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What Do Pregnancy Weight, Marketing, and Schools Have in Common?

What Do Pregnancy Weight, Marketing, and Schools Have in Common?. Linda D. Meyers, Ph.D., Director, Food and Nutrition Board Annual Meeting of The Association of State & Territorial Public Health Nutrition Directors (ASTPHND) and

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What Do Pregnancy Weight, Marketing, and Schools Have in Common?

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  1. What Do Pregnancy Weight, Marketing, and Schools Have in Common? Linda D. Meyers, Ph.D., Director, Food and Nutrition Board Annual Meeting of The Association of State & Territorial Public Health Nutrition Directors (ASTPHND) and The Association of Graduate Programs in Public Health Nutrition (AGPPHN) Portland, Maine -- June 2007

  2. Outline • Context for IOM reports • Updates on • Pregnancy Weight • Food Marketing • Nutrition Standards

  3. IOM At-a-Glance • Established in 1970 • Private, independent nonprofit • Part of the National Academies • 150+ staff • 1600 elected members • 40+ published reportsper year • Mission statement: “Advising the Nation. Improving Health.”

  4. The National Academies Organization

  5. The National Academies Institute of Medicine National Academy of Sciences National Academy of Engineering Honorific National Research Council Program IOM Programs DBASSE DELS DEPS TRB PGA

  6. IOM Boards Population Health andPublic Health Practice Rose Marie Martinez Director Health Sciences Policy Andrew M. Pope Director Health Care Services Michelle Orza Acting Director Global Health Patrick W. Kelley Director Food and Nutrition Linda D. Meyers Director Children, Youth, and Families Rosemary Chalk Director African Science Academy Development Patrick W. Kelley Director Health Policy Educational Programs and Fellowships Marie E. Michnich Program Director Military and Veterans Health Medical Follow-Up Agency Rick Erdtmann Director

  7. Activities • Committee Studies • Convening Activities, e.g., • Workshops • Forums • Fellowships

  8. 79% 2% 2% 17% Clarifications Paid staff and volunteer experts Not government No line appropriation from Congress About 80% of funding from federal agencies Federal Private (incld Foundations)

  9. Dennis M. Bier, MD(Chair) Baylor College of Medicine Michael Doyle, PhD(Vice-Chair) University of Georgia Diane Birt, PhD Iowa State University Yvonne Bronner, ScD Morgan State University Susan Ferenc, DVM, PhD SAF*Risk, Arlington, VA & Chemical Manufactures and Producers Assn. Nancy Krebs, MD, RD University of Colorado Health Sciences Center J. Glenn Morris, MD, MPH&TM University of Maryland School of Medicine Reynaldo Martorell, PhD Emory University Suzanne Murphy, PhD, RD University of Hawaii Jose Ordovas, PhD Tufts University Jim Riviere, DVM. PhD North Carolina State Nicholas Schork, PhD University of California, San Diego John Suttie, PhD University of Wisconsin Linda Meyers, Ph.D.(Director) Food and Nutrition Board

  10. Food and Nutrition Board • Diet, Nutrient and Health Relationships • Quality, Adequacy, and Safety of the Food Supply • International Food and Nutrition • Military Nutrition Research

  11. Dietary Reference Intakes www.nap.eduwww.iom.edu/fnb

  12. Development of Dietary Reference Intakes, 1994-2004: Lessons Learned and New Challenges Workshop • Taking Stock of Lessons Learned • Contracts with US and Canada Govts • Workshop September 18-20, 2007 • Workshop Development • Planning Committee (John Suttie, Chair) • White Papers (background) • Presenters and Discussants www.iom.edu/DRIworkshop2007

  13. Obesity Prevention in Children 2004-2007

  14. The Influence of Pregnancy Weight on Maternal and Child Health: Workshop Report Released: February 27, 2007 Committee on the Impact of Pregnancy Weight on Maternal and Child Health Sponsor: Health Resources and Services Administration, HHS

  15. Committee • Maxine Hayes, M.D., M.P.H. (Chair), State of Washington Department of Health, Olympai • Barbara Abrams, Dr.P.H.,School of Public Health, University of California, Berkeley • Ezra C. Davidson, Jr., M.D.,Department of Obstetrics & Gynecology, Charles R. Drew University of Medicine and Science, Los Angeles • Lillian Gelberg, M.D., M.S.P.H., Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles • Matthew Gillman, M.D., S.M., Department of Nutrition, Harvard Medical School and Harvard Pilgrim Health Care, Boston • Janet King, Ph.D.,Children's Hospital Oakland Research Institute, Oakland • Ronald E. Kleinman, M.D., Pediatric Gastroenterology, Massachusetts General Hospital, Boston • Gregg Pane, M.D., District of Columbia Department of Health, Washington, DC • Kathleen Rasmussen, D.Sc.,Division of Nutritional Sciences, Cornell University, Ithaca • Leslie Sim, Study Director

  16. Plan Workshop and Prepare Workshop Report that Examines and Explores… • Examine research • that describes the distribution of maternal weight (before, during, and after pregnancy) among different populations of women in the U.S. • on the effects of different weight patterns during pregnancy on maternal and child health outcomes • on individual, community, and health care system factors that impede or foster compliance with recommended gestational weight guidelines

  17. Examine research and…. • Explore opportunities • for Title V Maternal and Child Health Programs to help childbearing women achieve and maintain recommended weight (before, during, and after) pregnancy • to inform future research and data collection needs

  18. Key Messages • No National Surveillance System • Adequately monitor pregnancy weight gain • Identify appropriate indicators to monitor • Monitor before, during, and after pregnancy, & infant/child weight • Nationally representative • Racial/ethnic minorities, adolescents, immigrant

  19. Key Messages • Update 1990 IOM Recommendations • New, but limited research available on factors that contribute to pregnancy weight gain • Components of gestational weight gain • Biological and social determinants • Underweight and overweight • Explore appropriate indicators and health outcomes for weight gain guidelines • BMI, infant/child health, chronic health conditions, others • Guidance needed for specific populations of women • Racial/ethnic minorities, obese women, adolescents, women of short stature

  20. Key Messages • Achieve and Maintain Appropriate Weight Gain • --Limited studies on effective interventions for achieving and maintaining appropriate weight during and after pregnancy • --Prepregnancy interventions non-existent in literature • --Explore prepregnancy and post-partum weight patterns on gestational weight gain and maternal and child health outcomes • --Explore possible dissemination efforts that would be effective to women of child-bearing age • --Importance of weight before, during, and after pregnancy on their health and their child’s health

  21. Report Details • Accessible on the National Academies Press website to purchase, read, or download free of charge: http://books.nap.edu/catalog/11817.html • Next: Reexamination of IOM Pregnancy Weight Guidelines – Project Development

  22. Report Origin Congressional request to CDC 18-month study Review evidence for food and beverage marketing impact on diet and health of children and youth Consider marketing approaches to promote healthful diets

  23. J. Michael McGinnis(Chair), Institute of Medicine Daniel Anderson, University of Massachusetts, Amherst J. Howard Beales III, George Washington University David Britt, Sesame Workshop (retired) Sandra Calvert, Georgetown University Keith Darcy, Ethics Officer Association Aimee Dorr, University of California, Los Angeles Lloyd Kolbe, University of Indiana Dale Kunkel, University of Arizona Paul Kurnit, Kurnit Communications & KidShop Robert Post, Yale Law School Richard Scheines, Carnegie Mellon University Frances Seligson, Pennsylvania State University Mary Story, University of Minnesota, Minneapolis Ellen Wartella, University of California, Riverside Jerome Williams, University of Texas, Austin Co-study Directors: Jennifer Gootman and Vivica Kraak Committee

  24. Major Conclusions • Many factors influence the diets of children and youth • Strong evidence that marketing shapes their diets • Marketing is out of balance with healthful diets • Corrective initiatives must be both public and private • Industry commitment must be part of the solution • Current public policy needs to be strengthened

  25. Growth in New Food Products Targeted to U.S. Children and Youth 1994 to 2004 New products targeted to total market New products targeted to children & youth Source: Williams J. 2005b. Product Proliferation Analysis for New Food and Beverage Products Targeted to Children, 1994–2004. University of Texas at Austin Working Paper.

  26. 10 Recommendations • Food and Beverage Companies • Restaurant Chains • Trade Associations • Marketing Practice Standards • Media and Entertainment Industry • Parents, Caregivers Social Marketing • School Environment • Government and Public Policy • Research • Monitoring Progress

  27. Diets of children and youth do not meet recommendations Marketing is one of many influences on diets Prevailing food and beverage marketing practices not balanced with overall diet recommendations Industry can play a leadership role in bringing balance to food and beverage marketing Report recommends voluntary actions, to be followed by legislation if industry action is insufficient Summary

  28. Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth • Congressional mandate to CDC for an IOM study • ~ 18 month study • Released April 25, 2007

  29. Competitive Foods are Widely Available in Schools

  30. The Task Review and make recommendations regarding appropriate nutrition standards for the availability, sale, content, and consumption of foods and beverages at school, with attention given to foods and beverages offered in competition with federally-reimbursable meals and snacks

  31. Virginia A. Stallings (chair) Children’s Hospital of Philadelphia, PA Dennis M. Bier Baylor College of Medicine, TX Margie Tudor Bradford Bardstown Independent School District, KY Carlos A. Camargo, Jr. Massachusetts General Hospital Isobel R. Contento Columbia University, New York Thomas H. Cook Vanderbilt University, TN Eric A. Decker University of Massachusetts, Amherst Rosemary Dederichs Minneapolis Public School District, MN Jay T. Engeln National Association of Secondary School Principals, VA Barbara N. Fish West Virginia Board of Education Tracy A. Fox Food, Nutrition, and Policy Consultants, MD James C. Ohls Mathematica Policy Research Inc., NJ (ret.) Lynn Parker Food, Research, and Action Center, Washington, DC David L. Pelletier Cornell University, NY Mary T. Story University of Minnesota, Minneapolis FNB Staff Ann Yaktine, Study Director Alice Vorosmarti, Research Associate Heather Del Valle, Senior Program Assistant Committee on Nutrition Standards for Foods in Schools

  32. Approach • Gathered information- • Reviewed literature • Held workshops and public forums • Deliberated • Developed Guiding Principles • Developed 2 Tier Approach

  33. The Guiding Principles The committee recognizes that: 1. The present and future health and well-being of school-age children are profoundly affected by dietary intake and the maintenance of a healthy weight. 2. Schools contribute to current and life-long health and dietary patterns and are uniquely positioned to model and reinforce healthful eating behaviors in partnership with parents, teachers, and the broader community.

  34. 3. Because all foods and beverages available on the school campus represent significant caloric intake, they should be designed to meet nutritional standards. 4. Foods and beverages have health effects beyond those related to vitamins, minerals, and other known individual components.

  35. 5. Implementation of nutrition standards for foods and beverages offered in schools will likely require clear policies; technical and financial support; a monitoring, enforcement, and evaluation program; and new food and beverage products.

  36. The committee intends that:6. The federally reimbursable school nutrition programs will be the primary source of foods and beverages offered at school.7. All foods and beverages offered on the school campus will contribute to an overall healthful eating environment.8. Nutrition standards will be established for foods and beverages offered outside the federally reimbursable school nutrition programs.

  37. The recommended nutrition standards will bebased on the Dietary Guidelines for Americans, with consideration given to other relevant science-based resources. 10. The nutrition standards will apply to foodsand beverages offered to all school-age children (generally ages 4 through 18 yrs) with consideration given to the developmental differences between children in elementary, middle, and high schools.

  38. STANDARDS: Nutritive Food and Beverages • Fat: < 35/10 / 0 • Total sugars < 35% kcal • <200 kcal/portion • <200 mg sodium/portion

  39. STANDARDS: NonNutritive Food and Beverages • Nonnutritive sweetener in beverages in high school after school • Caffeine-free

  40. STANDARDS: All Students During the School Day • Tier 1 foods and beverages • Water available and free • Sport drink limited to student athletes with >1 hr vigorous activity via coach • Not for reward or punishment for behavior or academic achievement • Minimize marketing of Tier 2 foods and beverages

  41. STANDARDS: After-School Setting • Tier 1 for elementary and middle school • Tier 1 and 2 for high school

  42. Implementing the Recommended Standards The recommended nutrition standards are among several elements of a school policy that could significantly improve the nutritional quality of foods offered in schools. The committee identified the key elements for success in implementing the recommended standards and actions to achieve them.

  43. Key Elements for Success Awareness and understanding of the standards by schools, parents, students, and federal, state, and local as well as other private stakeholders.

  44. Action for Implementation • Policy making bodies providing: • Regulatory guidance • Designate responsibility • Performance guidelines • Technical and financial support • Federal agencies and food and beverage industry • Identification system for Tier 1 and Tier 2 • Whole grain and combination products guidance

  45. Concluding Remarks Federal school nutrition programs are the main source of nutrition provided at school. However, when opportunities for students to select competitive foods arise, they should be used to encourage greater consumption of fruits, vegetables, whole grains, and nonfat or low-fat dairy foods. The recommendations in this report ensure that competitive foods are consistent with the DGA and will help encourage students to develop healthful life-long eating patterns.

  46. For more information • Purchase report, read it online, or download free summary at www.nap.edu search on school foods • Download Report Brief at www.iom.edu/SchoolFoods2006

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