E-Newsletter
may 2009


SPOTLIGHT

PUBLICATIONS

RESEARCH HIGHLIGHTS

MORE CHILDHOOD OBESITY NEWS


SPOTLIGHT

Limiting Exposure To Risk Factors Key To Curbing Childhood Obesity

May 7, 2009

Restricting the locations of fast food franchise development. Banning junk food and beverage sales in schools. Instituting new taxes to dissuade consumers from buying unhealthy food. Policymakers at all levels are discussing ways to increase the distance between students and unhealthful foods and beverages.

In response to a recent study that found that young teenagers tend to weigh more when there are fast-food restaurants within one block of their schools, Queens, NY, City Councilman Eric N. Gioia proposed a law to keep fast-food restaurants from opening so close to the city's schools.

"The Effect of Fast Food Restaurants on Obesity" study, conducted by the University of California, Berkley and Columbia University, found an increased obesity rate of at least 5.2 percent among teenagers at schools where fast-food outlets were a tenth of a mile — roughly one city block — or less away. If a fast-food restaurant opened a quarter-mile or more from a school, obesity rates were not affected.

"With the proliferation of fast-food restaurants directly around schools, it's a clear and present danger to our children's health," said Gioia, who proposed the ban at an April news conference at a school opposite a McDonald's in New York's Tribeca neighborhood.

"A fast-food restaurant on the corner can have a terrible impact on a child's life," he said. "Obesity, diabetes, hypertension — it's a step toward a less healthy life."

The study, which was published in February, culled data over eight years from 1,047 California high schools. It found that caloric intake could increase 30 to 100 calories a day depending on the proximity of a fast-food restaurant and that the effect was greatest for students who were Hispanic and female. Pregnant women, the study said, were also more likely to gain more weight if they lived within a tenth of a mile from a fast-food outlet.

Some health advocates cheered Gioia's proposal, saying it was one step among many that had to be taken to fight what has been described as a national obesity epidemic. According to data released last May by the Centers for Disease Control and Prevention, 32 percent of schoolchildren in the country were overweight or obese.

Gioia said the ban should be accompanied by other tactics to fight childhood obesity, like easing access to food stamps, putting greenmarkets in poor neighborhoods and educating children about healthy eating. He said he also looked at the neighborhoods in the city with the highest obesity rates and found 28 fast-food restaurants within one tenth of a mile of a school in these areas. In East Harlem alone, where about one third of people are obese, Gioia found 18 schools with fast-food restaurants within one tenth of a mile.

"If we're not willing to move harmful substances away just one block, what are we willing to do?" said Gioia.

Yet one critic, Rick Berman, the executive director of the Center for Consumer Freedom, a group supported by the food and restaurant industries, countered that the association between fast food and obesity did not prove causation. For example, he said some states with a high density of fast-food outlets have comparably low obesity rates.

"It's the exercise and energy equation that has a whole lot more to do with obesity than people eating a hamburger or salad," said Berman. "And quite frankly, salads are available at fast-food restaurants."

But an author of the study, which was published by the National Bureau of Economic Research, said the report factored out most extraneous variables, and indeed showed cause and effect.

"We looked at restaurants that open beside a school and whether that changes the fraction of students that are overweight," said Janet Currie, chairwoman of the economics department at Columbia University. "And it does."

From Down the Block to Down the Hall

Other groups are looking within schools, rather than around them, in order to increase the distance young people must travel to find unhealthful foods. The Senate Agriculture Committee, the National Parent Teacher Association (PTA) and the American Dietetic Association (ADA) recently urged Congress to pass legislation that would prohibit all sales of junk food in schools, reported Reuters.

The committee is holding a series of hearings in preparation for the reauthorization of federal childhood nutrition programs, which are up for renewal this year. Specifically, the PTA and ADA support legislation requiring that all foods sold in schools (including food sold in vending machines, a la carte items, and food sold during school fundraising activities) meet the same nutritional standards as foods provided through the National School Lunch Program.

Although advocates of the measure say it would provide all students with an "equal opportunity for a healthy school environment," others, including the National School Boards Association, say the measure could hurt the financial well-being of schools that rely on snack food sales to offset educational costs. The Senate committee plans to evaluate the appropriate federal role in such decisions and will review efforts to improve overall nutrition in schools.

Readying for the Sugar Beverage Ban

National legislation targeting unhealthful foods would just be icing on the cake for Colorado. The Colorado Board of Education unanimously approved a statewide ban last December on the sale of soda and other sugar-sweetened beverages in public schools.

Gov. Bill Ritter signed the new legislation related to nutrition in public schools into law last spring, but directed the State Board of Education to write the actual rules. The law officially goes into effect July 1, prohibiting the sale of beverages containing sugar to students in school cafeterias, vending machines, school stores, and fund-raising activities conducted on school campuses. Beverages sold at sports events and other school-sponsored events where parents and other adults are part of the audience are exempt.

The rules outline different beverage nutritional standards for elementary, middle and high schools, with allowances for some low-calorie beverages for older students. Across the board, beverages sold to students on school grounds must meet minimum nutrition requirements. However, individual school districts can implement more restrictive standards if they choose. Under the rule, elementary and middle schools are permitted to sell water, low-fat milk, low-fat flavored milk, milk substitutes approved by the U.S. Department of Agriculture, and 100 percent juice. High schools can sell the same items, plus low-calorie sports drinks and other low-calorie beverages, except diet soda, which the new measure specifically prohibits.

As with junk food legislation, some schools have expressed concern that Colorado's efforts could have a negative economic impact on state school districts that currently have lucrative contracts with soft drink vendors. Jefferson County School District, for example, has a contract with Pepsi Co. valued at between $800,000 and $1 million.

But many school districts have wasted no time in making adjustments. "Our middle schools no longer sell any drinks containing sugar," said Shannon Pelland, assistant superintendent of business for the Roaring Fork School District. However, some of the beverages in high school vending machines, such as diet soda and sports drinks, will need to be replaced when the new rules kick in.

Cafeterias at district schools in Glenwood Springs, Carbondale and Basalt have also already changed over, according to District Food Service Director Michelle Hammond. "In the elementary schools we only serve white milk now, and the middle and high schools follow the state guidelines," she said. "We have an overall goal of serving our students healthy beverages and foods, so it wasn't something I had to take a look at too much."

Meanwhile, the district is also considering whether to implement a healthy meals pilot program aimed at reducing the amount of processed food in school lunches.

Experts Argue for Tax on Sweet Drinks

A penny-per-ounce tax on sugary drinks could help fight obesity by cutting consumption and raising billions of dollars to help state and local governments pay for programs.

Just as taxes on cigarettes have been shown to reduce smoking, taxes on sugary drinks may help adults and children choose healthier options, which are often more expensive than sodas and other sweetened beverages, asserted a recent study in the New England Journal of Medicine.

A tax of one penny per fluid ounce (30 ml) on drinks such as soda, sports drinks, and sugar-sweetened fruit juice and iced tea could "reduce consumption of sugared beverages by more than 10 percent," wrote Kelly Brownell of Yale University and New York City Health Commissioner Dr. Thomas Frieden.

Similar tobacco taxes have been effective at reducing consumption, according to the researchers. One article reviewed suggested that for every 10 percent increase in the price of cigarettes, consumption decreased by 7.8 percent.

Studies show that children and adolescents now consume 10 percent to 15 percent of all their calories in beverages. Nevertheless, the American Beverage Association published a survey in March showing that 70 percent of Americans oppose a national tax on non-diet soft drinks.

The group says a tax could cost jobs in an industry that employs 220,000 people in the United States. New York was among several states to propose a tax on sugar sodas, but the idea proved unpopular and was dropped.

Brownell and Frieden said the tax revenue could be put to good use, raising $1.2 billion in New York alone. This could help offset some of the societal costs of drinking too many soft drinks.

"The contribution of unhealthful diets to healthcare costs is already high and is increasing – an estimated $79 billion is spent annually for overweight and obesity alone – and approximately half of these costs are paid by Medicare and Medicaid, at taxpayers' expense," they wrote.

"Sugar-sweetened beverages may be the single largest driver of the obesity epidemic," they added. "For each extra can or glass of sugared beverage consumed per day, the likelihood of a child's becoming obese increases by 60 percent."

***

Compiled from the following sources:

Buckley C. A Proposal to Separate Fast Food and Schools. April 20, 2009, The New York Times, http://www.nytimes.com/2009/04/20/nyregion/20obese.html?_r=1.

Senate Committee Considers Banning Sale of Junk Food in Schools. April 3, 2009, RWJF Childhood Obesity News Digest, http://www.rwjf.org/childhoodobesity/digest.jsp?id=10166.

U.S. Experts Argue For Tax On Sweet Drinks. April 8, 2009, Reuters, http://www.reuters.com/article/healthNews/idUSTRE5378SX20090408.

Stroud J. Colorado Schools Start Adjusting To Sugar Beverage Ban. April 15, 2009, Glenwood Springs Post Independent, http://www.postindependent.com/article/20090415/VALLEYNEWS/904149947/1074.

