April 2010






School Foods at the Forefront of Research, Initiatives

March 15, 2010, WebMD Health News (Laino)
March 17, 2010, Philadelphia Inquirer (Lubrano)
March 21, 2010, The Los Angeles Times (Susman)

More than one in three middle school students who regularly eat school lunches are obese or overweight. They’re also more likely to have high LDL or “bad” cholesterol levels than kids who bring lunch from home.

The research suggests that efforts to provide healthier choices on school lunch menus still have a long way to go, says Elizabeth Jackson, MD, MPH, assistant professor of internal medicine at the University of Michigan Health System in Ann Arbor.

“The school environment is an excellent opportunity we should not be missing to teach kids to make healthy choices, both in terms of food and exercise,” she tells WebMD.

That’s particularly important in middle school, as that’s when children start to become more independent, Jackson says. The choices they make then will shape their eating and exercise habits as they get older, she says.

Kids who bring lunch from home less likely to be overweight

The study involved 1,076 middle school students who filled out questionnaires asking what they ate, how much physical activity they got, and the number of hours they watched TV, played video games, and spent on the computer each day.

Then they were divided into three groups, depending on whether they said they “always” or “almost always” ate school lunches, “always” or “almost always” brought their midday meal from home, or sometimes did one and sometimes the other.

School lunch versus lunch from home

The findings were presented at the annual meeting of the American College of Cardiology. Compared with kids who brought lunch from home, those who ate school lunches were more likely to be overweight or obese (38.2% vs. 24.7%); were more likely to eat two or more servings of fatty meats like fried chicken or hot dogs daily (6.2% vs. 1.6%); were more likely to have two or more sugary drinks a day (19% vs. 6.8%); were less likely to eat at least two servings of fruits a day (32.6% vs. 49.4%); were less likely to eat at least two servings of vegetables a day (39.9% vs. 50.3%); and, had higher levels of LDL “bad” cholesterol.

The school-lunch kids also were less likely to participate in active sports like basketball, moderate exercise like walking, or team sports than their home-fed counterparts. And they spent more time watching TV, playing video games, and using computers outside of school.

“One-third of kids in the U.S. are now overweight or obese, which means one-third of kids are at risk of heart disease and diabetes as they age. That scares me,” Jackson says.

“If we don’t do something now, the recent trend toward fewer deaths due to heart disease among U.S. adults is in jeopardy of reversing, she says.

Parents’ options

So should you be packing your kids lunch? Michael Barrett, MD, co-chairman of the committee that chose which studies to highlight at the meeting and a cardiologist at Temple University in Philadelphia, says that’s not necessarily the solution.

There’s no way to be sure what you’re packing in their lunches is what they are actually eating; foods can be traded and snacks can be bought from vending machines or local stores, he says.

Instead, parents need to work with school systems to ensure that school lunches have less salt and fat and more fiber, Jackson says.

Parents also need to feed kids healthy foods at home, both at meals and for snacks, she says. From an exercise point of view, “integrate small steps such as walking to school,” Jackson says.

Recent data show that while an estimated 30.6 million U.S. students eat school lunches, only 6 percent of school lunch programs meet the requirements established by the U.S. Department of Agriculture. For example, the average sodium content was twice that recommended, and 80 percent of schools exceeded rules to keep fat to less than 30 percent of total calories.

Local Perspectives

Charlie Baltimore eyed the pizza in the cafeteria of the High School of the Future with simmering contempt.

“In a year,” the school administrator vowed, “we’re going to eliminate pizza.” Unlike most city schools, the technologically specialized West Philadelphia school has a full kitchen where many meals are prepared practically from scratch. Like just four other schools, it gets $5,000 a year in extra funding from the district to buy fresh produce. There’s even a vegetable garden.

Future is emblematic both of what healthy school eating can look like and of Philadelphia’s place in the forefront of cities seeking to improve school meals.

A push for healthier school offerings

But Future is a relative anomaly. And, according to Baltimore and others, much work has to be done to get other schools in the city – as well as across America – up to that same standard. . . . Baltimore’s call for change coincides with a movement to make school meals healthier.

There’s a battle on to beat back childhood obesity and to fight hunger among poor children, more of whom are eating subsidized school meals because of the economy. Often, schools serve the only nutritious meals children eat, advocates say. . . .

The Obama administration wants to increase the reimbursement rate for meals programs, saying it will help districts afford healthier food.

Though many suburban districts have fewer poor students, a move to more healthful offerings would apply to those schools as well.

Recently, Agriculture Secretary Tom Vilsack asked the Institute of Medicine, the health arm of the National Academy of Sciences, to assess school meals. The U.S. Department of Agriculture administers school food programs. The conclusion: Too much sugar, salt, and fat. First lady Michelle Obama, in Philadelphia in February for her campaign against childhood obesity, concurred. The IoM did the first major overhaul of school nutritional rules since the 1970s, said the director of the Children’s Hospital of Philadelphia Nutrition Center, Virginia Stallings, who headed the effort.

The report calls for more whole grains, fruits, and vegetables, while limiting fat, calories, and sodium. If accepted, the IoM’s recommendations could be in place by 2011. The reauthorization is also inspiring proposed changes rooted in a 19-year-old local program. In Philadelphia, all children in schools with high concentrations of poverty eat free meals without filling out forms. This avoids what advocates say are costly and stigmatizing applications that deter kids from eating.

A bill to make the Philadelphia program the law of the land has been introduced by Sens. Bob Casey and Arlen Specter, both Pennsylvania Democrats.

Further, Vilsack announced that the reauthorization bill should limit the sale of high-sugar drinks and snacks in school vending machines. And he wants to curtail “a la carte” items – non-USDA-sanctioned snacks that schools sell to make money. That also reflects a local practice.

“The Philadelphia school district is a national leader in getting soda and junk foods out of schools,” said Margo Wootan, director of nutrition policy with the nonprofit Center for Science in the Public Interest in Washington. She noted that the district also has banned fried foods. . . . Change is vital, say doctors who see obese children with adult illnesses such as high blood pressure and diabetes.

The nonprofit Physicians Committee for Responsible Medicine wants to improve nutrition by mandating vegetarian meals in schools, said Kathryn Strong, the organization’s dietitian.

