E-Newsletter
May 2012


SPOTLIGHT

PUBLICATIONS

RESEARCH HIGHLIGHTS

CHILDHOOD OBESITY NEWS


SPOTLIGHT

NCCOR’s work on display at Weight of the Nation

May 14, 2012, NCCOR

The National Collaborative on Childhood Obesity Research (NCCOR) showcased its projects and products at this year’s Weight of the Nation™ (WON) conference.

“The Weight of the Nation conference was a great opportunity to showcase NCCOR’s contributions to childhood obesity research,” said NCCOR Director Todd Phillips of FHI 360, NCCOR’s Coordinating Center. “With the NCCOR reception, booth and panel presentation, NCCOR members were able to connect with researchers and practitioners and share NCCOR’s work and successes with them.”

NCCOR brings together four of the nation’s leading research funders – the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Robert Wood Johnson Foundation (RWJF) and the U.S. Department of Agriculture (USDA) – to improve the efficiency, effectiveness, and application of childhood obesity research and to halt – and reverse – the current childhood obesity trend through enhanced coordination and collaboration.

NCCOR reception and booth

More than 100 people attended the NCCOR reception on the conference’s opening night. The event provided an excellent opportunity for conference attendees to network with NCCOR members and others interested in childhood obesity research.

The NCCOR booth also debuted at the conference, increasing the visibility and awareness of the Collaborative and its work. It allowed NCCOR members to share materials with attendees from all over the country. This included researchers and practitioners working in nutrition, physical activity, and obesity, as well as evaluators and state and local health department practitioners.

Panel activities

At a panel talk, RWJF distinguished fellow and NCCOR Steering Committee member C. Tracy Orleans discussed NCCOR efforts to improve the effectiveness of childhood obesity research focusing on the value of partnering and forming networks.

Another panel at WON focused on how child-care settings are regulated, and discussed whether local regulations can be an effective tool for advancing science-based obesity prevention strategies in early care and education programs. NCCOR Steering Committee member Laura Kettle Khan discussed preliminary evaluation results of child-care regulations adopted in New York City, including regulations to address increasing physical activity, reducing screen time, and promoting higher nutritional standards. Kettel Khan, of CDC currently directs the evaluation of the NYC Department of Health and Mental Hygiene regulations for group child-care centers.

Awards ceremony

NCCOR was honored to have several of its own members receive awards at the conference for their efforts to combat obesity. Orleans and NCCOR External Scientific Panel members Jim Sallis of the University of California, San Diego, and Mary Story of the University of Minnesota received awards for their work on RWJF’s Active Living Research and the Healthy Eating Research (HER) programs.

“The success of the HER program is a result of the RWJF’s commitment to evidence-based policy development, the vision and strategic guidance of Tracy Orleans our project officer, and the creativity and ingenuity of all the grantees that were funded by the program, and the hard and excellent work of our HER national program office staff, our senior advisors and our network of external reviewers,” said Story.

Senior leadership briefing

After the conference concluded, NCCOR hosted an invitation-only leadership meeting for the senior leaders from NCCOR’s funding organizations. The meeting focused on NCCOR’s activities, accomplishments, and future directions. Senior leaders in attendance included:

  • Rajen Anand, Ph.D., USDA
  • Ursula Bauer, Ph.D., M.P.H, CDC
  • Rebecca Bunnell, Sc.D., M.Ed., CDC
  • Robert Croyle, Ph.D., NIH
  • William Dietz, M.D., Ph.D., CDC
  • Alan Guttmacher, M.D., NIH
  • Van S. Hubbard, M.D., NIH
  • Chavonda Jacobs-Young, Ph.D., USDA
  • Robert M Kaplan, Ph.D., NIH
  • Edward B. Knipling, Ph.D., USDA
  • James Marks, M.D., Ph.D., RWJF
  • Debra Perez, Ph.D., RWJF
  • Dwayne Proctor, Ph.D., RWJF
  • Griffin Rodgers, M.D., M.A.C.P., NIH
  • Abebayehu Tegene, Ph.D., M.S., USDA
  • Janey Thornton, Ph.D., USDA
  • Catherine Woteki, Ph.D., USDA

Weight of the Nation™: Moving Forward, Reversing the Trend took place May 7-9, 2012, in Washington, D.C. The conference, hosted by CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO), was designed to provide a forum to highlight progress in the prevention and control of obesity through policy and environmental strategies.

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PUBLICATIONS

IOM report identifies key obesity-prevention strategies to scale back Weight of the Nation

May 8, 2012, News from the National Academies

America’s progress in arresting its obesity epidemic has been too slow, and the condition continues to erode productivity and cause millions to suffer from potentially debilitating and deadly chronic illnesses, says a new report from the Institute of Medicine (IOM). Solving this complex, stubborn problem requires a comprehensive set of solutions that work together to spur across-the-board societal change, said the committee that wrote the report. It identifies strategies with the greatest potential to accelerate success by making healthy foods and beverages and opportunities for physical activity easy, routine, and appealing aspects of daily life.

The report, which was released at the Centers for Disease Control and Prevention (CDC) Weight of the Nation™ conference and sponsored by the Robert Wood Johnson Foundation (RWJF), focuses on five critical goals for preventing obesity: integrating physical activity into people’s daily lives, making healthy food and beverage options available everywhere, transforming marketing and messages about nutrition and activity, making schools a gateway to healthy weights, and galvanizing employers and health care professionals to support healthy lifestyles. The committee assessed more than 800 obesity prevention recommendations to identify those that could work together most effectively, reinforce one another’s impact, and accelerate obesity prevention.

