Letter to the Editor by Shin-Yu, Lien to Advocating for the Prevention of Childhood Obesity: A Call to Action for Nursing

Obesity on the Rise: What Can Nurses Do?

April 2, 2012

Response by Angela Shin-Yu, Lien to Advocating for the Prevention of Childhood Obesity: A Call to Action for Nursing by Bobbie Berkowitz and Marleyse Borchard (January 31, 2009).

Dear Editor:

What’s the best strategy to prevent childhood obesity? I say lifestyle modification, for example Michelle Obama’s support of the ‘Choose My Plate’ platform.  Berkowitz and Borchard (2009) have described a comprehensive set of nursing skills that can be used to decrease childhood obesity.  I believe that developing a healthy lifestyle is the most important.  August and colleagues (2008) have suggested that a comprehensive and successful program for preventing pediatric obesity should focus on promoting and supporting healthy lifestyles for children at home, in school, and in the community.  Such programs should focus on the well being of all children rather than only on those children who are described as obese. 

Preventing and decreasing obesity can best be achieved by developing healthy eating and physical activity habits early in childhood. Koplan, Liverman, Kraak, and Wisham (2007) have emphasized that an imbalance between energy intake and expenditure induces obesity children and young people.  Lowery (2010) has noted the importance of helping children and their families find simple and easily recognized approaches for choosing healthful food. The United States’ First Lady, Michelle Obama, has led the way in supporting the ‘Choose My Plate’ platform <choosemyplate.gov> to clearly demonstrate the desired proportions of food consumption in every meal.  Her popularity and media coverage can be instrumental in ensuring policy success.  This platform offers a great teaching strategy for nurses to use in working with children and families. 

In Taiwan it is not permitted for a vending machine or school cafeteria to sell sugar-sweetened beverages and snacks on primary school campuses. School nurses and teachers encourage children to drink the convenient fresh water located near to each classroom. In Taiwan schools are now required to support more physical activity both during the recess time and after each 45 minutes of class time. Shortening the amount of time children spend watching TV and playing computer games is also encouraged as a means of preventing obesity. All of these policies are aimed at decreasing the consumption of unhealthy food and having children spend more time involved in physical activities to maintain the proper energy balance and thus prevent childhood obesity.

Children need the appropriate amounts of good nutrition and activity to enhance their growth and development.  The nursing intervention of lifestyle modification to prevent/address childhood obesity begins by encouraging healthy eating and physical activity.

Angela Shin-Yu, Lien, RN, MS
Lecturer, School of Nursing, Chung Gung University.
Doctoral Student, Department of Nursing, National Taiwan University
Taiwan (Republic of China)


August, G. P., Caprio, S., Fennoy, I., Freemark, M., Kaufman, F. R., Lustig, R. H.,…Montori, V.M. (2008). Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion. Journal of Clinical Endocrinology & Metabolism, 93(12), 4576.

Berkowitz, B.,  & Borchard, M. (2009). Advocating for the prevention of childhood obesity: A call to action for nursing. OJIN: The Online Journal of Issues in Nursing, 14, Manuscript 2.  doi:10.3912/OJIN.Vo14No1Man02.

Koplan, J., Liverman, C., Kraak, V., & Wisham, S. (Eds.). (2007). Progress in preventing childhood obesity. Washington, DC.: The National Academies Press.

Lowery, B. (2010). Obesity policy spotlight: The political feasibility of solving childhood obesity. Bariatric Nursing and Surgical Patient Care, 5(3), 249-253