Presentation Information Promoting Healthy Eating: How Restaurants Can Help Oma Ramsaroop, MPH student Walden University PUBH 6165 - 4 Instructor: Stephen D. Arnold, Ph. D. Spring, 2010 My name is Oma Ramsaroop, and I am a Masters of Public Health student at Walden University. The purpose of today’s presentation is to increase your awareness on the importance of nutritional information, and how we can incorporate that into being able to eat at some of our favorite restaurants. I hope that my presentation will inform you and the community on the benefits of making conscious healthy choices for yourselves and your family. CONFIDENTIAL

Presentation Objectives Presentation Information Presentation Objectives Current national and local obesity statistics Current trends in family dining Which restaurants currently carry nutritional information Health risks associated with bad food choices Nutritional Guidelines Current barriers At the end of this presentation, my goal is that all of you will have a better understanding on national statistics and where our county, Broward County, Florida, falls in regards to obesity. Also, how family dining plays into these statistics and which restaurants provide necessary information to make healthful choices and reduce risk factors. Finally, I will discuss laws on nutritional guidelines and barriers that exist to help make our country a healthier place. Objectives CONFIDENTIAL

Presentation Information National Statistics 58 million Americans are overweight (BMI 25-29) 40 million are obese (BMI > 30) 3 million are morbidly obese (BMI > 35) 8 out of 10 adults over age 25 are overweight Healthy People 2010 goals for obesity are 15% for adults and less than 5% for children. It is understood that obesity is a significant problem for the United States, so here are some specific statistics about the general population. Busy schedules, increased technology use, and environmental factors have helped make more and more Americans live sedentary lifestyles. Busy schedules require food that is convenient and quick, which often times compromises the food’s quality, and more desk jobs decrease the amount of physical activity that people engage in. Reference: Huse, D.M. (2007, April). Obesity in the workforce: Health effects and healthcare costs. Retrieved on April 25, 2010, from: http://home.thomsonhealthcare.com/uploadedFiles/Cost_of_Obesity_in_the%20Workplace.pdf Reference: Huse, 2007 CONFIDENTIAL

Percentage of Obesity in US Adults Presentation Information Percentage of Obesity in US Adults This chart obtained from CDC, shows how the state of Florida compares to the rest of the United States in 2008. The percentages are on a constant rise, and it is in the best interest of all of us to make a conscious effort towards change to help bring down these numbers. Reference: Center for Disease Control and Prevention (CDC). (2009). US Obesity Trends. Retrieved on April 25, 2010 from http://www.cdc.gov/obesity/data/trends.html#State Reference: http://www.cdc.gov/obesity/data/trends.html#State CONFIDENTIAL

Broward County Statistics Presentation Information Broward County Statistics Behavioral Risk Factors (BRFSS) Data (Percent of Adults...) Year(s) Age-Adjusted Rate1 Quartile2 State Age-Adjusted Rate U.S. Healthy People 2010 Goal3 With diagnosed hypertension 2007 26.5% 1 28.2% Who have diagnosed high blood cholesterol 37.6% 3 37.1% 17% Who had their cholesterol checked in the past 5 years 79.9% 78.5% Who meet moderate physical activity recommendations 33.8% 4 34.6% Who meet vigorous physical activity recommendations 24.3% 26.0% Who engage in no leisure-time physical activity 26.1% 2 26.4% 20% Who eat at least 5 servings of fruits and vegetables a day 27.6% 26.2% Who are overweight 36.9% 38.0% Who are obese 20.4% 24.1% 15% Florida Department of Health reported these numbers from the year 2007. All of these factors on the chart can be reduced by small adjustments made in daily lifestyle, including monitoring what they eat, either at home or at a restaurant. Obesity leads to many chronic diseases, which makes it very important to monitor everything that goes into your body. Reference: http://www.floridacharts.com/charts/DisplayHTML.aspx?ReportType=7244&County=6&year=2008 Reference: http://www.floridacharts.com/charts/DisplayHTML.aspx?ReportType=7244&County=6&year=2008 CONFIDENTIAL