Colorado State School Board Bans All Soft Drinks From Schools. Dec. 11, 2008, Childhood Obesity News Digest, http://www.rwjf.org/childhoodobesity/digest.jsp?id=9150.

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PUBLICATIONS

McKinnon RA, Reedy J, Handy SL, Rogers AB. Measuring The Food And Physical Activity Environments: Shaping The Research Agenda, Am J Prev Med 2009;36(4S):S81-S85.

Robust measures of the food and physical activity environments are required to enhance our understanding of the causes of variation in diet, physical activity, and weight; to strengthen interventions; and to form the foundation of research that can inform policy. Clearly, enormous strides have been made in recent years in measuring the food and physical activity environments, as researchers from a variety of backgrounds have come together to examine and inform the public health challenges associated with poor diet and physical inactivity. Yet equally clearly, much work remains. Our hope is that the papers in this supplement will stimulate interest and development in measuring food and physical activity environments (both in the research community as well as funding organizations); strengthen research on these environmental impacts on behavior; and inform policy to improve diet, physical activity, and health outcomes.

CLICK HERE TO DOWNLOAD A PDF OF THE FULL DOCUMENT

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McKinnon RA, Reedy J, Morrissette MA, Lytle LA, Yaroch AL. Measures Of The Food Environment: A Compilation Of Literature, 1990-2007, Am J Prev Med 2009;36(4S):S124–S133.

BACKGROUND: Valid and reliable measures are required to assess any effect of the food environment on individual dietary behavior, and form the foundation of research that may inform obesity-related policy. Although many methods of measuring the food environment exist, this area of research is still relatively new and there has been no systematic attempt to gather these measures, to compare and contrast them, or to report on their psychometric properties.
EVIDENCE ACQUISITION: A structured literature search was conducted to identify peer-reviewed articles published between January 1990 and August 2007 that measured the community-level food environment. These articles were categorized into the following environments: food stores, restaurants, schools, and worksites. The measurement strategies in these studies were categorized as instruments (checklists, market baskets, inventories, or interviews/questionnaires) or methodologies (geographic, sales, menu, or nutrient analyses).
EVIDENCE SYNTHESIS: A total of 137 articles were identified that included measures of the food environment. Researchers focused on assessing the accessibility, availability, affordability, and quality of the food environment. The most frequently used measure overall was some form of geographic analysis. Eighteen of the 137 articles (13.1 percent) tested for any psychometric properties, including inter-rater reliability, test–retest reliability, and/or validity.
CONCLUSIONS: A greater focus on testing for reliability and validity of measures of the food environment may increase rigor in research in this area. Robust measures of the food environment may strengthen research on the effects of the community-level food environment on individual dietary behavior, assist in the development and evaluation of interventions, and inform policymaking targeted at reducing the prevalence of obesity and improving diet.

CLICK HERE TO DOWNLOAD A PDF OF THE FULL DOCUMENT

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Story M, Giles-Corti B, Yaroch AL, Cummins S, Frank LD, Huang TK, Lewis LB. Work Group IV: Future Directions For Measures Of The Food And Physical Activity Environments, Am J Prev Med 2009;36(4S):S182–S188.

ABSTRACT: Much progress has been made in the past five to 10 years in measuring and understanding the impact of the food and physical activity environments on behavioral outcomes. Nevertheless, this research is in its infancy. A work group was convened to identify current evidence gaps and barriers in food and physical activity environments and policy research measures, and develop recommendations to guide future directions for measurement and methodologic research efforts. A nominal group process was used to determine six priority areas for food and physical activity environments and policy measures to move the field forward by 2015, including: (1) identify relevant factors in the food and physical activity environments to measure, including those most amenable to change; (2) improve understanding of mechanisms for relationships between the environment and physical activity, diet, and obesity; (3) develop simplified measures that are sensitive to change, valid for different population groups and settings, and responsive to changing trends; (4) evaluate natural experiments to improve understanding of food and physical activity environments and their impact on behaviors and weight; (5) establish surveillance systems to predict and track change over time; and (6) develop standards for adopting effective health-promoting changes to the food and physical activity environments. The recommendations emanating from the work group highlight actions required to advance policy-relevant research related to food and physical activity environments.

CLICK HERE TO DOWNLOAD A PDF OF THE FULL DOCUMENT

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RESEARCH HIGHLIGHTS

New Data Analysis Shows Possible Link Between Childhood Obesity And Allergies

May 4, 2009, NIH News Release

A new study indicates there may be yet another reason to reduce childhood obesity — it may help prevent allergies. The study published in the May issue of the Journal of Allergy and Clinical Immunology showed that obese children and adolescents are at increased risk of having some kind of allergy, especially to a food. The study was funded by the National Institute of Environmental Health Sciences (NIEHS) and the National Institute of Allergy and Infectious Diseases (NIAID), both parts of the National Institutes of Health.

"We found a positive association between obesity and allergies," said Darryl Zeldin, M.D., acting clinical director at NIEHS and senior author on the paper. The researchers analyzed data on children and young adults ages 2 to19 from a new national dataset designed to obtain information about allergies and asthma. "While the results from this study are interesting, they do not prove that obesity causes allergies. More research is needed to further investigate this potential link," Zeldin said.

The study is the first to be published using new data from the National Health and Nutrition Examination Survey (NHANES). NHANES is a large nationally representative survey conducted by the National Center for Health Statistics, a part of the Centers for Disease Control and Prevention. NHANES is designed to assess the health and nutritional status of adults and children in the United States. An allergy/asthma component was supported by NIEHS and added to the 2005–2006 NHANES study, making it the largest nationally representative dataset of allergy and asthma information ever assembled in the United States.

"We have all the pieces of the puzzle in this dataset," said Zeldin. "The allergy and asthma component of NHANES provides allergen exposure information, allergic sensitization information, as well as disease outcome information. There is a wealth of knowledge we will be able to gain by analyzing these data that will be useful to allergy and asthma sufferers."

In this study, the researchers analyzed data from 4,111 children and young adults aged 2-19 years of age. They looked at total and allergen-specific immunoglobulin E (IgE) or antibody levels to a large panel of indoor, outdoor and food allergens, body weight, and responses to a questionnaire about diagnoses of hay fever, eczema, and allergies. Obesity was defined as being in the 95th percentile of the body mass index for the child's age. The researchers found the IgE levels were higher among children who were obese or overweight. Obese children were about 26 percent more likely to have allergies than children of normal weight.

"The signal for allergies seemed to be coming mostly from food allergies. The rate of having a food allergy was 59 percent higher for obese children," said NIEHS researcher Stephanie London, M.D., a co-author on the study.

"As childhood obesity rates rise, NIEHS will continue to work to determine how environmental factors affect this epidemic," said Linda Birnbaum, Ph.D., NIEHS director. "Seeing a possible link between obesity and allergies provides additional motivation for undertaking the challenge of reducing childhood obesity."

"Given that the prevalence of both obesity and allergic disease has increased among children over the last several decades, it is important to understand and, if possible, prevent these epidemics," said Cynthia M. Visness, Ph.D., lead author on the paper and a scientist at Rho Federal Systems Division, Inc. in Chapel Hill, N.C.

***

Original Source: http://www.nih.gov/news/health/may2009/niehs-04.htm

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Child Obesity Is Linked to Chemicals in Plastics

April 17, 2009, The New York Times

By Jennifer Lee

Exposure to chemicals used in plastics may be linked with childhood obesity, according to results from a long-term health study on girls who live in East Harlem and surrounding communities that were presented to community leaders on Thursday by researchers at Mount Sinai Medical Center.

The chemicals in question are called phthalates, which are used to make plastics pliable and in personal care products. Phthalates, which are absorbed into the body, are a type of endocrine disruptor — chemicals that affect glands and hormones that regulate many bodily functions. They have raised concerns as possible carcinogens for more than a decade, but attention over their role in obesity is relatively recent.

The research linking endocrine disruptors with obesity has been growing recently. A number of animal studies have shown that exposing mice to some endocrine disruptors causes them be more obese. Chemicals that have raised concern include Bisphenol A (which is used in plastics) and perfluorooctanoic acid, which is often used to create nonstick surfaces.

However, the East Harlem study, which includes data published in the journal Epidemiology, presents some of the first evidence linking obesity and endocrine disruptors in humans.

The researchers measured exposure to phthalates by looking at the children's urine. "The heaviest girls have the highest levels of phthalates metabolites in their urine," said Dr. Philip J. Landrigan, a professor of pediatrics at Mount Sinai, one of the lead researchers on the study. "It goes up as the children get heavier, but it's most evident in the heaviest kids."

This builds upon a larger Mount Sinai research effort called "Growing Up Healthy in East Harlem," which has looked at various health factors in East Harlem children over the last 10 years, including pesticides, diet and even proximity to bodegas.

About 40 percent of the children in East Harlem are considered either overweight or obese. "When we say children, I'm talking about kindergarten children, we are talking about little kids," Dr. Landrigan said. "This is a problem that begins early in life."

The Growing Up Healthy study involves more than 300 children in East Harlem, and an additional 200 or so children in surrounding communities.

