Principal Investigator/Project Director: Rachel Novotny
Lead Site Co-Investigators/Co-Project Directors: Rachael Leon-Guerrero, Don Vargo, Jonathan Deenik,
Bret Luick, Jang Ho Kim
This research was supported by the National Research Initiative of the USDA National Institute of Food and Agriculture, grant award #2011-68001-30335
Remember Bruddah IZ - Native Hawaiian Musician
Died at 38 years of age, due to respiratory complications of obesity.
Alaska
Hawaii
American Samoa
Republic of the Marshall IslandsFederated States
of Micronesia
Commonwealth of the Northern Mariana Islands
Guam
Republic of Palau
US Affiliated Pacific Region
Alaska
Hawaii
American Samoa
Republic of the Marshall
Islands
Federated States of
Micronesia
Commonwealth of the Northern Mariana Islands
Guam
Republic of Palau
Young Child Overweight & Obesityi (%)US Affiliated Pacific Region
Age, y US 48 states
Alaska Am Samoa
CNMI Guam FSM Hawaii Palau RMI
2 - 4.9 24h 40a 37a 25b 33c 17a
5 - 7.9 33h 47f 26b 30d
8 - 9.9 33h 47f 45b 44g
a Supplemental Feeding Program for Women Infant & Children (WIC): 2009 AL, 2010 AS, Baruffi et al. 2004 HIb 2-3, 4-6,7-10 y, Paulino et al 2008, cluster surveyc Headstart Programd Kaiser Permanente Hawaiif 6-11y, http: // www.ctahr.hawaii.edu / adap / ASCC_LandGrant / technical_papers.asp, Reports 47, 48, 56g 6-13y, Healthy Foods Hawaii, Hawaii (Novotny PI), predominantly Native Hawaiian h NHANES, Ogden et al 2008, JAMAi 6-11y, >85th percentile BMI for age & sex, CDC
CNMI Food Intake (servings /day)Very high meat & low grain consumption
b Food groups Recommendations for 3 age groupsa
2 - 3 yn = 83
Mean ± SD
4 - 6 yn = 128
Mean ± SD
7 - 10 yn = 136
Mean ± SD
Grain 6 / 7 / 7.8 6.2 ± 3.8 5.2 ± 2.5 7.1 ± 4.3
Whole Grain Choose more whole grain 0.35 0.78 0.18 0.41 0.21 0.47
Vegetables 3 / 3.3 / 3.7 1.2 ± 1.5 0.95 ± 1.2 1.0 ± 1.3
Fruits 2 / 2.3 / 2.7 0.9 ± 1.9 0.6 ± 1.7 0.9 ± 1.9
Dairy 2 / 2 / 2 1.3 ± 1.4 0.78 ± 1.0 0.68 ± 0.8
Meat & meat alternatives
2 / 2.1 / 2.3 5.1 ± 3.8 5.5 ± 2.9 6.4 ± 4.0
Added sugar, tspc Use sparingly 10 ± 8.4 10 ±10 12 ± 11
Discretionary fat, g Choose lower fat options 52 ± 30 45 ± 27 49 ± 35
a Recommendations for 1-3 y, 4-8 y, 9-10 y, respectively. Uses Estimated Energy Requirement ranges for energy, Acceptable Macronutrient Distribution Range for % of energy from macronutrients, Adequate Intake for fiber & calcium, & Tolerable Upper Intake Level for sodium (IOM, 2006).b Except for added sugar & discretionary fat, recommendations are from the Food Guide Pyramid number of servings per day at food energy levels of 1300 for 2-3 y, 1800 for 4-6 y, & 2000 for 7-10 y, respectively (Basiotis et al, 2002). c 1 tsp = 5 g
Healthy Foods Hawaii (HFH) Children’s Food Group Intake, 6 - 13 y (predominantly Native Hawaiian children), n = 156 (Novotny PI, unpublished data)
Very high “added sugar” intake (eg. soda, sweets …)
Food Group
USDA 1992servings / d
a
Mean + SE, servings / d
Total Grain 7.8 7.23 ± 0.27
Whole Grain 0.95 ± 0.11
Non-whole Grain 6.28 ± 0.23
Total Vegetables 3.7 2.11 ± 0.16
Total Fruits 2.7 1.78 ± 0.18
Total Dairy, servings / d 2 1.76 ± 0.11
Total Meat, oz b 5.5 4.28 ± 0.24
Discretionary Fat, g < 66 61.5 ± 2.34
Added Sugars, tsp < 10 23.7 ± 1.20
a. USDA Food Guide Pyramid Recommended servings, 2000 calorie levelb. 1 teaspoon = 5 g “ Use sparingly”, 1 oz = 28.3 g