ACCESS THE REPORT

Specific strategies that the committee noted include requiring at least 60 minutes per day of physical education and activity in schools, industry-wide guidelines on which foods and beverages can be marketed to children and how, expansion of workplace wellness programs, taking full advantage of physicians’ roles to advocate for obesity prevention with patients and in the community, and increasing the availability of lower-calorie, healthier children’s meals in restaurants.

“As the trends show, people have a very tough time achieving healthy weights when inactive lifestyles are the norm and inexpensive, high-calorie foods and drinks are readily available 24 hours a day,” said committee chair Dan Glickman, executive director of congressional programs, Aspen Institute, Washington, D.C., and former secretary, U.S. Department of Agriculture (USDA). “Individuals and groups can’t solve this complex problem alone, and that’s why we recommend changes that can work together at the societal level and reinforce one another’s impact to speed our progress.”

The report’s proposed strategies and action steps aim to support individuals’ and families’ abilities to make healthy choices where they work, learn, eat, and play. For example, healthy food and beverage options should be available at competitive prices everywhere that food is offered and an effort should be made to reduce unhealthy products. Fast-food and chain restaurants could revise their recipes and menus to ensure that at least half of their children’s meals comply with federal dietary guidelines for moderately active children and charge little or no more for these options, the report says. Shopping centers, convention centers, sports arenas, and other public venues that make meals and snacks available should offer a full variety of foods, including those recommended by the dietary guidelines.

Americans are surrounded by messaging that promotes sedentary activities and high-calorie foods and drinks, the report notes. The food, beverage, restaurant, and media industries should step up their voluntary efforts to develop and implement common nutritional standards for marketing aimed at children and adolescents up to age 17. Government agencies should consider setting mandatory rules if a majority of these industries have not adopted suitable standards within two years. To increase positive messaging about physical activity and nutrition, government agencies, private organizations, and the media could work together to develop a robust and sustained social marketing campaign that encourages people to pursue healthy activities and habits.

Fiscal policies could help increase access to healthy foods and activity, the committee noted. For example, flexible financing or tax credits could be used to encourage developers to build sidewalks near new housing and locate supermarkets in communities without them.

Given that children spend up to half of their waking hours in school and consume a third to half of their daily calories there, schools can be a gateway to healthy habits, the report says. Schools should be given the resources and support to implement federal nutrition standards for meals and for products served in vending machines, concession stands, and other venues. Students in every grade should have opportunities to engage in at least 60 minutes of physical activity daily through quality physical education and active classroom activities. Schools should make food literacy part of their curricula; USDA could support this by developing age-appropriate nutrition information for lesson guides.

“Obesity is both an individual and societal concern, and it will take action from all of us — individuals, communities, and the nation as a whole — to achieve a healthier society,” said IOM President Harvey V. Fineberg. The report’s blueprint for action is being released in conjunction with the new “Weight of the Nation” initiative, which includes an HBO documentary series presented in collaboration with IOM, in association with CDC and the National Institutes of Health, and in partnership with Kaiser Permanente and the Michael and Susan Dell Foundation.

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Original source: http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=13275

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Poll shows support for food and beverage nutrition standards for school vending machines and á la carte lines

April 19, 2012, Kids' Safe & Healthful Foods Project

Eighty percent of American voters favor national standards that would limit calories, fat and sodium in snack and à la carte foods sold in U.S. schools and encourage the consumption of fruits, vegetables, and low-fat dairy items, according to a new poll commissioned by the Kids’ Safe & Healthful Foods Project, a joint project of The Pew Charitable Trusts and the Robert Wood Johnson Foundation.

The U.S. Department of Agriculture is expected soon to propose such updated standards. The standards likely will apply to snacks and beverages — such as sugary drinks, salty snacks, pizza, ice cream, and French fries — that can be purchased from vending machines, school stores, and cafeteria à la carte lines. The standard that applies to them now is 30 years old and does not reflect current nutrition science.

During a typical school day, four in 10 students purchase and consume snack foods or beverages, and such foods are often high in fat, sodium, and calories. Additionally, students’ access to snack foods and beverages has increased over the past decade. The availability of vending machines in middle schools has more than doubled since the 1990s, and in the 2009-2010 school year, nearly half of the nation’s elementary school students could buy unhealthy snack foods at school.

When asked about the healthfulness and nutritional value of food sold in schools:

  • Eighty-three percent of voters said they think that food sold in school vending machines is not really healthy/nutritious or only somewhat healthy/nutritious, compared with just 5 percent who think that vending machine food is totally/mostly healthy and nutritious.
  • Sixty-eight percent of voters said they think that food sold in cafeteria à la carte lines is not really healthy/nutritious or only somewhat healthy/ nutritious, compared with 21 percent who think that it is totally/mostly healthy and nutritious.
  • Sixty-eight percent of voters said they think that food sold in school stores is not really healthy/nutritious or only somewhat healthy/nutritious, compared with 10 percent who think that it is totally/mostly healthy and nutritious.

READ MORE POLL FINDINGS

VIEW THE PRESS RELEASE

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RESEARCH HIGHLIGHTS

Watching TV affects kids’ eating habits beyond screen time

May 16, 2012, Chicago Tribune

Parents may have another reason to limit the amount of television their children watch.

Watching TV affects what kids eat even when they are not glued to it, according to results from a study published this month in Archives of Pediatric & Adolescent Medicine.

