1. Presented by: Natanya M. Jennings, PharmD. Master of Public Health Candidate 1

2.  Overweight & Obesity Defined  Statistical & Economical Review of the Problem  Causes & Effects of Overweight & Obesity  Changes in Eating Habits  Nutrition Labeling Legislation  Summary 2

3.  Body Mass Index (BMI)  Measure of body fat utilizing the height and weight  Defines ranges of weight of which may identify: ▪ Weight that is unhealthy for a height ▪ Likelihood of other health issues and diseases  Adults  BMI between 25-29.9 regard as overweight  BMI of 30 or higher regarded as obese 3 Centers for Disease Control and Prevention [CDC]. (2009 August). Overweight and Obesity: Defining Overweight and Obesity. Retrieved October 20, 2009, from http://www.cdc.gov/obesity/defining.htmlhttp://www.cdc.gov/obesity/defining.html

4.  BMI is still the most common measurement for children and teens 2-19 years old  Overweight identified as:  At or greater than the 85 th percentile and lower than the 95 th percentile  Obesity identified as:  At or greater than the 95 th percentile 4 CDC. (2009 October). Overweight and Obesity: Defining Childhood Overweight and Obesity. Retrieved October 20, 2009, from http://www.cdc.gov/obesity/childhood/defining.html http://www.cdc.gov/obesity/childhood/defining.html

5.  There has been a striking increase of obesity  Majority of the states had a prevalence equal to or more than 25%  Ethnicity plays a role in obesity  African-Americans and Hispanics more likely to be obese than white counter part  Geographic location plays a role in obesity  Greater prevalence in the South and Midwest regions of the U.S. 5 CDC. (2009 August). U.S. Obesity Trends. Retrieved October 21, 2009, from http://www.cdc.gov/obesity/data/trends.htmlhttp://www.cdc.gov/obesity/data/trends.html

6. 1999 Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2008 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2008 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Slide adapted from the CDC Behavioral Risk Factor Surveillance System. CDC. (2009 August). U.S. Obesity Trends. Retrieved October 21, 2009, from http://www.cdc.gov/obesity/data/trends.htmlhttp://www.cdc.gov/obesity/data/trends.html

7.  Overweight and obesity prevalence 1  Over 35% of population is overweight  Nearly 30% of population is obese  Men’s Fitness 2009 25 Fattest Cities in America 2  San Antonio Ranked # 3  Houston Ranked # 6  El Paso Ranked # 7  Dallas/Ft. Worth Ranked # 14 7 1.CDC. (n. d.). Prevalence and Trends Data: Texas 2008 Overweight and Obesity (BMI). Retrieved October 21, 2009 from http://apps.nccd.cdc.gov/brfss/display.asp?cat=OB&yr=2008&qkey=4409&state=TX http://apps.nccd.cdc.gov/brfss/display.asp?cat=OB&yr=2008&qkey=4409&state=TX 2.Men’s Fitness. (2009). 2009 Fattest Cities in America: 25 towns in need of a fitness overhaul. Retrieved September 30, 2009, from http://www.mensfitness.com/lifestyle/216 http://www.mensfitness.com/lifestyle/216

8.  Lack of Caloric Balance  Consuming more calories than the body uses  Genetics  Possible genetic predisposition  Drugs and Diseases  Antidepressant and steroid use  Cushing’s Disease and Polycystic Ovary Syndrome 8 CDC. (2009 August). Causes and Consequences. Retrieved October 21, 2009, from http://www.cdc.gov/obesity/causes/index.htmlhttp://www.cdc.gov/obesity/causes/index.html

9.  Home  Increased TV/audiovisual dependency  Lack of daily routines  School  Lack of nutritional standards for daily meals  Lack of daily physical education  Community  Lack of healthy food choices by neighborhood grocers  Increased crime in neighborhoods  More urban commuter communities  Work  Long hours  Lack of gym facilities at work 9 CDC.(2009 August). Causes and Consequences. Retrieved October 21, 2009, from http://www.cdc.gov/obesity/causes/index.htmlhttp://www.cdc.gov/obesity/causes/index.html

10.  Type 2 Diabetes Mellitus  Cancer  Dyslipidemia  Stroke  Coronary Heart Disease  Liver Disease  Hypertension  Rheumatic Disease 10 CDC. (2009 August). Health Consequences. Retrieved October 20, 2009, from http://www.cdc.gov/obesity/causes/health.htmlhttp://www.cdc.gov/obesity/causes/health.html

