A Healthier Future for West Virginia - Healthy People 2010

19 - Nutrition and Overweight

Objectives | References

Background

Nutrition is essential for sustenance, growth and development, health and well-being. At the same time, nutritional factors contribute substantially to the burden of preventable illness and premature death in the United States and to the nation's economic burden. According to the Centers for Disease Control and Prevention (CDC), dietary factors are associated with 4 of the 10 leading causes of death: coronary heart disease, some types of cancer, stroke, and Type 2 diabetes mellitus. Estimated medical costs to society in medical charges (medical costs and lost productivity) of over $200 billion each year are a result of these health conditions. Glanz et al. state that good nutrition can reduce some of these costs and consequences in the short run and can affect others through population-wide declines in disease rates and in disease severity over the longer term.

The obesity epidemic has increased dramatically across the United States as well
as in West Virginia. The rapid spread during the 1990s occurred across all states, regions, and demographic groups. According to Wolf and Colditz, in 1995 total costs (medical costs and lost productivity) attributable to obesity alone amounted to an estimated $99 billion in the U.S. Overweight and physical inactivity account for more than 300,000 premature deaths each year, second in number only to tobacco-related deaths. State efforts will need to be coordinated with national and local interventions to control this epidemic, particularly since West Virginia was ranked first in the prevalence of obesity among adults in 1998 according to data collected by the Behavioral Risk Factor Surveillance System (BRFSS).

The following 2010 objectives for West Virginia were selected to:

• promote healthy weights throughout our population;
• measure implementation of the Dietary Guidelines for Americans;
• establish healthy eating behaviors in our youth; and
• address the issue of food insecurity in our state.

The Objectives

FLAGSHIP OBJECTIVE
OBJECTIVE 19.1. Reduce the proportion of people aged 18 and older who are obese.
19.1a. Reduce to 37% the proportion of people who are obese as defined by the Metropolitan Life Insurance tables as being at least 20% over ideal body weight. (Baseline: 43.0% in 1998)
19.1b. Reduce to 20% the proportion of people who are obese as defined by having a body mass index (BMI) of 30 or greater. (Baseline: 23.9% in 1998)

Data Source: West Virginia Bureau for Public Health (WVBPH), Office of Epidemiology and Health Promotion (OEHP), BRFSS

OBJECTIVE 19.2. Increase to 35% the proportion of people aged 18 and older who consume at least five servings of vegetables and fruits per day. (Baseline: 18.7% in 1998)

Data Source: WVBPH, OEHP, BRFSS

OBJECTIVE 19.3. Increase to at least 60% the proportion of people aged 18 and older who meet dietary recommendations for calcium as defined by the Institute of Medicine's Dietary Reference Intakes for Calcium, Phosphorus, Magnesium and Fluoride. (Baseline: 35.0% in 1998)

Data Source: Statewide Diet and Physical Activity Survey, West Virginia University (WVU) Department of Community Medicine, Division of Exercise Physiology

OBJECTIVE 19.4. Increase to 75% the proportion of people aged 18 and older who consume less than 10% of total calories from saturated fat. (Baseline: 45.0% in 1998)

Data Source: Statewide Diet and Physical Activity Survey, WVU Department of Community Medicine, Division of Exercise Physiology.

OBJECTIVE 19.5. Decrease food insecurity among WV households by 5% from baseline. (Baseline: 9% in 1998 from USDA; data available in 2001 from BRFSS)

Data Sources: USDA Prevalence of Food Insecurity and Hunger (per state) Survey; WVBPH, OEHP, BRFSS

OBJECTIVE 19.6. Increase the proportion of adolescents who consume breakfast daily by 5% from baseline. (Baseline data available in 2001)

Data Source: Youth Statewide Diet and Physical Activity Survey, WVU Department of Community Medicine, Division of Exercise Physiology.

OBJECTIVE 19.7. Increase the proportion of adolescents who consume at least five servings of fruits and vegetables per day by 5% from baseline. (Baseline: 20.4% in 1999 from Youth Risk Behavior Survey [YRBS]; data available in 2001 from Youth State Diet and Physical Activity Survey)

Data Source: WV Department of Education (WVDOE), Office of Healthy Schools, YRBS; WVU Department of Community Medicine, Division of Exercise Physiology

OBJECTIVE 19.8. Increase the proportion of adolescents who meet dietary
recommendations for calcium by 5% from baseline. (Baseline data available in 2001)

Data Source: Youth Statewide Diet and Physical Activity Survey, WVU Department of Community Medicine and Division of Exercise Physiology

OBJECTIVE 19.9. Increase the proportion of adolescents who consume less than 10% total calories from saturated fat by 5% from baseline. (Baseline data available in 2001)

Data Source: Youth Statewide Diet and Physical Activity Survey, WVU Department of Community Medicine, Division of Exercise Physiology

OBJECTIVE 19.10. Reduce the proportion of children and adolescents who are overweight or obese by 5% from baseline. Overweight or obese is defined as equal to or above the gender- and age-specific 95th percentile of BMI from the revised NCHS/CDC growth charts. (Baseline: 23% in 1998 from the CARDIAC PROJECT; data available in 2001 from the Youth Statewide Diet and Physical Activity Survey, WVU)

Data Sources: Dr. Bill Neal's CARDIAC PROJECT, WVU School of Medicine; Youth Statewide Diet and Physical Activity Survey, WVU Department of Community Medicine, Division of Exercise Physiology

OBJECTIVE 19.11 At a minimum, maintain current standards for Nutrition Education in schools (Grades K-12).

