7/10/2013
1
Public Enemy #2 Poor Diet and Physical Inactivity
Carrie Brummer, Brandon Rachal, & Latoya Woods
7/10/2013
2
73% of adult population in US either
overweight or obese in 2006
Where have we come from?
7/10/2013
3
Obesity in US continues to rise despite more
people dieting & spending $33 Billion per year
on diet foods & books, weight loss programs,
and gym memberships
Jennifer Hudson, Weight Watchers Success
7/10/2013
4
Epidemiology
Influenced by Defined by BMI
Genetics
Individual & Social
Factors
Diet
Physical Inactivity
Wt (kg)/ht (sq. meters)
BMI 25-29.9
Overweight
BMI >30
Obese
Between 2003-2006 in
US, 71.6% of men &
61.2% of women either
overweight or obese
7/10/2013
5
Racial Differences
African Americans Caucasians
80.5% women
overweight
70% men overweight
Optimal BMI 23-30
Asians have more risks with
excess weight, so their BMI cutoff
is lower
57.4% women
overweight
70.1% men overweight
Optimal BMI 23-25
7/10/2013
6
Socioeconomic Status
College graduates are thinner regardless of sex
Significant difference between women
Women with less than 12 years of education are 2x more
likely to be overweight vs college graduates
Poor women more likely to be overweight than wealthy
women
7/10/2013
7
Obesity in Children
Increasing steadily since 1960s
Overweight & obesity in kids 6-19 years old has
increased from 5% in earliest studies to 33% in
2006.
Calculated based on growth curve of BMI for age:
CDC defines overweight as >85th percentile & obese as
>95th percentile.
Staggering Statistics
40% of Mexican American teenage boys & 44% of
Black teenage girls are overweight
Fat kids equal fat adults
Increased risks of chronic diseases
Type 2 diabetes is no longer “adult onset diabetes”
Obese teenage girls 2-3x as likely to die by middle
age as normal weight girls.
7/10/2013
8
The Trouble Continues…
Obese kids experience depression, anxiety, social
isolation, & low self-esteem
Increased risk for eating disorders
Anorexia & Bulimia
Less likely to graduate from college
More likely to live in poverty
Brooke Bates
7/10/2013
9
Diet & Nutrition
Diet plays a key role in prevention of chronic
diseases
Americans eat too much protein and fat, and too few
fruits and vegetables
Diets high in meat and fat and low in fruits and vegetables
have let to increased incidents of colon cancer, breast
cancer and diabetes
Diets low in calcium my lead to osteoporosis
Dietary Guidelines
Created by US dept of agriculture and departments
of health and human services
Reviewed every 5 years
Food guide pyramid was established to make the
recommendations more understandable
7/10/2013
11
We Continue to Fall Short…
Only 1-3% of people eat the recommended servings
from each food group per day
Too much fat and sugar being consumed
Too many children and adults consuming sweetened
beverages instead of milk and water
Too many “empty calories” being consumed
Junk Health
Snack Aisle (1200 calories)
Soda Aisle (875 calories)
Jack In the Box (400 calories)
Taco Bell (460 calories)
Produce (280 calories)
OJ (150 calories)
7/10/2013
12
Average Kid’s Meal
McDonald’s Mighty
Kid’s Meal
840 Calories
Wendy’s Kid’s Meal
770 Calories
KFC Kid’s Meal
800 Calories
Better Choices Under 500 Calories!
McDonald’s - 480
Premium Grilled Chicken
Side Salad with Low Fat
Balsamic Dressing
Med Iced Tea
Wendy’s - 480
Ultimate Chicken Grill
Mandarin Orange Cup
Med Iced Tea
KFC - 475
3 Crispy Strips
Green Beans
Corn on the Cob
Med Diet Pepsi
Burger King - 445
Whopper Jr. no mayo
Garden Salad
10oz Minute Maid OJ
7/10/2013
13
Between 1977 – 2001…
The calories from soft drinks and fruit drinks doubled
Milk consumption decreased 38% in children ages 2-18
years old.
Fruits are the most commonly omitted item
Marketing a Healthier Lifestyle
7/10/2013
14
Barriers to Healthy Eating
Many social, cultural and socioeconomic factors
contribute to eating habits
Influences include family, ethnicity, media,
environment
Changing eating patterns is difficult
Food and beverage industries adding fillers, processing foods to
enhance taste, encouraging larger portions
Making healthy food readily available
What are we doing about this epidemic?
