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Prescription for Healthy Life Styles Alabama's State Obesity Task Force: How You Can Play a Role in Limiting Alabama's Growing Obesity

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Title: Prescription for Healthy Life Styles Alabama's State Obesity Task Force: How You Can Play a Role in Limiting Alabama's Growing Obesity


1
Prescription for Healthy Life Styles Alabama's
State Obesity Task Force How You Can Play a
Role in Limiting Alabama's Growing Obesity
  • Miriam J Gaines, MACT, RD, LD
  • Nutrition and Physical Activity Unit
  • Alabama Department of Public Health

2
Healthy Lifestyles
  • Nutrition
  • Physical Activity
  • Family and Consumer Sciences Education Course of
    Study
  • Promoting optimal nutrition and wellness across
    the life span

3
Alabama Number 1?
Red color indicates 25 or more are obese
4
Obesity in ALABAMA
5
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6
Overweight or ObeseAlabama Respondents, BRFSS
2002
Behavioral Risk Factor Surveillance System
7
(No Transcript)
8
Pediatric Overweight
  • Definitions of overweight in pediatric population
  • BMI gt95th overweight
  • BMI gt85th but lt95th at risk for overweight
  • Obesity is an adult medical diagnosis
  • Increased risk of adult obesity
  • More than16 of US adolescents (aged 6 -19) are
    overweight
  • Prevalence of overweight children and adolescents
    has more than tripled since 1980.

9
Children Then
10
Children Now
11
Overweight in AL Youth
  • Screening in 5 AL public schools found
  • 15 of tweens at risk of overweight
  • 25 of tweens overweight
  • (40 potential weight problems)
  • ALABAMA vs. UNITED STATES  2003 YOUTH RISK
    BEHAVIOR SURVEY
  • PERCENTAGE OF STUDENTS WHO DESCRIBED THEMSELVES
    AS SLIGHTLY OR VERY OVERWEIGHT 
  • T-AL  26.5 (2.2) F 32.8 (3.9) M 20.4 (3.7)
  • T-US  29.6 (1.9) F 36.1 (3.1) M 23.5 (1.4)

12
Health Conditions Related to Overweight and
Obesity
  • Heart disease
  • Some forms of cancer
  • Stroke
  • Diabetes / insulin resistance
  • Kidney disease
  • Hypertension
  • Sleep apnea
  • Gallbladder disease

13
Obesity Health Problems
  • Gout
  • Osteoarthritis
  • Infertility
  • Joint problems
  • Gastro esophageal reflux
  • Asthma
  • Depression

14
Type 2 Diabetes In Pediatrics
  • 90- 95 of diabetes in adults is Type 2.
  • New epidemic is Insulin Resistance in children
    and teens

15
Diabetes Type 2 in Children
  • 1992 2 - 4 of all childhood diabetes
  • 1994 16 of new cases in urban area
  • 1999 8 - 45 of all new cases

16
Pediatrics and Atherosclerosis
  • Fatty streaks in arteries developing from age
    five (5) through 20
  • Fibrous plaques progress from some fatty streaks
    from 20 - 30 years of age
  • Direct association of cholesterol levels in
    children with coronary heart disease in adults

17
Pediatrics and Hypertension
  • Obesity is responsible for 50 of childhood
    hypertension.
  • 20-30 of obese youth have elevated BP.
  • Youth who are obese are 9X as likely to have
    hypertension as young adults as non-obese youth.

18
Psychosocial Effects
  • Poor self-esteem
  • Peer and adult relationships
  • Social discrimination
  • Natl. Longitudinal Study of Youth
  • Obese females had less education, less income,
    higher poverty rates, and decreased rates of
    marriage than non-obese females

19

Obesity is Complex
  • Dietary habits are important. But, in Alabama
  • 78.9 of adults do not eat 5 A Day
  • 86 of youth ate less than 5 A Day
  • 92 of youth drank less than 3 cups of milk a day

20
Proportion of Vegetable Servings
21
The Problem of Portion Distortion
22
High Fat, High Calorie Foods are Cool

23
Sources of Sugar
  • Soft drinks and school aged children
  • 56 of 8 year olds consume them daily
  • 1/3 of teen boys drink at least 3 cans a day
  • Soft drinks contribute 11 of calories and 15 tsp
    of sugar a day to most youth
  • Soft drinks are replacing milk as the beverage of
    choice.

