Food, Fitness,  Obesity and Diabetes in the Bronx

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Food, Fitness, Obesity and Diabetes in the Bronx

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1. Food, Fitness, Obesity and Diabetes in the Bronx Jane Bedell, MD Assistant Commissioner Bronx District Public Health Office NYC Dept of Health & Mental Hygiene

2. What is “Obesity”? Determined by Body Mass Index (BMI) Height and Weight are used to calculate BMI Adults: Overweight: BMI between 25 and 29.9 Obese: BMI of 30 or higher Children: Takes gender and age into account Overweight: BMI between the 85th and 95th percentiles Obesity: BMI in the 95th percentile or higher It’s important to remember that Obesity defined from a health pov not an aesthetic pov, that is when we say somebody is obese we’re not defining that based on looks but rather on a ratio/calculation of height and weight that is thought to be detrimental to overall health. Obesity is defined by the Body mass Index or BMI. Depending on a person’s BMI value or in the case of a child where his or her BMI falls in relation to other childrens’ BMIs that individual is classified as either underweight, of normal weight, overweight or obese. [Developed by Belgian statistician Adolphe Quelet 1796-1874 (weight in lbs * 703) / height in inches^2 OR Weight in kilos / height in meters^2 Morbid Obesity BMI > 40 Malignant Obesity BMI > 50[It’s important to remember that Obesity defined from a health pov not an aesthetic pov, that is when we say somebody is obese we’re not defining that based on looks but rather on a ratio/calculation of height and weight that is thought to be detrimental to overall health. Obesity is defined by the Body mass Index or BMI. Depending on a person’s BMI value or in the case of a child where his or her BMI falls in relation to other childrens’ BMIs that individual is classified as either underweight, of normal weight, overweight or obese. [Developed by Belgian statistician Adolphe Quelet 1796-1874 (weight in lbs * 703) / height in inches^2 OR Weight in kilos / height in meters^2 Morbid Obesity BMI > 40 Malignant Obesity BMI > 50[

3. Why do we care?? Obesity Increases the Risk of: Diabetes High Blood Pressure High Cholesterol Some cancers Heart Disease Sleep Apnea / Sleep Disorders Arthritis Premature Death As we all know, obesity negatively effects health. I’ll spend a little more time toward the end of the presentation discussing the co-existing epidemics of obesity and diabetes, but first, I want to present Bronx specific obesity data.As we all know, obesity negatively effects health. I’ll spend a little more time toward the end of the presentation discussing the co-existing epidemics of obesity and diabetes, but first, I want to present Bronx specific obesity data.

4. NYC Kids Are Increasingly Overweight or Obese Only Half of NYC’s Elementary School Children Are at a Healthy Weight

5. Diabetes in Children 1/3 to ½ of today’s 5 year olds will develop diabetes in their lifetime 1 Narayan et al. Lifetime risk of diabetes in the United States. JAMA. 2003; 290:1884-1890.

6. Public High School Students in the South Bronx are More Likely to Be Obese than are Their Peers in the City 38% of public high school students are either overweight (21%) or obese (17%) And in this case we do see significant differences between our communities in the Bronx and City as a whole. 17% of SBX public high school students are obese compared to 13% in the BX and 12% in NYC Thanks to the YRBS, we have some insight into what contributes to the adolescent obesity epidemic…38% of public high school students are either overweight (21%) or obese (17%) And in this case we do see significant differences between our communities in the Bronx and City as a whole. 17% of SBX public high school students are obese compared to 13% in the BX and 12% in NYC Thanks to the YRBS, we have some insight into what contributes to the adolescent obesity epidemic…

8. South Bronx Public High School Students Attend Fewer PE Classes Significantly fewer teens in the South Bronx report having phys ed at least 3 times a week compared to kids in other parts of the Bronx and kids in other parts of this city. And it’s a large difference – less than 50% compared to almost 75%. New York State mandates that public school children receive at least 120 minutes of structured physical education a week and fewer than half of our teens report receiving that amount of physical education. Next, we’ll turn to adults among whom these differences are even starker…Significantly fewer teens in the South Bronx report having phys ed at least 3 times a week compared to kids in other parts of the Bronx and kids in other parts of this city. And it’s a large difference – less than 50% compared to almost 75%. New York State mandates that public school children receive at least 120 minutes of structured physical education a week and fewer than half of our teens report receiving that amount of physical education. Next, we’ll turn to adults among whom these differences are even starker…

9. Phys inactivity + obesity diabetes cardiovascular disease/ESRD/other

10. South Bronx Percent = 26%( 21%- 32%) Population = 80,000 South Bronx Percent = 26%( 21%- 32%) Population = 80,000

11. Within the Bronx, the South Bronx has the Highest Proportion of Adult Obesity And the South Bronx has the highest proportion of obese adults in the borough with 30% of residents having a BMI of 30 or higher. Before I wrap up by discussing what we at the Bronx District Office and the larger DOHMH are doing and what you as school and community leaders can do to fight the obesity epidemic, I’d like to spend a minute or 2 talking about the twin burdens of obesity and diabetes in our South Bronx communities.And the South Bronx has the highest proportion of obese adults in the borough with 30% of residents having a BMI of 30 or higher. Before I wrap up by discussing what we at the Bronx District Office and the larger DOHMH are doing and what you as school and community leaders can do to fight the obesity epidemic, I’d like to spend a minute or 2 talking about the twin burdens of obesity and diabetes in our South Bronx communities.

12. Many S Bx Adults Do Not Get Enough Exercise and Nearly All Consume Less than the Recommended Amount of Fruits and Vegetables Many Adults Do Not Get Enough Exercise and Nearly All Consume Less than the Recommended Amount of Fruits and Vegetables 96% is a huge number. I also want to point out that slight variations in obesity within the borough do exist…Many Adults Do Not Get Enough Exercise and Nearly All Consume Less than the Recommended Amount of Fruits and Vegetables 96% is a huge number. I also want to point out that slight variations in obesity within the borough do exist…

13. Diabetes Prevalence in NYC Up 2½x in the Past Decade Adults with Self-Reported Diabetes, NYC, 1994-2003

16. Diabetes in Children 1/3 to ½ of today’s 5 year olds in the Bronx will develop diabetes in their lifetime 1 Narayan et al. Lifetime risk of diabetes in the United States. JAMA. 2003; 290:1884-1890.

17. Opportunities Build on Bronx history and past accomplishments Momentum growing Opportunity for lasting changes in schools, the built environment, traffic patterns, and resulting changes in behaviors

18. Thanks. Jane Bedell, MD Assistant Commissioner Bronx District Public Health Office [email protected]

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