Intervening at community and institutional level
Promoting healthy eating in schools
Education on disease prevention through a healthy diet
Healthy food available at lunch
Food industry is providing more low-fat/low-calorie foods
Restaurants offer ‘heart healthy’ selections
Calorie information appears on menu’s
7/10/2013
15
Promoting Healthier Eating
Grocery stores and restaurants adopting “Point of
choice” information
American Heart Association & Weight Watchers
campaigns
California’s “5-A-Day” campaign
Proven successful at encouraging public to consume 5
fruits and vegetables/day
http://www.youtube.com/watch?v=6C9ShzCKgOU
7/10/2013
16
Public Health Interest vs. Food Companies
Challenging food companies on deceptive
advertising
Lawsuit against Kellogg for using SpongeBob to
advertise sweetened cereals
Advertising to children
Limit vending machines in schools / provide healthy
alternatives
Challenging fast food companies
To lower prices on nutritional foods
Provide caloric intake in menu
7/10/2013
17
Let’s Move!
Most effective weight loss includes diet and physical
activity
Lose fat and preserve lean muscle mass
Physically active people live longer
Greatest protection against heart disease
Increase HDL
Reduces risk of diabetes
Reduces cancer risks
Proven for colon cancer
Breast / Prostate cancer inconclusive
How Much?
Benefits increase with intensity, frequency, and
duration
American College Sports Medicine
Minimum 150 kilocalories of light/moderate activity
30 minute brisk walk
15 minute run
Controversial
7/10/2013
19
1:4 Americans engage in no physical
activity in their leisure time
Our Future
Activity falls off dramatically during the high school
years
9th Grade // No participation in physical activity
Boys 8.4%
Girls 9.7%
12th Grade
Boys 10.9%
Girls 17.0%
44.5% Boys and 34.6% Girls are enrolled in P.E.
classes in 12th grade
7/10/2013
20
Time is money calories
More time watching TV and playing video games
than doing anything except sleeping
Obesity directly associated with TV watching
Cutting TV by ½ to 1/3 reduced BMI
significantly
TV encourages snacking
Commercials
7/10/2013
24
Only The Beginning…
Ecological Model to Change
Physical Environment
Social Environment
Only 49% of PCP’s believe that regular daily activity
is important to the average patient
AHA and AMA recommend promotion in patient visits
Educate physicians on counseling patients
7/10/2013
25
Environmental Factors
Suburban lifestyle
Drive wherever you want
Inconvenience and inaccessibility of exercise facilities
Schools underutilized for community recreation
High crime
How Simple
Sign stating “Stay Health, Save Time, Use the Stairs”
Increase from 8 to 17% usage
Are We Missing Something?
7/10/2013
26
Insuring our Future
Develop habit of exercise in children and
adolescents
Only 26% of states require high schools to offer
course on physical activity
“The return of physical activity as the norm in
everyone’s everyday life—the ‘restoration of
biological normality’—will require cultural change on
a scale similar to that which has occurred with
smoking”
Insuring our Future
Helping Farmers Grow Healthy Food
Organic School Project – Chicago, IL
“Grow, Teach, Feed”
Promote Farmer’s Markets
Increase Lobbying Against Big Companies
Language
Obese employee costs 11% more in HC costs
7/10/2013
27
At Home…
Sommerville, MA King County, WA
“Shape Up
Sommerville”
$1.5M Grant
Miles on Maps
Bike Trails
“Shape Up Approved
Restaurants”
Offices with gyms
Weights on phones
Bus Drivers get
subsidies for weight
loss classes
Spring slowed down
elevators
Tightening Our Belts
Obesity is now an epidemic
Costs of treating diseases secondary to obesity account for 9.1% of total US medical expenditures
$92.6 billion in 2002
Paid by Medicare, Medicaid, GHIP, PHI, & individuals
Dr. Oz
Dr. Phil
Dr. Drew
The Doctors
7/10/2013
29
A Better Future – 2000
USDA & Surgeon General
David Satcher
“The Surgeon General’s Call to Action to Prevent
and Decrease Overweight and Obesity”
Promote healthy eating habits and adequate physical
activity, beginning in childhood and continuing across the
lifespan
The Discord…