Transcript The Policy and Public Health Importance of ICAD

National Guidelines for Diet
and Physical Activity:
International Implications
Richard P. Troiano, Ph.D.
Second Forum on NCD Prevention and Healthy
Lifestyles Promotion
«For Healthy Life»
Presentation Overview
1. Background of diet and physical activity
guidelines in US
2. Guidelines development process
3. International application and harmonization
4. Benefits of national guidelines
Dietary Guidelines for Americans
• First released in 1980
– Required by legislation to be reviewed and updated
every 5 years
– Review and recommendations by group of scientific
experts
• Joint effort of the U.S. Department of Health and
Human Services (HHS) and the U.S.
Department of Agriculture (USDA)
• Provide the basis for federal food and nutrition
policy and education initiatives
Physical Activity Guidelines
• Not required by legislation
• Recommendations by professional groups since
1970s
– American Heart Association, American College of
Sports Medicine
– Focused on exercise for fitness and risks of exercise
• Focus shifted to a public health model in 1990s
1996
2008 PHYSICAL ACTIVITY
GUIDELINES FOR AMERICANS
Objective
•
Comprehensive, evidence-based physical activity
guidelines
– Cardiorespiratory
– Strength
– Balance
•
•
Harmonize various recommendations
Address subpopulations
– Older adults, persons with disabilities
PA Guidelines Development Process
Processes
Systematic Evidence Review
PA Guidelines Advisory Committee
PA Guidelines Writing Group
Products
Searchable Data Base
(now public access)
650+ Page Report
summarizing the science
2008 Physical Activity
Guidelines For Americans
Communications Workgroup
Launch “Team” (Public/Private)
Dissemination plan,
materials for public,
materials for partners,
logo & key messages
4 Key Adult Guidelines
•
•
Avoid inactivity
•
More health benefits from high amounts of aerobic
activity
•
Muscle-strengthening activities provide additional
health benefits
Substantial health benefits from medium amounts
of aerobic activity
International Harmonization
2010
www.who.int/dietphysicalactivity
National Guidelines Informed by US Report
•Austria
•UK
•Ireland
•Canada
UKK Institute - Finland
IMPACT OF HAVING
GUIDELINES
Meeting Physical Activity Recommendations
50
Proportion of the Population (%)
45
40
Men
35
Women
30
25
20
15
10
5
0
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Year
Data from Behavioral Risk Factor Surveillance System
Healthfulness of the US Food Supply
Krebs-Smith, Reedy, Bosire 2010, Am J Epid
Toward a Comprehensive,
Public Health Approach
•
Individual
– Personal goal setting
•
Interpersonal
– Social support, encouragement
“Healthy
choice should be the easy choice.”
• Organizational
•
•
– Worksite health promotion
Community
– Access to parks and recreational facilities
Public policy
– Policies that promote active transportation
16
From Guidelines to Action
Multi-Sector Approach
• The National Physical Activity Plan includes
recommendations that are organized in eight societal
sectors:
–
–
–
–
–
–
–
–
Business and Industry
Education
Health Care
Mass Media
Parks, Recreation, Fitness and Sports
Public Health
Transportation, Land Use, and Community Design
Volunteer and Non-Profit
www.globalpa.org.uk
HEPA Europe – European network for the
promotion of health-enhancing physical activity
• Brings together different
institutions and organizations from
all over Europe
• Collaborates closely with
WHO/Europe
• Facilitates multi-sectoral
approaches
• Advocacy and exchange of
information
• Promotes and disseminates
innovative HEPA strategies,
programmes, approaches and
good practice
• Promotes and engages in
research
www.euro.who.int/hepa
Midcourse Report
21
Role of Physical Activity Guidelines
• Justify expenditure of public funds for promotion
and programming
– Science to establish legitimacy among other public
health interventions
• Define benefits to be expected by various
population groups and the necessary dose of
activity
• Unified message and behavior targets
– Consistent metrics for short- & long-term evaluation
• Support economic arguments in terms of health
care cost savings as well as moral justification
based on equity and human rights
Key Messages
• Provision of information alone, even
scientifically-based physical activity guidelines,
is not sufficient to bring about behavior change.
• Physical activity guidelines are necessary, but
not sufficient, to increase levels of healthenhancing physical activity.
• Action at multiple levels is needed to support
health-enhancing physical activity.
Thank you
Questions?