Goal: Capacity building, systems change & policy change to prevent child obesity
Specific Aims:
1. Conduct program / data inventories & situation analysis
2. (Degree) Train 22 professionals & paraprofessionals in obesity prevention
3. Develop Pacific food, nutrition & physical activity data management & evaluation system
4. Develop & conduct an environmental intervention (to prevent, maintain or decrease young child overweight & obesity in the Pacific Region)
5. Evaluate the community - based primary - prevention environmental intervention
6. Incur at least one obesity prevention policy change per state / jurisdiction
Active Play /PhysicalActivity
Political / Economic Env.Laws / Policies -
International, NationalState / Jurisdiction;
Program; Food / Activity Costs
Physical / Built Env.Mountain,
Garden / Farm,Ocean,
Health Center,Church, School,
Store, Home
HealthyFood Intake
Goal: Build the social / cultural, physical / built & political / economic environment to promote active play and intake of
healthy food to prevent young child obesity in the Pacific Region.
Child Healthy Living / Obesity
Prevention
Social / Cultural Env.Senator, Governor,
Doctor, Chief,Pastor, Teacher
Extended Family,Parents
Formal degree training in accredited programs - multidisciplinary aspects of obesity prevention (Associates to Doctorate)
Requirements:o Enroll in an appropriate CHL degree programo Develop & execute CHL project in home jurisdictiono Translate CHL materials for local language & culture o Disseminate/feedback to community
CHL project supervised by CHL faculty & should align with local initiatives
Formal Training/Education Plan
CNMI
ASHI GuamAK Palau FSM RMI
22 2 2 2 22 2 2
Total number of trainees = 22 2 2
FAS
Trainee Degree Program
• Formal degree training in accredited programs - multidisciplinary aspects of obesity prevention (Associates to Doctorate)• University of Alaska
• MA,MS, PhD – Interdisciplinary Studies• MS, PhD – Natural Resource Management• MPH• AA – Rural Nutrition Services
• University of Guam• BS – Nursing• BS – Health Sciences (Public Health Track)
• University of Hawaii at Manoa• BS – Food Science and Human Nutrition• MS, PhD – Nutrition
Training/Education Plan
• Formal degree training in accredited programs - multidisciplinary aspects of obesity prevention (Associates to Doctorate)• University of Hawaii at Manoa
• MPH, DrPH• MS – Public Health• PhD – Epidemiology
• University of Hawaii at Kapiolani Community College• AS – Exercise and Sports Science
• University of Hawaii at Windward Community College• AS - Nursing
Training/Education Plan
Education Program: Capacity Building
Program Development Enhance/expand existing
programs Develop curriculum Provide technical
expertise
Distance Learning Enhance/expand existing
efforts
Training Identify needs Develop programs
Community Colleges Key Partners
Local Advisory Committees Formed
Role:• Provide guidance to CHL program • Ensure CHL activities align & support
existing initiatives• Assist in judicious management of
resources• Assist in advocating for policy change• Ensure sustainability of the program
http://www.chl-pacific.org/
• Website page live!• www.CHL-Pacific.org/program-overview
• On-line application posted!
Training Program Information