Monday, March 17, 2014

Prevention Obestiy 911

TAG of the Week:

Obesity is now a  public health emergeny.

Read this week's reading on obesity, life-course perspective, and these two news link.
In your comment: briefly propose an intervention using the life-course theory to decrease obesity. 

Comments on this

Obesity Is Found to Gain Its Hold in Earliest Years


Can Mom's Pregnancy Diet Rewire Baby's Brain For Obesity?



72 comments:

  1. Lauren TamburelloMarch 17, 2014 at 4:55 PM

    Life course perspective intervention for obesity would be very effective because we know that obesity is due to many environmental, genetic, as well as behavioral factors and that there is recent evidence that shows that prenatal diet and early life are crucial in the development of obesity. It is important that research studies obesity development over years of life. Based on the research, an intervention that aims to improve maternal diets and emphasize healthy eating during pregnancy and lactation would be effective in reducing excessive weight gain of mothers and consumption of too many fatty acids, which have been shown to increase the rates of obesity in children. I think OBGYN doctors need to ask pregnant mothers what they are eating and monitor their weight gain. Mothers gaining too much weight or eating improperly should be referred to a dietitian. In addition, the evidence also shows that obesity is established in early life and that those who are obese in kindergarden are much more likely to be obese in eighth grade. This means intervention efforts need to be implemented as early as kindergarden. I propose that healthy eating habits should be taught in schools, exercise encouraged, and primary care physicians and pediatricians need to be monitoring the weight of children and making sure parents know and introduce healthy eating habits in the home from a very young age. This ensures the continuation of healthy eating habits throughout the child's life.

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  2. I agree that life course perspective intervention would be a good course of action for the reduction of the obesity epidemic. Because research shows that the factors that influence obesity can be found as early as in pregnancy and are instrumental to causation of obesity as early as the first few years of life, a course of action that includes changing these contributors throughout the life span would be most beneficial. I was actually really surprised about the effect pregnant moms' diets have on their children being obese later in life. I know that obese moms are more likely to beget obese children, based on genetics as well as perpetuated lifestyle factors and choices. However, it was still jarring to me to find out that the diets of mothers who are not even obese can effect the outcomes of their children. As we learned earlier in the semester, through the use of genomics, it makes sense that the diets of past generations can have impacts on the health of future generations, but this phenomenon is different from even that. This makes me wonder about the mechanisms that cause this phenomenon to actually happen. Is the genome actually being changed in the almost fully developed child in the third trimester from the mother's diet, or are the mother's actions rewiring the child's brain in this time? Is the mother who eats a high-fat diet during pregnancy but is not obese also at risk for becoming obese after pregnancy with the same changes happening in her brain?

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  3. I think that life-course perspective is helpful in reducing obesity. I also think that more money should be put to nutrigenomics to increase the studies that directly impact how we understand the food-human body interaction.

    I think that since so much research indicates that the mother’s diet has severe consequences on the child’s growth, implementation of a mandatory nutrition course for the 9 months of pregnancy and a few months after birth would be incredibly helpful. Although I feel many people would opposed to this type of compulsory intervention, I think that it would get mothers who aren’t aware of their eating habits to make an effort to change in order to keep their baby healthy. It might even be a better option to enroll both parents into this course, or to make it obligatory and offer incentives like discounts on baby formula if parents participate. This type of intervention would increase awareness to fight obesity and the risks that come with it, focus on healthier eating for the long run, and teach the parents about how food really impacts their immediate and future health – possibly even their grandchildren’s.

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  4. I think that diseases and conditions that have a genetic component as well as a lifestyle component, such as diabetes, heart disease, and obesity, are very interesting. You cannot change your genes, but you can change your lifestyle. In terms of obesity in children, it is extremely important to educate parents about how these processes in the body work, and what they can do to combat them. A problem with this though, is it can cost a lot of money, and involve major lifestyle changes such as a complete change in diet and everyday activities such as TV watching. I think that the second article about mothers’ diets during pregnancy affecting their offspring’s’ weight very interesting as well. You can’t change your genes, but, according to this preliminary research in mice, mothers have an influence over their child’s obesity battle before they are even born. Prevention is the best solution to many public health problems, and obesity is one of them. More research is needed in this topic as it pertains to humans, but it is a fascinating subject.

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  5. Haniya Saleem SyedaMarch 18, 2014 at 2:24 PM

    I think interventions built on the life-course theory are necessary and can have a huge impact on the obesity issue in this country. The issue that we deal with when it comes to public health interventions in the US is the lack of funding. Only 3% of the country's healthcare expenditures go to prevention making it crucial to create and implement interventions that will lead to effective improvements to the health and wellness of communities.

    If the problem of obesity starts at an early age and fetal stage of life due to environmental and lifestyle factors for both the mother and child, regardless of the roles genes play, interventions should target these sensitive stages of life. One possible intervention is starting mandated nutritional programs for expecting mothers or free nutrition consulting for expecting mothers.

    I think the problem with interventions targeted at kindergarten children or school based programs is, not only that the obesity problems starts earlier according to this study, but that often, children have very little control over what they eat. Parents control what children eat. They cook for them, pack their lunch, schedule their day. Interventions should target parents in order to make an effective lifestyle change in children. Guides and resources for healthy lifestyles must be readily available to parents. For example, healthy cooking recipes, activities involving physical movement, and advice from experts should be made available to parents whether it's from an online resource, or easy-to-read pamphlet guides handed to parents by their children's pediatrician during their checkups. By getting pediatricians involved in the process, parents can use them as a resource for questions and, by having the pamphlets given at every appointment, the information on the pamphlets can be age targeted.

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  6. I think an implementation of a mandatory nutrition course for expecting mothers that Anika suggest is a very interesting idea. I also agree that more people would be willing to do it if there was an incentive--especially for less well off mothers-to-be that may tend to eat foods in higher fats because it is a cheaper alternative. Around the same idea I think there could possibly be an option to have mothers enroll in a nutrition plan with their OBGYNs. Maybe something along the lines of those smoothie weight loss programs that the meals are easy and planned out for you but one more geared to expecting mothers. Something that they take once or twice a day that will enhance their nutrition while pregnant. I also think it is really hard to get everyone on board with that even with an incentive. I could be beneficial if there was more of an emphasis on nutrition of the mother during check-ups so that they are aware of the implications. Another problem is after the birth and the importance of the first couple of years. If pediatricians offered a more insight and made more frequent and regular check-ups this could help. Overall it's a very interesting and serious problem but one that is very hard to control because of how different everyone and their diet is. Not saying it would be impossible to implement but definitely a long time challenge.

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  7. Michelle TagermanMarch 18, 2014 at 8:23 PM

    The life-course theory could be very useful in creating interventions to decrease the rate of obesity. Since there are many factors that can lead to or cause obesity, ranging from genetic mutations to behavioral influences, it is important to take a holistic approach to combating obesity.

    Since many people who are going to become obese do so at a young age, usually by age 5, it is important to address this issue early in life. While some have stressed the importance of pregnant mothers eating healthy and not being overweight or obese, I feel that if an obese woman becomes pregnant, it is unlikely that she will be able to significantly change her eating habits and lose weight during her pregnancy. Since “obese mothers beget obese children,” we need to fix this issue before a woman becomes pregnant. This is why nutrition counseling for pregnant mothers is not enough. We need to fix this issue before pregnancy.

    To do so, we need to address the issue of a lack of education about healthy diets and exercise habits and the high costs of many healthy foods, foremost. We need to make the healthy choice the easy choice, and thus make fruits and vegetables cheaper and more appealing than fast food. We need to change the culture of eating processed, high-fat and high-calorie foods. In addition, focusing obesity interventions on high risk groups, such as those of low socioeconomic status, we could decrease the rate of childhood obesity.

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  8. I do believe healthy eating is something that should be encouraged during pregnancy. However, we must also keep in mind that for many women their appetite and ability to keep down foods is impacted when pregnant, resulting in many of them developing otherwise strange eating habits and preferences. Nevertheless, I think that the core cause of obesity in these young children can be attributed to how they were fed when infants. The first study fails to take into account whether or not these "fat kindergarteners" were bottle or breast fed. Bottle-fed babies tend to be over fed, which may be a potential confounding factor that they are overlooking in the first study. If this is a contributing factor to the overwhelming prevalence of obesity in young school children, the solution is educating parents of healthy eating. Although I do think the previously suggested compulsory nutrition program does sound helpful, maybe there should be a program that solely targets children born at a large weight because they are more likely to become obese at a younger age. By implementing the compulsory nutrition program for parents of larger (and therefore more at risk for obesity) infants, we can create focused programs that may be more financially feasible considering the small portion of our current healthcare budget appropriated for preventative efforts.

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  9. Both of these articles were very interesting, and gave me some new perspective when thinking about what affects obesity. Unfortunately, as mentioned in the article, even kindergarten may be too late to begin implementing changes such as diet and exercise. This must start from the beginning.

