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Physical Activity
and Good Nutrition:
Essential Elements to Prevent Chronic Diseases and
Obesity
At A Glance
2008
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“Changing the culture from one of treating sickness
to staying healthy calls for
small steps and good choices to be made each and every day.”
Michael O. Leavitt
Secretary, U.S. Department of Health and Human Services
The Importance of Physical Activity and Good Nutrition
Chronic diseases accounted for 5 of the leading 6 causes of death in
2002 in the United States. The prolonged illness and disability
associated with many chronic diseases also decreases the quality of life
for millions of Americans. Much of the chronic disease burden is
preventable. Physical inactivity and unhealthy eating contribute to
obesity and a number of chronic diseases, including some cancers,
cardiovascular disease, and diabetes.
The Obesity Epidemic
In the past 30 years, the prevalence of overweight and obesity has
increased sharply for both adults and children. Since 1976–1980, the
prevalence of obesity among U.S. adults has approximately doubled. In
2005–2006, more than 34% of adults aged 20 years or older were obese. The
prevalence of overweight among children aged 2–5 years increased from 5.0%
during 1976–1980 to 13.9% during 2003–2004. During the same period, the
prevalence increased from 6.5% to 18.8% among young people aged 6–11 years,
and 5.0% to 17.4% among those aged 12–19 years.
People who are obese are at increased risk for heart disease, high blood
pressure, diabetes, arthritis-related disabilities, and some cancers. The
estimated total cost of obesity in the United States in 2000 was about $117
billion.
Promoting regular physical activity and healthy eating and creating an
environment that supports these behaviors are essential to addressing the
problem.
Lack of Physical Activity
Regular physical activity reduces risk and provides therapeutic benefits
for people with heart attack, colon cancer, diabetes, and high blood
pressure and may reduce their risk for stroke. It also helps to control
weight; contributes to healthy bones, muscles, and joints; reduces falls
among older adults; helps to relieve the pain of arthritis; reduces symptoms
of anxiety and depression; and is associated with fewer hospitalizations,
physician visits, and medications. Moreover, physical activity need not be
strenuous to be beneficial. For example, adults of all ages benefit from
moderate-intensity physical activity, such as 30 minutes of brisk walking
most days of the week.
Despite the proven benefits of physical activity, more than 50% of U.S.
adults do not get enough physical activity to provide health benefits; 25%
are not active at all in their leisure time. Activity decreases with age,
and sufficient activity is less common among women than men and among those
with lower incomes and less education. About two-thirds of young people in
grades 9–12 are not engaged in recommended levels of physical activity.
Daily participation in high school physical education classes dropped from
42% in 1991 to 33% in 2005.
The Critical Role of Good Nutrition
Research shows that good nutrition can help to lower people’s risk for
many chronic diseases, including heart disease, stroke, some cancers,
diabetes, and osteoporosis. However, a large gap remains between healthy
dietary patterns and what Americans actually eat. In 2005, about 1 in 3 U.S.
adults ate fruit two or more times a day, and 1 in 4 ate vegetables three or
more times a day.
Good nutrition begins in infancy. Children who were not breastfed are at
increased risk for overweight, asthma, and some childhood infections. Of
concern for both children and adults, particularly in underdeveloped
countries, is micronutrient malnutrition, which can negatively affect
survival and growth for children, health and pregnancy outcomes for women,
and resistance to illness for both.
CDC’s
Nutrition and Physical Activity Program to Prevent Obesity
and Other Chronic Diseases (2006)
States funded by this
program use the social-ecological model to implement interventions
to address all levels of influence within a community to help
residents make behavior changes.
State
interventions* addressed the following five levels of the
social-ecological model:
- Societal level: 20
interventions
- Community level: 39
interventions
- Organizational
level: 54 interventions
- Interpersonal level:
52 interventions
- Individual level: 65
interventions
State
interventions also addressed the following target areas:
- Increase physical
activity: 65 interventions
- Increase consumption
of fruits and vegetables: 66 interventions
- Decrease consumption
of sugar-sweetened beverages: 24 interventions
- Increase
breastfeeding: 14 interventions
- Decrease television
viewing: 21 interventions
This
program leveraged about $1.7 million for every $1 CDC provided.