The phthalate study follows a separate group of about 400 girls in the same communities, who range in age from 9 to 11.

One thing researchers have found is that the levels of phthalates measured in children in both studies are significantly higher than the average levels that the Centers for Disease Control and Prevention have measured for children across the entire United States.

The findings may presage a new approach to thinking about obesity — drawing environmental factors into a central part of the equation. "Most people think childhood obesity is an imbalance between how much they eat and how much they play," Dr. Landrigan said.

But he thinks the impact of endocrine disruptors on obesity could be more significant than many people believe. "Most people think it's marginal," he said, paling in comparison with diet and exercise.

But he likened it with the impact of lead on a child's I.Q. "Lead never makes more than 3 or 4 percent difference in margin, but 3 to 5 I.Q. points is a big deal," he said.

Of course, at this stage, researchers cannot say if the exposure actually causes obesity, simply that it seems to be linked. "Right now it's a correlation; we don't know if it's cause and effect or an accidental finding," Dr. Landrigan said. "The $64,000 question is, what is causal pathway? Does it go through the thyroid gland? Does it change fat metabolism?"

The National Children's Study, which will follow 100,000 children from across the country from birth to age 21, will look more broadly at endocrine disruptors and other issues.

"Some of the clues that come out of East Harlem will actually be pursued in the larger one," Dr. Landrigan said. Meanwhile, Dr. Landrigan advised people to reduce their exposure to phthalates as a precautionary measure. "You can't avoid them completely, but you can certainly reduce their exposure," he said.

It's somewhat difficult to do, since many things do not contain labels identifying phthalates, and in the case of perfumes they can simply be labeled as "fragrance."

Phthalates are found in certain personal care products (like nail polish and cosmetics), though recent regulation has encouraged companies to reduce or eliminate them. They are also found in common everyday objects, including vinyl siding, toys and pacifiers. A number of environmental Web sites, including The Daily Green, have advised certain strategies, including learning to recognize the abbreviations for certain common phthalates and to prefer certain kinds of recyclable plastics over others.

***

Original Source: http://cityroom.blogs.nytimes.com/author/jennifer-8-lee/

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Junk Food Makes Kids Fatter, But Happier, Study Suggests

April 14, 2009, ScienceDaily

Fast food and soft drinks may be making children fatter but they also make them happy. Programs aimed at tackling childhood obesity, by reducing children's consumption of unhealthy food and drink, are likely to be more effective if they also actively seek to keep children happy in other ways, according to Professor Hung-Hao Chang from National Taiwan University and Professor Rodolfo Nayga from the University of Arkansas.

Childhood obesity is a major public health issue worldwide. It is well accepted that unhealthy eating patterns are partly responsible for the increase in childhood obesity.

However, very little is known about the relationship between fast food and soft drink consumption and children's happiness.

For the first time, Chang and Nayga looked at the relationship between unhealthy dietary habits and children's psychological health. In particular, they studied the effects of fast food and soft drink consumption on children's body weight and unhappiness. Using data from the National Health Interview Survey in Taiwan – a nationwide survey carried out in 2001 – the authors looked at the fast food and soft drink consumption, body weight and level of happiness of 2,366 children aged between 2 and 12 years old. Fast food included French fries, pizza and hamburgers; soft drinks included soda and other sugar-sweetened beverages.

A quarter of the children in the survey sample were overweight or obese and approximately 19 percent sometimes or often felt unhappy, sad or depressed. The study's key finding was that children who ate fast food and drank soft drinks were more likely to be overweight, but they were also less likely to be unhappy. The authors' analysis also highlighted a number of factors influencing children's body weight, eating patterns and happiness. For example, mothers' consumption of fast food and soft drinks predicted her child's eating habits. Those children who ate fast food were more likely to also consume soft drinks. Children from lower income households were more likely to have unhealthy dietary habits and be overweight or obese.

The authors conclude: "Our findings suggest that consumption of fast food and soft drinks can result in a trade-off between children's objective (i.e. obesity) and subjective (i.e., unhappiness) well-being. Policies and programs that aim to improve children's overall health should take these effects on children's objective and subjective well-being into account to facilitate the reduction in childhood obesity without sacrificing children's degree of happiness."

Their findings are published in Springer's Journal of Happiness Studies.

***

Original Source: http://www.sciencedaily.com/releases/2009/04/090414085325.htm

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Childhood Obesity, Diabetes, And Related Conditions Investigated

April 13, 2009, ScienceDaily

Factors identified early in childhood could predict obesity in the teen years and beyond, and researchers continue to assess methods to prevent and treat excess weight gain and its consequences in children and teens, according to several reports published in the April issue of Archives of Pediatrics & Adolescent Medicine.

Studies featured in this issue include the following:

School-Based Intervention Changes Some, But Not All, Behaviors and Measures of Obesity

An interdisciplinary program designed to increase awareness of obesity and change the behaviors of Dutch school children appears to have reduced the amount of sugary beverages consumed by boys and girls and also improved body composition in girls alone, but did not seem to affect other behaviors. Amika S. Singh, Ph.D., and colleagues at VU University Medical Center, EMGO Institute, Amsterdam, the Netherlands, assessed the effectiveness of the intervention among 1,108 adolescents (average age 12.7). The program included 11 lessons in biology, physical education and lifestyle changes over eight months.

Students at the 10 schools that participated in the program drank fewer sugar-sweetened beverages at the end of the intervention (287 milliliters per day less for boys and 249 milliliters per day less for girls) and 12 months later (233 milliliters per day less for boys and 271 milliliters per day less for girls) than did those in the eight schools that did not participate. In addition, at a 20-month follow-up, the intervention remained effective in preventing unfavorable increases in the sum of all skinfold measurements (taken at the triceps, biceps, below the shoulder and between the hip joint and ribcage) in girls. However, no changes were seen in consumption of snacks or in walking or biking to school.

"Hence, our results do not show consistently positive findings on all anthropometric and behavioral outcome measures. Our findings are important, especially when considering the need for evidence on the long-term effectiveness of interventions in the field of obesity prevention," the authors write. "Reducing intake of sugar-containing beverages should therefore be considered a good behavioral target for future interventions aimed at the prevention of overweight among adolescents."

Schools remain "an obvious and important channel for providing obesity-prevention programs, as the vast majority of youth spend a great deal of time each week throughout their development from childhood to young adulthood in schools," writes Leslie A. Lytle, Ph.D., of the University of Minnesota, Minneapolis, in an accompanying editorial. "However, as the extent of the published research in this field is substantial and the findings consistently mixed and modest, it may be time to re-evaluate where the research needs to move."

Teens Who Give Birth More Likely to Be Overweight

Girls who give birth between ages 15 and 19 appear to be substantially heavier, with more abdominal fat, regardless of their childhood weight or of other risk factors for weight gain. Erica P. Gunderson, Ph.D., of Kaiser Permanente, Oakland, Calif., and colleagues studied 1,890 girls (983 black and 907 white) who were age 9 to 10 at the beginning of the study in 1987-1988. After nine to 10 years—in 1996-1997—31 percent of black girls and 10 percent of white girls had given birth during adolescence or young adulthood. Those who did were more likely to experience increases in weight, body mass index, hip circumference and percentage of body fat. The association was stronger among black women than white women.

"Our findings are potentially important because adolescence has been identified as one of the critical periods of development that set the stage for the onset of obesity later in life," the authors write. "Earlier age at a first birth (younger than 20 years) has been associated with increased rates of coronary heart disease in women. Thus, the influence of gestational weight gain on changes in growth and adiposity during adolescence is an important aspect for future investigation."

Diabetes and Blood Pressure Medication Prescriptions Increase Among Children and Teens

The number of children and teens prescribed medicine to treat high blood pressure or diabetes appears to have increased between 2004 and 2007. Joshua N. Liberman, Ph.D., of CVS Caremark in Hunt Valley, Md., and colleagues analyzed the prescription records of more than 5 million commercially insured individuals ages 6 to 18 covered by a pharmacy benefits manager.

The prevalence of children and teens who were prescribed medications for hypertension (high blood pressure), dyslipidemia (abnormal cholesterol) or diabetes (including insulin) increased 15.2 percent, from 3.3 per 1,000 youths in November 2004 to 3.8 per 1,000 youths in June 2007. "The increasing use of oral anti-diabetic and antihypertensive pharmacotherapy among children and adolescents, especially in the younger age group, indicates either an increased awareness of treatment needs or increased incidence of cardiovascular risk factors typically associated with adult populations," the authors write.

When assessed separately, cholesterol-controlling therapy was uncommon (prescribed to 0.2 per 1,000 youths overall) and declined 22.9 percent during the study period. "The decrease in treatment of dyslipidemia may reflect the ongoing controversy regarding statin use," the authors conclude.

The results indicate that these drugs are not currently being overused in this population, writes Stephen R. Daniels, M.D., Ph.D., of the University of Colorado Denver School of Medicine, in an accompanying editorial. "While the potential for misuse of these medications remains, that does not appear to be happening at this time. Nevertheless, it will be important to collect data in an ongoing manner to monitor use of these medications but also to identify appropriateness of use and ultimate reduction of risk factor levels in children and adolescents."

