March 25, 2015

/Oral Health America @Smile4Health

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OUR MISSION

Oral Health America changes lives by connecting

communities with resources to drive access to care,

increase health literacy and advocate for policies

that improve overall health through better oral

health for all Americans, especially those most

vulnerable.

OHA PRIORITIES

ADVOCACYEDUCATIONACCESS

OHA’s Programs and Campaigns are designed to improve

access to care, oral health literacy and policies that

prioritize the impact of oral health on the overall health of all

Americans – particularly those most vulnerable.

OUR PROGRAMS

Provides oral disease preventive

services in school-linked settings

Served 460,000 children during the 2013-2014 school year, with 304

program partners in 47 states

Facilitated donation of more than 500,000 units of dental product

through our Product Donation Project

Provided nearly $400K grants plus

technical assistance to treatment partners

Focused on the oral health needs of

community-dwelling older

adults and their caregivers

Toothwisdom.org, first-of-its-kind website connecting older adults and caregivers to oral health resources and education

Tooth Wisdom: Get Smart About

Your Mouth, a health education curriculum for older adults delivered in community settings

OUR CAMPAIGNS

Educate the public, including policy makers, about the importance of oral health for overall health

Emphasize the need to prioritize oral disease alongside other serious health conditions

Advocate for policies that positively impact programs and stakeholders

Current campaigns include:

Technical Assistance

Product Donation

Grant Funding

The NEW Drink Pyramid2015 Smiles Across America Webinar

© 2013

D.N. Stone, DMD

drinkpyramid@gmail.com

The NEW Drink Pyramid

• Who?

• What?

• When?

• Where?

• Why?

• How?

• (not necessarily in that order)

WHO?

Dr. Nikki Stone has been practicing dentistry since 1995 and is currently an Associate Professor who holds a joint appointment with the University of Kentucky Colleges of Dentistry and Medicine. She directs UK’s first regional dental program in southeastern Kentucky, in the heart of Appalachia. She created the Drink Pyramid in 2000 after several years of frustration with the oral health effects demonstrated in the caries rates of the children she served in Appalachia.

WHERE?

• University of Kentucky Center of Excellence in Rural Health

– Hazard, KY

– Southeastern KY

• Eastern Kentucky Ronald McDonald Care Mobile

– Serves Head Start and elementary children in four counties

WHAT?The (NEW) Drink Pyramid

Background

The Pyramids & Plates

• 1916 – first USDA food guide published

• 1974 – first food pyramid in Sweden

• 1992 – first US Food Guide Pyramid

• 2005 – revised version www.MyPyramid.gov

• 2011 – revised to www.ChooseMyPlate.gov

The 1992 Food Pyramid

The 1992 Food Pyramid

• The original US food pyramid was very effective.– In the 20+ years since it’s introduction, America

listened and learned! Some of the outcomes: • 7% decrease in saturated fat consumption

• 21% decrease in cholesterol consumption

• 4% lower blood cholesterol

• Decrease in US death rates for heart disease

• The original pyramid shape proved itself to be an effective tool for communicating the concepts of moderation and proportion.

The 2005 Food Pyramid

The 2005 MyPyramid

The 2005 MyPyramid (Kids)

The 2011 MyPlate

MyPyramid.com

• The MyPyramid didn’t go over too well…

• Why?

– It was no longer simple.

– You had to have a computer and enter lots of information about yourself to use it.

• Lots of people don’t have computers at home!

– People don’t understand the big pile of food at the bottom, and it doesn’t show us how much we are supposed to be eating. (confused…)

2011 Choose My Plate

• So, they changed it to an easier-to-understand PLATE instead…

• It only came out 2 years ago, so we don’t know how well the PLATE is working, but so far…

– We are definitely not eating the right foods.

– And we sure aren’t DRINKING the right drinks.

versus

Food vs. Drinks

• So, Americans have been learning about what FOODS we should eat since 1992.

• But we didn’t talk about what to DRINK until the MyPlate came out in 2011.– But all it says on the cup is “Dairy.”– Do you know what that means??– Does it tell you HOW MUCH Dairy

to drink??– And why does it look like you’re

supposed to be drinking something colored BLUE??

Drinks

• We know that most Americans are NOT drinking what we’re supposed to…

• Americans are drinking “Sugary Drinks.”

From the Pyramid to the Plate

• The newer MyPyramid and MyPlate icons have been criticized for being accessible only to high-income households with internet access and computer skills.

• The websites have been criticized for being too complicated, confusing, and cumbersome.

