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Healthy Eating and Active Lifestyles. After this presentation, participants will be able to: Articulate trends in obesity and overweight Describe how.

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Presentation on theme: "Healthy Eating and Active Lifestyles. After this presentation, participants will be able to: Articulate trends in obesity and overweight Describe how."— Presentation transcript:

1 Healthy Eating and Active Lifestyles

2 After this presentation, participants will be able to: Articulate trends in obesity and overweight Describe how obesity affects Job Corps Discuss how the built environment affects health status Describe the Healthy Eating and Active LifeStyles (HEALS) program List various center staff members’ responsibilities in creating a healthy environment and center culture 2

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5 So, what’s the big deal? Medical significance of obesity. Associated with increased risk for many conditions: High blood pressure Diabetes Elevated cholesterol Heart Disease Stroke Gall bladder disease Sleep apnea Certain cancers: uterine, prostate, colorectal 5

6 Employment Significance of Obesity: Bias and Discrimination Hiring prejudice Inequity in wages, promotions and termination Education setting Medical setting 6 Source: Puhl R, Brownell, KD. Bias, discrimination, and obesity. Obesity Research. 2001 Dec; 9(12):788-805

7 Costs of Obesity 7 Source: The George Washington University School of Public Health. (2010). First-ever report on the individual cost of obesity. Retrieved online from:

8 ACCESS TO CARE ENVIRONMENT GENETICS HEALTH BEHAVIORS ACCESS TO CARE 88% OTHER 8% HEALTH BEHAVIORS 4% 10% 20% 50% Influence National Health Expenditures $1.2 Trillion Sources: Centers for Disease Control and Prevention, University of California at San Francisco, Institute for the Future. Reprinted from Advances: The Robert Wood Johnson Foundation Quarterly Newsletter, 2000, Issue 1, supplement, page 1 Factors That Influence Health Status

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10 Environment and Weight Status Neighborhoods have disparity in access to healthy foods in the U.S. Unhealthy foods are more available, more convenient, more heavily advertised and less expensive (especially in low income neighborhoods) Proximity to fast-food restaurants positively associated with likelihood of gaining more than 20kg weight during pregnancy For residents of urban neighborhoods, higher concentrations of small grocery stores was positively related to obesity and BMI

11 Environment and Weight Status More affluent neighborhoods – more supermarkets, easier access to whole grains, low-fat foods, more diverse fresh fruits and vegetable choices Increase in portion sizes at restaurants and pre-packaged foods

12 Neighborhoods and Chronic Disease Economic disadvantage Social environment – Connectedness and social order – Immigration, concentration of crime, segregation, residential stability Built environment – Connectivity, air pollution, density Source: Freedman et al. Neighborhoods and Chronic Disease in Later Life; AJPH, 2011; Vol 101(1).12

13 Neighborhoods and Chronic Disease Looked at 6 common chronic conditions (self- report) – Hypertension, heart problems, stroke, diabetes, cancer and arthritis When all neighborhood factors included, disadvantaged neighborhoods associated with: – Increased risk heart problems and cancer in women – Increased risk cancer for when all neighborhood factors included – Proposed result of possible stress response 13

14 Costs of Treating Heart Disease Estimated costs to treat – will triple by 2030 Includes treatment of hypertension, coronary heart disease, heart failure and stroke $273 billion to $818 billion in 2030 U.S. medical expenditure already highest in world; 15% of GDP 36.9% of Americans have some form of heart disease today Estimated 40.5% by 2030 based on current rates of rise Source: Circulation: JAMA; Costs to Treat Heart Disease will triple by 2030; January 25, 2011.14

15 Primary Disease Prevention Costs Savings Modest reductions (5%) in prevalence of diabetes and hypertension would save $9 billion annually If include reductions in co-morbidities- could save $24.7 billion annually Focus on well-designed interventions to improve lifestyle related risk factors Ormond et al (2011) Potential National and State Medical Care Savings From Primary Disease Prevention; AJPH Vol 101(1). 15

16 Food “Choices” Taste – Acquired – Can expand Cost Convenience Source: Drewnowski et al (2009) can low-income Americans afford a health diet?

17 Physical Activity and Weight Status 25% of all trips in U.S. are less than 1 mile and yet 75% of these trips are taken by car Increased time in car per day increases risk of obesity Safety and community design influence method of transportation; the more “walkable” a community, the lower the risk of obesity

18 Environment and Weight Status Surgeon General report in 2010 – 8 to 18 year olds spend over 7 hours per day playing video games, on the computer, or watching TV Social norms influence weight – if your friends gain weight, you are more likely to gain weight

19 Behavioral Ecological Model

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21 Step 1: JC Data Collection Collaboration Leadership Motivation Variety 21

22 Step 2: Public Schools 22

23 Step 3: Job Corps Centers 23 Lunch at Delaware Valley JCC

24 Step 4: A Meeting of the Minds 24

25 The Program Holistic and individualized Step-by-step guide Website for food service staff Evidence-based curriculum A guide for recreation staff Policy (food service, recreation, programmatic) Webinars Tips to create a healthy environment 25

26 It takes a “village” to promote student health. 26

27 The Triumvirate Three powerful individuals, each a triumvir The core: health and wellness, recreation, and food service 27

28 Who Else? Social Development Instructors CD/Administration Finance SGA/students Community Connections Others 28 Poll question

29 What Makes a Successful Program? Collaboration Leadership Motivation Variety 29 The Healthy Eating and Active LifeStyles Committee! Poll question

30 Sneak Preview 30

31 Overeating as an Addiction

32 Game Break! True or False? The same parts of the brain are responsible for both food and cocaine addiction. 32

33 True Functional neuroimaging studies revealed that good smelling, looking, tasting, and reinforcing food has characteristics similar to that of drugs of abuse. Source: Liu, Y. et al. (2010). Food addiction and obesity: evidence from bench to bedside. Journal of Psychoactive Drugs. 42(2); 133-145.

