Jeremy Nobel Changing the Way We Think About Public Health

8/12/2019 Jeremy Nobel Changing the Way We Think About Public Health

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2012

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

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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.

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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

Documents

Jeremy Nobel Changing the Way We Think About Public Health