Upload
ghpc
View
1.707
Download
0
Embed Size (px)
DESCRIPTION
Debra Kibbe, senior research associate with the Georgia Health Policy Center, recently presented "Hungry and Heavy: What ingredients are needed for change?" at the Southeastern Executive Chef’s Table in Georgia. This event was a twelve-state summit on nutrition in the south and included a focus on outdoor activity and the use of Georgia State Parks.
Citation preview
first annual Southeastern
Executive Chef’s Table on February 24th.
For: Southeastern Executive Chef’s Table
February 24-26, 2012
Smithgall Woods State Park - Helen, GA
Presenter: Debra Kibbe, MS
Georgia Health Policy Center [email protected] 404-413-0287
Hungry and Heavy: What ingredients are needed for change?
The Paradox
of Food
Insecurity &
Obesity in the
Southeastern
United States
Objectives
• Examine issues related to the hunger and obesity paradox
• Explore existing initiatives
• Discuss the Executive Chef’s ingredients for change to address hunger and obesity
This [event] will be a tremendous opportunity for us
to leverage our passion and our positions.” Holly Chute
The Hunger-Obesity Paradox
• Research findings are complex – do not illustrate direct relationships
• Food insecure women are at greatest risk for obesity
• Factors related to both food insecurity and obesity stem from poverty!
– Stretching the food dollar
– Feast or famine (binge eating, storing)
– Lack of safe places to play
3
Issue: Hunger/Food Insecurity
GOAL: FOOD SECURITY FOR ALL
―Access by all people at all times to
enough food for an active, healthy life."
C.C. Campbell
Issue: Food Insecurity & Obesity in SE US
Source: 1) Food Research & Action Center. 2) F as in Fat Report, 2011
State Food Insecurity % (Rank) 1
Adult OB % (Rank)2
Alabama 15% (7) 32.3% (2)
Arkansas 17.7 (1) 30.6 (9)
Florida 14.2 (14) 26.1 (29)
Georgia 15.6 (4) 28.7 (17)
Kentucky 13.4 (22) 31.5 (6)
Louisiana 10 (45) 31.6 (5)
Mississippi 17.1 (3) 34.4 (1)
N Carolina 14.8 (9) 29.4 (14)
Tennessee 15.1 (6) 31.9 (4)
Texas 17.4 (2) 30.1 (12)
W Virginia 13.4 (22) 32.2 (3)
Prevalence of
Household-
Level Food
Insecurity
2007-2009
Southeastern U.S.:
• 7 of top 10 food
insecure states
• 8 of top 10 most
obese
Issue: Hunger & Food Access
Sources: 1) The Food Trust. Food for Every Child: The need for more supermarkets in Georgia.
June 2011, p. 9. 2) Treuhaft S, Karpyn A. PolicyLink and The Food Trust. The Grocery Gap: Who
has access to healthy food and why it matters. Oakland (CA), 2010.
Low Sales, Low Income, High Deaths
Other
Major Cities
Park, forest or non-residential
Recommendation:
Southeastern states must address
the critical need for more super-
markets in many communities, both
rural & urban.
Issue: Obesity
Source: HealthyPeople.gov, 2020 Objectives
GOALS: Healthy People 2020
• Increase proportion of Adults 20+yrs who are healthy
weight (from 30.8% to 33.9%)
• Reduce the proportion of adults who are obese (from 34%
to 30.6%)
• Reduce the proportion of children and adolescents who
are considered obese (from 16.2% to 14.6%)
Issue: Obesity & Disparities
Source: 1. CDC, Child Overweight and Obesity. http://www.cdc.gov/obesity/childhood/data.html
2. Ogden CL, Lamb MM, Carroll MD, Flegal KM. NCHS Data Brief, No. 51, Dec 2010. Obesity
and Socioeconomic Status in Children and Adolescents: United States, 2005-2008.
Among 2 to 19 year olds1 in 2007—2008:
• Boys: Hispanic more likely to be OB than non-Hispanic
white.