Obesity Related Health Problems Presentation Information Obesity Related Health Problems 80% of Type II diabetes 70% of cardiovascular diseases 42% of breast & colon cancer diagnoses are among obese patients 26% of obese individuals have high blood pressure Obesity has an enormous impact on the health of our society. A study conducted at Thompson Healthcare demonstrated a relationship between increasing body weight and the prevalence of a wide range of health problems (Huse, 2007). Reference: Huse, D.M. (2007, April). Obesity in the workforce: Health effects and healthcare costs. Retrieved on April 25, 2010, from: http://home.thomsonhealthcare.com/uploadedFiles/Cost_of_Obesity_in_the%20Workplace.pdf Reference: Huse, 2007 CONFIDENTIAL

Obesity and Healthcare Costs Presentation Information Obesity and Healthcare Costs Moderate obesity ($670 increase – 21%) Severe obesity ($2,441 increase – 75%) A weight loss of 10% in an obese individual is estimated to save $2,200 to $5,300 in medical costs Huse (2007) also reported that obesity has become a contributing factor in a significant proportion of the total healthcare costs in the US. When compared to individuals with a normal weight, moderate obesity caused a $670 increase in costs, and severe obesity was associated with a $2441 increase in costs (Huse, 2007). Increases followed a similar pattern for inpatient, outpatient and pharmacy services as well (Huse, 2007). Health costs that are related to obesity are thought to top $100 billion (Ludwig & Pollack, 2009). A weight loss of just 10% in an obese individual could save roughly $2200 to $5300 in medical costs per person! Reference: Huse, D.M. (2007, April). Obesity in the workforce: Health effects and healthcare costs. Retrieved on April 25, 2010, from: http://home.thomsonhealthcare.com/uploadedFiles/Cost_of_Obesity_in_the%20Workplace.pdf Reference: Huse, 2007 CONFIDENTIAL

Nutritional Information Presentation Information Nutritional Information 1/3 of a person’s daily calories come from restaurants Consumers spend over $400 billion annually dining out. Majority of consumers underestimate sodium levels, saturated fats, calories, & fat intake. Nutritional information is something that more Americans need to become aware of. Most people, have no idea what they are really putting into their bodies and the long term consequences that these choices can have. On a national average, one third of a person’s daily calories comes from restaurants, and Americans spend more than four hundred billion dollars each year dining out. Studies have shown that once people are shown nutritional information and understand its meaning, they make healthier choices. Reference: Macera, C.A. (2010). Promoting Healthy Eating and Physical Activity for a Healthier Nation. National Center for Chronic Disease Prevention and Health Promotion. Reference: Macera, 2010 CONFIDENTIAL

Presentation Information Fast Food vs Dine - In Fast food restaurants are more likely to make nutritional information available to consumers through brochures or websites Ex. Subway, Taco Bell, McDonald’s, Starbucks Most “dine-in” restaurant do not disclose their food’s nutritional information It is harder because of custom orders, daily specials, etc. Only 54% of large chain restaurants in the U.S. provide nutritional information to consumers. Many fast food restaurants provide their customers with nutritional information via brochures or websites, but “dine-in” restaurants often do not provide any type of nutritional information due to the fact that it requires much more work on their parts. Some reasons include daily specials, custom orders, varying meat deliveries, etc. Although regulations exist requiring packaged foods to have nutritional information, restaurants are not currently required to provide consumers with nutritional information. With nearly 300 large chain restaurants within the United States, only fifty-four percent provide their consumers with nutritional information. Reference: Macera, C.A. (2010). Promoting Healthy Eating and Physical Activity for a Healthier Nation. National Center for Chronic Disease Prevention and Health Promotion. Reference: Macera, 2010 CONFIDENTIAL