    Therefore, I agree with Lauren that earlier intervention can start with OBGYNs. Many people, myself included, are simply unaware that the diet a mother has during pregnancy can have a great effect on children. Expectant mothers should definitely be educated on proper nutrition, exercise, and proper weight gain during pregnancy.

    However, I feel as though this is more of an overall lifestyle change. I think that those who are at highest risk may not be the ones to seek out the help of an OBGYN, or pediatrician or any health care worker. These are the ones who may have poor diet and exercise habits already. Therefore, I propose that more public health messages should be made available to increase awareness of these concerns for obesity and why it matters to new mothers and their children, such as the health impacts in the future. Furthermore, I believe that health professionals should also be more available and affordable in areas at highest risk, which may include the poorer neighborhoods. This could happen through non profit organizations, volunteer work, etc; I simply believe that more attention and care should be given to high risk neighborhoods, and as early as possible.

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  10. I was surprised to find such a strong association between mom's diet and the likelihood of the child becoming obese. I knew that obesity was genetic, but the fact that maternal diet alone could have such strong implication is shocking. I think the most essential and important intervention is to make people aware of this. These studies need more media attention, and doctors should inform all female patients in childbearing age. I think most people know what they should, and shouldn't be eating, and the effect it will have on them, yet they still don't change anything. However, if they knew the affect it would have children they would be much more like to do something. Many woman try their entire lives to quit smoking, but aren't successful until they are pregnant, and have extra motivation.

    Secondly, many woman cannot afford to eat costly fruits and vegetables, especially if they are out of season or live in certain areas. The cheaper foods are generally unhealthy, or low in nutritional content. So maybe as part of the welfare program, like food stamps, or as part of a publicly funded health care program like medicaid, there should be a special program and grocery stores for pregnant woman, that provide healthy food for free or at a subsidized cost.

    Finally, I agree with Michele that we need to address the bigger overall problem, which is the obesity epidemic. Obviously both schools and health institutions need to increase educational nutrition programs. I also believe schools should have daily PE classes for students not participating in sports.

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  11. The quotation at the end of the second article truly resonates, "Genes, at this point, are not modifiable, whereas diet and pregnancy weight gain are." It is not new information that what you eat influences your body and your children. It seems rather selfish for a mother to ruin their child's (in the womb) health, which depends heavily upon the mother's actions. It was found years ago that drinking alcohol during pregnancy led to fetal alcohol syndrome, which debilitates the child. It seems intuitive that a mother's actions truly affects the health of their child. If one are pregnant, you need to keep your children in mind while you eat, because you are essentially feeding yourself and your child in the womb. If one is determined to keep your children away from high-fat foods, it does not make sense to eat high-fat foods while you're pregnant. People cannot change their genes, and their predisposition to obesity, but people are able to control what they eat, and what to avoid to prevent triggering the genetic predisposition. It seems almost depressing that once a child is a bit overweight or is obese while they are at the sensitive period of their childhood, they can no longer stray from imminently becoming or staying obese.

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  12. These two articles were quite interesting and informative. I had read a number of articles related to obesity in its earliest years," however, I didn't realize that kindergarten was such a breaking point in obesity. It seems that children seem to stay obese if they are still overweight by kindergarten, and "if you can make it to kindergarten without the weight, your chances are immensely better" [of not being overweight]. This was quite eye-opening.
    However, if a child is to maintain a healthy weight to kindergarten, doesn't mean a healthy lifestyle should start during kindergarten; it must be started way before. I think it's up to the parents to be educated properly and feeding their children properly and up to them to lead their child in the right direction regarding food, diet, and exercise. And in order for this to happen, I agree with what a few students have agreed upon, and that is early intervention with OB/GYNs or pediatricians. It would be a good idea for these OB/GYNs or pediatricians to have their place accompanied with some sort of diet/nutritional plan. This should include a healthy plan not only for the expectant child, but also for what the mother's diet should be like as well.
    For those already obese or mothers who are already obese and pregnant, I think in the end, it really comes down to making the right decisions. Make healthy lifestyle choices, eat the right kinds of food, keep things in moderation, and at least do the minimum amount of exercise. Though I see see how nutrition and genomics can go hand-in-hand, I'm afraid people will just blame being overweight due to their genes and go on with their poor lifestyle choices. In some cases, it's just a matter of self control.

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  13. Both articles have further solidified for me just how important it is to recognize and try to resolve the obesity epidemic. I believe that because obesity has so many underlying roots, like genetics, lifestyle, social and environmental factors, among others, it needs to be dealt with from many different angles. One important angle to use would be the life course perspective.

    Using the life course perspective with obesity could be extremely effective to start with moms, and specifically their eating habits during the third trimester. It's important that their clinicians and OB/GYNs stress the importance of healthy eating habits for their babies futures. However, I do agree with Kendra when she says that this is more of an overall lifestyle change. Many of those at high-risk don't have a doctor, or don't see one regularly, thereby they would not receive extra counseling or advise on their nutrition, since they aren't receiving any at all. Public health measures are needed to educate and make aware those who are at high-risk.

    As with many other public health problems, I feel as though obesity also ties in with SES and race. Obesity is entangled in a web of many different social determinants, and in order to fully make change we need to get through every root and every determinant, to make an effort to better improve our health system in general.

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  14. While I think educating children at an early age about healthy nutrition, I feel as though it is more effective to target expectant mothers. Many expectant mothers attend childbirth classes leading up to labor. These classes could include time in the schedule to discuss nutrition for both the mother and child. For women who can't afford childbirth classes, there should be more emphasis placed on discussions surrounding nutrition during doctor's visits. Many times the mother and doctor discuss the baby without really discussing the mother. If doctors were encouraged to discuss the mother's health and nutrition she could really learn a lot. Doctors could also print pamphlets and reading material so the mothers could read about nutrition on their own time.

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  15. An intervention using the life-course theory would greatly decrease obesity. The first component is to have a focus on education. Monitoring both maternal diet/health as well as the child’s diet/health as the mother’s diet can affect the child’s risk of developing obesity, as we also saw in the Ghost in Your Gene video. Perhaps expecting mothers can take a nutrition/dieting class to understand the effects of the food they eat on both themselves and their children, with easy to follow nutrition guides/pamphlets, and healthier alternatives to not so healthy food choices. Schools should also have nutrition classes for children to understand the importance of proper nutrition and the effects it has on their health.

    A second component for the intervention is exercise promotion. Being predisposed to obesity will always stay in your DNA, however, changing your lifestyle to exercising and being more active can prevent obesity. Schools should have better PE programs for all students, or perhaps a fitness education class on the importance of exercise.

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  16. One of the articles mention a study that found that 12.5% of children starting kindergarten were already obese. As a result, the target population for this intervention will be mothers who have recently given birth because they are the primary caretakers and will most likely be the ones deciding what their newborns eat. Primary care physicians should provide nutritional advice to mothers starting from when the baby is just born. Once the baby can start eating real foods, other than baby food and milk, the physicians should meet with the mothers again to discuss meal plans. Mothers who are overweight or obese should be reccommended to a nutritionist, where they can learn about nutrition and weight management for them and their babies. In addition, the nutritionist should provide mothers with a sample meal plan that is both affordable and culturally appropriate. Another possibility is the addition of cooking workshops that take place once a month to show mothers how to cook healthy meals and correct portion sizes.

    I believe that this intervention will be useful because it will teach both the mothers and the children healthy eating habits that can be sustained over the lifetime. According to the life-course theory, individuals are at risk of diseases and other health conditions even before they are born. As a result, children who have healthy eating habits at an early age will continue these habits. In the future, these children will grow up to become healthy adults and have children of their own. These children will then be less likely to become obese because their parents started healthy habits since birth.

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  17. Upon learning of a pregnancy, healthy lifestyle and eating habits must be instituted. This can start with a woman's first obstetrician visit. Topics such as diet and exercise should be discussed and the life-course connection regarding obesity and genetics needs to be introduced. If the woman is currently obese it should be highly recommended that a nutritionist is involved in planning meals and giving advice throughout her pregnancy. This will not only help the mother keep a healthy weight after the pregnancy but also helps the child avoid becoming obese early on and further when they grow up.

    According to Kolata's article, obesity is predicted by age 5, which tells us early intervention in pre-schools is a priority. Restricting certain high fat snacks and beverages can be part of the solution and by introducing more fruits and vegetables to "snack time". From a socioeconomic prospective, not every family has the means and access to maintain a diet that will lead a child to healthy habits. Children's tastes can be influenced easier at an early age before too many sweets and high fat foods become the preference.

    I believe these interventions can be helpful in preventing obesity in early childhood leading to a healthy adulthood.