Data Source: WV Department of Education, Instructional Goals and Objectives

Meeting the Objectives

Health Promotion Channels for Achieving Objectives:

• Worksites
• Schools
• Public Health Programs
• Networks
• Health Care System
• Higher Education

The West Virginia Nutrition and Chronic Disease Coalition (WVNCDC) was established in 1993 to address nutrition behaviors and the Healthy People 2000 nutrition objectives. The WVNCDC's mission is the promotion of healthy nutrition behaviors to prevent nutrition-related diseases among West Virginians. Since its inception, the WVNCDC has been involved in efforts to promote healthy nutrition behaviors such as cooking schools, the National Cancer Institute's "Pick 5" program in elementary schools, and sponsorship of nutrition speakers at various health promotion conferences.

In July of 1999, the West Virginia Bureau for Public Health received cardiovascular health core capacity grant funding from the CDC to address policy and environmental strategies for nutrition and physical activity, as well as culturally appropriate strategies for promoting health and preventing disease in the minority population. Through this grant funding, an inventory of policies will be conducted to assess what interventions would be most appropriate to pursue. Policies to be assessed include the following: requirements for heart-healthy food and beverage choices in vending machines at worksites; requirements to promote heart-healthy food and beverage choices in the school environment that compete with school meals; requirements for employers to provide and/or subsidize heart-healthy food and beverage choices during work-related meetings and functions; requirements for managed care organizations to include the American Heart Association's Guide on Primary Prevention of Cardiovascular Diseases as part of their primary health care services for participants.

Glanz et al. state that policy and environmental strategies influencing the availability of healthy foods, access to information for making healthy food choices, and the accessibility, consistency, and attractiveness of nutrition education experiences can promote healthy eating behaviors throughout our population. The West Virginia Nutrition and Chronic Disease Coalition will take the leadership in shaping policy and environmental strategies in the area of nutrition for a healthier West Virginia.

The following list includes some of the organizations that will be leading the initiatives to reach the 2010 objectives:

WV Nutrition and Chronic Disease Coalition
WV Coalition of Food and Nutrition
Division of Health Promotion, WVBPH
WVU Extension Services
WVU Department of Community Medicine
Office of Healthy Schools, WVDOE
Office of Child Nutrition, WVDOE
Office of Nutrition Services, WVBPH

Agencies represented on the West Virginia Nutrition and Chronic Disease Coalition (WVNCDC) include:

WV Coalition of Food and Nutrition
Division of Health Promotion, WVBPH
WVU Extension Services
WVU Department of Community Medicine
Office of Child Nutrition, WVDOE
Office of Nutrition Services, WVBPH
American Heart Association
American Cancer Society
Dairy and Nutrition Council
WV Dietetics Association
WV Health Promotion Specialist Network, WVBPH
Minnie Hamilton Health Care
Cabell Huntington Hospital

Working Group Members

Karen Wheeler, MS, RD, LD, Work Group Leader, Nutrition Manager, Division of Health Promotion, WVBPH
Linda St. Clair, MS, RD, LD, Food Service Director, Highland Hospital
Debra Krummel, PhD, RD, Assistant Professor, Department of Community Medicine, WVU
Gwen Brown, PhD, RD, Extension Specialist-Nutrition and Health, WVU Extension Services
Kathy Talley, Nutrition Education and Training Coordinator, Office of Child Nutrition, WVDOE
Dixie Copley, MS, CFSC, Nutrition Education and Media Consultant, Dairy and Nutrition Council
Katherine Greenlief, Rural Health Education Partnerships (RHEP) Site Coordinator, Mountain Health Consortium, Braxton County Memorial Hospital
Jennifer Allen, RHEP, Site Coordinator, Rural Ohio Valley Education Resources Consortium
Cindy Hall, Pregnancy and Pediatric Nutrition Surveillance System/Geographic Information System Project Coordinator, Office of Nutrition Services, WVBPH
Betty Puffenbarger, School Food Service Director, Upshur County Board of Education
Linda Facemyre, Assistant Manager, Sissonville Foodland
Lauren Smith, Department Manager, Braxton County Memorial Hospital - Cardiopulmonary Services
Jessica G. Wright, RN, MPH, CHES, Director of Chronic Disease Programs, Division of Health Promotion, WVBPH

References/Resources

Frazao E. "The American diet: a costly problem." Food Review 19 (January-April 1996):2-6.

Glanz K et al. "Environmental and policy approaches to cardiovascular disease prevention through nutrition: opportunities for state and local action." Health Education Quarterly 22, no.4 (1995): 514.

Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium and Fluoride. Washington DC: National Academy Press, 1997.

National Center for Health Statistics (NCHS). "Report of Final Mortality Statistics, 1995." Monthly Vital Statistics Report 45, no.11 (12 June 1997): supplement 2.

Roper W et al. "Priorities in prevention excess weight and obesity epidemic." Partnership for Prevention. June 2000: www.prevent.org.

Wolf AM and Colditz GA. "Current estimates of the economic cost of obesity in the United States." Obesity Research 6, no.2 (1998): 97-106.

For More Information

Nutrition Program
Office of Epidemiology and Health Promotion
350 Capitol Street, Room 319
Charleston, WV 25301-3715
Phone: (304) 558-0644; Fax: (304) 558-1553

This page was last updated June 27, 2001.
For additional information about HP2010, contact Chuck Thayer at (304) 558-0644 or Chuck.E.Thayer@wv.gov