24
No One Weight Loss Plan
  • Gradual weight loss is best
  • Child ? to grow taller, not strict diet but
    CHANGE FOODS EATEN
  • Limit/ Avoid empty calories
  • Refined sugar (honey, sugar, brown sugar)
  • Sweet drinks (Kool-aide, juice punches, colas)
  • Desserts (pies, cakes, Little Debbies pastry)

25
Physical Activity is Important
  • In Alabama
  • 59.6 of adults do not get 30 minutes or more
    moderate activity on five or more days of the
    week.
  • 81 of youth do not get moderate physical
    activity 30 minutes or more on 5 or more days of
    the week. (Recent recommendation of one hour per
    day)

26
Physical Activity is Important
  • In Alabama
  • 59 of youth were not enrolled in physical
    education classes
  • 41.7 of youth watched three or more hours of
    television a day

27
Physical Activity Can Help
  • Weight control
  • Strengthen heart
  • Lower blood sugar
  • Lower cholesterol and triglycerides
  • Increase good cholesterol (HDL)
  • Reduce hypertension
  • Strengthen muscles
  • Increase metabolism
  • Handle stress
  • Think clearer
  • Improve moods (PMS too)
  • Improved attitude

28
Alabama Obesity Task Force
  • The purpose
  • To bring together partners.
  • Initial meeting was May 4, 2004.
  • Over 70 representatives
  • public health, academia, health care, education,
    businesses, and community groups

29
Purpose continued
  • To develop and implement a comprehensive state
    plan to reduce obesity in Alabama among all
    segments of the population.
  • Work groups were formed
  • 1. General Nutrition
  • 2. Physical Activity
  • 3. Data
  • 4. Youth and Family
  • 5. Community
  • 6. Health Care

30
Developing a State Obesity Plan
  • A social - ecological model with multiple levels
    of influence
  • individual
  • interpersonal
  • organizational
  • community
  • public policy
  • It recognizes the individuals self
    responsibility to make positive lifestyle changes
    as well as acknowledges the importance of outside
    influences and environmental factors.

31
General Nutrition Subcommittee
  • Goal Stress prevention as a means to address
    obesity.
  • Preventing obesity
  • Preventing those already in the obese category
    from gaining additional weight.
  • Relationships with food will be explored to
    address cultural, emotional, and traditional
    beliefs that form eating habits.

32
General Nutrition SubcommitteeSpecific areas of
intervention
  • Breastfeeding
  • Early Childhood- includes family, daycare
  • School Age- includes family, school, and
    community
  • Adults- includes family, work, community,
    legislation
  • Senior adults- family, community, etc.

33
General Nutrition Subcommittee
  • 1. Breastfeeding
  • Eating habits of preschool children
  • Course of Study Parent and Child Dynamics-
    Parenting- section Parenthood, Child Development,
    and Physical and Safety Needs)
  • 6. Expectant mother and unborn child
  • 8. Assess postnatal care of the mother and
    infant
  • 15. Analyze ways to protect children from
    diseases and illnesses
  • 19 Effective ways to communicate..
  • 22. Nutritious meals..

34
General Nutrition Subcommittee Breastfeeding
  • Breastfeeding Grand Rounds Satellite Broadcast
    (Free)
  • Thursday, August 4, 2005 730 a.m. - 930 a.m.
    ET
  • Program Obesity and Breastfeeding
  • http//www.albany.edu/sph/coned/bfgr05.htm
  • Impact of Breastfeeding on Pediatric Obesity
  • Impact of Breastfeeding on Maternal Obesity
  • Questions and Answers - Phone in questions toll
    free This program will be available via Web
    streaming within 1-2 weeks after the broadcast.

