E-Newsletter
october 2013


SPOTLIGHT

PUBLICATIONS AND TOOLS

RESEARCH HIGHLIGHTS

CHILDHOOD OBESITY NEWS


SPOTLIGHT

Schools should not let liability concerns keep them from promoting physical activity

Oct. 8, 2013, NCCOR

Kids spend many of their waking hours at school. This puts schools in a unique position to help promote physical activity and healthy habits among children. However, many schools are deterred by fears of increased risk of legal liability for personal injuries.

A new article in the American Journal of Public Health outlines three school-based strategies for promoting physical activity—Safe Routes to School (SRTS) programs, joint use agreements, and playground enhancement— and describes how schools can substantially minimize their liability risk by engaging in an number of different approaches that include creating and maintaining safe facilities, having adequate insurance, and partnering with other organizations to share liability risk. In some cases schools are also protected under governmental immunity, further lowering their liability risk.

Initiatives such as SRTS, which encourages walking and biking to school; joint use (or shared use) agreements, which make school playground and recreational facilities publicly available during non-school hours; and the use of design strategies and equipment to provide more engaging school playgrounds have all been shown to help increase levels of student physical activity. Many schools fail to permit or actively promote physical activity approaches like these because of concern over increased exposure to lawsuits for personal injuries.

“Schools have a lot of anxiety about liability risk because they worry about effects on their already constrained budgets — that’s a really significant area of concern,” said Sara Zimmerman, senior staff attorney at ChangeLab Solutions and lead author of the article. “They also genuinely are concerned about kids' well-being — they don't want kids to get injured. For them, that sense of ‘maybe this is dangerous’ when it comes to potentially hurting kids and affecting their overall budget creates a big barrier.”

There are a number of steps schools can take to minimize their liability. School administrators can make sure they have adequate insurance and can explore entering into agreements where a partnering group agrees to take on some of the liability risk. Additionally, though it varies by state, schools are afforded a certain amount of governmental immunity, which precludes a plaintiff from recovering even if negligence is shown.

Zimmerman and her colleagues suggest that the best way for schools to decrease their liability risks is to make sure they are being thoughtful and responsible in how they set up and run physical activity programs. Schools should anticipate potential problems and take reasonable steps to avoid them, not just as they run programs, but also as they set up playgrounds and other school recreational facilities in good, safe, responsible ways.

“The best approach for schools is to look at whether the benefits of what they're doing outweigh the risk,” said Zimmerman. “This is how we all approach decisions in life, consciously or not, and healthy physical activity programs should be approached in the same way. Will this program help kids grow and thrive? Will that make enough of a difference that we should accept the risk while, of course, minimizing it as best we can?”

The development of this AJPH article was funded by the National Policy & Legal Analysis Network to Prevent Childhood Obesity (NPLAN), which is a Robert Wood Johnson Foundation (RWFJ) funded project at ChangeLab Solutions. RWJF is part of the National Collaborative on Childhood Obesity Research (NCCOR). NCCOR contributor Matthew Trowbridge of the University of Virginia School of Medicine is also an author of the article. To learn more about NCCOR and its efforts to reduce childhood obesity please visit, www.nccor.org.

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Teenagers are getting more exercise and vegetables

Sept. 16, 2013, The New York Times

By Anahad O’Connor

Teenagers are exercising more, consuming less sugar, and eating more fruits and vegetables, a trend that may be contributing to a leveling off of obesity rates, a new study shows.

The findings suggest that aggressive anti-obesity messages aimed at children may be starting to make a difference, albeit a small one. The study was published in the journal Pediatrics on Sept. 16.

Still, most teenagers were falling short of federal recommendations, which call for children to get at least an hour of physical activity daily, a central message of Michelle Obama’s signature Let’s Move! campaign. The new data showed that most children engaged in an hour of exercise fewer than five days a week and spent more than two hours a day watching television, chatting online, and playing video games.

The numbers also revealed something of an age and racial divide. Younger children had the highest levels of physical activity and fruit and vegetable consumption. But as children got older, the frequency of eating junk foods and engaging in sedentary behaviors crept up, along with average body mass index, a crude measure of obesity. Black and Hispanic adolescents lagged behind whites on almost every measure of progress, even after the researchers tried to take into account the influence of socioeconomic factors.

“In some ways you can interpret what we found positively by saying we’re beginning to bend the curve, and hopefully we’ll start seeing a downward trend in obesity,” said Dr. Ronald J. Iannotti, a study author and chair of the department of exercise and health sciences at the University of Massachusetts Boston. “But there’s large room for improvement.”

The study analyzed data from a national survey of tens of thousands of schoolchildren in grades six through 10, which was carried out once every four years from roughly 2001-2010.

Childhood obesity rates, which have more than doubled since 1980, rose slightly between 2001-2006, then leveled off by 2010, at roughly 13 percent. The proportion of those who were overweight also plateaued at around 17 percent.

Obesity tends to follow children into adulthood, raising the risk of heart disease and cancer as well as type 2 diabetes, a disease that has also risen sharply among children.

