Nutrition and Physical Activity
Iowans will enjoy balanced nutrition,
lead physically active lives
and live in healthy communities
Promoting Nutrition & Physical
Activity
CDC Planning Grant
CDC’s Charge



Write a comprehensive state plan, involving a
wide range of community partners
Describe the plan in terms of the socialecological model
Base plan on science-based interventions or
promising interventions
Public Health Approach to Obesity,
Physical Activity & Nutrition
Describe Problem
Outreach &
education
•Burden
• to inform public
•Identify at risk populations
•Identify contributing factors
Evaluate &
improve
programs
•to inform and
prepare providers
Work with
communities for
systems change
Scope of Activities




Conduct Community Forums
Visit with professionals at conferences &
meetings
Invite partners to a Kick Off Summit to begin
process of writing a plan
Form Channel Work Groups to write portions
of the plan
Social-Ecological Model
Socio-Ecologic Model
Public Policy
Healthy
Policy
national, state, local laws
Community
relationships among organizations
Organizational
organizations, social institutions
Interpersonal
family, friends, social networks
Individual
knowledge, attitudes,
skills
Source: Adapted from McLeroy, et al., An ecological perspective on health promotion programs.
Health Education Quarterly 1988; 15:351-77.
Behavior Change Strategies



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Increase breastfeeding initiation and duration
Reduce TV viewing
Increase physical activity
Increase fruit and vegetable consumption
Other dietary changes such as decreasing
soft drink intake or reducing portion sizes
Increase parental involvement, but not
parental control
The Epidemic


The prevalence of obesity among Iowa
adults has increased by 84% from 1990 to
2004 (Behavioral Risk Factor Surveillance System BRFSS).
The 2004 BRFSS data indicates 37.4% of
adult Iowans are overweight, and 23.5%
are obese (for a total of 61% of Iowa adults
compared to the national average of
59.9%)
Disparities




31% of low-income children between 2 and 5
years of age in Iowa are overweight or at risk of
becoming overweight. (CDC PedNSS, 2003)
Overweight and obesity prevalence rises with
increasing age in Iowa up to age 64.
Obesity prevalence is highest (28.2%) in those
with income less than $15,000.
Ethnicity data not available for Iowa
National Data on Adult Obesity: 1988-94
to 1999-2000
2010 Target
1988-94
Total
White
Female
Male
Black
Female
Male
Mexican American
Female
Male
0
10
20
Percent
30
Note: Data are for ages 20 years and over, age adjusted to the 2000 standard population.
Obesity is defined as BMI >= 30.0. Black and white exclude persons of Hispanic origin. Persons
of Mexican-American origin may be any race.
Source: National Health and Nutrition Examination Survey, NCHS, CDC.
40
50
Obj. 19-2
Early Childhood
Iowa PedNSS 2003
31% of low-income children 2-5 years of
age in Iowa are overweight or at risk of
becoming overweight.
 Overweight: 13.6% vs. 14.7% U.S.
 Ever Breastfed: 60% vs. 53.2% U.S.
 Breastfed 6 months: 27.5% vs. 21.5%
U.S.

Children and Adolescents
National Trends in
Child and Adolescent Overweight
Percent
20
Percent
20
15
15
Males 12-19
10
10
Males 6-11
Females 12-19
5
5
Females 6-11
0
1963-67
1971-74
1966-70
1976-80
1988-94
Note: Overweight is defined as BMI >= gender- and weight-specific 95th percentile from the
2000 CDC Growth Charts for the United States.
Source: National Health Examination Surveys II (ages 6-11) and III (ages 12-17), National
Health and Nutrition Examination Surveys I, II, III and 1999-2000, NCHS, CDC.
1999-2000
0
Obj. 19-2
Prevalence of Overweight of
4th, 5th, and 6th grade youth in the
UNI PANARY surveillance project