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  18. I am a huge proponent of the life course perspective. I believe that implementing healthy lifestyle choices, such as nutritious eating habits, can make a huge impact on health outcomes (in this case obesity) in later stages of life. If obesity can be predicted a as early as 5 years old, I think that education interventions at or before this age could make a huge difference in decreasing the obesity trend. Like many of my classmates have already highlighted, even just educating women about the correlation between their eating habits during pregnancy and their child's risk of becoming obese could have huge, positive implications.

    However, for a life course model to be successful, both mothers and children of all socioeconomic status need to have equal access to education, healthy food sources, safe places to exercise, etc. Without changes in the current system, I do not believe that the life course model could be successful.

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  19. I believe the life course perspective is the only way to approach the obesity problem. My intervention to decrease obesity relies on early intervention. I would suggest the target audience to be children at preschool age as well as their parents. I would suggest physical education class during school be implemented earlier than it is currently. This would be at the preschool level. If children begin playing outside and running around at an earlier age they could be more likely to continue this routine as they get older. I believe the parents should also be included because they should be educated on what types of foods to cook and which ones to avoid. Parents can also have a big influence on monitoring children's behavior. One example would be promoting more outdoor playing and less time watching tv or playing video games. An intervention model like this would be very effective in my opinion.

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  20. Obesity is a growing problem in the United States. More and more children are becoming obese and developing health issues like diabetes and heart disease. Unfortunately for them, it is usually not really their fault at all. Children born to obese parents are more likely to struggle with their weight and be obese. A major change is needed to stop the cycle of obesity. Children that are at a greater risk of obesity due to genetics need to be monitored more closely and their parents need to make extra efforts to keep them healthy. Nutrition classes and more regimented physical education should absolutely be mandatory in elementary schools at a young age, so that children are comfortable with the concept of healthy living from the beginning.

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  21. As startling as this information is, after what we've learned in class, I don't find it all that surprising. The environment plays a crucial role in deciding our fate, so saying that a woman's eating habits while she's pregnant or a child's weight early in life is an indicator of obesity later in life doesn't seem all that far-fetched to me. Armed with this new information, health care professionals may be even more successful in preventing obesity, as they can educate pregnant women and new mothers on proper nutrition for women and their young children.

    That being said, the intervention I propose centers primarily around education. By educating pregnant women on the importance of eating healthy, public health officials could possibly slow the growing problem of obesity. I suggest holding classes or seminars for expectant or new mothers. These classes would go over the importance of eating a good diet, what kinds of foods to eat, and how the women could take steps to help their children be healthy not just in the near future, but later in their lives, as well. I feel as though the most important thing is spreading the word about the connection between a mother's diet and obesity in the child. Women may be a little reluctant to make a lifestyle change for their own sake, but they would probably be much more likely change their habits if they knew their lifestyle could impact their children in such a negative way. An educational intervention would be the best method to get this information to the public.

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  22. The life course perspective is a crucial tool for evaluating and implementing interventions for both infections and noncommunicable diseases. Obesity has become an epidemic in the United States, threatening the livelihood of adolescents and adults of various ages. Children who are born to obese parents have a much greater risk of eventually being obese than those who are not born to obese parents. With the life course perspective in mind, I believe that the most effective intervention must focus on the education system. Children and adolescents spend more time in school than anywhere else. This is also a very vulnerable time in their lives where they are susceptible to various risk factors that promote the development of obesity. Schools need to be required to promote healthy lifestyles through various interventions such as mandatory physical education classes, nutritious lunch options, interactive health education classes that keep students engaged, and after school sports programs that encourage physical activity. Many schools do this, but more effective programs clearly need to be implemented. The life course perspective and other scientific research has shown the vast contribution that adolescent health, specifically obesity, has on adult health. Intervening in adolescents and teens will lead to lower rates of obesity in adulthood and have a positive effect on the cyclical relationship of generational obesity.

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  23. These news articles show more information about the obesity epidemic in the United States and sheds more light on adolescent obesity that is very important to realize. I was shocked when I read that more children who are obese or overweight by 5 will most likely be overweight/obese as adults. This research shows the need for interventions not just to pediatricians and OBGYN's, but also to parents. Mothers who find out they are pregnant need to immediately change their diets so that they are eating nutritious foods for their baby. And after they have the baby, parents need to make sure that their child is eating nutritious foods at home. This is difficult for families who live in poverty and do not have the resources to feed their children good meals. So, I think an intervention to provide food assistance in impoverished areas to help parents of newborns and toddlers as well as pregnant women would be helpful. Also, making sure that schools have the money to provide nutritious and healthy foods once the child is in school will help curb the obesity epidemic. The life course perspective shows that a healthy lifestyle including nutritious food and access to physical education is necessary for children to become healthy adults. The articles show that there is a vast need for these interventions in pregnant women and children under 5, but there is also a need for more programs to help after the age of 5 as well for those children who are overweight to help them live a healthier lifestyle to hopefully combat their chances of staying overweight or obese in the future. The interventions would need to be given through OBGYN's to pregnant women and through pediatricians/communities to parents of at risk children. These interventions are necessary everywhere in the US but starting them in impoverished communities would be a great start.

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  24. Obesity in children is a growing problem in this generation due to the availability of unhealthy food, the lack of incentive to exercise, and new researcher citing the mothers diet during pregnancy has an effect on a child’s genetic makeup. The life course perspective would be a good way to combat childhood obesity. As we have learned, epigenetics involved both genes and a person’s environment and situations. This being so, although you cant to change your genes, you can change your lifestyle in order to be a healthy person.

    I believe it is important for young children to be involved in healthy eating and exercise starting as early as possible. Parenting books should include ways to teach your baby about nutrition and also exercises to do with them. Most children learn by example, so by cooking and eating similar things as your child will help them to learn what to eat. Limiting exposure to unhealthy foods such as fast food will deter children from eating it. Pre school programs should have healthy eating and exercises integrated into their curriculum. As one article is stated, by the time the children are in kindergarten sometimes it is too late to deal with their obesity problem. It is essential to prevent obesity in children, rather than to treat it. This is the job of the mother, the parents, and any other daycare or preschool setting children are in.

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  25. If epigenetics has taught us anything, it is that a genetic predisposition for a certain health outcome does not definitively result in the health outcome; there is always the possibility of avoiding it. For a health concern such a obesity, life course perspective and primary prevention could have a huge impact. Over the course of one's life, he or she will develop certain eating habits, the problem is how can he/she pick up the good habits? In this situation, food and nutrition education is so important. For example, for as seen in the NPR piece, a baby can pick up a mother's eating habits while in the womb. If expecting mothers were urged by doctors about the possibility of their eating habits could predisposing their children to obesity, maybe mothers would be more conscious of what they're eating. From there, healthy eating habits should continually be promoted among families and schools. However, there is also the possibility that families cannot afford nutritious foods and are forced to turn to fast food alternatives. I agree with Lindsay above, that families who live in poverty may not have to resources to adequately food their children good meals. Socioeconomic status plays such a huge role in one's health ... education leads to jobs, jobs leads to money, money leads to resources and good resources lead to good health. If we were able to decrease the disparities due to SES, (e.g. through government funding), health outcomes, not just for obesity, could be greatly improved. Everyone could get the necessary education and support necessary to live a healthy lifestyle.

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  26. Both articles show us that both your genes and your environment play a role in your overall health. It seems to me that the best place to start targeting obesity would be with pregnant mothers. There are dozens of different rules that a woman is told to follow when she is pregnant, from limiting caffeine intake to taking vitamin supplements to support the baby's growth. Doctors should include recommendations for healthy eating in order to promote a healthy baby. Pregnant women should have nutritional information available to help them understand that decisions that they make both during and after pregnancy can have a lifetime effect on their children.
    With this information available, parents will be better equipped to deal with any genetic predispositions to obesity. Armed with the knowledge that a child who is overweight in kindergarten is likely to stay that way, will allow parents to take an active role in providing a healthy diet and exercise opportunities (riding a bike as opposed to watching television) for their children.

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  27. These articles were interesting but also had many controversial implications. I remember learning a year or two ago that people could be genetically predisposed to obesity and diabetes, which I remember caused an immediate reaction of sympathy. I felt as though obesity was out of certain people's control. Like my initial reaction, many people take a genetic predisposition as a sort of justification for a certain state. These articles imply a hopelessness, a permanent fate- which is not at all the case. Just because someone is genetically susceptible to a condition, does not mean they will become that way- as with the case of many other known genetic diseases. These articles downplay the epigenetic effects of diet and exercise. Instead, knowledge on genetics should be incorporated into pregnancy literature and classes alike to combat the obesity epidemic in the US. The more knowledge generated on genetic effects during pregnancy and the first five years of a child's life, the more parents will be able to clearly differentiate between malnourishment, adequate nourishment, and excessive food intake. However, education does not guarantee behavior change. Before this knowledge on genetics influencing obesity was known, people still had an idea that obesity was hereditable. Yet many still fed their children chemically processed, empty-caloric foods that are publicly known to cause obesity. While there are many reasons that might cause this behavior, one prominent reason is the optimism bias (or the belief that bad things will only happen to other people, not me or my children.) That is why, along with increased education, I propose that physicians come up with a way to clearly show the effect of improper food intake on an obese individual's body. Even genetics is arbitrary- so telling a person they are genetically susceptible (via a mutation) might go in one ear and out the other. In a life-course intervention against obesity, the cardiac and respiratory symptoms must be shown clearly (perhaps by visual computer simulations based on different BMI's) and the prospective results must be simply stated and/or displayed.

