National Guidelines for Diet and Physical Activity: International Implications Richard P. Troiano, Ph.D. Second Forum on NCD Prevention and Healthy Lifestyles Promotion «For Healthy Life»

Presentation Overview Background of diet and physical activity guidelines in US Guidelines development process International application and harmonization Benefits of national guidelines

Dietary Guidelines for Americans First released in 1980 Required by legislation to be reviewed and updated every 5 years Review and recommendations by group of scientific experts Joint effort of the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) Provide the basis for federal food and nutrition policy and education initiatives

Physical Activity Guidelines Not required by legislation Recommendations by professional groups since 1970s American Heart Association, American College of Sports Medicine Focused on exercise for fitness and risks of exercise Focus shifted to a public health model in 1990s

1996

2008 physical Activity Guidelines for Americans

Objective Comprehensive, evidence-based physical activity guidelines Cardiorespiratory Strength Balance Harmonize various recommendations Address subpopulations Older adults, persons with disabilities

PA Guidelines Development Process Processes Products Systematic Evidence Review Searchable Data Base (now public access) PA Guidelines Advisory Committee 650+ Page Report summarizing the science PA Guidelines Writing Group 2008 Physical Activity Guidelines For Americans Communications Workgroup Dissemination plan, materials for public, materials for partners, logo & key messages Launch “Team” (Public/Private)

4 Key Adult Guidelines Avoid inactivity Substantial health benefits from medium amounts of aerobic activity More health benefits from high amounts of aerobic activity Muscle-strengthening activities provide additional health benefits

International Harmonization 2010 www.who.int/dietphysicalactivity

National Guidelines Informed by US Report Austria UK Ireland Canada

UKK Institute - Finland

Impact of having guidelines

Meeting Physical Activity Recommendations

Healthfulness of the US Food Supply Krebs-Smith, Reedy, Bosire 2010, Am J Epid

Toward a Comprehensive, Public Health Approach Individual Personal goal setting Interpersonal Social support, encouragement Organizational Worksite health promotion Community Access to parks and recreational facilities Public policy Policies that promote active transportation “Healthy choice should be the easy choice.”

From Guidelines to Action

Multi-Sector Approach The National Physical Activity Plan includes recommendations that are organized in eight societal sectors: Business and Industry Education Health Care Mass Media Parks, Recreation, Fitness and Sports Public Health Transportation, Land Use, and Community Design Volunteer and Non-Profit

www.globalpa.org.uk

HEPA Europe – European network for the promotion of health-enhancing physical activity Brings together different institutions and organizations from all over Europe Collaborates closely with WHO/Europe Facilitates multi-sectoral approaches Advocacy and exchange of information Promotes and disseminates innovative HEPA strategies, programmes, approaches and good practice Promotes and engages in research www.euro.who.int/hepa

Midcourse Report

Role of Physical Activity Guidelines Justify expenditure of public funds for promotion and programming Science to establish legitimacy among other public health interventions Define benefits to be expected by various population groups and the necessary dose of activity Unified message and behavior targets Consistent metrics for short- & long-term evaluation Support economic arguments in terms of health care cost savings as well as moral justification based on equity and human rights

Key Messages Provision of information alone, even scientifically-based physical activity guidelines, is not sufficient to bring about behavior change. Physical activity guidelines are necessary, but not sufficient, to increase levels of health-enhancing physical activity. Action at multiple levels is needed to support health-enhancing physical activity.

Thank you Questions?

4/20/2017 National Cancer Institute