The Latin American Diet Pyramid: Serving the Latino Population?

Size: px
Start display at page:

Download "The Latin American Diet Pyramid: Serving the Latino Population?"

Transcription

1 Elena Blebea 12/22/09 HSOC Senior Thesis The Latin American Diet Pyramid: Serving the Latino Population? Abstract: Poor nutrition is a prominent health issue in the United States and has significantly contributed to the rising obesity epidemic. Various studies have shown that the prevalence of obesity is higher among Latinos as compared to non-latino Whites due to multiple factors such as low socioeconomic status and cultural differences in food beliefs and behavior. In 1996, the Oldways Preservation Trust created the Latin American Diet Pyramid, a food pyramid incorporating traditional Latino foods as well as a physical activity component, in an attempt to address these influential factors and thus improve Latino nutrition. This study proposes to evaluate the effectiveness of the pyramid as a nutritional tool and a dietary guideline for Latinos in the US. The study takes place in South Philadelphia and consists of focus groups, interviews, and a local grocery store NEMS-based survey. My hypothesis that the Latin American Diet pyramid is ineffective because it does not fully account for the socioeconomic and cultural structures in the US Latino population was only partially upheld. There were actually few socioeconomic barriers inhibiting the effectiveness of the Pyramid. However, there were some cultural and educational barriers which could perhaps best be addressed through revisions of the Pyramid, a nutrition class based on the Pyramid, and the establishment of market vendors such as the Italian Market in Latino communities. Introduction In April 2005, at the Latin American Diet Summit in Mexico City, Mission Foods announced a surprise donation of $100,000 to Oldways Preservation Trust for the foundation of the Latino Nutrition Coalition (LNC). 1 The much-needed coalition was promptly established that summer in order to realize the Summit goals of improving and maintaining the health of Latinos through traditional foods and active lifestyles. 2 The LNC began its work with the following mission statement: to provide the Latino community, and those that serve them, with easy-to-understand nutrition, cooking, shopping, and health information. 3 That a coalition such as the LNC was much-needed was not in question. Poor nutrition is a major health concern in the United States and has significantly contributed to a marked increase in obesity rates. This is especially alarming considering that obesity increases risk for hyptertension, dyslipidemia, type-2 diabetes, low glucose tolerance, and heart disease. 4 Various 1

2 studies have shown that the prevalence of obesity is higher among Latinos as compared to non- Hispanic Whites. 5 For example, the prevalence of obesity among Latino 6-11-year-olds is 39.3% as compared to 26.2% among their non-hispanic White counterparts. 6 This higher level of obesity has led to significant health outcome disparities with Latinos now almost twice as likely to develop diabetes as non-hispanic Whites of the same age. 7 Factors that influence this health disparity include acculturation, 8 the language barrier, 9 low socioeconomic status, 10 and cultural differences in food beliefs and behavior. 11 These Latino-specific factors confirm findings that Latino nutrition education cannot merely consist of translated materials originally developed for non-hispanic Whites. 12 The need for health literature designed particularly for Latinos only began to be recognized around 1990 and there is still a dearth of such material. Thus, although the Latino growth rate is over three times that of the total US population and Latinos are known to experience this health disparity, there is currently no standard tested nutritional guideline which can adequately address the needs of this growing population. 13 The LNC recognized this health situation and decided that, in order to successfully improve Latino health outcomes through easily understandable and practical nutrition information, it would utilize the Latin American Diet Pyramid. The Oldways Preservation Trust created this pyramid in 1996 in order to provide a healthy dietary recommendation and educational tool for Latinos which focuses specifically on traditional Latino food. 14 It has become the cornerstone of the LNC and been used as a basis for many LNC health initiatives. The pyramid has also received national attention and been incorporated in programs launched by prominent organizations such as the Mayo Clinic and the Harvard School of Public Health. 15 However, although its proposed diet is in accordance with current nutritional recommendations, the actual impact of the pyramid on the US Latino population has never been evaluated. 16 Thus, 2

3 I propose to analyze the effectiveness of the Latin American Diet Pyramid as an educational nutritional tool and a dietary guideline capable of promoting behavioral change in the US Latino population. This research will help to determine whether and how organizations such as the LNC should continue to promote the pyramid. On a larger scale, this research will provide insight into successful methods for addressing the obesity health disparity in the Latino population. As a double major in Health & Societies and Hispanic Studies, I am well-suited to conduct research on the Latin American Diet Pyramid and have experience and knowledge regarding health, nutrition, and Latino culture. Not only do I have access to the literary resources of my two major departments, but I also have the opportunity to work with Penn experts such as the following: Dr. Frances K. Barg at the Department of Family Practice and Community Medicine; Dr. Janet Chrzan, a nutritionist at the Department of Anthropology; Dr. Shiriki Kumanyika, a health disparities expert at the Department of Biostatistics and Epidemiology; Dr. Amy Hillier at the Department of Urban Studies; Dr. Seema Sonnad of the Department of Surgery at the Hospital of the University of Pennsylvania; and Dr. Steven Larson, one of the directors of Puentes de Salud, a free clinic for Latino immigrants in South Philadelphia and a doctor at the Department of Emergency Medicine. I have been working with Dr. Larson and volunteering at Puentes de Salud for the past two years. Thus, I am familiar with a Latino community in the US and have contacts in the area. I also have access to an unpublished nutritional survey of the South Philadelphia Latino population conducted in the summer of 2008 by Marc Rabner, a Puentes volunteer and a medical student at the University of Pennsylvania. I am fluent in Spanish and English and thus able to conduct interviews and focus groups in the preferred language of the research participants. State of Studies 3

4 The general scholarly literature regarding Latino nutritional health in the US has thus far focused on the aspects of the cultural and socioeconomic environment of Latinos which might cause health disparities and magnify obesity risk factors. The research primarily examines factors such as acculturation, legal status, insurance, the language barrier, lower socioeconomic status, a difference in food beliefs and behavior, and the Spanish-language media. Oldways attempted to account for many of these factors while constructing the Latin American Diet Pyramid in the tradition of the USDA food guides. However, the effectiveness of the pyramid remains unknown and must still be evaluated. A number of studies have examined the effects of acculturation, which is defined as those phenomena which result when groups of individuals having different cultures come into continuous first-hand contact, with subsequent changes in the original culture patterns of either or both groups. 17 It is unclear what effect US acculturation has on Latino dietary practices as various studies have found differing results. For example, Katarina M. Sussner and others conducted a study which found that a high level of acculturation in the US promotes obesity through a reduction of fruit and vegetable intake, a tendency of over-consumption of certain unhealthy foods, and decreased breastfeeding duration. 18 However, H. Balcazar found that groups with a low level of acculturation actually had a higher level of obesity. 19 The Viva la Familia Study, on the other hand, reported that acculturation did not, in fact, have any impact on weight gain in second-generation Latino children. 20 The obesity disparity among Latinos may also be due to a lack of or reduced access to medical care. The legal status of Latinos in the US and an inability to secure health insurance are two factors that can significantly influence the decision to seek needed health care. Illegal immigrants and their children born outside of the US are not eligible for state or federally 4

5 sponsored health insurance. Latinos are the most likely to be uninsured of all racial or ethnic groups. They comprise nearly 25% of the nation s uninsured people 21 as compared to African Americans, who represent 17% of the US uninsured. 22 It is important to note that these statistics are derived by reviewing only the legal population and thus the number of uninsured Latinos is actually much higher. 23 The lack of insurance and fear of deportation has contributed to decreased preventative care, a lack of regular care, and access to lower-quality care. 24 In fact, the Center for Disease Control found that Latinos are three times as likely as non-hispanic Whites to lack a regular health care provider. 25 The lack of a regular health care provider prevents access to nutritional education and probably decreases the likelihood of obesity detection and intervention. The language barrier has also been cited by many studies as a contributing factor to Latino nutrition disparities. In 1994, The American Public Health Association acknowledged that, because of the dearth of bilingual health practitioners and Spanish or multilingual health messages, the inability to speak English greatly undermines the ability of those of other cultures to receive health information, communicate with health providers, and identify available health services in their community for themselves and their children. This is a major barrier to the use of health care services by Latinos. 26 However, since the time of that report, bilingual services have become more widely available. Although the language barrier and different cultural concepts are still an issue in providing health care and health messages, they do not appear to be the central barrier to Latino access to care. 27 A study by the Pew Hispanic Center in Washington could help to explain why the language barrier can be overcome. The study found that although only 23% of the first- generation immigrants from Spanish-speaking countries said that they speak English very well, 88% of the members of the second generation described themselves as strong English speakers. 28 These 5

