Nutrition:
 
The 1988 Surgeon General's Report on Nutrition and Health stated "Diseases of dietary excess and imbalances rank among the leading causes of illness and death in the United States, touch the lives of most Americans, and generate substantial health care costs." Furthermore, dietary factors are associated with 4 of the 10 leading causes of death.

Over the past ten years, there has been a significant increase in the number of overweight or obese persons. Overweight or obesity is associated with a number of diseases. These diseases are hypertension, stroke, coronary heart disease, type 2 diabetes, and some types of cancer.

Heart disease is the nation's and Arizona's leading cause of death. The major dietary-related risk factors for developing cardiovascular disease are hypertension, obesity and high blood cholesterol. All three of these risk factors can be prevented with dietary and lifestyle changes.

Cancer is the second leading cause of death in the United. There were 8,851 cancer deaths in Arizona in 1999. Cancer is mostly a preventable disease with the chief causes being tobacco and inappropriate diet. Eating five servings of fruits and vegetables a day can reduce cancer rates by 20%.

Diabetes is the eighth leading cause of death in the United States and it is the seventh leading cause of death in Arizona. Successful nutrition intervention which controls the individual blood sugar level can prevent the onset of diabetes complications.

When we examine the nutritional status of Arizonans, we find:

• The five year average 1994 - 1999 shows that 47.2% of Arizonans are considered overweight with a Body Mass Index greater than 25.0.
• The five year average 1994 - 1999 shows that only 22.2% to 23.0% of Arizona residents eat 5 or more fruits and vegetables per day.
• Information from the 1995 University of Arizona Prevention Center Dietary Profile reveals that 40.1 % of Arizonans consume a diet which contains <10% saturated fat and 42.0% of Arizonans consume a diet which contains <30% total fat per day.
• Information from the 1995 University of Arizona Prevention Center Dietary Profile shows that 22.5% of Arizonans consume 100% RDA (Recommended Daily Amount) of calcium.
• It is estimated that 13.8% of Arizona households are food insecure⁽¹⁾.

According to the American Dietetic Association, the goals of nutrition preventive care are to keep people healthy in their communities, reduce the incidence and severity of preventable diseases, improve health and quality of life, and reduce total medical costs, specifically costs for medication, hospitalization and extended care.

Objective #1 
Reduce iron deficiency anemia among infants, young children and females of childbearing age.
 
Strategy 1.1 
Incorporate anemia prevention messages with existing programs, i.e. nutrition network, head start, food stamp program, beef council.
Strategy 1.2 
Develop a partnership between physician community and WIC to provide consistent anemia messages regarding intervention.
Strategy 1.3 
Develop a statewide protocol for referral and nutrition intervention.
Strategy 1.4 
Investigate factors within the population and WIC system that would result in higher values (needs clarification).
Strategy 1.5 
Track correlation between WIC nutrition education and corresponding client anemia rates.

Objective #2 
Increase the proportion of persons aged 2 years and older who consume at least two daily servings of fruit and at least three daily servings of vegetables, with at least one-third being dark green or deep yellow vegetables.
 
Strategy 2.1 
Promote increased consumption of fruits and vegetables in schools through classroom education, food service, activity/sports programs and parent education.
Strategy 2.2 
Promote increased consumption of fruits and vegetables through the media, public relations activities and community events.
Strategy 2.3 
Promote increased consumption of fruits and vegetables in retail and other settings such as grocery stores, farmer's markets and community gardens.
Strategy 2.4 
Promote increased consumption of fruits and vegetables in food and nutrition programs as WIC, food stamps, EFNEP, Head Start, school lunch and breakfast and the Arizona Nutrition Network.

Objective #3 
Increase food security among AZ households, and in doing so, reduce hunger.
 
Strategy 3.1 
Develop statewide and local food councils in Arizona for the coordination of planning and policy around food security.
Strategy 3.2 
Ensure availability and access to food through better coordination of programs and services.
Strategy 3.3 
Develop public awareness / education marketing plan on food and nutrition availability.

Objective #4 
Increase the proportion of children, adolescents and adults who are at a healthy weight. Gather data by age group.
 
Strategy 4.1 
Establish baseline data by using existing data (BRFSS-WIC-Head Start).
Strategy 4.2 
Establish baseline data by developing partnerships with schools, universities, aging and adult programs and other community agencies.
Strategy 4.3 
Develop a strategy to pursue funding to create a data infrastructure and interventions.
Strategy 4.4 
Establish a protocol that provides a target measure for the population grouping by age.

Objective #5 
Increase the proportion of persons aged 2 years and older who meet dietary recommendations for calcium.
 
Strategy 5.1 
Promote increased consumption of calcium through schools including classroom education, policy change, physical activity opportunities, menu changes, staff training, health education and parent programs. (Note: need baseline and measurement strategies.)
Strategy 5.2 
Promote increased consumption of calcium through healthcare providers and programs such as women's health programs, obstetricians, gynecologists, community health centers, pharmaceutical companies and pediatricians.
Strategy 5.3 
Promote increased consumption of calcium incorporating Arizona nutrition network common messages and strategies into food and nutrition programs such as WIC, food stamps, EFNEP, Head Start, school lunch and breakfast and other programs.

¹  Food Security: Access by all people at all times to enough food for an active, healthy life.  It includes, at a minimum (1) the ready availability of nutritionally adequate and safe foods, and (2) and assured ability to acquire acceptable foods in socially acceptable ways.