• However, did you know that the PLATE icon is very similar to the BOWL that 3,000 polled Americans chose (over the pyramid!) before it was first released?

The Drink Pyramid

• The new Drink Pyramid is a combination!

– It includes the COLORFUL plate/bowl concept preferred by Americans in that it incorporates the visible cups filled with various drinks.

– And it also incorporates the simplicity and recognition of the pyramid design to promote the concept of proportion and moderation.

WHEN?• The Drink Pyramid

– was developed in 2000

– was revised first in 2009

– was revised again in 2010

– was copyrighted in its final version in 2013

– usage has spread across the nation and the world!

The Drink Pyramid

• The Drink Pyramid was first piloted in several locations throughout Kentucky with remarkable success and has received a national spotlight for its message in Head Start’s National publication!

• Presentations have also been made at the National Oral Health Conference, the Southern Obesity Summit, West Virginia’s School Oral Health Conference, Kentucky Oral Health Coalition Summit, and on local Kentucky television stations.

WHERE?

• The Drink Pyramid is now in use in the following locations: – Kentucky

– West Virginia

– Tennessee

– Oklahoma

– Maine

– Minnesota

– Illinois

– NEW ZEALAND !

The Drink Pyramid was developed by a dentist, and has obvious oral health benefits,

but can also be a useful tool in targeting overall health issues obesity, diabetes, and general

health behaviors.

The Drink Pyramid

• Simple.

• Straightforward.

• Easy for children and adults with low literacy levels to understand.

• Include both words and pictures to convey messages.

• Include mnemonic letter cues to help aid in memorization.

The Mnemonics & Pictures

• W/W: Water Whenever– 7 water glasses are pictured to represent the

recommended “6-8 glasses per day.”

• M/M: Milk with Meals– 3 milk glasses are pictured to represent the typical three

meals per day in American diets.

• J/J: Juice Just once a day– Just 1 glass of juice is pictured to represent the AAP

recommendation for only one serving of juice per day.

• P/P: Pop only at Parties – Only 1 glass of pop is pictured to emphasize the

importance of saving pop only for special occasions and not for daily consumption.

• Alternate wording for northeastern populations: Soda Sometimes.

Remember….

• Sugar-sweetened beverages (SSBs) are the LARGEST source of added sugar and calories in the US population, especially among youth.

• Rather than an occasional treat, SSBs have become an essential part of the US diet.

– In 2009, the average American consumed

45 gallons of SSBs! • Even more for low-income Americans…

SSBs as a % of Daily Calories

• In 1965, SSBs made up less than 3% of US adults daily calories.

• By 2009, that had tripled to 9% for adults, and even higher for youth: – 11% for youth

– 13% for teens

– 16% for low-income groups

0

2

4

6

8

10

12

14

16

SERIOUSLY ??!!

• How can this be possible? Are Americans really drinking 45 gallons a year?!

• Are low income kids really consuming enough SSBs to make up 16% of their diet?

– There’s only one way to find out, ASK THE KIDS!

– Our dental outreach program sees over 2,000 low income kids annually, and rumor has it that eastern Kentucky consumes more Pepsi Co. products than anywhere else in the USA…

KENTUCKY KIDS

• We asked the kids in EAST KY:

– What did you drink this MORNING

• before you came to school?

– What did you drink LAST NIGHT

• when you got home from school?

• Then we also asked the kids in WEST KY too…

But before we asked them, we wondered whatanswers to look for? What do the “experts” saythey SHOULD be drinking?

• American Academy of Pediatrics recommends:

– Ages 1-6

• Only 4-6 ounces a day of SSBs (this includes fruit juice!)– That’s ½ CUP

– Ages 7-18

• Only 8-12 ounces a day of SSBs (this includes fruit juice!)

– That’s 1 CUP, NOT a super-size!

Kids Reported MORNING Drinks

MORNING Eastern KY

WATER

POP

MILK

JUICE

MORNING Western KY

WATER

POP

MILK

JUICE27% MILK

24% JUICE23% WATER

16% POP 48% MILK

16% JUICE 23% WATER

5% POP

Kids Reported EVENING Drinks

EVENING Eastern KY

WATER

POP

MILK

JUICE

EVENING Western KY

WATER

POP

MILK

JUICE15% MILK

16% JUICE29% WATER

40% POP22% MILK

19% JUICE

36% WATER

20% POP

Untreated Tooth DecayCompared with National Data (NHANES) 2006

0

10

20

30

40

50

60

70

White Black MexicanAmerican

WESTKENTUCKY

EASTKENTUCKY

AmericanIndian

HP2010 Goal

Pre-School (ages 2-5)

Elementary (ages 6-12)

Drink Behaviors Do Matter!!!!!!

