1. 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»

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

3. 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

4. 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

5. 1996

6. 2008 physical Activity Guidelines for Americans

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

8. 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)

9. 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

10. International Harmonization
2010

11. National Guidelines Informed by US Report
Austria UK
Ireland
Canada

12. UKK Institute - Finland

13. Impact of having guidelines

14. Meeting Physical Activity Recommendations

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

16. 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.”

17. From Guidelines to Action

18. 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

20. 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

21. Midcourse Report

22. 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

23. 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.

24. Thank you
Questions?

25. 4/20/2017
National Cancer Institute