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8/12/2019 Jeremy Nobel Changing the Way We Think About Public Health
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Food and Health:Changing the Way We think About (and
ACHIEVE!) Public Health, By Putting Food First
FMI ConferenceOrlando, Florida
March 20, 2012
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History is a racebetween
education andcatastrophe.
- H.G. Wells
An Appropriate Note of Urgency
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0
5
10
15
20
25
30
35
1970
1975
1980
1985
1990
1995
2000
2005
2010
2015
2020
2025
2030
2035
2040
2045
2050
2055
2060
2065
2070
2075
2080
%o
fGDP
CBO Long-Term Federal Spending Projections
as a Percentage of GDP
Medicare, Medicaid, ExchangeSubsidies, and CHIP Outlays
Social Security Outlays
Other Noninterest Outlays
Source: 2011 CBO Long-Term Budget Outlook
The Coming Catastrophe?
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Reducing the Burden of Chronic Disease
is a Social Mandate
Data from: Harvard Public School of Health's project on
the global burden of disease
Source: WSJ WALDHOLZ ON HEALTH By MICHAEL WALDHOLZ: November 20, 2002
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Real Cost of Obesity is Hidden in Resulting Medical Conditions
Pulmonary disease abnormal function
obstructive sleep apnea hypoventilation syndrome
Nonalcoholic fatty liver
disease steatosis
steatohepatitis cirrhosis
Coronary heart disease
Diabetes
DyslipidemiaHypertension
Gynecologic abnormalities abnormal menses
infertility polycystic ovarian syndrome
Osteoarthritis
Skin
Gall bladder disease
Cancer breast, uterus, cervix
colon, esophagus, pancreas
kidney, prostate
Phlebitis venous stasis
Gout
Idiopathic intracranial
hypertension
Stroke
Cataracts
Severe pancreatit is
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Overweight & Obesity Are Key Factors Driving Health Costs
Sturm R. Health Affairs 21:245, 2002;
0
100
200
300
400
Obesity Overweight Current or
ever smoking
Problem
Drinking
Aging 20
years
Increaseinannualcostsvs.
tho
se
withoutrisk
factor($/year)
Direct and indirect costs of obesity-associated conditions areestimated to cost U.S. employers nearly $80 billion.
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Moving from Urgency to Opportunity
Except for smoking, obesity is the leading cause of preventable
death in the US, causing over 300,000 deaths a year
- C. Everett Koop MD
To say that obesity is caused by merely consuming too many
calories is like saying that the only cause of the AmericanRevolution was the Boston Tea Party
-Adelle Davis
We don't need new discoveries or new inventions to reverse this
trend. We have the tools at our disposal to reverse it. All we
need is the motivation, the opportunity and the willpower, to do
what needs to be done.
-Michelle Obama
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Public Health Eating Programs Key Elements & Phases
Opportunity
Identification &
Quantification
Evaluation &
OptimizationReporting
Community
Based
Engagement
Communication
Education
Support
Solution
Set
Development
Analytic Epidemiology
Predictive Modeling
Cost Benefit Analysis
Cost Effectiveness
Analysis
1st Phase Stakeholder Engagement
Program Development
Deployment and Ongoing
Communication and
Outreach
2nd Phase Quantification of Benefit
Identification and
Mediation of Barriers and
Obstacles
Synergistic Expansion
3rd Phase
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Critical Elements of a Food First Public Health Program
Nutrition Science
- Guidance on micro- and macro-nutrient aspects of food choices
- Guidance adjusted for individual risk factors and conditions (e.g.
sodium intake and hypertension)
- Guidance on portion control and daily energy consumption parameters
Environment- Ever-improving access to healthy choices and trusted guidance
- Daily exposure to visible cueing; optimized for info-mediation
- Include ALL environments; Brick and mortar, and virtual
Behavior- Changing behavior is a marathon, not a sprint
- Make the right thing to do easy to do, AND rewarded
- Leverage social biases and assumptions to celebrate success
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In-store Shelf Labeling Programs
Public Health Rationale
Solves knowledge management
challenge to address consumer
need to know requirements Convenient visual cueing and
info-mediation at time of
decision making
Cross indexed to other healthyfood choice guidance platforms
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Guiding Stars:
A Food First Public Health Case Study
Guides consumers toward more nutritious food
choices, by meeting them where they are
(and where they are eating!).
Scientifically based, user friendly programfunctions effectively in all environments: Stores,
workplace, restaurants, online, mobile.
Links synergistically to other community
engagement and behavior change strategies Cited by the U.S. Surgeon General as a
program that positively impacts eating behavior.
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Addresses Consumers Need to Know
Only foods that score above 0 receive stars
Good Nutritional Value
Better Nutritional Value
Best Nutritional Value
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NOTE: All foods are rated.
Only some receive stars.
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Info-mediation at
Time of Decision Making
Supermarkets, schools, cafeterias,hospitals, etc.
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Mobile Applications
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Smart
ShoppingPlanner
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Scientific Transparency is Critical:Guiding Stars Nutrition Rating Algorithm Goes Public
16
American Journal of Health Promotion Publishes Science Behind Food
Ratings, Answering Call for Greater Transparency in Nutrition Guidance
Guiding Stars, the worlds first storewide nutrition guidance program, today
announced the online publication of the Guiding Stars algorithm in the
November/December 2011 issue of theAmerican Journal of HealthPromotion. The publication of the algorithm allows the public to fully understand
the scientific basis for the nutritional ratings of foods. The publication showcases
the research and development that went into the Guiding Stars algorithm, and
the important role a transparent program can have in simplifying the process of
choosing healthier foods in all areas of the supermarket.
