 4.83 4.41 PE days – child 4.23 3.46 Recess days – log 4.16 1.18 R10-R11 = 82 min/week

39. Direct Observation of PE Class (SOFIT; n = 19 schools) HP 2010 objective MVPA = % of PE class time where students are engaged in movement to vigorous physical activity

41. Trends in Prevalence of Youth Overweight 1 United States Compared to Texas 1 Overweight is > 95th Percentile for BMI by Age/Sex Sources: Hoelscher et al., SPAN, 2004-2005 HP 2010 Goal

42. Change in Prevalence of Overweight Among Texas Health Service Regions, SPAN, 2000-2002 to 2004-2005, 4 th Grade *Statistically significant difference (CI do not overlap) HSR 2000-2002 CI 2004-2005 CI 1 20.0 17.0-23.3 23.0 18.6-28.0 2-3 21.1 17.0-25.8 20.9 19.4-22.5 4-5N 21.3 18.9-23.9 20.6 18.0-23.6 6-5S 28.5 18.8-40.6 22.6 13.8-34.7 7 23.3 20.2-26.6 23.5 19.5-28.0 8 30.3 24.9-36.3 28.7 24.0-34.0 9-10* 25.8 23.5-28.3 18.8 15.1-23.3 11 25.8 21.8-30.3 30.6 26.8-34.7

43. Average BMI