Healthier Families May Start at the Dinner Table

1. Healthier Families May Start at the Dinner Table Miriam Gaines, MACT, RD, LD Nutrition and Physical Activity Director Alabama Department of Public Health February 2009

2. The Problem

3. Trust for America’s Health (2005- 2007) ranked Alabama as: 2nd highest for adult hypertension (33.5%) 3rd highest for adult obesity (30.1%) 4th highest for diabetes (10%) 6th highest for physical inactivity (29.6%) Overview of Alabama’s Adults

4. Obesity Trends* Among U.S. AdultsBRFSS, 1986 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%

5. 1991 Obesity Trends* Among U.S. AdultsBRFSS,1991, 1996, 2003 (*BMI 30, or about 30 lbs overweight for 5’4” person) 1996 2003 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

6. Obesity Trends* Among U.S. AdultsBRFSS, 2004 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

7. Obesity Trends* Among U.S. AdultsBRFSS, 2005 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14 15%–19% 20%–24% 25%–29% ≥30%

8. Obesity Trends* Among U.S. AdultsBRFSS, 2006

9. Obesity Trends* Among U.S. AdultsBRFSS, 2007

10. Obesity in Alabama 2004

11. Obesity in Alabama2006

12. Obesity Trends in Alabama

14. Obesity is ComplexDietary Habits Are Important • In Alabama, 78.9 % of adults do NOT eat 5 servings of fruits and vegetables a day.

15. Obesity is Complex A Sedentary Society Burns Fewer Calories • Contributories • Automobiles • Television • Computers • Convenience Engineering • Built Environment • Human Nature

16. Physical Activity is Important • In Alabama, 59.6% of adults do NOT get 30 minutes or more of moderate activity on 5 or more days of the week.

17. Diabetes Cancer Endometrial Breast Colon Heart Disease Hypertension High cholesterol Heart attacks Sleep disorders Respiratory problems Abdominal pain (gallbladder, constipation) Menstrual abnormalities Anxiety ETC Obesity is Associated with Over 30 Health Problems

18. Adults Diabetes in US2005 http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx

19. Adult Diabetesin Alabama 2005 http://apps.nccd.cdc.gov/DDT_STRS2/CountyPrevalenceData.aspx

20. Cancer Trends in Alabama

21. Cancer Death RatesAlabama vs. United States, 2004 http://apps.nccd.cdc.gov/StateCancerFacts/Table.aspx?Group=5f&TableType=MORT&SelectedState=Alabama

22. Health Indicators and TrendsHeart Health

23. Alabama’s Children Follow Our Adults • 11th in nation for childhood obesity (10- 17 yr) • 16.7% obese children (Trust for America’s Health) • Recent after school studies in Alabama indicate the rate may be higher.

25. ADPH Dental Program 2006-2007 Heights & weights collected for 3rd grade students 17.9% overweight 24.6% were obese 42.5% of 3rd graders Alabama’s Children Are OUR Children

26. Alabama’s Children are Following the Adults in Obesity Rates Overweight/Obesity, 3rd Graders, Alabama,, 2006-7

27. Overweight and Obese in Alabama High Schools1999-2007 YRBS

28. 81% of youth do NOT get moderate physical activity 30 minutes or more on 5 days or more of the week 59% of youth were not enrolled in physical education classes Sedentary Students in Alabama

29. 41.7% of youth watched three or more hours of television a day Over 2 hours a day is related to obesity Sedentary Students in Alabama

30. Children view an average of one food ad every 5 minutes of TV viewing time. Average child views 2-3 hours of food ads each week.

31. Nutrition and Physical Activity 2005, YRBS

32. What DO Our Children Eat?

34. What Influences Our Children?

35. Recognize These?

36. Marketing Strategies • Many venues • Schools, grocery stores, malls, theaters, sporting events, child care • Many media vehicles • Broadcast and print media, Internet, videogames, cell phones • School-based marketing practices • Product sales, direct and indirect advertising, marketing research

37. US Ad Spending in Millions 2003 McDonald’s $ 619 M Burger King $ 294 M Pepsi/diet Pepsi $ 207 M Coke/diet Coke $ 167 M Mountain Dew $ 60 M M&M candies $ 73 M Snickers candy bar $ 70 M Frito-Lay chips/snacks $ 57 M Pringles $ 35 M Kool-Aid $ 25 M Lunchables $ 23 M Advertising Age, June 2004

38. Budget Comparison U.S. government’s entire budget for nutrition education Is one-fifth the advertising budget for… Altoids mints Nestle, 2002

39. Amount Spent on Advertising to Children Approximately $2 billion a year is for advertisements targeting children This is a 20-fold increase from 1990. J. McNeal, 2003

40. Growth in New Food Products Targeted to Children and Youth 1994 to 2004 New products targeted to total market New products targeted to children & youth Source:Williams J. 2005b. Product Proliferation Analysis for New Food and Beverage Products Targeted to Children, 1994–2004. University of Texas at Austin Working Paper.

41. 1) They are a primary market - they spend their own money 2) They are an influence market - they influence their parents’ spending 3) They are a future market - they will spend money in the future. Heavy marketing to children is driven by desire to build brand awareness, brand preference and brand loyalty (BRANDING) Why Are Youth and Children Targeted?

42. Advertising on School Buses

43. Logos on Scoreboards, Banners, Bulletin Boards

44. Textbook covers Gatorade “Cover Concepts places your brand directly into the hands of kids and teens in a clutter-free environment.” Juicy Fruit Gum

45. BRAND LOGOS TOUCH EVEN YOUNGER CHILDREN

49. Basic Counting Books

50. Internet Marketing to Children