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Healthy
People 2010: Weight Management and Physical Activity Focus Areas
By: Dr.
Stefanie Kelley
March 2003
When making a
behavior change it is challenging to move from contemplating a change to
acting and maintaining that change. Many New Year's resolutions never make
it past the point of contemplation and planning. Lose weight and exercise
more are common health related resolutions that Americans continuously fail
to take action on or maintain if initial action was started. Healthy People
2010 is a public health agenda designed to measure health progress and serve
as a roadmap to improve the health of all people in the United States during
the first decade of the 21st century (US Department of Health and Human
Services (HHS), 2000). Healthy People 2010 provides general focus and direction
for a healthy life, moving our country through the early stages of change,
pre-contemplation, contemplation, and preparation. But the action and maintenance
of health is up to communities and individuals to meet the goals of promoting
and improving health with weight management and physical activity.
Healthy People 2010 is a comprehensive, national health promotion and disease
prevention plan that identifies 467 health objectives in 28 focus areas.
Specific objectives of Healthy People 2010 are derived from the Leading
Health Indicators. The Leading Health Indicators are the major public health
concerns in the United States. Physical activity and overweight/obesity
are the top two Leading Health Indicators and two of the 28 focus areas
of Healthy People 2010 that continually impact the health of Americans.
Look around your classroom, neighborhood, and your family. How are people
measuring up to weight management and physical activity? During the period
of 1988-1994, only 42 percent of adults aged 20 years and older were at
a healthy weight, as defined by a body mass index (BMI) equal or greater
than 18.5 and less than 25 (US Department of Health and Human Services).
HP 2010 has proposed a goal of 60 percent of adults at a healthy weight
to promote health and reduce chronic disease associated with diet and weight.
Furthermore, HP 2010 has set a goal to reduce the proportion of adults who
are obese (BMI greater than 30) from 23 percent to 15 percent by the year
2010. Children and adolescents have also been targeted by HP2010. The 1988-1994
baseline data indicated that 11 percent of children aged 6 to 19 years were
overweight or obese. The goal is to reduce that proportion to 5 percent.
In regards to physical activity and fitness, 40 percent of adults aged 18
years and older participated in no physical activity in 1997. The goal is
to reduce the proportion of adults that participate in no physical activity
to 20 percent. HP 2010 moves our country further into action by proposing
that 30 percent of adults aged 18 years and older participate in moderate
physical activity for at least 30 minutes every day. In 1997, only 15 percent
of adults participated in 30 minutes of moderate physical activity 5 days
a week.
Weight management and physical activity are crucial to promoting health
and preventing disease. Americans consume too much saturated fat. We eat
too few fruits, vegetables, and grains, which provide vitamins, minerals,
carbohydrates, and fiber that are essential for good health. The United
States has many food options but the easiest options are often the least
healthy. Fast food, snack foods, and non-dairy or non-fruit beverages are
quick and easy substitutes for healthy eating. In addition, the television
and the computer have become our houseguests during mealtime, which often
results in overeating.
HP 2010 defines physical activity, moderate physical activity, and vigorous
activity (HHS, 2000). Physical activity is defined as body movement that
substantially increases energy expenditure. Moderate physical activity are
activities that use large muscle groups, like brisk walking, swimming, cycling,
dancing, gardening, domestic and occupational activities. Vigorous physical
activity are rhythmic, repetitive physical activities at 70 percent or more
of maximum heart rate for age including jogging/running, lap swimming, cycling,
jumping rope, racquet sports, group sports. While lengthy workdays and school
budget cuts have reduced the opportunities for structured physical activity,
Americans are choosing fewer leisure-time physical activities.
HP 2010 can assist health care providers, educators, communities, and elected
officials in developing strategies, implementing plans, and measuring progress
towards achieving the goals and objectives of healthy Americans in 2010.
One useful source of information to help Americans promote health and reduce
chronic disease associated with diet and weight is the 2000 Dietary
Guidelines for Americans. The Dietary
Guidelines for Americans is a guideline for persons 2 years and
older in making food choices and physical activity to promote health and
prevent disease (U.S. Department of Agriculture (USDA), 2000). The Dietary
Guidelines for Americans focus on A - aim for fitness, B
- build a healthy base and C - choose sensibly. The food pyramid,
BMI scale, and recommended serving size are incorporated in the dietary
guidelines.
