Community Nutrition Community Nutrition n Aims to prevent

Community Nutrition

Community Nutrition… n Aims to prevent problems related both to food insufficiencies and excesses, and to promote wellbeing through a secure and safe food supply and healthful eating habits

Public Health Nutritionist n Responsible for n n n n planning organizing managing directing coordinating evaluating nutrition component of public health unit programming

Public Health Nutritionist n Establishes links with related community nutrition programs n n nutrition education food assistance social services elder care community based research

Public Health Nutritionist n n Focus on society Promote health & prevent disease Promotes healthy lifestyle Works on issues that affect largest segments of community OR have greatest long-term health benefits

Public Health Nutritionist n n n Targets underserved groups Requires collaboration Monitors health of community n n to ensure programs respond to needs assessment

Prevention n Three inter-related components: n n n personal health community-based social policies/systems-based

Levels of Prevention n Three levels n n n Primary Secondary Tertiary

Community Practice Settings n Public Health Departments Community Health Centres Health Promotion Organizations Health Charities Homes Family Resource Centres Grocery Stores n . . . n n n

Organizations involved in community nutrition… Voluntary Agencies Social Services Day Care, Schools Agricultural Extension Food Aid Programs Public Health Agency Food Industry Self-help Groups Fitness Centres Work Site Health Care Providers (Obert, 1986 in Davis, 1989)

Responsibilities in Community Nutrition Assessment Planning Evaluation Implementation

Nutrition Guidelines How did nutrition professionals develop food guidance documents? 1. Recommended Nutrient Intakes 2. Canada’s Guidelines for Healthy Eating 3. Eating Well with Canada’s Food Guide n

Community Nutrition in NS n n Nutrition for Health: An Agenda for Action (1997) 4 strategic directions n n Reinforce healthy eating practices Support nutritionally vulnerable populations Continue to enhance the availability of foods Support nutrition research

Community Nutrition in NS n Healthy Eating Nova Scotia (2005) n n n A framework for comprehensive action on healthy eating Provides an evidence-based, intersectoral, and strategic approach to improving the nutritional health of Nova Scotians Priorities for Action: n n Breastfeeding Children and Youth Food Security Fruit and Vegetable Consumption

Community Nutrition in Focus Childhood Obesity

Measuring Obesity n n Body Mass Index In adults n n wt in kg / ht in m 2 Children and Adolescents n n n BMI for age & sex > 95 th percentile overweight/obese 85 th – 95 th at risk

Evolution of Overweight in Canada Boys and girls, 7 to 13 years old 33% 35 27% 30 25 20 15 11% 13% 10 5 0 17 Boys (Katzmarzyk et al. 2001) Girls 1981 1996

Evolution of obesity in Canada Boys and girls, 7 to 13 years old 12 10% 10 9% 8 6 1981 1996 4 2 0 18 2% Boys Définition de Cole – Données de l’ELNEJ (Katzmarzyk et al. 2001) 2% Girls

Weight Classification of NS Grade 3 Students 2001 -2005 Boys 2001 Healthy 63. 0% Weight At Risk 17. 6% Boys 2005 53. 0% Girls 2001 55. 4% Girls 2005 59. 6% 21. 5% 24. 7% 20. 6% Over- 19. 4% weight 25. 6% 19. 9% Campagna, Wadsworth, et al. , 2007

Weight Classification of Grade 7 Students 2001 -2005 Boys 2001 Healthy 63. 3% Weight At Risk 16. 4% Boys 2005 59. 7% Girls 2001 60. 1% Girls 2005 69. 7% 21. 8% 20. 5% 17. 1% Over- 20. 4% weight 18. 5% 19. 4% 13. 2% Campagna, Wadsworth, et al. , 2007

Weight Classification of NS Grade 11 Students 2001 -2005 Boys 2001 Healthy 66. 1% Weight At Risk 16. 7% Boys 2005 69. 4% Girls 2001 75. 0% Girls 2005 69. 8% 16. 6% 17. 1% 20. 2% Over- 16. 2% weight 14. 1% 7. 9% 10. 0% Campagna, Wadsworth, et al. , 2007

Childhood Obesity n What factors are associated with development of obesity? n n n Activity – TV/Cmpt AND ↓ PE classes Minorities Low income levels Older children/youth Become obese adults?

OBESITY PREVALENCE FACTORS Energy Intake – Food Marketing “Marketing approaches matter for public health. They influence our own – and in particular our children’s – patterns of behaviors. Given that they are designed to succeed, they have serious consequences for those at whom they are targeted. ” Gro Harlem Brundtland Director General of WHO Address to the 55 th World Health Assembly 2002 Susan L. Roberts, JD, MS, RD Drake University Agricultural Law Center

Physical Activity – PACY 2001 -2005 Campagna, Wadsworth, et al. , 2007

Portion sizes… In the US, 67 % of persons reported eating everything in their plate regardless of the portion size On average, people eat 30% more, when exposed to a portion 2 times bigger.

PUBLIC HEALTH STRATEGIES REAL Action q. Effective public policies q. Appropriate infrastructure q. Adequate funding q. Monitoring & evaluation q. Continuing research

Required Readings n n Meldrum, & Willows, 2006. Food insecurity in university students. (online) Glanville, & Mc. Intyre, 2006. diet quality of Atlantic families headed by single mothers.