Others agree. “If we take 100 calories a day out of school meals, we move the needle on obesity,” said Gary Foster, director of the Center for Obesity Research and Education at Temple University.

The IoM is attacking calories. Until now, USDA school-meal guidelines have stipulated minimum calories only, without any upper limits. In the 1970s when the minimums were first set, doctors were worried that children weren’t eating enough, Stallings said.

For example, the only rule about calories in lunches for kids in grades seven through 12 has been that they contain at least 825 calories. The new proposal calls for a range of calories: no fewer than 750 calories, but no more than 850 calories per lunch for that age group.

“That’s a big change,” Stallings said, acknowledging that the IoM’s recommendations would increase food costs – 18 percent for breakfast, 4 percent for lunch.

A whole-grain bun can be 10 cents more than a regular bun, said Wayne Grasela, senior vice president of the division of food services for Philadelphia schools. As a remedy, Vilsack is asking Congress for an increase in the USDA reimbursement. Throughout the country, the USDA reimburses school districts for meals on a scale connected to income.

The agency pays $2.68 per free lunch for children whose families live below 130 percent of the U.S. poverty level; $2.28 for reduced-price lunches for children at 130 to 185 percent of poverty; and about 25 cents for full-price lunches for those above 185 percent. (The poverty level for a family of four is about $22,000.) Breakfast reimbursements run about $1 less per meal. The nonprofit School Nutrition Association requested a 35-cent-per-meal increase.

In 2009, about 32 million children participated in the school-lunch program, with nearly 64 percent receiving free or reduced-price meals, USDA figures show. About 11 million ate breakfast at school, with about 84 percent eating free or reduced-price meals. In Philadelphia, as many as 120,000 lunches and 58,000 breakfasts are served each day, the vast majority free or reduced-price.

From 2008 through 2009, the number of children eating subsidized lunch nationwide increased by 600,000, attributable to the bad economy, Wootan said. About 20 percent of the food in school cafeterias comes from the USDA commodities program, a list of 180 foods donated by the agency. The rest is purchased on the open market with reimbursement dollars.

Beef and cheese make up 75 percent of the items districts get from the commodities list, Wootan said.

Many districts – Philadelphia included – divert fresh commodities to processors, Wootan said.

“Too many schools turn chicken into nuggets, or pork into pizza toppings,” she said. In Philadelphia schools, much of the food comes from a Brooklyn, N.Y., distributor, which prepares, packages, and ships frozen meals to schools to be warmed, Grasela said. Two-thirds of city schools (mostly elementary and middle schools) have no kitchens, said Sandy Sherman, director of nutrition education at the nonprofit Food Trust in Philadelphia. . . .

NY schools ban homemade goods

Homemade spinach pies are out; packaged baked potato chips are in. Mom’s pumpkin bread is out; Kellogg’s Pop-Tarts are in – but they must be the whole-grain brown-sugar cinnamon variety.

At public school bake sales, Pop-Tarts are among 29 items the Department of Education has deemed nutritionally sound enough to sell in lieu of homemade goods, which have been banned in part because they do not list nutritional content.

Parents say the regulation, issued last month, pushes kids to eat processed food and undercuts parental efforts to teach nutrition at home by outlawing homemade goodies like organic popcorn balls and vegan cookies, which they argue are healthier than anything housed in a vending machine.

“What’s the message we’re sending here? That highly processed foods are healthier than food cooked at home,” said Elizabeth Puccini, the mother of two elementary school pupils in Manhattan.

“You’re bound to create a lifetime of bad eating habits with that,” said Puccini, who organized a “bake-in” outside City Hall last month to protest the rules.

Even by New York standards, it was an unusual gathering. Scores of parents, teachers and children banged wooden spoons, whisks, sifters and pots and pans while chanting, “Read our lips, no more chips!” and waving signs reading, “Save our bake sales” and “Pure, not processed.”

Protesters set up two tables laden with goods. One featured banned items: plates of mini- empanadas, vanilla cupcakes with pale pink icing, and pumpkin bread among them. The other showed what is permitted, such as bags of low-fat Doritos, granola bars and packaged cookies.

The Department of Education says the regulations are aimed at combating obesity among the city’s more than 1.1 million public school children, about 40 percent of whom are overweight. By restricting bake sale offerings to goods limited in calories and wrapped in packaging that lists nutritional information, schools will help children reduce their intake of unhealthy snacks, officials say.

Among the approved items: Glenny’s Brown Rice Marshmallow Treats, baked cheddar and sour cream chips and a variety of granola bars, popcorn clusters and cookies. None has more than 200 calories or 200 milligrams of sodium per serving. The Pop-Tarts weigh in at 200 calories each.

But critics say the numbers are beside the point because the rule discourages home-baking practices that teach children to value fresh food and give people a reason to go to a bake sale, which can bring in several hundred dollars to pay for extras such as field trips and school supplies.

“Why would you go to a bake sale to buy baked potato chips?” said Registered Dietician Mitzi Dulan. . . . A better plan would be to offer parents recipes for healthier snacks to sell, she said.

David Cantor, the education department’s spokesman, said the city was simply in line with a nationwide effort to combat childhood obesity, which first lady Michelle Obama has made one of her priorities.

“We restrict sales of homemade food because we cannot monitor its nutritional value,” Cantor said, adding that “homemade is not synonymous with healthful.” A recent photo of items at a bake sale showed a sign for bacon chocolate-chip cookies, he said.

ut Dulan, as well as parents and teachers, said it’s more important to look at what goes into the food. The mini-empanadas had the most ingredients, at 19, including spinach, tofu, cilantro, lime juice, and black beans. Compare that with the Pop-Tart, with 27 ingredients, including riboflavin, polydextrose and high-fructose corn syrup.

“I’d rather eat something higher in calories that doesn’t contain a bunch of chemicals I can’t pronounce,” said Stephanie Seitman, a high school English teacher.

New York isn’t the first school district to take on child weight problems, but with 1,500 public schools, it is the biggest and among the most influential in the country, and it appears to have gone further than others with the latest regulations.