* Some
interventions addressed more than one level. |
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CDC's National Leadership
CDC is committed to ensuring that all people, especially those at
greater risk for health disparities, will achieve their optimal lifespan
with the best possible quality of health in every stage of life. With
agency-wide health protection goals that support healthy people in
healthy places across all life stages, CDC is setting the agenda to
enable people to enjoy a healthy life by delaying death and the onset of
illness and disability by accelerating improvements in public health.
The mission of CDC’s Division of Nutrition, Physical Activity and Obesity
(DNPAO) is to lead strategic public health efforts to prevent and control
obesity, chronic disease, and other health conditions through regular
physical activity and good nutrition. Our goals include the following:
- Increasing health-related physical activity through population-based
approaches.
- Improving aspects of dietary quality most related to population
burden of chronic disease and unhealthy child development.
- Decreasing prevalence of obesity through prevention of excess weight
gain and maintenance of healthy weight loss.
With fiscal year (FY) 2008 funding of $38 million, DNPAO has worked to
reduce chronic diseases and obesity through state programs, research,
surveillance, training, intervention development and evaluation, leadership,
policy and environmental change, communication and social marketing, and
partnership development.
In FY 2007, the Nutrition and Physical Activity Program to Prevent
Obesity and Other Chronic Diseases (NPAO) funded obesity prevention and
control activities in 28 states (http://www.cdc.gov/nccdphp/dnpa/obesity/state_programs/funded_states/index.htm).
In FY 2008, a new funding announcement will be released. Newly funded states
will address the following six target areas:
- Increase physical activity.
- Increase consumption of fruits and vegetables.
- Decrease consumption of sugar-sweetened beverages.
- Increase breastfeeding initiation and duration.
- Decrease consumption of high energy-dense foods.
- Decrease television viewing.
State efforts will include making policy and environmental changes to
encourage access to healthy foods and places to be active, and strengthening
obesity prevention and control programs in preschools, child care centers,
work sites, and other community settings. All funded states will continue to
evaluate their interventions to determine their effectiveness and to guide
future efforts. CDC is the federal health authority for the National Fruit
and Vegetable Program and a founding member of the National Fruit and
Vegetable Alliance. The alliance works to increase access and consumption of
all forms of fruits and vegetables to improve public health. DNPAO supports
this target area through scientific, partnership, and programmatic efforts.
Our programmatic efforts are integrated into the NPAO program.
Progress in Obesity
CDC’s efforts have helped to increase recognition of obesity as a
national public health problem. During 2000–2006, the number of articles on
obesity published in the national press increased from 2,000 to 6,000
(International Food Information Council). At both state and national levels,
increases in the prevalence of obesity appear to be slowing. For example,
the National Health and Nutrition Examination Survey found no increase in
obesity prevalence among women during 1999–2006, and Arkansas reported a
modest decrease in the prevalence of overweight among children. The state
received support from the NPAO program.
Training and
Technical Assistance
CDC provides consultation and technical assistance to numerous partners,
including support to states to develop comprehensive state plans, community
interventions, and leadership capacity to address nutrition, physical
activity, and obesity. In 2007, CDC worked with the Center of Excellence for
Training and Research Translation to sponsor a course on obesity prevention
for public health practitioners, including state health departments. In
addition, CDC’s annual evaluation workshop included representatives from 13
states not currently receiving cooperative agreement funds.
CDC also continues to work with its longtime partner, the University of
South Carolina, as co-sponsor of the Physical Activity and Public Health
Courses. In addition, CDC has developed an international course with the
International Union of Health Promotion and Education. These courses provide
intensive training in physical activity for both public health practitioners
and public health researchers.
Promising Practices
With support from CDC and other partners, an expert panel released new
recommendations as part of a supplement titled
Assessment of
Child and Adolescent Overweight and Obesity in the journal
Pediatrics
in June 2007. CDC also worked with the National Initiative for Children’s
Healthcare Quality to develop a network to share promising practices and
policies in medical settings to reduce childhood obesity (information
available at http://www.NICHQ.org).