The food pyramid was introduced in 1992 and has served as a pictorial guide
for Americans to make their food choices. It also lists the number of servings
to consume in each good group.
The introduction of the new food label in 1993 provides nutrition information
for packaged food, which helps consumers make good food choices (U.S. Food
and Drug Administration, 1999).
With all these tools available, consumers struggle to understand how much
they consume especially when many food options are "super-sized."
Packaged food serving sizes and the food pyramid's suggested number of servings
are often not equivalent. Just to refresh metric conversions, one ounce
is equal to 30 g. One (1) ounce or 30 g of dry breakfast cereal is one grain
serving. The label on one of the most popular dry cereals lists serving
size as 1 ¼ cup or 60 g, which is 2 ounces or 2 grain servings. For
more information, the USDA has an easy to read brochure to understand "How
much are you eating?"
The latest information on physical activity now indicates that all individuals
benefit from regular physical activity (HHS, 2000). Regular physical activity
can substantially reduce the risk of developing or dying from heart disease,
high blood pressure, diabetes, and some cancers. Vigorous physical activity
is no longer the most beneficial method to promote health. Physical activity
that is regular and daily, which is the important distinction, is now considered
the most beneficial to promote health. The U.S. Surgeon General has recommended
a minimum of 30 minutes on most, if not all days of the week (HHS, 1996).
Some suggestions to make healthy choices are described. Keep a food diary.
Record everything that is consumed in a day for 5 days. Be specific. For
example, list the number of pieces of bread and pieces of meat on your sandwich
and if you had lettuce, tomato, and cheese. All the extras on a sandwich
count toward the daily servings. But don't forget the chips and drink! Then
compare this to the food pyramid. This is a way to evaluate how MUCH and
WHAT foods are eaten. It may be surprising. One sandwich can actually count
for 2 servings of meat, 2 veggies, 1 dairy, and 2 grains. Let the food pyramid
guide your food choices and how much to eat.
Also, keep a physical activity diary. Record all activity in a day for 5
days. Measure the time participating in all activities. Parking at the furthest
spot from your work place or taking the stairs to the office is a way to
add to physical activity twice in one day. Add up the time each day. Begin
to look for opportunities to exercise in your daily activities. Thirty minutes
of physical activity adds up quickly. Instead of cleaning up right after
dinner, put the dishes in the sink and take a family walk. This allows for
physical activity but also family time and digestion time. Or, during television
commercials get up and march in place or dance with the kids.
Americans are looking for quick and easy solutions in their pursuit of health.
Making good choices about what is fast and easy can affect personal health
and the health of our communities. There are healthy, fast and easy options
for weight management and physical activity. But good health starts by deciding
to make a change and moving towards action and maintenance. HP 2010 has
started the change process for the United States. It is now up to individuals
and communities to make the actions and build upon our nation's health.
Additional Readings:
Healthy
People 2010
Dietary
Guidelines for Americans
References:
U.S. Department of Agriculture (USDA) and HHS. (2000). Dietary guidelines
for Americans. 5th ed. Washington, DC: USDA.
U.S. Food and Drug Administration. (1999). The Food Label. Retrieved
February 17, 2003 from http://www.fda.gov/opacom/backgrounders/foodlabel/newlabel.html.
U.S. Department of Health and Human Services (HHS). (2000). Healthy People
2010. 2nd ed. Washington, DC: U.S. Government Printing Office.
HHS (1996). Physical activity and health: A report of the Surgeon General.
Atlanta, GA: Centers for Disease Control. Retrieved February 17, 2003 from
http://www.cdc.gov/nccdphp/sgr/sgr.htm.
Stefanie
J. Kelley, ND, RN, CS has been in the nursing field for over 10 years.
She has clinical expertise in general pediatrics and pediatric hematology,
oncology, and bone marrow transplantation. As a family nurse practitioner
she has advanced practice expertise in internal medicine, urban health care,
and general pediatrics. As a faculty member at Texas A&M University
and Case Western Reserve University, she has taught in the undergraduate
and graduate didactic and clinical portions of nursing. Dr. Kelley's interest
in web-based instruction and health care has been a part of her academic,
clinical, and research practice.
Dr. Kelley welcomes your comments about her article or suggestions for future
topics. She can be emailed at sjkelley6@yahoo.com.
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