***

Original Source: http://www.sciencedaily.com/releases/2009/04/090406192343.htm

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Substituting Water For Sugar-Sweetened Beverages Can Reduce Excess Calorie Consumption

April 6, 2009, Columbia University's Mailman School of Public Health

Replacing consumption of sugar-sweetened beverages (SSBs) with water could eliminate an average of 235 excess calories per day among children and adolescents, according to a study published in the April 2009 Archives of Pediatrics & Adolescent Medicine. The study's authors conclude that such a replacement would be a simple and effective way to reduce excess intake of calories causing childhood overweight and obesity, as well as address dental cavities and other health problems associated with added sugar. And they predict no detrimental effects on nutrition.

"The evidence is now clear that replacing these 'liquid calories' with calorie-free beverage alternatives both at home and in schools represents a key strategy to eliminate excess calories and prevent childhood obesity," said Y. Claire Wang, MD, ScD, assistant professor of Health Policy and Management at Columbia University Mailman School of Public Health and the study's lead author.

Dr. Wang and colleagues analyzed what children and teens reported they ate and drank on two different days, using nationally representative data from the 2003-2004 National Health and Nutrition Examination Survey. They then estimated the impact of substituting water for SSBs on the total energy intake of youths ages two to 19.

No data suggest that youths increase their consumption of other foods and beverages to compensate for drinking fewer SSBs, and so every can of soda or fruit drink that is replaced by water means a net reduction of calories. Almost 90 percent of U.S. children and adolescents currently consume SSBs on any given day, including soda, fruit drinks, punches, sports drinks and sweetened tea, and the calories contained in these drinks can represent more than 10 percent of their total daily intake. There is growing evidence that sugar-sweetened beverage consumption is an important contributor to rising youth obesity rates in the United States.

"This study shows the substantial impact that replacing sugar-sweetened beverages with water could have," said C. Tracy Orleans, senior scientist and distinguished fellow at the Robert Wood Johnson Foundation, which co-funded the study along with the Centers for Disease Control and Prevention. "Reversing the rise in childhood obesity requires finding approaches like this to close the gap between daily energy intake and daily energy expenditure. Changes such as this one can potentially add up to significant benefits for the population as a whole."

In contrast to the caloric reduction noted when replacing SSBs with water, the researchers found no difference when replacing SSBs with milk. But they emphasized the calcium, protein and other nutritional benefits that reduced-fat milk provides, in contrast to most SSBs. Though the findings suggest that reducing SSB consumption may prevent unhealthy weight gain, the researchers say that widespread recommendations to decrease SSB consumption are unlikely to lead to unnecessary or harmful weight loss in healthy-weight or underweight teens.

A 2008 study by the same team of researchers found that children consume SSBs in a variety of locations-homes, schools, fast-food establishments and other restaurants. Up to 70 percent of the consumption occurs in the home environment, whereas seven to 15 percent of consumption occurs in schools.

"Making children and teens more active is important," Dr. Wang noted, "However, simply eliminating the extra calories they don't need from these sugary drinks can tip the energy balance in a major way." A typical 15-year-old boy would need to jog for 30 minutes in order to burn off the calories contained in a 12-oz can of soda. The alternative drink best suited to reduce excess caloric consumption is water.

"These beverages are nothing more than different forms of sugar water, which kids don't need." said Steven Gortmaker, PhD, professor of the Practice of Health Sociology at the Harvard School of Public Health and the senior author on the study. "Unless they are running marathons, which we do not recommend for kids, water is the best choice for quenching their thirst. It is also low cost, especially when it comes from a clean tap source."

***

Original Source: http://www.eurekalert.org/pub_releases/2009-04/cums-swf040309.php

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ADDITIONAL RESEARCH HIGHLIGHTS

Researcher Clarifies Native Childhood Obesity Findings

April 24, 2009, Indian Country Today

By Rob Capriccioso

From segments on cable news to Associated Press reports, the national news media has been abuzz, reporting findings from a recent study that indicated Native American children to be suffering from an exceptionally high rate of obesity compared to other racial groups. The lead researcher of the study now says the buzz may have been overblown.

The reports stemmed from a study released in April's Archives of Pediatrics & Adolescent Medicine, which found that obesity prevalence was 31.2 percent for Native preschoolers, compared with 15.9 percent for white children and 12.8 percent for Asian kids. The next closest group to the Native youngsters was Hispanic children, which were found to have a 22 percent obesity rate – 10 points better than American Indian children.

The reports were eye opening for many health experts, especially since there has historically been very little research on youth obesity sorted by racial group. Of the research that has been done, Native American youth have not often been singled out because there are too few of them represented in most studies to allow conclusive findings to be drawn.

Epidemiologist Sarah E. Anderson, of Ohio State University, knew about the historical problem of under sampling of Native kids, so she and her colleagues decided to analyze data on 8,550 children involved in the Early Childhood Longitudinal Study who were born in 2001 and assessed in 2005.

The scientists who put together the ECLS study purposely oversampled Native Americans, so statistically significant research could be conducted.

Despite their use of statistically significant data, the researchers involved with the youth obesity study did not single out environmental, social or other factors that may have skewed the numbers. For instance, they did not control for socioeconomic status to determine whether more affluent Native children suffered from higher obesity rates than those living in extreme poverty.

Outside researchers who have explored the study noted that the data does not provide a firm picture on whether race was the determining factor in the obesity differences, or whether some other cause, such as socioeconomic status, played a role.

Gary Nelsestuen, a biochemist with the University of Minnesota who has conducted studies involving Native Americans, believes it was an "oversight" for the researchers not to have matched their findings.

"If you matched for socioeconomic status, the differences between races would likely be much smaller. The research ends up holding much less significance."

While there may be some genetic component to childhood obesity – something that has not been proven conclusively – Nelsestuen cautioned that environmental factors could be as large, or even bigger. Based on the limitations of the study at hand, he said he'd put more weight on environmental over racial factors.

Anderson said the prevalence of obesity she found for Native kids was surprising to her – and that the findings do not necessarily mean that American Indians are more prone to childhood obesity.

"Our analyses were very descriptive, and did not adjust for factors such as socioeconomic status," Anderson noted, saying that it was "absolutely" important to point out limitations of the study.

Other research in older populations focused on obesity and socioeconomic status has been conducted, but the results have been mixed. Not all studies, for instance, have found that socioeconomic status is the sole determining factor for obesity or overweight conditions.

"We were not, in this analysis, trying to determine or explain what led to differences in obesity rates at early ages," Anderson said. "Certainly, much, much more research is needed to understand how it is by age 4, there is such a high prevalence [of obesity] across racial groups."

Citing her sensitivity to the way the study has been covered in the national media, Anderson said she worried that some people might be led to believe that Native American genetics is correlated with obesity.

"This study cannot say that at all," she said. "I think that it is very important to be clear that we don't think that the differences in obesity are due to race/ethnicity, per se, but they may be due to different cultural contexts. We did not look at that at all in this research."

Anderson said she didn't think the media attention is a bad thing necessarily, and she hopes her research helps highlight the need to understand obesity in all younger kids.

Despite the limitations, Anderson said the study is important because it is the first national analysis of the obesity of 4-year-olds that looked at racial groups. "We've started on this path; now it's time for more detailed research that can begin to account for our limitations."

Various tribal and federal health experts have said there is an across-the-board need for childhood obesity prevention efforts to begin early in life for all children, regardless of race.

***

Original Source: http://www.indiancountrytoday.com/living/health/43281782.html

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Nearly 20 Percent Of 4-Year-Olds Are Obese, Study Finds

April 6, 2009, The Associated Press

A striking new study says almost 1 in 5 American 4-year-olds is obese, and the rate is alarmingly higher among American Indian children, with nearly a third of them obese. Researchers were surprised to see differences by race at so early an age.

Overall, more than a half-million 4-year-olds are obese, the study suggests. Obesity is more common in Hispanic and black youngsters, too, but the disparity is most startling in American Indians, whose rate is almost double that of whites.

The lead author said that rate is worrisome among children so young, even in a population at higher risk for obesity because of other health problems and economic disadvantages.

"The magnitude of these differences was larger than we expected, and it is surprising to see differences by racial groups present so early in childhood," said Sarah Anderson, an Ohio State University public health researcher. She conducted the research with Temple University's Dr. Robert Whitaker.

Dr. Glenn Flores, a pediatrics and public health professor at University of Texas Southwestern Medical School in Dallas, said the research is an important contribution to studies documenting racial and ethnic disparities in children's weight.

"The cumulative evidence is alarming because within just a few decades, America will become a 'minority majority' nation," he said. Without interventions, the next generation "will be at very high risk" for heart disease, high blood pressure, cancers, joint diseases and other problems connected with obesity, said Flores, who was not involved in the new research.

The study is an analysis of nationally representative height and weight data on 8,550 preschoolers born in 2001. Children were measured in their homes and were part of a study conducted by the government's National Center for Educational Statistics. The results appear in April's Archives of Pediatrics & Adolescent Medicine.

Almost 13 percent of Asian children were obese, along with 16 percent of whites, almost 21 percent of blacks, 22 percent of Hispanics, and 31 percent of American Indians.

Children were considered obese if their body-mass index, a height-weight ratio, was in the 95th percentile or higher based on government BMI growth charts. For 4-year-olds, that would be a BMI of about 18.

For example, a girl who is 4 1/2 years old, 40 inches tall and 42 pounds would have a BMI of about 18, weighing 4 pounds more than the government's upper limit for that age, height and gender.

Some previous studies of young children did not distinguish between kids who were merely overweight versus obese, or they examined fewer racial groups.

The current study looked only at obesity and a specific age group. Anderson called it the first analysis of national obesity rates in preschool kids in the five ethnic or racial groups.

The researchers did not examine reasons for the disparities, but others offered several theories.

Flores cited higher rates of diabetes in American Indians, and also Hispanics, which scientists believe may be due to genetic differences.

Also, other factors that can increase obesity risks tend to be more common among minorities, including poverty, less educated parents, and diets high in fat and calories, Flores said.

Jessica Burger, a member of the Little River Ottawa tribe and health director of a tribal clinic in Manistee, Mich., said many children at her clinic are overweight or obese, including preschoolers.

Burger, a nurse, said one culprit is gestational diabetes, which occurs during a mother's pregnancy. That increases children's chances of becoming overweight and is almost twice as common in American Indian women, compared with whites.

She also blamed the federal commodity program for low-income people that many American Indian families receive. The offerings include lots of pastas, rice and other high-carbohydrate foods that contribute to what Burger said is often called a "commod bod."

"When that's the predominant dietary base in a household without access to fresh fruits and vegetables, that really creates a better chance of a person becoming obese," she said.
Also, Burger noted that exercise is not a priority in many American Indian families struggling to make ends meet, with parents feeling stressed just to provide basic necessities.

To address the problem, her clinic has created activities for young Indian children, including summer camps and a winter break "outdoor day" that had kids braving 8-degree temperatures to play games including "snowsnake." That's a traditional American Indian contest in which players throw long, carved wooden "snakes" along a snow or ice trail to see whose lands the farthest.

The hope is that giving kids used to modern sedentary ways a taste of a more active traditional American Indian lifestyle will help them adopt healthier habits, she said.

***

Original Source: http://www2.tbo.com/content/2009/apr/06/061739/nearly-20-4-year-olds-are-obese-study-finds/news-breaking/

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University of Michigan Study:
Parent Self-Control May Impact Kid Obesity

April 6, 2009, Detroit Free Press

By Cassandra Spratling
cspratling@freepress.com

Parents need to model self-control as part of teaching it to their children, and doing so can be a valuable weapon in the battle against childhood obesity.

That's the lesson behind a study released today by the University of Michigan's and appearing in the April issue of the Journal of the American Medical Association's Archives of Pediatrics & Adolescent Medicine.

The study, which looked at a group of 805 children at age four and checked back on them at age 11, found that children who are able to delay gratification are less likely to be overweight.

In the study, a group of 4-year-olds was asked to choose candy, animal crackers or pretzels as their preferred food and left alone with two plates of different quantities of the food.

They could eat a larger portion of chosen food if they waited until the examiner returned. If they could not wait until the examiner returned, they could ring a bell to summon the examiner back into the room, at which time they could eat the small quantity.

Almost half (47 percent) of the 805 children failed the test, either by ringing the bell before a seven-minute waiting period elapsed, spontaneously beginning to eat the food, becoming distressed, going to the door or calling for a parent or the examiner.
Children who had difficulty delaying gratification were about 30 percent more likely to be overweight by age 11 than those who could delay gratification, says study coauthor Dr. Julie Lumeng, a developmental and behavioral pediatrician at the University of Michigan Health System.

The weight of the mother made a difference in the child's ability to wait to eat, Lumeng adds.

"Moms who are overweight themselves have kids that are less able to wait," Lumeng says. "No study like this one can prove causation, but there's an association." The influence of maternal weight status on child weight reflects genetic as well as environmental factors, and both factors are possible explanations for this finding, she said.

This study suggests that if parents want to reduce the risk of obesity in their children, they should teach the child to delay gratification and model the behavior themselves, Lumeng says.

***

Original Source: http://www.freep.com/article/20090406/FEATURES08/90406069/
U-M+study++Parent+self-control+may+impact+kid+obesity+

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Rapid Infant Weight Gain Linked To Childhood Obesity;
Study Suggests Water Fountain Access May Reduce Childhood Obesity

March 30, 2009, China Daily

Babies who gain weight quickly during the first six months of life may be more prone to obesity as toddlers, Harvard researchers report.

"We need to start our preventive methods when children are much younger," said study author Dr. Elsie M. Taveras. "Even in the first couple of weeks of life, we can start guiding parents about how to prevent rapid weight gain in their infants."

While past research has established a link between birth weight and obesity, the impact of factors such as length of gestation, height and lifestyle of the mother were often not considered.

The researchers tracked 559 children who were part of Project Viva, an ongoing study of pregnant women and their children. The babies were measured for weight and height at birth, at 6 months and again at the age of 3.

After adjusting for factors such as the babies' length, researchers found that those who increased their body-mass index (BMI) during their first six months were more likely to be classified as obese at age 3.

"At present, most guidelines around obesity management recommend that we start assessment and treatment of children after the age of 2," Taveras said.

According to the National Institutes of Health, nearly a third of adults in the United States are obese. Obese people are 10 percent to 50 percent more likely to die of all causes. In 2000, the obesity epidemic cost the U.S. health system $117 billion.

"The key indication for this study is the importance of better education about feeding infants," said Connie Diekman, director of university nutrition at Washington University in St. Louis. "Since the study did not look at what children were fed after weaning, it is hard to know if overfeeding then is a contributor."

Water Fountain Access

Addressing this issue may involve simply making minor changes. In Germany, water fountains were installed in 32 schools located in poor areas of two German cities. Teachers then presented four lesson plans to second- and third-grade students about the benefits of water consumption.

The study found that the students who attended these schools were 31 percent less likely to become overweight than those who attended other schools not involved in the study.
Both studies are to be published in the April issue of Pediatrics.

"The researchers themselves identified that we need to study caregiver and infant relationships, since other studies have shown when there is a lack of a bonding during feeding, infants will change what they eat," says Diekman. "In addition, other potential confounders need to be removed, and then the study repeated, to see if weight gain during pregnancy is a factor."

"Our study raises a lot of questions about the reason rapid infant weight gain results in obesity later on," Taveras said. "We need more research to identify the factors that explain this relationship."

***

Original Source: http://www.chinadaily.com.cn/life/2009-04/03/content_7647479.htm

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School-Based Physical Fitness Programs Fail To Curb Childhood Obesity

March 31, 2009, RWJF Childhood Obesity News Digest

A study in a recent issue of the Canadian Medical Association Journal suggests that, although school-based physical fitness programs can improve some aspects of children's health, they are ineffective at reducing obesity, HealthDay reports. To examine the impact of school fitness programs on child health, researchers from BC Children's Hospital in Vancouver, B.C., analyzed 18 studies involving over 18,000 children and conducted over periods from six months to three years. They found that school-based physical education programs produced no consistent changes in body mass index (BMI) or other body composition measures. However, the researchers did find that such programs were associated with improvements in blood pressure, muscle mass, bone mineral density, lung capacity and flexibility. Based on the findings, the researchers conclude that although school-based physical activity programs have been proven to improve overall health, they may fail to offer enough vigorous activity to prevent childhood obesity. Writing in an accompanying editorial, Louise Baur from the University of Sydney in Australia noted that reversing childhood obesity trends will require broader, more long-term approaches that include healthier school meals and changes to the built environment in which children live (HealthDay News, 3/30/09; Harris et al., Canadian Medical Association Journal, 3/31/09 [subscription required]).

***

Original Source: http://www.rwjf.org/childhoodobesity/digest.jsp?id=10117

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MORE CHILDHOOD OBESITY NEWS

Top Policy Groups Take Action to Create Healthy Communities,
Prevent Childhood Obesity

April 30, 2009, PRNewswire

Eleven of the nation's most prominent policymaker groups have endorsed a host of comprehensive policy strategies and environmental changes to create healthier communities and help reverse the childhood obesity epidemic. Their support will be announced next week at the second Childhood Obesity Prevention Summit hosted by Leadership for Healthy Communities.

More than 200 elected and appointed officials and other leaders will attend the biennial summit, which will take place May 7-8 at the Ronald Reagan Building and International Trade Center in Washington. Representing states, schools and localities nationwide, they will focus on policy options that advance healthy eating and increased physical activity.
They also will honor five colleagues whose communities have implemented innovative approaches: New York Mayor Michael Bloomberg; Superintendent Roel Gonzalez of the Rio Grande City Consolidated Independent School District in Texas; Mayor Darwin Hindman of Columbia, Mo.; San Francisco Mayor Gavin Newsom; and Mayor Claude Ramsey of Hamilton County, Tenn.