• Girls: Non-Hispanic black more likely to be OB than non-
Hispanic white.
Low income children & adolescents are more likely
to be obese than higher income youth...‖2
Obesity & Food Insecurity1
People with unreliable access to food are:
• Not getting healthy affordable food,
• More likely to be obese, and
• Exposed to higher levels of stress.
1. Food Insecurity and Obesity: Understanding the Connections.
Washington: Food Research and Action Center, Spring 2011.
Obesity & Food Insecurity1,2
Food-insecure households tend to:
• choose foods high in fat,
• choose foods that may satisfy hunger more easily, but they typically do not provide sufficient nutrients, and
• overeat when they do have access to food.
1. Dinour LM, Bergen D, Yeh M. “The Food Insecurity-Obesity Paradox: A Review of
the Literature and the Role Food Stamps May Play.” American Dietetic Association,
107(11): 1952-1961, 2007. 2. Food Research and Action Center.
Obesity: Energy Gap Among U.S. Children
• Excess weight gain estimated based on 1988-1994
normal weight distribution1
• All adolescents: excess 0.43 kg/yr over 10 yrs ( .95 lbs)
• Energy gap = 110-165 kcals/day
• OW adolescents: excess 2.65 kg/yr over 10 yrs ( 5.8 lbs)
• Energy gap = 678-1017 kcals/day
1) Wang et al, Pediatrics 2006;118:e1721.
2) Butte NF et al. Obesity 2007;15:3056.
• Energy imbalance in Hispanic children2:
• median weight gain 6.1 kg in 1 yr ( 13.4 lbs)
• 244 to 267 kcals/day (considers P.A. levels)
Issue: Diet Quality
Source: Food Research and Action Center poll of 1,013 registered voters.
Conducted by Hart Research Associates, January 11-17, 2012.
Don't dig your grave with your
own knife and fork.
~ English Proverb
Top Sources of Calories Among Americans 2 Years & Older
1. Grain-based desserts – Cake, cookies, pie, cobbler, sweet rolls, pastries, donuts
2. Yeast breads – White bread and rolls, mixed-grain bread, flavored bread,
whole-wheat bread, bagels
3. Chicken and chicken mixed dishes – Fried and baked chicken parts, chicken strips/patties, stir-fries,
casseroles, sandwiches, salads, other chicken mixed dishes
4. Soda/energy/sports drinks – Sodas, energy drinks, sports drinks, and sweetened bottled
water/ vitamin water
5. Pizza
Source: NHANES 2005-2006, Available at http://riskfactor.cancer.gov/diet/foodsources/
Top Sources of Calories by Age Group
Alcoholic beverages are a major calorie source for adults
Sodas & pizza contribute more calories among adolescents than younger children
Fluid milk is a top calorie source for younger children
Source: NHANES 2005-2006, Available at http://riskfactor.cancer.gov/diet/foodsources/
Comparison of Consumption to Recommendations
U.S. Department of Agriculture Center for Nutrition Policy and Promotion
*solid fats and
added sugars
*
Reduce: Sodium Intake
U.S. Department of Agriculture Center for Nutrition Policy and Promotion
Reduce: Solid Fats
Food Sources of Solid Fats U.S. Department of Agriculture
Center for Nutrition Policy and Promotion
Food Sources of Added Sugars
Reduce: Added Sugars
U.S. Department of Agriculture Center for Nutrition Policy and Promotion
Food Sources of Refined Grains
Reduce: Refined Grains (especially
those w/ solid fats, added sugars, and sodium)
U.S. Department of Agriculture Center for Nutrition Policy and Promotion
Issue: Food Assistance Programs
Source: Food Research and Action Center poll of 1,013 registered voters.
Conducted by Hart Research Associates, January 11-17, 2012.
“Nutrition programs provide a safety net.”
Executive Director, Greater
Chicago Food Depository
Income Eligibility for WIC* Benefits
WIC Family Size
Annually Monthly Weekly
Family of 1 $20,147 $1,679 $388
Family of 2 27,214 2,268 524
Family of 3 34,281 2,857 660
Family of 4 41,348 3,446 796
*Special Supplemental Nutrition Program for Women, Infants
and Children. Target: Women and their children 0-5 yrs.
