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Healthy Eating and Moving Healthy Eating and Moving More: Why is it important More: Why is it important and what works?and what works?
Steven H Kelder, PhD, MPHSteven H Kelder, PhD, MPHBeth Toby Grossman Professor in
Spirituality and Healing
Michael & Susan Dell Center for the Michael & Susan Dell Center for the Advancement of Healthy LivingAdvancement of Healthy Living
University of Texas School of Public HealthUniversity of Texas School of Public Health
Austin Regional CampusAustin Regional Campus
Healthy Eating and Moving Healthy Eating and Moving More: Why is it important More: Why is it important and what works?and what works?
Steven H Kelder, PhD, MPHSteven H Kelder, PhD, MPHBeth Toby Grossman Professor in
Spirituality and Healing
Michael & Susan Dell Center for the Michael & Susan Dell Center for the Advancement of Healthy LivingAdvancement of Healthy Living
University of Texas School of Public HealthUniversity of Texas School of Public Health
Austin Regional CampusAustin Regional Campus
Action Framework For A Comprehensive Public Health StrategyTo Prevent Heart Disease And Stroke
Fatal CVD Complications/ Decompensation
Unfavorable Social and Environmental Conditions
Adverse Behavioral Patterns
Major Risk Factors
First Event/ Sudden Death
Disability/ Risk of Recurrence
The Present Reality
Good Quality of Life Until Death
Social and Environmental Conditions Favorable to Health
Behavioral Patterns that Promote Health
Low Population Risk
Few Events/ Only Rare Deaths
Full Functional Capacity/Low Risk of Recurrence
A Vision of the Future
Policy and Environmental Change
Behavior Change
Risk Factor Detection and Control Emergency
Care/Acute CaseManagement
Rehabilitation/ Long-term Case Management
InterventionApproaches
End-of-Life CarePREVENTION
Action Framework For A Comprehensive Public Health StrategyTo Prevent Heart Disease And Stroke
Fatal CVD Complications/ Decompensation
Unfavorable Social and Environmental Conditions
Adverse Behavioral Patterns
Major Risk Factors
First Event/ Sudden Death
Disability/ Risk of Recurrence
The Present Reality
Good Quality of Life Until Death
Social and Environmental Conditions Favorable to Health
Behavioral Patterns that Promote Health
Low Population Risk
Few Events/ Only Rare Deaths
Full Functional Capacity/Low Risk of Recurrence
A Vision of the Future
Policy and Environmental Change
Behavior Change
Risk Factor Detection and Control Emergency
Care/Acute CaseManagement
Rehabilitation/ Long-term Case Management
InterventionApproaches
End-of-Life Care
TREATMENT
Energy Intake Energy Expenditure
Energy Balance
Individual Factors
Behavioral Settings
Social Norms and Values
Communities
Worksites
Health Care
Schools and Child Care
Home
Demographic Factors (e.g., age, sex, SES, race/ethnicity)
Psychosocial Factors
Gene-Environment Interactions
Other Factors
Government
Public Health
University
Health Care
Agriculture
Education
Media
Land Use and Transportation
Communities
Foundations
Industry
Food
Beverage
Retail
Leisure and Recreation
Entertainment
Physical Activity
Sectors of Influence
Food & Beverage Intake
IOM Comprehensive approach for preventing and addressing childhood obesity
SOURCE: Institute of Medicine, Progress in Preventing Childhood Obesity, 2007, pg 20.
The Public Health System of the 21st Century
Mgmt Care Orgs
Home Health
Parks
Economic Development
Mass Transit
Employers
Nursing Homes
Mental HealthDrug
Treatment
Civic GroupsCHCs
Laboratory Facilities
Hospitals
EMS Community Centers
Doctors
Health Dept
Churches
Philanthropist
Elected Officials
Tribal Health
Schools
Police
Fire
Corrections
Environmental Health
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
Energy Balance
~ 500 calories per day
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
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
Evidence-based Interventions to Promote Physical Activity
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 LivingPromoting 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 Campus313 E. 12th St., Suite 220Austin, TX 78701512-482-6167512-482-6185 (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