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Addressing Obesity By Changing Environments

Addressing Obesity By Changing Environments. Kelly D. Brownell Yale University. www.YaleRuddCenter.org. Examples of Major Initiatives. Nutrition in schools. Food labeling. Food marketing and children. Sugared beverages & t axes. A Conceptual Scheme. Educate. Knowledge. Medicate.

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Addressing Obesity By Changing Environments

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  1. Addressing Obesity By ChangingEnvironments Kelly D. Brownell Yale University

  2. www.YaleRuddCenter.org

  3. Examples of Major Initiatives Nutrition in schools Food labeling Food marketing and children Sugared beverages & taxes

  4. A Conceptual Scheme

  5. Educate Knowledge Medicate Operate Implore Motivation How Best to Make Change? The Individual Less Obesity?

  6. % of US Population Getting Recommended Physical Activity (1986-2000) CDC, BRFSS

  7. % of US Adults Getting Recommended Fruit & Vegetable Servings NHANES

  8. % of US Children Getting Recommended Fruit & Vegetable Servings Youth Risk Behav Survey

  9. Educate Knowledge Implore Motivation What Are We Doing Now? The Individual Less Obesity?

  10. Educate Knowledge Medicate Operate Implore Motivation How Best to Make Change? The Individual Less Obesity?

  11. Legislation Economics Optimal Defaults The Individual Less Obesity? Regulation Environment

  12. Another Example – Organ Donation Johnson & Goldstein, Science, 2003 “Do defaults save lives?”

  13. Disastrous Defaults (examples) • Portions • The economics of food • Too much access • Too little access • Food marketing

  14. Food Marketing

  15. Food Marketing Powerful Relentless Exploitative

  16. The Best Dozen TV Advertising Adver- gaming Other Youth Websites Bunnies EnviroKids Organic Puffins Cheerios None Kix Life Hannah Montana Clifford Crunch Mighty Bites Honey Sunshine Organic Wild Puffs Mini Wheats

  17. The Worst Dozen TV Advertising Adver- gaming Other Youth Websites x x x Reese’s Puffs x x x Corn Pops x x x Lucky Charms Golden Grahams x x x Cinnamon Toast Crunch x Cap’n Crunch Count Chocula x x x Trix x x x Froot Loops Smorz x x x Fruity/Cocoa Pebbles x x Cocoa Puffs

  18. RWJF $100 million/yr vs. Child Marketing January 4!

  19. The Special Case of Sugar-Sweetened Beverages

  20. The World’s Most Valuable Brand?

  21. % Calories Per Day From 2 Beverages 10 Milk 8 6 4 2 Soft Drinks 0 1977-78 1989-91 1994-96 1999-2001 Nielsen & Popkin. Am J Prev Med, 2004

  22. Why Soda? • Single greatest source of added sugar • Completely empty calories • Poor calorie compensation • Sugar may be addictive • Gratuitous addition of caffeine • Targeting of vulnerable populations • Rock solid proof of harm

  23. SSBs: How Much? Average intake = 50 gallons/yr (189 liters) Average child = 175 calories/day

  24. Children Ages 2-18 Empty calories = 40% of total intake Largest contributor to overall intake SSBs + Juice Drinks, 173 kcal/day Reedy & Krebs-Smith J Amer Dieteitic Assn, 2010

  25. Brownell et al. New Engl J Med, 2019

  26. How Worried is Industry?

  27. Millions Spent Lobbying Coke & Pepsi + ABA Los Angeles Times Feb 7, 2010

  28. Sugared Beverages in Latin America Household Budget Surveys Expenditure records (all beverages) Household income & number of residents Industry Reports Market volume & market value Underestimates Captures about 50% of intake

  29. Data: Datamonitor 2009, Euromonitor 2009, Andreyeva et al 2011

  30. Consumption Trends Peru, 1997 - 2009 Data: Peru, Encuesta Nacional de Hogares

  31. Consumption Trends Mexico, 1984 - 2008 Data: Mexico, Encuesta Nacional de Ingresos y Gastos de Hogares

  32. Consumption Trends & Income Data: Mexico, Encuesta Nacional de Ingresos y Gastos de Hogares

  33. Consumption Trends & Income Data: Mexico, Encuesta Nacional de Ingresos y Gastos de Hogares

  34. Estimated Revenue (20% tax) Revenue (US Dollars) Peru $191 million Chile $256 million Colombia $857 million Mexico $2.37 billion Brazil $2.66 billion Calculations based on Datamonitor 2010, Euromonitor 2010, World Bank 2009

  35. Who Are The Change Agents?

  36. Legislators federal, state, local Legal Authorities e.g., state attorney’s general The Press Litigators

  37. Dr. Thomas Frieden NYC Commissioner of Health Michael Bloomberg Mayor Legal Defaults

  38. Game Changing Developments NYC trans fat ban in restaurants Menu labeling Conn. Attorney General – Smart Choices White House Announcements Soda tax proposals

  39. www.YaleRuddCenter.org

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