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Lecture%204%265%20Chapter%208%20Obesity%20SB - Community...

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Unformatted text preview: Community Nutrition GCH 421 Chapters 8 Why are overweight and obesity so prevalent? Why Why is the rate of obesity increasing? Why Genetic makeup of population has not changed. Food consumption patterns, urban sprawl, the Food built environment. built BMI = body mass index ≤18.5 = unhealthy; 18.6-24.9 = healthy; 25-29.9 = 18.5 overweight; >30 = morbidly obese overweight; Calculate BMI = [weight (lbs)/height (in) 2] x 703 Calculate Central obesity – waist circumference>40 (men), >40 >35(women) >35(women) Children - BMI≥ CDC growth chart criteria of 95th Children 95 percentile (obesity) 85th percentile (overweight) based on 85 gender, age standards. gender, Data generated by NHANES and BRFESS (Behavioral Data Risk Factor Surveillance System) Risk In women, prevalence of obesity is greater in non-Hispanic In Blacks and Mexican Americans; no difference in men. Blacks Differences is greater in Hispanic and African American Differences children children Trends on obesity in children and adolescents Obesity Trends* Among U.S. Adults BRFSS, 1990, 1998, 2007 (*BMI ≥ 30, or about 30 lbs. overweight for 5’4” person) 1990 1998 2007 No Data 25%–29% <10% ≥30% 10%–14% 15%–19% 20%–24% Total economic burden of obesity (Surgeon Total General’s Report 2001) - $117 billion in 2000 General’s If current trend continues- by 2030, cost would be If $860 – 987 billion US dollars $860 See table 8-3 p. 243 – problems associated with See obesity in adults and children. obesity Metabolic syndrome – increased blood glucose Metabolic and lipid levels, hypertension and Quality of life/discrimination Determinants –imbalance of energy Energy-dense-low nutrient foods; low physical Energy-dense-low activity activity One 150 calorie can of soda, all else being the One same – 16 lb weight gain in a year! same No one gene Increase of 300 cal/day or 12% since 1985 Why?? Portion size, refined sugars and added fat, Why?? fast foods, maternal employment, the built environment environment Poverty –cost, access Poverty access Obesity Prevention and Treatment Interventions Prevention goals – maintain a stable weight over Prevention time; Food guide Pyramid time; Treatment – lose weight over time Broad reach in the population of interest and Broad consistent implementation in real-life settings consistent National Weight Control Registry – study National examining habits of people who lost 30 lbs and kept it off for a year or more –regular exercise, breakfast breakfast Children- school-based physical education Adolescents- peer programs Government agencies: USDA, DHHS, FTC under DHHS – CDC, NIH, FDA (CDC) Steps to a HealthierUS – community (CDC) based see www.smallstep.gov; Health www.smallstep.gov Health Protection Research Initiative – benefits and cost effectiveness of a healthy workplace cost NIH – Obesity Research Task Force- (2003) NIH coordinated inter-agency efforts to increase funding for obesity-related research funding Behavioral and environmental Pharmacological and surgical Link between obesity and disease Special populations Translating basic science results into clinical Translating research and community intervention strategies research Dissemination National Heart Lung and Blood Institute (NHLBI) National www.nhlbi.nih.gov –weight control, hypertension, healthy www.nhlbi.nih.gov lifestyle lifestyle National Cancer Institute (NCI) -5 A Day Weight-control information network (WIN) within Weight-control NIDDK –science-based materials on obesity, “Sisters Together” –African American Community Together” http://www.win.niddk.nih.gov/notes/index.htm National Institute of Environmental Health – link between National obesity and built environment. obesity USDA – nutrition guidance, food labeling, USDA education, distribution to schools, oversight over agriculture and dairy markets over Food and Nutrition Service (FNS) school Food lunch, assistance programs lunch, FTC – health claims, deceptive marketing Other environments? Restaurants? TV ads to children? School vending machines “competitive foods”? Physical education? Zoning regulations? Zoning Prices Prices Subsidize fruits and vegetables? Tax snack foods? Global – increasing rates of obesity as well as Global poverty poverty In general, environmental changes will follow a In strong lead from policy and/or social change. What can the community nutritionist do? Build awareness: IOM’s Preventing Childhood Obesity; The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity see list and page 266. page Popular Diets Atkins Zone South Beach Weight Watchers Dean Ornish Eat Right for Your Blood Type Volumetrics (review pp 272-275) Read the Case Study p 270 Identify Learning Objectives- write out Identify your responses, Answer Step 4 parts 1,2,&3. Be prepared to discuss in class ...
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