Nutrition and Physical Activity

Iowans will enjoy balanced nutrition, lead physically active lives and live in healthy communities

Obesity Trends Among U.S. Adults between 1985 and 2004

Source of the data: The data shown in these maps were collected through CDC’s

Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health departments use standard procedures to collect data through a series of monthly telephone interviews with U.S. adults.

Prevalence estimates generated for the maps may vary slightly from those generated for the states by BRFSS (http://aps.nccd.cdc.gov/brfss) as slightly different analytic methods are used.

Obesity Trends* Among U.S. AdultsBRFSS, 1985

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1986

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1987

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1988

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1989

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1990

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1991

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1992

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1993

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1994

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1995

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1996

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1997

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1998

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1999

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2000

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2001

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

Obesity* Trends Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity* Trends Among U.S. AdultsBRFSS, 2004

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

The Epidemic

The prevalence of obesity among Iowa adults has increased by 84% from 1990 to 2004 (Behavioral Risk Factor Surveillance System BRFSS).

The 2004 BRFSS data indicates 37.4% of adult Iowans are overweight, and 23.5% are obese (for a total of 61% of Iowa adults compared to the national average of 59.9%)

Disparities

31% of low-income children between 2 and 5 years of age in Iowa are overweight or at risk of becoming overweight. (CDC PedNSS, 2003)

Overweight and obesity prevalence rises with increasing age in Iowa up to age 64.

Obesity prevalence is highest (28.2%) in those with income less than $15,000.

Ethnicity data not available for Iowa

Obj. 19-2

TotalWhite

FemaleMale

Black Female

MaleMexican American

FemaleMale

2010 Target

National Data on Adult Obesity: 1988-94 to 1999-2000

0 10 20 30 40 50

Note: Data are for ages 20 years and over, age adjusted to the 2000 standard population. Obesity is defined as BMI >= 30.0. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Percent

1988-94

Children and Adolescents

Childhood obesity

has been declared “the most pressing health concern in the country”

(American Heart Association, American Stroke Association, Robert Wood Johnson Foundation, 2005)

Obesity in children and adolescents

is associated with significant health problems such as high blood cholesterol, high blood pressure, hypertension, diabetes, and depression

(American Academy of Pediatrics, 2003).

If current trends continue

it is estimated that over one-third of the children born in the year 2000 will go on to develop diabetes

(K.M. Venkat Narayan, MD, Chief of the Diabetes Epidemiology Section, Center for Disease Control and Prevention).

Risk of Overweight and Obesity

1 in 4 children is at risk for overweight.

More than 60 percent of young people eat too much fat.

Less than 20 percent of children eat the recommended 5 or more servings of fruits and vegetables each day.

-Centers for Disease Control and Prevention, 2004

Childhood Obesity

Since the 1970s, obesity prevalence has:– Doubled for preschool children aged 2-5 years– Doubled for adolescents aged 12-19 years– Tripled for children aged 6-11 years

More than 9 million children and youth over 6 years are obese

Similar trends in U.S. adults and adults internationally

-IOM, 2004

0

5

10

15

20

0

5

10

15

20Percent

1963-67 1971-74 1976-80 1988-94

Obj. 19-2

Percent

Males 12-19

Females 12-19

National Trends in Child and Adolescent Overweight

Note: Overweight is defined as BMI >= gender- and weight-specific 95th percentile from the2000 CDC Growth Charts for the United States. Source: National Health Examination Surveys II (ages 6-11) and III (ages 12-17), NationalHealth and Nutrition Examination Surveys I, II, III and 1999-2000, NCHS, CDC.

