LHI Webinar: Nutrition, Physical Activity, and Obesity (Part 1 of 5)

Uploaded by ODPHP on 10.09.2012

CARTER BLAKEY: During today’s webinar you will hear from several distinguished speakers.
Assistant Secretary for Health, Howard Koh will introduce this month’s LHI topic, nutrition,
physical activity and obesity. You will also hear remarks from HHS Regional Director for
Region VI, Marjorie McColl Petty. And from CATCH Texas, Deanna Hoelscher will discuss
the coordinated approach to child health or CATCH, which is an evidence-based primary
prevention intervention designed to instruct children, their schools and their families
in healthy eating and physical activity.
Dr. Hoelscher will also talk about the success CATCH Texas has had implementing CATCH across
the state. So what is Healthy People? For those of you who aren’t familiar, for four
decades now Healthy People has provided a comprehensive set of national 10-year objectives
that has served as a framework for public health activities at all levels and across
all sectors of the public health community. Often called a roadmap for nationwide health
promotion and disease prevention efforts, Healthy People is about understanding where
we are now and taking informed actions to get to where we want to go over a 10-year
Then the Leading Health Indicators, the focus of this series, represent critical health
issues that, if addressed appropriately, will dramatically reduce the leading causes of
preventable deaths and illness. These indicators, or critical health issues, are linked to specific
Healthy People 2020 objectives. They have been selected to communicate high priority
health issues to the public along with actions that can be taken to address them with the
overall goal of improving the health of the entire population.
There are 12 leading health indicator topics, and this month we are focusing on Nutrition,
Physical Activity, and Obesity. For the complete list of the leading health indicators and
to view our past webinars, please visit http://healthypeople.gov. And with that, I’d like to turn the podium
over to Dr. Koh.
DR. HOWARD KOH: Thank you so much, Carter. We’re all so grateful for your leadership
and passion in this area for so many years, so thank you for helping us kick off this
webinar. Thank you everyone for attending the webinar and for your interest in Healthy
People and the LHIs. So I’m delighted to just spend a couple minutes giving you an
overview on this month’s topic, Nutrition, Physical Activity, and Obesity.
The issues of overweight and obesity have tremendous impact, not just on our health,
but also on our economic condition, so promoting physical activity and nutrition is absolutely
critical to reducing the risk of overweight and obesity and reducing the risk of disease.
Research has shown us that people who are overweight and obese have higher risks of
certain conditions such as heart disease, type 2 diabetes and certain cancers, and you
have probably heard the estimates that medical costs associated with obesity are around $147
So we have been very active as a department and as an Office of Disease Prevention and
Health Promotion to put forward guidelines for Americans to incorporate physical activity
and dietary guidelines. The 2008 Physical Activity Guidelines for Americans put out
by our Office of Disease Prevention and Health Promotion puts forward the benefits of physical
activity and its related health benefits in areas such as lowering risk of early death,
heart disease, stroke, type 2 diabetes and high blood pressure.
And the 2010 Dietary Guidelines for Americans that we unveiled in collaboration with the
U.S. Department of Agriculture puts forward guidelines with respect to balancing calories
with physical activity and encouraging Americans to consume healthier foods like fruits, vegetables
and whole grains. The indicators for Nutrition, Physical Activity, and Obesity serve as a
call to action for all of us, and there are four objectives that we are following closely.
First, adults who meet current federal physical activity guidelines, the ones that we just
mentioned that were put forward in 2008; second, the percentage of adults who are obese defined
as a body mass index over 30; third, children and adolescents who are considered obese who
are in the 95th percentile of weight and above; and fourth, total vegetable intake for persons
aged two years and older.
So let’s look closer at the obesity trends, particularly in adults and children over the
next couple slides. On this slide you see the prevalence in obesity among children and
adolescents; that’s defined as people ages 2- 19 and adults; that’s defined as people
aged 20 and above, by sex in this country from 1988 up through 2010. The top two lines
have to do with obesity rates in adult women and men.
The women are in the top line, the blue line, and men are in the orange line, and you can
see from 1999 where the adult obesity prevalence was about 30 percent to 2009-2010, just a
decade later, the obesity rates have risen to close to 36 percent. That’s a 17 percent
increase in just a decade. Similarly, you see increases for boys and girls. Those are
the lower two lines from roughly an obesity rate of about 14 percent in 1999 to close
to 17 percent by 2009-2010. That’s a 22 percent increase.
Of interest, the rate and rise has been significant for boys and men, but not as striking as for
women. Just last month, we had a Weight of the Nation Conference here in D.C. sponsored
by the CDC and it was announced there that it’s projected that the number of Americans
who will be obese by 2030 will rise to 42 percent, so these are stunning numbers that
show the gravity of the epidemic that the country is facing.
On the next slide we see child and adolescent obesity in 2009-2010. The total is the top
line. Currently it’s about 17 percent as I mentioned, and we want to get it down to
closer to 15 percent. That’s the Healthy People target noted in the black vertical
line. And then we see disparities by race and also by family income. First, the middle
set of bars by race, we see that the Black non-Hispanic childhood and adolescent obesity
rates are the highest of any racial ethnic group, more than one and a half times what
you see with White non-Hispanics.
And then in the lower set of bars, you’ll see that obesity is directly linked to family
income, that families with income under 100 percent federal poverty level have the highest
rates of obesity compared to those with much higher incomes. So these disparities by race
and income are very striking for kids and adolescents as summarized on this slide. So
the way to go forward to address this has got to be a broad public health approach,
and that’s summarized on the next slide.
We need environmental factors, access to safe places to exercise and affordable healthy
food. We need to address these factors where people live, learn, work and play, the so
called social determinants approach. These are the underlying themes of the First Lady’s
Let’s Move! initiative as well, and we are very delighted that the program CATCH has
been highlighted today and we’ll be hearing more from Dr. Hoelscher in just a second.
And then the final slide that I’m presenting just gives a summary of federal actions with
respect to nutrition, physical activity and obesity. The Let’s Move! initiative pioneered
by the First Lady has really catalyzed and galvanized the country. We’re very proud
to be a part of that. The National Prevention Strategy was unveiled last year as required
by the Affordable Care Act has involved some 17 federal agencies across government. I already
mentioned the 2010 Dietary Guidelines for Americans and the 2008 Physical Activity Guidelines
for Americans.
And then we also have a revitalized President’s Council on Fitness, Sports and Nutrition that
is putting forth a series of PALA challenges, that’s Presidential Active Lifestyle Award
challenges. In 2010 we put forward the challenge of whether a million people could sign up
and follow the physical activity guidelines for six weeks, going on http://fitness.gov
to make public your commitment, and we were thrilled when 1.7 million people actually
signed up and implemented this challenge.
That was well exceeding our goal. So we now have a PALA+ challenge that incorporates objectives
for physical fitness and nutrition, and these are just some of the ways that we are as a
department working to get the message out about these key issues.