11.  Estimated National Price of Obesity 1  Medical expenses $140 billion  Normal weight expenditure $4700/year  Obese expenditure $6400/year  Estimated Cost of Obesity in Texas 2  Medical expenses $10.1 billion  2040 future estimated costs $39 billion 11 1.Chimes, A. (2009 July). Study Estimates Cost of Obesity at $140 Billion. Retrieved October 20, 2009, from http://www.voanews.com/english/archive/2009- 07/2009-07-29-voa32.cfm?moddate=2009-07-29http://www.voanews.com/english/archive/2009- 07/2009-07-29-voa32.cfm?moddate=2009-07-29 2.Texas Department of State Health Services. (2009 July). Obesity. Retrieved October 20, 2009, from http://www.dshs.state.tx.us/obesity/default.shtmhttp://www.dshs.state.tx.us/obesity/default.shtm

12. THE GROWING PROBLEM OF OVERWEIGHT AND OBESITY IN HOUSTON? 12

13.  Fighting the bulge among the public  Unaware of daily caloric intake  Unaware of calories associated with foods & beverages  Providing consumers with nutritional facts  More conscious consumers  Encourages restaurants and other eateries to offer healthier foods 13 Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):26-33.

14. 14  Americans are eating away from home more  Americans are consuming more high calorie snacks  Food advertisements are more elaborate at toward specific populations Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):26-33.

15.  New York City Menu Labeling Law 1  1 st to implement menu labeling law  Restaurants with ≥ 15 locations must post calorie counts on menus  California Menu Labeling Law 2  1 st state implemented menu labeling law  Restaurants with ≥ 20 locations must post calorie counts on menus  Philadelphia Menu Labeling Law 3  Restaurants with ≥ 15 locations must post calorie counts (sodium, trans/saturated fat, & carbohydrates) on menus 15 1.USA Today. (2008 April). NYC’s calories-on menus law upheld. Retrieved October 21, 2009, from http://www.usatoday.com/news/health/weightloss/2008-04-16-nyc- calories_N.htmhttp://www.usatoday.com/news/health/weightloss/2008-04-16-nyc- calories_N.htm 2.Los Angeles Times. (2009 July). Menu labeling law takes effect: How many calories in that sandwich? Retrieved October 21, 2009, from http://latimesblogs.latimes.com/dailydish/2009/07/menu-labeling-law-takes-effect-how-many-calories-in-that-sandwich.html http://latimesblogs.latimes.com/dailydish/2009/07/menu-labeling-law-takes-effect-how-many-calories-in-that-sandwich.html 3.CalorieLab. (2008). Philadelphia passes strictest menu labeling law. Retrieved October 21, 2009, from http://calorielab.com/news/2008/11/10/philadelphia-passes-strictest-menu- labeling-law/#more-2962http://calorielab.com/news/2008/11/10/philadelphia-passes-strictest-menu- labeling-law/#more-2962

16.  Nearly 30% of the Texas population is obese (BMI ≥ 30) 1  Houston ranked #6 on the “25 Fattest Cities in America” 2  The economic impact of obesity in Texas is $10.1 billion 3  Americans are eating away from home more 4  Legislature is in effect for menu labeling 5,6,7 16 1.CDC. (n. d.). Prevalence and Trends Data: Texas 2008 Overweight and Obesity (BMI). Retrieved October 21, 2009 from http://apps.nccd.cdc.gov/brfss/display.asp?cat=OB&yr=2008&qkey=4409&state=TXhttp://apps.nccd.cdc.gov/brfss/display.asp?cat=OB&yr=2008&qkey=4409&state=TX 2.Men’s Fitness. (2009). 2009 Fattest Cities in America: 25 towns in need of a fitness overhaul. Retrieved September 30, 2009, from http://www.mensfitness.com/lifestyle/216http://www.mensfitness.com/lifestyle/216 3.Texas Department of State Health Services. (2009 July). Obesity. Retrieved October 20, 2009, from http://www.dshs.state.tx.us/obesity/default.shtmhttp://www.dshs.state.tx.us/obesity/default.shtm 4.Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):26-33. 5.USA Today. (2008 April). NYC’s calories-on menus law upheld. Retrieved October 21, 2009, from http://www.usatoday.com/news/health/weightloss/2008-04-16-nyc-calories_N.htmhttp://www.usatoday.com/news/health/weightloss/2008-04-16-nyc-calories_N.htm 6.Los Angeles Times. (2009 July). Menu labeling law takes effect: How many calories in that sandwich? Retrieved October 21, 2009, from http://latimesblogs.latimes.com/dailydish/2009/07/menu-labeling-law-takes- effect-how-many-calories-in-that-sandwich.htmlhttp://latimesblogs.latimes.com/dailydish/2009/07/menu-labeling-law-takes- effect-how-many-calories-in-that-sandwich.html 7.CalorieLab. (2008). Philadelphia passes strictest menu labeling law. Retrieved October 21, 2009, from http://calorielab.com/news/2008/11/10/philadelphia-passes-strictest-menu-labeling-law/#more-2962http://calorielab.com/news/2008/11/10/philadelphia-passes-strictest-menu-labeling-law/#more-2962

