Health Promotion – The diet and disease connection Lizann Powers Hammond Shirley Broughton

Goals for today: Health Promotion -Consumer perspective Health Promotion Framework Diet and Chronic Disease what’s new? Heart Disease Diabetes Cancer Sorting through the evidence

Communicating Science Based Evidence The New Nutrition Conversation is all about talking with consumers rather than at them to find out what they are thinking and why when it comes to nutrition. International Food and Nutrition Information Council IFIC.org

Are consumers losing their FOOD Are consumers losing their appetite for… NUTRITION International Food and Nutrition Information Council IFIC.org

Many people find it difficult to separate valid recommendations from fad diet advice. Consumers are bombarded with nutrition information from a variety of sources. Web Sites Food Labels TV and Radio News Popular Magazines Medical Experts Consumer Nutrition information is often seen as contradictory, even from equally valid sources. Media Images Fad Diet Gurus Friends and Family Food Ads Gov’t Guidelines SOURCE: IFIC Foundation, 2004

Consumers Say 85% say that diet and nutrition are important to them personally. Only 25% say they have made significant changes to achieve a healthful diet. Source: ADA trends survey, 2002

Consumers Say Consumers get most of their nutrition information from TV, newspapers, magazines. Consumers value the information form health professionals the most. Source: ADA Trends survey, 2002

Consumers Say… 38% “I’m already doing it.” 30% “I know I should, But…” About achieving a healthy nutritious diet… 38% “I’m already doing it.” 30% “I know I should, But…” 32% “Don’t bother me.” ADA Trends Survey 2002

Consumers Say 57% agree “Based on the information I’ve heard, I believe there are some foods I should never eat.” 54% believe “taking vitamin supplements is necessary to ensure good health” 33% believe “herbal dietary supplements are safe because they are natural” ADA Trends Survey 2002

Missing Ingredient Tips – Where is the ACTION is! Don’t just tell us what to do, tell us HOW to do it! Consumers

SIMPLE POSITIVE PRACTICAL CONSISTENT Consumers need how-to information about nutrition information that is … SIMPLE POSITIVE PRACTICAL CONSISTENT

Consumers Definition of Health Healthy is…. Active Energetic Confident Smiling Good complexion Good Posture Bright and wide eyed Works out/ is fit Positive Attitude Well Rested Addressing the obesity debate: Consumers point of view IFIC 2003

Consumers Definition of Health More broadly, consumers also describe health holistically, involving components of mental, emotional, and physical health. They state all of these elements must work together in contributing to good health.

The Health Promotion Framework

Elements of Health Promotion Physical – Fitness and nutrition. Medical self-care. Control of substance abuse. Emotional - Care for emotional health.  Stress management, calming. Social – Community, families, friends. Intellectual – Education, achievement, career development. Spiritual – Love, hope, charity.

Alleviation of Condition Medical Model Problem/Condition Diagnosis Treatment Alleviation of Condition

Perspectives on Obesity Medical Model Weight is the problem. Treatments focuses on weight loss. Medical interventions are available to change body weight.

Weight Loss Methods Diet Exercise Prescription drugs Behavior modification Diet pills Herbal remedies Liposuction Bariatric surgery Acupuncture Lotions/creams Hypnosis Stimulants

The Magic Cure? The medical model is the western cultural norm. The search for a simple “magic cure” fits with the medical model.

Perspectives on Obesity Health Promotion Model Body weight above normal suggests a person is out of balance. Seek to discover underlying issues and restore balance to life.

Exploration of Weight Issues Physical Diet and activity patterns, substance use? Emotional Stress levels, stress eating, emotional eating? ACE? Social Connection to others? Intellectual Mental stimulation, Happiness with life? Spiritual Connection to world and nature?

Broadening the Focus Medical Model How can we get people to lose weight? Health Promotion Model How can we promote a holistic approach to health and well-being?

The Life Balance Wheel

Disease Prevention Medical Model Identify risk factors. Intervention targets risk factors. Often fear based, desire to avoid disease state.

Disease Prevention Health Promotion Model Examine life balance and holistic well-being. Focus in on maximizing health not just absence of disease.

Addressing Chronic Disease Medical Model You have an illness, symptoms are treated. Health Promotion You can be well and optimize health through lifestyle, even with a disease.

Diet and Disease Update Heart Disease Diabetes Cancer

Top 10 Killers Heart disease Cancer Stroke Chronic lower respiratory diseases Accidents (unintentional injuries) Diabetes Alzheimer's disease Influenza/Pneumonia Nephritis, nephrotic syndrome, and nephrosis Septicemia

Diet and Heart Disease Where we have been… Saturated Fat  Cholesterol  Vegetable oils 

Diet and Heart Disease What’s New…. Trans fats  Fish Oil 

Diet and Heart Disease What’s in the News…. Nuts / Flaxseed - Omega 3 vs Omega 6 Plant Sterols Tropical Oils

Diet and Diabetes Where we have been… Amount of Carbohydrate Balanced diet

Diet and Diabetes What’s new… Maintain healthy weight Physical activity 30 minutes a day  Dietary Fiber 

Diet and Diabetes What’s in the news… Glycemic Index / Glycemic Load High Fructose Corn Syrup Cinnamon Chromium

Diet and Cancer Where we have been… Low in fat, alcohol and salt. High in whole grains, fruits and vegetables.

Diet and Cancer What’s New… Phytochemicals Antioxidants Cruciferous vegetables Omega-3 fatty acids

Diet and Cancer: What’s in the news… Supplements Juicers Sugar substitutes Green tea Soy products

Energy Drinks Contain significant amounts of caffeine and other legal stimulants. Additional ingredients imply “health” benefits.

AHA Diet Recommendations Balance calories and activity – achieve/ maintain a healthy weight Consume a diet rich in fruits and vegetables Choose Whole grains and High fiber foods Consume fish, especially oily fish at least twice a week Limit saturated fat and trans fat and cholesterol Choose and prepare with little or not salt Alcohol in moderation Diet and Lifestyle Recommendation Revision 2006: A Scientific Statement from AHA

American Diabetes Association Guidelines - prevention Moderate weight loss (7%) Through Lifestyle changes 150 minutes/week exercise Reduce calories / fat High Fiber Diet 14 gram / 1000 calories American Diabetes Association: Clinical Practice Recommendations 2007

American Cancer Society Nutrition and Physical Activity Guide Maintain a healthy weight throughout life. Adopt a physically active lifestyle. Eat a healthy diet, with an emphasis on plant sources. If you drink alcoholic beverages, limit consumption. American Cancer Society Nutrition and Physical Activity Guide

Take home message: Type and Quality of Carbohydrates: Make half of your grains whole Eat more fruits and vegetables Type and Quality of Fats: Replace saturated fats with vegetable oils Eat 2 fish meals / week Lean meats Low fat dairy

Focus on Lifestyle Eating behaviors: Eat plenty of fruits & vegetables daily. Enjoy whole grain foods. Choose lean meats and/or protein sources. Select low-fat dairy products. Drink adequate fluids. Keep portion sizes reasonable. Pick healthful snacks. Listen to hunger and satiety signals.

Take home messages Science is Evolutionary Not Revolutionary Simple, Positive, Practical, Consistent nutrition and health messages

Thank you!

Resources American Diabetes Association: Clinical Practice Recommendations 2007 Diet and Lifestyle Recommendations 2006: Scientific Statement from the AHA American Journal of Public Health International Food Information Council American Dietetic Association Food and Nutrition Trends Survey