Study: Older, heavier kids take in less calories

Sept. 10, 2012, MedPage Today

By Michael Smith

Despite stereotypes, overweight, and obese children older than age 9 actually consume fewer calories than their peers who have a healthy weight, researchers found.

But the reverse is true in younger children, according to Asheley Skinner, Ph.D., and colleagues at the University of North Carolina School of Medicine in Chapel Hill. The findings suggest that approaches to overcoming childhood obesity should vary depending on age, Skinner and colleagues wrote online in Pediatrics .

The findings come from an analysis of 19,125 children, ages 1 to 17, who took part in the National Health and Nutrition Examination Surveys from 2001 to 2008, Skinner and colleagues reported. They suggest that once a child has become obese or overweight, he or she actually needs fewer calories to maintain the weight, Skinner said in a statement, so that trying to cut down on their food intake is unlikely to be beneficial.

“It makes sense for early childhood interventions to focus specifically on caloric intake,” he said, “while for those in later childhood or adolescence the focus should instead be on increasing physical activity, since overweight children tend to be less active.” While cutting calories would work eventually, older children with a weight problem “would actually have to eat much less than their peers, which can be a very difficult prospect for children and, especially, adolescents,” Skinner added.

The researchers initially hypothesized that obese and overweight children of all ages would overeat, compared with their healthy weight peers, and were interested in pinpointing variations by age and sex. They used the measured heights and weights of the survey participants to categorize their weight status as weight-for-length percentiles for those under age 2 or body mass index (BMI) percentile for those ages 2 to 17.

The participants or their parents, depending on age, reported dietary intake in computer-assisted interviews. Overall, the researchers found, 15.4 percent of the participants were either obese or very obese, 14.9 percent were overweight, 66.3 percent had a normal healthy weight, and 3.4 percent were underweight. As expected, analysis showed that for girls younger than 9 and boys younger than 12, the obese and overweight took in more calories than those with a healthy weight, although the trends were for the most part non-significant.

But surprisingly, that pattern flipped in the older groups. Specifically, obese and overweight girls, ages 9 to 11 (P=0.045), ages 12 to 14 (P=0.003), and ages 15 to 17 (P<0.0001), ate less than their healthy peers and the trends were significant.

Obese and overweight boys, ages 12 to 14 (P=0.004) and ages 15 to 17 (P<0.0001), ate less than their healthy peers and again the trends were significant.

“For many children, obesity may begin by eating more in early childhood,” Skinner said. “Then as they get older, they continue to be obese without eating any more than their healthy weight peers.” The researchers cautioned that dietary intake used in the study was self-reported, either by children or by a proxy, which could introduce bias. But the automated multiple pass method that was employed has been repeatedly validated as a tool to collect dietary intake data in a way suitable for large surveys, they noted.

Also, the study utilized cross-sectional data, which says little about energy intake patterns and obesity within an individual child.


Original source: http://www.medpagetoday.com/Pediatrics/Obesity/34655/



New report finds adult obesity rates could exceed 60 percent in 13 states by 2030

The number of obese adults, along with related disease rates and health care costs, are on course to increase dramatically in every state in the country over the next 20 years, according to F as in Fat: How Obesity Threatens America’s Future 2012, a new report from the Robert Wood Johnson Foundation and Trust for America’s Health.

For the first time, the annual report forecasts adult obesity rates in each state by 2030 and the likely resulting rise in obesity-related disease rates and health care costs. It also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030.



Implementing childhood obesity policy in a new educational environment: The cases of Mississippi and Tennessee

A new case study published in the July issue of the American Journal of Public Health found policies designed to address health and social problems in high-school settings face significant barriers to effective implementation. The study investigated the processes involved in, and outcomes of, implementing three new state-level, school-oriented childhood obesity policies enacted between 2004 and 2007. Researchers followed policy implementation in eight high schools in Mississippi and Tennessee. They found significant barriers to the effective implementation of obesity-related policies. These most notably include a value system that prioritizes performances in standardized tests over physical education (PE) and a varsity sport system that negatively influences opportunities for PE. These and other factors, such as resource constraints and the overloading of school administrators with new policies, mitigate against the implementation of policies designed to promote improvements in student health through PE.



Declining childhood obesity rates — where are we seeing the most progress?

This research brief from the Robert Wood Johnson Foundation summarizes the declines in childhood obesity rates in Philadelphia and recent declines in New York City, Mississippi, and California. The brief notes that the places reporting declines are those that are taking comprehensive action to address the childhood obesity epidemic.




Study: Exercise programs for kids seem to have little impact

Sept. 27, 2012, HealthDay

By Steven Reinberg

Formal physical exercise programs for children have only a small impact on overall activity and thus on weight loss, British researchers report.

Their study raises questions about the best ways to help children attain or maintain a healthy weight.

“Physical activity interventions are not increasing physical activity sufficiently to impact on the body mass or body fat of children,” said lead researcher Brad Metcalf, of the Department of Endocrinology and Metabolism at Peninsula College of Medicine and Dentistry in Plymouth, England. “It is in everyone’s interest to find something that works effectively,” he added.