    As an aside, I came across a funny Buzzfeed quiz entitled "Are Your Genetic Traits Dominant or Recessive?" The quiz implies that dominance and recessiveness are dichotomously more prevalent in an individual person, which of course is not always the case. One recessive trait does not increase the likelihood of a second, separate recessive trait. I found it a funny example of how media adds to the confusion of genetics. Here it is if anyone wants to take a look:
    http://www.buzzfeed.com/kasiagalazka/are-your-genetic-traits-dominant-or-recessive

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  28. While it comes as no surprise that obese and overweight mothers would give birth to high birth weight babies who are at risk for obesity, I was surprised when I found out that a poor diet during pregnancy even for somebody of normal weight could have such an impact on the obesity risk for their children. Armed with the information that children who are obese and overweight in kindergarten, as early as 5 years old, can multiply the likelihood of being obese and overweight in 8th grade, I would try to establish and intervention that controls and monitors maternal diet as well as controlling and monitoring young children with a high BMI, even before these children hit kindergarten.

    Controlling maternal diet, through interventions such as maternal nutrition programs, will help reduce the risk of having a child that will have to fight obesity across their lifetime. Furthermore, it is only by nature that some moms-to-be will still have poor diets and eat for two during pregnancy, which is where the second part of the intervention comes into play. For those young children with a high BMI, nutritional programs for these kids pre-kindergarten will help decrease their risk of continuing obesity into their later years of life. Simple programs such as increasing physical activity and reducing screentime may also prove to be highly effective.

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  29. Obesity is an epidemic that has been present in the United States for far too long. The US experiences higher rates of obesity as compared to any other country in the world. This is an issue that certainly needs to be addressed. The life course perspective with obesity is definitely a method that I think could bring about greater awareness of how to prevent obesity, especially for pregnant women in their third trimesters. The life course perspective combined with education will be widely beneficial, in my opinion. It is important to illustrate the epigenetic factors that influence the development of obesity in individuals. Nutritional education and counseling may also be efficient methods of ensuring that consequences of poor nutritional health can impact one's child while pregnant. As part of the nutritional counseling,

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  30. The life-course perspective could be a very useful tool in combatting obesity in the US. As the life-course article states, in order to reduce racial-ethnic disparities in birth outcomes, we need interventions that target the sensitive periods of development, but that are also sustained across the lifespan. I would propose an annual school-based intervention targeted at the parents of the students; in this way, it will cover the sensitive periods of early childhood and puberty, while also providing continued education and support to both the students and the parents. I believe that it should be targeted at the parents instead of the children themselves because I see them as having the most influence over their children's lifestyle behavior, especially in their early age. Additionally, studies have continuously shown that children's lifestyle habits that they carry into adulthood develop based on their parents. If this intervention can motivate the parents to change their negative behaviors, they can then influence their children to follow suit. More specifically, this intervention should be education based, but in a more interactive way. I imagine something attuned to an annual seminar that both teaches parents about healthy eating and physical activity, while also providing them with tangible tools of improving these aspects of their and their children's lives. Of course, there would need to be some sort of added incentive to get attain a high turn out at these seminars.

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  31. From these articles it's evident how important understanding the life course perspective for obesity is for people. I wasn't as surprised of how much your mothers' genetics plays a part in your weight. My mom can eat a lot and still be skinny, and I'm the same so I know the role of genetics in weight gain.

    I agree with everyone else who have said that intervention should start with OB/GYNs who should educate expectant mothers about the life course perspective for obesity and the importance of eating nutritious food during pregnancy. They should be also educated about keeping stress free during pregnancy. These advice should then be passed down to the children when they are born.

    While there are mandatory physical education in schools already, I believe that there needs to be more done by the parents in encouraging them to play outside more when they are younger. Joining or creating physical activities with them should be done also. Intervention should start with pregnant women and continue for the child when they are born.

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  32. Based on the life coruse perspective, intervention for obesity should occur prenatally. Expectant mothers, especially those who are predisposed to obesity, should be educated on proper diet during pregnancy. She should also be educated on providing proper diet and physical activity once her children are born.
    Despite the presence of physical education in schools, the curriculum should be tailored more to encourage more "fun" activities, with the goal of having obese children voluntarily lose weight. Nutrition and wellness courses should be included in the curriculum as well, exploring topics like healthy diets and physical activity.

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  33. It is evident that some form of health intervention must be implemented if Americans wish to end the increasing trend of obesity. One intervention that I would implement would be offering informational and educational nutrition counseling to newly pregnant women to stress the importance of healthy eating on their future child's life. Since this would technically be a "preventative care" intervention, under the new Affordable Care Act it should be covered by health insurance companies. Through this life-course approach, a longitudinal study could be done to follow the women and children who choose to utilize this program and those who do not. The results could then be compared to determine if this intervention has beneficial outcomes. It is clear that women's dietary choices during pregnancy, specifically during their third trimester is imperative to understanding the weight of their children over their life time. Moreover, healthy choices should be carried out until the child is ready to make their own choices regarding food; today, studies show that french fries are the vegetable consumed most by babies and small children, an obvious issue in American society. Lastly, we discussed the biological derivatives behind cravings in pregnant women; there are no biological reasons that women have these cravings and often women do not need to increase their caloric consumption as early in their pregnancy or as greatly as they do throughout their term. These are all factors that should be addressed since women may not be aware of these biological facts.

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  34. I believe that the life course perspective for any disease including obesity is beneficial. The article brings up a familiar concept that we learned earlier in the semester. We learned that ancestral exposures significantly affects future generations. This information ties into the fact that exposures that women face over the course of their lives may have an effect on their children. Therefore, I believe that there should be great efforts to educate women earlier especially women who plan to have children. This is important because we now know that genetics has a huge role in the etiology of disease. For instance, we learned today that mutations of beta-adrenergic receptors often lead to patients being overweight and diabetic.

    I agree with everyone else that OBGYN's should step up and inform their patients about risks and complications. I believe an educational intervention is needed because many women/people do not know that certain decisions or exposures can cause problems for their baby. The usual proposed solutions for obesity is to get people to eat healthy which sounds simple. However, this ideal is not feasible for most families because healthy food options are usually too expensive. Therefore, legislative policies need to be placed to provide adequate access to healthy food.

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  35. Alexander de GrootMarch 21, 2014 at 1:56 AM

    To tackle the obesity epidemic in the United States, I think it is important to create an intervention that addresses two key areas using the life-course approach: 1) the mother's diet and eating habits during pregnancy, and 2) weight regulation in children prior to their turning 5 years of age.

    Addressing the first key point, when a woman becomes pregnant, her doctor should consult with her regarding healthy eating habits and the positive impact such actions could have on her child's future weight. Furthermore, programs that encourage healthy eating and nutrition, such as WIC, should be expanded, so that lower income families can have access to healthy food sources.

    Addressing the second key point, once a child is born, it is important to ensure that his or her weight is maintained at a healthy level. A proposed intervention for this involves regular weight follow-up and consistent nutrition education prior to the age of 5 for all children. One way of doing this is through annual doctor visits. Doctors should keep track of the child's weight and provide nutrition education to parents so that their children are fed healthily. In an ideal world, however, such a program would be implemented in pre-schools. At pre-schools, teachers could teach students about healthy eating and lifestyle habits, as well as more consistently keep track of a child's weight. Unfortunately, the key limitation here is that preschools are expensive and the United States does not have a universal preschool requirement. In any case, it is key to ensure that children are not obese prior to turning 5, as studies have shown that children who are obese at that age tend to be obese in future years.

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  37. If we truly want to minimize the risks associated with obesity, there should be not only a focus on educating pregnant women but also granting them access to those resources that would allow them to utilize their new-found education long after the public health officials leave. OB/GYNs have a responsibility to educate these women, certainly, and I do believe that we should focus on teaching them about their diets and exercise in a manner that's accessible to them. After all, as we learned when watching the Ghost in Our Genes, mothers' diets can epigenetically modify their children's genes in a manner that puts them at a much higher risk than other children.

    Like Maureen said, healthy food options are usually too expensive for poor families - and those poor families often have a higher chance of obesity than wealthier families because of their SES. Legislation might be one route to ensuring that they receive healthier food, but community gardens or "pop up" grocery stores that supply fresh fruits and vegetables to those neighborhoods might be just as beneficial - and easier to set up - than passing a law to subsidize fruit crops. Education is only the first step in a crucial obesity prevention program; accessibility and affordability are the next two major stops that will ensure whether the public health officials intervened properly, or if they intervened in a manner that only addresses obesity in the short-term.

