Obesity in Palm Beach County

Transcription

1 1 Obesity in Palm Beach County Consequences and Preven8on Efforts March 25, 2015 Cynthia C. Clayton MD FAAP Clinical Associate Professor Pediatrics, Nova Obesity Coach, American Academy of Pediatrics

2 2 Problem

3 Best Ways to Stay Healthy 3 Reduce non business screen time Eat at regular times Eat variety of healthy foods Sleep Exercise daily (30min1hour) Eat local, fresh produce

4 Emo8onal Health and Nutri8on 4 Food Choices Reflect: Mood Control over life s circumstances Attitudes & Beliefs

5 Rising Average Weight of Our Ci8zens 5 Changes over past 20 years in lifestyle EaDng habits Level of physical acdvity Long work hours with no one at home Long commutes to work Need for convenient take- out Explosion of snack industry Time spent on electronic devices

6 The Sugar Problem 6 Many Americans get 13% of their calories from added sugar- 18 teaspoons/day or 268 calories Children are most vulnerable for acquiring a taste for sugar The World Health OrganizaDon recommends an intake of 6 teaspoons a day

7 Calories in=energy Expended 7 Excess calories over Dme lead to healthy weight out of control Eventual development of chronic health problems Expensive health treatments Shortened lifespan for some

8 Serious Health Problems Occur More With Unhealthy Weight 8 Type 2 diabetes Hypertension(high blood pressure) Osteoarthritis(degeneration of the joints) Cardiovascular disease(heart disease) Hyperlipidemia(cholesterol and triglycerides)

9 Serious Health Problems (Cont.) 9 Stroke FaVy liver and gallbladder disease Respiratory Problems Sleep apnea Some cancers Source: US Department of Health and Human Services

10 10 Florida Department of Health Healthiest Weight Florida esdmates 65% of adults and 30 % of children are at an unhealthy weight 26% of adults and 17% of children are obese Many young children and adults have extreme obesity, difficult to treat The costs of care for chronic disease from obesity alone are esdmated to be $34B over the next 17 years

11 High Price for Treatment of Type 2 11 Diabetes % of US populadon over 20 years old has diabetes type 2, esdmated by survey Total and direct esdmated costs of treatment: 245 billion dollars For those with pre- diabetes(abnormal blood sugar measurements), reducing weight and sugar intake by a small percentage could delay the onset of more serious problems

12 Body Mass Index 12 Main research tool for measuring the health consequences of obesity BMI is a person s weight in kilograms divided by their height in meters squared Overweight starts at 27 Obesity is defined without complicadons as a disease at 30

13 Problem With Weight 13 Easy to gain weight, but hard to lose The body adapts to weight gain and may prevent any significant weight loss Reversal of weight loss benefits aeer onset of diabetes No diet superior to another over Dme Intense physical acdvity may halt the energy storage adaptadon

14 Research on Causes of the Disease of 14 Obesity Enlarged fat cells and inflammatory adipose Dssue Hypothalamic signaling pathways of the brain develop resistance to lepdn, the key hormone in reguladon of sadety and fat storage. GestaDonal diabetes Insulin resistance main reason for diabetes mellitus, type 2

15 Influence of the BMI on Society 15 Obese children and adults more oeen suffer from social discriminadon and are targets for bullying Obese adults may not be hired for jobs The BMI level limits pardcipadon in many occupadons such as the military and police forces Some health insurance companies may charge a penalty for obesity and its consequences, but refuse to pay for counseling or therapy

16 Problems in Infancy 16 Overweight mothers have more overweight infants GestaDonal diabetes Inadequate support for breast feeding in the hospital and home Nursing a baby with a full Dme job SubsDtuDon of commercial formulas in place of breast milk, as the main source of nutridon

17 17 Problems in Childhood School food: daycare, preschool, regular school Snacks available everywhere, constantly consumed Vending machine use popular Persistent obesity at 8-12 years tends to remain throughout adulthood. Start of incidence of type 2 diabetes of childhood Health not a priority in school curriculum

18 18 Problems for Adults Take- out, drive through, fast food,restaurants on every corner. Sugary and salty treats abundant Lack of basic healthy staples available in low income areas- - food deserts Many fewer individuals cooking healthy food at home

19 Problem for Older Adults 19 Access to nutridous food limited by: TransportaDon difficuldes Few grocery delivery opdons Mobility Reliance on family, charity, and neighbors

20 Emo8onal Problems Related to Food 20 Food obsessions OvereaDng and binge eadng Bulimia and anorexia

21 PREVENTION 21 Only way to make a difference in reducing the incidence of obesity and its medical consequences PrevenDon must start at beginning of life and extend through every age Requires the avendon of the whole community

22 22 Social Ecological Model- Influences of Obesity Adapted from Koplan JP, Liverman CT, Krrak VI, editors. Preventing childhood obesity: health in the balance. Washington DC: Institute of Medicine, National Academies Press 2005

23 Preven8on = Advocacy 23 Gather advocates who can influence changes in health for a community Advocate for bever nutridon habits and opportunides for a healthy diet in all neighborhoods Create opportunides for meaningful, safe, physical acdvity

24 Advocate to Change AXtudes 24 Change aktudes and responsibilides for staying healthy Align healthy habits with the many cultural differences in the community Make new health behaviors the normal roudne Flickr: UDSA(2014)

25 Advocacy in Palm Beach County 25 First Community Call to AcDon on Obesity, February 16, 2012 All volunteer effort organized by Palm Beach County Medical Society(Cynthia C Clayton MD FAAP) and the Health Department of Palm Beach County(Alina Alonso MD MPH, Director) 50 professionals from 30 organizadons avended

26 Ingredients for Change 26 Advocacy Community Involvement Engaging Champions/recognizing the need for funding Stressing the need for local government to include a discussion of health in all policies

27 Current Programs 27 2 community diabetes prevendon programs started by the Health Department and the Palm Beach County Medical Society Let s Move media campaign championed by Palm Healthcare FoundaDon and CBS 12, encouraging physical fitness Constant improvement in school menus and free breakfast

28 More Current Programs 28 InstallaDon of a Fitness Zone Park in a Lake Worth low income neighborhood New community gardens 5/2/1/0 media message: 5 servings of fruits and vegetables daily Limit use of non business electronics to 2 hrs 1 hour physical acdvity daily Reduce sugared beverages and other products

29 29

30 Barriers to Success 30 Call to AcDon unfunded and without dedicated management Difficulty in engaging influendal community champions(government, universides, large healthcare organizadons, dieddans, food industry) Successful mainly as supporter of community programs

31 Obesity in Palm Beach County 31 Consequences PrevenDon Efforts

32 32 References Prevalence of Childhood and Adult Obesity in the United States, ,JAMA,2014;311(8): ChooseMyPlate.gov CDC Grand Rounds:Childhood Obesity in the United States, JAMA,March9,2011- Vol305,No.10