But other experts said instead of dismissing organized interventions as ineffective, policy makers should conclude that still more is needed to stem childhood obesity. In the United States, about 17 percent of children aged 2 years and older are obese.

“I disagree that the importance of physical activity to childhood obesity control, or health promotion, has been called into question by this study,” said Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Conn.

On the contrary, “we have cause to question if we are doing enough to make routine activity the cultural norm, so that such programming can achieve greater effects,” Katz said. “An intervention, no matter how good, can only achieve so much if not surrounded by cultural supports.”

Katz also faulted the study for not including data from the many studies that show a significant benefit from exercise. For the study, published in the Sept. 27 online edition of the BMJ , the researchers analyzed 30 studies conducted between 1990 and 2012 involving children aged 16 and younger.

This type of study, known as a meta-analysis, is used to find common threads running through multiple studies. Problems with this type of analysis can arise from the weakness of any of the studies included and the difficulty of combining disparate data.

Unlike some other studies of children’s activity, these studies measured actual movement during children’s waking hours using accelerometers and didn’t rely on questionnaires.

Eight of the 30 studies included only overweight or obese children. One U.S. study followed more than 700 children, average age 11, taking part in 90 minutes of after-school physical activity three times a week. Another involved more than 250 Scottish nursery school children who did 30 minutes of physical activity three times a week. Overall, the researchers said the programs achieved “small-to-negligible” increases in children’s total activity with small improvements in time spent in moderate or vigorous intensities – about four minutes’ walking or running per day.

This could have only a minimal effect on weight, they concluded. “It’s been shown by others that four minutes extra walking/running is only associated with a 2 millimeter difference in waist circumference,” Metcalf said. While the added activity sessions might offer other benefits, including better coordination, improved ability at a sport, team participation and genuine enjoyment, they won’t “have a meaningful impact on obesity prevention,” he said.

These programs may not work because they might replace physically demanding after-school activities that take place outdoors and last for longer periods, the researchers said. It’s also possible that children eat more after these sessions, they noted.

Mark Hamer, from the Department of Epidemiology and Public Health at University College London and co-author of an accompanying journal editorial, said the study has limitations but “provides the best evidence to date on the effectiveness of physical activity interventions in childhood.”

Better approaches to increasing children’s physical activity are needed, Hamer said. Perhaps physical changes to the indoor and outdoor environment can facilitate activity, he suggested.

He and others maintain that a wealth of evidence supports the association between an active lifestyle and better health. Samantha Heller, exercise physiologist and clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Conn., pointed out that programs that aim to boost children’s activity levels may not influence sedentary behavior at home or once the programs conclude.

Also, “many interventions do not include a nutrition component that could impact food choices, overall nutrition or calorie intake,” she said.

School environments need to shift toward a more active day for kids, Heller said. “We need to continue to develop programs, environments, and classes that encourage and educate children and teens on the importance of exercise and physical activity in ways that are meaningful and fun for them,” she added.


Original source: http://health.usnews.com/health-news/news/articles/2012/09/28/exercise-programs-for-kids-seem-to-have-little-impact-study/


Taste buds less sensitive in obese kids

Sept. 19, 2012, MedPage Today

By Michael Smith

Obesity in children and adolescents may be a matter of taste.

In a cross-sectional cohort study, obese children and adolescents were less sensitive to salty, bitter, and umami (savory) tastes than those of normal weight, according to Susanna Wiegand, M.D., of Charité Children’s Hospital in Berlin, and colleagues.

There were no significant differences overall in the case of sweet and sour tastes, but obese participants consistently rated sweet samples as less sweet than did the normal-weight volunteers, Wiegand and colleagues reported online in Archives of Disease in Childhood.

Differences in taste perception may influence the rate of food consumption and thereby contribute to obesity, the researchers argued. But little is known about tastes other than bitter (the compound propylthiouracil), which has been the subject of a large number of studies in children and adolescents, they noted.

To help fill the gap, they enrolled 94 normal-weight (mean body mass index 18.2 kg/m2) and 99 obese (mean BMI 29.9 kg/m2) children and adolescents between ages 6 and 18, who were in good health and not taking any medications or suffering any diseases that affect taste and smell. The children were multi-ethnic and these obese participants came from the hospital’s pediatric obesity center.

Each participant was tested using “taste strips” made of filter paper impregnated with each of the five taste sensations at four different levels of intensity, as well as two blank strips. They were asked to avoid eating or drinking anything other than water and to refrain from chewing gum for at least one hour before the tests. In one experiment, all 22 taste strips were presented in increasing concentrations, but at each concentration the order of the tastes was varied randomly.

Participants got one point for each correct identification and the two blank strips were not included in the score, so a best-possible score was 20.

Total scores ranged between 2 and 19, Wiegand and colleagues reported, and the obese children and adolescents had an average score of 12.6, significantly lower (P<0.001) than the 14.1 achieved by the control group.

