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Public Enemy #2 Poor Diet and Physical Inactivity

Carrie Brummer, Brandon Rachal, & Latoya Woods

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73% of adult population in US either

overweight or obese in 2006

Where have we come from?

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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

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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

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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

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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

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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.

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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

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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

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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)

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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?

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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

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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

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2006, Obesity Killed 112,000

Americans a year

2006, Terrorism Killed 28

Americans

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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…

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Move Your Body!