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Healthy Eating and Moving More

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					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
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
Action Framework For A Comprehensive Public Health Strategy
            To Prevent Heart Disease And Stroke
                                       A Vision of the Future
Social and
                  Behavioral                           Few               Full Functional
Environmental                         Low                                                        Good Quality
                  Patterns that                        Events/           Capacity/
Conditions                            Population                                                 of Life Until
                  Promote                              Only Rare         Low Risk of
Favorable to                          Risk                                                       Death
                  Health                               Deaths            Recurrence
Health




Policy and
Environmental   Behavior
Change          Change
                                  Risk Factor
                                  Detection
                                  and Control          Emergency
                                                       Care/Acute Case




PREVENTION
                                                                          Rehabilitation/
                                                       Management
                                                                          Long-term Case
                                                                          Management            End-of-Life
                                           Intervention                                         Care
                                           Approaches


Unfavorable                              The Present Reality
                 Adverse                                                                    Fatal CVD
Social and                        Major Risk       First Event/     Disability/ Risk
                 Behavioral                                                                 Complications/
Environmental                     Factors          Sudden Death     of Recurrence
                 Patterns                                                                   Decompensation
Conditions
Action Framework For A Comprehensive Public Health Strategy
            To Prevent Heart Disease And Stroke
                                       A Vision of the Future
Social and
                  Behavioral                           Few               Full Functional
Environmental                         Low                                                        Good Quality
                  Patterns that                        Events/           Capacity/
Conditions                            Population                                                 of Life Until
                  Promote                              Only Rare         Low Risk of
Favorable to                          Risk                                                       Death
                  Health                               Deaths            Recurrence
Health




Policy and
Environmental
Change
                Behavior
                Change              TREATMENT
                                  Risk Factor
                                  Detection
                                                       Emergency
                                  and Control
                                                       Care/Acute Case
                                                                          Rehabilitation/
                                                       Management
                                                                          Long-term Case
                                                                          Management            End-of-Life
                                           Intervention                                         Care
                                           Approaches


Unfavorable                              The Present Reality
                 Adverse                                                                    Fatal CVD
Social and                        Major Risk       First Event/     Disability/ Risk
                 Behavioral                                                                 Complications/
Environmental                     Factors          Sudden Death     of Recurrence
                 Patterns                                                                   Decompensation
Conditions
              IOM Comprehensive approach for preventing
                   and addressing childhood obesity
                                                                                         Government
   Communities                                 Social Norms                             Public Health
   Worksites                                    and Values
                                                                                         University
   Health Care                                                                          Health Care
   Schools and                                 Sectors of
                                                                                         Agriculture
    Child Care                                  Influence
                                                                                         Education
   Home
                                                                                         Media
                                                 Behavioral
                                                                                         Land Use and
                                                  Settings
                                                                                          Transportation
   Demographic
                                                                                         Communities
    Factors (e.g.,
    age, sex, SES,                               Individual                              Foundations
    race/ethnicity)                               Factors
                                                                                         Industry
   Psychosocial
                                      Food &                  Physical                     Food
    Factors
                                   Beverage Intake             Activity                    Beverage
   Gene-
    Environment                                                                            Retail
    Interactions               Energy Intake                    Energy Expenditure         Leisure and
   Other Factors                                                                           Recreation
                                                                                           Entertainment

                                               Energy Balance
SOURCE: Institute of Medicine, Progress in Preventing Childhood Obesity, 2007, pg 20.
         The Public Health System of the 21st Century
          Police
                            Community                                   Home Health
           EMS                                 Mgmt Care Churches
                             Centers             Orgs

                                              Health Dept
                                                                  Corrections    Parks
                                      Schools
                                                        Elected
     Doctors        Hospitals                           Officials Nursing        Mass
                                                                  Homes         Transit
                             Philanthropist
                                   Civic                    Environmental
           CHCs                    Groups                      Health
                                                                                 Fire
                                              Tribal Health
   Laboratory     Drug                                             Economic
    Facilities Treatment Mental Health                  Employers Development
SOURCE: Dr. Lloyd Kolbe, personal communication, 2007
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
             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
           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
      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
               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
    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
            Policy Categories
 Healthy food
 Recreation
 Breast feeding
 Built Environment
 City Planning/Transportation
 Education
 Media
 Industry
 Wellness
            Sectors to involve
 Federal/State
 Media
 Schools
 Faith-based organizations
 City
 County
 Worksites
 Health-care
         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.
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.
     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.
                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 78701
    512-482-6167
    512-482-6185 (fax)
    http://www.sph.uth.tmc.edu/dellhealthyliving/home.asp
   Website for CATCH:
    http://www.sph.uth.tmc.edu/catch/
   Website for SPAN survey:
    http://www.sph.uth.tmc.edu/DellHealthyLiving/default.asp?id=4061

				
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