There were no significant differences between the groups in the ability to identify sweet and sour, with average correct scores of 3.7 and 1.9, respectively, for each group.

On the other hand, the obese participants did significantly less well at identifying salty (P=0.002), umami (P<0.001), and bitter (P=0.018) tastes.

In a separate experiment, participants were asked to rate the intensity of four different concentrations of sweet, Wiegand and colleagues reported.

Obese participants rated the lowest three concentrations as being less sweet than did members of the control group. The between-group differences were significant for the lowest concentration (P=0.002), for the next lowest (P=0.007), and for the third lowest (P<0.001). Only at the sweetest concentration did the groups agree.

Girls and older participants were better at picking out the right tastes, the researchers reported.

Wiegand and colleagues cautioned that the participants’ socioeconomic status, which was not controlled for, could be a confounding factor, adding that 85 percent of the obesity cohort at their clinic has a low socioeconomic status. Also, there were differences in ethnicities and sex between the two cohorts. Finally, the cross-sectional study should be followed up by a longitudinal analysis.

Nonetheless, they concluded that the results “support the hypothesis that obese and non-obese children and adolescents differ in their taste perception,” although exactly how remains a matter for investigation. “Further studies on taste sensitivity and hormonal status in obese subjects are required [that might lead to] further strategies of obesity prevention and therapy in childhood,” Wiegand and colleagues stated.


Original source: http://www.medpagetoday.com/Pediatrics/Obesity/34846


Study: Short bouts of exercise can cut heart risks in kids

Sep. 11, 2012, CTV News

Engaging in less than 10 minutes of vigorous exercise as part of daily physical activity appears to provide increased heart-protective health benefits in children and teens, a Canadian study suggests.

Bouts of high-intensity physical activity — such as running, swimming or playing soccer —are superior to longer periods of light and moderate exercise in reducing the risk factors that set kids on a path towards cardiovascular disease.

The findings were published online Sept. 10 by the Archives of Pediatrics & Adolescent Medicine .

In the study of 605 Alberta schoolchildren, aged 9 to 17, researchers found that seven minutes a day of intense physical activity was associated with significant reductions in body weight and blood pressure levels, as well as increased fitness.

When it came to waist circumference, participants who did the highest amount of vigorous exercise each day pared their mid-sections by seven centimeters on average. Overweight subjects in that group reduced their waistlines by five centimeters.

“That is a huge difference,” said principal researcher Jonathan McGavock, an exercise physiologist at the Manitoba Institute of Child Health.

“If we look at physical activity as the magic bullet or drug that is going to have health benefits, such as reducing the risk of overweight or reducing the risk of high blood pressure, a higher intensity is like taking a higher dose of that drug,” he said on Sept. 10 from Winnipeg.

“It says that the more intense the exercise is, the less likely (youth) are to be overweight or to have high blood pressure, compared to (those doing) lower-intensity exercise.”

The cross-sectional study included 248 boys and 357 girls, about a quarter of whom were overweight or obese. Data was taken from the 2008 Healthy Hearts Prospective Cohort Study of Physical Activity and Cardiometabolic Health in Youth.

Participants wore accelerometers on their hips, which measure the amount and intensity of physical activity, for a maximum of seven days. The minimum time for inclusion in the study was three days, 10 hours.

Those who engaged in the lowest-intensity exercise, deemed light physical activity, clocked 133 minutes or just over two hours of easy walking. Participants who tallied the highest amount of light exercise walked for 244 minutes, almost twice as much.

“Despite the fact that they’re getting over an hour – almost two hours – more light activity, we didn’t see any differences in their waist, in their body weight, in their blood pressure or in their fitness,” said McGavock.

Yet those engaging in vigorous activity, ranging from a low of a minute and a half to 8.7 minutes daily, appeared to reap greater rewards from a more intense – albeit much shorter – physical workout, he said.

“So what was really novel was that over a very short increment in time, you were seeing a lot of health benefits associated with it.”

Canada’s physical activity guidelines recommend that children aged 5 to 17 need 60 minutes of moderate- to vigorous-intensity exercise daily. This should include both vigorous-intensity activities and muscle and bone-strengthening activities at least three days a week.

“We need to start incorporating vigorous physical activity into those guidelines and emphasizing higher-intensity exercise,” said McGavock.

“So the final message I would give to parents is try to get your children outside and into games they enjoy, but games in which they are more active, they are breathing hard, it’s increasing their body temperature, they’re red in the face — that kind of exercise — so we can see greater health benefits.”

Mark Tremblay, director of active living and obesity research at the Children’s Hospital of Eastern Ontario, said the Manitoba study is useful and supports the Canadian Physical Activity Guidelines.

Those guidelines stress that more is better, whether referring to duration, intensity, frequency, or variety of physical activity.

“I think the particular value that this (study) adds is it throws a number out there,” said Tremblay, referring to the seven-minute span.