Puccini, however, said school cafeterias continue to dish out sugary, processed food. “Why are we suddenly picking on bake sales as opposed to looking at the things that are available every single day?” she said, rejecting the notion that whole-grain Pop Tarts foster good health.

“In the end,” she said, “it’s still a Pop-Tart.”


Original Sources:




U.S. DHHS Awards Wellness and Prevention Grants to 44 Communities

March 31, 2010, NCCOR

As part of the Community Putting Prevention to Work initiative, the U.S. Department of Health and Human Services awarded grants to prevent chronic disease and promote wellness to 44 communities in 31 states across the country. The grants, totaling more than $370 million, will support public health efforts to improve nutrition, increase physical activity, reduce obesity and decrease tobacco use.

Twenty-three communities will focus solely on preventing obesity. Fourteen will work on preventing tobacco use. Seven additional communities will address both public health opportunities.

Under the Community Initiative, the communities receiving awards are diverse. Grouped by type of project, the communities recognized are: communities funded for both obesity and tobacco; large cities with obesity projects; large cities with tobacco projects; urban area tobacco projects; small cities/rural areas obesity projects; small cities/rural areas tobacco projects; obesity projects by tribes; and, tobacco projects by tribes.

Learn more about the communities and projects receiving grants.



Database for Child Obesity Prevention Legislation

Robert Wood Johnson Foundation Center to Prevent Childhood Obesity

View a continually evolving list of legislation that has been introduced at the federal level addressing child health and obesity prevention.


Health Affairs Issue Highlights Key Research

March 2, 2010, RWJF Childhood Obesity News

In its March 2010 issue, Health Affairs focuses almost exclusively on the childhood obesity epidemic and the policy approaches that could have greatest impact for helping to solve this public health crisis.

The special issue, which was funded by the Robert Wood Johnson Foundation, looks at policy changes on the local, state and federal levels. RWJF grantees authored several of the studies, including:

“Are ‘Competitive Foods’ Making Our Children Fat?” by Nicole Larson and Mary Story, who confirm what many people have long suspected—a child’s risk for obesity increases when unhealthy, high-calorie foods are available in school stores and vending machines.

“Lessons from Pennsylvania’s Mixed Response to Federal School Wellness Law,” by Claudia Probart and colleagues, which examines Pennsylvania’s comprehensive, multi-faceted response to the local wellness policy requirement in the Child Nutrition and Women, Infants, and Children (WIC) Reauthorization Act of 2004. Though implementation results were mixed, the state offers valuable lessons to others trying to promote good nutrition and wellness.

“Federal Food Policy and Childhood Obesity: A Solution or Part of the Problem?” by Rachel Tolbert Kimbro and Elizabeth Rigby, which concludes that subsidized meals at school and day care may help children, particularly low-income children, maintain a healthy weight. But the authors found that food assistance programs may contribute to childhood obesity in cities with high food prices because healthier foods aren’t affordable.

In addition, the journal explores the role of personal responsibility in childhood obesity, parallels between the anti-smoking movement and obesity prevention, and the economics of childhood obesity in terms of investment and cost.

Access the studies here.

In conjunction with its March 2010 special issue, Health Affairs has prepared a series of policy briefs. The issue itself demonstrates that policy leaders can and should take crucial steps to address the obesity epidemic, and the briefs encapsulate policy recommendations from articles within the issue. The briefs also contain links back to the full-length Health Affairs articles for additional information.

More on the briefs can be found here.


Original Source:


High-Calorie Drinks Decrease Dramatically in U.S. Schools

March 8, 2010, American Beverage Association

Full-calorie sodas and other sugary drinks are disappearing from the lunch lines, vending machines and store shelves of schools, according to a new report on the impact of a 2006 agreement that sought to create a healthier school environment by reducing the number of beverage calories available to children during the school day.

The final report on the impact of the Alliance School Beverage Guidelines shows that since the start of the 2004-05 school year: the number of beverage calories shipped to schools has dropped by 88 percent; the overall volume of full-calorie carbonated soft drinks shipped to schools has dropped by 95 percent; and, nearly 99 percent of the public and private schools and school systems measured have come into compliance with the agreement.

The impact of the agreement, signed by the Alliance for a Healthier Generation, American Beverage Association, Coca-Cola, PepsiCo and Dr. Pepper Snapple Group (formerly Cadbury Schweppes), has been assessed annually by Keybridge Research LLC.




Is There an Obesity Tipping Point in Infancy?

March 23, 2010, TIME

By Tiffany O’Callaghan

If there is any reason for hope among the data on national obesity rates in the United States (the numbers should be familiar by now: two-thirds of adults and nearly one-third of children are overweight or obese in this country), it is that they finally seem to be leveling off.

According to the most recent published reports by epidemiologists at the Centers for Disease Control and Prevention, long-term federal obesity data suggest that after decades of ballooning in size, American adults and children may have gotten about as fat as they’re ever going to get.

Of course that still means that the majority of Americans are currently overweight and at high risk of chronic health problems, such as heart disease, diabetes and certain cancers. These risks continue to propel several national campaigns aimed at preventing obesity, particularly in children, including those spearheaded by first lady Michelle Obama and former President Bill Clinton. But some researchers say such programs, which involve school-age children, may begin too late to benefit all children.

Increasingly, evidence suggests that obesity prevention measures need to be taken earlier, in infancy or even before birth. According to the CDC’s National Health and Nutrition Examination Survey, rates of obesity in youngsters aged 2 to 5 have more than doubled since 1980, from 5 percent to 12.4 percent. And once a child sets down the road to unhealthy weight, it becomes increasingly difficult for him to change course: according to one study, 80 percent of children who are overweight between ages 10 to 15 grow up to become obese 25-year-olds.

In November 2009, with funding from the Robert Wood Johnson Foundation, the Institute of Medicine (IoM) formed the Committee on Obesity Prevention Policies for Young Children, whose members will for the first time review evidence on obesity risk factors and health effects in children from 0 to 5 years old, and identify potential opportunities for intervention in this age group. The committee’s first report is expected in early 2011.

