1. ISDH Strategies to Reduce Overweight and Obesity
Community Nutrition/Obesity Prevention Division

2. Overweight and Obesity – A Critical Public Health Threat

3. Overweight and Obesity – A Critical Public Health Threat
An Overview of the Presentation

4. Overweight and Obesity – A Critical Public Health Threat
An Overview of the Presentation
National trends
State statistics
Key strategies to decrease overweight and obesity in Indiana

5. America is Battling Overweight and Obesity:
More than 64.5% of U.S. adults are overweight or obese.
One in seven children are overweight or obese.

6. From 1960 to 2000:
Percentage of overweight children has increased from 18% to 33%.
Number of children who are obese has risen from 7% to 17%.
At present, approximately nine million children over 6 years old are considered obese.

7. Risks Associated with Obesity
Heart Disease
Type II Diabetes
Hypertension
Some Cancers
Asthma
High Blood Pressure
Sleep Apnea

8. Obesity Trends Among U.S. Adults BRFSS, 1991

9. Obesity Trends Among U.S. Adults BRFSS, 1992

10. Obesity Trends Among U.S. Adults BRFSS, 1993

11. Obesity Trends Among U.S. Adults BRFSS, 1994

12. Obesity Trends Among U.S. Adults BRFSS, 1995

13. Obesity Trends Among U.S. Adults BRFSS, 1996

14. Obesity Trends Among U.S. Adults BRFSS, 1997

15. Obesity Trends Among U.S. Adults BRFSS, 1998

16. Obesity Trends* Among U.S. Adults BRFSS, 1999

17. Obesity Trends Among U.S. Adults BRFSS, 2000

18. Obesity Trends Among U.S. Adults BRFSS, 2001

19. Obesity Trends Among U.S. Adults BRFSS, 2002
No Data <10% %–14% %–19% %-24% 25%
Source: Behavioral Risk Factor Surveillance System, CDC

20. 2003
During the past 20 years there has been a dramatic increase in obesity in the United States. In 1985 only a few states were participating in CDC's Behavioral Risk Factor Surveillance System (BRFSS) and providing obesity data. In 1991, four states had obesity prevalence rates of 15–19 percent and no states had rates at or above 20 percent. In 2003, 15 states had obesity prevalence rates of 15–19 percent; 31 states had rates of 20–24 percent; and 4 states had rates more than 25 percent.

21. Cost of Overweight and Obesity
The US Department of Health and Human Services estimates cost of medical expenses in treatments and lost productivity to be $117 billion annually

22. In Indiana 62.1% of adults are classified as overweight or obese
25.5% of adults are classified as obese
2004 Behavior Risk Factor Surveillance System

23. In Indiana
14.2% of high school students are at risk of being overweight
11.5% reported they were overweight
2004 Behavior Risk Factor Surveillance System

24. In Indiana One in four Hoosier adults is obese.
Indiana is the 9th most obese state in the country based on CDC averages.
2004 Behavior Risk Factor Surveillance System

26. Causes of Overweight and Obesity
Lack of physical activity
Unhealthy eating patterns
Related to technological, social, economic and environmental changes that have reduced physical activity and increased food access and passive consumption
Family environment
Genetics plays a limited role

27. Prevention is the key…

28. CDC Guidance… Physical Activity Strategy Five-A-Day Strategy
Extended Breastfeeding Strategy
Television Viewing Reduction Strategy
Portion Size Control Strategy

29. Community Nutrition and Obesity Prevention Division
"To improve the quality of life in Indiana by helping Hoosiers incorporate healthy habits into their routines.”

30. Mission:
Our mission is to increase public awareness of healthy eating and activities, to promote healthy life styles, and to prevent obesity and related chronic diseases.

31. Program Focus:
To promote and promise individual, community, and environmental strategies to prevent and control obesity and related chronic diseases.

32. Community Nutrition/Obesity Prevention
Educate physicians and the public about prevention and management of overweight and obesity.
Develop and support policies and legislation that promote daily physical activity and balanced healthy eating by all Hoosiers.
Promote and collaborate with statewide and local medical and specialty societies, and other private organizations to promote daily physical activities and balanced healthy eating in Indiana.