17. Thank you for your attention. 17

18. CalorieLab. (2008). Philadelphia passes strictest menu labeling law. Retrieved October 21, 2009, from http://calorielab.com/news/2008/11/10/philadelphia-passes- strictest-menu-labeling-law/#more-2962http://calorielab.com/news/2008/11/10/philadelphia-passes- strictest-menu-labeling-law/#more-2962 CDC. (2009 August). Causes and Consequences. Retrieved October 21, 2009, from http://www.cdc.gov/obesity/causes/index.htmlhttp://www.cdc.gov/obesity/causes/index.html CDC. (2009 August). Health Consequences. Retrieved October 20, 2009, from http://www.cdc.gov/obesity/causes/health.htmlhttp://www.cdc.gov/obesity/causes/health.html CDC. (2009 August). Overweight and Obesity: Defining Overweight and Obesity. Retrieved October 20, 2009, from http://www.cdc.gov/obesity/defining.htmlhttp://www.cdc.gov/obesity/defining.html CDC. (2009 October). Overweight and Obesity: Defining Childhood Overweight and Obesity. Retrieved October 20, 2009, from http://www.cdc.gov/obesity/childhood/defining.html http://www.cdc.gov/obesity/childhood/defining.html CDC. (n. d.). Prevalence and Trends Data: Texas 2008 Overweight and Obesity (BMI). Retrieved October 21, 2009, from http://apps.nccd.cdc.gov/brfss/display.asp?cat=OB&yr=2008&qkey=4409&state=TX http://apps.nccd.cdc.gov/brfss/display.asp?cat=OB&yr=2008&qkey=4409&state=TX CDC. (2009 August). U.S. Obesity Trends. Retrieved October 21, 2009, from http://www.cdc.gov/obesity/data/trends.htmlhttp://www.cdc.gov/obesity/data/trends.html Chimes, A. (2009 July). Study Estimates Cost of Obesity at $140 Billion. Retrieved October 20, 2009, from http://www.voanews.com/english/archive/2009-07/2009-07-29- voa32.cfm?moddate=2009-07-29http://www.voanews.com/english/archive/2009-07/2009-07-29- voa32.cfm?moddate=2009-07-29 Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):26- 33. Los Angeles Times. (2009 July). Menu labeling law takes effect: How many calories in that sandwich? Retrieved October 21, 2009, from http://latimesblogs.latimes.com/dailydish/2009/07/menu-labeling-law-takes-effect-how-many-calories-in-that-sandwich.html http://latimesblogs.latimes.com/dailydish/2009/07/menu-labeling-law-takes-effect-how-many-calories-in-that-sandwich.html Men’s Fitness. (2009). 2009 Fattest Cities in America: 25 towns in need of a fitness overhaul. Retrieved September 30, 2009, from http://www.mensfitness.com/lifestyle/216 http://www.mensfitness.com/lifestyle/216 Texas Department of State Health Services. (2009 July). Obesity. Retrieved October 20, 2009, from http://www.dshs.state.tx.us/obesity/default.shtmhttp://www.dshs.state.tx.us/obesity/default.shtm USA Today. (2008 April). NYC’s calories-on menus law upheld. Retrieved October 21, 2009, from http://www.usatoday.com/news/health/weightloss/2008-04-16-nyc- calories_N.htmhttp://www.usatoday.com/news/health/weightloss/2008-04-16-nyc- calories_N.htm 18

19.  Kuchler, F., Golan, E., Variyam, J. N., & Crutchfield, S. R. (2005 June). Obesity Policy and the Law of Unintended Consequences. Economic Research Service/USDA, 3(3):26-33.  Texas Department of State Health Services. (2005). Strategic Plan for the Prevention of Obesity in Texas 2005-2010. Retrieved October 23, 2009, from http://www.dshs.state.tx.us/obesity/pdf/strategic_plan.pdf http://www.dshs.state.tx.us/obesity/pdf/strategic_plan.pdf 19