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