“That’s the sort of information that is severely lacking in the literature,” he said from Ottawa. “It at least is putting a line in the sand, which I really value,” said Tremblay, lead author of the activity guidelines.

“Hopefully there will be more (studies) like this so that when five years from now, when we’re updating the guidelines again, we’d be able to say and include vigorous-intensity activities at least three days of the week for at least ‘blank-blank’ duration.”


Original source: http://www.ctvnews.ca/health/short-bouts-of-exercise-can-cut-heart-risks-in-kids-study-1.951065#ixzz26FbZ4zrH


Some anti-obesity campaigns may backfire, researchers say

Sept. 12, 2012, Los Angeles Times

By Melissa Healy

As U.S. health authorities prosecute an all-out war against obesity, a small cadre of researchers is warning that the nation’s 78 million obese adults and 12.5 million obese children are already suffering collateral damage.

The message that they will become victims of self-inflicted disease, poor role models for their families, and a drag on the economy unless they lose weight has left many obese Americans feeling depressed, defeated, and ashamed, these experts say.

Ironically, some of the campaigns aimed at obese Americans could sink efforts to help them improve their health by eating better and exercising more, the experts wrote Sept. 11 in the International Journal of Obesity .

Anti-obesity campaigns viewed as stigmatizing “instill less motivation to improve health,” and the messages that appeared most effective at encouraging behavior change didn’t mention obesity at all, according to the research team from Yale University’s Rudd Center for Food Policy and Obesity.

The study comes as state and federal public health officials grapple with an obesity crisis that threatens to swamp efforts to contain healthcare costs and prolong Americans’ life spans. In a bid to reverse surging rates of obesity in the United States and the industrialized world, public health officials have spawned a slew of campaigns that take a variety of approaches.

Many encourage behavior change with helpful tips such as “eat a variety of colorful fruits and vegetables every day,” as a program backed by the Centers for Disease Control and Prevention advises. But other campaigns have been less upbeat. In Georgia, a controversial series of video and billboard advertisements reminds parents that “fat kids become fat adults” and that “being fat takes the fun out of being a kid.” An Australian anti-obesity campaign pointedly warns viewers that “the more you gain, the more you have to lose.”

Such messages are broadcast amid widespread stigma against the obese: Heavy workers earn less, are more likely to be passed over for jobs and promotions, and are more likely than their thinner peers to be viewed as lazy and undisciplined, researchers have found. A poll released last month by Harris Interactive/HealthDay found that 61 percent of Americans did not consider negative remarks about a person’s weight to be offensive.

Even among physicians, obese patients elicit feelings of prejudice and blame. A 2003 survey, published in the journal Obesity Research , found that half considered their obese patients awkward, ugly, unattractive, and unlikely to follow their advice. In addition, one-third of doctors viewed obese patients as weak-willed, sloppy, and lazy.

Against this backdrop, it’s little wonder that some public health campaigns would employ guilt and shame to motivate people to lose weight, said Rebecca Puhl, the Rudd Center’s research director and leader of the new study.

“There tends to be a sense that maybe a little bit of stigma isn’t such a bad thing, that maybe it’ll give overweight or obese viewers a little motivation,” she said.

But such views do not account for shame’s boomerang effect. “When children or adults are made to feel stigmatized, shamed, or teased about their weight, they’re likely to engage in binge eating and unhealthy weight-control practices, and to avoid physical activity,” Puhl said. “We find that people actually cope with stigma by eating more food.”

To Nina Savelle-Rocklin, a Sherman Oaks psychotherapist who specializes in treating those with eating disorders, the link between shame and overeating is clear.

“Shame is about feeling bad about who you are,” Savelle-Rocklin said. That message “is unbearable and intolerable” to most, and those who quell negative emotions by eating “are going to turn to food.... It’s just a recipe for disaster.”

UCLA psychologist Matthew D. Lieberman, who studies the neuroscience of persuasion, said the latest study was in line with research showing that public health campaigns can be successful only if they “fit with our sense of ourselves.”>

When he’s in the lab watching the persuasive process unfold on brain scans, the messages that spur people to action are the ones that activate a region of the brain involved in thinking and reflecting about one’s self. Negative thoughts aren’t likely to recruit the neural systems that convert a message into action, Lieberman said.

Puhl and her colleagues asked 1,014 volunteers to evaluate 30 public service announcements from several countries aimed at curbing obesity. The team found that obese subjects were likely to perceive shame and stigma more strongly and more often than their slimmer counterparts.

Past research suggests that their long exposure to others’ negative attitudes toward them may prime obese viewers to experience stress when the subject of weight is raised. They commonly respond to such stress by consuming more calories, Puhl said.

“It’s not a helpful public health tool,” she said. “It reinforces the problem and makes the situation worse.”

Far more effective were messages that suggested specific steps that would improve health, conveyed a sense of empowerment, and left references to obesity unspoken.

