Transcript Recommended actions to prevent overweight and obesity

1
2015 NM Objectives
Manage the
obesogenic
environment
Encourage
action to attain
normal weight
Increase awareness on
proper nutrition and
physical activity to
prevent obesity
Outline
•
What is overweight and obesity?



•
•
Assessment
Status
Causes and consequences
Current efforts
Recommendations
Overweight and Obesity
Abnormal or excessive fat accumulation
When energy “in”
is greater
than energy out
= weight gain
4
Measures of
overweight and obesity
•
•
•
•
Weight-for-age
Body Mass Index
Waist circumference
Waist-hip ratio
5
Weight-for-age
For children 0-5 years old
6
Body Mass Index (BMI)
For older children (61 months and above)
and adults
BMI = weight in kilograms
height in meters2
7
BMI Classification
BMI
<18.5
18.5-24.9
25.0-29.9
30.0-34.9
35.0-39.9
≥40.0
Source: WHO
Classification
Chronically Energy
Deficient
Normal
Overweight
Obese Grade I
Obese Grade II
Obese Grade III
Disease risk
Normal
Increased
High
Very high
Very high
8
Waist Circumference (WC)
• Measurement of
abdomen around top of
iliac crest (middle point
of last rib and pelvic
bone)
• Excess fat in abdomen is
out of proportion to total
body fat
9
Waist Circumference (WC)
You have higher risk of developing
noncommunicable diseases if your waist
circumference is:
Equal or more than 88 cm for women
Equal or more than 102 cm for men
10
Waist-Hip Ratio (WHR)
• Measures waist at narrowest point and
hip at widest point
• Divide waist circumference by hip
circumference
• Ex: woman with 35” waist and 46” hip
35/46 = 0.76
11
Waist-Hip Ratio (WHR)
You have higher risk of developing
noncommunicable diseases if your
waist-hip ratio is:
Equal or more than 0.85 for women
Equal or more than 1.0 for men
12
Trend of overweight
and obesity in the Philippines
13
Prevelance of overweight and obese among
children and adolescents by region, 2013
Region
O-5 years
Source: 8th National Nutrition Survey, DOST-FNRI.
5.08 -10 years
10.08-19 years
Prevalence of overweight and obese adults by
place of residence and wealth index, 2013
Source: 8th National Nutrition Survey, DOST-FNRI.
15
Trend in high waist circumference among
adults, 20 years and older, 1998-2013
Source: 8th National Nutrition Survey, DOST-FNRI.
16
Trend in high waist hip ratio among
adults, 20 years and older, 1998-2013
Source: 8th National Nutrition Survey, DOST-FNRI.
17
Physical inactivity
Unhealthy diet
Child undernutrition
Poor breastfeeding
practices
Overweight
&
Obesity
E
N
V
I
R
O
N
M
E
N
T
18
Distribution of adults 20 years and
older, by physical activity level, 2008
Source: Philippine Nutrition Facts and Figures 2008, FNRI-DOST.
20
Comparison in low physical activity among
adults 20 years and older, by domain,
2003-2008
Source: Philippine Nutrition Facts and Figures 2008, FNRI-DOST.
21
Physical activity among adolescents
•
Only 13.9% students were physically
active for a total of 60 mins per day
•
Only 22% of students went to physical
education class for 3 or more days each
week during school year
•
32.3% spent 3 or more hours/day sitting
Source: WHO Global School-based Student
Health Survey – Philippines
22
Changing dietary patterns
•
•
•
Filipinos have been eating more meat,
fish and eggs which are good sources of
protein
High consumption of sugars and syrups,
fats and oils
Low consumption of vegetables, fruits
and complex carbohydrates
23
Per capita food consumption pattern of
Filipinos, 1978-2013
Food group
Consumption (gram), raw as purchased
1978 1982 1987 1993 2003 2008 2013
Cereals and products
367
356
345
340
364
361
387
Starchy roots & tubers
37
42
22
17
19
17
31
Sugars and syrups
19
22
24
19
14
17
16
Fats and oils
13
14
14
12
18
15
16
Milk and products
42
44
43
44
49
42
7
Fish and products
102
113
111
99
104
110
101
Meat and products
23
32
37
34
61
58
58
Egg
8
9
10
12
13
14
17
Dried beans, nuts, seeds
8
10
10
10
10
9
9
Vegetables
145
130
111
106
111
110
120
Fruits
104
102
107
77
54
54
44
Source: National Nutrition Surveys, FNRI-DOST
24
Changing dietary patterns
•
•
•
•
•
increasing urbanization – diets that are high in
fat, simple sugars, processed foods, refined
carbohydrates
globalization – increased trade liberalization
making available wide variety of processed and
fast food establishments
increased frequency of eating away from home
ICT – rampant use of computers, online games
influence of mass media
Source: Pedro, et.al.
