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Healthier Families May Start at the Dinner Table. Miriam Gaines, MACT, RD, LD Nutrition and Physical Activity Director Alabama Department of Public Health February 2009. The Problem. Trust for America’s Health (2005- 2007) ranked Alabama as: 2 nd highest for adult hypertension (33.5%) - PowerPoint PPT Presentation
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Healthier Families May Start at the Dinner Table
Miriam Gaines, MACT, RD, LDNutrition and Physical Activity DirectorAlabama Department of Public Health
February 2009
The Problem
Overview of Alabama’s Adults• Trust for America’s
Health (2005- 2007) ranked Alabama as:– 2nd highest for adult
hypertension (33.5%)– 33rdrd highest for adult highest for adult
obesity (30.1%)obesity (30.1%)– 4th highest for
diabetes (10%)– 6th highest for physical
inactivity (29.6%)
Obesity Trends* Among U.S. AdultsBRFSS, 1986
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
1996
1991
2003
Obesity Trends* Among U.S. AdultsBRFSS, 1991, 1996, 2003
(*BMI 30, or about 30 lbs overweight for 5’4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2004
(*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, 2005
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2006
Obesity Trends* Among U.S. AdultsBRFSS, 2007
Obesity in Alabama 2004
Obesity in Alabama 2006
Obesity Trends in Alabama
Obesity is ComplexDietary Habits Are Important
• In Alabama, 78.9 % of adults do NOT eat 5 servings of fruits and vegetables a day.
Obesity is Complex A Sedentary Society Burns Fewer Calories
• Contributories– Automobiles– Television– Computers– Convenience
Engineering– Built Environment– Human Nature
Physical Activity is Important
• In Alabama, 59.6% of adults do NOT get 30 minutes or more of moderate activity on 5 or more days of the week.
Obesity is Associated with Over 30 Health Problems
• Diabetes• Cancer
– Endometrial– Breast– Colon
• Heart Disease– Hypertension– High cholesterol– Heart attacks
• Sleep disorders• Respiratory problems• Abdominal pain
(gallbladder, constipation)
• Menstrual abnormalities
• Anxiety• ETC
Adults Diabetes in US2005
http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx
Adult Diabetes in Alabama 2005
http://apps.nccd.cdc.gov/DDT_STRS2/CountyPrevalenceData.aspx
Cancer Trends in AlabamaCancer Type Rate per 1000,000 population
In Alabama
All cancers 214.2
Lip, oral, pharynx, esophagus
7.5
Prostate 23.4
Female reproduction organs
18.0
Trachea, lung 67.1
Cancer Death Rates Alabama vs. United States, 2004
http://apps.nccd.cdc.gov/StateCancerFacts/Table.aspx?Group=5f&TableType=MORT&SelectedState=Alabama
Health Indicators and TrendsHeart Health
Major Heart Disease Totals State
351.7
Hypertension 8.9
Atherosclerosis 4.5
Ischemic Heart Disease 125.9
Alabama’s Children Follow Our Adults
• 11th in nation for childhood obesity
(10- 17 yr)• 16.7% obese children
(Trust for America’s Health)
• Recent after school studies in Alabama indicate the rate may be higher.
Alabama’s Children Are OUR Children
• ADPH Dental Program 2006-2007
• Heights & weights collected for 3rd grade students
• 17.9% overweight• 24.6% were obese
42.5% of 3rd graders
Alabama’s Children are Following the Adults in Obesity Rates
0
10
20
30
40
50
60
overweight obese
obese 23.9 26.3 35.8 20.9 28.8 31.1
overweight 17.6 17.4 17.9 18.3 18.6 15
White Male
Black Male
Hispanic Male
White Female
Black Female
Hispanic Female
Overweight/Obesity, 3rd Graders, Alabama,, 2006-7
Overweight and Obese in Alabama High Schools
1999-2007 YRBS
0
5
10
15
20
25
30
35
overweight obese
obese 11.1 12.3 13.5 14.8 13.6
overweight 17.3 15.2 14.5 17.8 16.6
1999 2001 2003 2005 2007
Sedentary Students in Alabama
• 81% of youth do NOT get moderate physical activity 30 minutes or more on 5 days or more of the week
• 59% of youth were not enrolled in physical education classes
Sedentary Students in Alabama
• 41.7% of youth watched three or more hours of television a day
• Over 2 hours a day is related to obesity
• Children view an average of one food ad every 5 minutes of TV viewing time. Average child views 2-3 hours of food ads each week.
Nutrition and Physical Activity 2005, YRBS
14.78.5
58.2
21.7
38.445.1
20.116.2
64.1
26.5
37.233
0
10
20
30
40
50
60
70
5 a Day 3 a Day VigorousPA
ModeratePA
TV Daily PE
AL 05 US 05
What DO Our Children Eat?
What Influences Our Children?
Recognize These?