In the study, the slogan that got the highest marks for motivation was “Eat well. Move more. Live longer.” Part of a British campaign called Change4Life, it was rated stigmatizing by less than 30 percent of participants, and 85 percent said it would move them to make changes.

The most stigmatizing messages — and those with which participants said they were least likely to comply — were aimed at parents on the subject of childhood obesity.

An Australian message that asserts that “childhood obesity is child abuse” was rated stigmatizing by 62 percent of subjects, and just 44 percent said it would move them to action. Fifty-seven percent considered the message “Chubby kids may not outlive their parents” — a product of Georgia’s Strong4Life campaign — to be stigmatizing, and just under half said it would prompt them to change their behavior.


Original source: http://www.latimes.com/news/science/la-sci-obesity-20120912,0,5230176.story



Soda purge in schools is largely successful, but obesity remains

Sept. 6, 2012, Newsday

By Kyle Nagel

Beverage companies decreased drink calories offered in schools by 90 percent between 2004 and 2010, according to a recent study, a strategy industry and school officials said was meant to help the country’s fight against childhood obesity.

The report comes six years after the country’s major soft drink companies partnered with the William J. Clinton Foundation and the American Heart Association in agreeing to lower beverage calories available in schools.

Nationally, full-calorie drinks available in schools dropped from about 8.2 billion ounces in 2004 to 294 million ounces in 2010, according to the American Journal of Public Health. The decrease of about 97 percent significantly limits students’ access to high-calorie drinks in schools, officials said.

The study’s authors were commissioned to confirm that the soft drink companies were following their agreed-upon guidelines, said lead author Robert Wescott.

“I would say the record of the companies is not perfect, but it’s pretty darn good,” said Wescott, president of Washington, D.C.-based economic research firm Keybridge Research.

Many school vending machines look much different than widely circulated machines. They contain mostly water, juice, sports drinks, and milk. Some are painted in the black and white pattern of a cow to underline their message. Many schools don’t sell any soft drinks to students.

Feeling that much of the work on school soft drinks has been done, officials have turned more attention to foods in the lunch lines and activity guidelines in the ongoing struggle with obesity. Last year, the Centers for Disease Control and Prevention reported that Ohio’s high school student obesity rate was 15 percent, making it one of 12 states to reach that level.

“I think it’s a good step in the right direction,” said Danielle Hodge, a registered dietitian at West Chester Hospital north of Cincinnati, of limiting drink calories in schools. “I think kids do drink too many sodas and too many flavored coffees, so I think this is a good step to try to curb some of those obesity problems in teenagers.”

As concern about student health increased, officials began to more closely watch what children were consuming at school. Those memories make the changes of the last decade even starker.

“Nine years ago I came into this segment of food service, and you’d see a Honey Buns and two Mountain Dews for breakfast,” said Christopher Ashley, supervisor of food and nutrition for Springfield, Ohio City Schools. “Now kids are going through the line and getting a better breakfast. That’s just the start.”

Hoping to make an impact on what children received in school, the William J. Clinton Foundation and American Heart Association combined to form the Alliance for a Healthier Generation in 2005. One of the new alliance’s first targets was the beverage industry.

In May 2006, The Coca-Cola Company, Dr Pepper Snapple Group, PepsiCo, and the American Beverage Association joined with the Alliance for a Healthier Generation to form the School Beverage Guidelines. Those guidelines eliminated certain drinks in some schools and limited the calories available for older students.

“It’s hard to say no to Bill Clinton, right?” said Kimberly McConville, executive director of the Ohio Soft Drink Association. “They were forming a big domestic project, and the beverage companies said they would be part of it.”

The results could be seen earlier this week at Centerville High School, where sophomores Leena Hirani and Mia Smith and freshman Kendra Phong ate lunch in a commons area. Each had purchased their lunches at school in suburban Dayton, Ohio (schools can’t forbid students to bring what they would legally like to eat or drink), and they were drinking chocolate milk and orange juice.

“I would drink this anyway,” Smith said of her orange juice.

Other students carried a variety of beverages including Mountain Dew, Sunkist, milk, and fountain drinks from fast-food restaurants, as juniors and seniors can leave the campus for lunch. One student, sophomore Jadon Bischoff, carried a gallon jug filled with a mix of lemonade and iced tea.

“Most days I’ll bring something,” he said. “It can be expensive to buy.”


Original source: http://newyork.newsday.com/news/health/soda-purge-in-schools-is-largely-successful-but-obesity-remains-1.3958221


School lunch rules for healthier meals get mixed reviews from students

Sept. 14, 2012, Huffington Post

By Michael Hill

One student complains because his cafeteria no longer serves chicken nuggets. Another gripes that her school lunch just isn’t filling. A third student says he’s happy to eat an extra apple with his lunch, even as he’s noshing on his own sub.

Leaner, greener school lunches served under new federal standards are getting mixed grades from students piling more carrots, more apples, and fewer fatty foods on their trays.

“Now they’re kind of forcing all the students to get the vegetables and fruit with their lunch, and they took out chicken nuggets this year, which I’m not too happy about,” said Chris Cimino, a senior at Mohonasen High School in upstate New York.