“We found that both the amount of television viewing as well as the frequency of snacking while watching TV were related to a cluster of unhealthy eating behaviors,” said Leah Lipsky, the study’s lead author and a staff scientist at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health, in Bethesda, Md.

The study also found that the relationship between television watching and some unhealthy eating patterns remained even when children were not watching TV, according to Lipsky and co-author Ronald Iannotti, also a staff scientist at NICHD.

Lipsky and Iannotti used survey data from 12,642 students in grades five to 10 in public and private schools across the United States during the 2009-10 academic year. Surveys asked participants about the number of hours per day they watched TV, the days per week they snacked while watching television and their dietary habits.

Results found that, after controlling for socioeconomic factors, computer use and level of physical activity, watching television was associated with eating fewer fruits and vegetables and eating more candy, soda, and fast food, as well as skipping breakfast.

The unexpected result was that the relationship between television watching and some unhealthy eating habits remained even after the researchers controlled for television snacking. (The associations between viewing TV and eating candy, soda, and fast food were moderately weakened when controlling for TV snacking.)

“Most people say: ‘Oh yeah, no, I snack when I’m at the TV. This is nothing new,’” Iannotti said. “But even when you control for snacking while at the computer or at the TV, the effect or the relationship between TV viewing and this dietary pattern continues, so it suggests that TV viewing may have an effect beyond simply what you’re doing while you’re watching TV. I think that’s important.”

The study showed associations between activities and behaviors, so statements about cause and effect can’t be made, said Maryann Mason, director of community and evaluation research at the Consortium to Lower Obesity in Chicago Children. But based on previous research, she said, television advertising may help explain how viewing can affect eating behaviors at times when children aren’t even watching TV.
Advertising “sort of has a ripple effect into lifestyle behavior beyond just when you’re sitting in front of it (television) and viewing it,” said Mason, who has a doctorate in sociology.

“Watching a food advertisement can affect a child’s food choices and preference after a very short period of time,” Lipsky said. Previous studies have found that foods featured in commercials generally have poor nutritional content, she noted.
 It is rare for a TV commercial to advertise healthy foods like fruits or vegetables, Iannotti said.

The study led by Lipsky and Ianotti is unique, Mason said, because while research previously has analyzed the association between advertising and diet, no studies have looked at “when the eating of those foods happens. Is it happening during (television) viewing time or not?”

One of the study’s other findings is that older children are more likely to have unhealthy eating habits than younger children.

Even though children are older and more independent, “there’s still a need for guidance and rule-setting in that group,” Mason said.

Skipping breakfast is associated with obesity, Iannotti said. Sugary snacks and soda add only calories and no nutritional value, Lipsky added.

The take-home point for parents, Iannotti noted, is to limit children’s TV watching and computer use as much as possible.

It’s also important to provide children with healthful snacks, such as fruit, and to limit the availability of unhealthy foods like candy, soda and chips, he said.

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Original source: http://www.chicagotribune.com/health/ct-x-tv-and-chid-health-0516-20120516,0,3859596.story

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Childhood obesity: Scientists find two gene variants that predispose kids to weight gain

April 9, 2012, Time

By Alexandra Sifferlin

In the United States, childhood obesity has more than tripled in the last 30 years and everyone from the food industry to parents to school lunch providers have been dished their fair share of blame.

While environmental factors can have a profound effect on children’s weight, researchers also know that genes increase susceptibility to weight gain, and in a recent study, scientists found two gene variants that appear to play a large role in predisposing some children to obesity more than others.

“It is clear from our research that there is a genetic signature to childhood obesity. This should motivate us and other researchers to uncover further genetic components to the trait,” says the study’s lead author, Dr. Struan Grant, associate director of the Center for Applied Genomics at the Children’s Hospital of Philadelphia.

Previous research on the genetics of obesity has focused on variants that are associated with extreme obesity in children and adults, but the new study isolates genes involved in common obesity — the kind we normally attribute to sloth and overeating.

Genetic researchers collaborating internationally conducted a meta-analysis of 14 studies looking at childhood genetic data from the United States, Canada, Australia and Europe. Together, the studies involved 5,530 obese kids and 8,318 non-obese kids. It is the most extensive look at genetic influences on childhood obesity.

Grant and his team found two gene variants they believe increase the risk of obesity: one near the OLFM4 gene on chromosome 13, and the other within the HOXB5 gene on chromosome 17. Although the exact function of these genes is unknown, Grant says the biology of the genes “hints at a role of the intestine” and could be related to the function of bacteria that live in the gut.

“Once the picture gets increasingly clear we can start addressing gene-environment interactions,” says Grant. “Post that, we should be in a position to start tailoring lifestyle and dietary advice to children based on their genetic makeup. These genetic ‘signposts’ give us novel insights in to the biology of childhood obesity, which in turn presents us with new intervention opportunities through the development of more effective therapies.”

The greatest contribution from these findings is the possibility for improved development of pharmacological treatments for overweight kids, says Karen Winer, a program director at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health, which helped fund the new study. “Certain kids, even in the best environments, are prone to be obese because of genetics. Actually identifying the genes really helps. Grant connects the genes to gut physiology, which could help us develop pharmaceutical developments in the future,” she says.

And the need for these developments is growing increasingly dire. “Clearly we don’t have really good treatments for obesity,” says Winer.

“We treat it once it has adverse consequences like insulin resistance. But to really treat and prevent obesity in kids and adults — we don’t have that. Some very obese adults undergo surgery, but pharmacological interventions have not been available for these individuals, and there are so many. There’s a huge number of obese kids in the U.S. today that could benefit.”