33. CNOP Programs  CDC DNPA Continuing Education Program
 Childhood Obesity Prevention Initiatives
 Data and Policy Development
 Eating Disorders
 Education and Training
 Extended Breastfeeding Program
 Extended Farmer’s Market Program
 Five-A-Day Program
Community Outreach/ Health System Development
Senior Farmer’s Market Program

34. CNOP Special Projects  Vending Machine Choices, Healthy Corner
CATCH (Community Access to Child Health) Obesity Prevention Project
“You Can – Step to Healthier Aging” Campaign
 School Height and Weight BMI Collection
 Fatty Liver and Overweight Prevention
 3-A-Day Community Collaboration Proposal
Healthy Club ( and web-based)
CHIP Program
Calcium Promotion Project
Data Assessment Project
Needs Assessment and State Strategic Plan

35. Regional Outreach Program
The program is designed as a powerful grass-root movement tool to provide and deliver educational information and technical assistance to local communities in order to assist development of local coalition and community-based plans in terms of healthy living, healthy life choices, and overweight and obesity prevention.

37. Five-A-Day Program
5-A-Day for Better Health is a national program and partnership that seeks to increase the number of daily servings of fruits and vegetables that Americans eat to five or more.
A daily diet high in colorful fruits and vegetables and low in saturated fat and cholesterol, combined with daily physical activity, can help fight overweight, obesity, and other related chronic diseases such as cancer, heart disease, and other chronic diseases.
2003 YBRSS data indicated that only 33% of the Hoosier children, adults, and adolescents consume at least 3-5 fruit and vegetables a day.  

38. 2005 New Dietary Guidelines for Americans
Identified a critical nutrient gap for potassium, fiber, and vitamins A and C. Fruit and vegetables are rich in each of these nutrients.
Established a stronger role for fruit and vegetables in helping fight heart disease, high blood pressure, type 2 diabetes, stroke, and cancer.
Established role for fruits and vegetables in helping people lose weight and maintain a healthy weight.

39. Five-A-Day Program
Fruits and vegetables provide essential vitamins and minerals, fiber, and other substances that are important for good health. Most fruits and vegetables are naturally low in fat and calories and high in fiber which is filling.
For everyone, 5-A-Day is an essential daily dietary practice for a healthier life. Research has demonstrated the unique disease-prevention capacity and long-term health benefits of consuming a colorful variety of fruits and vegetables every day.

40. Five-A-Day Program Partners
Department of Education/Schools
Purdue Extension
WIC Farmer’s Market Program
Maternal and Child Health
Community Health Clinics
Area Agency on Aging
Faith-based Communities

41. Childhood Overweight and Obesity Prevention Program
Functions as one of the obesity prevention programs.
Utilizes Dr. Wishner as a special consultant for 18 months.
Sets up a model for programs regardless of ages.

42. Strategic Plan on Child Obesity
Goal 1:
Increase awareness of overweight and obesity as a public health issue that impacts the quality of life of Indiana children and adolescents and their families.
Goal 2:
Enable Indiana stakeholders including families, schools, businesses and communities to create opportunities allowing for choice in lifestyles that promote and maintain a healthy weight.
Goal 3:
Promote enabling policies and environmental changes that support healthful eating habits and physical activity.
Goal 4:
Monitor overweight and obesity rates, related behaviors and health conditions for fiscal planning, evaluation, and dissemination activity
Goal 5:
Foster and encourage stakeholders participation in Indiana childhood and adolescent overweight and obesity strategies and initiatives

43. Weight and Height Collection Project
Collaborative effort of ISDH and DOE
Involves all schools (K-12)
First time in Indiana
Critical height and weight data will establish a baseline
Starts in Fall, 2005

44. In Summary: Obesity is a critical public health issue.
Community Nutrition/Obesity Prevention plays a significant role in addressing this issue.
5-A-Day is one of the key strategies to address overweight and obesity issues.
Coordination and collaboration are critical for success.

45. Thank you!