Healthy People Consortium Meeting
"Implementing Healthy People 2010"
November 11, 2000
Summary of Breakout Group Discussion Concerning:
Nutrition and Overweight; Food Safety
Recorder Note: The session did not specifically follow the questions provided for discussion. Although not all questions were addressed, where possible the information has been tied to the questions.
Nancy Crane presented the history of the Healthy People 2010 nutrition and overweight objectives, as well as the objectives themselves with the differences noted from the objectives for Healthy People 2000. There are two developmental objectives in the new focus area: 19-14 (Reduce iron deficiency among pregnant females) and 19-15 (Increase the proportion of children and adolescents aged 6 to 19 years whose intake of meals and snacks at school contribute to good overall dietary quality). FDA and NIH plan to initiate interagency task forces to help establish criteria and operational definitions for measuring these objectives. An interagency work group will be formed to establish criteria for measurement of this objective. There are many questions to answer: What do we want to measure? What can we measure? For example, the following questions might be considered for the "healthy eating at schools" objective: What aspects of current eating patterns in the school setting might be of most public health significance, and how should this be assessed? Shall we measure daily intake? Weekly intake? Food from home as well as what the school offers? All meals and snacks for the entire school day or just lunch or what? Public comment received on the proposed objective also supported the development of measures for tracking progress on this objective that would be useful in targeting interventions at all levels.
Elisa Elliot presented the eight Healthy People 2010 food safety objectives, comparing them to the four Healthy People 2000 objectives.
2. How do you suggest we work with local community groups in implementing the Healthy People 2010 objectives?
Partnerships are key. Melanie Miller (Executive Director, Partnership for Food Safety Education) on food safety education for consumers that emphasizes partnerships to inform the consumer. The top 10 reasons to partner are:
The Fight BAC Campaign was discussed as an example of effective partnering with supermarkets, State organizations, Federal agencies, and corporations.
Food safety will be a Girl Scout badge beginning in 2001. How to create partnerships is on the Web at (http://www.fightbac.org). The future for informing consumers about food safety will involve creating more partnerships. More corporations are participating, and media coverage is emphasized. At risk and specialty audiences (e.g., elderly persons, people with compromised immune systems) are being targeted. The Partnership for Food Safety Education Web site will be made interactive in the future, but right now there are many important community tips on this site. Melanie Miller can be reached by e-mail at firstname.lastname@example.org and by phone at 703-768-7980.
Local, grassroots initiatives to reach people are the most effective means to change behavior. Community action is needed to get change. Children and adults need a change in environment for a lifestyle change. There is no grassroots constituency for nutrition and food safety. It is important to engage activism. Presently, nutrition and food safety questions are not even included in State standardized tests.
Use of safety belts/child restraints got legislated, but the grassroots car/child seat momentum got the car industry partially behind them before legislation was enacted.
A lot of success can be achieved through local coalitions. Tobacco has had much success around local coalitions--especially in terms of getting tobacco education into schools.
3. What are the challenges/barriers to meeting the Healthy People 2010 objectives? And how do you suggest we work to overcome them?
Education is a challenge: Educating must be done at multiple levels. A big gap in educating the general population is the education of the practitioner/clinician/teacher. Healthy People is still not known among practicing physicians. To reach them, an exhibit booth at their conferences is suggested. Educated health care professionals should be advocating for change in their communities.
Nutrition and food safety need more role models. Some members of our food industry are not good role models.
How do you get a commitment from organizations? Nutrition is such a cross-cutting factor in chronic disease that it can be difficult to focus.
How To Overcome Barriers
To reach the target for the Healthy People 2010 objective to increase the proportion of people who get counseled in nutrition, NIH is funding nutrition academic awards. Schools must have a senior staff person develop a curriculum for medical students or to improve continuing education for physicians. CD-ROM programs have been developed for medical students. There is also an evaluation component: the grantees must examine their data to determine if their program has made a difference.
The food/pharmaceutical/health industries will have to be shown that it's in their best interests to pay attention to nutrition and food safety. Put in a lobby carousel in clinics.
Partner with organizations that are ripe to blend food safety messages into their ongoing programs. The American Heart Association has cooking classes; diabetes education and management programs are already in place, etc.
Develop a certification program for adolescents. Canada has a successful program teaching 10th graders about food safety. They receive a certification so that they are more easily hired by food service organizations (mainly fast food restaurants).
Project Lean/5-A-Day nutrition has a history of coalitions. Cholesterol programs have also traditionally used partners. But the visibility of the program and whether the program is actually working are two different things.
A workshop to begin to address the problem of overweight and obesity in the United States is planned for 12/7-8 at NIH. It will serve to kick off a national action plan, "A Surgeon General's Initiative." The national action plan will be addressing two Healthy People 2010 Leading Health Indicators: overweight and physical activity. It will be a start on elevating overweight as a national priority. The focus will be more on prevention, not intervention; but principles are the same--the packaging is different. Over the next 15 to 18 months, many other activities are being planned to bring public attention to the rise in overweight and to develop strategies to reverse the present trend. There will be five panels representing different environmental settings: Family and Community, Schools, the Health Care Industry, the Media, and Worksites. The charge of this workshop is to identify top strategies, both focused and broad; for example, how do you get more activity into schools? Examples of successful partnerships and resource leveraging will be requested. Because there is a 150-person capacity; each attending organization is limited to one person. The conference will be Web cast live.
NIH also has Special Interest Project grants.
6. How can we work more effectively with the media in implementing the Healthy People 2010 objectives?
The media is where most people get their information. "Food TV" has become quite popular--there is a whole channel devoted only to cooking. These shows can be used as role models. It took a while, but now most shows have a sink, and the cooks wash their hands after handling raw meat.
Use the entertainment industry. Grab a personality; provide them with research and basics. Make it sexy.
"No" messages are negative, and there is much confusing information. We have the "Nutrition Police," but not, for example, the "Physical Activity" police. Information should be presented consistently and with a positive spin.
Facilitators: Nancy Crane, Van Hubbard, and Elisa Elliot
Recorder: Kathleen Turczyn
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