Lunch lines at schools across the country cut through the garden now, under new U.S. Department of Agriculture (USDA) nutrition standards. Mohonasen students selecting pizza sticks this week also had to choose something from the lunch line’s cornucopia of apples, bananas, fresh spinach, and grape tomatoes, under the standards. Calorie counts are capped, too.

Most students interviewed in this suburban district near Schenectady seemed to accept the new lunch rules, reactions in line with what federal officials say they’re hearing elsewhere. Still, some active teens complain the meals are too skimpy. And while you can give a kid a whole-wheat pita, you can’t make him like it.

“I was just trying to eat it so I wouldn’t be hungry later on,” Marecas Wilson said of his pita sandwich served this week at Eastside Elementary in Clinton, Miss.

Though the fifth-grader judged his pita “nasty,” he conceded: “The plum was very good.”

Kim Gagnon, food service director in the Mohonasen district, said while students generally have been receptive to the fruits and vegetables, “we have noticed that kids are throwing it out or giving it to friends, leaving it on counters, so we haven’t quite gotten there yet.”

The guidelines approved by the USDA earlier this year set limits on calories and salt and phase in whole grains. Schools must offer at least one vegetable or fruit per meal. They can still serve chocolate milk, but it has to be nonfat.

The biggest update to federal school-food guidelines in 15 years might please parents who recall washing down cheeseburgers and tater tots with full-fat chocolate milk. In Pueblo, Colo., Megan Murillo said she feels more comfortable letting her first-grader, Sophie, eat cafeteria-prepared lunches knowing there are more vegetable and whole grains.

Reactions in schools so far this fall have been positive, according to Kevin Concannon, the USDA’s undersecretary for Food, Nutrition and Consumer Services.

“I don’t mind it because I always got the extra apple and fruit and veggies and all that,” said Anthony Sicilia, a senior at Mohonasen, who nonetheless was eating a Subway sub for lunch. “But I think it’s good because it actually forces kids to eat healthy.”

But new guidelines or no, many kids are still picky eaters. In Clinton, Miss., the elementary students served flatbread roast beef sandwiches with grated cheese ate most of the meat but left large chunks of whole-wheat pita. Most plums were gnawed to the pits, and several salads were half eaten.

“I liked the meat but not this,” fifth-grader Kenmari Williams said, pointing to his pita. “Every time you eat it, you get something white on your hands.”

One thornier complaint is that the new lunches are too little for active teens now that the calorie range for high school lunches is 750 to 850. Rachelle Chinn, a freshman from Clarence, Mo., who plays softball, said school lunches are now so slight it once left her with a headache.

“The fruits and vegetables are good at first but once they wear off, I get hungry,” she said. “It’s just not enough to get me through the day.”

Her mom, Chris Chinn, now packs her protein-heavy snacks like peanut butter crackers and granola bars. Chinn, a critic of what she calls the “one size fits all” standards, said many athletes aren’t getting enough to eat. Similarly, Katie Pinke in Wishek, N.D., gave up on school lunches for her strapping freshman son Hunter and packs him meaty sandwiches.

Hunter is a 6-foot-5-inch, 210-pound football player who, based on his size and active lifestyle, needs more than 4,700 calories daily to maintain his weight. He said lunches topping out at 850 calories aren’t enough.

“I think it’s kind of ridiculous that people say how much we get to eat when there are a lot of kids that are big,” Hunter said. “When we can’t have our meat and bread, for a guy especially, it’s not fun.” Concannon noted the calorie ranges are adjusted for age, increasing as students move from elementary to middle to high school. If some children need more, Concannon said, schools have the option of offering an afternoon snack or parents can send snacks from home.

“If you look at colleges in the United States, if you’ve ever looked at the tables where they’re feeding just the football players. Good God ... If you emulated that, we’d all be wearing size 48 suits by our 20s,” he said. “You have to use common sense.”

And just weeks into the school year, it’s probably too early for final grades. In Mississippi, Keba Laird, child nutrition supervisor for the Clinton district, said she is phasing in the nutritional changes to help children grow accustomed to eating healthier.

“We don’t want a revolt on our hands,” she said. “We want them to enjoy eating with us.”


Original source: http://www.huffingtonpost.com/2012/09/14/mixed-grades-for-new-heal_n_1883763.html


At school, overweight children carry a heavy burden

Sept. 23, 2012, NPR

By Kavitha Cardoza

One in three children in the United States is overweight or obese. Significant numbers of those young people are grappling with health problems like heart disease, high blood pressure, and diabetes. Those conditions can be difficult for children to manage in any setting, but they can pose particular challenges for children during the school day.

Dr. Yolandra Hancock used to be an elementary school teacher, and it shows. She’s patient, encouraging and has an endearing way of ending her sentences with “my love” and “my sweet.”