Early warning signs

In a recent study of more than 1,800 children, who were tracked from before birth to age 4, Harvard researchers identified several risk factors for obesity that began in pregnancy or early childhood. They included pre-pregnancy obesity; gestational diabetes; low birth weight and rapid weight gain in infancy; stopping breast-feeding early; introducing solid foods before 4 months; short sleep in infancy; TV in children’s bedrooms; and higher consumption of fast food and sugary beverages in childhood. In many cases, these early risk factors were more common in black or Hispanic families than in white families, regardless of income.

The findings, first published online March 1 by the journal Pediatrics, help explain why minority children are at a higher risk for obesity early on: 16.7 percent of Mexican-American children ages 2 to 5 are obese, compared with 14.9 percent of black children and 10.7 percent of white children, according to CDC data. The authors emphasize that obesity prevention must not only begin early, but also address cultural issues and include education targeted to specific groups.

The good news, says study author Dr. Elsie Taveras, an assistant professor of pediatrics and prevention at Harvard Medical School and a member of the IoM obesity committee, is that many risk factors involve behaviors than can be modified, and are not due only to socioeconomic inequalities.

“As a pediatrician, it’s frustrating for me to think how am I going to change this person’s household income? But, what a hopeful message to know that, it’s actually not that in many cases,” she says.

Obesity threshold hypothesis

How early in life that prevention efforts need to target children is quickly becoming a central question to childhood obesity research. One intriguing notion is that there exists an obesity threshold — or tipping point — in infancy, before which a chubby child may be safely steered away from a lifetime of obesity.

A small study, led by Dr. John Harrington, an associate professor of pediatrics at Eastern Virginia Medical School and Children’s Hospital of The King’s Daughters, analyzed childhood medical records of 111 obese children and adolescents — those with a body mass index (BMI) equal to or higher than 85 percent of their same-age peers — in order to determine the age at which children first became overweight.

On average, researchers found, overweight individuals first crossed the threshold into overweight territory before 22 months of age. In some kids it was even earlier, with about 25 percent of children already having gained more weight than recommended for their age and height at 3 months. The trajectory typically began early and remained consistent: the BMI of overweight children continuously diverged from that of normal-weighted children, the difference increasing by .072 units per month starting at birth and crossing the 85th-percentile mark at about 21 months.

Within the small sample, half of overweight children became overweight before age 2, and 90 percent became overweight by age 5.

“You’ve got to look at it in terms of intervention and prevention,” Harrington says. “If you’re trying to intervene at age 5, you’ve already missed the boat.” Part of the problem is that parents and pediatricians tend to overlook early signs of obesity. Many people view children with excess “baby fat” as healthy, and believe they’ll shed the weight as they grow.

Harrington advises physicians to start screening babies earlier for immoderate weight gain and to broach the topic sooner with parents. There’s a lot parents can do at home to encourage healthy weight in their children, Harrington says, and making even one or two small changes can lead to lowered risk. For instance, Harrington advises parents to adhere to infants’ own cues for fullness and hunger, rather than encouraging them to eat more. Keep in mind that toddlers are “grazers” and that it’s perfectly healthy for them not conform to an adult schedule of three squares per day, he says.

Harrington’s study, first published online in February 2010 by the journal Clinical Pediatrics, suggests the optimal age for instilling healthy eating and activity behaviors is before age 2. As children get older it becomes more difficult to unlearn behaviors, and reverse the trend, Harrington says. “The first thing to do is to recognize that there’s a problem, and to see that maybe it didn’t start at age 4 or 5, or 6 or 7, but maybe before then,” he says. “The longer you’re overweight, the more likely it is that you’re going to be overweight as an adult.”

Getting a head start

Not all chubby kids grow up to be overweight adults; indeed, many heavy babies do shed their baby fat and remain slim thereafter. Determining which children are at higher risk, however, is easier said than done.

The study that could answer that question has not yet been conducted. “The only way to do that is to do a prospective study of 10,000 kids, following them from birth to see what their trajectories are,” Harrington says. One such study is currently in the works — the National Children’s Study, which aims to follow 100,000 babies from the womb to age 21, was authorized by Congress in 2000 — but results from that research are still years away.

For now, researchers say national childhood obesity prevention and education efforts should include families with newborns and toddlers, and promote healthy habits starting in pregnancy or earlier. Even seemingly minor actions, such as reminding pregnant women that they should not in fact be “eating for two” could reduce children’s chances of becoming obese, says Taveras.

“Some of these things become so embedded in our thinking that they actually become our standard of care for our children,” laments Taveras. “If we really try to start focusing on prevention earlier,” she says, “we might have a greater impact.”


Original Source: http://www.time.com/time/specials/packages/article/


Frequent Snacking Directly Related to Childhood Obesity Rise

March 2, 2010, Reuters

U.S. children eat an average three snacks a day on top of three regular meals, a finding that could explain why the childhood obesity rate has risen to more than 16 percent, according to researchers.

Children snack so often that they are “moving toward constant eating,” Carmen Piernas and Barry Popkin of the University of North Carolina reported. More than 27 percent of calories that American kids take in come from snacks, Piernas and Popkin reported in the journal Health Affairs. The researchers defined snacks as food eaten outside regular meals.

The studies will help fuel President Barack Obama’s initiative to fight obesity in childhood, something Obama’s wife, first lady Michelle Obama, notes could drive up already soaring U.S. healthcare costs.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, wrote a commentary calling for taxes on sugary drinks and junk food, zoning restrictions on fast-food outlets around schools and bans on advertising unhealthy food to children. “Government at national, state, and local levels, spearheaded by public health agencies, must take action,” he wrote.

Piernas and Popkin looked at data on 31,337 children aged 2 to 18 from four different federal surveys on food and eating.

“Childhood snacking trends are moving toward three snacks per day, and more than 27 percent of children’s daily calories are coming from snacks. The largest increases have been in salty snacks and candy. Desserts and sweetened beverages remain the major sources of calories from snacks,” they wrote.

“Children increased their caloric intake by 113 calories per day from 1977 to 2006,” they added.

Constant eating

“This raises the question of whether the physiological basis for eating is becoming deregulated, as our children are moving toward constant eating.”

In a second study in the journal, Christina Bethell of the Oregon Health and Science University in Portland and colleagues analyzed data from the 2007 National Survey of Children’s Health to find the rate of obesity for children 10 to 17 rose from 14.8 percent in 2003 to 16.4 percent in 2007.