Presentation Information Labeling Laws Nutrition Labeling and Education Act (NLEA) of 1990 Requirements: serving size, servings per container, amount per serving, calories, percent daily value, fat, cholesterol, sodium, carbohydrates, dietary fiber, protein, vitamins A & C, calcium, and iron The Nutrition Labeling and Education Act (NLEA) was brought on in 1990 by the Food and Drug Administration, with the purpose of requiring nutrition labels on regulated foods. These nutrition label requirements included serving size, servings per container, amount per serving, calories, percent daily value, fat, cholesterol, sodium, carbohydrates, dietary fiber, protein, vitamins A & C, calcium, and iron. Other vitamins and minerals were not required but could be added on a voluntary bases. The only exemptions to this act are certain small businesses, but this is determined based on gross annual sales and other criteria. Reference: Food and Drug Administration (FDA). (2009). Nutritional Labeling and Education Act (NLEA) Requirements (8/94 - 2/95). Retrieved from http://www.fda.gov/ICECI/Inspections/InspectionGuides/ucm074948.htm on April 25, 2010. Reference: http://www.fda.gov/ICECI/Inspections/InspectionGuides/ucm074948.htm CONFIDENTIAL

Presentation Information Target Audience Restaurant vendors & suppliers Restaurant managers/ owners Broward County residents Within schools Public meetings This project can only be affective if it is geared towards the targeted audience and in a manner that is appealing to them. It is very important to include local restaurant owners and management in discussions regarding the health of our community. They must provide diners with healthier choices to aid in the overall health of the community, especially because about a third of daily intake comes from restaurants. Also, the residents must be addressed directly, within schools or public meetings, in order to educate them about their own health and how their choices now will impact their futures and families. Students must be reached at younger ages to help provide a good foundation to their health. Target Audience CONFIDENTIAL

Addressing the Community Presentation Information Addressing the Community Educational presentation Fact sheet distribution & informal exchange Small group discussions Group recommendation compilation The targeted audiences need different forms of information to be customized to their specific needs. However, these suggestions provide a starting point for addressing the community. Educational information must be provided in order for individuals to truly understand the importance of making healthier choices. Also, information needs to be provided in an effective manner in order to provoke change. One example of this is to provide healthier alternatives for their favorites. People are less likely to change if they are told that they must give up the things that they enjoy. Also, provide many various forms of exercise. In today’s economy people will be less likely to spend on a gym membership. However, alternatives such as taking a walk thru the park or going for a swim must be provided. Addressing the Community CONFIDENTIAL

Presentation Information Outcomes Increased number of local restaurants with healthy options and nutritional information Increased community interest in making healthier choices The hope of this project is that Broward County will take a forefront in their own health and in making healthier choices. Small changes must take place in order to lead to larger ones. However, these small changes are all we need to begin a healthy level of change. Outcomes CONFIDENTIAL

How will restaurants benefit from providing nutritional info??? Presentation Information How will restaurants benefit from providing nutritional info??? Increased ratings  increased customers  increased income In today’s world, more people are trying to become health conscious. People are being educated about preventative medicine, which includes monitoring every bite they take. By restaurants providing nutritional facts with their menus, it entices even the health-conscious to give into “outside food”. That will automatically build-up the ratings of the restaurant, because so many people are in search of a healthy bite. That automatically means better business and more money. Benefits to Restaurants CONFIDENTIAL

Presentation Information References Centers for Disease Control and Prevention (CDC). (2009). Obesity and overweight: Introduction. Retrieved on April 25, 2010 from http://www.cdc.gov Food and Drug Administration (FDA). (2009). Nutritional Labeling and Education Act (NLEA) Requirements (8/94 – 2/95). Retrieved from http://www.fda.gov/ICECI/Inspections/InspectionGuides/ucm074948.htm on April 25, 2010. Florida Department of Health (FLDOH). (2008). Broward County Chronic Disease Profile. Retrieved on April 25, 2010 from http://www.floridacharts.com/charts/DisplayHTML.aspx?ReportType=7244&County=6&year=2008 References CONFIDENTIAL

Presentation Information References (cont) Huse, D.M. (2007, April). Obesity in the workforce: Health effects and healthcare costs. Retrieved on April 25, 2010, from: http://home.thomsonhealthcare.com/uploadedFiles/Cost_of_Obesity_in_the%20Workplace.pdf Macera, C.A. (2010). Promoting Healthy Eating and Physical Activity for a Healthier Nation. National Center for Chronic Disease Prevention and Health Promotion. References (cont) CONFIDENTIAL