HELWOSHealthy Life Without Obesity via Sports

Sempati Sport Club Association

World Health Organization (WHO) definitions for obesity

BMI = Weight kg/Height m²

Underweight: <18.5 BMI

Healthy weight: 18.5-24.9 BMI

Overweight (Grade I obesity): 25.0-29.9 BMI

Obese (Grade II): 30.0-39.9 BMI

Morbidly obese (Grade III): 40 or above BMI

Super obese (Grade IV): BMI >50

Portion Distortion:Do You Know How Food Portions Have

Changed in 20 Years?

French FriesFrench Fries 20 Years Ago Today

210 Calories2.4 ounces

How many calories are in these fries?

610 calories6.9 ounces

Calorie Difference: 400 calories

*Based on 72 Kg person

How long will you have to walk to burn* 400 calories?How to burn* 400 calories: Walk leisurely for 1 hr 10 Minutes

SodaSoda20 Years Ago

Today

85 Calories 6 ½ ounces

Calorie Difference: 165 calories

How many calories are in this soda?

250 calories 20 ounces

*Based on 72 Kg person

How long would you have

to garden to burn 165 calories?.How to burn* 165 calories:

Garden for 35 Minutes

Turkey SandwichTurkey Sandwich

20 Years Ago Today

320 calories

Calorie Difference: 500 calories

How many calories are in this turkey sandwich? 820 calories

*Based on 60 Kg person

How long would you have to biketo burn up 500 calories?How to burn 500 calories:Bike for 1 hour and 25 minutes

The Obesity EnvironmentThe Obesity Environment

Consumption of energy encouraged!– Wide variety, low cost, good taste, high fat/energy

dense foods available everywhere – Large portions

• Expenditure of energy discouraged!– Reduction of jobs requiring physical labor– Reduction of PE at schools– Increased time spent watching TV, web, video

games– Urban sprawl

But the obesity epidemic is NOT just an individual problem…

We have to reach the

WHOLE POPULATION

Potential strategies - 1

• Global (WHO, EU, others)– With governments, examine the role of globalization on food availability

and consumption; transport and urban planning; social networks; local and national economies

– Promote the importance of evidence-based, independent research in the role of diet, physical activity, economic/ psychosocial factors in reducing SE inequalities in obesity

• National / local

– Create funds for local authorities, voluntary organisations and community groups to deliver a range of local schemes such as safe routes to school, community regeneration projects, local coalitions to reducing health inequalities

– Examine pricing policies to ensure that healthy foods are accessible to all and ensure that foods like fruit and vegetables are no longer luxury items

Example : Re-prioritizing access and

price• Less of this… • More of this…

School fruit tuck shop in Swansea

Junk food at school and in the curriculum

Potentialstrategies - 2

• NGO– Develop programmes for low income households on how to prepare

low-cost healthy meals and on how and where to access physical activity opportunities at low cost

– Support local agriculture and community physical activity initiatives to promote social cohesion, sense of worth, healthier food intake and higher activity level

• Food supply– Encourage more farmers’ markets and grocery stores to establish

themselves in low income areas, to reduce ‘food deserts’ and provide sources of healthy food within walking distance

– Increase the visibility and appeal of healthy foods in supermarkets, and those accepted by particular ethnic groups

Potential strategies - 3

• Media– Attract celebrity role models in the promotion of healthy eating and

physical activity– Promote a healthy lifestyle culture (e.g. incorporate positive

behaviour change messages into television programmes and popular magazines)

UNDP "Teams to end Poverty"

• Health care– Increase health professionals’ awareness of SE inequalities in

obesity– Develop partnerships between health services, social services and

local authority which can provide a catalyst for increased community networks to support disadvantaged groups and liaise with existing physical activity and diet initiatives

Potential strategies - 4

• Education sites– Improve access to pre-school education– Have school nutrition policies to ensure good nutritional quality of

foods served in cafeterias– Incorporate physical activity into the school day as integrated in the

curriculum– Develop clear policies about bullying related to body size

• Work sites– Include healthy food choices (e.g. subsidize healthy foods in

cafeterias) and physical activity options (e.g. exercise facilities and changing rooms) at the workplace

– Actively address hiring discrimination and stigmatization

Population Strategy

Parks and recreation:• Provide a unique venue for children, adults, and

seniors to learn about heart healthy lifestyles.• Adopt programs to meet the needs of the

community.• Mobilize community partners and bring people

together

Physical Activity

Physical Inactivity

• Many studies show that Turkish People are becoming too sedentary.

• Due to – Increased use of technology.– Increased use of automobiles.

According to the Behavioral Risk Factor Surveillance System, in 2000 more than 26 percent of adults reported no leisure time physical activity.

Physical Inactivity

• Physical inactivity contributes to premature deaths.• Rates differ by race and ethnicity.

– Hispanic women - most inactive– Non-Hispanic women – second– Asian and Pacific islander women – third and, lastly, – White non-Hispanic women - fourth.

Physical Activity

• Contributes to weight loss.• Helpful for the prevention of overweight and obesity.• Helps maintain weight loss.