The new study was published online in the journal Nature Genetics.

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Original source: http://healthland.time.com/2012/04/09/childhood-obesity-scientists-find-two-gene-variants-that-predispose-kids-to-weight-gain/#ixzz1v4GIfOqf

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New technology maps the surprising subtleties of childhood and teen obesity

April 10, 2012, Scientific American

By Katherine Harmon

The obesity epidemic has already reached the youngest demographic: About 17 percent of U.S. children and teens are obese, and about one in three are overweight. These numbers, reflected in many other countries, have risen steadily in recent decades. And researchers are racing to find the most powerful drivers behind these scary figures, as children who carry the extra pounds into adulthood increase their risks for diabetes, heart disease and other chronic diseases.

The most basic cause—no surprise, has to do with too much unhealthful food and not enough physical activity. Looking more closely at the roots of childhood obesity across different populations yields a complex and nuanced puzzle. Lifestyle and environmental factors that lead to obesity differ for a high schooler in the Bronx versus one in rural Alabama.

Many researchers have turned to geographic information systems (GIS) as powerful analysis tools to map this massive health problem and its possible causes. A special report, published online April 10 in the American Journal of Preventive Medicine, presents six new studies in this growing subfield, some with surprising results that could have implications for health, education and urban planning policy.

“To fully understand the multifaceted nature of childhood obesity, a geographic perspective should be considered,” Celeste Torio, of the Department of Health and Human Service’s Agency for Healthcare Research and Quality, wrote in an essay published online in the same issue of American Journal of Preventive Medicine. “Many of the contributing factors to childhood obesity (particularly social, policy and environmental determinants) have place-to-place variation.”

Here’s one example. Where do you think children ages 12 to 16 years get most of their daily physical activity? Sports? Gym class? At home? The answer turns out to be largely dependent on where they live. In a study led by Daniel Rainham, of the Environmental Science Program at Dalhousie University, researchers tracked 380 adolescents for a week, using both accelerometers and GPS. They found that teens who lived in rural areas did, in fact, get most of their recommended one-hour daily moderate-to-vigorous physical activity at school. However, kids who lived in suburban and urban environments logged most of their active time getting from place to place. And both groups got a fair amount (10 percent to 25 percent) at home.

Rainham and his colleagues also found that girls were getting more physical activity than boys, and that urban teens seemed to be getting the most overall. “Policy makers should be aware that active transportation is an important source of moderate-to-vigorous physical activity for urban youth,” they wrote. And likewise, they contend, education policies should recognize that school-day activities continue to be an important source of exercise for rural teens.

In addition to differences in physical activity, urban and rural adolescents also seem to pick different food options — even when faced with the same smattering of fast food restaurants. Researchers have continued to debate about whether proximity of fast food leads to greater levels of consumption and poorer health outcomes. But another new study, led by Lorna Fraser, of the School of Geography at the University of Nottingham in England, suggests that the culpability of a fast food burger and fries for that extra weight might depend largely on where teens live.

The researchers measured the number of fast food establishments within one kilometer of the study participants’ homes along with each 13- to 15-year-old’s obesity status and reports from caretakers about how often the teens ate at fast food joints.

Those subjects who ate more fast food meals were, predictably, more likely to be obese. Interestingly, a larger number of fast food restaurants in an urban area did not lead to increased consumption (in fact, it seemed to make teens less likely to eat there), but the trend reversed in more rural environments. The results suggest that “public health interventions that place restrictions on the location of fast food outlets may not uniformly decrease consumption,” the researchers noted.

Additional studies like these should help policy makers zero in on the most effective ways to combat childhood and teen obesity at a more fine-grained scale, allowing GIS modeling to analyze “complex reality by breaking it down into layers of information,” she wrote in her essay.

The improved spatial resolution will not provide all of the answers about how to fight childhood obesity. “GIS is not a panacea,” Stephen Matthews, of the Pennsylvania State University, noted in an essay published online in the same issue of American Journal of Preventive Medicine. “The role of place and how children interact with place is just one part of the obesity puzzle.” But she hopes that further study of the spatial environment will help provide new insights into battling childhood obesity.

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Original source: http://blogs.scientificamerican.com/observations/2012/04/10/new-technology-maps-the-surprising-subtleties-of-childhood-and-teen-obesity/

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CHILDHOOD OBESITY NEWS

A mathematical challenge to obesity: A conversation with Carson Chow

May 14, 2012, The New York Times

By Claudia Dreifus

Carson C. Chow deploys mathematics to solve the everyday problems of real life. As an investigator at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [and a contributor to the National Collaborative on Childhood Obesity Research (NCCOR) Envision project], he tries to figure out why one in three Americans are overweight.

We spoke at the recent annual meeting of the American Association for the Advancement of Science, where Chow, 49, gave a presentation on “Illuminating the Obesity Epidemic With Mathematics,” and then later by telephone; a condensed and edited version of the interviews follows.

You are an M.I.T.-trained mathematician and physicist. How did you come to work on obesity?
In 2004, while on the faculty of the math department at the University of Pittsburgh, I married. My wife is a Johns Hopkins ophthalmologist, and she would not move. So I began looking for work in the Beltway area. Through the grapevine, I heard that the NIDDK, a branch of the National Institutes of Health, was building up its mathematics laboratory to study obesity. At the time, I knew almost nothing of obesity.

I didn’t even know what a calorie was. I quickly read every scientific paper I could get my hands on.