1999-20001966-70

Females 6-11

Males 6-11

Prevalence of Overweight Among Children and Adolescents Ages 6-19 Years

0

2

4

6

8

1 0

1 2

1 4

1 6

1 9 6 3 - 7 0 1 9 7 1 - 7 4 1 9 7 6 - 8 0 1 9 8 8 - 9 4 1 9 9 9 - 0 2

A g e s 6 - 1 1A g e s 1 2 - 1 9

-Centers for Disease Control and Prevention, 2004

Obj. 19-3c

Total

FemaleMale

WhiteBlack

MexicanAmerican

0 10 20 30Percent

National Child and Adolescent Overweight by Race:

1988-94 to 1999-2000

Note: Overweight is defined for ages 6-19 years as BMI >= gender- and weight-specific 95th percentile from the 2000 CDC Growth Charts for the United States Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

2010 Target1988-94

Early ChildhoodIowa PedNSS 2003

31% of low-income children 2-5 years of age in Iowa are overweight or at risk of becoming overweight.

Overweight: 13.6% vs. 14.7% U.S.Ever Breastfed: 60% vs. 53.2% U.S.Breastfed 6 months: 27.5% vs. 21.5% U.S.

Prevalence of Overweight of 4th, 5th, and 6th grade youth in the UNI PANARY surveillance project Measured BMI of 2,740 4th – 6th grade

children 60% were in the normal weight zone (70%

U.S.) 20% were in the “at risk for overweight” zone

(16% U.S.) 20% were in the “overweight” zone (15%

U.S.)Joens-Matre, Welk, Russell, Nicklay, & Hensley (2005).

Medicine and Science in Sports and Exercise. May Supplement.

Prevalence of Overweight of 4th, 5th, and 6th grade youth from Urban, Small Cities, and

Rural areas in the PANARY surveillance project Urban

Small Cities

Rural

Normal weight 62.8% 62.9% 53.1%

At-Risk for Overweight

17.8% 19.5% 21.8%

Overweight 19.4% 17.6% 25.1%(Joens-Matre, Welk, Russell, Nicklay, & Hensley, 2005)

Iowa 2003-Consumption of Fruits and Vegetables  

Consume 5 or more servings per day17% of Iowa adults 23.6% of older adults 19% of adults with income < $15,00011.3% of adults without a HS/GED

degree22% of US adults

National Proportion of Vegetable Servings

1999-2000

Obj. 19-6Note: Data are age adjusted to the 2000 standard population for adults 20 years and over.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Children 2-19 years Adults 20 years and over

Dark green/ orange

8%

Tomatoes9%

Legumes6% All others

22%

Other potatoes

10%

Fried potatoes

46%

Dark green/ orange

11%

Tomatoes11%

Legumes8%

All others35%

Other potatoes

13%

Fried potatoes

22%

Target = At least 1/3 dark green/orange

0

1

2

3

4

Average number of servings

Objs. 19-5 19-6

Fruits and Vegetables: U.S. Average Number of Daily Servings by Race:

1999-2000Minimum Recommended

Note: Data are age-adjusted to the 2000 standard population for ages 2 years and over. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Fruits Vegetables

Total White Black Mexican American

0Age-adjusted percent

2010Target

30 4010 20

19992002

50

Obj. 22-2

Moderate Physical Activity for U.S. Adults by Race/Ethnicity

Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Moderate physical activity is regular leisure-time physical activity (moderate activity 30+ minutes/5+ times a week or vigorous activity 20+ minutes/3+ times a week). American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. I = 95% confidence interval.Source: National Health Interview Survey, NCHS, CDC.

White

American Indian

Hispanic

Asian

Black

Iowa 2003-Meet the recommended amount of physical activity

43% of Iowa adults (Men- 45%; Women- 42%)

32% of older adults 38% of adults with income < $15,000 36% of adults without a HS/GED degree 47% of U.S. adults meet the

recommended amount of physical activity

0

20

40

60

80

100

Vigorous Physical Activity for U. S. Adolescents by Grade Level: 2001

11th10th

Obj. 22-7

9th

Percent

12thNote: Vigorous physical activity is activity that made students in grades 9-12 sweat or breathe hard for 20+ minutes on 3+ of the past 7 days. I = 95% confidence interval.Source: Youth Risk Behavior Surveillance System, NCCDPHP, CDC.

