How We Eat…and How It Affects Our Health and Society

How We Eat…and How It How We Eat…and How It Affects Our Health and Affects Our Health and

SocietySociety

Mary Stein, MS

Department of Health and Human Development

Montana Team Nutrition Program

mstein@montana.edu

Question?Question?Have you ever thought about Have you ever thought about how the rest of the world eats how the rest of the world eats

compared to how we eat in compared to how we eat in the US?the US?

Japan: The Ukita family of Kodaira City

Food expenditure for one week: 37,699 Yen or $317.25Favorite foods: sashimi, fruit, cake, potato chips

Italy: The Manzo family of Sicily

Food expenditure for one week: 214.36 Euros or $260.11Favorite foods: fish, pasta with ragu, hot dogs, frozen fish sticks

Chad: The Aboubakar family of Breidjing Camp

Food expenditure for one week: 685 CFA Francs or $1.23Favorite foods: soup with fresh sheep meat

Kuwait: The Al Haggan family of Kuwait City

Food expenditure for one week: 63.63 dinar or $221.45 Family recipe: Chicken biryani with basmati rice

China: The Dong family of Beijing

Food expenditure for one week: 1,233.76 Yuan or $155.06Favorite foods: fried shredded pork with sweet and sour sauce

Egypt: The Ahmed family of Cairo

Food expenditure for one week: 387.85 Egyptian Pounds or $68.53Family recipe: Okra and mutton

Poland: The Sobczynscy family of Konstancin-Jeziorna

Food expenditure for one week: 582.48 Zlotys or $151.27Family recipe: Pig's knuckles with carrots, celery and parsnips

Ecuador: The Ayme family of Tingo

Food expenditure for one week: $31.55Family recipe: Potato soup with cabbage

Mongolia: The Batsuuri family of Ulaanbaatar

Food expenditure for one week: 41,985.85 togrogs or $40.02Family recipe: Mutton dumplings

Bhutan: The Namgay family of Shingkhey Village

Food expenditure for one week: 224.93 ngultrum or $5.03Family recipe: Mushroom, cheese and pork

Germany: The Melander family of Bargteheide

Food expenditure for one week: 375.39 Euros or $500.07Favorite foods: fried potatoes with onions, bacon and herring, fried noodles with eggs and cheese, pizza, vanilla pudding

Mexico: The Casales family of Cuernavaca

Food expenditure for one week: 1,862.78 Mexican Pesos or $189.09Favorite foods: pizza, crab, pasta, chicken

Great Britain: The Bainton family of Cllingbourne Ducis

Food expenditure for one week: 155.54 British Pounds or $253.15Favorite foods: avocado, mayonnaise sandwich, prawn cocktail, chocolate fudge cake with cream

United States: The Caven family of California

Food expenditure for one week: $159.18Favorite foods: beef stew, berry yogurt sundae, clam chowder, ice cream

United States: The Revis family of North Carolina

Food expenditure for one week: $341.98Favorite foods: spaghetti, potatoes, sesame chicken

How Is the Way We Eat in How Is the Way We Eat in the US Affecting Our Health?the US Affecting Our Health?

Kids Health is in JeopardyKids Health is in Jeopardy

16% of kids (ages 16% of kids (ages 6-19) are 6-19) are overweightoverweight

– Higher in certain Higher in certain ethnic subgroupsethnic subgroups

Percentage of U.S. Children Percentage of U.S. Children and Adolescents Who Were and Adolescents Who Were

Overweight*Overweight*

0

2

4

6

8

10

12

14

16

1963-70 1971-74 1976-80 1988-94 1999-2000

Ages 12-19

Ages 6-11

1963-70 data are from 1963-65 for children 6-11 years of age and from 1966-70 for adolescents 12-17 years of age* >95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth chartsSource: National Center for Health Statistics

Percentage of U.S. Children and Percentage of U.S. Children and Adolescents Who Were Overweight*Adolescents Who Were Overweight*

0

2

4

6

8

10

12

14

16

1963-70** 1971-74 1976-80 1988-94 1999-2000

Ages 12-19

Ages 6-11

5

4

15

* >95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts**Data are from 1963-65 for children 6-11 years of age and from 1966-70 for adolescents 12-17 years of ageSource: National Center for Health Statistics

Increase in Increase in Overweight/ObesityOverweight/Obesity

ADULTSADULTSFrom 1980 – 2000, From 1980 – 2000, obesity rates in U.S. obesity rates in U.S. doubled among adults doubled among adults aged 20-74aged 20-74

From 15% - up to 31%From 15% - up to 31%(From the National Center on Health Statistics)(From the National Center on Health Statistics)

65% of the US 65% of the US population is population is categorized as categorized as overweight or obeseoverweight or obese

Obesity Trends* Among U.S. AdultsBRFSS, 1985

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1986

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1987

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1988

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1989

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1990

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1991

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1992

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1993

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1994

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1995

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1996

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1997

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1998

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1999

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2000

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2001

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

Obesity* Trends Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity* Trends Among U.S. AdultsBRFSS, 2004

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Consequences of Consequences of ObesityObesity

Increased Risk for Increased Risk for

Many Chronic DiseasesMany Chronic Diseases

Adults Diagnosed with Adults Diagnosed with DiabetesDiabetes

Type 2 DiabetesType 2 Diabetes

Centers for Disease ControlCenters for Disease Control estimates that one in three people estimates that one in three people born in the U.S. in 2000 will born in the U.S. in 2000 will develop diabetes sometime in develop diabetes sometime in their life – unless significant their life – unless significant changes in eating and exercise changes in eating and exercise habits occur. habits occur.