25
Child undernutrition
• Particularly during first 1,000 days of
life
• Infants who experienced growth failure
early in life and had rapid weight gain
are at risk to adult obesity and NCDs
26
Poor breastfeeding practices
•
•
•
Breastmilk has protective factor against
obesity and NCDs in adulthood
Breastfeeding improves feeding
method, affects infant’s appetite
Physiological differences between
breastmilk and infant formula
27
Consequences of obesity
http://www.hkjpaed.org/details.asp?id=43&show=1234
Current efforts to address
overweight and obesity
Philippine Plan of Action for Nutrition
(PPAN), 2011-2016
•
•
•
•
Target is “no increase in 2008
prevalence”
Promote healthy lifestyle
Increased consumption of vegetables
and fruits
Increase physical activity
30
National Policy on NCDs
DOH Administrative Order 2011-003
“National Policy on Strengthening the
Prevention and Control of Chronic Lifestylerelated NCDs”
• Addresses the four shared risk factors of
NCDs – smoking, unhealthy diet, physical
inactivity, consumption of alcohol
31
DOH-Healthy lifestyle promotion
a. Pilipinas Go 4 Health
b. Recognition system
through “Outstanding
Healthy Lifestyle Advocacy
Awards”
c. Belly Gud for Health
32
Promote Good Nutrition Program NNC
•
•
•
Nutrition counseling and education
Exclusive breastfeeding and appropriate
complementary feeding
Nutritional Guidelines for Filipinos
33
34
Pinggang Pinoy – Healthy Food Plate
• easy-to-understand
• uses a familiar food plate
model to convey right
food group proportions
• per-meal basis to meet
energy and nutrient
needs of Filipino adults
35
Nutrition labelling
DOH AO 20140030 requires
mandatory
labelling of all
processed
food products
36
Nutrition labelling
FDA Circular 2012015 – voluntary
front-of-pack panel
labelling of caloric
content of
processed foods
37
Promotion of desirable infant and
young child feeding (IYCF) practices
•
•
•
•
EO 51 or The Milk Code
RA 10028 – Expanded
Breastfeeding Promotion Act
of 2009
Mother-Baby Friendly Hospital
Initiative
IYCF National Plan of Action
2011-2016
38
School-based interventions
to prevent obesity
•
•
•
DepED AO No. 08 S2007 on sale of
healthy foods in school canteens
Integration of health, nutrition and PE in
school curriculum
Bi-annual nutritional assessment
39
Obesity prevention interventions
for individuals
• Achieve energy balance between intake
and use of calories
• Limit intake of total fats, unsaturated fats
vs. saturated fats and sugars
• Eat more veggies, fruits, legumes, whole
grains, nuts
• 30 minutes of regular, moderate-intensity
physical activity on most days of the week
40
Obesity prevention interventions
among children
• Practice exclusive breastfeeding for the first
six months of life and give appropriate
complementary feeding starting at six
months while continuing breastfeeding
• Instruct mothers to accept child’s ability to
regulate energy intake rather than feeding
until plate is empty
41
Obesity prevention interventions
among older children and adolescents
• Promoting an active lifestyle
• Promoting intake of vegetables and fruits
• Limiting intake of energy-dense,
micronutrient-poor foods
• Targeting mass media campaign to parents
and care providers, school children and
adolescents
42
Obesity prevention interventions
among older children and adolescents
• Enacting legislation to support healthier
composition of food choices
• Developing policies to encourage
consumption of healthier food products and
increase access to recreational physical
activity
• Providing an enabling environment to
increase physical activity
43
Recommended actions to prevent
overweight and obesity
Individual/Family
1. Eat a variety of foods everyday - more of
vegetables and fruits, legumes and other
fiber-rich foods
2. Prepare food at home more often
3. Exclusively breastfeed newborns up to six (6)
months, then give appropriate
complementary foods while continuing
breastfeeding
44
Recommended actions to prevent
overweight and obesity
Individual/Family
4. Monitor and manage weight of family
members.
5. Have regular exercise with the family.
Encourage children to play games.
6. Limit exposure of children to television,
computers, other electronic gadgets to no
more than 2 hours a day.
45
Recommended actions to prevent
overweight and obesity
Community leaders
1. Grow vegetables and fruit-bearing trees
within the community.
2. Organize regular exercise activities that
encourage participation of community
members.
3. Provide access and support to community
members to be able to measure and monitor
their weight.
46
Recommended actions to prevent
overweight and obesity
Community leaders
4. Encourage mothers to exclusively breastfeed
infants and practice appropriate
complementary feeding practices.
5. Provide safe play area for children and other
supportive infrastructure to encourage
physical activity.
6. Mobilize youth groups for sports activities
and to have healthy diets.
47
Recommended actions to prevent
overweight and obesity
School administrators
1. Serve healthy food choices in school
canteens and cafeterias.
