Community Nutrition

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…

Public Health Nutritionist

Responsible for planning organizing managing directing coordinating evaluating

nutrition component of public health unit programming

Public Health Nutritionist

Establishes links with related community nutrition programs nutrition education food assistance social services elder care community based research

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

Public Health Nutritionist

Targets underserved groups Requires collaboration Monitors health of community

to ensure programs respond to needs

needs assessment

Prevention

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

Levels of Prevention

Three levels Primary Secondary Tertiary

Community Practice Settings

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

Public Health Agency

Organizations involved in Organizations involved in community nutrition…community nutrition…

(Obert, 1986 in Davis, 1989)

Social Services

Day Care, Schools

Agricultural Extension

Food Industry Health Care Providers

Fitness Centres

Work Site

Self-help Groups

Voluntary Agencies

Food Aid Programs

Responsibilities in Community Nutrition

Assessment

Evaluation

Implementation

Planning

Nutrition Guidelines How did nutrition professionals

develop food guidance documents?

1. Recommended Nutrient Intakes2. Canada’s Guidelines for

Healthy Eating3. Eating Well with Canada’s Food

Guide

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

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

Community Nutrition in Focus

Childhood Obesity

Measuring Obesity

Body Mass Index In adults

wt in kg / ht in m2

Children and Adolescents BMI for age & sex > 95th percentile

overweight/obese 85th – 95th at risk

Evolution of Overweight in Canada

17 (Katzmarzyk et al. 2001)

Boys Girls0

5

10

15

20

25

30

35

1981199611%

33%

13%

27%

Boys and girls, 7 to 13 years oldBoys and girls, 7 to 13 years old

Evolution of obesity in Canada

18 Définition de Cole – Données de l’ELNEJ (Katzmarzyk et al. 2001)

0

2

4

6

8

10

12

19811996

Boys and girls, 7 to 13 years oldBoys and girls, 7 to 13 years old

2%

10%

2%

9%

Boys Girls

Weight Classification of NS Grade 3 Students 2001-2005

Boys2001

Boys2005

Girls2001

Girls2005

Healthy

Weight

63.0% 53.0% 55.4% 59.6%

At Risk 17.6% 21.5% 24.7% 20.6%

Over-weight

19.4% 25.6% 19.9% 19.9%

Campagna, Wadsworth, et al., 2007

Weight Classification of Grade 7 Students 2001-2005

Boys2001

Boys2005

Girls2001

Girls2005

Healthy

Weight

63.3% 59.7% 60.1% 69.7%

At Risk 16.4% 21.8% 20.5% 17.1%

Over-weight

20.4% 18.5% 19.4% 13.2%

Campagna, Wadsworth, et al., 2007

Weight Classification of NS Grade 11 Students 2001-2005

Boys2001

Boys2005

Girls2001

Girls2005

Healthy

Weight

66.1% 69.4% 75.0% 69.8%

At Risk 16.7% 16.6% 17.1% 20.2%

Over-weight

16.2% 14.1% 7.9% 10.0%

Campagna, Wadsworth, et al., 2007

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?

Susan L. Roberts, JD, MS, RD

Drake University Agricultural Law Center

OBESITY PREVALENCE FACTORS

Gro Harlem Brundtland Director General of WHO Address to the 55th 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

Physical Activity – PACY 2001-2005

0102030405060708090

100

Gr3B Gr3G Gr7B Gr7G Gr11B Gr11G

20012005

Campagna, Wadsworth, et al., 2007

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.

PUBLIC HEALTH

STRATEGIES

REAL Action

Effective public policies

Appropriate infrastructure

Adequate funding

Monitoring & evaluation

Continuing research

Required Readings

Meldrum, & Willows, 2006. Food insecurity in university students. (online)

Glanville, & McIntyre, 2006. diet quality of Atlantic families headed by single mothers.