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  38. The life-course perspective is potentially one of the most valuable we have to combat the rising rates of obesity. There virtually indisputable out there that claims the content of the mother’s diet during pregnancy can drastically alter the developing fetus, even when it is as late as the third trimester. With this in mind, it is clear that interventions for the parents are necessary. In reality, many people are not mindful of how their actions will affect not only their health, but others as well. While it may be the children that are becoming obese, parents are generally the ones who dictate what and how much food they eat when they are younger. This, combined with misinformed parents, can lead children to becoming obese since these lifestyles are usually passed from a parent to their child. The first step to reducing the obesity epidemic in America is to educate individuals, both parents and children, about the consequences of their health choices. For parents, especially mothers, it is important for them to realize how every choice they make while they are pregnant, from food choices to doing drugs, can drastically affect the development of their child. For children, they are likely as educated about their health as their parents. Therefore, both groups should be targeted to effectively send the overall message.

    However, in my personal opinion, I am skeptical of the effectiveness of interventions such as this. As I am sure many people are aware, controlling people’s behavior is a very difficult thing to do. As of now, education is obviously our best course of action. However, people are ultimately going to do what they want. It is similar to how years ago the public was slowly becoming more educated regarding the harmful effects of smoking cigarettes. Still, even with the substantial amount of evidence presented, a good number of people still smoke today. Similarly, its difficult to outright have people resist cravings for high-fat content foods etc. Therefore, I think there should be stricter regulations on what kind of food is available to us. Research has shown the harmful effects of high-fat content food and while eating unhealthy is the current America’s way of life, we need to make changes regardless. Obesity may be slightly reduced over time with education, but as a society, we need to more than just educate people since a good number of people don’t seem to care about their health too much anyway.

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  39. I agree with everyone above about how the life-course perspective is necessary. Obesity is an issue that stems from a variety of factors and is a life-long battle for many people. It is not a quick decision; it is a lifestyle decision that must be maintained throughout a person’s life.
    I agree with many people as well about the important of stemming an intervention off of education. I, even as a person with a sufficient education in public health, didn’t realize that impact that a mother’s maternal diet can have on the duration of a child’s life. As one of the articles state, “Exercise and a healthy diet can often reduce, but not completely overcome, the effects of genes.” I always thought that the parents influence on obesity was more focused on lifestyle, so the education of the impact on genes and the difficulty to overcome those needs to be stressed to mothers.
    Where I disagree, is that there needs to be much more than education to truly make a change. A lot of these issues stem from disparities in income, location, ethnicities, etc. where just giving education doesn’t address the issues firsthand. One student mentioned earlier a mandatory course during the 9 months of pregnancy. I agree with this, as many mothers’ I’m sure don’t realize their impact. But in order to make it something people actually attend, I think it needs to be a fun, activity centered program so women have an incentive to attend. For example, through an OBGYN, a healthy cooking workshop where woman can talk to other pregnant mothers and learn how to cook healthy, quick meal options could be a great resource for woman. Each course should be designed specifically for the groups of woman present. Therefore, the specifically designed class could target the main reasons why the mother may not be able to eat healthy.
    In addition, I think another intervention that addresses accessibility of resources is critical. An intervention that I believe implementing would help would be to create a delivery system of healthy food or meals for women who can’t because of time, income, etc. Providing this during pregnancy could be a sliding-scale payment system to that way it can be accessible to everyone. Stressing this option could allow mothers to feel it is in their reach to create this healthy lifestyle for themselves.
    I also think that the “norms” of eating while pregnant need to be changed. I believe that many mothers have the mindset that women are hormonal and it’s okay to crave high-fat types of food. People use the excuse that they are “eating for two.” However, many women should realize that there isn’t really an excuse for this-it is a social norm that has been created that public health officials should work to change. If the norm was to eat healthy during pregnancy because your children’s risk of obesity during their lifetime depends of it, many more women would choose that option. People need to remember this is not a temporary change-it should be a lifelong lifestyle decision.

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  40. Public health interventions for obesity need to start taking place earlier in a child's life - perhaps even before the child is born. As both of these articles point out, obesity risk is very much determined by the time a child reaches the age of five. Public health interventions need to be done earlier and more intensely. I suggest creating two different campaigns that would utilize television commercials, billboards, public transit advertising, magazine ads, etc.

    The first should be focused on maternal health during pregnancy. The campaign should focus on the importance of eating healthily during pregnancy while being realistic about the effect weight gain during pregnancy has on that child's weight later on in his/her life. I don't think many women realize the connection between too much weight gain during pregnancy and obesity for their child. If the correlation was made into common knowledge by advertising that over 40 pounds of weight gain during pregnancy drastically increases a child's chances of becoming obese, women would have a clear idea of how much food/weight gain is unhealthy during pregnancy.

    The second should focus on diet and exercise in the very early stages of the child's life. This campaign should focus heavily on statistics because statistics are powerful when it comes to health. The campaign should be geared towards healthier eating. But just to be clear this campaign is for infants and toddlers, because like I mentioned before, much of a child's lifetime weight is determined by kindergarten. If the family has healthy lifestyle habits established by the time the child is in kindergarten, those habits will likely continue as the child grows.

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  41. The early years of a child's life is when he/she can be most susceptible to health problems that can persist onto adulthood. Obesity is a disease that does not always get the attention it needs when a child has shown physical symptoms being overweight. It is the assumption that a child can lose all that weight as he/she grows up that limits parents and health care professionals from providing necessary preventions.

    Genetic factors do affect obesity, but environmental factors are also as significant. Since it may take a while for doctors and scientists to tackle the genetic aspect of obesity, attention should be given to nutrition, an essential influence that we often neglect. From a public health perspective, an possible intervention program in kindergartens and daycare centers is one that focuses on educating the caretakers or teachers on nutrition values in meals and the importance of exercising. At home, parents should be able to receive similar information so that they can provide their children with appropriate meal plans. Another intervention program may be one that suggests ideal meals and daily exercises as guidelines for parents or caretakers to help children maintain a healthy weight.
    It is important to establish healthy habits in children from a young age, since it can significantly improve their health outcomes as they grow up and are exposed to even more environmental factors that may increase the risks of being obese.

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  42. There is no question that good health begins in the womb. In addition to obesity, other negatives outcomes that arise later in life such as stroke, heart disease, and (as we have learned) even diabetes are linked to the fetus's quality of life in the mother's womb. The transfer of chemicals into the placenta plays a huge role in the baby's outcomes in life. But another major factor, is obviously genetic predisposition. In combatting obesity, in future generations we need several prevention policies and interventions. A series of interventions would be necessary to combat obesity since it is indeed a disease of polygenetic nature.

    Developing a step-by-step lifespan plan would be the best method for those predisposed to obesity as well as those who aren't:

    1. Initiating OBGYN nutritional programs and exercise programs to keep pregnant women healthy
    2. Encouraging exercise programs and nutritionally focused classes for children as young as kindergarten age
    3. Restricting the sales (or increasing that taxes) on sugary, high saturated fat foods.
    4. Having policies in place to create rewards programs for those participating in YMCAs and acquiring fresh produce (particularly in the local hay markets that are substantially cheaper than grocery stores)
    5. Giving benefits to communities that have regular group "walks" or community "active programs"

    These are general recommendations that could easily be implemented and that can significantly change the behaviors that may exacerbate the expression of the obesity gene. Further, the plans can prevent someone who lacks the predisposition of obesity from developing the disease over the course of their lifetime.

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  43. In my opinion, a large issue with obesity prevention is the fact that US healthcare does not dedicate nearly enough resources to prevention itself. After reading the articles for obesity, it is evident that obesity prevention needs to start in the womb and continue into early childhood. Imagine the healthy lives that could be created and the healthcare costs saved from just eating right, from mothers to young children and beyond. Type 2 diabetes, heart disease, and high blood pressure all could be reduced just from controlling obesity. However, there is no other way to do this than with programs early on to educate parents and young children. If pregnant mothers were taught how to eat right during pregnancy, the effects on their child if they don't, and parents taught how to provide their children with a nutritious diet, the rates of obesity could decline immensely. While it is great that our country is beginning to promote nutrition and exercise, a focus on obesity prevention earlier in life needs to come to the forefront and education is critical in doing so.