35
General Nutrition Subcommittee Student Project
Ideas
  • Survey or study to determine if your community
    has Baby Friendly areas and what it would take
    to have such areas.
  • Does your school allow breast pumps for new
    mothers?
  • For more information
  • http//www.cdc.gov/breastfeeding/support-home.htm
  • www.adph.org (WIC Breastfeeding support)

36
General Nutrition SubcommitteeSpecific areas of
intervention
  • School age students, who already have a low
    consumption of fruits and vegetables but high
    consumption in empty calorie-laden foods through
  • Gardens and other agriculture programs
  • Increasing F/V at school day
  • Improved environmental influences

37
General Nutrition Subcommittee Adding Fruits and
Vegetables
  • In some schools, gardens are being integrated
    into the curriculum to teach children about
  • Plants
  • Nature
  • Outdoors
  • History
  • Economics
  • Poetry
  • Math
  • Science studies

38
Programs to Encourage Fruits and Vegetables..
Student projects
  • School and local gardens
  • http//www.urbanharvest.org/directory/alphabetical
    .html
  • http//www.casagarden.com/ (Huntsville area)
  • http//www.kidsgardening.org/
  • Local contact
  • Vasha Rosenblum, Ph.D.
  • 2690 Altadena Road
  • Birmingham, AL 35243
  • 205-969-2254
  • vashan1_at_bellsouth.net
  • Farm to school programs
  • Alabama Agriculture in the Classroom (AITC)
    http//www.alabamaaitc.org/class_material.html
  • Farmers markets-
  • programs to increase the availability and
    consumption of local fruits and vegetables.

39
Better Choices at School
  • Student Health Task Force SBOE
  • Schools should provide a consistent environment
    that is conducive to healthful eating behaviors
    during school hours and during after-school child
    care programs. Healthy and appealing foods should
    be available in
  • 1.a.) cafeteria meals, a la carte items
  • 1.b.) vending machines, snack food items sold in
    the cafeterias, school stores

40
School MealsStudent Health Task Force SBOE
  • Under specific USDA guidelines
  • Changes at the local level will include improving
    quality by
  • Increasing the whole grain options
  • Using low fat milk
  • Increasing fruit and vegetables
  • Using freshly grown, Alabama produce

41
Student Health Task Force SBOEVending and
Funding
  • This Committee understands the economical impact
    of vending machines and school stores and there
    is no intention of taking that income away.
  • Selling low-nutritive foods sends unspoken
    messages
  • It is acceptable to compromise health for
    financial reasons
  • Schools contradict health messages taught in
    class.

42
Ways to Address the Problem
  • Healthy and appealing foods can be available at
    schools and at after school programs.
  • Cafeteria meals Cafeteria snacks
  • Vending machines
  • School stores
  • School/after school site parties (LONG RANGE)
  • Student incentives (LONG RANGE)

43
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44
Vending Selections
  •   

45
Vending Machine Changes
  • Strategic plan
  • To include input of the customers (teachers and
    older students)
  • Focus groups made of students, staff, and parents
    to review, taste appropriate food selections
  • If a focus group is not possible, group surveys
    can identify opinions
  • When items are selected, promotion strategies
    inform
  • All students and parents about foods selected.
  • For example, students and staff make signs,
    contests, games, health fairs, advertisements,
    flyers, banners, etc.

46
Vending Issues Fit in the Alabama Courses of
Study
  • Teen Living, Food Dimensions
  • 17. Evaluate the effect of food on health and
    appearance
  • 18. analyze facts affecting teen food choices
  • 20. compare the nutritive value and costs of
    snack and fast foods
  • 23. prepare nutritious snacks and meals
  • Family Dynamics, Food Dynamics
  • 11. Determine the nutritive value and costs of
    snacks, fast foods, eating out, and home cooked
    meals
  • Consumer Dynamics
  • 36. Utilize a management plan to meet the beeds
    and wants of t families comparative shopping

47
Student Health Task Force SBOE
  • Fundraising Activities
  • All fundraising activities that involve the
    selling of food should reinforce food choices
    that promote good health.
  • Project idea?
  • Work with clubs in the school, area, county, etc.
    to develop or distribute list of good sales
    projects.