6 children have the capacity to act as translators for the first generation, although in a hospital setting this is technically prohibited. In addition, the language barrier may be less of an issue since the Office of Minority Health implemented the National Standards on Culturally and Linguistically Appropriate Services (CLAS) in March of 2001 which dictates that healthcare organizations must offer and provide language assistance at no cost to the patient. 29 Much of the literature has focused on the low socioeconomic status (SES) of the Latino population, which contributes to poor nutrition through producing food insecurity and reducing the availability of quality food. Food insecurity is a condition in which people lack sustainable physical or economic access to enough safe, nutritious, and socially acceptable food for a healthy and productive life. 30 Relative to non-latino Whites, Latinos in the United States have a lower SES profile. 31 Low SES increases the likelihood of food insecurity. For example, in three low income immigrant Latino Chicago communities, thirty percent of residents reported household food insufficiency caused by a lack of money or Food Stamps. 32 Not only are low SES people compromised in their purchasing power, but they may also be unable to find quality foods in their neighborhood. Many low SES neighborhoods are food deserts, areas in which there is little or no access to foods needed to maintain a healthy diet. For example, minority and lowincome communities have fewer than average supermarkets and convenience stores that stock fresh, high-quality, affordable foods such as whole grains or low-fat dairy products and lean meats. 33 One study found that areas with predominantly Latino communities had 38% less fresh fruit and vegetable retailers than areas with smaller Latino populations. 34 Philadelphia in particular has the second lowest amount of supermarkets per capita of major US cities. 35 Supermarkets not only increase access to food, but they also have been shown to improve diet 6

7 because each additional supermarket in a community increases fruit and vegetable intake by thirty-two percent. 36 Rather than supermarkets, there is a high concentration of fast food restaurants in many low-income neighborhoods. Although it is unclear whether a high density of fast food restaurants is an environmental risk factor for obesity, it has clearly been shown that eating fast food is associated with a higher BMI, reduced vegetable intake, reduced exercise, and a high fat diet. 37 Furthermore, income level affects fast food intake, probably because fast food is cheaper than food sold at non-fast food restaurants or even grocery stores. For example, in a California study of adolescents, approximately 47% of low-income teens reported eating fast food the previous day as compared to 37% of teens who were more affluent. 38 Latino children may have a high frequency of fast food dining. For example, in a 2008 study of Latino mothers and their children living in San Francisco, nearly two-thirds of the children ate fast food every week. 39 The bodega, a small food variety store, is another prominent provider of food in lowincome neighborhoods and has been linked to obesity. A study of the Latino population in Bushwick, Brooklyn revealed that Latino families often bought basic food necessities at local bodegas. However, the bodegas consisted of fewer choices, lower-quality food, and limited fruits and vegetables. Families who shopped there also tend to purchase high-fat, high-carbohydrate, processed foods such as ham, egg, and cheese sandwiches, chips, and soda. 40 A separate study in an inner-city Latino community reported that although low-fat milk was sold in two-thirds of the bodegas, in some of the stores it was more expensive than whole milk. 41 Another potential contributing factor to the obesity disparity is that perceptions about the traditional Latino ideal body weight is heavier than that of non-hispanic Whites. For example, one study of Latina mothers showed that most believed that a heavier infant was a healthier 7

8 infant. 42 An ethnographic study of a Puerto Rican community in Philadelphia showed that there are positive associations with obesity as well as a lack of social stigma regarding overweight people. 43 The Tarahumara of Northern Mexico traditionally believe that large, fat thighs are an essential component of beauty. In fact, an attractive woman is often called a beautiful thigh. 44 Although traditional cultural beliefs favor a heavier body image as compared to non-latino Whites, as the level of acculturation increases, these beliefs may conform more to the American norm which prizes thin body types. 45 This can be seen in a study which showed that secondgeneration Latina women feel more stress regarding weight than their first generation peers and tend to have a thinner ideal body image. 46 Cultural food behaviors may also lead to the obesity disparity among Latinos. In a 1995 study, it was shown that Mexican-American mothers regulated their child s food intake more than Anglo mothers did. This increased involvement in their child s diet was associated with a higher skin-fold ratio, indicating a higher level of obesity, perhaps because their children were then unable to regulate their own diets. 47 Latino parents were also more indulgent than African- American parents, meaning that they were more likely to grant most of their children s food requests. This indulgence is associated with higher Body Mass Index measurements, possibly because children do not learn how to carefully choose healthy foods or are given more unhealthy foods and/or calories than children of less indulgent parents. 48 The Spanish-language media can contribute to obesity and poor nutritional habits through advertisements. Latino children spend significantly more time watching TV and movies and playing video games than do White children. 49 During after-school hours on Spanish-language television, 31% of food/drink commercials advertised fast food, and 27% advertised drinks, of which 54% were sugared. Only 16% of the food/drink commercials contained health-related 8

9 messages. 50 These advertisements can affect purchase selection, especially because consumers in low-income households are more likely to heavily consider television commercials when shopping. 51 Research has only recently begun to focus on designing effective methods to improve Latino nutrition through accounting for at least some of the aforementioned factors of acculturation, legal status, insurance, the language barrier, a lower SES, heavier ideal body image, food behavior, and the Spanish-language media. Oldways and its Scientific Committee attempted to consider all of the above when creating the Latin American Diet Pyramid food guide. Food guides have an extensive history as a critical component of US nutritional policy. The essential objective of food guides is to translate dietary standards and recommendations into simple nutrition education tools that are useful for consumers. 52 Arguably, the most wellknown food guides in America have been published by the United States Department of Agriculture (USDA), which was established in 1862 with the mission to acquire and diffuse among the people of the United States useful information on human nutrition as well as to oversee and promote US agriculture. Unfortunately, these two components of the mission statement have the potential for dissonance if the USDA promotes an American food product which may be unhealthy when consumed in large quantities. 53 Thus, from the inception of food guides, nutrition experts have maintained skepticism regarding the political influences which may affect the recommended diet. The first food guide, entitled Food for Young Children, was published in 1916 by the USDA. 54 During the Great Depression, the USDA published the first buying guides, which specified how many servings of each food should be consumed per week and how to select foods economically. 55 The USDA created additional food guides during World 9

10 War II such as the Basic Seven, 56 describing the seven basic food groups, and later the Basic Four, a revised version of the Basic Seven. Finally, in 1992, the USDA released the first Food Guide Pyramid. Since its creation, the USDA Food Guide Pyramid has become an American dietary icon. The pyramid was meant to function as an easily comprehensible pictorial representation of the Dietary Guidelines for Americans, which are reviewed and updated every five years by national nutrition experts. 57 In testing multiple potential graphic representations such as bowls, picnic designs, and pie charts, consumer research showed that pyramid shape was the most effective in communicating the primary dietary messages. 58 The pyramid originally included six food categories with the bread, cereal, rice and pasta group as the base with a recommended 6-11 servings, and fats, oils, and sweets as the top with a caution to use sparingly. 59 Among the many initial goals of the pyramid were the following: a focus on overall health rather than diets to prevent and/or treat specific diseases; a basis in recent authoritative dietary standards and food consumption data; and usefulness to consumers. 60 It was also intended to be most useful when used as a complement to population-wide nutrition education campaigns or individualized nutrition counseling rather than as a stand-alone teaching device. 61 Although the pyramid was revised in 2005 to become the MyPyramid.gov pyramid, which maintains the six basic categories albeit 10

11 with different formatting, it still reflects the key concepts of variety, moderation, and proportionality. 62 The exact impact and effectiveness of the Food Guide Pyramid and subsequent MyPyramid.gov have been somewhat unclear. One of the well-cited positive aspects of the pyramid is its widespread recognition. In the 1997 American Dietetic Association Nutrition Trends Survey, two thirds of consumer respondents recognized the pyramid. 63 In a more recent 2000 Gallup survey for the Wheat Foods Council, 75% of consumers stated that they were either somewhat or very familiar with the pyramid. 64 Although many Americans have been exposed to the Pyramid, there have been few studies to evaluate how increased familiarity with the Pyramid actually affects diet. The majority of Americans do not adhere to the recommended diet. In the Healthy Eating Index, only 16% of the population ate a good diet, whereas the diets of 74% needed improvement. 65 Food group Recommended range of servings Average number of servings consumed per day, 2-day average US Department of Agriculture Food Surveys Research Group. Available at: odsurvey/fsrgfaq.html#pyramid. Grains 6 to Vegetables 3 to Fruits 2 to Dairy 2 to Meat (oz) 5 to A potential factor contributing to this lack of adherence could be that the pyramid has often been regarded as a stand-alone nutrition education document, contrary to the original conceptions of the USDA. Another potential factor could be that the pyramid was designed for adults with at least a high school education, whose eating patterns were typical of the general US population, and for whom food cost was not an overwhelming concern. 66 Thus, many nutrition experts felt 11

12 that the pyramid would not be nearly as relevant, and thus effective, for minority groups with different eating patterns. For example, Liz Mintz, the director of the Latino Nutrition Coalition, noted the inadequacy of USDA Food Pyramid for Latinos and stated, Many times, Latin American people see the [USDA] pyramid and they say, What do I do with this? 67 Mintz s informal analysis was confirmed in a study conducted by the School of Public Health of the University of California at Berkeley which found that the USDA Mypyramid.gov has no culturally tailored messages that would make the pyramid easily comprehensible and usable for minorities such as Latinos. 68 At the 1996 Latin American Diet Summit in El Paso, Texas, the lack of relevance to Latin American nutrition in the USDA Food Guide Pyramid design was of great concern. 69 The conference was part of a multiyear conference series, "Public Health Implications of Traditional Diets," organized by the Harvard School of Public Health and sponsored by Oldways Preservation Trust. The Oldways Preservation Trust was founded by K. Dun Gifford in 1990 as a non-profit food issue think tank based in Boston. For the summit, Oldways formed a Scientific Committee comprised of nutritionists, scientists, and food experts. At the time, Latino health was already a pressing issue as the US Latino population was rapidly expanding. According to the Census of 1996, Latinos, along with Asians, were expected to represent more than half of US population growth every year for the subsequent 50 years and were projected to become the largest minority of color by Nutrition for the general US population was a growing issue due to the rising incidence of obesity; however, the obesity disparity in the Latino population was particularly alarming. This disparity, which was clearly caused by Latino-specific factors 12

13 such as low socioeconomic status and different food beliefs and practices, illustrated the need for culturally relevant nutrition education materials. Also, nutrition experts at the summit believed that a major factor influencing the disparity was that Latinos were replacing traditional healthy foods with unhealthier, processed foods popular in the US. 71 The Oldways Scientific Committee decided to address the need for culturally appropriate nutrition materials for Latinos as well as the need to return to traditional healthy diet patterns by creating the Latin American Diet Pyramid. 72 The Latin American Diet Pyramid represents a compilation of the USDA food guide tradition, Oldways tradition, and Latino nutrition research. The Latin American Diet Pyramid was formatted in the pyramid shape established by the USDA Food Guide Pyramid. The process of constructing the Pyramid was based on the procedure which Oldways used when developing Original Latin American Diet Pyraid LatinAmericanDietPyramid.htm the Mediterranean Diet Pyramid in This process consisted of having certain members of the Oldways Scientific Committee evaluate data on food consumption in Latin American countries as well as Pan American Health Organization (PAHO) health profiles of Latin American countries to formulate a healthy diet pyramid. Although a list the members of the original Oldways Scientific Committee has not been published, through interviews with members of the Committee which revised the Pyramid in 2005, it seems that the original committee consisted of nutrition experts and academics such as Hannia Campos, Dr. Hector Bourges, and K. Dun Gifford. 74 According to K. 13

14 Dun Gifford, the president and founder of Oldways, Committee members compared available quality food consumption statistics with the PAHO country health profiles to develop a profile of people, what they eat, and how it relates to public health statistics. 75 They then worked with chefs and used the diets which seemed to promote the healthiest populations to form the Latin American Diet Pyramid and provide relative serving size proportions and a general sense of serving frequency. 76 The Scientific Committee was also sure to maintain a focus on traditional foods. According to the Latino Nutrition Coalition, the pyramid s use of traditional Latino foods was based upon two historical periods in Latin American history which are associated with good health. The first is the period of the Aztecs, Mayas, and Incas. The second begins with the arrival of Columbus and continues to the present. 77 According to K. Dun Gifford, the Pyramid was originally meant to be used by public health agencies, physicians, dietitians, and families. 78 Since 1996, Oldways and its Scientific committee have added a few minimal revisions to the pyramid such as the following: changing the cartoon format to one consisting of food photographs; altering the beverage recommendations from stating alcohol in moderation and six glasses of water a day to stay hydrated, drink a variety of beverages; and adding specific portion amounts such as 5-7 portions per day. 79 The creation of the Latin American Diet Pyramid has many positive attributes. The Pyramid ostensibly has filled the gap for a culturally tailored dietary guideline for Latinos by attractively demonstrating how popular traditional Latino foods can be healthfully consumed. It also is a visual guide following the tradition of food pyramids so allegedly many people in the US have already had exposure to that type of nutrition information. The Pyramid is also research-based and was created by experts from a variety of professions including Latino chefs and nutritionists. 14

15 Although the creation process of the Pyramid has several positive aspects, it also has some negative facets. From the information provided on the Oldways and Latino Nutrition Coalition websites as well as interviews with available members of the Oldways Scientific Committee, 1 it seems that the research to construct the pyramid may have been poorly conducted. First, relating health and food consumption patterns does not control for potentially significant confounding variables such as country GDP, locally grown foods, and socioeconomic disparities within the country. Thus, it is impossible to exactly define the relationship between Revised Latin American Diet Pyramid -LatinAmericanDietPyramid.htm health profiles and consumption patterns. Second, data were only used from countries that were considered to have quality data. None of the sources explained how quality was defined or which specific countries were examined. It is possible that the Committee only utilized data from a couple of countries and thus the Pyramid is not actually representative of Latin American diets. For example, many traditional and frequently-consumed Honduran foods such as passion fruit and zapote are not included. As Simopoulos and Painter have stated, to be effective, food guides must incorporate the unique dietary components of specific populations and perhaps this Pyramid does not actually look at the unique components of all of the populations which it claims to review. 80 Third, it is unclear how many people were actually involved in developing the Pyramid. The Oldways website claims that Oldways and the Scientific Committee developed the Pyramid, however Oldways is a small organization only 1 Six out of the nine members were interviewed. Three of them (Hector Bourges and Miriam and Adolfo Chavez) are deceased, according to K. Dun Gifford 15

16 consisting of five core people. 81 Furthermore, of the nine people on the Committee, six were interviewed and only three (Hannia Campos, K. Dun Gifford, and John Foreyt) confirmed that they were actually involved in creating the Pyramid. Those three people mentioned differing timelines for creating the Pyramid. K. Dun Gifford stated that the Pyramid creation process took two or more years, 82 Ms. Campos stated that the Pyramid took about six months 83 to create, and Mr. John Foreyt said that the creation of the Pyramid occurred only during the Latin American Diet Summit which lasted for a few days. This could indicate that a few people were much more involved in the creation process than others so the process was less of a collaboration and thus potentially less valid. Finally, there has been absolutely no follow-up research on the Latin American Diet Pyramid and only one review in 2005 to see if revisions were needed. 84 Another negative aspect of the Pyramid is that it could include some Western notions which may render it ineffective for the Latino community. It was created based on the USDA Food Guide Pyramid. The USDA pyramid form has been rejected in a few Latin American Countries such as Mexico, which uses a plate form that was thought to be more comprehensible. 85 Also, the Pyramid itself has included a picture of a milk carton which says Milk instead of leche, clearly not adapted to Spanish-speakers. The Latin American Diet Pyramid was created following a long tradition of food guides in the US at a time when Latino health was a growing concern. Although the Pyramid has several positive attributes, it also has some negative characteristics. Since its creation, the Latin American Diet Pyramid has been cited in articles in national media outlets, such as MSNBC 86 and USAToday, 87 and utilized in multiple nutritional campaigns for Latinos. However it is unclear whether the pyramid actually does overcome many of the structural socioeconomic and cultural barriers which contribute to the Latino obesity disparity. Because it has never been 16

17 critically evaluated, its effectiveness is unknown and it is unclear how the Latino population interprets and uses the Pyramid. As Ms. Hannia Campos stated, What would be interesting would be to see what people actually say about the pyramid itself. Usually research and scientists are far away because we try to teach people something, but they see something totally different. 88 This thesis is exactly the research which Hannia Campos has suggested. In this study, I evaluated the impact of the Latin American Diet Pyramid on Latinos in the US both as an educational nutritional tool and a dietary guideline which can inspire behavioral change. The research was conducted with Latino adults living in South Philadelphia. Adults were the target population because the first and arguably more widely used Latin American Diet Pyramid was created specifically for adults and a Latino Children s Diet Pyramid was only constructed in South Philadelphia was chosen for its large Latino population and my connections to the community. The area of South Philadelphia is defined as the section bounded by South Street to the north, the Delaware River to the east and south, and the Schuylkill River to the west. 90 The effectiveness of the pyramid will be defined by evaluating both educative and behavioral influence through assessing the following criteria: knowledge of the existence of the pyramid, ability to access the pyramid, ability to understand the message of the pyramid, ability to use the pyramid as a dietary guideline, and the potential to inspire a healthy diet change. The ability to use the pyramid as a dietary guideline includes the capacity to purchase and prepare the recommended food. Thus, my research question is: Is the Latin American Diet Pyramid effective? I hypothesize that the Latin American Diet Pyramid will prove ineffective as a nutritional tool and dietary guideline for Latinos in the US as it does not fully account for the socioeconomic and cultural structures in Latino communities such as the inability to purchase the 17

18 food due to low income, food deserts, and the variety of dietary practices throughout Latin America. The research that I use to test my hypothesis is comprised of pilot data using focus groups, face-to-face interviews, and grocery store surveys based on the Nutrition Environment Measures Surveys (NEMS) created by Dr. Karen Glanz. Methodology Pilot Data I used a focus group to develop and refine individual survey questions. The focus group research subjects were recruited from an English as a Second Language (ESL) Course taught by Ms. Victoria Behrend, a graduate student at the University of Pennsylvania. The class was chosen because class participants were adult residents of South Philadelphia who self-identified as Latino. The focus group was held after the ESL class at approximately 11 AM on May 6, 2009 at the Annunciation B.V.M Church, the site of the ESL class, in South Philadelphia. The group consisted of six adult participants, three women and three men. I conducted the group in Spanish because the participants were all native Spanish-speakers who would probably feel most comfortable and able to express their sentiments in their native language. Jonathan Rivera, a bilingual senior at the University of Pennsylvania and a volunteer at Puentes de Salud, assisted me by taking notes during the session. The meeting was audio recorded to ensure accuracy of data collection. Questions for the focus group were designed to determine which factors might influence the effectiveness of the pyramid. After signing an informed consent form approved by the University of Pennsylvania Internal Review Board [Appendix A], the focus group members completed a short form regarding the following socio-demographic parameters: age, selfidentification of race, residential zip code, educational level, marital status, number of children, 18

19 date of immigration to US, weight, height, family health issues with obesity, and country of origin [Appendix B]. I requested this information in order to determine eligibility for the study, obtain socio-demographic information considered to be standard for Latino obesity studies, and evaluate which factors might affect the usefulness of the pyramid. Following these forms, questions were posed to the focus group [Appendix C]. These questions were informed by feedback from the following experts from the University of Pennsylvania: Frances K. Barg (Department of Family Practice and Community Medicine), Amy Hillier (City and Regional Planning School of Design), Shiriki Kumanyika (Department of Biostatistics and Epidemiology), Janet Chrzan (Department of Anthropology), Steven Larson (Department of Emergency Medicine), and Seema Sonnad (Department of Surgery). The questions also integrated information from literature searches, thus enhancing content validity. Jean Knight, a Hispanic Studies professor at the University of Pennsylvania, ensured that the questions were equivalent in English and Spanish. The Institutional Review Board of the University of Pennsylvania also reviewed them to verify accurate translation. At the completion of the meeting, I gave each participant a free copy of Camino Mágico, a Latino Nutrition Coalition bilingual supermarket shopping guide translated into both English and Spanish which gives nutrition advice based on the Latin American Diet Pyramid. The focus groups also included light snacks and beverages using the foods in the Latin American Diet Pyramid. These snacks followed the focus group session so as not to influence answers regarding the preparation of food. Both Camino Mágico and the refreshments were funded by the Louis H. Castor Undergraduate Research Award. The nutrition literature 19

20 and food were meant to act as an incentive which would encourage focus group attendance without exerting undue influence. Although the participants were already acquainted with each other due to the ESL class, I made every effort to ensure confidentiality outside of the session. Every participant signed a confidentiality agreement and I explained that nothing discussed should leave the room. The data have been kept in a locked drawer and during analysis names were coded using pseudonyms and no identifiers were used. Jonathan Rivera also signed a statement agreeing to protect the security and confidentiality of identifiable information. After the study is completed, all identifying data will be permanently erased. Face-to-Face Interviews The second part of the study consisted of face-to-face interviews in order to ask more formalized quantifiable questions suggested by the focus group results. A face-to-face interview was chosen instead of a survey because of the low literacy rate among Latinos in the US. 91 Interview subjects (n=64) were recruited from June 4, 2009 to October 1, 2009 from multiple sites and events in order to ensure adequate representation. These sites included the following places: Puentes de Salud waiting room, Juntos meetings, the Latina Womens Health Services waiting room, the Mexican Independence Day Fair, the South Philadelphia WIC office waiting room, and all Mexican shops on 9 th street between South and Wharton Street in South Philadelphia. Upon going to these venues, I invited people to complete the brief minute interview. Each person signed an IRB-approved consent form [Appendix D]. All interviews except one were conducted in Spanish because that was the preferred language of participants. The structured interview consisted of a series of questions [Appendix E] separately approved by the 20

Selection and Preparation of Foods Management of the Food Budget*

Selection and Preparation of Foods Management of the Food Budget* Selection and Preparation of Foods Management of the Food Budget* Healthy meals on a limited budget! How can you serve healthy meals on a limited budget? It takes some time and planning, but you and your

More information

The relationship between socioeconomic status and healthy behaviors: A mediational analysis. Jenn Risch Ashley Papoy.

The relationship between socioeconomic status and healthy behaviors: A mediational analysis. Jenn Risch Ashley Papoy. Running head: SOCIOECONOMIC STATUS AND HEALTHY BEHAVIORS The relationship between socioeconomic status and healthy behaviors: A mediational analysis Jenn Risch Ashley Papoy Hanover College Prior research

More information

Food and Beverage Marketing to Children. July 1, 2015

Food and Beverage Marketing to Children. July 1, 2015 Food and Beverage Marketing to Children July 1, 2015 2 Objectives and Method Methodology Composition and Recruitment A total of eight in-person focus groups were conducted: four with White moms, two with

More information

Oklahoma county. Community Health Status Assessment

Oklahoma county. Community Health Status Assessment Oklahoma county Wellness Score 2014 Community Health Status Assessment Mental and Social Health Overall Mental Health score The World Health Organization defines mental health as a state of well-being

More information

DIABETES & HEALTHY EATING

DIABETES & HEALTHY EATING DIABETES & HEALTHY EATING Food gives you the energy you need for healthy living. Your body changes most of the food you eat into a sugar called glucose. (glucose) Insulin helps your cells get the sugar

More information

Fad Diets vs Healthy Weight Management: A Guide for Teens

Fad Diets vs Healthy Weight Management: A Guide for Teens Center for Young Women s Health www.youngwomenshealth.org Fad Diets vs Healthy Weight Management: A Guide for Teens Fad diets are marketed as quick ways to lose weight. The most popular fads tend to change

More information

Maintaining Nutrition as We Age

Maintaining Nutrition as We Age SS-207-06 For more information, visit the Ohio Department of Aging web site at: http://www.goldenbuckeye.com and Ohio State University Extension s Aging in Ohio web site at: http://www.hec.ohio-state.edu/famlife/aging

More information

Boston Public Health Commission Healthy Food Procurement Guidelines. Standards for Purchased Beverages and Foods

Boston Public Health Commission Healthy Food Procurement Guidelines. Standards for Purchased Beverages and Foods Boston Public Health Commission Healthy Food Procurement Guidelines Standards for Purchased Beverages and Foods Boston Public Health Commission Healthy Food Procurement Guidelines Standards for Purchased

More information

Talmudical Academy Wellness Policies on Physical Activity and Nutrition

Talmudical Academy Wellness Policies on Physical Activity and Nutrition Talmudical Academy Wellness Policies on Physical Activity and Nutrition Preamble Whereas, children need access to healthful foods and opportunities to be physically active in order to grow, learn, and

More information

Introduction to WIC. Objectives

Introduction to WIC. Objectives Objectives Introduction to WIC After completing this lesson, you will be able to: Describe the participants served by WIC. Describe how WIC improves the health of participants. Identify the history and

More information

Case Study: U.S. Department of Defense Initiatives

Case Study: U.S. Department of Defense Initiatives Case Study: U.S. Department of Defense Initiatives June 2012 Case Study: U.S. Department of Defense Initiatives 1 Following the end of World War II, President Truman worried about the impact of poor nutrition

More information

OBESITY: Health Crisis in Orange County

OBESITY: Health Crisis in Orange County OBESITY: Health Crisis in Orange County Orange County Health Needs Assessment Poor Diet + No Exercise = FAT Why are so many children and adults getting fat? While it is true that several factors have contributed

More information

Income is the most common measure

Income is the most common measure Income Goal A healthy standard of living for all Income is the most common measure of socioeconomic status, and a strong predictor of the health of an individual or community. When assessing the health

More information

The U.S. House Committee on Education and Labor Hearing Improving Children s Health: Strengthening Federal Child Nutrition Programs

The U.S. House Committee on Education and Labor Hearing Improving Children s Health: Strengthening Federal Child Nutrition Programs The U.S. House Committee on Education and Labor Hearing Improving Children s Health: Strengthening Federal Child Nutrition Programs Carolyn Morrison President, National CACFP Forum Executive Director Child

More information

County of Santa Clara Public Health Department

County of Santa Clara Public Health Department County of Santa Clara Public Health Department PH05 042710. DATE: April 27, 2010 Prepared by:. Colleen Martin Health Care Program Manager TO: Board of Supervisors FROM: Dan Peddycord, RN, MPA/HA Public

More information

The eatwell plate is based on the Government s Eight Tips for Eating Well, which are:

The eatwell plate is based on the Government s Eight Tips for Eating Well, which are: Teachers Notes The eatwell plate The eatwell plate is a pictorial food guide showing the proportion and types of foods that are needed to make up a healthy, varied and balanced diet. The plate has been

More information

STATEMENT OF POLICY. Healthy Food Access

STATEMENT OF POLICY. Healthy Food Access 13-04 STATEMENT OF POLICY Healthy Food Access Policy Many residents of urban and rural areas lack access to healthy foods within their communities. Inadequate healthy food sources have perpetuated chronic

More information

A GUIDE TO HELP PLAN, PURCHASE & PREPARE YOUR OWN HEALTHY FOOD. FOOD SENSE HEALTHY MEALS ON A BUDGET

A GUIDE TO HELP PLAN, PURCHASE & PREPARE YOUR OWN HEALTHY FOOD. FOOD SENSE HEALTHY MEALS ON A BUDGET A GUIDE TO HELP PLAN, PURCHASE & PREPARE YOUR OWN HEALTHY FOOD. FOOD SENSE HEALTHY MEALS ON A BUDGET You ll be surprised at how affordable, delicious & convenient your own meals can be! the Great Plate:

More information

Nutrition Education Competencies Aligned with the California Health Education Content Standards

Nutrition Education Competencies Aligned with the California Health Education Content Standards Nutrition Education Competencies Aligned with the California Health Education Content Standards Center for Nutrition in Schools Department of Nutrition University of California, Davis Project funded by

More information

Prepared by: Michael R. Cousineau, Dr.PH Gregory D. Stevens. Ph.D. With assistance from Jessica Van Gurt. USC Division of Community Health

Prepared by: Michael R. Cousineau, Dr.PH Gregory D. Stevens. Ph.D. With assistance from Jessica Van Gurt. USC Division of Community Health Disparities in Health in the United States A conceptual framework for a multi-disciplinary approach to understanding health disparities and proposing policy solutions towards their elimination First Draft

More information

A Study of Adolescent Nutrition Amanda J. Degner and Samantha L. Klockow

A Study of Adolescent Nutrition Amanda J. Degner and Samantha L. Klockow A Study of Adolescent Nutrition Amanda J. Degner and Samantha L. Klockow Abstract This descriptive study involved 60 adolescent participants (30 males and 30 females) ranging in age from 14 to 18 years

More information

A Province-Wide Life-Course Database on Child Development and Health

A Province-Wide Life-Course Database on Child Development and Health Patterns of health and disease are largely a consequence of how we learn, live and work A Province-Wide Life-Course Database on Child Development and Health Summary of Results April 2007 Principal Investigator

More information

2012 Executive Summary

2012 Executive Summary The International Food Information Council Foundation s 2012 Food & Health Survey takes an extensive look at what Americans are doing regarding their eating and health habits and food safety practices.

More information

Access to Healthy Food for Young Children Act

Access to Healthy Food for Young Children Act Access to Healthy Food for Young Children Act Summary Reduce the Child and Adult Care Food Program (CACFP) area eligibility test from 50 percent to 40 percent eligible to streamline access to healthy meals

More information

Family Medicine Philanthropic Consortium Grant Awards SAMPLE APPLICATION: PUBLIC HEALTH

Family Medicine Philanthropic Consortium Grant Awards SAMPLE APPLICATION: PUBLIC HEALTH To download the FMPC Grant Awards Application go to www.aafpfoundation.org/fmpc, then click on FMPC Grant Awards Program. ANSWERS FROM A TOP-SCORING 2013 FMPC APPLICATION Answers are taken directly from

More information

NE LESSON CODE NR-000-13 Fad Diets

NE LESSON CODE NR-000-13 Fad Diets NE LESSON CODE NR-000-13 Fad Diets OBJECTIVES Participants will be able to recognize a fad diet from brief descriptions. Participants will be able to list two red flags of fad diets. Participants will

More information

UNDERSTANDING MILLENNIAL EATING BEHAVIOR MARCIA GREENBLUM MS, RD SENIOR DIRECTOR, HEALTH AND WELLNESS

UNDERSTANDING MILLENNIAL EATING BEHAVIOR MARCIA GREENBLUM MS, RD SENIOR DIRECTOR, HEALTH AND WELLNESS UNDERSTANDING MILLENNIAL EATING BEHAVIOR MARCIA GREENBLUM MS, RD SENIOR DIRECTOR, HEALTH AND WELLNESS WHY ADDRESS EATING BEHAVIOR IN THE FIRST PLACE? Rise of obesity: The Millennial generation has poor

More information

Making Healthy Food Choices. Section 2: Module 5

Making Healthy Food Choices. Section 2: Module 5 Making Healthy Food Choices Section 2: Module 5 1 Nutrition For Health What is healthy Tips on planning meals Making a shopping list/ Bulk orders Using WIC foods Cook and freeze What foods to choose How

More information

CITY OF EAST PALO ALTO A COMMUNITY HEALTH PROFILE

CITY OF EAST PALO ALTO A COMMUNITY HEALTH PROFILE CITY OF EAST PALO ALTO A COMMUNITY HEALTH PROFILE www.gethealthysmc.org Contact us: 650-573-2398 hpp@smcgov.org HEALTH BEGINS WHERE PEOPLE LIVE Over the last century, there have been dramatic increases

More information

Grocery Shopping Within a Budget

Grocery Shopping Within a Budget Grocery Shopping Within a Budget Lesson Plan Grade Level 10-12 Take Charge of Your Finances National Content Standards Family and Consumer Science Standards: 1.1.6, 2.1.1, 2.1.2, 2.1.3, 2.5.1, 2.6.1, 2.6.2,

More information

NEW BEGINNINGS SCHOOL FOUNDATION SCHOOL WELLNESS POLICY

NEW BEGINNINGS SCHOOL FOUNDATION SCHOOL WELLNESS POLICY Purpose: New Beginnings School Foundation wellness policy was developed to fulfill the school s commitment to the health of its students, as well as to comply with the federal Child Nutrition Reauthorization

More information

Helping Shoppers Overcome the Barriers to Choosing Healthful Foods

Helping Shoppers Overcome the Barriers to Choosing Healthful Foods Helping Shoppers Overcome the Barriers to Choosing Healthful Foods Table of Contents Introduction...3 Are We Meeting Shopper Needs?...4 Providing Guidance in the Store...6 Eating Healthy or Not?...7 Minding

More information

Obesity in the United States: Public Perceptions

Obesity in the United States: Public Perceptions The Associated Press-NORC Center for Public Affairs Research Research Highlights Obesity in the United States: Public Perceptions T. Tompson, J. Benz, J. Agiesta, K.H. Brewer, L. Bye, R. Reimer, D. Junius

More information

Section C. Diet, Food Production, and Public Health

Section C. Diet, Food Production, and Public Health This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Section I: Summary. Section II: Statement of Purpose

Section I: Summary. Section II: Statement of Purpose Cherokee Choices Diabetes Prevention Program for Native American Cherokee Indians (USA-Government) http://www.cherokee-hmd.org/cherokee-choices/index.html Section I: Summary Cherokee Choices is a community-based

More information

GET TO KNOW COOKING MATTERS AT OPERATION FOOD SEARCH

GET TO KNOW COOKING MATTERS AT OPERATION FOOD SEARCH GET TO KNOW COOKING MATTERS AT OPERATION FOOD SEARCH WHAT IS COOKING MATTERS? Cooking Matters is a program of the No Kid Hungry Campaign. Today, one in five children in the United States doesn t have the

More information

When counseling women with gestational diabetes mellitus about postpartum issues, consider the following strategies:

When counseling women with gestational diabetes mellitus about postpartum issues, consider the following strategies: After Delivery Note to the Health Care Provider: Topics in this handout are discussed in Chapter 10 of the American Dietetic Association Guide to Gestational Diabetes Mellitus (1). When counseling women

More information

Save Time and Money at the Grocery Store

Save Time and Money at the Grocery Store Save Time and Money at the Grocery Store Plan a Grocery List Making a list helps you recall items you need and also saves you time. Organize your list according to the layout of the grocery store. For

More information

Healthy Food for All. Submission on Budget 2014 to the Minister for Social Protection

Healthy Food for All. Submission on Budget 2014 to the Minister for Social Protection Healthy Food for All Submission on Budget 2014 to the Minister for Social Protection Theme: Improve food and nutrition consumption for children and families in poverty 1. Enhance low-income household s

More information

Demographic Analysis of the Salt River Pima-Maricopa Indian Community Using 2010 Census and 2010 American Community Survey Estimates

Demographic Analysis of the Salt River Pima-Maricopa Indian Community Using 2010 Census and 2010 American Community Survey Estimates Demographic Analysis of the Salt River Pima-Maricopa Indian Community Using 2010 Census and 2010 American Community Survey Estimates Completed for: Grants & Contract Office The Salt River Pima-Maricopa

More information

Background (cont) World Health Organisation (WHO) and IDF predict that this number will increase to more than 1,3 million in the next 25 years.

Background (cont) World Health Organisation (WHO) and IDF predict that this number will increase to more than 1,3 million in the next 25 years. Diabetes Overview Background What is diabetes Non-modifiable risk factors Modifiable risk factors Common symptoms of diabetes Early diagnosis and management of diabetes Non-medical management of diabetes

More information

The affordability of healthy eating for low-income households

The affordability of healthy eating for low-income households Policy Briefing October 2009 The affordability of healthy eating for low-income households Introduction Healthy Food for All is an all-island multiagency initiative which seeks to combat food poverty by

More information

Inspired Teaching Demonstration PCS Local Wellness Policy SY 2015 2018

Inspired Teaching Demonstration PCS Local Wellness Policy SY 2015 2018 Background The U.S. Congress established a requirement in the Child Nutrition and Women, Infants and Children (WIC) Reauthorization Act of 2004, that all school districts with a federally funded school

More information

The Basics of Nutrition: Understanding Nutrition Facts, Servings Sizes, & Adequate Portions

The Basics of Nutrition: Understanding Nutrition Facts, Servings Sizes, & Adequate Portions The Basics of Nutrition: Understanding Nutrition Facts, Servings Sizes, & Adequate Portions K AT I E L. H O W E H E A LT H E D U C AT O R D I V I S I O N O F S T U D E N T A F FA I R S U S C U P S TAT

More information

Help Your Child Grow Up Healthy and Strong

Help Your Child Grow Up Healthy and Strong Help Your Child Grow Up Healthy and Strong Department of Health and Human Services Department of Agriculture Department of Education Body Mass Index: A Useful Tool Body Mass Index, or bmi, is used to assess

More information

HEALTHY TRENTON: COMMUNITY SURVEY

HEALTHY TRENTON: COMMUNITY SURVEY *Priority Key H = High M= Medium L = Low HEALTHY TRENTON: COMMUNITY SURVEY Child Care Food and Activity 1. Provide regular opportunities for physical activity and play 2. Adopt a comprehensive food policy

More information

Presentation Prepared By: Jessica Rivers, BASc., PTS

Presentation Prepared By: Jessica Rivers, BASc., PTS Presentation Prepared By: Jessica Rivers, BASc., PTS Presentation Outline Why should we care about our eating habits? Why is nutrition so important as we age? How do we know if we are eating healthy? What

More information

Diabetes Prevention in Latinos

Diabetes Prevention in Latinos Diabetes Prevention in Latinos Matthew O Brien, MD, MSc Assistant Professor of Medicine and Public Health Northwestern Feinberg School of Medicine Institute for Public Health and Medicine October 17, 2013

More information

Healthy Eating at Farmers Markets The Impact of Nutrition Incentive Programs

Healthy Eating at Farmers Markets The Impact of Nutrition Incentive Programs Healthy Eating at Farmers Markets The Impact of Nutrition Incentive Programs Program Partners Forest Grove Farmers Market Hillsboro Farmers Market Hollywood Farmers Market Lents International Farmers Market

More information

Eating Well with Diabetes. Cassie Vanderwall UW Health Nutrition Registered Dietitian Certified Personal Trainer Certified Diabetes Educator

Eating Well with Diabetes. Cassie Vanderwall UW Health Nutrition Registered Dietitian Certified Personal Trainer Certified Diabetes Educator Eating Well with Diabetes Cassie Vanderwall UW Health Nutrition Registered Dietitian Certified Personal Trainer Certified Diabetes Educator Outline What is Diabetes? Diabetes Self-Management Eating Well

More information

RE: Food Industry Marketing to Children and Adolescents Study: Paperwork Comment; Project No. P094511

RE: Food Industry Marketing to Children and Adolescents Study: Paperwork Comment; Project No. P094511 Donald S. Clark Federal Trade Commission Office of the Secretary Room H-1345 600 Pennsylvania Ave NW Washington DC 20580 RE: Food Industry Marketing to Children and Adolescents Study: Paperwork Comment;

More information

Global Advertising Specialties Impressions Study

Global Advertising Specialties Impressions Study Global Advertising Specialties Impressions Study A cost analysis of promotional products versus other advertising media Released at the 2010 ASI Power Summit This report may be reproduced and used in presentations

More information

Ready, Set, Start Counting!

Ready, Set, Start Counting! Ready, Set, Start Counting! Carbohydrate Counting a Tool to Help Manage Your Blood Glucose When you have diabetes, keeping your blood glucose in a healthy range will help you feel your best today and in

More information

Carbohydrate Counting. Who chooses what you eat every day? Setting The Stage. Pre-Test. Pre-Test. Eating for Diabetes Made Easier

Carbohydrate Counting. Who chooses what you eat every day? Setting The Stage. Pre-Test. Pre-Test. Eating for Diabetes Made Easier Carbohydrate Counting Eating for Diabetes Made Easier Kris Williams, MS RD Department of Health Education Kaiser Permanente, Kern County Setting The Stage Who chooses what you eat every day? Pre-Test.

More information

Local School Wellness Policy Goals for Student Health: Nutrition promotion/food marketing

Local School Wellness Policy Goals for Student Health: Nutrition promotion/food marketing Local School Wellness Policy Goals for Student Health: Nutrition promotion/food marketing Definition School based promotion/marketing of positive nutrition behaviors and foods using marketing techniques

More information

School Nutrition Policy Background

School Nutrition Policy Background School Nutrition Policy Background Overview: From what s offered in lunch lines to what s stocked in vending machines, schools are in a powerful position to influence children s lifelong dietary habits.

More information

Grocery Shopping Within a Budget Grade Level 10-12

Grocery Shopping Within a Budget Grade Level 10-12 1.8.2 Grocery Shopping Within a Budget Grade Level 10-12 Take Charge of Your Finances Materials provided by: Heide Mankin, Billings Senior High School, Billings, Montana Janice Denson, Twin Bridges High

More information

Eat Well, Live Well Lesson 9: The Lowdown on Cholesterol

Eat Well, Live Well Lesson 9: The Lowdown on Cholesterol Getting Started 1. Review lesson plan before each session 2. Copy handouts. 3. Gather supplies Eat Well, Live Well Lesson 9: The Lowdown on Cholesterol Supplies Needed 1. Handouts 2. Supplies for activity:

More information

MATERNAL AND CHILD HEALTH BRIEF #2:

MATERNAL AND CHILD HEALTH BRIEF #2: MATERNAL AND CHILD HEALTH BRIEF #2: OBESITY AMONG CHILDREN AND ADOLESCENTS SEPTEMBER 2012 OBESITY DEFINED Obesity and overweight are typically measured OVERVIEW in terms of Body Mass Index or BMI. BMI

More information

Georgia. Georgia uses step-by-step social marketing process. assistance can come with

Georgia. Georgia uses step-by-step social marketing process. assistance can come with Georgia Georgia uses step-by-step social marketing process Background Overview. The Georgia Division of Public Health worked closely with the Fulton County Health Department in Atlanta to develop a nutrition

More information

Poverty. Worth County Estimates. Poverty Status of Individuals. Families at Selected Ratios of Income to Poverty Level

Poverty. Worth County Estimates. Poverty Status of Individuals. Families at Selected Ratios of Income to Poverty Level Poverty And Food Needs, Iowa Poverty and food insecurity impact the welfare of individuals, families, and communities. This profile describes indicators of poverty, food insecurity, and other measures

More information

Chapter 5 DASH Your Way to Weight Loss

Chapter 5 DASH Your Way to Weight Loss Chapter 5 DASH Your Way to Weight Loss The DASH diet makes it easy to lose weight. A healthy diet, one that is based on fruits, vegetables, and other key DASH foods, will help you have satisfying meals,

More information

Make a Difference at Your School!

Make a Difference at Your School! Make a Difference at Your School! CDC Resources Can Help You Implement Strategies to Prevent Obesity Among Children and Adolescents U.S. Department of Health and Human Services Centers for Disease Control

More information

Are Food Prices the Answer to The Obesity Problem?

Are Food Prices the Answer to The Obesity Problem? Are Food Prices the Answer to The Obesity Problem? Laurian Unnevehr Director, Food Economics Division, USDA/ERS Presentation at the Farm and Food Policy and Obesity Workshop UC Davis, May 21, 2010 Overview

More information

Policy Forum. Racial and Ethnic Health Disparities in Illinois: Are There Any Solutions?

Policy Forum. Racial and Ethnic Health Disparities in Illinois: Are There Any Solutions? Policy Forum I N S T I T U T E O F G O V E R N M E N T&P U B L I C A F F A I R S I N S T I T U T E O F G O V E R N M E N T&P U B L I C A F F A I R S Racial and Ethnic Health Disparities in Illinois: Are

More information

Do children with diabetes need a special diet?

Do children with diabetes need a special diet? Do children with diabetes need a special diet? No! The basic nutritional needs of a child or adolescent with diabetes is the same as their peers Healthy eating is important for all children Children with

More information

Canada s Organic Market National Highlights, 2013

Canada s Organic Market National Highlights, 2013 Canada s Organic Market National Highlights, 2013 IN LATE 2012, THE CANADA ORGANIC TRADE ASSOCIATION LAUNCHED THE ORGANIC MARKET RESEARCH PROGRAM, THE MOST COMPREHENSIVE STUDY OF CANADA S ORGANIC MARKETPLACE

More information

Proposal for Supplemental Nutrition Assistance Program Nutrition Education (SNAP-Ed) in Menominee and Shawano Counties during Fiscal Year 2014

Proposal for Supplemental Nutrition Assistance Program Nutrition Education (SNAP-Ed) in Menominee and Shawano Counties during Fiscal Year 2014 Proposal for Supplemental Nutrition Assistance Program Nutrition Education (SNAP-Ed) in Menominee and Shawano Counties during Fiscal Year 2014 Overview of Supplemental Nutrition Assistance Program Nutrition

More information

ASSESSING THE PHILADELPHIA NUTRITION ENVIRONMENT: IN-STORE MARKETING AND NEMS

ASSESSING THE PHILADELPHIA NUTRITION ENVIRONMENT: IN-STORE MARKETING AND NEMS ASSESSING THE PHILADELPHIA NUTRITION ENVIRONMENT: IN-STORE MARKETING AND NEMS 1 Alison Leung and Gabriela Abrishamian-Garcia Mentor: Karen Glanz, PhD., MPH. OUTLINE Overview of nutrition environments In-Store

More information

Dr. Paul Naughton, Teagasc Dr. Sinéad McCarthy, Teagasc Dr. Mary McCarthy, UCC

Dr. Paul Naughton, Teagasc Dr. Sinéad McCarthy, Teagasc Dr. Mary McCarthy, UCC Healthy s and healthy living: An examination of the relationship between attitudes, food choices and lifestyle behaviours in a representative sample of Irish adults Dr. Paul Naughton, Teagasc Dr. Sinéad

More information

All students in grades K-12 will have opportunities, support, and encouragement to be physically active on a regular basis.

All students in grades K-12 will have opportunities, support, and encouragement to be physically active on a regular basis. EFA. DISTRICT WELLNESS PROGRAM Introduction Childhood obesity has become a national epidemic. Obesity rates have doubled in children and adolescents over the last two decades (NIH Word on Health, June

More information

FOSTERING COMMUNITY BENEFITS. How Food Access Nonprofits and Hospitals Can Work Together to Promote Wellness

FOSTERING COMMUNITY BENEFITS. How Food Access Nonprofits and Hospitals Can Work Together to Promote Wellness FOSTERING COMMUNITY BENEFITS How Food Access Nonprofits and Hospitals Can Work Together to Promote Wellness 2 fostering community benefits INTRODUCTION: NONPROFIT HOSPITALS AND THE AFFORDABLE CARE ACT

More information

Cornerstones of Care DIET/HEALTHY ACTIVITIES WELLNESS PLAN

Cornerstones of Care DIET/HEALTHY ACTIVITIES WELLNESS PLAN Cornerstones of Care DIET/HEALTHY ACTIVITIES WELLNESS PLAN Committee Members: 05-17-2016 Director of Health services integration Cheryl Carson MS RD LD Nutritional Health Services: Personnel Manager, Administrative

More information

Health and Social Services Needs in Whitman County. 2015 Community Needs Assessment Results General Report COMMUNITY REPORT OF RESULTS

Health and Social Services Needs in Whitman County. 2015 Community Needs Assessment Results General Report COMMUNITY REPORT OF RESULTS COMMUNITY REPORT OF RESULTS This report contains an overview of the results collected by the Health and Social Services Needs in Whitman County Survey. A description of Whitman County, the survey process,

More information

HEALTHY RECOMMENDATIONS AND PORTION CONTROL FACTSHEET

HEALTHY RECOMMENDATIONS AND PORTION CONTROL FACTSHEET HEALTHY RECOMMENDATIONS AND PORTION CONTROL FACTSHEET Dining Services Portion control can be a major obstacle, especially for college students with on-campus meal plans. As you can see on the table below,

More information

Welcome and Introductions

Welcome and Introductions Clinical Research, Inclusion, and You A Scientific Forum, was the signature event for National Women s Health Week at NIH activities and the annual ORWH scientific seminar. The scientific forum explored

More information

The Center for Rural Studies 207 Morrill Hall University of Vermont Prepared by: Kate E. Howe, Amy S. Hoskins, Jane M. Kolodinsky, Ph.D.