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  44. I believe that obesity, as suggested by both articles, is heavily influenced by one's parents and their dietary habits. The reason that intervention programs in schools have not been as effective as we would hope is because children will get a decent meal at the school, but could return home to a meal high in saturated fats and sugars. One good meal will not constitute the loss of weight if the rest of the food eaten during the day is unhealthy. If parents tend towards obesity themselves, and have poor dietary habits, naturally their children will look to them as an example. It is important to focus on adults first, then the changes in diet and lifestyle will trickle down into their children's lives as well. This is no easy feat, however; as some people simply do not want to change, cannot afford healthy foods, or cannot afford to get the help they need. There are already food assistance programs in the US, but they do not necessarily monitor the types of foods that people will purchase. I recommend regulating food assistance programs by setting strict guidelines on what types of foods may be purchased. I would also suggest offering nutrition services for little to no cost in community clinics for those who may not necessarily be able to afford these services normally. For those who have no financial burdens, I believe that a program by physicians could be established that will inform patients of the potential dangers of an unhealthy diet; not only to themselves, but to their children as well. The general public does not search for this information on their own, presumably, therefore it is important to provide it to them in any way possible.

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    1. I agree with Brittany. Targeting children by educating them on important foods and healthy lifestlye choices is key, however, it is parents who must purchase and prepare the food for their children. Yes, a child can ask for vegetables and water if they know it is healthy for them but at the young stages in life where a nutritional foundation is established it is the parents who make all the decisions for their children. Also as Brittany has stated, access to healthy foods may be problematic for lower income families, however, there are also many government and non-profit subsidized agencies that aid parents in nutrition education and provide vouchers for healthy foods only. From personal experience I can say that genetics and food habits are most certainly co-contributors to obesity. As a child my parent were both fit but I was in the 95th percentile for weight and 50th percentile for height until third grade. I was always taught about the food pyramid, had physical education classes, and played many sports. When I went home, however, my dad was the main cook in the house in prepared food in a very southern way and loved when people ate as much as they wanted. This environment I believe is detrimental to children's health and is another reason why parents should definitely be the focus for targeting obesity in children. For the research it appears as though parents make their children fat by their lifestyle choices and the genes they pass along to their offspring.

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  45. I'm currently taking HS450 Noncommunicable diseases and learned that obesity is a risk factor for cardiovascular disease, diabetes, and cancer. So far what I learned from that class, the life-course perspective is a crucial evaluation tool to target causes of obesity and implement interventions where it can be most effective. However, the life-course perspective can be challenging to apply. Socioeconomic status is shown to be a determinant for obesity for those with lower socioeconomic status. Often, individuals under a low socioeconomic status cannot afford fruits and vegetables and opt for the unhealthier options and don't have the education or tools to live a healthy life style, such as their neighborhood infrastructure where there are no healthy grocery stores but only fast food restaurants, and no gyms (or people can't afford memberships) or a safe place to exercise. Overall, many factors within being of a low socioeconomic status can contribute to obesity. This affects children the most because parents are just continuing this unhealthy life-style and passing it onto their kids who are more likely to be obese growing up.
    Knowing what I know so far, my intervention to prevent this childhood obesity epidemic would be to implement more education regarding obesity and how to live a healthy lifestyle, especially within schools and in the doctor's office. Like one of the articles states, advice from the doctor isn't taken seriously or the doctor doesn't emphasize enough the importance of preventing obesity. A national education campaign needs to occur to educate the public and reeducate health care worker to strive to prevent obesity amongst the nation.
    As I have stated before, individuals may be educated about the dangers of being obese but may not have the means to counter it. Another intervention that can occur is to change the infrastructure of neighborhoods to assure access to healthy living. Examples include eliminating fast food restaurants and placing affordable grocery stores and gyms. My interventions would cost a lot of money and time, and would be difficult to implement due to the economy but it can offset the costs in the long-term from treating chronic diseases due to obesity.

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  46. After reading these articles, it seems that the best course of action is to start educating families when they become pregnant. I think exercise and dietary habits should be discussed by the doctor with the pregnant mother, helping her understand how her actions now can affect her child later. As Abbey mentioned, pregnant women are already told many guidelines to follow that help protect their child, and giving expecting mothers guidelines on how/what to eat would be beneficial.
    I agree with many of my classmates that life-course perspective seems like an essential tool in helping reduce rates of obesity, but I believe that our education system has to increase its contributions to keeping kids healthy. When I was in kindergarten, every month we would go to the school's kitchen and learn how to make a healthy afternoon snack; these are still snacks I eat to this day. I believe that making healthy choices fun for kids will help combat the bad habits many carry today, though obviously parents need to be willing to help their kids make healthy choices from a very young age.

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  48. Life-course perspective is a great and essential tool to prevent obesity. In addition I know the best way to prevent obesity is to enforce good habits with eating and exercise during childhood before adolescence and early adult/ pregnancy but that is the ideal situation. Having at least 30 minutes physical activity during the school day for children is crucial and should be mandated and observed throughout all school in the US K-8 even in high schools. The taking away of recess time is ridiculous. You cannot simply feed children healthy foods and then have them sit in class all day. The trick here would be to balance proper nutritious foods with an adequate amount of physical activity. Pregnant moms should be thoroughly informed about what they should and should not eat. Also pregnant moms need to hydrate adequately and be advised on what moderate exercise alternatives are available to keep them and their child safe and healthy.

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  49. Even though genetics and lifestyle both contribute to obesity I personally believe no matter your genetics you have a choice to live a healthy lifestyle. There are prevention methods out there such as healthy food choices and exercise. But this all starts with the parents of the world. Parents must be educated and able to teach their children that eating junk food and not being active will eventually lead to their children being sick or obese. Many health problems and diseases come with obesity, along with medical bills. Prevention techniques don't only save you money in the long run, they will lead to healthier lives and higher self-esteem. Being healthy can lead to better health mentally, physically, and emotionally, as they are all tied together. Obesity is an issue we must address more and more in the current world. These articles are very interesting, but I believe that prevention techniques are the best way to attack the obesity epidemic.

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  50. Based off the articles, I would say its evident that an obesity intervention needs to be developed around the critical development phases of children and fetuses. However, children and fetuses don't have the mental capability to make healthy choices yet. Therefor, if seems that interventions should also be geared toward the people that are taking care of them: their parents. The parents or guardians are the ones who children look up to and are raised by. They make all the executive decisions in the house and therefore are responsible for the well being of all the house hold members. We should think about offering more health education programs to all parents, including those expecting. These programs could be available anywhere including community centers, schools, and local clinics. They should focus on not only the importance of nutrition for children and infants, but also for parents as well. Because whether parents realize it or not, their children look up to them and mimic their every move. If a child sees their mother eating sugary, fatty, high caloric foods all the time, then they are more likely to do the same. As well, parents can also genetically pass down bad or good eating habits. This is evident by the mother's pregnancy article where she passed down her love of specific foods to her son. It seems that the problem of childhood obesity is complex and growing in complexity as more information comes out on the topic. However, if we tackle all players of the issue, and spread out the wealth of intervention, we might be closer to a viable solution.

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  51. Interventions would be most effective if implemented around age 5 since obesity is more or less determined by then. However, what children consume in early childhood is almost entirely up to their parents. Therefore, an effective way to address the childhood obesity epidemic would be to teach parents that good nutrition and physical exercise can prevent obesity in childhood and adulthood. Some parents, when they see their child gaining weight, might think to themselves, "My child is young and has plenty of time to develop healthy habits and lose weight." I think it would be important to educate these parents, as well as parents who have a tendency to put on weight themselves and parents who have a family history of obesity. Taking the time to explain to these parents how childhood obesity is an indicator for obesity later in life would be an effective way to reduce the obesity rate in young children. Hopefully, with more knowledge about overall health and obesity, parents would approach feeding their children a bit differently. They might start preparing healthier snacks or taking time to play outside with their children. Additionally, they might keep certain foods away from their children. For example, a family friend of mine introduced her child to McDonald's Kids' Meals at age 3. At the time, the child was probably too young to care that she was eating McDonald's but as she grew older, she requested dinner from McDonald's multiple times a week. Her mother struggled to say no to her, and by second grade she was quite overweight and physically inactive. I think instilling good nutrition at home, keeping high-fat content foods out of the house, and encouraging outdoor exercise are easier said than done but if properly implemented, these methods would prevent childhood obesity and therefore obesity later in life.

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  52. After reading the articles it is clear that an obesity intervention must be set up. As many of the previous comments have stated, infants and young children do not have the capacity to understand healthy food and exercise choices. Most of the time they do not have the luxury of choosing for themselves what they eat or what activities they participate in. Therefore, I feel that the burden relies heavily on the cooperation between parents, physicians, and school administrators. Physicians need to keep a closer eye on children who may have a predisposition to be overweight and guide the parent in how to help prevent an unhealthy weight and maintain a healthy weight for their child. In addition, parents need to be more aware of what they are feeding their child. Balanced meals, a good breakfast to start the day, and monitoring exercise by making sure children are getting outside to play for at least 60 minutes a day or even enrolling their child in a sport could help as well. School lunches, I believe can also be a big problem. Healthier lunch choices need to be available. Instead of fries with their chicken nuggets, schools can offer diced carrots or apples. These are all just a few examples of what obesity intervention can look like. Obesity is becoming a great problem in society today and if we start to tackle the problems at a young age, which seems to be where it all stems from, then we are closer as a society to becoming healthier.

