1. 2015 nm objectives increase awareness on proper nutrition and physical activity to prevent...

2015 NM Objectives

Increase awareness on proper nutrition and physical activity to prevent obesity

Encourage action to attain normal weight

Manage the obesogenic environment

Outline

• What is overweight and obesity? Assessment Status Causes and consequences

• Current efforts• Recommendations

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Overweight and Obesity

Abnormal or excessive fat accumulation

than energy out= weight gain

When energy “in” is greater

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Measures of overweight and obesity

• Weight-for-age• Body Mass Index• Waist circumference• Waist-hip ratio

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Weight-for-age

For children 0-5 years old

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Body Mass Index (BMI)

For older children (61 months and above) and adults

BMI = weight in kilograms height in meters2

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BMI Classification Disease risk<18.5 Chronically Energy

Deficient

18.5-24.9 Normal Normal25.0-29.9 Overweight Increased30.0-34.9 Obese Grade I High35.0-39.9 Obese Grade II Very high≥40.0 Obese Grade III Very high

Source: WHO

BMI Classification

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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

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Waist Circumference (WC)

You have higher risk of developing noncommunicable diseases if your waist circumference is:

Equal or more than 88 cm for womenEqual or more than 102 cm for men

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• 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

Waist-Hip Ratio (WHR)

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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 womenEqual or more than 1.0 for men

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Trend of overweight and obesity in the Philippines

Prevelance of overweight and obese among children and adolescents by region, 2013

Region O-5 years 5.08 -10 years 10.08-19 years

Source: 8th National Nutrition Survey, DOST-FNRI.

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Prevalence of overweight and obese adults by place of residence and wealth index, 2013


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Trend in high waist circumference among adults, 20 years and older, 1998-2013


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Trend in high waist hip ratio among adults, 20 years and older, 1998-2013


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Physical inactivity

Overweight&

Obesity

Unhealthy diet

Child undernutrition

Poor breastfeeding practices

ENVIRONMENT

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Source: Philippine Nutrition Facts and Figures 2008, FNRI-DOST.

Distribution of adults 20 years and older, by physical activity level, 2008

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Comparison in low physical activity among adults 20 years and older, by domain, 2003-2008

Source: Philippine Nutrition Facts and Figures 2008, FNRI-DOST.

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Physical activity among adolescents

Source: WHO Global School-based Student Health Survey – Philippines

• 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

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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

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Per capita food consumption pattern of Filipinos, 1978-2013

Food groupConsumption (gram), raw as purchased

1978 1982 1987 1993 2003 2008 2013Cereals 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

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• 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

Changing dietary patterns

Source: Pedro, et.al.

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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

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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

Consequences of obesity

http://www.hkjpaed.org/details.asp?id=43&show=1234

Current efforts to address overweight and obesity

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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

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National Policy on NCDsDOH Administrative Order 2011-003

“National Policy on Strengthening the Prevention and Control of Chronic Lifestyle-related NCDs”• Addresses the four shared risk factors of

NCDs – smoking, unhealthy diet, physical inactivity, consumption of alcohol

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DOH-Healthy lifestyle promotion

a. Pilipinas Go 4 Health b. Recognition system

through “Outstanding Healthy Lifestyle Advocacy Awards”

c. Belly Gud for Health

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Promote Good Nutrition Program - NNC

• Nutrition counseling and education• Exclusive breastfeeding and appropriate

complementary feeding• Nutritional Guidelines for Filipinos

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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

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Nutrition labelling

DOH AO 2014-0030 requires mandatory labelling of all processed food products

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Nutrition labelling

FDA Circular 2012-015 – voluntary front-of-pack panel labelling of caloric content of processed foods

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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

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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

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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

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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

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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

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Obesity prevention interventionsamong 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

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Recommended actions to prevent overweight and obesity

Individual/Family1. Eat a variety of foods everyday - more of

vegetables and fruits, legumes and other fiber-rich foods

2. Prepare food at home more often3. Exclusively breastfeed newborns up to six (6)

months, then give appropriate complementary foods while continuing breastfeeding

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Individual/Family4. 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.

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Community leaders1. 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.

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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.

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School administrators1. 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.

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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.

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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”

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Food industry

1. Self-regulate marketing of foods and non-alcoholic beverages to children.

2. Reformulate food products to reduce saturated fats, sodium and sugars.

3. Comply with nutrition labelling guidelines issued by FDA.

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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

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National government agencies3. Strictly enforce the Milk Code, RA 10028 and

implement policies that promote, protect and support appropriate infant and young child feeding practices.

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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.

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Legislators1. Enact legislation to regulate the marketing of

foods and non-alcoholic beverages to children.

2. Enact legislation to increase taxes on sugar-sweetened beverages.

3. Develop policies on rural and urban planning and transport to create facilities that support physical activity.

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

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For more details:

National Nutrition Council2332 Chino Roces Ave Extension, Taguig City

http://www.nnc.gov.phwww.facebook.com/nncofficialwww.twitter.com/NNC_Official

www.youtube.com/user/[email protected]

Tel. (02) 843-0142 Fax. 816-4239

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Regional NM plansRegion Activities

1 Nutrition Forum; Biggest Loser Challenge; Nutri-outreach

2 Launching, 10 Kumainments and Pinggang Pinoy school caravan, Nutrikalesa painting contest, simultaneous vegetable planting and hataw activity, various contests, media exposure

CAR Launcing/Kapihan, Walk for Nutrition, media exposure

3 Seminar on “State of the Art of Obesity Research in the Philippines; various contests

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NCR “BNS Hataw na” Dancercise event; Advocacy Forum on Child Obesity; Photo-essay and poster making contests

4B Launching; Stakeholders’ Forum and Regional NAOs Conference; Regional Nutrition Awarding Ceremony

56 Dance exercise with school faculty, children, and

LGUs; Recognition of 40 longest serving BNSs

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7 Weight Management Counselling in schools and Healthy Lifestyle Promotion and Health Management Booths in malls, media exposures

8 Launching, walkathon, BMI assessment, NGO forum, BNS Day

9 Promotion of local healthy food recipes; “Thirst Quencher Master Chef" contest focusing on the benefits of healthy drinks

10 Launching, forum on prevention of overweight and obesity, joint Hi5 & NM Nutrifair in Camiguin, school/university activities, media exposures, culmination activity

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11 Zumba contest, nutrition counseling, 10 Kumainments and Pinggang Pinoy exhibits, press conference; media exposures

12 Launching, Fat Run and Zumba, health and 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

1. 2015 nm objectives increase awareness on proper nutrition and physical activity to prevent...

Documents

greater slide

obesogenic environment

normal weight

weight gain

body mass index bmi

measures of overweight

older children

proper nutrition