2. Grow fruit-bearing trees and vegetables in
schools.
3. Include enjoyable physical activities and
sports events in schools.
48
Recommended actions to prevent
overweight and obesity
Local policy makers and program managers
1. Formulate local policies to support
consumption of healthy diet and increase
access to recreational physical activity.
2. Implement wellness programs or conduct
regular exercises for community members.
3. Recreate physical environments to support
active commuting like walking or biking.
49
Recommended actions to prevent
overweight and obesity
Employers
1. Serve healthier food choices during meetings,
seminars, conferences, and other events
2. Conduct seminars/lectures on the
importance of healthy diet and active lifestyle
3. Implement wellness programs for employees
such as the “Belly Gud for Health”
50
Recommended actions to prevent
overweight and obesity
Food industry
1. Self-regulate marketing of foods and nonalcoholic beverages to children.
2. Reformulate food products to reduce
saturated fats, sodium and sugars.
3. Comply with nutrition labelling guidelines
issued by FDA.
51
Recommended actions to prevent
overweight and obesity
National government agencies
1. Develop and implement food and agriculture
policies to have adequate supply of food
particularly vegetables and fruits at
affordable prices
2. Disseminate information on good nutrition
and healthy lifestyle
52
Recommended actions to prevent
overweight and obesity
National government agencies
3. Strictly enforce the Milk Code, RA 10028 and
implement policies that promote, protect and
support appropriate infant and young child
feeding practices.
53
Recommended actions to prevent
overweight and obesity
National government agencies
4. Use sin taxes to finance health promotion
activities, nutrition education and
promotion of physical activity.
5. Regulate advertisements on consumption of
high-fat, high-sodium and high-sugar
products.
54
Recommended actions to prevent
overweight and obesity
Legislators
1. Enact legislation to regulate the marketing of
foods and non-alcoholic beverages to
children.
2. Enact legislation to increase taxes on sugarsweetened beverages.
3. Develop policies on rural and urban planning
and transport to create facilities that support
physical activity.
55
Celebrating Nutrition Month
•
•
•
•
•
Hang Nutrition Month streamers
Conduct seminars and other fora
Promote physical activity
Implement wellness programs
Conduct nutrition assessment and
nutrition counselling sessions
Nutrition Month activities
• National Launch on 1 July
• Tie-up with Mandaluyong City on 19 July
for biggest Zumba dance to beat Guinness
Record
• Mass media promotion
• Seminars and lectures
For more details:
National Nutrition Council
2332 Chino Roces Ave Extension, Taguig City
http://www.nnc.gov.ph
www.facebook.com/nncofficial
www.twitter.com/NNC_Official
www.youtube.com/user/NNC1974
[email protected]
Tel. (02) 843-0142 Fax. 816-4239
58
Regional NM plans
Region
Activities
Nutrition Forum; Biggest Loser Challenge; Nutri1
outreach
2
CAR
3
Launching, 10 Kumainments and Pinggang
Pinoy school caravan, Nutrikalesa painting
contest, simultaneous vegetable planting
and hataw activity, various contests, media
exposure
Launcing/Kapihan, Walk for Nutrition, media
exposure
Seminar on “State of the Art of Obesity
Research in the Philippines; various contests
59
Regional NM plans
Activities
Region
NCR “BNS Hataw na” Dancercise event; Advocacy
4B
5
6
Forum on Child Obesity; Photo-essay and poster
making contests
Launching; Stakeholders’ Forum and Regional
NAOs Conference; Regional Nutrition Awarding
Ceremony
Launching; nutri-parade; nutrition and diet
counselling; media exposures; seminars and
fora; press conference
Dance exercise with school faculty, children, and
LGUs; Recognition of 40 longest serving BNSs 60
Regional NM plans
Region
Activities
Weight Management Counselling in schools and
7
8
9
10
Healthy Lifestyle Promotion and Health
Management Booths in malls, media exposures
Launching, walkathon, BMI assessment, NGO
forum, BNS Day
Promotion of local healthy food recipes; “Thirst
Quencher Master Chef" contest focusing on the
benefits of healthy drinks
Launching, forum on prevention of overweight
and obesity, joint Hi5 & NM Nutrifair in
Camiguin, school/university activities, media
61
exposures, culmination activity
Regional NM plans
Region
Activities
Zumba contest, nutrition counseling, 10
11
Kumainments and Pinggang Pinoy exhibits,
press conference; media exposures
Launching, Fat Run and Zumba, health and
12
nutrition assessment, obesity forum, tri-media
CARAGA Launching, nutrition forum, nutrition
assessment and counseling, BNS conference,
NM campaign in correctional facilities, media
exposures
ARMM Nutri-parade and Nutri-hataw; Nutrition Month
Forum; school and community-based info drive
62