Nutrition, Physical Activity, and Obesity

Keeping Americans Healthy at Every Stage of Life
At A Glance 2016

Good nutrition and regular physical activity are essential to keeping current and future generations of Americans healthy. People who eat a healthy diet and get enough physical activity live longer and have fewer chronic diseases, such as type 2 diabetes, heart disease, and obesity.

CDC leads our nation’s fight against chronic diseases by promoting good nutrition, regular physical activity, and a healthy weight in places where people live, work, and play.

Public Health Problem

Chronic Diseases Are Common, Costly, and Preventable

Seven of the top 10 leading causes of death in the United States are due to chronic diseases, and treating people with chronic diseases accounts for 86% of our nation’s health care costs. People with chronic diseases often have a lower quality of life. Almost 1 in 5 (12 million) children and more than 1 in 3 (78 million) adults in the United States struggle with obesity, causing $147 billion in obesity-related health care costs each year. Young children with obesity tend to keep extra weight into adulthood. Fortunately, eating a healthy diet, getting enough physical activity, and not using tobacco help prevent most chronic diseases.

Mothers Need Support to Breastfeed Their Babies

Breastfeeding is the best method for early infant feeding and the healthiest option for most mothers and babies. Mothers and their children show short-term and long-term health benefits from breastfeeding. Although 80% of mothers start out breastfeeding, more than 50% stop before they intended. Only about 22% of infants are being exclusively breastfed as recommended by the time they are 6 months old. These low rates of breastfeeding add more than $2 billion a year to direct medical costs in the United States.

Americans Need Access to Healthy Foods

Poor diet is a major factor affecting the health of Americans. In every state, fewer than 1 in 5 adults eats enough fruit, and fewer than 1 in 7 eats enough vegetables. Many low-income people live in places that lack access to affordable and healthy food options. Few early care and education (ECE) facilities meet best practice standards for nutrition for the children they serve.

Americans Need Safe Places for Physical Activity

Physical activity offers many benefits for the health of individuals and communities. Specifically, getting enough physical activity can prevent 1 in 8 cases of breast cancer, 1 in 8 cases of colorectal cancer, 1 in 8 cases of type 2 diabetes, and 1 in 12 cases of heart disease. Unfortunately, limited access to safe and convenient places for physical activity—like biking paths, sidewalks, and parks—makes getting physical activity hard for some people. Only half of US adults and less than one-third of youth get recommended amounts of physical activity. Inadequate physical activity accounts for $117 billion in annual health care costs.

CDC’s Response

The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) works in four key areas or domains: epidemiology and surveillance, environmental approaches, health care system interventions, and community programs linked to clinical services. This comprehensive approach supports healthy choices and behaviors, makes healthier options more available, and helps Americans better manage their health.

CDC works with partners—such as state and local health departments, nonprofit groups, universities, and national organizations—to try to ensure that all Americans have access to good nutrition and regular physical activity and can maintain a healthy weight. With $62 million in FY 2016 funding, CDC’s Division of Nutrition, Physical Activity, and Obesity supports these efforts by focusing its activities in three of NCCDPHP’s four domains: epidemiology and surveillance, environmental approaches, and health care system interventions.

CDC Funding for Nutrition, Physical Activity, and Obesity Programs, 2015

Complete data points are also available.

Source: State and Local Programs website.
 

Epidemiology and Surveillance

CDC uses data to monitor long-term trends in nutrition behaviors, physical activity, breastfeeding, and obesity at national, state, and territorial levels and among specific population groups. Data collected from multiple sources, including through ongoing surveillance systems, provide evidence of what interventions are working. CDC partners use this evidence to help state, local, territorial, and tribal health departments create healthier environments in ECE facilities, worksites, hospitals, and communities. For example, the CDC Breastfeeding Report Card provides state data to measure the types of support used to promote breastfeeding and whether states are making progress toward Healthy People 2020 goals.

Surveillance data can also be used to focus resources on reaching populations at highest risk and eliminating racial and ethnic health disparities.

Environmental Approaches

CDC’s goal is to help Americans maintain health and prevent disease. The agency supports evidence-based interventions designed to create lasting changes in key settings and communities by making healthy choices the easy choices. CDC works with health departments, universities, communities, and nongovernmental organizations across the country to achieve this goal.

Early Care and Education Health Improvement Programs

ECE facilities are an ideal place to teach healthy habits early because they reach millions of children younger than 5 on a regular basis. CDC funds grantees in all 50 states to support obesity prevention standards and practices for nutrition, physical activity, reduced screen time, and breastfeeding supports in ECE facilities. Learning collaboratives in 9 states support improved obesity prevention for over 145,000 children in more than 1,400 ECE facilities. In addition, over 18,000 ECE providers serving more than 1 million children have pledged to meet best practices for healthier foods and drinks, physical activity, screen time, and breastfeeding support.

Physically Active Communities

CDC helps state and local governments support community designs that make physical activity, like walking, safer and more convenient. The agency promotes the recommendations in Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities, the Physical Activity Guidelines for Americans, and the National Physical Activity Plan. CDC also supports a wide range of national partners to use the goals and strategies in the Call to Action. As a result, more and more communities are providing safe and easy opportunities for physical activity, like safe routes to schools and Complete Streets policies. Currently, 1 in 5 elementary schools has a Safe Routes to School Program, and more than 850 agencies at local, regional, and state levels have adopted Complete Streets policies.

Health Care System Interventions

Breastfeeding Support in Hospitals

Hospital practices in the first hours and days after birth make the difference in whether and how long infants are breastfed. The Baby-Friendly Hospital Initiative of the World Health Organization and the United Nations Children’s Fund is the global standard for hospital care to support breastfeeding, with the Ten Steps to Successful Breastfeeding at its core.

Because of this work, the percentage of infants born in Baby-Friendly hospitals increased from 1.7% in 2007 to 16.0% in 2016, more than double the Healthy People 2020 target. To address racial disparities, CDC focused on funding hospitals that serve populations with low breastfeeding rates, including African American women. CDC has also worked with community organizations to increase access to lactation care providers in predominantly African American communities.

Quality Care for Children with Obesity

The US Preventive Services Task Force recommends that providers screen children aged 6 or older for obesity and refer those with  obesity to comprehensive, family-based behavioral interventions to improve nutrition, physical activity, and weight. CDC is developing resources to increase insurance coverage and adoption of these recommendations. For example, the Childhood Obesity Research Demonstration (CORD) Project works to help families develop healthy habits and to ensure screening for low-income children and provision of healthy weight programs for children with obesity, especially those eligible for the Children’s Health Insurance Program or Medicaid. The CORD 1.0 Project (2012-2016) funded interventions in three states, including the use of electronic health records to refer children to behavioral management programs. Fifteen health care centers, 75 schools, and 60 ECE centers participated. The CORD 2.0 Project (2106) funded two states for projects that include pediatric weight programs in community health centers and local YMCAs.

Future Directions

To help ensure that all people are healthy at every stage of life, CDC will support the following activities:

Focus on Healthy Environments

• Support health departments and universities to promote healthy eating and physical activity.
• Promote availability and consumption of healthy food.
• Encourage safe places for physical activity by promoting walkable communities.

Focus on Healthy Children

• Improve nutrition, increase physical activity, reduce screen time, and encourage breastfeeding in ECE settings.
• Promote early identification and referral of children with obesity to family-based weight management programs.
• Increase breastfeeding support in hospitals, worksites, and communities and work to ensure that children have the best nutrition in their first 2 years of life.