November 3, 2011
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Guiding Stars Cited
by U.S. Surgeon General
Surgeon GeneralCDC: Weight of the Nation Conference
Importance of in-store nutri tion labeling programs:
a powerful model that shows when consumers are empowered with
simple, easy to understand information at the point of purchase, they
make better choices and it didnt take the regulatory process or a
lawsuit to have the company step up and do the right thing.
7.27.09
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Summing It Up: Problem & OpportunityThe Problem
Many of us, across all age and socioeconomic
strata make poor nutrition choices, and have
poor eating habits overall.
Rampant obesity and related chronic diseases
like heart disease and diabetes place increasedpressure on the healthcare system and on
society in general.
The Opportunity
Its starts with healthy eatingcoordinatingcommunity resources to influence eating and
other lifestyle behaviors so as to improve health
and wellness, increase productivity and drive
down healthcare costs.
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Resistance to Innovation Isnt New!
That it will ever come into generaluse, notwithstanding its value, isextremely doubtful because itsbeneficial application requiresmuch time and gives a good bit oftrouble, both to the patient and tothe practitioner because its hueand character are foreign and
opposed to all our habits andassociations.
The London Times, 1834
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Healthy Diet: A Public Health Concern
Prevalence for Cardiovascular Health Factors in U.S. Adults
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Healthy Diet: A Public Health Concern
Prevalence for Cardiovascular Health Factors in U.S. Children
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Nutrition Center
Vision: To lead positive change in Americans health and wellness by guid ing nutrition choiceswhere they are made, and ultimately creating heart-healthy mindsets and eating environments.
Food Supply
Policy and
Collaborations
Environment Consumer Behavior
FoodCertExpansionVirtualNutritionHQ
Nutrition Strategy
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Change The
Food Supply
Policy:Work with the FDA and USDA to ensure that school child nutrition
regulations and food labeling revisions encourage healthier foodchoices and reduce consumption of sodium, added sugars, and
saturated and trans fat, and that schools adopt robust wellness
policies.
25
Collaborations:
1. Heart-Check Food Certification Program companiesreformulating to meet revised program criteria.
2. Industry Nutrition Advisory Panel (INAP): Coalition of the AHA
Nutrition Committee and food industry organizations which
provides a platform for open dialogue on the application of
basic nutrition science to food processing technology.
3. Sodium Reduction: Working with government, industry, othernon-profits and healthcare professionals to coordinate sodium
reduction efforts.
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Environment:
Guidance Where and When Choices are Made
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Changing Consumer Behavior
HeartCheckFoodCertification
HighAwareness:83%aidedconsumerawareness
HighTrust:
73%
trust
the
AHA
most
to
decide
ifaproduct
is
healthy
2010SalesLiftAnalysis:averageincremental5%liftinsalesacrossallheart
checkcertifiedproductswhenpromotedinstore. Salesdrivenincertainkey
categorieswithdoubledigitlift:Hot&RTECereal,Soup,FreshVegetables,
CannedVegetables,RefrigeratedJuice,FreshMeat&Poultry,Meals&
Entrees,Snacks.
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VirtualNutritionHeadquarters
NutritionNavigator
GroceryListBuilderApp
HealthyEating/HealthyLivingCenter
UseQRcodetechnology
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1. Food modeling was conducted by Dr. Victor Fulgoni of Nutrition
Impact.2. National Health and Nutrition Examination Survey (NHANES) data
were used to evaluate the relationship of consuming foods that meet
American Heart Association Heart-Check Program criteria to Diet
Quality [as measured by the Healthy Eating Index.]3. Relationships of percentage of calories from AHA-certifiable foods in
specific nutrient/food group intakes and physiological parameters
including body weight, BMI, lipids, and blood pressure were examined.
Results: The data demonstrate that a greater consumption (as percentageof total calories) of foods that meet AHA Heart-Check Program
criteria is associated with better diet quality and lower cardiovascular
disease risk.
DoesPuttingFoodFirstHaveAPositiveImpactonPublicHealth?
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hank You
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FMI Health & Wellness Conference
Break-Out Session PanelYour Shoppers: Changing The Way We Think About Public Health by Putting Food First
March 20, 2012
Julie Greene, Hannaford Supermarkets
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Id rather pay the grocer than the doctor.(From Michael PollansFood Rules)
Shoppers visit supermarkets at least twiceper week, on average.
Considering the impact of diet on chronic
illness, and the frequency with which people
visit supermarkets, choices made insupermarkets can have a major impact on
the health of our communities.
Awareness of food deserts has increased,
but access doesnt address all challenges.
Product, Price, Placement & Promotion
purposely impact the choices we make,
which in turn, profoundly impact our health.
Weve heard of the hazards of mindless eating
What about mindless shopping?
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Stack It High & Watch It Fly
Why doesnt this work with broccoli?
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Make the Easy Choice a Healthy & Affordable Choice
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Driving Demand for Food that
Supports Good Health
Beyond Access Other Barriers: Nanny State paranoia
Non-immediate impact of diet on disease
Personal stories that reinforce lack of control,
validating unhealthy behaviors
Balancing business necessities with public
health realities- Low margin industry has limited patience for
displaying and promoting low volume product
- Slotting fees & allowances are a factor
Whats it going to take?
Rewards- Stick? Carrot? Both?- Who participates?
- Who pays?
Fear
Pop Culture
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