The percentage of children who are overweight stayed at around 15 percent, they found.

“While combined overweight and obesity rates appear to be leveling off, our findings suggest a possible increase in the severity of the national childhood obesity epidemic,” Bethell said in a statement.

Parents, educators and policymakers all hold responsibility for this, Michelle Obama told the School Nutrition Association conference in Washington last month.

“Our kids didn’t do this to themselves,” Obama said.

“From fast food, to vending machines packed with chips and candy, to a la carte lines, we tempt our kids with all kinds of unhealthy choices every day.”

Other studies have shown that obese children are more likely to stay obese as adults, and they develop chronic conditions at younger ages, burdening the healthcare system.

“You see kids who are at higher risk of conditions like diabetes, and cancer, and heart disease – conditions that cost billions of dollars a year to treat,” Michelle Obama said. The administration has launched an initiative to tackle the issue by improving nutritional standards, getting food companies to voluntarily improve nutrition standards, help kids exercise more and educating parents.

The effects extend beyond health. Bethell’s study found that overweight or obese children were 32 percent more likely to have to repeat a grade in school and 59 percent more likely than normal weight kids to have missed more than two weeks of school.


Original Source: http://www.reuters.com/article/idUSTRE6210HC20100302


Research Shows Probiotics May Reduce Risk of Childhood Obesity

March 19, 2010, EmaxHealth

A study that has been published in the British Journal of Nutrition discovered that expectant mothers who consume probiotic foods while pregnant may reduce the chances of their offspring having weight issues later in life.

Researchers say women who consumed probiotics during their first trimester were less likely to suffer from gestational diabetes, which can result in delivering an overweight baby. Overweight infants may also suffer from excess insulin and be at risk for becoming obese or developing type 2 diabetes during adulthood, according to the American Diabetes Association.

In the study, 256 women in their first trimester of pregnancy either received the probiotics Lactobacillus rhamnosus GG and Bifidobacterium lactis or did not. Researchers found that probiotic intervention reduced the frequency of gestational diabetes, which happens when the body is unable to make and use all the insulin it needs for pregnancy. The end result was that high blood glucose levels for the mother during pregnancy, and the risk of delivering an infant with macrosomia (i.e., an overweight baby.) According to the American Diabetes Association, “babies with macrosomia face health problems of their own, including damage to their shoulders during birth.

“Taken together, long-term health benefits for mothers and children may be conferred by balanced maternal nutrition during pregnancy and lactation and by promoting the healthy gut microbiota in the mother and the child,” wrote the researchers, led by Raakel Luoto.

“The results of the present study add weight to the argument that the continuing burden of Western lifestyle diseases is modifiable. Based on the present findings, perinatal dietary counseling combined with probiotics could provide a safe and cost-effective tool in addressing the obesity epidemic,” added Luoto.

The term “probiotics” refers to dietary supplements or foods that contain beneficial, or “good,” bacteria that are similar to those normally found in your body. Fermented dairy products like yogurt and kefir are the most common sources for probiotics. It can be found in cheese, including cottage cheese, and buttermilk. Fermented soy products . . . also have probiotics as well as bananas and artichokes. Alliums like onions and garlic contain probiotic compounds. Be sure to read the labels as foods with probiotics will have ingredients like inulin, lactose, arabinogalactan, fructooligosaccarides (FOS), polydextrose or lactitol.

“Bacteria are passed from mother to child through the birth canal, as well as through breast milk, and research indicates that early nutrition may influence the risk of obesity later in life. There is growing evidence that this approach might open a new angle on the fight against obesity, either through prevention or treatment,” said Kirsi Laitinen, a nutritionist and senior lecturer at the University of Turku.


Original Source: http://www.emaxhealth.com/1357/5/36107/research-shows-probiotics-may-reduce-risk-childhood-obesity.html



Study Examines Extreme Obesity Prevalence in Children

March 21, 2010, 7th Space Interactive

Extreme obesity is affecting more children at younger ages, with 12 percent of black teenage girls, 11.2 percent of Hispanic teenage boys, 7.3 percent of boys and 5.5 percent of girls now classified as extremely obese, according to a Kaiser Permanente study of 710,949 children and teens that appears online in the Journal of Pediatrics.

This is the first study to provide a snapshot of the prevalence of extreme obesity in a contemporary cohort of children aged 2 to 19 years, and from a large racially and ethnically diverse population using the recent 2009 U.S. Centers for Disease Control and Prevention extreme obesity definition. Previous research was based on recent National Health and Nutrition Examination Survey (NHANES) data and included information on obesity but not extreme obesity.

“Children who are extremely obese may continue to be extremely obese as adults, and all the health problems associated with obesity are in these children’s futures. Without major lifestyle changes, these kids face a 10 to 20 years shorter life span and will develop health problems in their twenties that we typically see in 40 to 60 year olds,” said study lead author Corinna Koebnick, PhD, a research scientist at the Kaiser Permanente Southern California’s Department of Research and Evaluation in Pasadena, Calif. “For example, children who are extremely obese are at higher risk for heart disease, type 2 diabetes, fatty liver disease and joint problems, just to name a few.”

Researchers used measured height and weight in electronic health records to conduct a cross-sectional study of 710,949 children aged 2 to 19 years in the Kaiser Permanente Southern California integrated health plan in 2007 and 2008. Children in the study had an average of 2.6 medical visits per year where height and weight were measured.

The study found that 7.3 percent of boys and 5.5 percent of girls were extremely obese, translating into more than 45,000 extremely obese children in this cohort. The percentage of extreme obesity peaked at 10 years in boys and at 12 years in girls. The heaviest children were black teenage girls and Hispanic boys. The percentage of extreme obesity was lowest in Asian-Pacific Islanders and non-Hispanic white children.

According to recent CDC recommendations, extreme obesity is defined as more than 1.2 times the 95th percentile, or a body mass index (BMI) of more than 35 kilograms/meter squared. Obesity is defined as more than the 95th percentile or a BMI of more than 30 kg/m2. Overweight is defined as more than the 85th percentile or a BMI of more than 25 kg/m2. The BMI is a reliable indicator of body fatness and calculated based on height and weight. For children, BMI percentiles are the most commonly used indicator to assess the size and growth patterns of individual children. The percentile indicates the relative position of the child’s BMI number among children of the same sex and age.