48

Guide to Healthy School Fundraising
  • CREATIVE FINANCING AND FUNDRAISING
  • Alternative Examples to Selling Candy
  • FRUIT
  • Candles Spirit/seasonal flags
  • Gift wrap, boxes, and bags Bumper
    stickers
  • Holiday wreaths License plates or
    holders w/school logo
  • Flowers, bulbs, poinsettias Yearbook
    covers
  • Cookbooks
  • T-shirts, sweatshirts
    Music, videos, CDs
  • Books, calendars Christmas trees
  • Football seats Giant coloring books
  • Plants Hats/Caps

49
Guide to Healthy School Fundraising
  • Jewelry
  • School spirit gear Monograms
  • First aid kits School art drawings
  • Emergency kits for cars Newspaper
    space, ads
  • Stationery Stadium pillows
  • Pocket calendars School Frisbees
  • Raffle donations Garage sale
  • Coffee cups/mugs
  • Foot warmers
  • Things to Support Academics
  • Read-a-thon
  • Science fair
  • Spelling bee

50
Fund Raising Ideas
  • Things to Do
  • Gift wrapping Fun runs
  • Magic shows Family glamour portraits
  • Walk-a-thons Treasure hunt/scavenger
    hunt
  • Bike-a-thons Tennis/horseshoe
    competition
  • Jump-rope-a-thons Raffle (movie
    passes, theme bags)
  • Rent-a-teen helper (rake leaves,
    Workshops/classes
  • mow lawns, walk dogs) Festivals
  • Carnivals (Halloween, Easter) Recycling
    cans/bottles/paper
  • Dances (kids, father, daughter, family)
    Golf Tournament
  • Skate night/skate-a-thon Bowling/
    bowl-a-thon

51
At the National Level.
  • Senator Tom Harkin of Iowa and Representative
    Lynn Woolsey of California bill "The Child
    Nutrition Promotion and School Lunch Protection
    Act,"
  • Goal To improve the nutritional quality of foods
    sold out of
  • vending machines
  • a la carte (snack) lines
  • school stores
  • fundraisers
  • and other venues outside of school meals
  • This bill would call on the U.S. Department of
    Agriculture to review, revise, and update the
    definition of "foods of minimal nutritional
    value" (FMNV) and extend this definition to cover
    the whole school campus and school day.

52
Obesity Task ForceGeneral Nutrition
SubcommitteeSpecific areas of intervention
  • Adult interventions
  • Work environment (food and physical activity
    opportunities)
  • Teacher/Staff lounge
  • Mature adult interventions
  • Affordable, balanced eating patterns

53
General Nutrition Subcommittee
  • Relationships with food will be explored to
    address cultural, emotional, and traditional
    beliefs that form eating habits. (Reasons we eat)
  • Course of study
  • Human Dynamics- Life Connections, Balancing Work
    and Family
  • 13. Devises strategies for dealing with stress
    in the home, workplace, and community.
  • Family Wellness- Personal and Family Health,
    Health Behavior
  • 3. Develop an individual health plan that
    includes all dimensions of health and wellness
  • 4. Determine ways culture influences
    individual and family health-
  • 8 - 16

54
General Nutrition Project Ideas
  • http//www.healthfinder.gov/library/nho/

55
Obesity Task ForceCommunity Subcommittee
  • Goal To have an environment which permits
    healthy lifestyle choices of physical activity,
    healthy eating, and a healthy weight as the
    accepted norm.
  • Involve community leaders
  • Assessments with business, faith, school, and
    medical components for current and potential
    changes.

56
Obesity Task ForcePhysical Activity Subcommittee
  • Goal To have physical activity as the norm.
  • Improved and expanded school based fitness
    programs
  • A change in the attitude and behaviors associated
    with physical activity versus exercise
  • An exercise friendly, walkable, and bikable
    community
  • Community assessments to identify ways for
    physical activity to be incorporated

57
Community and PA InterventionsImproved
Environmental Influences Wellness Policies
(USDA Required, SDOE Task Force Recommendation)
  • What does your school have in place? What changes
    are needed? Where do you start?
  • Examples of survey tools
  • CDCs Healthy School Index
  • USDAs Team Nutrition
  • After the survey is completed
  • Schools will know what area to address first.

58
The School Health Index (SHI) Self-Assessment
Planning Guide
  • Developed by CDC in partnership with school
    administrators and staff, school health experts,
    parents, and national nongovernmental health and
    education agencies for the purpose of
  • Enabling schools to identify strengths and
    weaknesses of health and safety policies and
    programs,
  • Enabling schools to develop an action plan for
    improving student health, which can be
    incorporated into the School Improvement Plan,
    and
  • Engaging teachers, parents, students, and the
    community in promoting health-enhancing behaviors
    and better health.
  • http//apps.nccd.cdc.gov/SHI/Static/Introduction.a
    spx

