Obesity, Nutrition, and Physical Activity - PowerPoint Presentation

Slide1

Obesity, Nutrition, andPhysical Activity

U.S. Department of Health and Human Services

Centers for Disease Control and PreventionSlide2

Rapid Increases in Adult Obesity in the U.S.BRFSS: 1990, 1999, 2009Slide3

Rapid Increases in Obesity Among U.S. YouthNHANES 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.Slide4

Shifts in Dietary patterns in the United StatesRelative prices of more healthful foods have increased faster than prices for less healthful foods.Increased portion sizeIncreased consumption of processed foods typically higher in sodium

Increased schools vending and a la carte foodsSlide5

Active Transportation by Youth has DecreasedMode for Trips to School – National Personal Transportation Survey

McDonald NC. Am J

Prev

Med 2007;32:509.Slide6

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 television70% 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.Slide7

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.Slide8

Reductions in Salt Intake Can ReduceHigh Blood PressureIncreased 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 thresholdSlide9

Reductions in Salt Intake Can Reduce

High Blood Pressure

(continued)

Sodium intake affects

Blood pressure levels – a meta-analysis

1

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 annually

2

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;152:481-487Slide10

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 costsGain 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.Slide11

Principal Winnable Battle InitiativesImprove dietary qualityIncrease fruit and vegetable intakeDecrease intake of high-energy, low-nutrient foods

Reduce consumption of sugar sweetened drinksReduce sodium in the food supply

Eliminate industrially produced trans fat from the food supplyIncrease breastfeeding

Increase physical activity

Prevent micronutrient malnutrition

Enhance state and community capacity to improve population-level healthSlide12

Priority Strategies to Address Select Winnable Battle Initiatives

Energy densityApply 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 schoolsSlide13

Priority Strategies to Address Select Winnable Battle Initiatives

BreastfeedingPolicy 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 settingsSlide14

Priority Strategies to Address Select Winnable Battle Initiatives

Sodium reductionEstablish 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 Slide15

“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, MPH Director, Centers for Disease Control and Prevention, Administrator, Agency for Toxic Substances and Disease RegistrySlide16

www.cdc.gov/winnablebattlesU.S. Department of Health and Human Services

Centers for Disease Control and Prevention