“Our focus and concern is all about health and not about appearance. Children who are morbidly obese can do anything they want . . . but the one thing they cannot be is healthy,” said study co-author Amy Porter, MD, a Kaiser Permanente Baldwin Park pediatrician who leads the Pediatric Weight Management Initiative for Kaiser Permanente’s Southern California Region.

“The most important advice to parents of extremely obese children is that this has to be addressed as a family issue. There is rarely one extremely obese kid in a house where everyone else is extremely healthy. It’s important that everyone in the family is invested in achieving a healthier lifestyle,” Porter said.

“This publication is only the beginning. Now we are trying to quantify the health risks and long-term effects associated with extreme obesity, determine which groups are affected most, and develop strategies for population care management to reduce these health risks. Children’s health is important and we have a long way to go,” Koebnick said.

Other study authors included: Ning Smith, MS, Karen J. Coleman, PhD, Darios Getahun, MD, Kristi Reynolds, PhD, Virginia P. Quinn, PhD, and Steven J. Jacobsen, PhD, from the Kaiser Permanente Department of Research and Evaluation; Amy H. Porter, MD, from Kaiser Permanente Baldwin Park Medical Center, and Jack K. Der-Sarkissian, MD, from Kaiser Permanente Medical Center, Los Angeles.


Original Source: http://7thspace.com/headlines/339014/study_provides_snapshot_


Childhood Obesity Gains, Losses

March 16, 2010, Chicago Sun-Times

By Monifa Thomas

Fewer Chicago kids entering kindergarten and first grade were obese in 2008 versus five years earlier. But children in Chicago are still more likely to be fatter than kids nationwide and, by sixth grade, more than one in four kids here is obese.

Those are the key findings of a new study by the Consortium to Lower Obesity in Chicago Children that suggests that efforts to fight childhood obesity in Chicago might be starting to have an effect but also reflects how daunting the problem is.

Efforts here to attack early childhood obesity “seem to be making a difference,” said Adam Becker, executive director of the Chicago consortium, based at Children’s Memorial Hospital. “But we still have a lot of work to do.”

Those efforts include promoting healthy eating and getting physical activity. Among children aged 3 to 7 in Chicago schools, 22 percent were obese in 2008 versus 24 percent in 2003.

No other major city has reported a similar decrease in this age group, though some are starting to see obesity rates level off, Becker said.

But the new report also found that, among Chicago students entering sixth grade, 28 percent were obese, a sign that kids are getting fatter as they get older.

The new figures are based on school health examination forms for more than 4,500 children entering Chicago’s public schools and Catholic schools run by the Archdiocese of Chicago.

Nationally, 10 percent of 2- to 5-year-olds and almost 20 percent of 6- to 11-year-olds are obese, similar to decade-old results, the Centers for Disease Control and Prevention reports.


Original Source: http://www.suntimes.com/news/2104620,CST-NWS-obese16.article



USDA Effort Targets Link between Obesity and Food Stamps

March 15, 2010, Scientific American

By Lynne Peeples

The bustling food market on the corner of 165th Street and Grand Concourse in the Bronx almost has a casino feel, except that the chips are dull brown, and rather than cherries on a slot machine real fruit and vegetables are lined up on display. But the cheers are no less exuberant: “This is so awesome!” exclaims one happy customer clutching a handful of tokens and tomatoes.

“It’s just like Atlantic City.”

With a swipe of a food stamp debit card on a handheld credit machine, shoppers at the Harvest Home Farmers Market receive a stack of wooden tokens worth a dollar apiece. And for every five they cash in for bananas, lettuce and the like, they win a two-dollar “Health Bucks” coupon to buy more.

A growing number of local programs from Boston to San Diego are trying to make healthier foods more appealing and affordable for low-income families—the population of Americans who are most reliant on food stamps, and most likely to be obese. Meanwhile, public health researchers are looking hard at the federal food stamp program itself, now known as the Supplemental Nutrition Assistance Program (SNAP). They’re questioning why the long-standing strategy for helping the hungry may, in some cases, actually be hurting their health by packing on extra pounds. But could a few simple changes transform SNAP into a powerful vehicle for curbing obesity?

“There needs to be a way for a family to not have to choose between hunger and obesity,” says Lauren Dinour, a nutrition expert at the City University of New York. “I see huge potential in some new ideas.”

While obesity rates have risen to about 30 percent of the U.S. population—carrying with it an epidemic of diabetes—food stamp enrollment has also exploded. About one in eight Americans now rely on the assistance, according to data just released from the U.S. Department of Agriculture (USDA), up from one in 50 people in the 1970s.

A separate study, published in August 2009, linked these two striking statistics. People never receiving food stamps had lower rates of obesity than those who had been on them at some point in their lives, even after accounting for differences in socioeconomic status. This effect was most striking for white women: a two-unit increase in body mass index (BMI).

“Obesity cannot be totally pinned on food stamps,” says Jay Zagorsky, a research scientist at The Ohio State University’s Center for Human Resource Research and lead author of the study, “but it certainly is related to how the program is structured.”

The full monthly SNAP allocation, now averaging $124 per person nationwide, is provided at the beginning of each month. Research published in 2000 concluded that the bulk of participants also do their grocery shopping once monthly, shortly after the benefit is credited. (Wal-Mart reports a spike in sales at 12:01 a.m., as soon as federal assistance funds hit SNAP accounts.)

Another study from 2004 found a corresponding decrease of 10 to 15 percent in food consumption over the course of the month, suggesting some recipients may eat well for the first couple weeks after they’ve shopped and then run low on food near month’s end. This kind of “binge–starvation” cycle has been linked to changes in metabolism, insulin resistance and, ultimately, increases in BMI.

Now that funds are delivered electronically rather than as paper “food stamps,” however, the additional cost to distribute SNAP money every other week would be minimal. Participants themselves have suggested that the change could help them spread out their grocery shopping and keep adequate food around through the month, notes Parke Wilde, an agricultural economist at Tufts University’s Friedman School of Nutrition Science and Policy in Boston and lead author of the shopping cycle paper.

