1. Healthy Eating and Moving More: Why is it important and what works?
Steven H Kelder, PhD, MPH
Beth Toby Grossman Professor in Spirituality and Healing
Michael & Susan Dell Center for the Advancement of Healthy Living
University of Texas School of Public Health
Austin Regional Campus

2. Healthy Eating and Moving More: Why is it important and what works?
Steven H Kelder, PhD, MPH
Beth Toby Grossman Professor in Spirituality and Healing
Michael & Susan Dell Center for the Advancement of Healthy Living
University of Texas School of Public Health
Austin Regional Campus

4. Action Framework For A Comprehensive Public Health Strategy To Prevent Heart Disease And Stroke
Good Quality of Life Until Death
Social and Environmental Conditions Favorable to Health
Behavioral Patterns that Promote Health
Low Population Risk
Few Events/ Only Rare Deaths
Full Functional Capacity/ Low Risk of Recurrence
A Vision of the Future
Policy and Environmental Change
Behavior Change
Risk Factor Detection and Control
Emergency Care/Acute Case Management
Rehabilitation/ Long-term Case Management
Intervention
Approaches
End-of-Life Care
PREVENTION
Fatal CVD Complications/ Decompensation
Unfavorable Social and Environmental Conditions
Adverse Behavioral Patterns
Major Risk Factors
First Event/ Sudden Death
Disability/ Risk of Recurrence
The Present Reality

5. Action Framework For A Comprehensive Public Health Strategy To Prevent Heart Disease And Stroke
Good Quality of Life Until Death
Social and Environmental Conditions Favorable to Health
Behavioral Patterns that Promote Health
Low Population Risk
Few Events/ Only Rare Deaths
Full Functional Capacity/ Low Risk of Recurrence
A Vision of the Future
TREATMENT
Policy and Environmental Change
Behavior Change
Risk Factor Detection and Control
Emergency Care/Acute Case Management
Rehabilitation/ Long-term Case Management
Intervention
Approaches
End-of-Life Care
Fatal CVD Complications/ Decompensation
Unfavorable Social and Environmental Conditions
Adverse Behavioral Patterns
Major Risk Factors
First Event/ Sudden Death
Disability/ Risk of Recurrence
The Present Reality

7. State of Obesity in Texas
IOM Comprehensive approach for preventing and addressing childhood obesity
Government
Public Health
University
Health Care
Agriculture
Education
Media
Land Use and Transportation
Communities
Foundations
Industry
Food
Beverage
Retail
Leisure and Recreation
Entertainment
Communities
Worksites
Health Care
Schools and Child Care
Home
Social Norms and Values
Sectors of Influence
Behavioral Settings
Demographic Factors (e.g., age, sex, SES, race/ethnicity)
Psychosocial Factors
Gene- Environment Interactions
Other Factors
Individual Factors
Food & Beverage Intake
Physical Activity
Energy Intake
Energy Expenditure
Energy Balance
SOURCE: Institute of Medicine, Progress in Preventing Childhood Obesity, 2007, pg 20.
Hoelscher, SPAN

8. State of Obesity in Texas
The Public Health System of the 21st Century
Police
Community Centers
Home Health
EMS
Mgmt Care Orgs
Churches
Health Dept
Corrections
Parks
Schools
Nursing Homes
Elected Officials
Hospitals
Mass Transit
Doctors
Philanthropist
A Public Health System is Complex
This illustration has been referred to as “the eggs” or “the web” – it is a cluttered representation of the complexity of a public health system and examples of organizations and groups that make up the system network.
As you can see, there are many partners and groups represented who contribute to health and delivery of the EPHS. These include:
Healthcare providers like hospitals, physicians, community health centers, mental health, labs, nursing homes and others who provide preventive, curative, and rehabilitative care.
Public safety such as police, fire and EMS. Their work is focused on preventing and coping with injury and other emergency health situations.
Human Service and Charity Organizations such as food banks, public assistance agencies, transportation providers, and others that assist people to access healthcare and receive other health-enhancing services.
Education and Youth Development Organizations like schools, faith institutions, youth centers, and others groups that assist with informing, educating, and preparing children to make informed decisions and act responsively regarding health and other life choices and to be productive contributors in the community.
Recreation and Arts-related Organizations who contribute to the physical and mental well-being of the community and those that live, work and play in it.
Economic and Philanthropic Organizations such as employers, community development and zoning boards, United Way, community and business foundations that provide resources necessary for individuals and organizations to survive and thrive in the community.
Environmental Health
Civic Groups
CHCs
Fire
Tribal Health
Laboratory Facilities
Economic Development
Drug Treatment
Mental Health
Employers
SOURCE: Dr. Lloyd Kolbe, personal communication, 2007
Hoelscher, SPAN

