obesity prevention in new york city: improving health through system, infrastructure, and...

Obesity Prevention in New York City:

Improving Health through System, Infrastructure, and Environmental Change

Strategies

Gretchen Van Wye, PhD, MADeputy Director, Chronic Disease Prevention

New York City Department of Health and Mental Hygiene

Lancaster SummitMay 24, 2012

Overview of NYC

New York City

• 8.4 Million residents• 5 boroughs (counties)• Many neighborhoods• Ethnically diverse

35% White 27% Hispanic 24% Black 36% Foreign-born

• 21% live in poverty• 1.8 million on Supplemental Nutrition Assistance Program (SNAP)

Bronx

Manhattan

Queens

Brooklyn

Staten Island

Obesity Has Been Increasing in Adults

Self reported obesity, NYC, 1994-2010

12.3%

14.0%15.0%

15.5%

18.2%

20.1%

21.7%

19.9%21.1%

22.1% 22.6%23.3% 23.4%

0%

5%

10%

15%

20%

25%

1994-95 1996-97 1998-99 2000-01 2002 2003 2004 2005 2006 2007 2008 2009 2010

% o

f N

YC

Ad

ult

s O

be

se

57% of adults overall and 70% of adults in high-need areas are overweight or obese

9.3% report diabetes

30.3% drank one or more sugar-sweetened beverages per day.

Citywide Prevalence: 11.6%

The Obesity Problem: No Balance

Calories consumed exceeds calories burned

Physical activity: Has been designed out

of our environment

Food is now:UbiquitousCheapHigh in CaloriesServed in Large PortionsHeavily Promoted

Food is Ubiquitous:Food Store Density in New York

City

Food outlet type Outlets per square kilometer

Food storesSupermarkets and medium-sized groceries 3.5

Fruit and vegetable markets 1.6

Bodegas/convenience stores 16.6

Other food stores 10.4

RestaurantsFast food 3.4

Pizza 4.2

Other restaurants 38.9

Total 78.6Source: Rundle A et al. Neighborhood food environment and walkability predict obesity in New York City. Environ Health Perspect 2009;117:442-447.

Cost: Junk foods are Cheaper Compared to Fruits and Vegetables

(F&V)

Who would expect this many calories (more than half a day’s worth for

most adults)

in one meal?

Source: The World of Coca Cola, Atlanta Georgia 2011.

16 ounces of Coke used to be enough for 3 people!

Exploding Beverage Sizes: McDonald’s Drinks Have Grown 457% Since 1955

1. Young L. The Portion Teller Plan: The No-Diet Reality Guide to Eating, Cheating, and Losing Weight Permanently. New York: Morgan Road Books, 2005. Print ; McDonald’s Website, retrieved November 10, 2010: http://nutrition.mcdonalds.com/getnutrition/nutritionfacts.pdf

Promotions encourage customers to purchase large portions to get “value”

McDonald’s and Wendy’s have dropped the Supersize, Biggie and Great Biggie descriptors and now call the same huge sizes Medium or Large

…Heavily Marketed...

Healthy Eating

16

• Promote environmental changes that increase access to healthy foods and decrease consumption of unhealthy foods

• Encourage adoption of healthier food procurement standards in public and private settings

• Continue to lead and expand the National Salt Reduction Initiative and manage the national salt monitoring system

• Support the achievement of baby-friendly hospital status among NYC hospitals

Goal: Reduce by 5% the percentage of adults who consume 1 or more daily sugar sweetened beverages

Impact: Approximately 93,000 of 1,856,000 adult NYers who reported consuming an average of 1 or more SSBs per day in 2010

How: •Educating New Yorkers on the harms of sugary drink consumption•Develop additional standards for healthy foods and beverages in new settings, for example meetings and events located at City agencies

Reducing Consumption of Sugar-Sweetened

Beverages

Reducing Sodium Consumption

Goal: Monitor trends in sodium and key nutrients in US processed foods as part of the National Salt Reduction Initiative (NSRI) goal to reduce sodium in packaged and restaurant foods by 25% by 2014

Impact: Impact all of the US population- approximately 311 million people

How: •28 companies have committed to date

•Monitoring changes in sodium through databases and company reports --analyses underway

Decrease sodium

content in foods by 25% over 5 years

Decrease population

sodium intake by

20% over 5 years

Reduce risk of heart

disease– the leading cause of

death in US

Baby-FriendlyGoal: Increase from 2 to 12 the number of NYC public and private hospitals that are certified as Baby Friendly and increase the number of hospital working to become more baby friendly.

Impact: Approximately 78,750 births in NYC over the next 5 years; 46,000 mothers of low SES. 25 of 40 maternity hospitals in NYC.

How: By establishing and running a Hospital Learning Collaborative and providing technical assistance.

Early Successes

Obesity Prevalence in K-8 Decreased from 21.9% to 21%

22.9

22.2

21.721.1

20.2

18.3

21.9

21.0

18.0

19.0

20.0

21.0

22.0

23.0

24.0

25.02006-07 2007-8 2008-9 2009-10

Obe

sity

pre

vale

nce

7 to 10 year olds

11 to 14 year olds

5 and 6 year olds

Overall

NYC Fitnessgram data, 2006-2010

Decrease in Sugary Drinks

Decrease in Percent of Adults Eating No Fruits &

Vegetables

Thank you!

Gretchen Van Wye, PhD, MADeputy Director – Chronic Disease PreventionNew York City Department of Health & Mental

Hygienegvanwye@health.nyc.gov