1. Indiana Healthy Weight Initiative Laura Hormuth, MS, RD, CD Division of Nutrition & Physical Activity Indiana State Department of Health Purdue Extension Bi Annual Conference November 4, 2009

2. Presentation Outline I.The new State Indicator Report on Fruits and Vegetables, 2009 II.Fruits & Veggies—More Matters logo and Website video center III.The Indiana Healthy Weight Initiative

3. Objectives for Today I.You will know where to find Indiana data on Fruits and Vegetable consumption and policy and environmental support II.You will understand how to use the video center on the Fruits & Veggies—More Matters Website III.Learn what Indiana is doing to improve the health and weight of Indiana residents through the Indiana Healthy Weight Initiative

4. NEW State Indicator Report on Fruits and Vegetables, 2009 http://www.fruitsandveggiesmatter.gov/health_pr ofessionals/statereport.html

5. Logo and Website

6. Fruits & Veggies—More Matters http://www.fruitsandveggiesmorematters.org/

7. www.inhealthyweight.org

8. obesity in America

9. Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

10. Obesity Trends* Among U.S. Adults BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

11. Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

12. Obesity Trends* Among U.S. Adults BRFSS, 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

13. Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

14. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

15. Obesity Trends* Among U.S. Adults BRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

16. Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

17. Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

18. Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

19. Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

20. Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

21. Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

22. Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

23. Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

24. Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

25. Obesity Trends* Among U.S. Adults BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

26. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

27. Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

28. Obesity Trends* Among U.S. Adults BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

29. Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

30. Obesity Trends* Among U.S. Adults BRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

31. Obesity Trends* Among U.S. Adults BRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

32. Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: http://www.cdc.gov/obesity/data/trends.html; retrieved 10-1-09http://www.cdc.gov/obesity/data/trends.html

33. obesity and Indiana

34. 53% of IN adults report being a normal weight in 1990 % of IN Adults who Self-Report Being at a Normal Weight, 1990-2008 Source: Indiana BRFSS Data, 1990-2008 Only 36% of IN adults reported being a normal weight in 2008

35. % of IN Adults who self-reported being either overweight or obese, 1990-2008 Source: Indiana BRFSS Data, 1990-2008 In 2008, 64% of IN adults reported being either or overweight/obese.

36. Source: Indiana BRFSS Data, 1990-2008 % of Indiana Adults who Self-Report being Overweight or Obese, 1990-2008 27% 37%

37. Current State 64 % of Indiana adults are considered overweight or obese (BRFSS) 29 % of Indiana High School students are considered overweight or obese (YRBS) Of Indiana children 2-4 participating in WIC, 31% are overweight or obese (PedNSS)

38. endless sugary drink options cul-de-sacs schools outside neighborhoods transportation portion distortion changing family unit explosion of restaurants 24/7 fast food building design stair access? roads without sidewalks roads without bike lanes automobile only access high traffic – 4-5 lane intersections working parents unsafe neighborhoods CHEAP processed, high energy dense foods lack of access to healthy food lack of access to places to be physically active TV, computers, video games family dinners? How did this happen?

39. www.inhealthyweight.org

40. Funded States

41. The Purpose The purpose of the Indiana Healthy Weight Initiative is to improve healthy eating and physical activity to prevent and control overweight and obesity and other chronic diseases among Indiana residents

42. Six Priority Areas 1.Increased physical activity 2.Increased consumption of fruits and vegetables 3.Increased breastfeeding (initiation, duration, and exclusivity) 4.Decreased consumption of high energy-dense foods (e.g., candy, chips, cookies) 5.Decreased consumption of sugar-sweetened beverages 6.Decreased television/screen time

43. Initiatives Activities The activities include: Plan, implement and evaluate a state plan for encouraging healthy weight Organize and maintain a task force of statewide partnerstask force Build and sustain statewide capacity for addressing overweight and obesity

44. Initiative’s Progress to Date Added staff to the DNPA Organized a task force with 8 workgroups that meet monthly/bimonthly Created a Website www.inhealthyweight.orgwww.inhealthyweight.org Vision, Mission and Goals have been approved by the CDC Workgroups are currently working on objectives

45. Indiana State Department of Health Division of Nutrition and Physical Activity Ellen Whitt, JD Director ewhitt@isdh.in.gov, (317) 232-1200 Schools: Juliana Hammer, MPH, C.H.E.S. jhammer@isdh.in.gov, (317) 233-5588 Nutrition, Breastfeeding & Faith-Based Initiatives: Laura Hormuth, MS, RD, CD lhormuth@isdh.in.gov, (317) 234-3498 Data and Research: Amanda Raftery, MPH, RD, CD araftery@isdh.in.gov, (317) 234-3798 Physical Activity & Older Adults: Mike Lindbloom, MS mlindbloom@isdh.in.gov, (317) 234-3580 Communities & Early Childhood: Marcie Memmer, MPH, C.H.E.S. mmemmer@isdh.in.gov, (317) 233-7726 Worksite Wellness: Jamie Delaney jadelaney@isdh.in.gov, (317) 234-2923

46. Task Force Membership State-wide organizations with a stake in obesity prevention 148 individuals 83 organizations

47. Task Force Workgroups –Breastfeeding –Communities –Early Childhood/Childcare –Faith-Based –Healthcare –Schools –Older Adults –Worksites Organization 8 workgroups – including the school setting 2 advisory committees 1 steering committee

48. Indiana Healthy Weight Initiative Vision All Hoosiers practice and enjoy a lifestyle of healthy eating and physical activity within an environment that supports health, wellness and vitality. Mission To enhance the health and quality of life of Hoosiers by promoting good nutrition, regular physical activity and a healthy weight through policy, environment and lifestyle change.

49. State Plan: Overarching Goals 1.Increase access to and consumption of healthy foods and beverages. 2.Increase opportunities for and engagement in regular physical activity. 3.Increase efforts aimed at achieving a healthy weight. 4.Reduce disparities related to breastfeeding, nutrition, physical activity, overweight, obesity, and chronic diseases. 5.Increase the capacity of communities and settings to develop and sustain a healthy lifestyle and culture. 6.Increase strategic partnerships to share resources, identify and reach priority populations, and increase capacity to prevent and control obesity and chronic diseases.

50. Current Recommendations for Interventions Population-based approaches affecting a large # of different populations simultaneously Must be sustainable Policy Systems Environment

51. Centers for Disease Control and Prevention –Institute smaller portion size options in public service venues –Limit advertisements of less healthy foods and beverages –Discourage consumption of sugar-sweetened beverages –Increase support for breastfeeding –Require physical education in schools –Increase the amount of physical activity in physical education programs in schools –Increase opportunities for extracurricular physical activity –Reduce screen time in public service venues –Improve access to outdoor recreational facilities

52. Next Steps for the Division of Nutrition and Physical Activity Finish writing the state plan (Summer 2010) Work with Indiana communities to implement strategies in the state plan Provide training and technical assistance to communities Report success stories on the Indiana Healthy Weight Initiative Website

53. www.inhealthyweight.org

54. Questions?