Leadership for Healthy Communities is a national program of the Robert Wood Johnson Foundation that works in collaboration with 11 influential groups: the American Association of School Administrators; International City/County Management Association; Local Government Commission; Council of State Governments; National Association of Counties; National Association of Latino Elected and Appointed Officials Educational Fund; National Association of State Boards of Education; National Conference of State Legislatures; National League of Cities; National School Boards Association; and the U.S. Conference of Mayors.

"The need for action is clear," the organizations declare in an unequivocal joint statement. Signed by each group's executive director, it concludes, "When policy leaders unite for a common purpose, it enables communities to tap into a larger network of social and financial resources. Together, they can support healthy schools, healthy communities and healthy children."

As part of a multiyear effort, Leadership for Healthy Communities now will recruit additional policymaker champions to join the growing movement to reverse the epidemic of childhood obesity by 2015. They will benefit from a new toolkit to be released at the summit. Action Strategies for Healthy Communities, developed by the national program and its partners, recommends policy measures to increase physical activity and improve nutrition among children and families. It places special emphasis on the populations most affected by obesity and its serious health consequences.

"Day in, day out, the policymakers gathered here demonstrate a commitment to improving the health of their communities and of our nation's children," said Maya Rockeymoore Cummings, Ph.D., director of Leadership for Healthy Communities. "Their work is especially impressive and important given the economic challenges confronting state and local governments, as well as families across the nation."

The summit's honorees, who will receive the Healthy Communities Leadership Award, were chosen from more than 40 nominees. Their approaches illustrate the gamut of policies that can help prevent childhood obesity:

  • In New York, Mayor Bloomberg helped make that city the first in the nation to require fast-food and chain restaurants to provide nutrition information on menus. It also was the first city to adopt formal nutrition standards for schools and city agencies.
  • In the Rio Grande City Consolidated Independent school district, Superintendent Gonzalez eliminated fried foods, desserts, whole milk and fat-laden salad dressings from cafeteria menus. Gonzalez also opened up school facilities for community use during after-school hours.
  • In Columbia, Mayor Hindman's leadership in active transportation helped the city secure a $25 million federal grant. It has used the funding to develop a network of walking and biking trails that connect businesses and shopping centers to parks, schools and neighborhoods.
  • In San Francisco, Mayor Newsom supported an ordinance expanding farmers' markets in lower-income communities and requiring vendors to accept payment from federal, state and local food assistance programs. He also provided funding to 25 public schools for salad bars featuring locally grown produce and wholegrain breads.
  • In Hamilton County, Mayor Ramsey launched an initiative to make school facilities available to children and families outside of school hours. The county partnered with schools, restaurants and community groups to promote healthy menu selections and reasonable portion sizes using cartoon characters created by DC and Marvel Comics artists.

Today, nearly 33 percent of children and adolescents and about 65 percent of adults in the United States are overweight or obese. This health crisis disproportionately affects African-Americans, Latinos, American Indians and Alaska Natives, as well as people living in lower-income communities, placing them at increased risk of developing type 2 diabetes, heart disease, and other serious, chronic problems.

Beyond the personal health toll, overweight and obesity put added pressure on an already overburdened health care system. Studies estimate that the obesity epidemic is costing the country more than $117 billion per year in direct medical expenses and indirect costs such as reduced productivity and absenteeism.

***

Original Source: http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=104&STORY=/
www/story/04-30-2009/0005016465&EDATE=

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Massachusetts Town Takes Steps To Trim Fat, Health Care Costs

April 21, 2009, USA Today

By Mimi Hall

Kelle Shugrue's 7-year-old son eats fresh fruit and vegetables at his public school, rides his bike along neighborhood paths and walked to school last week as part of a community effort to get kids moving.

The Shugrue family lives in Somerville, Mass., a Boston suburb hailed by health advocates for its seven-year investment in programs fighting childhood obesity and encouraging healthful living.

The model program is beginning to be replicated around the country, a small start on a huge task: preventing the onset of chronic diseases such as diabetes and heart disease that now account for 75 percent of the nation's health care spending. As the Obama administration and Congress tackle an overhaul of the health care system, chronic disease looms as a major impediment to controlling costs.

According to the Partnership to Fight Chronic Disease, 45 percent of Americans — 133 million people — suffer from at least one chronic disease such as asthma or hypertension. Because many of the conditions are brought on or exacerbated by obesity, which has doubled nationwide since 1987, experts say they can be prevented or at least better managed.

"Improving the management of chronic disease is a critical component of our plan to drive down the skyrocketing cost of health care," says Nancy-Ann DeParle, director of the White House Office for Health Reform. "Two-thirds of Medicare spending is for beneficiaries with five or more chronic conditions."

A down payment is coming. In February, as part of the $800 billion economic stimulus package, Congress approved $1 billion for disease prevention and wellness programs. A third of that money is slated for immunizations; two-thirds for new programs to prevent chronic diseases.

The Department of Health and Human Services plans to announce early this summer how it will use that new money. "We want to help prevent disease and illness before Americans end up at the doctor's office or the emergency room," says Nick Papas, a department spokesman.

Experts at the disease partnership and in Congress say controlling chronic disease requires a two-pronged approach: preventing diseases before they begin and doing a better job helping patients manage their chronic conditions once they develop.

The issue will be up for discussion in the Senate on Tuesday when Finance Committee Chairman Max Baucus, D-Mont., holds the first of three roundtable discussions on health care reform. The subject of the session, which will include insurance company CEOs, doctors and nurses, and policy analysts, is how to make the health care delivery system more effective, including by better managing chronic care.

Building Blocks of Fitness

Somerville's experiment began in 2002, when researchers from Tufts University decided to find out whether efforts to promote exercise and healthful eating could help prevent obesity among schoolchildren.

The program, Shape Up Somerville, was first aimed at elementary school kids, 44 percent of whom were either overweight or at risk of becoming overweight. With grants from the federal Centers for Disease Control and Prevention and philanthropic groups, the researchers had schools replace French fries, candy, soda and other unhealthful foods with fresh fruit, skim milk and other nutritious choices. The city added bike lanes and pedestrian crosswalks to encourage people to exercise. Restaurants offered more healthful items on menus; residents planted community gardens.

After just one year, the schoolchildren first targeted showed results: They gained 15 percent less weight than other average kids their age. Twice as many people were riding bikes along the community's bike paths.

"It's powerful to see those numbers change like that," says Nicole Rioles, who runs the ongoing Shape Up program.

Shugrue, 37, says she and her husband always have promoted healthful choices at home and she's happy that the schools and the community reinforce that message for their second-grader, Henry, rather than undermine it.

Dozens more cities from Oakland to Louisville are following Somerville's lead to develop similar programs. "We would love to give our two cents to the White House and anyone else planning for really healthy communities," Rioles says.

Without such efforts, the Partnership to Fight Chronic Disease and other groups say, the government will never get a handle on health care costs.

According to the chronic disease partnership, the federal government spent $586 billion in 2008 on patients with at least one chronic condition, such as diabetes or heart disease.
Kenneth Thorpe, director of the Partnership, says those people who already have developed chronic conditions must be better managed so that their conditions don't deteriorate and they don't end up with costly hospital stays.

He favors community health teams made up of nurse practitioners and coordinators to monitor patients' progress and make sure they take their medication.

Preventative Steps

DeParle says the Obama administration is taking steps to improve care, even before the health care debate heats up.

"The administration has already begun reforming Medicare's payment by rewarding doctors for better quality, efficiency and coordination of care," she says. Jeffrey Levi, director of the nonprofit Trust for America's Health, is more focused on solving the problem before it begins.

Levi says he's sure changes to the health-care system will include funding and programs to prevent chronic disease. That wasn't the case in 1993-94, during the last overhaul effort, when he said public health advocates were "banging at the door" to get heard.
"I am very confident (legislation) will include a serious commitment to public health and prevention," Levi says.

***

Original Source: http://www.usatoday.com/news/nation/2009-04-20-chronic_N.htm

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Developing Tools To Fight Childhood Obesity

April 17, 2009, eMaxHealth.com

The Department of Health Healthy Hawai'i Initiative (HHI) and University of Hawai'i (UH) Department of Pediatrics have developed educational obesity prevention materials to help pediatricians talk to families with children during routine health visits. The materials consist of handouts for families that outline healthy eating habits proven to have an effect on weight and will be piloted at the Kapi'olani Medical Center for Women and Children's Pediatric Clinic. Physicians have been trained in the use of the curriculum.

A DOH study conducted in 2003 found that almost one-third of the children entering Hawai'i public schools are either overweight or at risk of becoming overweight. As they grow older, overweight children and adolescents are at increased risk for numerous health conditions, including type 2 diabetes, hypertension, cardiovascular disease, as well as shorter life expectancies.

An extensive literature review was conducted by Dr. Gina French, Kapi'olani Pediatric Clinic medical director, to identify key behaviors of healthy families that have shown to be effective for attaining a healthy weight. The project is based on the latest research available and presents user friendly information to families during periodic well child visits. Doctors trained in using the materials share the information with the child's parent or caregiver during the well child visit, and provide a handout for them to take.

