Introduction
This is the 2011 – 2020 Montana Nutrition and Physical Activity State Plan to Prevent Obesity.
The title reflects several key elements of this plan.
First, it supports many of the national Healthy People 2020 goals and charts a course for reaching these goals in the coming decade.
Second, it is a Montana plan. It draws on the latest science available nationally, but it is crafted specifically by and for Montanans.
Third, it focuses on nutrition, including breastfeeding. This document explains the link between specific eating behaviors and weight management, describes other health benefits of good nutrition, and proposes strategies for improving the nutrition environment in Montana.
Fourth, this plan highlights the critical role of physical activity not only in weight management but also in overall health maintenance, and it offers many strategies for increasing opportunities for active living.
Fifth, it is a state plan. The process of drafting the plan has been coordinated by the Montana Nutrition and Physical Activity Program (NAPA), a project funded by the US Centers for Disease Control and Prevention (CDC) and operated through a partnership between the Montana Department of Public Health and Human Services and Montana State University. The fact that this is a state plan does not imply that the State of Montana is committed to funding, implementing or evaluating it. In addition, there is no guarantee that NAPA will continue to exist throughout the life of the plan, as NAPA is a grant-funded program. This is a state plan because it has been created by, and will ultimately be implemented by, partners throughout the state – and it will benefit Montana residents statewide.
Finally, a very important purpose of this plan is to prevent (and reduce) obesity. (Please see the section titled, “Obesity: Why Talk About It?” for a discussion of obesity as a public health issue.) The rising rate of obesity over the last several decades has not been caused by changes in human nature or genetics; it has been caused by changes in our environment that make it more likely that we will eat a high-calorie diet and less likely that we will be physically active. The environment has become “obesogenic.” This plan seeks to reverse that trend through policy and environmental changes that support healthy eating and active living for all Montanans. It is a primary prevention plan that focuses mostly on upstream interventions.
Upstream interventions are those that help people maintain their health before it is compromised. There is a story that is often used, in one version or another, to illustrate this concept. In the story, a doctor is standing by a river when he hears a cry for help coming from the water. He jumps in, rescues the drowning person, and resuscitates him. Then he hears a second cry for help, and he does the same thing. This goes on all day. The doctor is so busy rescuing drowning people that he doesn’t have time to go upstream and find out why people are falling into the water. Is there a hole in a bridge leading over the river? Is there no sign to warn people of the danger? The moral of the story is that in the long run we may do more good by moving upstream where we can do something to prevent people from getting in over their heads in the first place.
This plan is designed as an on-line tool that can be updated as new information and recommendations about nutrition and physical activity emerge. We hope that it will help you move upstream and make the healthy choice the easy choice in your own community.