Measured BMI of 2,740 4th – 6th grade
children
60% were in the normal weight zone (70%
U.S.)
20% were in the “at risk for overweight” zone
(16% U.S.)
20% were in the “overweight” zone (15%
U.S.)
Joens-Matre, Welk, Russell, Nicklay, & Hensley (2005).
Medicine and Science in Sports and Exercise. May
Supplement.
Prevalence of Overweight of 4th, 5th, and 6th
grade youth from Urban, Small Cities, and
Rural areas in the PANARY surveillance project
Small
Cities
Rural
62.8%
62.9%
53.1%
At-Risk for
Overweight
17.8%
19.5%
21.8%
Overweight
19.4%
17.6%
25.1%
Urban
Normal
weight
(Joens-Matre, Welk, Russell, Nicklay, & Hensley, 2005)
National Child and Adolescent Overweight
by Race:
1988-94 to 1999-2000
2010 Target
1988-94
Total
White
Black
Mexican
American
Female
Male
0
10
20
30
Percent
Note: Overweight is defined for ages 6-19 years as BMI >= gender- and weight-specific 95th percentile
from the 2000 CDC Growth Charts for the United States Black and white exclude persons of Hispanic
origin. Persons of Mexican-American origin may be any race.
Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Obj. 19-3c
Iowa 2003Consumption of
Fruits and Vegetables
Consume 5 or more servings per day
 17% of Iowa adults
 23.6% of older adults
 19% of adults with income < $15,000
 11.3% of adults without a HS/GED
degree
 22% of US adults
National
Proportion of Vegetable Servings
1999-2000
Fried
potatoes
22%
Fried
potatoes
46%
Tomatoes
9%
Legumes
6%
All others
22%
Tomatoes
11%
Other
potatoes
10%
Dark
green/
orange
8%
Children 2-19 years
Legumes
8%
All others
35%
Other
potatoes
13%
Dark green/
orange
11%
Adults 20 years and over
Target = At least 1/3 dark green/orange
Note: Data are age adjusted to the 2000 standard population for adults 20 years and over.
Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Obj. 19-6
Fruits and Vegetables: U.S. Average
Number of Daily Servings by Race: 19992000
Total
Average number
of servings
White
Black
Mexican American
Minimum Recommended
4
3
2
1
0
Fruits
Vegetables
Note: Data are age-adjusted to the 2000 standard population for ages 2 years and over. Black and white
exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.
Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Objs. 19-5
19-6
Iowa 2003Meet the recommended amount of
physical activity

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43% of Iowa adults (Men- 45%; Women42%)
32% of older adults
38% of adults with income < $15,000
36% of adults without a HS/GED degree
47% of U.S. adults meet the
recommended amount of physical activity
Moderate Physical Activity for U.S.
Adults by Race/Ethnicity
2010
Target
American Indian
1999
Asian
2002
Black
White
Hispanic
0
10
30
20
Age-adjusted percent
Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Moderate physical
activity is regular leisure-time physical activity (moderate activity 30+ minutes/5+ times a week or vigorous
activity 20+ minutes/3+ times a week). American Indian includes Alaska Native. Black and white exclude
persons of Hispanic origin. Persons of Hispanic origin may be any race. I = 95% confidence interval.
Source: National Health Interview Survey, NCHS, CDC.
40
50
Obj. 22-2
Vigorous Physical Activity for U. S.
Adolescents by Grade Level: 2001
Percent
100
80
60
40
20
0
9th
10th
11th
Note: Vigorous physical activity is activity that made students in grades 9-12 sweat or
breathe hard for 20+ minutes on 3+ of the past 7 days. I = 95% confidence interval.
Source: Youth Risk Behavior Surveillance System, NCCDPHP, CDC.
12th
Obj. 22-7
Cost of Overweight

Today’s children will be the first generation in
memory to have a shorter life span than their
parents. - Sir John Krebs, Chairman of the United Kingdom’s
Food Standards agency

Iowans pay $783 million in health care costs
for problems associated with obesity - ~17%
is covered by Medicaid & Medicare (Finkelstein,
Fiebelkorn, & Wang, 2004)

Overweight children report lower quality of
life than children with cancer.
Community Forum Suggestions
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Banning/restricting access to vending
machines during school hours would help
curb obesity.
Community Forum Suggestions


More time should be allotted for physical
education.
Schools should devote more time to
promoting healthy lifestyles.
Community Forum Suggestions


Increase the awareness about all the
resources available in each city/county.
Develop a health coalition for each county.
Community Forum Suggestions

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Promote one major event every 6 months
such as a “Kids Walk-to-School” event in
October and a “No T.V. Week” in April.
Develop school district wellness committees.
New school wellness policy needs to be in
place by the 2006-2007 school year.