1 Prevalence of Diabetes and Impaired Fasting Glucose in Adults – United States, 1999-2000, MMWR, Sept. 5, 2003; 52(35);833-837

Cardiovascular Disease Cardiovascular Disease (CVD)(CVD)

Heart Disease and Heart Disease and StrokesStrokes

CVD accounts for CVD accounts for 40% of deaths in the 40% of deaths in the U.S.U.S.

Risk Factors for CVD:Risk Factors for CVD: Tobacco use, high Tobacco use, high

cholesterol levels, cholesterol levels, lack of physical lack of physical activity, poor activity, poor nutrition, high blood nutrition, high blood pressure and diabetespressure and diabetes

1 Preventing Heart Disease and Stroke: Addressing the Nation’s Leading Killers. CDC: April, 2003

So what?So what?

““For the first time in this For the first time in this country’s history, health country’s history, health experts question if this experts question if this generation of children generation of children

will be first to lead shorter will be first to lead shorter lives.”lives.”

~ ~ The Obesity EpidemicThe Obesity Epidemic

http://www.nsba.org/site/docs/32700/32675.pdf retrieved 3-6-06

What has What has changed? changed?

Why are Why are Americans Americans

Gaining Weight?Gaining Weight?

Portion Size…It’s Out of Portion Size…It’s Out of ControlControl

What Are Healthy What Are Healthy Portion Sizes?Portion Sizes?

May I take your order please?

< 2% Kids meet the < 2% Kids meet the recommendations of the Food recommendations of the Food

Guide PyramidGuide Pyramid

40% of a typical child’s 40% of a typical child’s

calories comes from calories comes from ADDED ADDED

fat and sugarfat and sugar

Food Is Around Every Food Is Around Every Corner…Corner…

Gas StationGas Station Laundry-MatLaundry-Mat SchoolSchool

VendingVending Food RewardsFood Rewards Classroom PartiesClassroom Parties Concessions at Sporting EventsConcessions at Sporting Events

Question?Question?We’re taking in too We’re taking in too many calories… but many calories… but are we getting all are we getting all of the nutrients of the nutrients

our body needs to our body needs to run properly?run properly?

Overfed But Undernourished

0

20

40

60

80

100

120

6-11 Mo. 1 Yr. 1-4 Yrs. 5-8 Yrs. 9-14 Yrs. 15-19 Yrs.

Calcium

Folate

% Children Consuming

Daily Recommende

d Intake

MagnesiumVitamin A

Vitamin C

Zinc

Iron

Phosphorus

Critical Age

Data compiled by Dr. John Lasekan, Ross LabsNHANES 1999-2000 and the Continuing Food Survey 1994-96, 1998

Let’s Look at Some Key Let’s Look at Some Key Nutrients/Food Groups of Nutrients/Food Groups of

Concern in Teen Diets:Concern in Teen Diets:

CalciumCalcium IronIron Vitamin DVitamin D Omega-3 FatOmega-3 Fat Fruits and Veggies!!Fruits and Veggies!!

CalciumCalcium

CalciumCalcium

    71% of females and 62% of 71% of females and 62% of

males age 6-11 are not males age 6-11 are not meeting calcium meeting calcium recommendations - note:  recommendations - note:  this percentage is even this percentage is even higher among adolescents. higher among adolescents.    

American per capita soft-American per capita soft-drink consumption has drink consumption has increased almost 500 increased almost 500 percent over the past 50 percent over the past 50 years. years.

Calcium…Calcium… During adolescence, During adolescence,

45% of adult 45% of adult skeletal mass is skeletal mass is gainedgained

It is a “one shot It is a “one shot deal” to have strong deal” to have strong bone density.bone density.

Weight bearing Weight bearing exercise helps bones exercise helps bones

Teenagers consume twice as Teenagers consume twice as much pop as milk in a typical much pop as milk in a typical

dayday

Vitamin DVitamin D

Vitamin DVitamin D

““Vitamin D Vitamin D Deficiency Called Deficiency Called

Major Health Major Health Risk” Risk” (Washington Post, (Washington Post,

May 2004)May 2004)

Why?Why? Decreased exposure Decreased exposure

to sunlightto sunlight Decreased intake of Decreased intake of

vitamin D rich foodsvitamin D rich foods

More about Vitamin D…More about Vitamin D…

October 2006October 2006: Article: “New study : Article: “New study gives further hope that vitamin D gives further hope that vitamin D can fight breast cancer”can fight breast cancer”