9. Elementary, My Dear Dr. Watson
Promote exposure to fruits, vegetables, grains, and calcium rich foods
Reduce consumption of unhealthy foods
Promote physical activity
Reduce screen time
Promote breastfeeding
~ 500 calories per day
Energy Balance

10. Dietary Guidelines for Americans
Aim for Fitness
Aim for a healthy weight
Be physically active each day
Build a Healthy Base
Let the Pyramid guide your food choices
Choose a variety of grains daily, especially whole grains
Choose a variety of fruits and vegetables daily
Keep food safe to eat

11. Dietary Guidelines for Americans
Choose Sensibly
Choose a diet that is low in saturated fat and cholesterol and moderate in total fat
Choose beverages and foods to moderate your intake of sugars
Choose and prepare foods with less salt
If you drink alcoholic beverages, do so in moderation

12. Other Plant-based Foods
7 or more servings of other plant-based foods such as whole grains and legumes
Whole grains are higher in fiber, vitamins, minerals, and phytochemicals than refined grains

13. New for 2005 Specificity of recommendations
At least 30 minutes to reduce risk of chronic disease
Up to 60 minutes of moderate to vigorous physical activity may be needed to prevent gradual weight gain that occurs over time
60 to 90 minutes of moderate-intensity physical activity to sustain weight loss
Recommendations for specific populations

15. Evidence-based Interventions to Promote Physical Activity
Informational
Community-wide campaigns
Point-of-decision prompts
Behavioral and social
School-based PE
Social support in community settings
Individually adapted behavior change
Environmental and policy
Enhanced access with outreach
Community-scale urban design
Street-scale urban design/land use

17. City Planning/Transportation Education Media Industry Wellness
Policy Categories
Healthy food
Recreation
Breast feeding
Built Environment
City Planning/Transportation
Education
Media
Industry
Wellness

18. Faith-based organizations City County Worksites Health-care
Sectors to involve
Federal/State
Media
Schools
Faith-based organizations
City
County
Worksites
Health-care

19. Potential population impact (certainty of effectiveness)
Effective: Policy option was tested in one or more well-designed scientific studies and found to affect nutrition and or nutrition behavior.
Promising: Policy was tested in one or more well-designed scientific studies and results of effectiveness are ongoing.
Untested: Policy is potentially a great idea, but is untested or does not have definitive results.

20. The World According to Steve
Start young – school based programs work. Children can be found at school. Young parents, preschool.
Physical activity quickly declines as young girls enter middle school and high school
Promote calcium consumption and weight bearing physical activities to women and girls
Reinforce school lessons at home and in the community.
Promote use of community parks and recreation.
Create social events; eating and PA are social behaviors
Where: worksites, point of purchase, church, school
Stay in it for the long haul.

21. Michael & Susan Dell Center for Advancement of Healthy Living Promoting a Future of Healthy Children
We will strive to become one of the leading national research institutions with a focus on improving healthy living in communities, homes, and schools by addressing:
The childhood obesity epidemic,
Child and adolescent development,
Community programs and
policies supporting these efforts.

22. Contact Information
Steven H. Kelder, MPH, PhD Michael & Susan Dell Center for Advancement of Healthy Living
UT School of Public Health,
Austin Regional Campus 313 E. 12th St., Suite 220 Austin, TX (fax)
Website for CATCH:
Website for SPAN survey: