National Guidelines for Diet and Physical Activity: International Implications

1. National Guidelines for Diet and Physical Activity: International Implications Richard P. Troiano, Ph.D. Second Forum on NCD Prevention and Healthy Lifestyles Promotion «For Healthy Life»

2. Presentation Overview • Background of diet and physical activity guidelines in US • Guidelines development process • International application and harmonization • Benefits of national guidelines

3. Dietary Guidelines for Americans • First released in 1980 • Required by legislation to be reviewed and updated every 5 years • Review and recommendations by group of scientific experts • Joint effort of the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) • Provide the basis for federal food and nutrition policy and education initiatives

4. Physical Activity Guidelines • Not required by legislation • Recommendations by professional groups since 1970s • American Heart Association, American College of Sports Medicine • Focused on exercise for fitness and risks of exercise • Focus shifted to a public health model in 1990s

5. 1996

6. 2008 physical Activity Guidelines for Americans

7. Objective Comprehensive, evidence-based physical activity guidelines Cardiorespiratory Strength Balance Harmonize various recommendations Address subpopulations Older adults, persons with disabilities

8. PA Guidelines Development Process Processes Products Systematic Evidence Review Searchable Data Base (now public access) PA Guidelines Advisory Committee 650+ Page Report summarizing the science PA Guidelines Writing Group 2008 Physical Activity Guidelines For Americans Communications Workgroup Dissemination plan, materials for public, materials for partners, logo & key messages Launch “Team” (Public/Private)

9. 4 Key Adult Guidelines • Avoid inactivity • Substantial health benefits from medium amounts of aerobic activity • More health benefits from high amounts of aerobic activity • Muscle-strengthening activities provide additional health benefits

10. International Harmonization 2010 www.who.int/dietphysicalactivity

11. National Guidelines Informed by US Report • Austria • UK • Ireland • Canada

12. UKK Institute - Finland

13. Impact of having guidelines

14. Meeting Physical Activity Recommendations

15. Healthfulness of the US Food Supply Krebs-Smith, Reedy, Bosire 2010, Am J Epid

16. Toward a Comprehensive,Public Health Approach • Individual • Personal goal setting • Interpersonal • Social support, encouragement • Organizational • Worksite health promotion • Community • Access to parks and recreational facilities • Public policy • Policies that promote active transportation “Healthy choice should be the easy choice.”

17. From Guidelines to Action

18. Multi-Sector Approach • The National Physical Activity Plan includes recommendations that are organized in eight societal sectors: • Business and Industry • Education • Health Care • Mass Media • Parks, Recreation, Fitness and Sports • Public Health • Transportation, Land Use, and Community Design • Volunteer and Non-Profit

19. www.globalpa.org.uk

20. HEPA Europe – European network for the promotion of health-enhancing physical activity • Brings together different institutions and organizations from all over Europe • Collaborates closely with WHO/Europe • Facilitates multi-sectoral approaches • Advocacy and exchange of information • Promotes and disseminates innovative HEPA strategies, programmes, approaches and good practice • Promotes and engages in research www.euro.who.int/hepa

21. Midcourse Report

22. Role of Physical Activity Guidelines • Justify expenditure of public funds for promotion and programming • Science to establish legitimacy among other public health interventions • Define benefits to be expected by various population groups and the necessary dose of activity • Unified message and behavior targets • Consistent metrics for short- & long-term evaluation • Support economic arguments in terms of health care cost savings as well as moral justification based on equity and human rights

23. Key Messages • Provision of information alone, even scientifically-based physical activity guidelines, is not sufficient to bring about behavior change. • Physical activity guidelines are necessary, but not sufficient, to increase levels of health-enhancing physical activity. • Action at multiple levels is needed to support health-enhancing physical activity.

24. Thank you Questions?