1. Everyday Nutrition & Physical Activity Choices for Better Health Colleen Doyle, MS, RD Director, Nutrition and Physical Activity National Home Office

2. On any given day in the United States... 815 billion calories are consumed (200 billion more than needed) 47 million hot dogs 4 million pounds of bacon 60 million pounds of red meat 170 million eggs

3. On any given day in the United States... 3 million gallons of ice cream 10 million pounds of candy 16 million gallons of beer and ale 1.5 million gallons of hard liquor (enough to make 26 million people drunk!)

4. Where Our Calories Come From

5. More than half the adult population in every state is overweight; the percentage of adults who are overweight exceeds 60% in 28 states The total US healthcare costs due to obesity is $94 billion per year. Half that cost is paid through Medicare and Medicaid (CDC)

6. Because of the extra weight that Americans gained over the last decade, the airline industry spends an additional $275 million per year on jet fuel (Am J Prev Medicine 2004)

7. Leading Causes of Death Diet and inactivity are cross-cutting risk factors, contributing significantly to four out of the six leading causes of death. 1. Heart Disease 684,462 2.Cancer554,643 3.Stroke157,803 4. Chronic Lower Respiratory Diseases126,128 5.Accidents105,695 6.Diabetes73,965 7. Pneumonia and Influenza64,847 8. Alzheimer’s Disease63,343 9.Nephritis42,536 10.Septicemia34,243 11.Suicide30,642 12. Chronic Liver Disease/Cirrhosis27,201 13. High Blood Pressure21,841 14. Parkinson’s17,898 15. Pneumonitis17,457 National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. 2005

8. Access and Availability  Food is just about everywhere  222,000 fast food restaurants  Over 3 million vending machines  New products  Schools and vending/school stores:  43% of elementary schools  74% of middle/junior high schools  98% of senior high schools Source: CDC, School Health Policies and Programs Study 2000

9. Evidence of life on Mars….

11. Marketing and Advertising to Kids Food and Drink Packages Computers and TV Games and Toys Schools

12. Marketing and Advertising in Schools  Vending Machines  Exclusive soft drink contracts  Half of districts (GAO 2000)  Direct advertising on vending machines, scoreboards, posters, book covers, banners and Channel One  7 out of 10 ads for fast food, candy, soft drinks and chips

13. Physical (In)Activity

15. Zykofsky, Creating Livable Walkable Communities ASTPHND Nat’l Mtg, June 2004. States spend 131 times more Federal dollars on Highways and Bridges than they do on Pedestrian projects: $72.00 vs. $.55 per person per year

18. What Do Consumers Know? In a 2006 survey:  80% of respondents connected excess weight to heart disease  over 50% connected it to diabetes  less than 10% connected being overweight to cancer.

19. What About Funding for Nutr and PA? Over 75% of deaths in the US are due to chronic diseases. Yet, the budget for CDC’s National Center for Chronic Disease Prevention and Health Promotion represents only 11% of CDC’s overall budget. While 1/3 of premature deaths in the US are attributable to poor nutrition and physical inactivity, funding for DNPAO represents just ½% of the CDC’s total budget, and is 5% of the CDC’s chronic disease budget. Only 28 states have a CDC state-based nutrition and physical activity program.

20. So….What Do We Have? An obesity epidemic An environment that doesn’t help Not enough people aware of importance Not enough funding

21. Everyday Choices Campaign Scientific Publication Ad Council Campaign Launch Outreach to Healthcare Providers Advocacy USDA Dietary Guidelines and Food Guide Pyramid PE Legislation and School Nutrition Standards CDC Funding

22. Everyday Choices Campaign Scientific Publication Ad Council Campaign Launch Outreach to Healthcare Providers Advocacy USDA Dietary Guidelines and Food Guide Pyramid PE Legislation and School Nutrition Standards CDC Funding

24. Everyday Choices Campaign Scientific Publication Ad Council Campaign Launch Outreach to Healthcare Providers Advocacy USDA Dietary Guidelines and Food Guide Pyramid PE Legislation and School Nutrition Standards CDC Funding

25. Where Do We Go From Here…. Disparities becoming an increasingly important issue for each organization access to healthcare access to healthy, affordable foods access to safe places to be physically active

26. Culture Social Injustice CAUSES OF HEALTH DISPARITIES Poverty/ Low Economic Status Freeman, Adapted from Cancer Epidemiology Biomarkers & Prevention, April 2003 Prevention Early Detection Diagnosis/Incidence Treatment Post Treatment/Qu ality of Life Survival and Mortality

27. Higher Risk Behaviors Poor Nutrition Low Qual. Treatment Low Qual. of Life Higher Mortality Physical Inactivity Obesity Lack of Access No Insurance Higher Incidence Low Screening Late Stage Dx Poverty Income Education Culture High risk Fatalism Injustice Racism Discrimination Hi Tob. Use Disparities Framework: A Synthesis of the Literature

28. People with Low Incomes – 2005 National Healthcare Disparities Report Reduced access to high quality care More likely to be at higher risk Higher tobacco use Poor nutrition Physically inactive Obese Less likely to be screened Higher incidence rates diagnosed at later stages Poor quality care Worse health and quality of life More likely to die prematurely

29. From National To State To Local….