Division of Nutrition, Physical Activity, and Obesity At A Glance
CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) leads our nation’s public health efforts to prevent chronic diseases at every stage of life by promoting good nutrition, regular physical activity, and a healthy weight. We work in places where people live, learn, work, and play. Through our support of state and community partners, we provide data, programs that work, and practical tools to promote healthy lifestyles.
DNPAO is also dedicated to removing barriers to health linked to race or ethnicity, ability, education, income, location, or other factors. These efforts help all people live healthier lives and avoid chronic diseases.
What We Do
With an FY 2022 budget of $115.6 million, DNPAO focuses on improving nutrition, supporting breastfeeding, increasing physical activity, reducing obesity, and achieving health equity by reducing disparities. Disparities are differences in health status or access to health care across different geographic, racial, ethnic, and socioeconomic groups.
To meet these goals, DNPAO works to:
Measure and report trends in breastfeeding, nutrition, physical activity, and obesity at national, state, and territorial levels and for specific populations.
- Study interventions to identify the best ways to create healthier environments in early care and education (ECE) facilities, worksites, hospitals, and communities.
- Fund and help guide states, universities, and other community, national, and global partners to use programs that work.
- Share information to help decision makers understand how to create environments that support healthy eating and active living at the community level.
Why We Do It
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Poor nutrition and inadequate physical activity are significant risk factors for obesity and other chronic diseases, such as type 2 diabetes, heart disease, stroke, certain cancers, and depression. Fewer than 1 in 10 children and adults eat the recommended daily amount of vegetables. Only half of adults get the physical activity they need to help reduce and prevent chronic diseases, and more than 100 million have obesity. During 1999–March 2020, obesity prevalence increased from 31% to 42% for adults and from 14% to 20% for children and adolescents.
Promote and Support Breastfeeding
Breastfeeding is the best first source of nutrition for most infants. It can reduce the risk of some short- and long-term health conditions for both infants and mothers. Although more than 80% of mothers start out breastfeeding, about 60% stop sooner than they planned.
Low rates of breastfeeding add more than $3 billion a year to medical costs for women and children in the United States.
DNPAO promotes breastfeeding by:
- Helping mothers who want to breastfeed get the support they need while in the hospital and once they return home. DNPAO helps hospitals improve maternity care practices and promotes breastfeeding support for mothers and babies in worksites, ECE settings, and communities.
- Measuring progress by conducting the national Maternity Practices in Infant Nutrition and Care (mPINC) survey. The Breastfeeding Report Card also tracks national progress by compiling data on breastfeeding practices and supports in all states, the District of Columbia, Puerto Rico, Guam, and the US Virgin Islands.
Examples of Our Impact
- The percentage of babies who started out breastfeeding increased from 70% in 2000 to 84% in 2018.
- Over 1 million babies—more than 29% of all births in 2020—were born in hospitals that had optimal policies and practices that support mothers who want to breastfeed. This is an increase from less than 2% of births in 2007.
- Over half (51%) of US employers have onsite lactation rooms.
Promote a Healthy Childhood
Good nutrition (including key micronutrients) and physical activity are vital for healthy growth and development. In contrast, poor nutrition and low levels of physical activity contribute to childhood obesity. Many settings influence a child’s diet and physical activity, including their home, ECE centers, schools, communities, and clinics.
DNPAO works to improve nutrition and physical activity for children by:
- Sharing effective strategies to promote good nutrition across the United States and globally.
- Promoting best practices in nutrition, breastfeeding, screen time, and physical activity in ECE settings. CDC also disseminates tools and resources to improve obesity prevention standards and practices in ECE settings.
- Helping communities create safe places for children to be physically active.
- Working with health care and community partners through Childhood Obesity Research Demonstration (CORD) Projects to improve obesity screening and counseling services and refer children to healthy lifestyle programs in their communities when needed.
Examples of Our Impact
- DNPAO provided funding and direct technical assistance to states and the District of Columbia to improve their statewide ECE systems to better prevent obesity. This support has strengthened thousands of ECE programs. In total, 40 states have embedded high impact obesity prevention standards in licensing regulations for ECE programs.
- DNPAO awarded Farm to ECE Implementation Grants to fund 10 states and the District of Columbia to strengthen statewide farm to ECE networks with a focus on health equity. These networks increase access to healthy, local foods in ECE settings to help children develop healthy eating patterns from a young age.
- Results from the CORD 1.0 project found that when prevention and treatment programs were used in facilities with limited resources, health and weight improved in children from families with low income.
- DNPAO has provided technical assistance to approximately 60 countries to improve micronutrient nutrition by addressing vitamin and mineral deficiencies.
Increase Access to Healthy Foods
People with healthy eating patterns live longer and have fewer chronic diseases. However, low-income communities and some racial and ethnic groups often lack access to affordable healthy foods. In 2014, about 79 million people in the United States lived in neighborhoods without access to at least one healthy food retailer.