I could see the facts on the epidemic were quite astounding. Between 1975 and 2005, the average weight of Americans had increased by about 20 pounds. Since the 1970s, the national obesity rate had jumped from around 20 percent to over 30 percent.

The interesting question posed to me when I was hired was, “Why is this happening?”

Why would mathematics have the answer?

Because to do this experimentally would take years. You could find out much more quickly if you did the math.

Now, prior to my coming on staff, the institute had hired a mathematical physiologist, Kevin Hall. Kevin, [also a contributor to NCCOR’s Envision project] developed a model that could predict how your body composition changed in response to what you ate. He created a math model of a human being and then plugged in all the variables — height, weight, food intake, exercise. The model could predict what a person will weigh, given their body size and what they take in.

ACCESS THE BODY WEIGHT SIMULATOR TOOL

However, the model was complicated: hundreds of equations. Kevin and I began working together to boil it down to one simple equation. That’s what applied mathematicians do. We make things simple. Once we had it, the slimmed-down equation proved to be a useful platform for answering a host of questions.

What new information did your equation render?
That the conventional wisdom of 3,500 calories less is what it takes to lose a pound of weight is wrong. The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight onto an obese person than on a thinner one.

Also, there’s a time constant that’s an important factor in weight loss. That’s because if you reduce your caloric intake, after a while, your body reaches equilibrium. It actually takes about three years for a dieter to reach their new “steady state.” Our model predicts that if you eat 100 calories fewer a day, in three years you will, on average, lose 10 pounds — if you don’t cheat.

Another finding: Huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake.

Did you ever solve the question posed to you when you were first hired — what caused the obesity epidemic?
We think so. And it’s something very simple, very obvious, something that few want to hear: The epidemic was caused by the overproduction of food in the United States.

Beginning in the 1970s, there was a change in national agricultural policy. Instead of the government paying farmers not to engage in full production, as was the practice, they were encouraged to grow as much food as they could. At the same time, technological changes and the “green revolution” made our farms much more productive. The price of food plummeted, while the number of calories available to the average American grew by about 1,000 a day.
Well, what do people do when there is extra food around? They eat it! This, of course, is a tremendously controversial idea. However, the model shows that increase in food more than explains the increase in weight.

In the 1950s, when I was growing up, people rarely ate out. Today, Americans dine out — with these large restaurant portions and oil-saturated foods — about five times a week.
Right. Society has changed a lot. With such a huge food supply, food marketing got better and restaurants got cheaper. The low cost of food fueled the growth of the fast-food industry. If food were expensive, you couldn’t have fast food.

People think that the epidemic has to be caused by genetics or that physical activity has gone down. Yet levels of physical activity have not really changed in the past 30 years. As for the genetic argument, yes, there are people who are genetically disposed to obesity, but if they live in societies where there isn’t a lot of food, they don’t get obese. For them, and for us, it’s supply that’s the issue.

Interestingly, we saw that Americans are wasting food at a progressively increasing rate. If Americans were to eat all the food that’s available, we’d be even more obese.

Any practical advice from your number crunching?
One of the things the numbers have shown us is that weight change, up or down, takes a very, very long time. All diets work. But the reaction time is really slow, on the order of a year.

People don’t wait long enough to see what they are going to stabilize at. So if you drop weight and return to your old eating habits, the time it takes to crawl back to your old weight is something like three years. To help people understand this better, we’ve posted an interactive version of our model at bwsimulator.niddk.nih.gov. People can plug in their information and learn how much they’ll need to reduce their intake and increase their activity to lose. It will also give them a rough sense of how much time it will take to reach the goal. Applied mathematics in action!

What can Americans do to stem the obesity epidemic?
One thing I have concluded, and this is just a personal view, is that we should stop marketing food to children. I think childhood obesity is a major problem. And when you’re obese, it’s not like we can suddenly cut your food off and you’ll go back to not being obese. You’ve been programmed to eat more. It’s a hardship to eat less. Michelle Obama’s initiative is helpful. And childhood obesity rates seem to be stabilizing in the developed world, at least. The obesity epidemic may have peaked because of the recession. It’s made food more expensive.

You said earlier that nobody wants to hear your message. Why?
I think the food industry doesn’t want to know it. And ordinary people don’t particularly want to hear this, either. It’s so easy for someone to go out and eat 6,000 calories a day. There’s no magic bullet on this. You simply have to cut calories and be vigilant for the rest of your life.

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Original source: http://www.nytimes.com/2012/05/15/science/a-mathematical-challenge-to-obesity.html?_r=1

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Chronicling the pounds, their risks and causes

May 11, 2012, The New York Times

By Brian Stelter

During the production of “The Weight of the Nation,” a set of films about obesity that premiered on HBO the week of May 14, John Hoffman watched over and over again the commercials for sugary snacks and gut-busting meals that appear in excerpts. He knew exactly which buttons the ads were trying to push and why, yet he still was not immune to them.

“When salt is sprinkled over fries and juicy meats are sliced open in front of my eyes, I can feel myself going, ‘Oh, that looks good,’ ” Hoffman said in an interview, recounting a day when one of the advertising sequences was being stitched together by editors. The ads, he said, “were operating in parts of my brain that are outside my control.”