State Programs in Action: Arkansas
Arkansas has developed a comprehensive plan
to prevent and control chronic diseases, including obesity,
among its residents. The plan, Changing the Culture of
Health in Arkansas, was developed by a coalition of
representatives
from many areas of health care and public health.
Environmental changes that support this plan include
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The Arkansas River Trails project is
creating 24 miles of new trails to link with an existing
225-mile wilderness trail and a pedestrian river bridge.
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Twenty new community gardens and 30 new
farmers markets were created to increase access to fresh
fruits and vegetables.
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Schools have added healthy food and
drink options to vending machines, implemented healthy
snack policies, changed cafeteria cooking methods to
reduce frying, and added more fresh fruit to menus.
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Conducting Essential Research
CDC supports research to enhance the effectiveness of physical activity
and nutrition programs. For example, studies focus on the effectiveness of
parent-focused strategies to reduce the time children spend watching
television, the home environment and sugar-sweetened beverage consumption,
the use of policy interventions to promote physical activity, and the
effectiveness of breastfeeding interventions in various settings. CDC
disseminates study results via publications and the Web.
Translating Research into Practice
CDC translates the results of research for practitioners and the lay
public. For example, the Research to Practice Series helps health
professionals stay abreast of the emerging science in nutrition, physical
activity and obesity. This series provides an overview of the science on a
specific topic that includes implications for public health practice. Some
installments include a tool geared to a lay audience, which can be used by
health professionals in practice to explain concepts correctly and provide
practical tips on implementing suggested strategies. Another example of how
CDC translates research into practice is The CDC Guide to Breastfeeding,
which helps practitioners select effective breastfeeding interventions.
Promoting Work Site Health
To identify strategies that work sites can use to prevent and control
obesity among their employees, CDC is conducting systematic literature
reviews, evaluating current programs, and conducting demonstration projects
at CDC work sites. Data collected is being translated into products that
employers can use to design their own programs (e.g., an interactive
Web-based tool).
Physical Activity Guidelines
Evidence-based guidelines for physical activity for youth, adults, and
older adults are being developed at the national level. Partners on this
project include CDC, the President’s Council on Physical Fitness and Sports,
and the U.S. Department of Health and Human Services’ Office of Disease
Prevention and Health Promotion. CDC is leading the literature review, which
will provide the scientific basis for the development of the guidelines.
Monitoring Nutritional Status
Through its Pediatric Nutrition Surveillance System (PedNSS) and
Pregnancy Nutrition Surveillance System (PNSS), CDC facilitates the
collection, analysis, and interpretation of key indicators of child
nutritional status and behavioral and nutritional risk factors for
low-income pregnant women. An interactive CDC Web site trains people to use
these systems.
Encouraging Global Collaboration
CDC’s World Health Organization Collaborating Center for Physical
Activity and Health Promotion provides global and regional leadership in
building capacity for evidence-based public health practice and research
related to physical activity and health. In addition, the Universal Flour
Fortification Initiative creates global acceptance for fortifying flour with
iron, folic acid, and other nutrients.
Future Directions
CDC and its partners will continue to create, evaluate, and modify
programs, policies, and practices to prevent and control obesity. CDC will
expand communication efforts to promote physical activity and good nutrition
in across multiple settings and will work with states and communities on
innovative strategies to promote physical activity and good nutrition. DNPAO
also will work within CDC to provide consistent public health
recommendations and promising practices.
For more information please contact
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion,
4770 Buford Highway NE,
Mail
Stop K–24, Atlanta, GA 30341-3717
Telephone: 800-CDC-INFO (232-4636) • TTY: 888-232-6348
E-mail: cdcinfo@cdc.gov • Web:
http://www.cdc.gov/nccdphp/dnpa
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Page last reviewed: April 15, 2008
Page last modified: April 15, 2008
Content source: National Center for
Chronic Disease Prevention and Health Promotion
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