1. Community Nutrition

2. Aims to prevent problems related both to food insufficiencies and excesses, and to promote well- being through a secure and safe food supply and healthful eating habits Community Nutrition…

3. Public Health Nutritionist Responsible for planning organizing managing directing coordinating evaluating nutrition component of public health unit programming

4. Public Health Nutritionist Establishes links with related community nutrition programs nutrition education food assistance social services elder care community based research

5. Public Health Nutritionist Focus on society Promote health & prevent disease Promotes healthy lifestyle Works on issues that affect largest segments of community OR have greatest long-term health benefits

6. Public Health Nutritionist Targets underserved groups Requires collaboration Monitors health of community to ensure programs respond to needs needs assessment

7. Prevention Three inter-related components: personal health community-based social policies/systems-based

8. Levels of Prevention Three levels Primary Secondary Tertiary

9. Community Practice Settings Public Health Departments Community Health Centres Health Promotion Organizations Health Charities Homes Family Resource Centres Grocery Stores...

10. Public Health Agency Organizations involved in community nutrition… (Obert, 1986 in Davis, 1989) Social Services Day Care, Schools Agricultural Extension Food IndustryHealth Care Providers Fitness Centres Work Site Self-help Groups Voluntary Agencies Food Aid Programs

11. Responsibilities in Community Nutrition Assessment Evaluation Implementation Planning

12. Nutrition Guidelines How did nutrition professionals develop food guidance documents? 1. Recommended Nutrient Intakes 2. Canada’s Guidelines for Healthy Eating 3. Eating Well with Canada’s Food Guide

13. Community Nutrition in NS Nutrition for Health: An Agenda for Action (1997) 4 strategic directions Reinforce healthy eating practices Support nutritionally vulnerable populations Continue to enhance the availability of foods Support nutrition research

14. Community Nutrition in NS Healthy Eating Nova Scotia (2005) A framework for comprehensive action on healthy eating Provides an evidence-based, intersectoral, and strategic approach to improving the nutritional health of Nova Scotians Priorities for Action: Breastfeeding Children and Youth Food Security Fruit and Vegetable Consumption

15. Community Nutrition in Focus Childhood Obesity

16. Measuring Obesity Body Mass Index In adults wt in kg / ht in m 2 Children and Adolescents BMI for age & sex > 95 th percentile overweight/obese 85th – 95 th at risk

17. Evolution of Overweight in Canada 17 (Katzmarzyk et al. 2001) BoysGirls 0 5 10 15 20 25 30 35 1981 1996 11% 33% 13% 27% Boys and girls, 7 to 13 years old

18. Evolution of obesity in Canada 18 Définition de Cole – Données de l’ELNEJ (Katzmarzyk et al. 2001) 0 2 4 6 8 10 12 1981 1996 Boys and girls, 7 to 13 years old 2% 10% 2% 9% BoysGirls

19. Weight Classification of NS Grade 3 Students 2001-2005 Boys 2001 Boys 2005 Girls 2001 Girls 2005 Healthy Weight 63.0%53.0%55.4%59.6% At Risk17.6%21.5%24.7%20.6% Over- weight 19.4%25.6%19.9% Campagna, Wadsworth, et al., 2007

20. Weight Classification of Grade 7 Students 2001-2005 Boys 2001 Boys 2005 Girls 2001 Girls 2005 Healthy Weight 63.3%59.7%60.1%69.7% At Risk16.4%21.8%20.5%17.1% Over- weight 20.4%18.5%19.4%13.2% Campagna, Wadsworth, et al., 2007

21. Weight Classification of NS Grade 11 Students 2001-2005 Boys 2001 Boys 2005 Girls 2001 Girls 2005 Healthy Weight 66.1%69.4%75.0%69.8% At Risk16.7%16.6%17.1%20.2% Over- weight 16.2%14.1%7.9%10.0% Campagna, Wadsworth, et al., 2007

22. Childhood Obesity What factors are associated with development of obesity? Activity – TV/Cmpt AND ↓ PE classes Minorities Low income levels Older children/youth Become obese adults?

23. Susan L. Roberts, JD, MS, RD Drake University Agricultural Law Center O BESITY PREVALENCE F ACTORS Gro Harlem Brundtland Director General of WHO Address to the 55 th World Health Assembly 2002 “Marketing approaches matter for public health. They influence our own – and in particular our children’s – patterns of behaviors. Given that they are designed to succeed, they have serious consequences for those at whom they are targeted.” Energy Intake – Food Marketing

24. Physical Activity – PACY 2001-2005 Campagna, Wadsworth, et al., 2007

25. Portion sizes… In the US, 67 % of persons reported eating everything in their plate regardless of the portion size On average, people eat 30% more, when exposed to a portion 2 times bigger.

26. P UBLIC H EALTH S TRATEGIES REAL Action  Effective public policies  Appropriate infrastructure  Adequate funding  Monitoring & evaluation  Continuing research

27. Required Readings Meldrum, & Willows, 2006. Food insecurity in university students. (online) Glanville, & McIntyre, 2006. diet quality of Atlantic families headed by single mothers.