It’s rare to hear a television executive like Hoffman, vice president for documentary films at HBO, talk about the psychological effects of advertising, and rarer still to see it talked about on television, a medium that depends in large part on advertising revenue. But “The Weight of the Nation,” which is billed as a wake-up call about an American obesity epidemic, would be incomplete without an acknowledgment of the billions of dollars that are spent to promote unhealthy foods on television and on the Internet. And so the series addresses food marketing at several points along the way, particularly as it affects children, many of whom grow up with affinities for McDonald’s Happy Meals and Taco Bell burritos. Examples flash by on the screen: Britney Spears drinking Pepsi; Eminem hawking Brisk Iced Tea; characters on “The Simpsons” drinking Cokes.

One expert featured in the series, Kelly Brownell of the Rudd Center for Food Policy & Obesity, says in one of the films that food marketing to children is “powerful, it’s pernicious, and it’s predatory.” Another, William Dietz of the Centers for Disease Control and Prevention (CDC), says, “It is the advertising which drives the food supply which drives the likelihood of obesity.”

Hoffman, an executive producer of the obesity series, said he agreed. “It’s not a coincidence that the foods that are marketed the most are the foods that are the most processed and the most profitable,” he said. “Those foods shape the cravings of the public. That then shapes the diet and is now shaping the nation.”

Of course, because “The Weight of the Nation” is a production of HBO, which carries no commercials, the network had no need to worry about advertiser blowback. The films were financed by HBO: a series of public health initiatives surrounding the films were supported by the health insurer Kaiser Permanente and the Michael and Susan Dell Foundation, which concentrates on health and education.

Hoffman said he doubted he would have been able to scrutinize food and beverage marketing practices if he had been making the films for another broadcaster. “A commercial network would be biting the hand that feeds it,” he said.

The president of HBO documentary films, Sheila Nevins, added this: “We don’t have time to duck any bullets.” She said she didn’t know if other networks would have pursued the topic of food marketing, and she added slyly, “I just know that sometimes food looks awfully good on television.”

HBO embarks on a health series like “The Weight of the Nation” every few years. It previously produced multipart series about addiction and Alzheimer’s disease. This time around, four films had their premieres: “Consequences” and “Choices” on May 14, and “Children in Crisis” and “Challenges” on May 15.

The four films are intentionally somewhat repetitive, recognizing that many viewers won’t watch all four. At their roots, the films all assert that obesity is an American epidemic that deserves urgent attention from policy makers, educators, and ordinary eaters. Solving the problem, Hoffman said, “is going to require a massive renovation of the way we live our lives.”

He said his intention is not to “villainize” the food industry but to “sound a very loud alarm” about the products that Americans are eating.

The films try to reorient conversations about obesity away solely from personal responsibility and toward a combination of environmental circumstances to explain why 70 percent of Americans are, according to federal statistics, either overweight or obese. While personal responsibility is an important piece, “you cannot say that all these people have lost all their willpower,” Hoffman said. “There’s clearly something more powerful going on.” Factors cited by the films include federal farm subsidies, marketing strategies, changes in the work force, the content of high-caloric foods and the genetic makeup of individuals.

To rope in the latest research on obesity the filmmakers worked with the nonprofit Institute of Medicine (IOM) and two federal agencies, CDC and the National Institutes of Health (NIH). What particularly fascinated Mr. Hoffman during his research, he said, was the notion of a biological mismatch between a human species whose genes evolved in a world of scarcity but that now exist in a world of abundance. “We’re hard-wired to respond to the colors of red and yellow — ripeness,” he said. “Why do you think McDonald’s and most fast-food companies use red and yellow?”

In an interview Phil Marineau, a former president of Pepsi-Cola North America and Quaker Oats, put it this way: “Our DNA has programmed us to want more, and our economic and cultural systems have delivered more.”

Marineau was the member of an IOM committee about how to accelerate progress in obesity prevention whose meetings were filmed for “The Weight of the Nation.” The meetings in 2010 and 2011 give the films a narrative arc, as do the personal stories of people trying to lose weight with the help of medical experts. Still, the films can feel academic at times, as if intended as much for classrooms as for living rooms. In fact, they are. They were distributed via DVD to thousands of community organizations and streamed on hbo.com so nonsubscribers can see them. And a companion series specially made for children will be shown in the fall.

Margo Wootan, a director at the nonprofit Center for Science in the Public Interest, said she was thankful HBO had targeted obesity prevention through the series and had included marketing in the conversations.

“It is challenging to get educational messages out to parents about the impact and the importance of marketing, because almost everyone who usually shares information with parents — especially broadcast media — has a conflict of interest, because they’re all running junk food ads aimed at kids,” said Wootan, who is quoted throughout the HBO series.

An increasing body of research has shown that advertising content affects eating behavior, and, as a couple of experts ruefully point out in the films, viewers would probably be hard-pressed to remember the last time they saw an ad for fruits or vegetables.

The food and beverage industries have self-regulated their marketing to youth, but they spend $2 billion a year on ads and other forms of outreach to children and teenagers, according to the Federal Trade Commission. “The food companies are participating in self-regulation a lot more than the media companies,” Wootan said.

Nevins said she sensed the films had already affected the consciousness of her staff at HBO. Some people there have lost “a considerable amount of weight,” she said, and others seem more aware of the foods and beverages they’re consuming. “They may not make the right choices,” she said, “but they know when they’re making the wrong ones.”

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Original source: http://www.nytimes.com/2012/05/13/arts/television/the-weight-of-the-nation-coming-to-hbo.html

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Battling junk food in high schools

May 11, 2012, CNN’s The Chart

By Leslie Wade

Five years ago, California passed some of the strongest school-food legislation in the nation in hopes of combating childhood obesity.

These rules limit the kinds of unhealthy foods that students can buy in vending machines or at a snack bar, which aren’t offered as part of lunch in the school’s cafeteria.

