Physical Activity and Nutrition Promotion,

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• Physical Activity and Nutrition Promotion,
• Obesity Prevention, and Public Health
• Evidence, Action and
• Areas of Uncertainty
• Mary Winnett, MD, MPH
• State Chronic Disease Epidemiologist
• Minnesota Department of Health

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Not enough Fruit and Vegetable consumption in
Minnesota Adults
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No Leisure Time Physical Activity in Minnesota
Adults
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Obesity Trends for Adults in Minnesota and USA
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Environmental influences on nutrition, physical
activity and obesity where we

• Live home and neighborhood - Whats in our
  cupboards and refrigerators? How much is the TV
  on? Is it easy to walk?
• Learn Whats offered in our school cafeterias?
  How close are the fast food restaurants? What are
  opportunities for physical activity?
• Work ditto above plus are there incentives for
  being physically active ?

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Environment where we..

• Play Stationary or moving?
• Eat Whats in our restaurants, what is the
  calorie count, how big are the portions and how
  often do we eat out?
• Transport Are biking or walking part way easy
  choices?
• See/hear Media What messages do our kids get
  about food choices? What do we see and hear?

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Given the multiplicity of influences

• How should efforts be focused to those at
  increased risk? To those at lower risk to
  maintain good habits? How much to environment vs.
  behavior?
• How do we define success? Is increased physical
  activity and/or better nutrition without a big
  change in BMI a reasonable goal?

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Evidence based approaches

• Physical Activity
• Community wide campaigns
• Point of decision prompts
• School-based physical education
• Creation and/or enhanced places for physical
  activity with information outreach activities
• Nutrition review of community based approaches
  is in progress, and a review of food and beverage
  advertising to children is planned

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Evidence based approaches

• Obesity
• Recommended multi-component worksite
  interventions aimed at diet, physical activity
  and cognitive change
• Insufficient evidence school-based programs for
  children and adolescents
• Review in progress health system and community
  wide approaches

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Minnesota Initiatives

• STEPS to a HealthierMN http//www.stepstoahealthie
  rmn.org/
• Northeast Minnesota Obesity Prevention Project
  http//www.health.state.mn.us/divs/cfh/ophp/system
  /conference/presentations/A1myhre2006.pdf
• Minnesota Action for Healthy Kids
  http//actionforhealthykids.org/state_profile.php?
  stateMN
• Minnesota Safe Routes to Schools
  http//www.dot.state.mn.us/saferoutes/index.html
• School Nutrition Activities
• Work site wellness activities

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National Organizations and Initiatives

• Robert Wood Johnson Foundation Active Living by
  Design http//www.activelivingbydesign.org/
• Alliance for a Healthier Generation
  http//www.healthiergeneration.org/
• Kaboom! http//www.kaboom.org/
• America on the Move http//aom.americaonthemove.or
  g/site/c.krLXJ3PJKuG/b.1524889/k.BFFA/Home.htm
• What Moves U NFL/AHA program targeted at
  schools http//www.whatmovesu.com/index.aspx?_vwM
  AIN

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Policy or Private Sector Responsibility?

• Advertising to kids what and how?
• Making information readily available on calories
  in fast food and restaurant food
• Subsidized foods