WIC contributes approximately $3.3 billion to the GA’s economy.
TX is the 2nd and GA is the 5th largest WIC programs in the U.S.
WIC Food Package & Farmers Market Program
In 2009, USDA introduced a new set of WIC food
packages based on IOM recommendations:
• More fruits and vegetables
• Increased whole grains
• Increased farmers market vouchers
• Reduced juice allowance
• Reduced dairy & egg allowance, only reduced fat milk
• More healthy food for breastfeeding mothers
Source: USDA FNS
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP):
AVERAGE MONTHLY BENEFIT PER PERSON
(Data as of February 1, 2012)
State/Territory FY 2008 FY 2009 FY 2010 FY 2011
Alabama 96.79 119.14 126.90 135.18
Arkansas 95.17 115.53 122.59 123.72
Florida 101.87 126.70 141.40 139.55
Georgia 104.19 125.95 134.35 135.37
Kentucky 97.66 119.00 127.05 127.60
Louisiana 108.04 128.86 129.77 130.59
Mississippi 92.59 113.83 122.54 123.29
Tennessee 101.95 124.66 133.86 133.82
“We put healthy food on the table for more than 46
million people each month.” USDA Food & Nutrition Service
Why Change SNAP?
• Virtually all food items allowed (no hot foods)
• Long-term FSP* participation is positively and significantly related to1:
– obesity and BMI for low-income women
– BMI for low-income married men
1. Gibson D. Food Stamp Program* Participation and Obesity: Estimates from the NLSY79.
Jan 2002. On-line: http://www.ipr.northwestern.edu/jcpr/workingpapers/wpfiles/gibson_obesity.pdf
Website: http://www.fns.usda.gov/snap/
Source: Food Research and Action Center poll of 1,013 registered voters.
Conducted by Hart Research Associates, January 11-17, 2012.
Explore existing initiatives
Objective #2
Eat more fingernails. They’re nutritionally more valuable than soda pop.
Brought to you by the University of Minnesota School of Public Health.
Social Marketing: TACOS
• Yr 1 - the # of promotions conducted in schools was significantly
associated with % lower-fat food sales.
• Yr 2 - the duration of promotions was significantly associated with %
lower-fat food sales.
• Conclusion: School-based environmental interventions to increase
availability and promotion of lower-fat foods can increase purchase of
these foods among adolescents.
Site: http://www.do-groove.com/
Social Marketing Campaign:
“do”
• For Worksites & Community
• Billboards, posters, TV ads,
handouts, & other resources
Social Marketing: Champion Moms (CA)
Build support for and create a message campaign for Moms in your state
Examples from Southeastern States
• Kentucky – Delta HOPE Initiative
• Tennessee – Funded Coordinated School Health, TAKE 10!
• Louisiana – Smart Bodies
• Georgia –Youth Fit for Life (YMCA), Tons of Fun,
• Arkansas – Delta Healthy Kids Project
• Texas – Juntos y Saludables, CATCH
Since 2000, documenting OB, PA & Nut
programs – list is 35 pages long!
GA DPH Nut & PA Initiative
Healthcare Work Group /
Obesity Action Network
Early Childhood Work Group
/Bright from the Start DECAL: Day cares, Head Start,
WIC, etc.
