Presented by: Natanya M. Jennings, PharmD. Master of Public Health Candidate 1

 Overweight & Obesity Defined  Statistical & Economical Review of the Problem  Causes & Effects of Overweight & Obesity  Changes in Eating Habits  Nutrition Labeling Legislation  Summary 2

 Body Mass Index (BMI)  Measure of body fat utilizing the height and weight  Defines ranges of weight of which may identify: ▪ Weight that is unhealthy for a height ▪ Likelihood of other health issues and diseases  Adults  BMI between regard as overweight  BMI of 30 or higher regarded as obese 3 Centers for Disease Control and Prevention [CDC]. (2009 August). Overweight and Obesity: Defining Overweight and Obesity. Retrieved October 20, 2009, from

 BMI is still the most common measurement for children and teens 2-19 years old  Overweight identified as:  At or greater than the 85 th percentile and lower than the 95 th percentile  Obesity identified as:  At or greater than the 95 th percentile 4 CDC. (2009 October). Overweight and Obesity: Defining Childhood Overweight and Obesity. Retrieved October 20, 2009, from

 There has been a striking increase of obesity  Majority of the states had a prevalence equal to or more than 25%  Ethnicity plays a role in obesity  African-Americans and Hispanics more likely to be obese than white counter part  Geographic location plays a role in obesity  Greater prevalence in the South and Midwest regions of the U.S. 5 CDC. (2009 August). U.S. Obesity Trends. Retrieved October 21, 2009, from

1999 Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2008 (*BMI 30, or about 30 lbs. overweight for 5’4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Slide adapted from the CDC Behavioral Risk Factor Surveillance System. CDC. (2009 August). U.S. Obesity Trends. Retrieved October 21, 2009, from

 Overweight and obesity prevalence 1  Over 35% of population is overweight  Nearly 30% of population is obese  Men’s Fitness Fattest Cities in America 2  San Antonio Ranked # 3  Houston Ranked # 6  El Paso Ranked # 7  Dallas/Ft. Worth Ranked # CDC. (n. d.). Prevalence and Trends Data: Texas 2008 Overweight and Obesity (BMI). Retrieved October 21, 2009 from Men’s Fitness. (2009) Fattest Cities in America: 25 towns in need of a fitness overhaul. Retrieved September 30, 2009, from

 Lack of Caloric Balance  Consuming more calories than the body uses  Genetics  Possible genetic predisposition  Drugs and Diseases  Antidepressant and steroid use  Cushing’s Disease and Polycystic Ovary Syndrome 8 CDC. (2009 August). Causes and Consequences. Retrieved October 21, 2009, from

 Home  Increased TV/audiovisual dependency  Lack of daily routines  School  Lack of nutritional standards for daily meals  Lack of daily physical education  Community  Lack of healthy food choices by neighborhood grocers  Increased crime in neighborhoods  More urban commuter communities  Work  Long hours  Lack of gym facilities at work 9 CDC.(2009 August). Causes and Consequences. Retrieved October 21, 2009, from

 Type 2 Diabetes Mellitus  Cancer  Dyslipidemia  Stroke  Coronary Heart Disease  Liver Disease  Hypertension  Rheumatic Disease 10 CDC. (2009 August). Health Consequences. Retrieved October 20, 2009, from

 Estimated National Price of Obesity 1  Medical expenses $140 billion  Normal weight expenditure $4700/year  Obese expenditure $6400/year  Estimated Cost of Obesity in Texas 2  Medical expenses $10.1 billion  2040 future estimated costs $39 billion 11 1.Chimes, A. (2009 July). Study Estimates Cost of Obesity at $140 Billion. Retrieved October 20, 2009, from 07/ voa32.cfm?moddate= http:// 07/ voa32.cfm?moddate= Texas Department of State Health Services. (2009 July). Obesity. Retrieved October 20, 2009, from

THE GROWING PROBLEM OF OVERWEIGHT AND OBESITY IN HOUSTON? 12

 Fighting the bulge among the public  Unaware of daily caloric intake  Unaware of calories associated with foods & beverages  Providing consumers with nutritional facts  More conscious consumers  Encourages restaurants and other eateries to offer healthier foods 13 Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):26-33.

