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Obesity, Nutrition, and

Physical Activity

U.S. Department of Health and Human Services


Centers for Disease Control and Prevention

Rapid Increases in Adult Obesity


in the U.S.
BRFSS: 1990, 1999, 2009

Rapid Increases in Obesity Among


U.S. Youth
NHANES 1963-2008

National Health Examination Surveys II (ages 6-11) and III (ages 12-17).
National Health and Nutrition Examination Surveys I, II, III and 1999-2008.
www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm.

Shifts in Dietary patterns in the


United States
Relative prices of
more healthful foods
have increased faster
than prices for less
healthful foods.
Increased portion size
Increased
consumption of
processed foods
typically higher in
sodium
Increased schools
vending and a la carte

Active Transportation by Youth has


Decreased
Mode for Trips to School National Personal
Transportation Survey

McDonald NC. Am J Prev Med 2007;32:509.

Increased TV Viewing Increases


Childhood Obesity Prevalence

NHES: National Household Education Surveys.


NLSY: National Longitudinal Survey of Youth.

$1.6 billion/year spent


on marketing of foods
and beverages to youth
$745 million on
television
Television viewing
associated with
consumption of foods
advertised on
television
70% children 8-18
years and 30% children
<3 year old have TVs in

Costs of Adult Obesity Are


Increasing

Total Costs

1998

2006

(in 2008 dollars)

(in 2008 dollars)

$75
billion/yr

$147
billion/yr

6.5%

9.1%

% of U.S.
Medical
Costs

Increased prevalence, not increased


per capita costs, was the main driver of
the increase in costs.
Finkelstein et al. Health Affairs 2009; 28:w822.

Reductions in Salt Intake Can


Reduce
High Blood Pressure

Increased sodium in the diet =


increased blood pressure = increased
risk for heart attack and stroke

Generally, lower consumption of salt means


lower blood pressure
Within the span of a few weeks, most people
experience a reduction in blood pressure when
salt intake is reduced

Even people with blood pressure in


the normal range benefit from
sodium reduction; there appears to
be no threshold

Reductions in Salt Intake Can


Reduce
High Blood Pressure (continued)

Sodium intake affects

Blood pressure levels a meta-analysis1 of


trials indicates that a median reduction of
urinary sodium to 1800 mg would
Reduce

systolic/diastolic blood pressure by 5.02.7 mmHg in persons with hypertension


Reduce systolic/diastolic blood pressure by 2.01.0 mmHg in non-hypertensives

Incremental rise in blood pressure with age


Prevalence of hypertension across
populations

Reducing salt intake could save


tens of thousands of lives annually2

1. J Hum Hypertens. 2002; 16: 761-770.


2. PloS Med. 2009;6(4):e1000058., N Engl J Med. 2010;362:590-599.; Ann Intern Med. 2010;152:481-487

Estimated Effects of Sodium


Reduction on Hypertension
Prevalence and Related Costs
Reducing average population intake to
2300 mg per day (current recommended
maximum) may
Reduce cases of hypertension by 11 million
Save $18 billion in health care costs
Gain 312,000 Quality Adjusted Life Years
(QALYs)
Reducing average population intake even
lower to 1500 mg per day (recommended
maximum level for specific populations
described in the Dietary Guidelines for
Americans) may
American Journal
of Health Promotion.
2009;24:49-57.
cases
of hypertension by 16 million
Reduce
Save $26 billion in health care costs

Principal Winnable Battle


Initiatives
Improve dietary quality

Increase fruit and vegetable intake


Decrease intake of high-energy, lownutrient foods
Reduce consumption of sugar sweetened
drinks
Reduce sodium in the food supply
Eliminate industrially produced trans fat
from the food supply

Increase breastfeeding
Increase physical activity
Prevent micronutrient malnutrition
Enhance state and community
capacity to improve population-level

Priority Strategies to Address


Select Winnable Battle Initiatives
Energy density

Apply nutrition standards in child care and


schools
Increase number of healthy food retail
outlets in underserved areas and improve
access

Fruits and vegetables

Increase access through retail stores


Support Farm to Institution policies
Leverage food policy councils

Sugared drinks

Ensure access to safe and good-tasting


water
Reduce accessibility of sugared drinks in

Priority Strategies to Address


Select Winnable Battle Initiatives
Breastfeeding

Policy and environmental supports in


maternity care facilities
Policy and environmental supports in
worksites
State and national coalitions to support
breastfeeding

Physical activity

Joint use agreements for after-hours


access to school facilities
Increase access to parks and recreational
facilities
Increase opportunities for physical activity

Priority Strategies to Address


Select Winnable Battle Initiatives
Sodium reduction

Establish sodium reduction standards in


government facilities and educational
institutions

Promote innovative restaurant initiatives


to reduce sodium content of restaurant
meals

Increase availability of lower-sodium


processed and restaurant food products

Obesity continues to be a major public


health problem. We need intensive,
comprehensive and ongoing efforts to
address obesity. If we don't, more
people will get sick and die from
obesity-related conditions, such as
heart disease, stroke, type 2 diabetes
and certain types of cancer some of
the leading causes of death.
Thomas R. Frieden, MD, MPH
Director, Centers for Disease Control and Prevention,
Administrator, Agency for Toxic Substances and Disease
Registry

www.cdc.gov/winnablebattles

For more information please contact Centers for Disease Control


and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov
Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily
represent the official position of the Centers for Disease Control and Prevention.

U.S. Department of Health and Human Services


Centers for Disease Control and Prevention