What Kind of Sugar Sweetened Beverages are Kids Drinking?(eastern Kentucky)

1. GATORADE

2. Mountain Dew

3. Pepsi

4. Sprite

5. Tea

6. Kool Aid

7. Diet Mountain Dew

8. Nehi Peach

9. Orange Crush

10. Mondo

11. Fruit Punch

12. Hi-C

13. Tea

14. Lemonade

Where do kids get SSBs like POP?

• The MAJORITY of SSBs are consumed in the HOME! Parents are buying them in alarming quantities!

– Only 1-5% come from vending machines or school cafeterias.

Can the Drink Pyramid change drink behaviors?

More studies are needed, but so far, it looks like it changes drink

behaviors for the better!

0 5 10 15 20 25 30 35 40

Pop

Juice

Milk

Water

Pop Juice Milk Water

Baseline 25 22 23 26

After School 20 19 22 36

Drink Behavior Change 2012-13

Baseline After School

Water increased!

Pop decreased!

What About Retention? Will kids remember the Drink Pyramid?

More studies are needed, but so far, it looks like they do remember, at

amazing rates!

Eastern KY Kids Remembered 7 Months after Learning About It

4 of 4

3 of 4

2 of 4

1 of 4

0 of 4

5%

80% of 3rd Grade Kids RememberedAll 4 Parts of the Drink Pyramid

7 Months Later!

5%

10%5% 5%

The Drink Pyramid was taught to three classrooms of 3rd graders at Roy G Eversole Elementary school in Perry County, KY in October 2012, and post-tested at the end of the school year in May 2013.62 students surveyed

Western KY Kids Remembered One Year after Learning About It

4%

Hopkins County

4 of 4

3 of 4

2 of 4

1 of 4

0 of 4

5%

90% of 2nd Grade Kids RememberedAll 4 Parts of the Drink Pyramid

One Year Later!

The Drink Pyramid was taught to 2nd graders in western KY in October 2012, and they were post-tested the following October 2013.293 students surveyed

Curriculum Examples

Classroom Use Ideas

Sample of Curriculum

Ages 1-6

SAMPLE CURRICULUM

Ages 1-6

SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

Ages 1-6

Sample of Curriculum

Ages 7-12

Older Curriculum has More Science

More Critical Thinking

More Interaction

More Discussion Time

More Problem Solving

SAMPLE CURRICULUM

Ages 7-12

SAMPLE CURRICULUM

Ages 7-12

SAMPLE CURRICULUM

Ages 7-12

SAMPLE CURRICULUM

Ages 7-12

SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

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SAMPLE CURRICULUM

Ages 7-12

Ways to Use the Drink Pyramid

Ways to Use the Drink Pyramid

• Teachers can use the new CURRICULUM to teach kids each part of the Drink Pyramid and why the amounts listed are recommended.

• Schools can put a POSTER of the Drink Pyramid in the school cafeteria and/or in each classroom as a reminder.

• Give each child a Drink Pyramid CUP as a visible and tangible reminder of exactly HOW MUCH a serving size is for his/her age.

• Give each parent a Drink Pyramid MAGNET to put on the refrigerator as a reminder about what to buy and serve at home.

• Community agencies can use the DISPLAY at health fairs and other events to raise awareness.

• Dentists/dental staff can wear T-SHIRTS every day to spark conversations!

Drink Pyramid Ideas !

Conclusions

Why the Drink Pyramid is Useful

Conclusions

• The new Drink Pyramid is:– fun,

– colorful,

– simple,

– straightforward,

– easy to learn,

– easy to remember,

– and may be a useful tool for teaching kids and families about making healthy drink choices.

• Pilot data shows that children remember it!

• Pilot data show that it can change drink behaviors!

The Drink Pyramid

• Contact:

– drinkpyramid@gmail.com

– www.drinkpyramid.com

Remember that the Drink Pyramid is copyrighted, so be sure to go to the website to purchase a copyright use fee if you plan to use the Drink Pyramid as a tool.

Also consider ordering the Drink Pyramid curriculum whenever possible, to help support a fund being established to help low income children in Dr. Stone’s hometown in eastern Kentucky.

Purchase Options ITEM PRICE

Curriculum, Ages 0-6 $25

Curriculum, Ages 7-12 $30

BOTH Curriculum $50

Copyright Usage Fee $100

Questions/Comments

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