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  53. Both articles on childhood obesity are supportive of the life-course theory - that a child's weight is predetermined by what their mother eats when pregnant and a child's diet during the first five years of their life. Studies have shown that environmental and social contexts have had a big impact on children's weight that persists with the child throughout their lifetime. This is an example of how a person's genes can be influenced by environmental factors.

    Considering the link between diet in the womb/early childhood and persistent obesity in life, an intervention that would be effective in decreasing obesity in the population is promoting healthy eating for pregnant mothers, women of childbearing years and for children in the early years of their life. This education and promotion campaign would focus on the importance of eating fruits and vegetables - especially organic to limit the amount of pesticides the fetus is exposed to in the womb. Health care providers would be instrumental in educating all women of childbearing years and especially pregnant mothers about eating a healthy diet, emphasizing the results of studies that show obesity is linked to diet during pregnancy and the first five years of a child. It's important to target all women of childbearing years when promoting a healthy diet because a healthy diet before a women becomes pregnant can further ensure the health of her baby.

    To cover the mothers and children who are most vulnerable and experience the biggest disparity, I think the WIC program for food packages should be reformed. Food packages should limit unhealthy food available through WIC benefits and promote healthy food and especially organic food for both the mother and baby's health.

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  54. Since it has been proven that a mother’s diet influences whether or not their child could be obese, I think that it is important that an intervention is implemented at the start of pregnancy. It is understood that genetic factors play a role in obesity, but it is also important to acknowledge the fact that environmental factors have a large influence on obesity as well. If we can address the environmental factors at an early stage, this can help prevent obesity. The intervention plan should be put into effect right at the beginning of pregnancy. OB/GYNs should speak with expectant mothers at the start of pregnancy and educate them on proper nutrition and how their diet can affect their child. If mothers understand the risks of having a poor diet during pregnancy, this could help promote a healthy diet. OB/GYNs could provide a nutritional plan to expectant mothers as an easy guide for a better diet. Exercise programs for pregnant women should also be included in the intervention plan, because both diet and exercise together will lead to a healthier life style for both mom and baby. The intervention plan should continue beyond pregnancy and into early childhood. The parents should encourage their child to participate in physical activity or sports to help maintain a healthy weight. Children should also be encouraged to eat healthy, but keep in mind that they are children and having “junk food” time to time would not be bad.

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  55. Reading these two news articles regarding Obesity in children did not shock me in any way. The rate at which fast food restaurants and unhealthy foods are so easily accessible in the U.S, we are almost set up for failure. What did shock me in these articles are that the mothers unknowingly are putting their children at such high risks for obesity. Many mothers cannot afford too and lack the education in order to give their babies proper nutrition. Many kids enter kindergarden from all sorts of family backgrounds, and I believe schools must be extremely rigid in their educating about nutrition from an early start. I disagree with the first article in that they should only educated the fat children. The government must give all schools funding so that they can provide healthy and nutritious meals for these children so they will not grow up and be obese. If the one third of children that were overweight in kindergarden become obese by eighth grade, this is something that schools have the duty to prevent because children spend majority of their day in school systems. If we can work to get rid of soda machines, snack machines, chocolates sold in snack bars, we can help to create a healthier environment for these children. They must educate children on nutrition as well as exercise to be an important part of their day.
    The life-course perspective shows how we can attempt to beat obesity in later stages of life when the child is still within the womb. So many decisions that the mother makes, directly affects the baby whether it's the food she eats, the medicines she takes, or whether or not she smokes. If we can continue to educate mothers on the decisions they make and how that impacts their child, the less infant mortalities, complications and obesity rates that we will see.

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  56. Based on the two articles above, the diet of the mother and the diet of children at early ages affects the children's weight for the rest of their life. Therefore, I think a good intervention should start with educating young women who are on the verge of having children. I think the awareness should begin before women even enter pregnancy because diet and lifestyle changes are not ones that can occur overnight. These types of lifestyle changes often take a while to change and make into a new habit. Therefore, I think it is important to educate and raise awareness about how the eating habits of a mother during pregnancy can negatively or positively affect her child. In this way, women who are planning to have children in the near or long term future can begin to work on fixing and changing their eating habits so that when they are in pregnancy they know what is best not to eat and what they should eat for their child's health. Also with regards to the early childhood obesity issue, I believe a good intervention would be educating mothers about eating habits when their children are between newborns and kindergarten. I agree with the last statement in the second article in that geners are not necessarily modifiable but diet and lifestyle changes are. Therefore, the early childhood obesity intervention should focus on educating mothers about feeding their children healthy options between the ages of newborn to kindergarten so that they can start off at a healthy weight and keep consistently healthy for the rest of their life. The intervention in both situations should consist of educating and raising awareness for mothers because the children only eat what their parents feed them.

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  57. After reading these articles, it is clearly evident that a health life begins in the womb, continues through childhood and extends all the way to adulthood. Our society is just recently trying to focus on the obesity problem in the US. It is very hard to change the lifestyle of people, especially adults. If adults have the habit of eating unhealthy, that will then extend on to their children, and these habits are hard to quit. However obesity is clearly becoming a major problem and we must find ways to try to fix it. Obesity is definitely more prevalent in low income families, who can only afford the unhealthy fast food and cannot necessarily afford the right health care. Education on obesity and eating healthy and exercise should be offered at little to no cost to low-income areas. Also, schools should start teaching kids about obesity and how to stay healthy at a very young age. Money going to schools from the government should be used more for healthy food rather than brand new technology. Early childhood obesity intervention should definitely teach mothers and fathers how to raise a healthy child and really stress the importance and seriousness of doing so.

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  58. It is clear from the articles that there needs to be a policy change about what age obesity intervention starts and who the intervention focuses on. If being obese in kindergarden correlates with being obese later in life, intervention needs to begin before the age of five. Also, if expecting mothers' diets can have an effect on the health of their child, intervention needs to begin before the child is even born.

    I think that the best obesity intervention should start during pre-natal care. In addition to the usual pre-natal care, pregnant women need to be taught about healthy eating habits and how their diet effect their child. They need to be taught that eating healthy while pregnant will help their ensure that their child is health later in life. Additional, expecting mothers should be taught about ways to help prevent their child from becoming obese at a young age. If mothers can understand how their diets effect their child's chance at obesity, and that healthy eating and exercise at a young age can set their child on the path to a healthy future, it could change the increasing incidence of obesity. Mothers need to be the first point of intervention, before even their children's health habits are started.

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  59. As many people have said, the findings of these articles are not surprising at all. The fact that environmental factors, especially parental diets and overeating have prolonged impacts on people's health is not a new phenomenon. However, the startling fact is that a child's health in kindergarten impacts their health and weight later in life. Thinking back on my own childhood, it is nerve-racking thinking about how the food I ate, the activities I participated in, and the eating habits my parents allowed to to develop could have a detrimental affect on me now. The interventions that are already in place, as the article speaks about, are aimed at an age group that is already too late to be significantly impacted. The group that we need to aim for are the children before they enter school. Parents need to be informed about how unhealthy decisions at a young age have a strong impact on their children later on in life. Part of this education comes from doctors educating pregnant mothers about how their eating and drinking habits are extremely important.

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  60. Obesity is an issue that arises from many factors and many of them start right in the womb. Therefore, the most critical population that we need to target as a nation, if we want to stop this epidemic, is parents, in particular pregnant mothers. Mothers need to be educated about healthy eating choices, especially while they are pregnant, but also later on in life as their kids are growing up and need essential nutrients for their development. Kids are reliant on their parents when they are younger, and so if we can get parents to realize how important healthy eating habits and regular exercise are for the well-being of their children, then they may start making healthier choices, and at the same time teaching their kids proper nutrition which will continue on with them for the rest of their lives. Teaching parents the importance of diet, and at the same time making sure they actually have a means of obtaining healthy food (as this is not always the case, due to socioeconomic reasons) will create a cycle, so that ‘if you are taught to love fruits and vegetables when you are younger, then you are more likely to love fruits and vegetables when you are older and will thus teach your children to love fruits and vegetables as well’. I think the best way to tackle this gigantic problem that we have in our society and all the troubles that it brings, is by really starting right at the source and that is usually, right at home.

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  61. I believe that the life course perspective would be the best course of strategy for reducing obesity within susceptible communities. There are so many things other than genetics that affect a fetus like the environment, epigenetics, and diet.

    I found it so interesting to learn that what pregnant mothers eat and how much weight they gain could potential effect the risk of obesity for this offspring. Considering this, I believe nutrogenomics should be used to educate expecting mothers about diet.