59
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60
Examples of questions on School Health Index
(SHI)
61
Community and PA InterventionsImproved
Environmental Influences
  • Student projects
  • Child Nutrition Program (CNP) staff
  • Changing the Scene - Improving the School
    Nutrition Environment tool kit that addresses the
    entire school nutrition environment.
    www.fns.usda.gov/tn/Resources/index.htm

62

Obesity Task Force PA Interventions
  • Suggestions for selecting a project are
  • Starting a walking competition to walk the miles
    every day to equal a trip across Alabama, USA, or
    in conjunction with history class.
  • Learning about Rome? Then walk there! Be sure
    to celebrate when you arrive.
  • Plan a trip to get to the moon.

63
Walking Programs
Blue Cross Blue Shield program
  • http//www.bcbsal.org/walkingworks/index.cfm
  • Lighten UP Alabama
  • http//www.lightenupalabama.org/main.shtml

64
More Walking Programs
  • Coca-Cola - Step With IT Program
  • Walks for diseases- Diabetes, Cancer, Heart,
    Arthritis, etc.
  • America on the Move-
  • http//www.americaonthemove.org/
  • http//www.ppheal.org/america_on_the_move.html
  • Shape Up Colorado

http//www.shapeupchallenge.org//
65
www.walktoschool.org
66
Ideas for implementation for both PA and Community
  • Complete assessment at school, town,
    neighborhood, etc.
  • Address sidewalks or walking paths, clear paths
  • Mark mileage in parking lot at the school or
    agreeable business
  • Visit Auburn, Alabama
  • http//www.auburnalabama.org/cycle/default.htm

67
State Obesity Task ForceYouth and Families
Subcommittee
  • Three priorities
  • Increase awareness of the burden of overweight
  • Equip parents, guardians, caregivers, and
    educators with skills to promote healthy
    behaviors.
  • Focus on family interactions (modeling), target
    obesigenic families

68
Youth and Families SubcommitteeIntervention
Suggestions
  • Focus on family interactions (modeling), target
    obesigenic families-
  • Course of Study
  • Teen Living
  • 9. Compare Characteristics of healthy families
  • Family Dynamics
  • 3.Utilize the decision making process to meet
    the needs and wants of the family across the
    life span
  • 4. Determine characteristics of strong
    families
  • Food Dynamics
  • 2.Analyze food habits of family members across
    the life span

69
Youth and Families SubcommitteeInterventions
  • Child Care settings- Books selected for children
    to focus on eating healthy or physical activity.
  • Family outing sponsored in neighborhood park.
  • Family Fun Day

70
Obesity Task ForceData Subcommittee
  • Goal is to have a data system with appropriate
    data collected in routine manner.
  • Appropriate additional data sources will be
    identified.
  • The data findings will be compiled and published
    to serve as the base for evaluation needs.
  • A data collection standard to be used on a
    statewide basis and to create a centralized
    clearing house (ADPH)

71
Obesity Task ForceData Subcommittee
  • Needs Alabama height and weights for youth.
  • To be collected in trained manner, sensitive to
    personal feelings.

72
The Health Care Subcommittee
  • Goal is to help medical professionals prevent and
    treat weight problems
  • A basic intervention model for providers with
    step by step guide for provider patient handouts

73
The Health Care SubcommitteeInterventions
  • Course of Study Teen Dynamics
  • Career Dynamics
  • 30. Analyze career options in family and
    consumer sciences career majors.
  • Student Project
  • Growth charts Share or sell?
  • Interview MD or registered dietitian

74
Media for Obesity Awareness
  • Comprehensive, coordinated media plan
  • Being sensitive in how losing weight is
    approached while addressing how exercise can be
    moderate and everywhere.
  • Emphasizing a healthy population is a natural
    resource of Alabama.

75
Logo
76
Logo
77
Logo II
78
Color Ad I
Color Ad I
79
Billboard Ad
Billboard Ad
80
Brochure
Brochure outside
81
For More Information
  • Miriam J Gaines, MACT, RD, LD
  • Nutrition and Physical Activity Director
  • Alabama Department of Public Health
  • RSA Tower, Suite 1010
  • P.O Box 303017
  • Montgomery, AL 36130
  • Phone 334-206-5649
  • Fax 334-206-5663
  • Email mgaines_at_adph.state.al.us
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