“It’s just a little change in the environment that still gives people freedom [to shop as often as they want], yet gives them a slightly different sense of the default behavior,” Wilde says. “I’m always surprised that there’s not more interest in the idea.”

Obesity risk also weighs heavily on the choices people make on their shopping trips—and the choices made available by retailers. In many urban neighborhoods the most convenient places to shop are corner stores, such as the bodega down the street from the Bronx farmers market.

Inside this store, past the rack of Little Debbie brownies, is a cash register framed by salt, fat and sugar. On the left are plastic compartments filled with Charleston Chews and Starbursts; on the right, Mike and Ike’s and Planter’s Peanuts. Double Bubble sits atop a cooler filled with caffeinated Monster drinks, alongside a cold case of ice cream. All of it can be purchased with food stamps.

Although often proposed, the idea of narrowing the list of foods eligible for purchase with SNAP funds has been stymied due to fears that fewer eligible people would participate, the prices of healthy foods could rise or marketers would simply repackage a candy bar to look like a granola bar. Similar concerns arise over adding taxes or fees to unhealthy foods. Focusing on positive reinforcement, such as financial incentives, “dodges that trouble,” Wilde says.

The USDA’s Economic Research Service recently found that a targeted 20 percent price reduction for fruits and vegetables would raise the average SNAP participant’s daily consumption of these foods by about a quarter of a cup. A New Zealand study published in December highlighted an 11 percent increase in the purchase of a wider range of healthy foods when a 12.5 percent discount was applied. This positive effect even remained significant six months after those discounts were removed.

Wilde is anxious for results from a larger, more rigorous study set to begin in the fall of 2011. The USDA-run “Healthy Incentives Pilot” evaluation will assess the effects of a 30 percent reduction in the cost of fruits and vegetables purchased with SNAP funds. The program’s update from paper coupons to debit cards, combined with current checkout technology, has made automatically adjusting the relative price of certain foods more feasible. In this case, the discount will be applied indirectly in the form of a rebate.

These price cuts may also be tested in conjunction with nutrition education. “It would be a powerful combination,” Wilde says, “similar to what marketers use to promote food products: communication with the customer and a real dollar benefit.” Whereas SNAP already runs nutrition courses that have proved effective in studies, they are not yet mandatory to all participants.

Once again, local programs are working to fill in the gap. Select New York City farmers markets even offer lessons on how to cook with fruits and vegetables that some shoppers may never have seen before.

“There’s a lot of innovation going on in farmers markets and various other programs within municipalities,” Wilde says. “But it would be even better to see fruit and vegetable promotions through all retail channels.” Depending on the outcome of the pilot study, a SNAP revamp could bring such pervasive changes by the end of 2013.


Original Source:


Organized Recess Addresses Obesity Problem

March 14, 2010, New York Times

By Winnie Hu

At Broadway Elementary School in Newark, N.J., there is no more sitting around after lunch. No more goofing off with friends. No more doing nothing.

Instead there is Brandi Parker, a $14-an-hour recess coach with a whistle around her neck, corralling children behind bright orange cones to play organized games. There she was the other day, breaking up a renegade game of hopscotch and overruling stragglers’ lame excuses.

They were bored. They had tired feet. They were no good at running. ...

Broadway Elementary brought in Parker in January out of exasperation with students who, left to their own devices, used to run into one another, squabble over balls and jump-ropes or monopolize the blacktop while exiling their classmates to the sidelines. Since she started, disciplinary referrals at recess have dropped by three-quarters, to an average of three a week. And injuries are no longer a daily occurrence.

“Before, I was seeing nosebleeds, busted lips, and students being a danger to themselves and others,” said Alejandro Echevarria, the principal. “Now, Coach Brandi does miracles with 20 cones and three handballs.”

The school is one of a growing number across the country that are reining in recess to curb bullying and behavior problems, foster social skills and address concerns over obesity. They also hope to show children that there is good old-fashioned fun to be had without iPods and video games.

Playworks, a California-based nonprofit organization that hired Ms. Parker to run the recess program at Broadway Elementary, began a major expansion in 2008 with an $18 million grant from the Robert Wood Johnson Foundation. It has placed recess coaches in 170 schools in low-income areas of nine cities, including Boston, Washington and Los Angeles, and of Silicon Valley. Playworks schools are not the only ones with organized recess games. In Florida, Broward County’s 140 elementary schools swapped recess for 30 minutes of teacher-supervised physical activities in 2007. Last year in Kearney, Neb., the district had a university professor and five students teach recess games and draw in students who tended to stand against the fence.

Although many school officials and parents like the organized activity, its critics say it takes away the only time that children have to unwind.

In Wyckoff, N.J., an upper-middle-class township in Bergen County with a population of 17,000, hundreds of people signed a petition in protest after the district replaced recess in 2007 with a “midday fitness” program.

“I just can’t imagine going through the entire day without a break, whether you’re an adult or a child,” said Maria Costa, a Wyckoff mother of three who said that every day her daughter came home feeling stress after rushing through lunch to run laps. “It’s just not natural.”

Recess has since been restored in Wyckoff’s middle school, and on alternating days in elementary schools.

Dr. Romina M. Barros, an assistant clinical professor at Albert Einstein College of Medicine in the Bronx who was an author of a widely cited study on the benefits of recess, published last year in the journal Pediatrics, says that children still benefit most from recess when they are let alone to daydream, solve problems, use their imagination to invent their own games and “be free to do what they choose to do.”

Structured recess, Barros said, simply transplants the rules of the classroom to the playground.

“You still have to pay attention,” she said. “You still have to follow rules. You don’t have that time for your brain to relax.”

Adeola Whitney, executive director for Playworks in the Newark area, said that the recess coaches used a playbook with hundreds of games and gave students a say in what they do.

“It’s not rigid in any way, and it certainly allows for their creativity,” Whitney said. “In some cases, we’re teaching children how to play if they can’t go to the park because it’s drug-infested, or their parents can’t afford to send them to activities.”