14  Americans are eating away from home more  Americans are consuming more high calorie snacks  Food advertisements are more elaborate at toward specific populations Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):26-33.

 New York City Menu Labeling Law 1  1 st to implement menu labeling law  Restaurants with ≥ 15 locations must post calorie counts on menus  California Menu Labeling Law 2  1 st state implemented menu labeling law  Restaurants with ≥ 20 locations must post calorie counts on menus  Philadelphia Menu Labeling Law 3  Restaurants with ≥ 15 locations must post calorie counts (sodium, trans/saturated fat, & carbohydrates) on menus 15 1.USA Today. (2008 April). NYC’s calories-on menus law upheld. Retrieved October 21, 2009, from calories_N.htmhttp:// calories_N.htm 2.Los Angeles Times. (2009 July). Menu labeling law takes effect: How many calories in that sandwich? Retrieved October 21, 2009, from CalorieLab. (2008). Philadelphia passes strictest menu labeling law. Retrieved October 21, 2009, from labeling-law/#more-2962http://calorielab.com/news/2008/11/10/philadelphia-passes-strictest-menu- labeling-law/#more-2962

 Nearly 30% of the Texas population is obese (BMI ≥ 30) 1  Houston ranked #6 on the “25 Fattest Cities in America” 2  The economic impact of obesity in Texas is $10.1 billion 3  Americans are eating away from home more 4  Legislature is in effect for menu labeling 5,6, CDC. (n. d.). Prevalence and Trends Data: Texas 2008 Overweight and Obesity (BMI). Retrieved October 21, 2009 from 2.Men’s Fitness. (2009) Fattest Cities in America: 25 towns in need of a fitness overhaul. Retrieved September 30, 2009, from 3.Texas Department of State Health Services. (2009 July). Obesity. Retrieved October 20, 2009, from 4.Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3): USA Today. (2008 April). NYC’s calories-on menus law upheld. Retrieved October 21, 2009, from 6.Los Angeles Times. (2009 July). Menu labeling law takes effect: How many calories in that sandwich? Retrieved October 21, 2009, from effect-how-many-calories-in-that-sandwich.htmlhttp://latimesblogs.latimes.com/dailydish/2009/07/menu-labeling-law-takes- effect-how-many-calories-in-that-sandwich.html 7.CalorieLab. (2008). Philadelphia passes strictest menu labeling law. Retrieved October 21, 2009, from

Thank you for your attention. 17

CalorieLab. (2008). Philadelphia passes strictest menu labeling law. Retrieved October 21, 2009, from strictest-menu-labeling-law/#more-2962http://calorielab.com/news/2008/11/10/philadelphia-passes- strictest-menu-labeling-law/#more-2962 CDC. (2009 August). Causes and Consequences. Retrieved October 21, 2009, from CDC. (2009 August). Health Consequences. Retrieved October 20, 2009, from CDC. (2009 August). Overweight and Obesity: Defining Overweight and Obesity. Retrieved October 20, 2009, from CDC. (2009 October). Overweight and Obesity: Defining Childhood Overweight and Obesity. Retrieved October 20, 2009, from CDC. (n. d.). Prevalence and Trends Data: Texas 2008 Overweight and Obesity (BMI). Retrieved October 21, 2009, from CDC. (2009 August). U.S. Obesity Trends. Retrieved October 21, 2009, from Chimes, A. (2009 July). Study Estimates Cost of Obesity at $140 Billion. Retrieved October 20, 2009, from voa32.cfm?moddate= http:// voa32.cfm?moddate= Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3): Los Angeles Times. (2009 July). Menu labeling law takes effect: How many calories in that sandwich? Retrieved October 21, 2009, from Men’s Fitness. (2009) Fattest Cities in America: 25 towns in need of a fitness overhaul. Retrieved September 30, 2009, from Texas Department of State Health Services. (2009 July). Obesity. Retrieved October 20, 2009, from USA Today. (2008 April). NYC’s calories-on menus law upheld. Retrieved October 21, 2009, from calories_N.htmhttp:// calories_N.htm 18

 Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):  Texas Department of State Health Services. (2005). Strategic Plan for the Prevention of Obesity in Texas Retrieved October 23, 2009, from