Her patients include a 13-year-old who weighs 400 pounds; a child whose teeth are so rotted she can’t bite into carrots; and many preteens who are diabetic. Today, Hancock is examining Derek Lyles, 13. He’s 4 feet 11 inches and weighs 256 pounds.

“When we look at his body mass index, which is how well his weight and height balance out, his BMI today is 46.7,” Hancock says. “For an adult male, we like to see a BMI of 30 or less.”

Hancock is also troubled by dark patches of skin around Derek’s neck.

“When little ones, especially around the back of the neck, have that sort of thick, almost velvety appearance to their neck, it means that their bodies are becoming less sensitive to insulin,” she says.

Back-to-school checkups for patients like Derek mean lots of follow-up work for Hancock. Their belly fat pushes down on their bladders, so she’ll have to write notes to principals, asking that her patients be allowed to go to the bathroom frequently. She must also draft requests to excuse children whose sleep apnea makes them appear drowsy in class, or whose joints hurt as they walk between classes.

Practical challenges, for kids and schools

These accommodations also mean more work for schools, says Camille Wheeler, a nurse at Bell Multicultural High School in Washington, D.C. “It’s a lot. It really is,” Wheeler says. “It takes a lot for the student, for the nurse, the parent, and the school. Especially the school. Because the majority of the time the students are here, you know?”

Wheeler says it’s not unusual for a child to arrive at school at 8 a.m. and depart at 6 p.m., depending on a family’s aftercare arrangements.

“That’s a large chunk of their time,” she says. On a recent afternoon, Wheeler is thumbing through stacks of paper, racing to process students’ health information.

“I have a whole stack here of many, many health certificates, dental forms, health records,” she says. “It’s about well over 200 forms in here, and I’m getting them daily.”

Many of the forms are related to obesity. Children with diabetes need midmorning snacks. Some are on special diets and some need medication. All this means time away from the classroom.

“It may not be in the forefront, like a broken bone for example, but it’s there and it affects the students every day,” says Shirley Schantz, nursing education director for the National Association of School Nurses.

Schantz says that nurses from across the country are increasingly calling her organization, asking for guidance on how to deal with childhood obesity in schools — even preschools.

“They see students that can’t walk upstairs,” she says. “They see students that are absent because they’re overweight or obese, [who] don’t want to go to physical education.”

The physical aspects of living with obesity can be difficult enough for a child. But there’s an emotional toll, as well. Bullying is a common problem for obese kids. Derek says other students often called him fat in middle school.

Taking a toll on learning

All these challenges can also affect learning. Dr. Hancock says there is evidence that children who are obese score less well on standardized tests and basic classroom tests.

“Some researchers believe that there may be something physiologically that’s affecting the child’s ability to learn,” Bell says. “Others believe, because of self-esteem issues and bullying, it makes them less eager to attend school and participate in school activities.”

Derek wants to lose weight so he can “walk fast like other kids.” And he really wants to start playing football again this year.

“During training camp, I couldn’t do most of the, like, exercise that other people was doing,” Derek says. “I just couldn’t do it.” For many obese children, even maintaining their weight when they’re not in school is challenging. This summer, Derek could eat whenever he wanted, and the fridge was always stocked with food. At school, he says, he ate cereal or a muffin for breakfast. But over the summer, he often ate sausage and eggs. The pounds piled on.

Hancock hopes eating meals at school will help Derek get his weight under control. She embraces Derek as she says goodbye.

“All right, handsome, give me some hugs,” Hancock says, embracing Derek. “I have faith you’ll be able to make changes, because you’ve done this before.”

As Hancock reminds her young patient, it’s a brand new school year — an opportunity to start fresh.


Original source: http://www.npr.org/2012/09/23/161584477/at-school-overweight-children-carry-a-heavy-burden


This is how Learning Gardens grow

Sept. 18, 2012, The Washington Post

By Jane Black

The slogan “Think Different” has become a mantra for a generation of Silicon Valley entrepreneurs. So when high-tech-millionaire-turned-restaurateur Kimbal Musk envisioned a network of Learning Gardens for public schools, he didn’t settle for the usual framed, raised beds.

Instead, he thought of swooping, curved planters made of food-grade plastic, each with an irrigation system tucked away inside: a “product” that could be replicated quickly, at relatively affordable prices.

Product is not a word usually associated with organic temples of experiential learning. But like chef-restaurateur Alice Waters, who launched the American school-garden craze 15 years ago in Berkeley, Calif., Musk, 39, says such gardens are essential to reversing obesity, which now afflicts one in three American children.

According to the Journal of American Dietetics, sixth-grade students involved in a garden-based nutrition education program increased their fruit and vegetable consumption by 2.5 servings per day, more than doubling their overall consumption. A class of fifth-graders who participated in garden-based lessons scored 15 points higher on science tests than students who learned in a traditional classroom.

“For me, there’s no point unless we are reaching a critical mass of people,” says Musk. “It’s not that small projects aren’t doing good things. If you serve four schools, you can feel very good about yourself. . . . The only way to solve the problem is to reach all of America’s 100,000 schools.”