    I think there are many populations that an intervention program could target. One path could be to start educating teens in high school so that they will understand the importance of diet during pregnancy when they become pregnant themselves. The most important niche to target however would be young married women or expecting mothers to teach them a correct died while they’re pregnant (and express the importance of the third trimester) and for when their child is born to feed the correct foods to the baby until kindergarten age. Compulsory nutrition programs could also be provided for this group but perhaps to mothers who have heavier children. Its important to target the mothers before the child gets to kindergarten because as Gina Kolata said in an article, children who reach kindergarten at over weight, has a higher change of being over weight for the rest of his or her life.

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  62. As we all know, obesity is a growing problem within out nation in which we are spending billions of dollars trying to battle its expansion. I believe that education is our best method of overcoming obesity. Providing a healthy meal for your family is hard to for anyone. For a parent with multiple children to feed multiple times a day, concocting and executing a well balanced meal can be difficult. For many families, the cost of fresh foods is not within their family budget. Our society makes it very easy to serve terrible meals because of the cheaper price and convenience that it brings. Educating mothers and fathers at an early age helps instill a better understanding of why healthy eating is so important. By educating our parents, they will better provide for their children until their kids are old enough to make their own choices. At this point, parents should lead their children’s choice-making by the example they lead with their own life. Keeping healthy foods around their house helps children make the right choices when deciding what to eat at home and away.

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  63. I have been overweight since the moment I was born- weighing in at almost 12 pounds. By the time I was in kindergarten I weighed over 60lbs. I have struggled with my weight most of my life and never received information about how to manage my weight until high school, and only started to take it seriously in college, where I have lost about 60 pounds. Early intervention in pregnancy and early childhood allows for mothers, children, and families to start and continue a healthy lifestyle. We need to aim for are pregnant women and children before they enter school. Parents need to be educated about what healthy and unhealthy decisions they should be making and how they impact their children now and later in life. It begins with doctors educating pregnant mothers about how their eating, drinking, and exercising habits, as well as pediatricians when children are growing up. A lot of times it is thought that children will grow out of their ‘baby fat’, but the evidence proves otherwise.

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  64. I believe that one of the best interventions for the fight against obesity is to improve access to fruits and vegetables, fresher foods in general. Unfortunately malnourishment and obesity go hand and hand since obesity is a consequence of eating nutrient poor food and processed foods. In many communities opening a weekly farmers market especially during peak harvest seasons will not only bring fresher foods to these areas but also at a lower cost. Not only is fresh food scarce in some communities but it is also expensive. If the department of health developed a program that not only helped sponsored a farmers market in a community but it could also provide subsidization to allow even lower income families enjoy fresh food.

    I think having a farmers market program will also educate individuals about cooking and the importance of eating healthy. The entire community could get involved by having local chefs prepare and demonstrate recipes using the local season food sold by local farms.

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  65. Health issues, such as obesity, is definitely a growing problem, especially in the United States. It's unfortunate that studies of obesity is only progressing now, when I feel it's already too late, as it becomes a more widespread epidemic. The findings of the two articles clearly reveal that developing obesity not only starts during childhood years, but even in the womb. Pregnant women, as well as fathers, should be able to undergo some type of free information seminar that stresses the point of eating habits directly correlates with the life of the child. Women should be eating healthy from the moment they find out they're pregnant because they're not just eating for themselves, but eating for their child as well. The situation kind of brings up the famous quote of "you are what you eat." Lifestyle choices are hard to make and don't happen overnight, but by making changes sooner rather than later, mother and child will be better off in the long run. The population needs to understand the importance of diet, healthy lifestyles, and physical activity and how these factors would greatly impact their life and the lives of their family. It may be too late for this generation to make a drastic change to their lifestyle, but if they at least make the effort to change, maybe the next generation will be better off in the future.

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  66. Like many others above me, I think expecting mothers should be required to meet with a nutritionist or dietician. Everybody knows that as a pregnant woman, you're eating for two; however, mothers often get cravings for odd and unhealthy and act on those cravings without realizing the potential harms of their actions. Giving dietary and exercise counseling to pregnant women would not only improve the health of the baby but would also hopefully foster better awareness of the mothers actions on her child before and after the child is born.

    As an aside though, I do have to womder why so many children are obese these days. I remember as a kid that we were always chubby but it was expected and often true that we would grow out of it. I understand that eating habits have changed with the times but genetically, I don't think much has changed since we were kids maybe 10 years ago.

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  67. Expecting mothers have such a huge influence on their children's health before they are even born. I think women should be educated by their OBGYN on the effect of their eating habits and lifestyle choices have on their baby. Obesity has become such a huge problem in the United States and it all starts with the children. I like the idea that pregnant women should be required to meet with a dietician or nutritionist to talk about healthy lifestyle choices and eating habits to allow their children to live the healthiest lives that they can. Women also might be more likely to pay attention to their choices if they know they'll have to share those choices with their doctor later on. Children are put at a disadvantage by their parents who do not have healthy habits because they are almost predisposed to be being obese. Young children often don't have a choice of what they eat, because they eat what their parents feed them. Exercise habits and healthy eating habits are essential to preventing obesity throughout the lifetime and through generations.

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  68. After doing the readings, it seems that life course perspective programs could really help reduce the impact of obesity. Obesity is something that affects many people, but from what I have learned in other classes, it seems to also disproportionately affect lower income families more than higher income families. Knowing that the people most affected by obesity would be unable to afford/access advanced medical treatments, surgeries, or medication, the life course perspective seems like the best preventative method that would be available to the people most affected by obesity.

    Having more education about the risk of childhood obesity extending to adolescence and adulthood available to parents of infants or even at OB/GYN visits prior to the child's birth. I think that have low cost healthy food available to families with young children in areas where low cost healthy food is not available. Having places like community centers or parts of clinics for families who are at greater risk of having children with obesity to support them and give them information to reduce their risk would be helpful to expecting parents and current parents throughout their children life. Continuing programs and following up with families throughout their children life would be important to making sure that children stay healthy and are able to reduce their risk of childhood obesity.

    (I tried to post this morning but did not realize until now that my post did not save/submit when I saw the email, so sorry this is not as detailed as my original post and late!!)

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  69. Life-course perspective intervention theory to decrease obesity before kid’s head into older parts of life is a good way to prevent obesity. There have been experiments and studies that show that intervening during pregnancy and early childhood would prevent obesity. During early pregnancy there has been facts said actually eating sweets and bunch of snacks during pregnancy is actually bad for the kid. Instead of thinking eating the sweet is fine since your technically feeding two people you should think that you should eat twice as healthier. Even for early childhood help we should make sure the children eat healthier earlier to make sure we prevent obesity among people later on in life. I really wonder why schools and parents are not educating kids about healthy eating.

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  70. The life-course perspective intervention is a very respectable way to try and reduce the rates of obesity that can be seen around the world today. Considering that obesity does not result from one single thing, but can result from many different interrelated factors, from genetic mutations to nutrition, I believe that taking a universal approach to try and reduce obesity id our best choice.

    After reading the two articles about how obesity can be influenced early in life or during pregnancy, I propose that there should be certain programs that require mothers to adhere to a strict nutritional plan while pregnant, and for parents to take a stronger role in deciding what there children should eat at a young age. The link between how your diet can affect transcription factors that mediate certain gene expressions, and how your genes may have certain variations that only become relevant based on your diet, are two areas of study that should prompt counties to require parents to adhere certain nutritional programs to try and reduce the rates of obesity.

    The interventions of strict nutritional programs would not only aim to reduce obesity rates, but to reduce the health problems and diseases that arise form obesity, such as diabetes and heart disease. If we can reduce obesity rates, we can reduce the rates of diabetes and heart disease, which in return improves the overall health of individuals on a worldwide level.

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  71. The general public first needs to be educated about the condition known as obesity first before any steps to alter people’s habits and perspectives can be taken. People need to be educated on what obesity is, what are the negative consequences, and then move on to how we can fight this problem. The fact that obesity does seem to have a genetic predisposition, as much as it does a cultural and socioeconomic predisposition, needs to be communicated. All these factors, and more, contribute to whether a child will either just live with a predisposition or will actually develop obesity. As the articles stated, both genetics and even a mother’s diet during the third trimester of pregnancy can have an effect on whether a child will develop obesity in their early/later years. Parents need to be educated on their role as caregivers and instigators of a child’s diet and exercise habits. Of course, environment too plays a part that is harder to control, but small precautions taken early on are always a better option than having to fight a largely difficult problem later on. At some point it does become the child’s choice whether they wish to eat health or not and whether they wish to play outside or watch television, but these habits are instilled in them from a younger age when parents are the ones making the decisions for them.
    I feel that the life-course theory should be used to identify the various vulnerable factors within differing cultural and socioeconomic groups that could contribute to higher rates of obesity. And that these factors along with methods of avoiding these factors should be relayed to parents along with the dangers of obesity. Stopping obesity should start with parents, even before a child is born. As or adults with obesity, being educated on these matters can only help them more than it will hurt them.

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