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Community Nutrition. Community Nutrition…. Aims to prevent problems related both to food insufficiencies and excesses, and to promote well-being through a secure and safe food supply and healthful eating habits. Public Health Nutritionist. Responsible for planning organizing managing
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Community Nutrition… • Aims to prevent problems related both to food insufficiencies and excesses, and to promote well-being through a secure and safe food supply and healthful eating habits
Public Health Nutritionist • Responsible for • planning • organizing • managing • directing • coordinating • evaluating • nutrition component of public health unit programming
Public Health Nutritionist • Establishes links with related community nutrition programs • nutrition education • food assistance • social services • elder care • community based research
Public Health Nutritionist • 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 • Targets underserved groups • Requires collaboration • Monitors health of community • to ensure programs respond to needs • needs assessment
Prevention • Three inter-related components: • personal health • community-based • social policies/systems-based
Levels of Prevention • Three levels • Primary • Secondary • Tertiary
Community Practice Settings • Public Health Departments • Community Health Centres • Health Promotion Organizations • Health Charities • Homes • Family Resource Centres • Grocery Stores • ...
Organizations involved in community nutrition… Support from Federal and Provincial Governments and the Private Sector Voluntary Agencies Food Aid Programs Social Services Self-help Groups Public Health Agency Day Care, Schools Fitness Centres Agricultural Extension Work Site Food Industry 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
Community Nutrition in NS • Nutrition for Health: An Agenda for Action (1997) • 4 strategic directions • Reinforce healthy eating practices • Support nutritionally vulnerable populations • Continue to enhance the availability of foods • Support nutrition research
Community Nutrition in NS • Healthy Eating Nova Scotia (2005) • 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: • Breastfeeding • Children and Youth • Food Security • Fruit and Vegetable Consumption
Community Nutrition in Focus Childhood Obesity
Measuring Obesity • Body Mass Index • In adults • wt in kg / ht in m2 • Children and Adolescents • BMI for age & sex • > 95th percentile overweight/obese • 85th – 95th at risk
Evolution of Overweight in Canada Boys and girls, 7 to 13 years old 33% 35 27% 30 25 20 1981 15 13% 11% 1996 10 5 0 Boys Girls (Katzmarzyk et al. 2001) 17
12 10 8 6 1981 1996 4 2 0 Evolution of obesity in Canada Boys and girls, 7 to 13 years old 10% 9% 2% 2% Boys Girls Définition de Cole – Données de l’ELNEJ (Katzmarzyk et al. 2001) 18
Weight Classification of NS Grade 3 Students 2001-2005 Campagna, Wadsworth, et al., 2007
Weight Classification of Grade 7 Students 2001-2005 Campagna, Wadsworth, et al., 2007
Weight Classification of NS Grade 11 Students 2001-2005 Campagna, Wadsworth, et al., 2007
Childhood Obesity • What factors are associated with development of obesity? • 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 55th 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 • Effective public policies • Appropriate infrastructure • Adequate funding • Monitoring & evaluation • Continuing research
Required Readings • Meldrum, & Willows, 2006. Food insecurity in university students. (online) • Glanville, & McIntyre, 2006. diet quality of Atlantic families headed by single mothers.