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KA 703. Nutrition Education and Behavior (Bernalillo County)

Plan Goal

Improve the health of Bernalillo County limited resource Citizens through healthy eating habits and wise nutrition decisions.

Situation Statement

Good nutrition is essential to improve and maintain health. Five of the leading causes of death include heart disease, cancer, stroke, diabetes and hypertension. These diseases have links to diet. Obesity now affects 57% of all New Mexicans. Specific obesity statistics were not available for Bernalillo County.
These individuals are at increased risk of illness from hypertension, lipid disorders, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and certain cancers.

According to NM Department of Health, the causes of death for New Mexicans, are heart disease at number one (22.3%); Diabetes at number five at (4.5%); and stroke at number six (4.3%). NMDH indicated that in 1991 diabetes death were at 27.6% in New Mexico. By 2004 diabetes deaths rates rose to approximately 34%.

New Mexico has one of the highest rates of poverty in the nation. Bernalillo County has 14.1% of it’s population living below poverty (US Bureau of Census, 2002). By estimates from the N M Department of Health, poverty of all ages total to 75,871 or 13.8%. Specifically there are 29,138 children ages below 18 years old (20.9%) that live in poverty. And there are specifically 18,478 children ages 5 to 17 years old (18.6%) who live in poverty. These numbers have grown over the last 10 years.

Ethnicity for Bernalillo County are 35% White; 53% Hispanic; 3 % African American 5% Native American; and 2% Asian/Pacific Islander.

Limited resource populations face numerous problems associated with inadequate nutrition. In some cases, children do not eat enough to sustain health and to grow and develop at optimal levels. Even more commonly, individuals make poor food choices, which can lead to chronic disease problems such as obesity, diabetes, and heart disease.

In 2003, 5,449 (.09) of Bernalillo County residence were receiving Temporary Assistance for Needy Families (TANF) and 19,912 (3.5%) were receiving food stamps. In 2001 Department of Health estimated that 31.6% of Bernalillo population were eligible for WIC and 52.1% were eligible for Commodities.

Although benefits such as Food Stamps and WIC provide vital resources to some of those in need of food assistance, this resource is often not maximized. This is often due to recipients’ lack of knowledge of the relationships between health and four areas: basic nutrition, food safety, food preparation, and food resource management. In addition, many limited-resource individuals do not receive the encouragement and reinforcement needed to put such knowledge into practice. Education can help limited resource families and individuals maximize their resources to improve their nutritional status. Youth as well as adults should be targeted so nutrition related disease and obesity can be prevented.
Reaching Bernalillo youth early in life with effective nutrition education will promote the adoption of healthy eating and food management practices. Establishing healthy habits early in life can have life long benefits in optimal health and disease prevention. Further, children are an ideal target for nutrition education in terms of habits being more amenable to change than later in life.

Key tools for use in nutrition education by Extension include USDA’s MyPyramid, Dietary Guidelines for Americans (2005), and the Nutrition Facts Label.

Obesity in Children/adults in New Mexico
Diabetes: Of the leading chronic diseases, diabetes is a particular concern in New Mexico. According to New Mexico Department of Health Diabetes Prevention and Control Program report in 2005, Approximately 1 in 11 New Mexico Adults have diabetes. A total of 130,000 New Mexican have diabetes. 92,000 know they have diabetes. 38,000 do not know the have diabetes. Of those diagnosed diabetes, 5% to 10% have type 1 and 90% to 95% have type 2 diabetes.
Native Americans are about 3 times more likely to have diagnosed diabetes than non-Hispanic Whites. Hispanics and African Americans are about 2 times more likely to have diagnosed diabetes than non-Hispanic Whites. Approximately 1662 New Mexican children have diabetes. Among New Mexicans without diabetes, there are serious, though potentially modifiable factors placing many at risk for developing diabetes. Over 1 in 2 New Mexican adults without diabetes are overweight or obese. Nearly 1 in 2 New Mexican adults without diabetes have no regular physical activity.
If left untreated and uncontrolled, diabetes can result in serious complications: blindness, amputations, kidney disease, stroke, heart disease and death. There is no cure for diabetes, but it can be controlled and complications can be prevented or at least delayed. Simple changes, such as healthier food choices and adding regular physical activity can have a significant effect on the health and well-being of people with diabetes. Extension has long taught these principles to the general population. Bernalillo County I CAN program can effectively reach those Bernalillo County with or at risk for diabetes.

Target Audience and Actions

**Target Audience**
I CAN limited resource audiences through the Expanded Food and Nutrition Education Program: including families with children and the Food Stamp Nutrition Education Program: participants that are on food stamps or qualify for food stamps, including individuals, families, youth, seniors of all ethnic make-up.
APS Pre-k – High School students who qualify for free or reduced lunch.
Agencies that work with limited resource clients, Policy makers, Mass media.
Diabetics, special focus on those with or at high risk for diabetes.

**ACTIONS**
Program tools include Eating Right is Basic Enhanced Version Nutrition Program, USDA MyPyramid Guidance System, Dietary Guidelines, Food Safety Information. Youth Component: USDA Team Nutrition and Power Panther Eat Right Play Hard educational programs. Additional food and food related materials from NMSU CAHE specialist. Diabetes: Kitchen Creations Diabetes Cooking Schools curriculum.

Short-Term Objectives

Short-Term Objectives
80% of participants will increase knowledge of MyPyramid, Dietary Guidelines and Nutrition Facts Labels.
80% of participants will increase knowledge of healthy food choices.
80% of participants will increase knowledge of food preparation and meal planning.
80% of participants will increase knowledge of food resource management.
80% of participants will increase knowledge of Diabetes Food Guide Pyramid and 50/50 method.

60% of participants will plan to use MyPyramid, Dietary Guidelines and Nutrition Facts Labels to make food choices and plan meals.
60% of participants will plan to increase fruit and vegetable consumption. 60% of participants will plan to control portion sizes.
60% of participants will plan to adopt new food preparation and meal planning techniques. 60% of participants will plan to adopt new food resource management techniques.
60% of participants will plan to use the Diabetes Food Guide Pyramid and 50/50 method.

Medium-Term Objectives

Medium-Term Objectives:
40% of participants will increase fruit and vegetable consumption one month after program participation.
40% of participants will control portion sizes one month after program participation.
40% of participants will adopt new food preparation and meal planning techniques one month after program participation.
40% of participants will adopt new food resource management techniques one month after program participation.
40% of participants will use the Diabetes Food Guide Pyramid and 50/50 method.

Long-Term Objectives

Long Term Objectives
30% of participants will sustain adopted practices 3 years after program completion.
30% of participants will decrease their rates of chronic disease (obesity, cancer, heart disease).

Evaluation Plan

Evaluation Plan
ICAN, and Kitchen Creations participant knowledge and behavior surveys for short and medium term objectives. Long-term objectives cannot be measured without additional funding.