Public Health Enemy #2: Poor Diet & Physical Inactivity (Fall 2022)

Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com What’s New in Public Health ? CHAPTER 16 Public Health Enemy Number Two—and Growing: Poor Diet and Physical Inactivity Copyright © 2021 by Jones & Bartlett...

Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com What’s New in Public Health ? CHAPTER 16 Public Health Enemy Number Two—and Growing: Poor Diet and Physical Inactivity Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com.  Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Why is Poor Diet and Physical Inactivity Public Health Enemy #2? Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Obesity in Adults Obesity is a common, serious, and costly disease Health Risks: The US obesity prevalence was 42.4% in 2017 – Cardiovascular disease Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com 2018. From 1999 –2000 through 2017 –2018, US obesity Diabetes prevalence increased from 30.5% to 42.4%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%. Some cancers Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. Arthritis These are among the leading causes of preventable, premature death. The estimated annual medical cost of obesityexternal icon in the United States was $147 billion in 2008. Medical costs for people who had obesity was $1,429 higher than medical costs for people with healthy weight. https://www.cdc.gov/obesity/index.html  Obesity and your heart It can change your cholesterol levels. Most of us know that obesity can cause a spike in bad cholesterol and triglyceride Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com levels, but did you know it can also lower good high-density lipoproteins (HDL) cholesterol? HDL cholesterol is important for removing bad cholesterol and working to reduce the risk for heart disease. It can cause your blood pressure to rise. Obese individuals require more blood to supply oxygen and nutrients to their bodies which causes an increase in blood pressure. Your body will also require more pressure to move this blood around. High blood pressure is also a common cause of heart attack, which are sadly more common for obese individuals. It can lead to diabetes. High cholesterol, blood pressure and heart attacks aren’t the only medical conditions you need to worry about if you’re obese. Obese individuals also have a much greater chance of developing diabetes. According to the American Heart Association, at least 68 percent of people aged 65 or older with diabetes also have heart disease. While individuals with diabetes are said to be two to four times more likely to be at risk for heart disease, the American Heart Association also lists diabetes as being one of the top seven major controllable factors to prevent heart disease. If you have diabetes but have yet to be diagnosed with heart disease, now is the time to act. https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2019/march/obesity-and-heart- disease#:~:text=Obese%20individuals%20require%20more%20blood,more%20common%20for%20obese%20individuals. Epidemiology of Obesity Prevalence of overweight and obesity have been increasing since the 1960s in all ages and genders. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com In the U.S., 74.6% of men and 67.4% of women are overweight or obese. Black women are more likely than white women to be overweight or obese. White men are slightly more likely than black men to be overweight or obese. Higher SES is associated with lower rates of overweight and obesity, especially among women.  Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com The U.S. adult obesity rate stands at 42.4 percent, the first time the national rate has passed the 40 percent mark, and further evidence of the country's obesity crisis. The national adult obesity rate has increased by 26 percent since 2008. Measuring Health Risk § BMI – Calculated from height and Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com weight – Overweight 25–29.9 BMI, Obese >30 BMI § Waist-to-hip ratio – Distribution of fat on the body – Pear-shaped versus apple- shaped bodies Overweight among Children § Prevalence of overweight among 2- to 19-year-olds increased from under 10% in 1988–1994 to >17.8% in 2013–2016. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § High prevalence exists among Black and Hispanic youth. § Type 2 diabetes is being diagnosed in children. Childhood Obesity Childhood obesity is a serious problem in the United States, putting children and adolescents at risk for poor health. Obesity prevalence among children and Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com adolescents is still too high. For children and adolescents aged 2-19 years in 2017- 20181: The prevalence of obesity was 19.3% and affected about 14.4 million children and adolescents. Obesity prevalence was 13.4% among 2- to 5-year- olds, 20.3% among 6- to 11-year-olds, and 21.2% among 12- to 19-year-olds. Childhood obesity is also more common among certain populations. Obesity prevalence was 25.6% among Hispanic children, 24.2% among non-Hispanic Black children, 16.1% among non-Hispanic White children, and 8.7% among non-Hispanic Asian children.  Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://stateofchildhoodobesity.org/2021report/ Youth 10-17 year olds What’s being done to address the obesity crisis? § https://www.cdc.gov/healthyweight/children/index.html Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Diet and Nutrition § Federal Dietary Guidelines for Americans: Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com – More fruits and vegetables, whole grains, low-fat milk and dairy products – Less refined grains, added sugar, salt, cholesterol, saturated and trans fats – ChooseMyPlate.gov Dietary Surveys by USDA § Diet of about 75% of U.S. population falls short of the federal Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com recommendations. § Vegetables are the most commonly omitted item. § Intake of sweetened beverages has increased; intake of milk has decreased. – Sweetened beverages account for about 7% of daily calorie intake. Promoting Healthy Eating § Many social, cultural, and economic factors contribute to dietary patterns. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Learn from tobacco control success. § Enhance self-efficacy and provide social support. § Apply California’s “5-A-Day” Campaign for Better Health. § Increase access to healthier food options. – Restaurants, schools, worksites § Reduce less healthy foods in public venues. – High calorie drinks and fast food in schools – Limit or tax sugar-sweetened beverages (SSBs) and junk food.  What Can Be Learned from Tobacco Control Programs? § Provide more food labeling: – For calories, fat, and sugar Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com content – In advertising and on wrappers/containers – 2018 law to post calorie counts on menus § Limit advertising of unhealthy options, especially those aimed at children. § Best hope is to focus on children, starting with encouraging breast- feeding. Physical Activity and Health § Exercise promotes health, independent of weight control. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com – Weight control works best when healthy eating is combined with physical activity. § Epidemiologic studies have demonstrated that people who are more physically active live longer. – Exercise helps to prevent heart disease, high blood pressure, harmful cholesterol levels, diabetes, and some forms of cancer. – Exercise clearly protects against cardiovascular disease. – Physical activity reduces colon and breast cancer risk. – Type 2 diabetes is related to weight gain in adults. 23 ½ hours: The single most important thing you can do for your health Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://www.youtube.com/watch?v=aUaInS6HIGo How Much Exercise? § Children = 60 minutes or more daily Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Adults = 150 to 300 minutes per week § Adults = muscle strengthening twice per week § More is better. § Most American adults fail to meet guidelines. § Lower SES is associated with more inactivity. § Children get less exercise as they get older. § Obesity in children is correlated with time using TV, computer, and video games. Promoting Physical Activity § Employ the ecological model, intervening at numerous levels of influence. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Remove environmental barriers and provide places to exercise. § Suburban lifestyle is to drive everywhere. – Add sidewalks, walking trails, bike paths. – Pedometers increase physical activity and reduce BMI and blood pressure. § Develop habits of exercise in children and adolescents. – Physical education classes should focus on activities that can be practiced throughout one’s lifetime. Confronting the Obesity Epidemic § Overweight and obesity could reverse public health improvements achieved in the 20th century. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Life expectancy will decline due to obesity. § Overweight and obesity diseases account for 20.6% of the U.S.’s total medical expenditures. § Bariatric surgery helps obese people lose weight and control diabetes. – Effective diet pills could do the same less drastically. Weight Loss Drugs § Fen-phen had to be removed from the market because it caused heart valve problems and pulmonary hypertension. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Belviq works by activating a part of the brain that controls hunger. § Qsymia is a combination of appetite suppressant and a drug used to treat epilepsy and migraines. § Orlistat works by inhibiting the absorption of dietary fats. Why is Physical Activity Important Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://www.cdc.gov/physicalactivity/about-physical-activity/index.html Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://www.cdc.gov/physicalactivity/about-physical-activity/index.html Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://www.cdc.gov/physicalactivity/about-physical-activity/index.html Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://www.cdc.gov/physicalactivity/about-physical-activity/index.html Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://www.cdc.gov/physicalactivity/about-physical-activity/index.html Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com https://www.cdc.gov/physicalactivity/about-physical-activity/index.html Discussion Question 1 § What are some of the environmental factors that discourage Americans from eating healthy diets? Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Discussion Question 2 § Referring to Table 16-2, estimate how many calories of energy you expend each day. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Do you achieve the minimum amount recommended by the CDC and the ACSM? § Can you think of two or three changes in your daily schedule that would increase your physical activity level? Discussion Question 3 § Visit www.choosemyplate.gov and determine the dietary guidelines and exercise recommendations individualized for you. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Use the ecological model (see Chapter 14) to design a community program to help people follow the recommendations of MyPlate. Discussion Question 4 § Visit the CDC’s Physical Activity website, www.cdc.gov/physicalactivity. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § In what ways is the CDC trying to promote more physical activity for Americans? § Under “Resources & Publications/Recommendations & Guidelines,” there are links to recommendations for different groups of the population. Find one relevant to you. § Can you find any ideas that you want to try?