"The doctor's recommendations consist of age related tips from infancy on and include topics such as breastfeeding, limiting sweet drinks, eating meals together as a family at home and turning off the television during meals," said Dr. Louise Iwaishi, principal investigator for the Pediatric Obesity Prevention Project. "These tips are supportive of healthy eating habits and encourage quality time with the family."

Research has shown that parents are often their children's most important role model. If children see their caregivers enjoying healthy foods and being physically active, they are more likely to do the same.

Therefore, the recommendations are aimed at having the whole family develop habits that help prevent overweight. In addition, age appropriate nutrition advice is provided for children ages 0-5.

"The obesity prevention project is an example of trusted people in our community sharing with local families actions they can take to live healthier lives," stated Health Director Chiyome Fukino, M.D. "Through this partnership we are working on a system change and encourage healthcare centers and physicians to use the materials created."

The next phase of the project will include creating translated versions of the handouts and posters in Marshallese and Chuukese. In addition, HHI and UH are working on making the curriculum into a permanent course offering at the UH-Manoa John A. Burns School of Medicine.

***

Original Source: http://www.emaxhealth.com/2/109/30509/developing-tools-fight-childhood-obesity.html

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Digital Campaign Uses Power Of Social Connections To Combat Obesity

April 14, 2009, PR Newswire

The Alliance for a Healthier Generation (http://www.healthiergeneration.org/) and AgencyNet (http://www.agencynet.com) strike back at the youth obesity epidemic, leveraging the power of digital communities to get kids moving and living healthier lives.

The Alliance, backed by The William J. Clinton Foundation and The American Heart Association, enlisted AgencyNet to launch a platform where America's youth are empowered and equipped to change the patterns of childhood obesity.

EmpowerMe2b.org (http://www.empowerme2b.org) provides teens and tweens with the information they need to improve their health and more importantly, gives them a positive place to share their stories and influence each other to lead healthier, happier lives. The digital medium represents the perfect forum for the Kids Movement because it engages youth where they are already spending much of their time.

America's obesity epidemic has hit our nation's youth hard. While adult obesity rates have doubled since 1980, alarmingly, our children have fared even worse. Over the same period, obesity rates for our youth have nearly tripled. Obesity subjects children to a wide range of physical, social and emotional consequences ranging from hypertension and diabetes to depression and social stigma.

Recognizing the stakes, AgencyNet and President Bill Clinton's Alliance for a Health Generation (AHG) first teamed up in 2007; launching igohugo.org, a website dedicated to activating kids and getting them moving.

Two years later, AgencyNet and AHG join forces again for this worthy cause. This time around, the kids are in charge. Founded in summer 2008, the Youth Advisory Board (YAB), consists of 21 youth representing a diverse mix of backgrounds. They are the de facto leaders of the movement; charged with providing feedback on Alliance Kids' Movement programs and strategies and, more importantly, generating new ideas on how to make healthy living the norm, not the exception. EmpowerMe2B.org serves as a soapbox for the YAB, allowing them into influence the Kids Movement nationwide. The site also serves as a recruitment tool, allowing Movement members the opportunity to join the board themselves.

But responsibility doesn't rest entirely with the YAB. They are joined by the rest of the Kids Movement who can connect on the site to share personal stories and best practices, motivating others to follow their example.

"Kids reported feeling overwhelmed by the adult voice in their lives. By passing the baton and putting kids at the helm, the EmpowerMe movement leverages the fact that tweens are powerful influencers for their peers," said Garett Bugda, Executive Creative Director for AgencyNet.

On the site, resources are provided to activate youth as the key instigators of change in their lives and communities. The 'empowerME@school' section provides students with a toolkit to bring positive changes to their school, while the 'empowerME4life' section provides resources to learn healthy habits that will last a lifetime. In the 'myStory' section, visitors can be inspired by the heartfelt success stories of other kids who have already made the pledge to live a healthier lifestyle and understand their reasons for doing so. In turn, they are encouraged to share their own story. Additionally, the site offers engaging tools, educational tips, real-time polls as well as edutainment-oriented games and videos.

The site was built on the open-source Drupal platform, providing both robust CMS services and customizable content modules. This allows site content to remain fresh and fully reflect all current and upcoming AHG and Kids Movement initiatives. More than a million committed kids across the nation are joined by celebrities, athletes and the former President to ensure that tomorrow's generation will live longer, healthier lives. All this and more make EmpowerMe2B.org a sustainable destination for those who believe that childhood obesity should be a thing of the past.

***

Original Source: http://www.prweb.com/releases/2009/04/prweb2312984.htm

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U.S. Department Of Health And Human Services Releases Public Service Announcements To Encourage Healthy Lifestyles – New 'Take The Lead' PSA To Highlight Childhood Overweight And Obesity Prevention Initiative

April 6, 2009, PR Newswire

The U.S. Department of Health and Human Services' Office of the Surgeon General released two public service announcements, in English, "Take the Lead" and in Spanish, "Mi Cocina," on childhood overweight and obesity prevention. Both PSAs encourage families to be physically active and eat healthy foods. The PSAs were released on the first day of National Public Health Week, which is April 6-12, 2009.

The Office of the Surgeon General is disseminating the PSAs as part of its "Healthy Youth for a Healthy Future" public information initiative.

The new PSAs encourage adults to adopt and maintain healthy lifestyles to improve their personal health and set an example for children to follow. More than 12.5 million children and adolescents – 17.1 percent of people ages 2 to 19 years – are overweight.

"Early intervention against overweight and obesity is crucial," said Acting Surgeon General Steven K. Galson, MD, MPH, a rear admiral in the U.S. Public Health Service. "This is because children learn lifelong eating and activity habits at a young age."

As they grow older, overweight children and adolescents are more likely to have risk factors associated with cardiovascular disease such as high blood pressure, high cholesterol, and Type 2 diabetes.

"To ensure a healthy future for America's children we must help kids get the recommended 60 minutes or more of daily physical activity," Dr. Galson said. "Using family time to help children develop good habits will benefit them now and throughout their lives."

The National Public Health Information Coalition, an independent organization dedicated to improving America's health through public health communications, will help distribute the PSAs to health departments nationwide and promote posting the announcements to the departments' Web sites.

The PSAs will be featured beginning today on Washington DC's W*USA 9 as part of its Lighten Up Campaign, a partnership between Children's National Medical Center, Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. and W*USA 9, that brings attention to childhood obesity. In addition, the PSAs will be highlighted by Weight Watchers on www.weightwatchers.com.

In the "Take the Lead" PSA, children emulate the adults as they exercise, make healthy food choices, and practice good hygiene. The PSA closes with a message from Dr. Galson urging everyone to take a part in leading our youth to a healthy future. He also directs the audience to the Office of the Surgeon General's website to receive a parent or caregiver checklist. The Spanish PSA "Mi Cocina," takes a family approach that encourages helpful tips on healthy eating. Both PSAs reinforce the importance of adults taking the lead in setting healthy examples.

***

Original Source: http://sev.prnewswire.com/health-care-hospitals/20090406/DC9453306042009-1.html

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Humana Foundation Launches Campaign To Improve Childhood Fitness

April 1, 2009, RWJF Childhood Obesity News Digest

The Louisville, Ky.,-based Humana Foundation, the philanthropic arm of health-benefits company Humana Inc., has launched a campaign aimed at reducing childhood obesity, the Louisville Courier-Journal reports. Piloted last year in Jefferson County Public Schools, the American Horsepower Challenge provides participating students with a pedometer that tracks the number of steps they take each day for four weeks. Each student's steps are uploaded into an interactive video game. As part of the virtual game, each student receives a cartoon horse avatar that rides a bus emblazoned with the name of the school the child attends as it races across a map of the world. The more steps the child logs, the faster the bus travels the course. Students can use their individual step totals to dress their horse and decorate the team school bus. According to the Humana Foundation, the pilot increased by 13 percent the number of steps taken by children and encouraged 62 percent of the children to exercise more, 53 percent of them to involve their families in their workout routines and 45 percent to begin eating healthier. The foundation aims to recruit 2,000 students from 100 middle schools to participate in the five-week challenge. In addition, 20 members of Congress representing states or districts with participating schools will tally their steps and add them to the students' totals (Carroll, Louisville Courier-Journal, 4/1/09; Humana Foundation release, 3/31/09).

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Original Source: http://www.rwjf.org/childhoodobesity/digest.jsp?id=10128

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ADDITIONAL CHILDHOOD OBESITY NEWS

BMI Screening Will Begin This Fall In Massachusetts Schools

April 8, 2009, The Boston Globe

By Stephen Smith

Public health regulators this morning unanimously approved screening Massachusetts students to determine if they are overweight, part of a major campaign to shrink bulging waistlines and stem obesity-related diseases once rarely seen in the young.

The vote by the Public Health Council – an appointed board of doctors, academics, and service providers – means that starting in the fall, public schools across the state will begin measuring and weighing first-, fourth-, seventh- and 10th-graders. Parents who do not want their children screened will be able to opt out.

The screenings will be phased in during the next two school years, with more than 286,000 students expected to have undergone evaluation by the end of the 2010-2011 academic year.