Each school pays Playworks $23,500 a year to run a recess program — Broadway Elementary is using a grant from Covanta Energy, which owns a waste-to-energy plant in Newark — and the rest of the expenses for training, equipment, after-school activities and field trips are covered through the nonprofit’s grants and donations.

It is not just about fun and games. At University Heights Charter School in Newark, another of New Jersey’s eight Playworks programs, students have learned to settle petty disputes, like who had the ball first or who pushed whom, not with fists but with the tried and true rock-paper-scissors.

“Recess used to end with bad feelings that would continue to play out in the first 20 minutes of class,” said Misha Simmonds, the charter school’s executive director. “Instead of recess being a refreshing time, it took away from readiness to learn.”

Parker, 28, the coach at Broadway Elementary, had worked as a counselor for troubled teenagers in a group home in Burlington, N.C., Besides her work at recess, she visits each class once a week to play games that teach lessons about cooperation, sportsmanship and respect.

“These are the things that matter in life: who you are as a human being at the core,” she said.

Broadway Elementary, with 367 students in kindergarten to fourth grade, rises above a rough-hewn industrial neighborhood in the North Ward. Nearly all the students are black or Hispanic, and poor enough to qualify for free or reduced-price lunches.

There are three 15-minute recesses, with more than 100 children at a time packed into a fenced-in basketball court equipped with nothing more than a pair of netless hoops. On a chilly morning, Parker shoveled snow off the blacktop so that the students could go outside after being cooped up in the cafeteria during recess in the previous week. She drew squares in blue and green chalk for a game called switch, a fast-paced version of musical chairs — without the chairs. (She goes through a box of chalk a week.)

Parker, who greets students with hugs and a cheerful “hello-hello,” keeps the rules simple so that they can focus on playing rather than on following directions. “We’re trying to get them to exert energy, to get it all out,” she said. “They can be as loud as they want. I never tell them to be quiet unless I’m telling them something.”

... Many say they look forward to playing different games every day when before, they used to just run and dribble a basketball.


Original Source: http://www.nytimes.com/2010/03/15/education/15recess.html?src=


Charter Media Launches Childhood Obesity Campaign

March 10, 2010, PR.com

With the rate of childhood obesity and chronic health problems doubling in the U.S. from 1988 to 2006, and with 12.5 million children currently overweight, Charter Communications’ advertising unit, Charter Media, feels a need to bring awareness to the urgent issue of childhood obesity.

Charter Media has launched the Move it! For Your Health campaign, in partnership with businesses in the area.

The Move it! campaign will use the power of cable TV to feature realistic activities and lifestyle choices that the entire family can embrace, in order to tackle this growing epidemic. The multimedia campaign will use TV commercials, weekly text messages, On Demand programming, and internet to encourage the community to make little lifestyles changes that will make big differences towards improving overall health.

Charter customers in Alabama, Georgia, Louisiana, South Carolina and Tennessee will soon have access to health and exercise tips supported by local businesses in the community.

For more information regarding Charter Media’s Move it! For Your Health campaign, go to www.CharterMediaMoveIt.com and do your part to overcome childhood obesity through family health initiatives.


Original Source: http://www.pr.com/press-release/218187



Pepsi Unveils Additional Plans for Nutrition Initiatives

March 22, 2010, Dow Jones Newswires

By Tess Stynes

PepsiCo Inc., unveiled more details of its plans to improve the nutritional quality of its products, as consumers and nutritional advocates step up their calls for healthier eating and lifestyles.

The company, whose brands include Frito-Lay snacks and Quaker cereals, said it is committed to reducing average sodium per serving by 25 percent by 2015 and saturated fat and added sugar by 15 percent and 25 percent, respectively, this decade. Pepsi also said it aims to increase the whole grains, fruits and vegetables, nuts, seeds and nonfat dairy in its product portfolio.

Initiatives include its experimentation with new “designer” salt crystals shaped and sized to reduce the amount of sodium ingested, to cut sodium levels by 25 percent in its Lay’s Classic potato chips and other products.

Last month Pepsi agreed to end the direct sale of full-sugar beverages to primary and secondary schools by 2012 in the face of public concerns about childhood obesity. The issue has come to the fore as first lady Michelle Obama has made combating childhood obesity one of her priorities and Congress considers regulating the drinks allowed in U.S. school vending machines.

The beverage industry, including Pepsi, in February unveiled plans to display calorie content more prominently, moving them to the front of containers by the end of 2012, also part of the wider initiative pushed by the first lady.


Original Source: http://english.capital.gr/news.asp?id=930390


Central Restaurant Products Launches School Nutrition Equipment Guide

March 24, 2010, PRWeb

Central Restaurant Products will launch its first School Nutrition Equipment Guide campaign in support of first lady Michelle Obama’s Let’s Move initiative against childhood obesity. Central’s campaign, which includes a print catalog and an online information area, is aimed at providing the latest products to help improve workflow, promote food safety techniques and encourage healthy food preparation methods in public and private K-12 school districts, colleges and universities

The School Nutrition Equipment Guide Catalog is available now. The Catalog contains more than 3,000 commercial foodservice products that are useful in any school foodservice application, as well as a simplified buying guide to some of the top-requested products.

In addition to the School Nutrition Equipment Guide Catalog, Central will launch a new area for school foodservice and nutrition information on their website. This new school foodservice area will allow shoppers to browse through a selection of equipment and supplies that are recommended for usage in school kitchens, cafeterias, food courts student unions and teachers’ lounges.

Whether shopping by catalog or online, Central’s Product Consultants offer free expert solutions for any school foodservice application. Services include facility workflow advice complete with CAD drawings, assistance with state/federal grant applications and customized product recommendations based upon need, budget and current trends, such as the Let’s Move initiative led by Michelle Obama.

The goal of Let’s Move is to solve the epidemic of childhood obesity within a generation, making it more important than ever for schools to put major focus on healthy foods and cooking methods. Central’s School Nutrition Equipment Guides offer the equipment and supplies necessary to perform the following healthy cooking methods promoted by the Let’s Move initiative ...

To obtain a School Nutrition Equipment Guide Catalog, you may submit a request online for your free copy. ... Visit the School Nutrition Equipment Guide website.


Original Source: http://www.prweb.com/releases/2010/03/prweb3768114.htm