Benefits of Proper Nutrition and Physical Activity

Increased bone density Enhanced cardiac wellness Longer-term reductions in weight and cholesterol

levels Improvements in body composition Lower risk for many chronic diseases Support of child growth and development Improved grades in school Decreased incidents of tobacco and alcohol use

-Centers for Disease Control and Prevention, 2004

Cost of Overweight Today’s children will be the first generation in

memory to have a shorter life span than their parents. - Sir John Krebs, Chairman of the United Kingdom’s Food Standards agency

Iowans pay $783 million in health care costs for problems associated with obesity - ~17% is covered by Medicaid & Medicare (Finkelstein, Fiebelkorn, & Wang, 2004)

Overweight children report lower quality of life than children with cancer.

Promoting Nutrition & Physical Promoting Nutrition & Physical ActivityActivity

CDC Planning Grant

CDC’s Charge

Write a comprehensive state plan, involving a wide range of community partners

Describe the plan in terms of the social-ecological model

Base plan on science-based interventions or promising interventions

Scope of Activities

Conduct Community Forums Visit with professionals at conferences &

meetings Invite partners to a Kick Off Summit to begin

process of writing a plan Form Channel Work Groups to write portions

of the plan

Iowans Fit for Life Work Groups

Early Childhood Educational Settings Older Iowans Health Care Community Business and Agriculture

Comprehensive State Plan Goals

Prevent and reduce the level of obesity in Iowans through improved nutrition, physical activity and supportive environments.

Reduce obesity through integration, coordination, and collaboration among organizations and entities that share expertise and maximize resources of existing programs and partnerships.

Social-Ecological Model

Socio-Ecologic Model

Source: Adapted from McLeroy, et al., An ecological perspective on health promotion programs.Health Education Quarterly 1988; 15:351-77.

knowledge, attitudes, skills

family, friends, social networks

organizations, social institutions

relationships among organizations

Public Policy

Community

Organizational

Interpersonal

Individual

national, state, local lawsHealthy Policy

Target Audience

Policy Environmental Support

Venue for Message Delivery

ChildHealthy lifestyles modeled in homeAll children have access to healthy foods, physical activity and a nurturing environment

Alternatives to TVAfter school programsSchool meals

Schools & child careMediaWIC

Individual Level of the Social Ecological Model

Other Target Audiences: Adolescents, young adults, middle aged, elderly, persons with disabilities

Behavior Change Strategies

Increase breastfeeding initiation and duration Reduce TV viewing Increase physical activity Increase fruit and vegetable consumption Other dietary changes such as decreasing

soft drink intake or reducing portion sizes Increase parental involvement, but not

parental control

Child Care and Afterschool Settings: The Perfect Venue to Promote Healthy Lifestyles

Dietary behaviors and habits of physical activity have their origins in early childhood.

Child care serves many of the specific groups of children—minorities and those in poverty—most at risk for being overweight.

School-age children are likely to be sedentary in the afterschool hours if not given active options.

Providers act as liaisons to parents who make critical nutrition and fitness decisions for their children.

Strategies to Promote Nutrition and Physical Activity

Program

Policy

Funding

Program Strategies

Games and Activities

Curricula and Lesson Plans

Engaging Parents

Policy Strategies

Develop physical activity and nutrition guidelines for child care and afterschool programs

Provide physical activity and nutrition training for child care and afterschool providers

Help child care and afterschool programs access food nutrition entitlement programs

Creative Finance Strategies

Make better use of existing resources

Create more flexibility in existing categorical funding

Build public-private partnerships

Today’s Activity

Identify potential partners.

Identify potential resources.

Identify existing efforts that relate to the focus areas of nutrition, physical activity, breastfeeding, and/or screen time.