The state is well-known for leading the nation with health trends, so it’s no surprise that its legislators are out front when it comes to cutting back on junk food in schools. A new study shows their efforts may be working; high school students in California are eating fewer calories and less added sugar and fat during the school day than students from other states.

According to researchers, high school students in California eat about 160 fewer calories a day than students in the 14 other states studied, which have less stringent standards for junk foods. Most of these saved calories came from eating less while in school, and when students headed home they didn’t appear to overeat to compensate for consuming fewer calories during the school day.

“If teenagers consume 158 fewer calories on average, while maintaining healthy levels of physical activity, it could go a long way toward preventing excess weight gain,” says Daniel Taber, lead author of the study and investigator at the Institute for Health Research and Policy at the University of Illinois in Chicago.

The research was funded by the Robert Wood Johnson Foundation and published in the Archives of Pediatrics and Adolescent Medicine.

Limiting calories from junk food could potentially help a student shed about 7.5 pounds over the school year, according to an accompanying editorial in the same journal by Dr. Barbara Dennison. This could add up to 30 pounds by the end of high school.

But registered dietitian Andrea Giancoli, who is a spokesperson for the Academy of Nutrition and Dietetics, points out that the study did not compare the weight of children in California to the weight of students in the 14 other states. Further studies are needed to find out if California students are indeed winning the obesity battle.

Taber says more work needs to be done.

“Just because students cannot purchase high-fat, high-sugar candies does not automatically mean they’re eating a spinach salad in its place. If we really want to improve the quality of students’ diet, we need to promote fruits, vegetables, whole grains and other healthy alternatives that appeal to students,” Taber said.

In 2010, President Barack Obama signed the Healthy, Hunger-Free Kids Act, which gave the U.S. Department of Agriculture the authority to regulate foods sold outside of the meal plan. Often referred to as competitive foods, these are snacks and junk food students can buy from the vending machines or at other locations in school. These standards may be completed within the next year.

In the meantime, California and several other states such as Oregon and Massachusetts have put together strong competitive food standards for their high school students to get a jump on the junk foods issue.

“The school setting can make significant change, but we all have to work together. It takes a village to raise a child. Neighborhoods and food companies, restaurants and the marketers of junk food have to jump on the bandwagon as well to solve this childhood obesity problem,” says Giancoli.

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Original source: http://thechart.blogs.cnn.com/2012/05/11/battling-junk-food-in-high-schools/

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Why so few walk or bike to school

May 11, 2012, Transportation Nation
[as reported by WAMU, American University Radio, 88.5]

By Martin Di Caro 

What was routine a couple generations ago is now relatively rare. Nearly 50 percent of Americans kids walked or biked to school in 1969. Today the figure is 13 percent.

The decline in children’s physical activity is blamed on an array of factors, from the design of road systems to accommodate automobiles instead of pedestrians and bicyclists, to poor parenting.

Whatever the reasons, the results are alarming: approximately 17 percent (or 12.5 million) of children and adolescents are obese. Supporters of more walking- and bike-friendly neighborhoods partly blame rising the obesity rates on the drop in the number of kids who walk or pedal to school.

In the greater Washington, D.C., area, determined parents and advocacy groups are trying to get kids moving again. The solutions, however, are not as easy as simply telling kids to get up and go. There are concerns about the safety of streets, including missing sidewalks, heavy traffic congestion around schools during morning rush hour and, in some places, crime.

It’s also a matter of convenience and time. Some kids live too far from their schools to make walking or bicycling practical; some parents find it more convenient to drop their kids off at school while driving to work.

“Kids just aren’t used to it right now. They are used to getting bused or being in the car. It’s really about teaching kids. That’s the education part,” says Christine Green, the regional policy manager at the Safe Routes to School National Partnership, a group that encourages communities to address this issue by making streets safer.

“My job as the regional policy manager is to bring all the players in the community together. That’s the school system, the transportation engineers, the planners, the public health folks, and the community advocates,” Green says. ”We bring everybody together under this common mission of not only kids walking and biking but entire communities being able to walk and bike for all their trips.”

Communities apply for federal Safe Routes to School grants. ”You must complete a school travel plan before you do an application,” Green says. “A school travel plan requires you to look at the infrastructure around your school, it requires you to do some counts about the numbers of kids walking and biking to school currently.”

The entire budget of the Safe Routes to School program covers only seven percent of all schools in the United States, according to Barbara McCann, the executive director of the National Complete Streets Coalition, based in Washington, D.C.

“There’s just a tremendous need to change the way we design our roads so that the people who need to use the roads do so, and that includes kids,” says McCann, who organization largely faults road designs over the last half century for the decline in peoples’ physical activity.

“When parents are looking at going with their kids to school they have to think about is there a sidewalk, is there a safe crosswalk, is there a signal?” McCann says. ”It should be a priority of the community to have safe routes to school. Sidewalks make a tremendous difference in safety. They can reduce pedestrian crashes exponentially. In many communities it hasn’t happened and hasn’t been a priority.”

In the Forest Hills neighborhood of northwest D.C., sidewalks are the focus of Robin Schepper, a mother of two young boys and leader of the Safer Routes to School program at Murch Elementary School. She has successfully fought to have sidewalks built on several streets, but some homeowners have also successfully resisted.

“There are a lot of people who really don’t want sidewalks,” says Schepper. ”They have landscaped all the way to the curb even though the city owns four to five feet up. They don’t want sidewalks because they don’t want to disturb their landscaping.”