The Center for Rural Studies 207 Morrill Hall University of Vermont Prepared by: Kate E. Howe, Amy S. Hoskins, Jane M. Kolodinsky, Ph.D. Vermonter Poll 2004 The Center for Rural Studies 207 Morrill Hall University of Vermont Prepared by: Kate E. Howe, Amy S. Hoskins, Jane M. Kolodinsky, Ph.D. Introduction The word obesity, commonly understood

More information

Healthy eating for toddlers

Healthy eating for toddlers Healthy eating for toddlers Toddlerhood is a time where children learn about new foods and where life long eating habits are often established. To help children grow up to be healthy adults, it is important

More information

DOWN SYNDROME PROGRAM www.massgeneral.org/downsyndrome. Living a Healthier Lifestyle

DOWN SYNDROME PROGRAM www.massgeneral.org/downsyndrome. Living a Healthier Lifestyle DOWN SYNDROME PROGRAM www.massgeneral.org/downsyndrome Living a Healthier Lifestyle DOWN SYNDROME PROGRAM www.massgeneral.org/downsyndrome Living a healthier lifestyle has many benefits, which means it

More information

Maximizing Nutrition at Minimal Cost

Maximizing Nutrition at Minimal Cost Maximizing Nutrition at Minimal Cost Outline: Get down to the nutrition basics Identify health issues at hand Understand the challenges & barriers Practical application & solutions Rate Your Plate What

More information

The National Survey of Children s Health 2011-2012 The Child

The National Survey of Children s Health 2011-2012 The Child The National Survey of Children s 11-12 The Child The National Survey of Children s measures children s health status, their health care, and their activities in and outside of school. Taken together,

More information

Pediatrics. Specialty Courses for Medical Assistants

Pediatrics. Specialty Courses for Medical Assistants Pediatrics Specialty Courses for Medical Assistants 7007 College Boulevard, Suite 385 Overland Park, Kansas 66211 www.ncctinc.com t: 800.875.4404 f: 913.498.1243 Pediatrics Specialty Certificate Course

More information

HEALTHY FAMILY HOME, HEALTHY OUT OF SCHOOL

HEALTHY FAMILY HOME, HEALTHY OUT OF SCHOOL HEALTHY FAMILY HOME, HEALTHY OUT OF SCHOOL YMCA of Greater Providence October 23, 2015 FOR YOUTH DEVELOPMENT FOR HEALTHY LIVING FOR SOCIAL RESPONSIBILITY HEALTHY FAMILY HOME: Educating Families and Providing

More information

MAUMEE CITY SCHOOL DISTRICT 8510/page 1 of 6 WELLNESS

MAUMEE CITY SCHOOL DISTRICT 8510/page 1 of 6 WELLNESS MAUMEE CITY SCHOOL DISTRICT 8510/page 1 of 6 WELLNESS As required by law, the Board of Education establishes the following wellness policy for the Maumee City School District. The Board recognizes that

More information

Soft Drinks and School-Age Children:

Soft Drinks and School-Age Children: Soft Drinks and School-Age Children: Trends in Soft Drink Consumption Soft Drink Contribution to Diets of Adolescents 6 According to the USDA, the per capita soft-drink consumption has increased almost

More information

Chapter III Health Care Service Use and Health Insurance

Chapter III Health Care Service Use and Health Insurance Chapter III Health Care Service Use and Health Insurance Where social services are concerned, the United States is split mainly along ethnic and racial lines. Unequal access to health care services in

More information

2010 SURVEY OF 18+ REGISTERED VOTERS IN WASHINGTON ABOUT STATE SERVICES AND THE STATE BUDGET SURVEY-IN-BRIEF

2010 SURVEY OF 18+ REGISTERED VOTERS IN WASHINGTON ABOUT STATE SERVICES AND THE STATE BUDGET SURVEY-IN-BRIEF 2010 SURVEY OF 18+ REGISTERED VOTERS IN WASHINGTON ABOUT STATE SERVICES AND THE STATE BUDGET AARP s Washington State Office commissioned this survey to explore the views of its 18+ registered voters about

More information

Nutrition for Family Living

Nutrition for Family Living Susan Nitzke, Nutrition Specialist; susan.nitzke@ces.uwex.edu Sherry Tanumihardjo, Nutrition Specialist; sherry.tan@ces.uwex.edu Amy Rettammel, Outreach Specialist; arettamm@facstaff.wisc.edu Betsy Kelley,

More information

Transforming Health Care: American Attitudes On Shared Stewardship

Transforming Health Care: American Attitudes On Shared Stewardship Transforming Health Care: American Attitudes On Shared Stewardship An Aspen Institute- Survey Submitted by zogby international may 2008 2008 Report Overview A new Aspen Institute/Zogby interactive survey

More information

Meet Richard Saitz, M.D., MPH

Meet Richard Saitz, M.D., MPH Meet Richard Saitz, M.D., MPH Richard Saitz, M.D., MPH, is a professor of medicine and epidemiology at Boston University, and also primary care physician and director of the Clinical Addiction Research

More information

Participant Guide Adopt a healthy lifestyle: prevent or better manage type 2 diabetes

Participant Guide Adopt a healthy lifestyle: prevent or better manage type 2 diabetes HealthSelectSM Lose and Win Session 13 of Texas Pre-diabetes & type II diabetes Participant Guide Adopt a healthy lifestyle: prevent or better manage type 2 diabetes Chances are that you know someone that

More information

New Jersey School Nutrition Policy Questions and Answers

New Jersey School Nutrition Policy Questions and Answers New Jersey School Nutrition Policy Questions and Answers FOR ALL GRADE LEVELS: Items that are prohibited to be served, sold or given out as free promotion anywhere on school property at anytime before

More information

Homework Help Heart Disease & Stroke

Homework Help Heart Disease & Stroke Preventing Heart Disease & Stroke What causes heart disease and stroke? high blood pressure high cholesterol diabetes smoking stress drinking too much alcohol not being physically active being overweight

More information

http://www.cdc.gov/nchs.

http://www.cdc.gov/nchs. As the Nation s principal health statistics agency, the National Center for Health Statistics (NCHS) compiles statistical information to guide actions and policies to improve the health of the population.

More information

I. Research Proposal. 1. Background

I. Research Proposal. 1. Background Sample CFDR Research Proposal I. Research Proposal 1. Background Diabetes has been described as the the perfect epidemic afflicting an estimated 104 million people worldwide (1). By 2010, this figure is

More information

Frozen Prepared Meals

Frozen Prepared Meals Frozen Prepared Meals Under Utilized Weapon in the War Against Obesity Institute of Medicine Food Forum November 2, 2010 Dr. Al Bolles EVP, Research, Quality, and Innovation ConAgra Foods Frozen Prepared

More information

BEST & WORST FOODS FOR BELLY FAT

BEST & WORST FOODS FOR BELLY FAT Belly fat is worse for you than fat elsewhere on your body. Excess accumulation of belly fat is more dangerous than excess fat around your hips and thighs. Belly fat is associated with serious health problems,

More information

Talking to Your Child About Weight. When, Why, & How To Have This Important Conversation

Talking to Your Child About Weight. When, Why, & How To Have This Important Conversation Talking to Your Child About Weight When, Why, & How To Have This Important Conversation Introduction As is also the case with adults, the topic of weight can be an extremely sensitive issue children, adolescents,

More information

Global advertising specialties impressions study

Global advertising specialties impressions study Global advertising specialties impressions study Melinda Ligos, Andy Cohen and Larry Basinait piece together a cost analysis of promotional products versus other advertising media 38 / www.cgasa.com www.cgasa.com

More information

Standard of Healthy Living on the Island of Ireland Summary Report

Standard of Healthy Living on the Island of Ireland Summary Report Standard of Healthy Living on the Island of Ireland Summary Report Summary Report: Standard of Healthy Living on the Island of Ireland Summary Report based on Research by: Dr Sharon Friel 1,2, Ms Janas

More information