34 TEAP Specialist’s Role Work with students who are struggling with both addictions/cravings Be cognizant of replacing one addiction with another Another good reason to work closely with recreation 34

35 The Mind and the Body

36 True of False? More people suffer from bulimia than from binge eating disorder. 36

37 False Approximately 2% of the population, and 10-15% of overweight people suffer from binge eating disorder. One out of every 200- 300 people summer from bulimia.

38 True of False? People who are depressed are more likely to be overweight. 38

39 True Sometimes obesity leads to depression; sometimes depression leads to obesity

40 Disordered Eating 75% of women eat, think, and behave abnormally around food some of the time. 40 Source: University of North Carolina at Chapel Hill, news release, April 22, 2008

41 CMHC’s Role Collaborate with recreation staff Incorporate exercise into groups Foods and Moods curriculum Screen for disordered eating – Partnership with outside treatment facility Brief cognitive behavioral therapy Food addictions group 41

42 Recreation

43 True of False? Eating healthy is more important than exercise for weight loss. 43

44 False—But really this is a trick question Food matters more for calories but physical activity is the #1 predictor of sustained weight loss.

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46 National Weight Control Registry (NWCR) There is variety in how NWCR members keep the weight off. Most report continuing to maintain a low calorie, low fat diet and doing high levels of activity. – 78% eat breakfast every day. – 75% weigh themselves at least once a week. – 62% watch less than 10 hours of TV per week. – 90% exercise, on average, about 1 hour per day. 46

47 Recreation’s Role Make physical activity fun Offer activity that appeal to male and female students Sell the stress-reduction benefits of exercise 47

48 Food Service 48

49 Game Break! True or False? Labeling a healthy food with a heart or other icon is the most effective way to get students to choose healthy foods. 49

50 False Labeling with an icon is a mixed bag; although there is some evidence that providing calorie information on menus reduces the number of calories people eat. Source: Albright, C.L. et al. (1990). Restaurant menu labeling: impact of nutrition information on entrée sales and patron attitudes. Health Education Quarterly. 17(2), 157167. Harnack, L.J. & French, S.A. (2008). Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices. International Journal of Behavioral Nutrition and Physical Activity. 26(5); 51.

51 Game Break! True or False? Slightly reducing the cost of healthy foods in comparison to unhealthy foods will encourage healthier eating. 51 $0.10

52 True As little as a 10% reduction in cost of healthy foods will encourage an increase in consumption of healthy foods. Larger reductions encourage people to buy more snacks and consume more calories. Source: French, S.A. (2003). Pricing effects on food choices. Journal of Nutrition. 133(3), 841S-843S.

53 Food Service’s Role Stay within budget Serve foods that students want to eat Control portion sizes Promote healthy foods Cut back on soda, fried foods, processed foods, etc. 53

54 Education and Programs 54

55 Game Break! True or False? Watching and discussing a health- related documentary, like Food, Inc., is more effective in eliciting behavior change than imparting basic nutrition knowledge during a health class. 55

56 True Students in a Food and Society course ate more vegetables and decreased high-fat dairy compared to students in a standard nutrition course. Source: Heckler, E.B., Gardner, C.D., & Robinson, T.N. (2010). Effects of a college course about food and society on students’ eating behaviors. American Journal of Preventative Medicine. 38(5), 543-547.

57 Game Break! True or False? Tangible prizes (e.g., t-shirts, gift cards) are the most effective way of motivating adolescents to change a health behavior. 57

58 False Fun activities, support, competence, and autonomy are effective ways of motivating students. Source: Ryan R.M. & Deci, E.L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist. 55(1), 68-78. doi:10.1039/0003-066x.55.1.68

59 Up for Grabs Use health education curriculum to teach students Run programs Plant a center garden Teach students how to grocery shop and cook 59

60 Nurses’ and Physicians’ Roles Intake Follow the Obesity Chronic Care Management Plan Track students’ BMI and waist circumference Lead the wellness team Lend expertise 60

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71 What’s Coming? “Best Health Mentor” competition A marketing kit for your center Two new websites Guidance on how to select a HEALS committee/submission of committees Staff trainings Ongoing program support Guidance to kick off the program Quarterly campaigns 71

72 Best Health Mentor Competition Each member of the Job Corps community may nominate one staff member and one student as the center’s Best Health Mentor. Nominees should be individuals who both model healthy behaviors and help others adopt these behaviors. One staff member and one student will be selected from each region as a Best Health Mentor. Email to 72

73 Any questions about your piece of the puzzle? 73

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