Marketing Strategies
• Many venues
– Schools, grocery stores, malls, theaters, sporting events, child care
• Many media vehicles
– Broadcast and print media, Internet, videogames, cell phones
• School-based marketing practices
– Product sales, direct and indirect advertising, marketing research
McDonald’s $ 619 MBurger King $ 294 MPepsi/diet Pepsi $ 207 M Coke/diet Coke $ 167 MMountain Dew $ 60 MM&M candies $ 73 MSnickers candy bar $ 70 MFrito-Lay chips/snacks $ 57 MPringles $ 35 MKool-Aid $ 25 MLunchables $ 23 M
US Ad Spending in Millions 2003
Advertising Age, June 2004
U.S. government’s entire budgetfor nutrition education
Is one-fifth the advertising budget for…
Altoids mints
Nestle, 2002
Budget Comparison
Amount Spent on Advertising to Children
Approximately $2 billion a year is for advertisements targeting children
This is a 20-fold increase from 1990.
J. McNeal, 2003
Growth in New Food Products Targeted to Children and Youth
1994 to 2004
New products targeted to total market
New products targeted to children & youth
Source: Williams J. 2005b. Product Proliferation Analysis for New Food and Beverage Products Targeted to Children, 1994–2004. University of Texas at Austin Working Paper.
Why Are Youth and Children Targeted?
1) They are a primary market - they spend their own money
2) They are an influence market - they influence their parents’ spending
3) They are a future market - they will spend money in the future.
Heavy marketing to children is driven by desire to build brand awareness, brand preference and brand loyalty (BRANDING)
Advertising on School Buses
Logos on Scoreboards, Banners, Bulletin Boards
Textbook covers
Gatorade
Juicy Fruit Gum
“Cover Concepts places your brand directly into the hands of kids and teens in a clutter-free environment.”
BRAND LOGOS TOUCH EVEN YOUNGER CHILDREN
Basic Counting Books
Internet Marketing to Children
Contests and Sweepstakes
Television Advertising to Children Still the Main
Medium
• Over 75% of food advertising budgets and 95% of fast food chain budgets are for TV
• An average child views about 3 hours of TV/ day; sees between 20,000 - 40,000 commercials per year
• Food is the most frequently advertised product category on children’s TV, accounting for over 50% of all ads.
Does food advertising and marketing influence children’s food preferences, eating behavior, and weight status?
So What?
YES
Effects of Food Promotion on Children’s Food Preferences and
Behavior
Strength of Evidence
Preferences Strong
Purchase-related behavior Strong
Consumption Modest
G. Hastings et al., 2003 Review The Extent and Nature of Food Promotion to Children
Strength of Evidence on Factors That Might Promote Weight Gain and
ObesityEvidence Increased RiskConvincing • Sedentary lifestyle
• High intake of energy-dense micronutrient poor foods
Probable • Heavy marketing of energy-dense foods andfast-food outlets
• High intake of sugar-sweetened drinks
Possible • Large portion sizes• High proportion of food prepared outside the home• “Rigid restraint/periodic disinhibition” eating patterns
Insufficient • Alcohol
Examined the strength of evidence linking diet and lifestyle factors to obesity.
Four levels of evidence:
– convincing
– probable
– possible
– insufficient
WHO/FAO Report, 2003
The Solution
What Can Be Done to Improve the Health of Our Children?
• National nutrition legislation
• State policies
• Local policies
• Family policies
Limiting Marketing of Low Nutrition Foods to Children
• Join nation groups against marketing low nutrition foods to children (Center for Science in the Public Interest)
• Encourage and thank sponsors for healthy eating – Fast food– TV Stations– ETC
What do you see in your child’s school and after school, church, gym, doctors office, etc… ?
Encourage Others to be Good Role Models
• Who is around your child - teachers, coaches, care givers, etc.?
• Who influences your child – state or local authorities, health providers, church leaders, etc.?
Family Policies What Can WE Do As Families?
• Be Good Role Models– Nutrition– Physical Activity
• Be Careful Food Gatekeepers
• Watch Out for Outside Influences
Be Good Role ModelsNutrition
• They learn from watching you.
• Eat fruits and vegetables and your kids will too.
Be Good Role Models
• Cook Together
• Eat Together
• Talk Together
Be Good Role Models Physical Activity
Food “Gate Keepers” Make Mealtime a Family Time
http://www.makemealtimefamilytime.com/
Why Family Meal Time?
Tips To Remember for Family Meals
• Sometimes new foods take time
• Patience versus pressure
• Let them learn by serving themselves at the table
Food Gate Keeper Includes Healthy Snacks
• Have fruits and vegetables cut and ready to eat
• Use the 10- 10- 5 guideline for snacks in the house – keep only healthy snacks
Let Your Kids Be Produce Pickers … Literally
In the garden In the stores
Finding Resources to Help Parents
More Resources
• Family Day - A Day to Eat Dinner with Your Children ™ is a national movement to inform parents that the parental engagement fostered during frequent family dinners is an effective tool to help keep America’s kids substance free. Family Day reminds parents that Dinner Makes A Difference! http://casafamilyday.org/familyday/
Tested Messages to Use for Older Children
• Eat Smart to Play Hard
• Drink milk at meals.
• Fuel up with milk at meals and soar. through your day like a rocket ship.
• Snack like a super hero. Eat fruit and veggies at meals and snacks.
Harry S. Truman, 1946
“No nation isany healthier than
its children”
Guard Our Children’s FutureEat Better and Move More