Parents will receive a report telling them how their children fared on the body mass index, a standard measurement used to analyze if someone weighs too much or too little. The report will also include recommendations on dealing with a child's weight problem, including a suggestion to visit the pediatrician.

"We think it would be a mistake to just send home a number and leave parents hanging without providing an interpretation," said Dr. Lauren Smith, medical director of the state Department of Public Health.

The initiative is modeled on programs in Arkansas and New York City schools that have been calculating the body mass index of students for several years.

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Original Source: http://www.boston.com/news/health/blog/2009/04/bmi_screening_w.html

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Wanted: 100,000 Places To Play

April 13, 2009, USA Today

By Jeanette Der Bedrosian

Play is serious business for KaBOOM!, a national nonprofit aimed at locating and funding play spaces. The organization has launched a campaign to locate 100,000 play spaces — playgrounds, skate parks and field complexes — in 100 days in an effort to ensure there is a play space within walking distance of every child.

Through its online play space locator, KaBOOM! is asking parents, teachers and community leaders to enter and rate their local play spaces. For every play space entered, $1 will be donated to charity in the name of country music singer and two-time Dancing With the Stars winner Julianne Hough. The result will help parents locate the best play spaces in their area and provide an honest analysis to community leaders of whether they have enough quality play spaces, says CEO Darell Hammond.

"KaBOOM! cannot build every play space that's out there or raise enough money to do so, but we can put the information out there and help people understand where the areas of issue are," Hammond says.

The organization has teamed up with six nonprofit partners to spread the word, Hammond says. The group is using interactive Google maps and social network Twitter to make entries easier.

"If a parent is out there at a playground, they can grab their iPhone or their Blackberry and 'tweet-pic' a photo of the play space to a nonprofit partner," Hammond says. Hammond is referring to a Twitter feature that enables camera phone users to quickly post photos.

KaBOOM! helped the city of Tucson recognize a problem with the locations of the city's play spaces, Hammond says. After applying for the nonprofit's designation as a Playful City USA, a playground audit of Tucson revealed many of the lower-income areas didn't have sufficient play spaces. As a result, Hammond says, the city has taken steps to open school playgrounds to the public on weekends.

"We want them to improve access, improve quality and improve quantity," Hammond says. "Having a sense of urgency in a short period of time is motivating people to participate locally but also to understand the ramifications nationally."

KaBOOM!'s campaign started March 23 and runs through June 30, or until 100,000 new play spaces are entered on the site. The organization is partners with YMCA of the USA, the National Wildlife Federation, Shaping America's Health, Jumpstart, America's Promise Alliance and First Book. As of Friday, the database had reached 4,000 new entries.

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Original Source: http://www.usatoday.com/news/health/2009-04-13-kaboom-play_N.htm

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Ohio Releases Comprehensive Statewide Obesity Prevention Plan

April 2, 2009, RWJF Childhood Obesity News Digest

The Ohio Department of Health's Office of Healthy Ohio has released a comprehensive statewide plan to reduce obesity, the Associated Press reports. Created in response to a 2008 directive from Gov. Ted Strickland to draft a plan aimed at addressing the problems of obesity, the 131-page Ohio Obesity Prevention Plan was developed with guidance and input from state agencies and obesity experts, as well as state and national recommendations for obesity prevention.

The five-year plan outlines three specific goals for preventing obesity, including enhancing opportunities for physical activity, improving access to healthy foods and limiting the availability of unhealthy foods, and better coordinating policies and resources designed to prevent obesity. Immediate objectives of the plan call for the Ohio Department of Education to collaborate with the U.S. Department of Agriculture on efforts to improve the nutritional quality of school meals and for schools to create plans to increase opportunities for physical activity. Additional high priority objectives include identifying existing rural and urban food deserts, developing and promoting a statewide trail system, creating and implementing a statewide obesity prevention campaign, and establishing government and public-private partnerships to evaluate program objectives and ensure continued progress. According to the plan, each of the immediate objectives should be completed by December 2009.

Meanwhile, short-term objectives, which are slated for completion by December 2011, include developing a plan to improve nutrition and physical activity requirements for child care facilities; increasing the number of farmer's markets that can accept food stamps; expanding programming efforts aimed at providing nutrition education to professionals and parents; and increasing training, education and resource opportunities for health care providers to promote obesity prevention. Long-term plan objectives, which the report says should be addressed by December 2014, include increasing the number of facilities adopting policies and practices that seek to reduce childhood obesity; promoting adoption of the national Farm-to-School and Safe Routes to Schools programs; increasing the number of restaurants that post calorie information on their menus; and coordinating with insurers and other payers to offer health plans that encourage members to achieve and maintain a healthy weight and lifestyle.

Although the current plan focuses on initiatives and goals to be accomplished within the next five years, the Ohio Department of Health views the plan as a working document that will be continually evaluated and updated as the state meets or falls short of the outlined goals. According to a government survey, 28.1 percent of adults and 19 percent of children living in Ohio were overweight in 2007 (AP/Newark Advocate, 4/1/09; Ohio Department of Health release, 3/31/09; Ohio Obesity Prevention Plan, March 2009).

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Original Source: http://www.rwjf.org/publichealth/digest.jsp?id=10156

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Report From Wildlife Group Urges Children To Play Outside

April 2, 2009, RWJF Childhood Obesity News Digest

The National Wildlife Federation (NWF) has issued a report encouraging states, cities, school districts and parents to develop strategies to encourage children to play outside, the Wichita Eagle reports. According to the NWF, the amount of time children in the United States spend outdoors has declined 50 percent during the last two decades.

The NWF's Children and Outdoors State Policy Solutions Guide includes model resolutions, executive orders and legislative suggestions designed to guide states as they launch efforts to reconnect children and their families with nature. For example, the report calls on states to provide additional funding to parks and wildlife departments for conservation education, build natural play areas for children and support the development of public bike and walking trails. The NWF also notes that school systems should play an active role in encouraging children to participate in outdoor activities, recommending that states encourage schools to develop environmental literacy plans, provide funding for environmental education and mandate that schools allot at least 20 minutes daily of unstructured outdoor play.

To leverage the impact of urban planning decisions on connectedness to nature, the report recommends that states and cities develop "complete streets" that can safely accommodate drivers, cyclists and pedestrians; create incentives for real estate developments to add features designed to promote physical activity; and support Safe Routes to School programs (Tobias, Wichita Eagle, 4/1/09; NWF release, 3/31/09; NWF report, March 2009). (Editor's Note: RWJF provides support to the Safe Routes to School National Partnership, a network of more than 400 organizations and professional groups working to set goals, share best practices, secure funding and inform agencies that implement SRTS.)

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Original Source: http://www.rwjf.org/childhoodobesity/digest.jsp?id=10150

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New Online Program Helps Parents Tackle Childhood Obesity

April 1, 2009, PRNewswire

Alere LLC, a leader in personal health support solutions, announced today the introduction of Healthy Kids, a program designed to help parents and caregivers promote healthy habits for children. Launched to employer and health plan clients last week, this groundbreaking program is the first to provide parents with a week-by-week, structured approach to improving family health and reducing risk for childhood obesity.

A Pressing Need

Employers and health plans are increasingly bearing the burden of childhood obesity, which has reached near epidemic levels:

  • The national cost of childhood obesity is estimated at $14 billion annually.
  • Sixteen percent of America's school children are overweight or obese.
  • Medical treatment for children with obesity averages $3,700 per year.
  • Obese children tend to be overweight as adults further adding to the nation's healthcare expenditures.

The root causes of the problem are preventable: poor diet and inactivity. This presents a clear opportunity for organizations to move proactively to address the problem for their populations.

"Giving parents tools, information and behavior change strategies to help them improve the health of their children supports Alere's mission of providing personal health support" says Ron Geraty, M.D., CEO of Alere. "By promoting better habits for kids, we can help change lifestyle behaviors for the entire family."

A Personalized Solution

The Healthy Kids program provides parents with clear, easy-to-implement strategies that they can incorporate into their daily lives. Developed with a team of clinicians experienced in working with families to prevent and address obesity, the online program is personalized and includes a range of criteria, such as age, activity level, even frequency of family meals.

From week one, the program provides a "To-Do List" of action items for parents. This personalized action list – which identifies the child or children by name – provides specific information about how they can make changes together. Tools and resources include online games and printable worksheets adults can complete with their kids. Younger children participate in fun activities that promote healthier food choices and active living, while older children learn valuable skills that can help them make better choices independently.

A Comprehensive Approach

The Healthy Kids program was developed to reflect Alere's philosophy of behavior change. This means focusing on realistic, sustainable actions that can help reduce risks. The program is offered as part of Alere's suite of wellness solutions, a comprehensive approach to personal health management that focuses on improving health based on the specific needs of each individual.

"Alere's core competency leverages clinical expertise and cutting-edge technology to improve the health of individuals," says Dr. Geraty. "The Healthy Kids program is an exciting new way to help our clients provide families with a path to better health."

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Original Source: http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=104&STORY=/
www/story/04-01-2009/0004998597&EDATE=

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