DNPAO works with states, communities, and national partners to help increase healthy food options for people in places where they live, learn, work, and play. The division also:
- Collects data to track the amount of fruits and vegetables that US children and adults eat.
- Works with partners to promote healthier food options in worksites, retail settings, and hospitals by developing guidelines and tools for employers.
- Works with Salad Bars to Schools, a public-private partnership that promotes and sponsors salad bars in schools.
Examples of Our Impact
- From 2015 to 2019, four states and the District of Columbia adopted food service guidelines policies that support the availability of healthier options. These policies apply healthier food standards to the foods and beverages sold or served in government worksites and on property owned or controlled by the state.
- Since 2010, nearly 6,000 schools nationwide have set up new salad bars, giving 2.9 million children easier access to fruits and vegetables each day.
Improve Environments to Promote Physical Activity
Physical activity can improve health now and in the future. Inadequate physical activity costs the nation $117 billion a year and contributes to a range of chronic diseases and premature death. Other potential benefits include better school performance, improved mental health, healthier aging, and improved military readiness.
Unfortunately, many Americans live in communities that lack safe, convenient places to be physically active. To help fix this problem, DNPAO launched Active People, Healthy NationSM to help 27 million Americans become more physically active by 2027. Through this initiative, DNPAO:
- Partners with states and local governments to promote equitable improvements in community design that make physical activity safer and more convenient for people of all ages and abilities.
- Educates the public about the health benefits of physical activity and tracks how much physical activity young people and adults are getting.
Examples of Our Impact
- The percentage of adults meeting the national guideline for aerobic physical activity increased from 44% in 2008 to 54% in 2018.
- Over 1,600 These policies formalize a community’s intent to plan, design, and maintain streets so they are safe for users of all ages and abilities. These changes make it easier for people to walk, bike, or wheelchair roll to essential places such as work, stores, and school.
Fund States and Communities to Reduce Risk Factors for Obesity and Other Chronic Diseases
CDC helps states, national and community organizations, universities, and other partners take actions that promote access to good nutrition and regular physical activity. These efforts help all people—regardless of race or ethnicity, ability, education, income, location, or other factors—improve their health and maintain a healthy weight.
As part of these efforts, DNPAO funds the following programs:
Through SPAN, DNPAO funds 16 states to use interventions that support good nutrition, safe and accessible physical activity, and breastfeeding. SPAN recipients work to reduce or eliminate health disparities within specific groups that are at higher risk of poor nutrition and physical inactivity.
Through HOP, DNPAO funds 15 land-grant universities to work with community extension services to increase access to healthier foods and safe, accessible places for physical activity in counties where more than 40% of the adult population has obesity. These communities tend to have less access to healthy foods and fewer ways to be physically active.
The REACH program is at the forefront of CDC’s efforts to achieve health equity across the United States. Through REACH, DNPAO funds 40 state and local organizations to reduce health disparities among racial and ethnic groups in communities with high risk or rates of chronic diseases, such as hypertension, heart disease, type 2 diabetes, and obesity. Recipients use culturally tailored interventions to promote breastfeeding, healthy eating, and physical activity and to increase access to health care and preventive care programs.
Examples of Our Impact
Because of the efforts of state programs funded during 2013–2017:
- 10,098 ECE facilities, 2,343 worksites, and 271 community settings adopted or implemented food service guidelines or nutrition standards. Community settings include parks, concession stands, community centers, sports arenas and stadiums, and restaurants.
- 2,274 communities developed or adopted a pedestrian or master transportation plan. These plans can include changes to the physical environment that support physical activity in small geographic or urban areas—for example through land use policies and urban design.
- 447 birthing facilities began using recommended breastfeeding practices, 141 facilities were designated as Baby-Friendly, 2,623 community sites provided professional and peer support for breastfeeding, and 1,909 employers provided space and time for nursing mothers to express breastmilk.
From 2014 to 2018, REACH communities reached over 2.9 million people with interventions designed to improve nutrition and over 320,000 people with smoke-free and tobacco-free interventions.
Health Equity Highlight: REACH
Data from 2018–2020 show notable differences in self-reported obesity prevalence by race and ethnicity. Obesity prevalence was at or above 35% for non-Hispanic White adults in 7 states (among 49 states*), Hispanic adults in 22 states (among 49 states*), non-Hispanic Black adults in 35 states and DC (among 48 states*), and Asian adults in 0 states (among 33 states*).
*Among states and territories with sufficient data.
DNPAO’s REACH program funds 40 organizations to achieve health equity. These efforts include culturally tailored interventions to promote breastfeeding, healthy eating, and physical activity, and to increase access to health care and preventive programs.
See the National Center for Chronic Disease Prevention and Health Promotion infographic to find out more about the center’s work to prevent heart disease, stroke, and other chronic diseases.