Becky Lankenau

Environmental and Policy Approaches to Cardiovascular Disease Prevention Through Nutrition: Opportunities for State and Local Action

This article reviews environmental and policy intervention approaches to cardiovascular disease prevention through nutrition and recommends opportunities for state and local health departments to initiate and participate in environmental and nutrition policy initiatives. By addressing these complementary aims, the authors hope to stimulate further efforts to achieve progress in nutrition promotion among state and local health-related organizations. Key categories of opportunity to develop new or expanded nutrition policies and environmental strategies include economic incentives, food assistance and feeding programs, regulations for institutional food service operations, and nutrition services in health care. Environmental strategies to reduce barriers to following dietary guidelines, such as point-of-choice programs and school nutrition programs, should be tailored for local communities and widely disseminated. In addition, current federal policy efforts, notably nutrition labeling rules, will provide a valuable focal point for state and local advocacy, education, and monitoring.

Physical activity policy and program development: the experience in Finland.

This article describes the development of sports and physical activity policies and programs in Finland during the past 30 years. The past two decades have been marked by a shift in emphasis from competitive and elite sports to health-enhancing physical activity for all, as seen most clearly in two successive sports acts and a government resolution. The new, increasingly multisectoral policies have led to substantial changes in the public funding of sports organizations, services, and construction of sports sites. Furthermore, three successive five-year national physical activity promotion programs have been launched. As a result, increased and new types of opportunities to participate in physical activity have become available, and the infrastructure and networks for provision of services have been strengthened. Until the mid 1990s, leisure time physical activity increased in Finland, but during the last seven to eight years, both leisure time and commuting physical activity have been stable. This finding may be an indication of the difficulty to increase physical activity in an industrialized country with already relatively high levels of physical activity even when systematic, long-term policies and measures are applied.

Community intervention and trends in dietary fat consumption among black and white adults

OBJECTIVE This study assessed whether a state public health department could effectively implement an affordable nutrition intervention program at the community level. DESIGN Cross-sectional data were collected via telephone surveys of 9,839 adults, aged 18 years or older, in 1987, 1989, and 1991 in two South Carolina communities. Nutrition education programs began in 1988 in one community. The other community served as a comparison site. We assessed and compared changes in community levels of dietary fat and weekly meat consumption, salt use, and nutrition promotion awareness with analysis of covariance regression techniques that included race, sex, and age as covariates. RESULTS We observed favorable changes in most eating behaviors and levels of awareness in both communities. The intervention community experienced greater absolute changes that the comparison community in use of animal fats (-8.9% vs -4.0%; P = .02) and liquid or soft vegetable fats (+8.4% vs +3.6%; P = .04), and in awareness of restaurant nutrition information (+33.0% vs +19.4%; P = .0001). Although the primary type of dietary fat used differed between black and white respondents, we observed significant change among both groups. CONCLUSIONS These results suggest that community-wide nutrition education programs may have augmented regional or national changes in dietary behavior among white and black adults in the intervention community.

Implementing national population based action on physical activity- challenges for action and opportunities for international collaboration

This paper summarises recent past and current international developments on physical activity looking at the challenges and opportunities they pose. Key elements of the WHOs Global Strategy on Diet, Physical Activity and Health (GSDPAH) are summarised, focusing specifically on the physical activity components, and by drawing upon recent fora (Atlanta, October 2002; Miami, December 2004; Cascais, February 2005; Beijing, October 2005; Bogota, November 2005), we outline the barriers and areas of support required for successful development and implementation of national, population-based action on physical activity. These gatherings focused particularly on the needs of developing countries, where to date little has been done to augment physical activity at a population level. Unless swift action is taken, these countries will soon suffer significantly from an increased prevalence of non communicable diseases (NCD). Existing initiatives and opportunities for national and international action on physical activity are identified. Specific actions are proposed for advocacy, communication and dissemination, networks and partnerships, fundraising, policy development and implementation, programme implementation and evaluation, surveillance and capacity building. The development of the Global Alliance for Physical Activity (GAPA) provides a structure for international collaboration.

Developing a national physical activity plan: the Kuwait example

A rapid increase in economic well-being and urbanization in Kuwait have been accompanied by profound changes in lifestyle, including low levels of physical activity in all population groups. These changes have contributed to a high prevalence of overweight and obesity and to the escalation of the non-communicable disease rates, particularly coronary heart disease, stroke, hypertension and diabetes. The evolution of physical activity promotion, internationally, and a series of related meetings in Kuwait and neighboring countries, have started to generate an awareness among health authorities of the importance of physical activity in health promotion and disease prevention. A National Physical Activity Committee has been formed to design and implement a National Physical Activity Plan, which could also serve as a model for other countries. The authors describe the background and principles behind the development of the National Plan, summarize a template based upon the Kuwait experience and share the lessons learned from these efforts.

Physical Activity Policy Development: A Synopsis of the WHO/CDC Consultation, September 29 through October 2, 2002, Atlanta, Georgia

Physical activity is an important part of the World Health Organizations integrated approach to the prevention and control of noncommunicable disease and the promotion of health, and, in particular, to the evolving World Health Organization Global Strategy on Diet and Physical Activity. To assist in these efforts, a joint World Health Organization/Centers for Disease Control and Prevention Consultation on Physical Activity Policy Development took place in Atlanta, Georgia, from September 29 through October 2, 2002. This article summarizes the context and outcomes of the consultation. It also includes elaboration of a Comprehensive Physical Activity Policy Framework developed as a product of the meeting.

International physical activity policy development: a commentary

Scientific evidence demonstrates, in different degrees for developing and developed countries, that physical activity is associated with substantial health, economic, and societal benefits. However, for varying environmental, social, and individual reasons, people do not tend to engage in the levels of physical activity that would be beneficial to them. Environmental and policy interventions hold particular promise for promoting physical activity because both are designed to influence large groups. Recent multisectoral actions have increased the visibility of physical activity promotion and its synergism with other important community and national issues. Together, these efforts have created an unprecedented opportunity to advance the development of international physical activity policy.

Public Health, NCDs, Health Promotion, and Business Partnering: Benefits, Concerns, Remedies, and Moving Towards Creative Partnering

Both developed and developing nations are currently facing a growing epidemic of non-communicable diseases (NCDs) with potentially catastrophic economic implications. In September 2011, a UN High-Level Meeting focused, for the first time, on NCDs and provided a prominent forum to spotlight the need to develop solutions to address the complex NCD problem. Organizations such as the World Health Organization and its Regional Offices have recommended actions to guide countries in tackling the NCD crisis. While these recommendations have consistently advocated for multi-sectoral partnering, this approach remains contentious in the public health realm, especially regarding private sector partnerships. The intent of this chapter is to encourage creative partnering as a means to maximize scarce resources and find sustainable solutions to NCDs. The authors discuss the benefits and concerns of developing partnerships, suggest remedies to alleviate concerns, offer approaches to establishing partnerships, and provide examples of multi-sectoral partnership efforts from around the world.