Musk’s first step toward mass-producing school gardens is to install 60 Learning Gardens in Chicago, 60 in his home state of Colorado, and 60 more across the country over the next year. An announcement with Chicago Mayor Rahm Emanuel and the city’s schools chief, Jean-Claude Brizard, could come as soon as Sept. 20, depending on the city’s teachers’ strike.

“Learning Gardens are great for Chicago and for students, and I’m pleased that 60 more of these gardens are coming to our schools,” Emanuel said via e-mail. “These gardens teach our kids about sustainability and help them learn to make healthy food choices in an engaging way. By developing healthy lifestyles and gaining the hands-on experience of working outside, the Learning Gardens improve the lives of thousands of our students and their families.”

Musk left his native South Africa in 1991 for Canada. But he soon migrated down to Silicon Valley where, with his brother Elon, he started a software company called Zip2. The brothers sold it in 1999 to computer firm Compaq. That year, Elon started a new company called PayPal in which Kimbal was an investor.

With money in the bank, Musk headed to New York to explore his interest in cooking. He enrolled at the French Culinary Institute and graduated right before the Sept. 11, 2001, terrorist attacks. In the weeks following, he cooked for firefighters and police working near Ground Zero.

“The energy I felt — that awful and incredible energy — made me want to open a restaurant,” he says. “One with that sense of community I had experienced in New York.”

The result was the Kitchen, which opened in 2004 in Boulder, Colo. It was a farm-to-table restaurant before the term became fashionable; supporting farmers was one way to build community. The Kitchen offered students cooking lessons and took them on farm tours. Soon, it started raising money for the Growe Foundation, a local school-garden organization.

Colorado might seem like an odd place to become radicalized about the threat of obesity. It is the leanest state in the country with an adult obesity rate of 20.7 percent. But the rate of childhood obesity is rising faster there than in any other state except Nevada, according to the National Survey of Children’s Health. Musk thought school gardens could halt, and possibly reverse, those numbers. In 2011, he and his business partner, chef Hugo Matheson, established a nonprofit organization called the Kitchen Community to bring Learning Gardens to schools across the country.

The gardens are designed to fit into any school footprint, whether it has acres of surrounding fields or only a small rooftop. Designed by Musk’s wife, artist Jennifer Lewin, the plastic containers come in three sizes and fit together to create an array of curves and spirals. Additional pieces create shaded areas, benches for seating and “art poles” for students to decorate.

So far, the costs are still high. A large garden and installation can cost as much as $50,000 — a huge sum for schools in challenging economic times. (Through fundraising — JP Morgan Chase has been the lead donor in Chicago — the Kitchen Community has raised $1.3 million to cover the costs.) But the modular nature of the gardens means that a small plot can cost as little as $3,000. As the program grows, Musk says, the costs will come down.

The planters are all but indestructible. And that’s important, says Musk, because Learning Gardens are integrated into school playgrounds. “I wanted a place kids could hang out,” he says. “The layout is like a maze. It’s easy to run around. It’s easy for them to come check on their planters. It’s a place that they’d like to be.”

At Irma C. Ruiz Elementary in Chicago, the Learning Garden is called Playground 3. Unveiled in May, it has 19 planters, in which the students grow collard greens, peppers, Swiss chard, tomatoes, and herbs. There’s a metal arbor with large rocks beneath it that serve as chairs, tables and objects to climb on.

Seventh-grader Luna McWilliams says the garden is different from the playground but just as fun: “The garden constantly offers a place to work and learn in nature. I find it a lot of fun to care for the plants, and I know my classmates do as well.”

Principal Dana A. Butler says the garden has been transformational “in the sense that beautification and things growing distract” from some ugly realities of the school’s tough neighborhood.

“It’s one more opportunity for authentic learning,” he says. It’s “an outdoor science lab. It’s about health and restoration. It’s a lot of wonderful things that the kids can be a part of and be connected to.”

Butler applauds Musk’s ambition, but he cautions that Silicon Valley timelines won’t be easy to pull off in a byzantine public school system, where even conducting a simple survey, as the Kitchen Community suggested last spring, requires multiple levels of approval and translation into foreign languages. “They need to come to terms with working with [Chicago Public Schools], which doesn’t work in ways that many people might think are efficient or common sense. I think they will be successful if they do it slowly, if they don’t try to do too much too fast,” he says.

But the challenges inherent in the country’s third-largest school district are exactly what attracted Musk to Chicago. The city has alarming rates of childhood obesity: More than 20 percent of low-income children aged 2 to 4 are obese, according to the Centers for Disease Control, compared with 14 percent nationally.

“If we can make it work in Chicago, with harsh demographics, the diversity, the difficult weather,” says Musk, “we will prove it can be done.”


Original source: http://www.washingtonpost.com/lifestyle/food/this-is-how-learning-gardens-grow/2012/09/18/94322aca-fcff-11e1-b153-218509a954e1_story.htmll