Physical Activity

– Occupational work• Carpentry, construction, waiting tables, farming

– Household chores• Washing floors or windows, gardening, or yard work

– Leisure time activities• Walking, skating, biking, swimming, playing Frisbee,

dancing, softball, tennis, football, aerobics

Physical Activity

• Physical activity decreases the risk for:– Colon cancer– Diabetes– High blood pressure

• Physical activity also helps to: – Control weight– Contribute to healthy bones, muscles,

and joints– Reduce falls among the elderly– Relieve the pain of arthritis.

Regular physical activity is good for overall health.

How Much Physical Activity a Day?

To reduce the risk of chronic diseases in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week.

To help manage weight and prevent gradual, unhealthy weight gain in adulthood: Engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements.

To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily moderate- to vigorous-intensity physical activity while not exceeding caloric intake requirements. (Some may need to contact their healthcare provider before participating in this level of activity.)

• Any activity helps. • Moderate physical activity brings

health benefits.• Make it personal.• Start slowly (10 minute walk/day).

How Much Physical Activity a Day?

2009

Increasing Physical Activity

You can increase your physical activity by taking small steps to change what you do everyday.

If you normally… Then try this instead!

Park as close as possible to the store Park farther away

Let the dog out back Take the dog for a walk

Take the elevator Take the stairs

Have lunch delivered Walk to pick up lunch

Relax while the kids play Get involved in their activity

Lack of Physical Activity for special Needs

• Children with special needs may have fewer opportunities for physical activity because of a need for constant supervision or for adaptive equipment.

• Children who are unable to walk burn fewer calories than those who walk.

• Children who walk with braces and crutches or walkers actually burn more calories than typical children during actual periods of walking.

Over-Permissive or Over-Restrictive Parenting

?????????????????????????????????????• Parents may try to compensate their child for

his/her medical or physical problem by allowing whatever they want to eat.

• Parents may be afraid to allow their child to do things for him/herself because of their disabilities

• Parents may be confused about how and when to set limits for a child with physical or mental disabilities.

What Are the Consequences of Overweight for the Child with

Special Needs?

Overweight Affects Quality of Life and Self Esteem

• Research has shown that overweight children are more likely to be teased and to be targets of bullies.

• Research on Health Related Quality of Life and children with developmental disabilities has shown progressive decreases in quality of life scores as BMI’s rise.*

• Overweight may lower self esteem by interfering with independence.

Overweight Promotes Dependence

Overweight reduces mobility by:–Causing braces and prostheses to be quickly

outgrown –Causing a need for larger and heavier braces

or wheelchairs with wider wheel bases

Overweight Becomes ******An Additional Disability*******

• Overweight Interferes with self care :

–Dressing oneself becomes difficult or impossible

–It’s hard to tie shoes–Transfers from wheelchairs become much

more difficult–Catheterizing oneself or using the restroom by

oneself may be impossible

Obesity Results in Health Risks and Complications

Increased risk of :– High blood pressure– Heart disease– Arteriosclerosis– Diabetes– Post surgical complications– Pressure sores– Joint problems (foot, knee and hip)– Blount’s disease– Fatty liver disease – Sleep apnea

Consequences of obesity may cause greater harm to people with disabilities due to: lower threshold of health associated with

various secondary and associated conditions accommodating certain disabling conditions.

difficulty in accessing health promotion programs in their home or community leading to continuing weight gain.

It is imperative that we increase awareness about the obesity-related health disparities that exist between adolescents with disabilities compared to their non-disabled peers.

Impact of Obesity on Persons with Disabilities

Youth with disabilities are often denied the opportunity to participate in the same physical and recreational opportunities as their non-disabled peers.

Certain accommodations are necessary to enable youth with disabilities to participate in physical activity and nutritional programs.

Many school-based obesity interventions do not address specific physical and nutritional concerns associated with particular disabilities.

Potential Barriers to Participation in Health Promotion Activities for Youth with Disabilities

Comparison of Obesity/Overweight between Youth (12-18 yrs) with Disability and w/o Disability - by Disability Type

 Disability Type

Youth with disability

(n= 461)

Youth w/oDisability

(n=12,973)OddsRatio 95% CI

Autism

% Obesity (> 95% tile) 24.6 13.0 2.19 1.44-3.31

% Overweight (>85% tile) 42.5 28.8 1.84 1.28-2.64

Down Syndrome

% Obesity (> 95% tile) 31.2 13.0 3.00 1.86-4.81

% Overweight (>85% tile) 55.0 28.8 3.01 1.95-4.66

Intellectual Disability

% Obesity (> 95% tile) 12.4 13.0 0.96 0.51-1.81

% Overweight (>85% tile) 27.2 28.8 0.93 0.58-1.49

Cerebral Palsy

% Obesity (> 95% tile) 4.0 13.0 0.30 0.13-0.68

% Overweight (>85% tile) 18.8 28.8 0.57 0.37-0.87

Spina Bifida

% Obesity (> 95% tile) 18.6 13.0 1.61 0.66-3.93

% Overweight (>85% tile) 64.5 28.8 4.50 2.16-9.41

aDRRP data; b2007 YRBS dataData were weight-adjusted by age, gender, and race using sample ranking so the proportion

segments of age, gender, and race were matched between data sets.

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Thanks for your attention…

Sempati Sport Club Association