1. Public Health Nutrition What is it? Amy Jesaitis, MPH, RD Healthy Heart Program New York State Department of Health

2. Stand if You... Choose low-fat milk, if you use milk Eat at least 5 servings of fruits and vegetables a day Eat Whole grain bread (e.g., 100% whole wheat) most of the time Drink water more often than soda Don’t “supersize” your meal when you eat out

3. Obesity Trends* Among U.S. Adults BRFSS, 1989 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

4. Obesity Trends* Among U.S. Adults BRFSS, 1991 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

5. Obesity Trends* Among U.S. Adults BRFSS, 1993 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

6. Obesity Trends* Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

7. Obesity Trends* Among U.S. Adults BRFSS, 1997 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

8. Obesity Trends* Among U.S. Adults BRFSS, 1999 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

9. Obesity Trends* Among U.S. Adults BRFSS, 1989 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

10. Obesity Trends* Among U.S. Adults BRFSS, 1991 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

11. Obesity Trends* Among U.S. Adults BRFSS, 1993 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

12. Obesity Trends* Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

13. Obesity Trends* Among U.S. Adults BRFSS, 1997 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

14. Obesity Trends* Among U.S. Adults BRFSS, 1999 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

15. Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

16. Source: Behavioral Risk Factor Surveillance System, CDC No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) Obesity Trends* Among U.S. Adults BRFSS, 2002

17. Source: Mokdad et al., Diabetes Care 2000;23:1278-83; J Am Med Assoc 2001;286:10. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS, 1990,1995 and 2001 19901995 2001

18. Childhood Overweight 12-19 year olds 6-11 year olds 0 2 4 6 8 10 12 14 16 18 1963-65, 1966-70 1971-741976-801988-941999-2000 Percent

19. NYS Statistics - Adults > 57% of New Yorkers report being overweight (2002) 26% report eating > 5 servings of fruits and vegetables per day 46% of milk sold in NYS is Whole, 16% is fat-free

20. Kids have poor eating habits 26% reported eating 5 or more servings of fruits/vegetables a day 16% do not meet any of the food guide pyramid recommendations 21% reported drinking 3 or more glasses of milk a day 45% (62% female) were trying to lose weight

21. Beverages Available in the U.S. Food Supply (Gallons/Person/Year)

22. Soft Drinks = Weight

23. Huge portion sizes Unprecedented access to a poor diet High calorie foods are everywhere Relatively low food cost Poor quality foods heavily promoted Good tasting foods Variety Conflicting information Challenges to Eating Well

24. Help at Hand ?

26. A, C, 2 Fs Phytochemicals 5 – 9; 8 – 10; 10

27. Important 400# Sat Fat Easy Permanent Got low-fat Milk?

29. What are We Preventing? DiabetesObesity Heart DiseaseHypertension OsteoporosisArthritis Neural Tube Defects Cancer

30. Steps to Promote Good Nutrition Policies Environmental Changes Special Promotions Programs/Classes

31. Common Nutrition Intervention Sectors Nutrition Programs (e.g., WIC, CACFP, Food Pantries) Schools Worksites General community

32. Programs/Classes Cooking classes at worksites Nutrition education in schools Lunch and learn about low-fat diets...

33. Special Promotions 5 A Day Low-fat milk “Healthy Food”

36. Environmental Changes Conduct School Health Index No use of food as a reward Healthy foods served at meetings Low-fat milk sold Healthful food in vending machines

37. “ Could you please eat that in the break room? My dietitian says that secondhand snacks aren’t good for me.” Close to Home

38. Policies 30% healthful items in vending machine Classroom snacks are healthful Cafeteria has at least one low-fat option Food pantry must provide fruit/vegetable as part of 3 of 5 food groups Healthful, tasty foods for all! Effective: May 15, 2000

39. “What do you have that’s rich in antioxidants?”