Vitamin D levels were lower in women with Vitamin D levels were lower in women with advanced breast cancer advanced breast cancer

Earlier studies show vitamin D stops cancer Earlier studies show vitamin D stops cancer cells from dividing and increases cancer cell cells from dividing and increases cancer cell death (apoptosis)death (apoptosis)

Transcription factor role of vitamin D – Transcription factor role of vitamin D – turns “on” and “off” genesturns “on” and “off” genes

IronIron

Iron:Iron:

Deficiency is Deficiency is common common (especially (especially among young among young women)women) Associated Associated

with impaired with impaired physical and physical and mental mental performanceperformance

Iron and LearningIron and Learning Study: School-aged children and Study: School-aged children and

adolescents who were iron adolescents who were iron deficient had lower standardized deficient had lower standardized math scores when compared to math scores when compared to their iron sufficient peers. their iron sufficient peers. 11

Study: Significant correlation iron Study: Significant correlation iron deficiency and poor cognitive deficiency and poor cognitive functionfunction22

11Halterman, Jill S., et al., “Iron Deficiency and Cognitive Achievement Halterman, Jill S., et al., “Iron Deficiency and Cognitive Achievement Among School-Aged Children and Adolescents in the United States”, Among School-Aged Children and Adolescents in the United States”, PEDIATRICS, Vol 107, No. 6, June 2001: 1381-1386.PEDIATRICS, Vol 107, No. 6, June 2001: 1381-1386.

22From Reuters Medical News: August 2, 2000 “Iron Deficiency in Teenaged From Reuters Medical News: August 2, 2000 “Iron Deficiency in Teenaged Girls Linked with Decline in Cognitive Function” (Note: Original Girls Linked with Decline in Cognitive Function” (Note: Original research published in THE LANCET, principal investigator: Dr. Michael research published in THE LANCET, principal investigator: Dr. Michael Nelson of King’s College in London).Nelson of King’s College in London).

Omega-3 FatOmega-3 Fat

Why Important? (cont)Why Important? (cont)

Evidence links Evidence links deficiency in deficiency in omega-3’s with omega-3’s with increases in many increases in many life-threatening life-threatening chronic diseaseschronic diseases

The Inuit Story…The Inuit Story…

What’s the Story with What’s the Story with Omega-3Omega-3

It’s a It’s a polyunsaturated fatpolyunsaturated fat

Common food Common food sources are:sources are: Long chain omega-Long chain omega-

3: Fish and fish oil3: Fish and fish oil Shorter chain Shorter chain

omega-3: Flaxseed omega-3: Flaxseed oil, walnutsoil, walnuts

Question:Question:Globalization… is it Globalization… is it affecting how the affecting how the

world eats?world eats?

Fast Food Comes to Fast Food Comes to AfricaAfrica

Eat Like an AmericanEat Like an American……

Western diet linked to breast Western diet linked to breast cancer in Asian womencancer in Asian women

Tuesday, July 10, 2007 | 12:16 PM ET Tuesday, July 10, 2007 | 12:16 PM ET CBC NewsCBC News

Western diet linked to greater Western diet linked to greater colon cancer recurrencecolon cancer recurrence

JAMA, August 2007JAMA, August 2007

How We Eat Affects More How We Eat Affects More than than

Just our Individual Health Just our Individual Health The Food MileThe Food Mile A measure of how far a food A measure of how far a food

travels from farm to plate.travels from farm to plate.

On average, food in America On average, food in America travels 1,300 miles from travels 1,300 miles from farm to plate. What are the farm to plate. What are the impacts of this distance on:impacts of this distance on:

Resource utilization (fossil Resource utilization (fossil fuels)fuels)

Taste and nutritionTaste and nutrition Impact on the local economyImpact on the local economy

Should “The Food Mile” be Should “The Food Mile” be lessened? What might be lessened? What might be some positive outcomes of some positive outcomes of this?this?

Solutions?Solutions?What are strategies for What are strategies for reversing the obesity reversing the obesity epidemic in America?epidemic in America?

Is it important to eat food Is it important to eat food that is grown closer to home? that is grown closer to home?

Why? Why?

Hints for Healthy Hints for Healthy LivingLiving

Shop the Grocery Store Shop the Grocery Store PerimeterPerimeter

Be Be physically physically

active active each day.each day.

BREAKFAST! Think 3!BREAKFAST! Think 3!

33% of kids skip breakfast 33% of kids skip breakfast before schoolbefore school

HydrationHydration

•Key organs are chronically dehydrated

•Brain

•Muscles

•Proper functioning of these organs require adequate hydration

•Carry a water bottle around all day

Family Meals When Family Meals When PossiblePossible

Family meals Family meals associated with:associated with: Improved Improved

communicationcommunication Healthier weights Healthier weights

for children and for children and adultsadults

Better Better performance at performance at school for school for childrenchildren

Who’s Your Farmer?Who’s Your Farmer?People who seek out local sources of food have a greater connection to the overall food system and

tend to eat a healthier diet.

Healthy Healthy

LivingLiving