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Obesity, Nutrition, andPhysical Activity
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Rapid Increases in Obesity Among U.S. Youth
NHANES 1963-2008
National Health Examination Surveys II (ages 6-11) and III (ages 12-17).National Health and Nutrition Examination Surveys I, II, III and 1999-2008.www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm.
Shifts in Dietary patterns in the United States
Relative prices of more healthful foods have increased faster than prices for less healthful foods.
Increased portion size Increased
consumption of processed foods typically higher in sodium
Increased schools vending and a la carte foods
Active Transportation by Youth has Decreased
Mode for Trips to School – National Personal
Transportation Survey
McDonald NC. Am J Prev Med 2007;32:509.
Increased TV Viewing Increases Childhood Obesity Prevalence
$1.6 billion/year spent on marketing of foods and beverages to youth• $745 million on
television Television viewing
associated with consumption of foods advertised on television
70% children 8-18 years and 30% children <3 year old have TVs in their rooms
NHES: National Household Education Surveys.NLSY: National Longitudinal Survey of Youth.
Costs of Adult Obesity Are Increasing
1998 (in 2008 dollars)
2006 (in 2008 dollars)
Total Costs$75
billion/yr$147
billion/yr
% of U.S. Medical Costs
6.5% 9.1%
Increased prevalence, not increased per capita costs, was the main driver of the increase in costs.
Finkelstein et al. Health Affairs 2009; 28:w822.
Reductions in Salt Intake Can Reduce
High Blood Pressure Increased sodium in the diet =
increased blood pressure = increased risk for heart attack and stroke • Generally, lower consumption of salt means
lower blood pressure• Within the span of a few weeks, most people
experience a reduction in blood pressure when salt intake is reduced
Even people with blood pressure in the normal range benefit from sodium reduction; there appears to be no threshold
Reductions in Salt Intake Can Reduce
High Blood Pressure (continued)
Sodium intake affects
• Blood pressure levels – a meta-analysis1 of trials indicates that a median reduction of urinary sodium to ≈1800 mg would
Reduce systolic/diastolic blood pressure by 5.0-2.7 mmHg in persons with hypertension
Reduce systolic/diastolic blood pressure by 2.0-1.0 mmHg in non-hypertensives
• Incremental rise in blood pressure with age• Prevalence of hypertension across
populations Reducing salt intake could save
tens of thousands of lives annually21. J Hum Hypertens. 2002; 16: 761-770.2. PloS Med. 2009;6(4):e1000058., N Engl J Med. 2010;362:590-599.; Ann Intern Med. 2010;152:481-487
Estimated Effects of Sodium Reduction on Hypertension
Prevalence and Related Costs
Reducing average population intake to 2300 mg per day (current recommended maximum) may…• Reduce cases of hypertension by 11 million• Save $18 billion in health care costs• Gain 312,000 Quality Adjusted Life Years
(QALYs)
Reducing average population intake even lower – to 1500 mg per day (recommended maximum level for “specific populations” described in the Dietary Guidelines for Americans) – may…• Reduce cases of hypertension by 16 million• Save $26 billion in health care costs• Gain 459,000 Quality Adjusted Life Years
(QALYs)
American Journal of Health Promotion. 2009;24:49-57.
Principal Winnable Battle Initiatives
Improve dietary quality• Increase fruit and vegetable intake• Decrease intake of high-energy, low-
nutrient foods• Reduce consumption of sugar sweetened
drinks• Reduce sodium in the food supply• Eliminate industrially produced trans fat
from the food supply Increase breastfeeding Increase physical activity Prevent micronutrient malnutrition Enhance state and community
capacity to improve population-level health
Priority Strategies to Address Select Winnable Battle Initiatives Energy density
• Apply nutrition standards in child care and schools
• Increase number of healthy food retail outlets in underserved areas and improve access
Fruits and vegetables• Increase access through retail stores• Support Farm to Institution policies• Leverage food policy councils
Sugared drinks• Ensure access to safe and good-tasting
water• Reduce accessibility of sugared drinks in
child care and schools
Priority Strategies to Address Select Winnable Battle Initiatives
Breastfeeding• Policy and environmental supports in
maternity care facilities• Policy and environmental supports in
worksites • State and national coalitions to support
breastfeeding
Physical activity• Joint use agreements for after-hours
access to school facilities • Increase access to parks and recreational
facilities• Increase opportunities for physical activity
in youth-serving settings
Priority Strategies to Address Select Winnable Battle Initiatives
Sodium reduction
• Establish sodium reduction standards in government facilities and educational institutions
• Promote innovative restaurant initiatives to reduce sodium content of restaurant meals
• Increase availability of lower-sodium processed and restaurant food products
“Obesity continues to be a major public health problem. We need intensive, comprehensive and ongoing efforts to address obesity. If we don't, more people will get sick and die from obesity-related conditions, such as heart disease, stroke, type 2 diabetes and certain types of cancer – some of the leading causes of death.”
– Thomas R. Frieden, MD, MPHDirector, Centers for Disease Control and Prevention, Administrator, Agency for Toxic Substances and Disease Registry
For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
www.cdc.gov/winnablebattles
U.S. Department of Health and Human ServicesCenters for Disease Control and Prevention