Schepper and a WAMU reporter made the 17-minute walk from her home west to Murch Elementary. On some streets there are no sidewalks on either side. She accompanies her sons, 6 and 10, on their walk to school every day.

“I was stopped by a police officer about two months ago and she said, “Hey, you got to be careful. This is not safe for your children.” And I said, “I know. I’ve been trying to get a sidewalk here for years,” Schepper says.

Missing sidewalks (and landscaping crews whose trucks make the streets even narrower) are not the biggest concern among neighborhood parents, says Schepper.

“We did a survey at Murch Elementary School when we got a ‘Safe Routes to School’ grant and we did a survey of what were parents’ biggest fears of letting their kids walk and bike to school. And the number one reason was speeding cars,” she says.

Connecticut Avenue runs north/south through Schepper’s kids’ route to school. The posted speed limit is 25 miles per hour, but motorists were seen speeding at about 45 or 50 miles per hour during her interview with WAMU.

“We have traffic coming from Maryland so Connecticut Avenue in the morning is like a speedway,” she says.

While Schepper fights for sidewalks in D.C., in Vienna, Virginia Jeff Anderson is waging a different crusade: getting kids on bicycles.

“I started here at Wolftrap Elementary by asking our principle for a bike rack one day,” says Anderson, who has three young kids with whom he bikes to school.

Once a month Anderson organizes a bike train – a caravan of bicycling students – to encourage more kids to eschew the back seats of their parents’ cars for a two-wheeler.

“I usually have between 10 and 15 kids who join me. We take the back roads and avoid the main roads,” says Anderson, who started the bike trains about 18 months ago. ”There was no bike rack. We now have four. The goal is to get them to see that it is easy to do. Eventually they don’t do the bike train anymore. They just ride on their own.”

Anderson says getting more kids on bicycles or walking is not as simple as he’d like. Parents are concerned about traffic congestion, and some just want to talk with their kids in the car for those precious few minutes before the busyness of the day takes over.

“Everyone is rushed these days to get out for all kinds of reasons. People err on the side of convenience and ease versus taking 15 minutes with your child walking to school,” he says. However, there is a downside to choosing convenience, says Anderson, a member of Fairfax Advocates for Better Bicycling.

“In the ‘60s, 50 to 60 percent of kids biked or walked to school. We didn’t have type 2 diabetes in children. We didn’t have an obesity problem in children. And now only 13 percent of children walk or bike to school nationally. That’s the same number we see here at our school on any given day, too,” he says.

Anderson’s daughter, 9, is happy to be in the minority. ”I like doing it because we are not using energy, it’s a lot of fun, and I like getting exercise,” she says. Her younger brother, 7, says he feels better at school after he bikes in the morning. You can think better,” he says.

Awareness of the benefits of safe streets is not lacking in Kentlands, a community of about 5,000 residents in Montgomery County, Maryland. A model of “new urbanism,” the Kentlands was designed for walking, not only driving. Sidewalks are wide and roads are narrow. Front steps meet the sidewalks.

“Narrow roads calm traffic, keep cars going more slowly, and keep the houses closer together which creates neighborliness. They also provide for wider sidewalks on each side,” says John Schlichting, the chairman of the Kentlands Community Foundation.

The children of the Kentlands were raised as walkers. Their schools, friends, and favorite hang-outs are close by.

“I always cross in the crosswalks, and there are lots crosswalks and sidewalks in the Kentlands, so it’s not like you’re walking in the middle of the street. But if I were somewhere else I might not feel as safe,” says a girl, 11. Her older sister, 13, says she notices a big difference between the way she lives compared to friends from other towns that rely on their parents for transportation.

“They have to get parent permission for everywhere they go, everything they do. Whereas I can be like, mom, I going to walk three doors down and go to my neighbor’s house,” she says.

Another 8-year-old child of the Kentlands says he is lucky to live there. ”I like walking to school because I also have friends that I can walk and talk with, too.”

The boy’s observation raises an issue any parent can relate to: No responsible adult would let their child walk to school, especially alone, if they believe the roads aren’t safe. Thirty percent of traffic deaths for children up to 14 years old happen when they are walking or bicycling.

In the Kentlands, no child has to walk by himself. he close proximity of neighbors produces camaraderie among the kids. Thus, advocates like Barbara McCann and Christine Green believe that the effort to get more kids walking and bicycling cannot succeed without major changes to the design of their neighborhoods and towns.

At the Montgomery County Department of Transportation, engineer Fred Lees is in charge of improving the “walkability” of roads. The head of the traffic engineering section, Lees is working on creating walking routes to the county’s schools.

“One of the biggest problems we have with schools in general is parents dropping off kids, buses, and kids walking, all converging in the same fifteen minute period,” says Lees. In fact, 20 percent to 30 percent of morning traffic is children being driven to school, according to the Safe Routes to School National Partnership.

“We’ve found that along some of the designated walking routes some of the crosswalks are not there or are in bad condition, so we will certainly go out there and mark those and remark ones that are faded,” says Lees.

Getting half of all American school kids walking or biking to school again may seem like an improbable task, but advocates say it is possible through a multi-pronged effort to improve the design of communities, educate parents and children, and encourage physical activity.

In D.C. Robin Schepper is determined to make a difference one street at a time.

“The proudest moment I have in doing this type of work is that when [my kids] point to sidewalks, they say that’s mommy’s sidewalk,” she says.

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Original source: http://transportationnation.org/2012/05/11/why-so-few-walk-or-bike-to-school/

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