Community Work Group: Cooking
Matters, Healthy Vending Project – includes Parks & Rec, Boys & Girls Club, Boys & Girl
Scouts, 4-H
Worksite Work Group: Health Matters Toolkit
developed
Faith Work Group: Annual
Conference (Jan) & Toolkit
developed
School Work Group - Action for
Healthy Kids, HealthMPowers,
Alliance for Healthier
Generation, Dept of Education
Policy / Education: GA Health Policy
Center & PLAY Initiative &
GPAN Coalition
Georgia Dept. of Public Health CDC-funded Obesity Grant
Focus areas:
Policy,
Systems, &
Environmental
Change
Steering Committee
Production
Processing
Distribution Waste Recycling
Consumption
Policy Level Action:
Georgia Food Policy
Council
GA DPH-funding
Deliverables:
• Expand members
• Develop state plan
• Host info gathering
meetings: 3
regional & 1
statewide
Share Our Strength’s Cooking MattersTM
Georgia Coalition for Physical Activity and Nutrition receives support from GA DPH Nutrition & PA Initiative
to implement
Cooking Matters in Georgia
GA DPH-funding Systems Level Action
Cooking Matters Teaches…
33
…Cooking
…Nutrition
Cooking Matters Teaches Shopping & Food Budgeting
34
A family meal for 4 for $10
Grocery Store Tour
Cooking Matters Uses Volunteer Chefs & Nutrition Educators
What are the ingredients for change to address hungry and heavy?
Objective #3
Source: Las Vegas Sun. The Associated Press. Monday, Feb. 20, 2012.
Web: http://www.lasvegassun.com/news/2012/feb/20/us-white-house-chef/
Consider the Food System
• Availability Roadblocks
– Affordability
– Access
• Structural Roadblocks
– Transportation Infrastructure
– Retail Models
– Supply Chain Development
– Adequate Healthy Food Supply
Ingredient #1: Family Meals1,2,3,4
Family meals provide opportunity for:
• modeling food behavior,
• influencing nutrition beliefs, and
• controlling the family food environment by offering healthy foods
Example -- Project EAT:
M.S. & H.S. youth who had more frequent family meals:
• ate more fruits, vegetables, grains, and calcium-rich foods
• drank fewer soft drinks
Key: help families address scheduling issues re: family meals
(1) Neumark-Sztainer, Hannan, Story, Croll, & Perry, 2003; (2) Johannsen & Johannsen,
2006; (3) Neumark-Sztainer et al., 2003; (4) Story M, Neumark-Sztainer D, 2005.
Ingredient #2: Food Quantity
Never order food in excess
of your body weight.
-- Erma Bombeck
Ingredient #3: Participation in Federal Food
Programs ↓ Food Insecurity
• SNAP benefits must be used for food & for plants and seeds to
grow food for a household to eat.
• Work with state SNAP, Cooperative Ext & Master Gardeners
groups to encourage purchase of plants & seeds for gardens
• Promote Wholesome Wave double value coupon program at
farmers markets
• WIC, SNAP & CACFP require nutrition education.
• Work with programs like Cooking Matters, Community
Gardens, etc. to improve the growing & cooking skills of
low income families.
• Support HHF Kids Act & School Nutrition: Chef’s Move in
School, Farm to School, School Gardens; Quality of breakfast,
lunch, dinner, summer meals & afterschool snacks
Sources: USDA FNS, Let’s Move
Governor Deal Launches 'Feeding For A Promising Future - No Kid Hungry Campaign‘*
(November 16, 2011)
Ingredient #4: Access and Hunger
Take a lead role in your state’s
―No Kid Hungry Campaign.‖
* with Share Our Strength and Georgia Food Bank Association
http://strength.org/press_release/20111116/
Ingredient #5: Access to & Adequate Food
Supply through Grocers/Markets
Work with your state governments and food
vendors/grocers:
create a grant & loan program to support
local supermarket development projects
incent grocers to place a store or help to
establish farmers markets in a low access
area (and price products fairly!)
which increases availability of affordable
& nutrition food in underserved areas.
e.g. Pennsylvania’s Fresh Food Financing Initiative –
since 2004, 83 stores in 27 rural and urban counties
Our Goal: Healthy, hunger free families & communities
in the Southeastern United States
Convene.
Collaborate.
Catalyze.
This [event] will be a tremendous opportunity for us
to leverage our passion and our positions.” Holly Chute
Final Quotes…
“Children have never been very
good at listening to their elders, but
they have never failed to imitate them.‖
-- James Baldwin
Thank you!
Questions?
Comments?
How To Weigh Yourself
Contact: Debra Kibbe
404-413-0287