In the past year, other studies have hinted at improvements in the obesity rate among younger children, with some even showing a decline in some cities. But little was known about the extent to which physical and dietary behaviors might have played a role.

The new study found that at the same time obesity and overweight appeared to level off, there were, on average, very slight increases in physical activity, fruit and vegetable consumption, and the eating of breakfast, another habit public health officials consider a marker of healthy behavior.

The opposite trend was seen for behaviors that are widely discouraged. The amount of time teenagers spent watching television fell from about three hours a day in 2001 to less than two-and-a-half hours by 2010. Teenagers also reported drinking slightly fewer soft drinks and eating less candy.

Boys overall reported more physical activity than girls, but they also watched more television and played more video games and ate fewer fruits and vegetables.

One expert who was not involved in the study, David B. Allison, the director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham, said it was impossible from the data to deduce a cause and effect, since any number of factors that could influence obesity rates may have changed over time.

“We should be very cautious about drawing any attributions about causes based on time trend data,” Dr. Allison said.

But Dr. Iannotti said the findings seemed to suggest a pattern. “I think the public health message is beginning to be accepted,” he said.

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Original source: http://well.blogs.nytimes.com/2013/09/16/teenagers-are-getting-more-exercise-and-vegetables/

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PUBLICATIONS AND TOOLS

CDC releases new guide for collecting body mass index measurements

The Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) recently released two new resources for health care providers called the “HL7 Height and Weight Report Implementation Guide” and the “IHE Quality, Research and Public Health Technical Framework Supplement for Healthy Weight.” The tools are designed to help practitioners transmit body mass index (BMI) data from electronic health record (EHR) systems to public health surveillance systems so it can be used to assess progress in the fight against the childhood obesity epidemic.

The Healthy Weight (HW) Integrating Healthcare Enterprise (IHE) can be viewed at the here.

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Fresh fruit and potato chips among most popular in-school snacks

A new infographic from The NPD Group, a leading global information company, shows students, ages 6-12, consume 4.1 snack-oriented convenience foods daily in and out of school, and teens, ages 13 to 17, consume 3.8 snacks daily. The most popular school snacks vary by age group. In the case of 6- to 12-year-olds, an age when parents often choose the foods and beverages their children eat, fresh fruit, fruit cups/applesauce, potato chips, meal kits, and yogurt are the top school snacks. Teens, who tend to make their own food choices, include gum, fresh fruit, potato chips, chocolate bars/candy bars, and granola bars among their most popular school snacks.

VIEW INFOGRAPHIC

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People who get food assistance are eating more whole grain products

Efforts to encourage healthy consumption of whole grains by people receiving federal food assistance are paying off, according to a study by the Yale Rudd Center for Food Policy & Obesity.

Purchases of 100 percent whole grain bread and brown rice increased among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) after the program changed in 2009 to offer foods that better reflect dietary recommendations for Americans. The study is published in the American Journal of Preventive Medicine.

READ THE STUDY

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RESEARCH HIGHLIGHTS

Obese kids at four-times higher risk of high blood pressure

Sept. 12, 2013, Everyday Health

By Amir Khan

Childhood obesity can lead to a host of health problems, including diabetes, heart disease, and hypertension, and the risk may be worse than previously thought, according to preliminary new research being presented at the American Heart Association (AHA) High Blood Pressure Research Scientific Sessions meeting. Researchers found that obese children are at a four-times higher risk of developing high blood pressure in adulthood compared to non-obese children — a finding that further underscores the danger of the growing epidemic of childhood obesity.

Researchers tracked 1,117 healthy adolescents for 27 years, beginning in 1986, and found that 16 percent were overweight, with another 16 percent obese. As adults, 26 percent of the obese children developed high blood pressure, compared to 14 percent of overweight children and 6 percent of normal weight children.

"It is important that pediatricians counsel patients on the risk of high blood pressure associated with overweight and obesity, and stress that a healthy diet, including reducing salt intake and exercise, may help reduce this risk," study author Sara Watson, M.D., a pediatric endocrinology fellow at Riley Hospital for Children at Indiana University in Indianapolis, said in a statement. "Interventions to prevent and treat obesity will play an important role in decreasing the significant burden of high blood pressure in adulthood."

Approximately one in three children and teens in the United States are overweight or obese, according to the Centers for Disease Control and Prevention, which means millions of people will be facing high blood pressure as they get older. However, researchers from the Institute of the Georgia Prevention Center at Georgia Regents University may have found a way to predict who will develop it, according to new research also presented at the AHA meeting. The researchers, led by Gregory Harshfield, Ph.D., director of the institute, conducted a urine test on 19 children between the ages of 10 and 19, and found that of the eight who did not excrete sodium in their urine, seven went on to develop high blood pressure. And while the researchers acknowledge the sample size was miniscule, the findings could help develop a simple test to determine who is at risk for hypertension.

"Hypertension is no longer an adult disease," Dr. Harshfield said in a statement. "The results of this test could also provide useful information that could help pediatricians better manage and treat hypertension in their patients."

Joshua Samuels, M.D., assistant professor of pediatrics in the division of pediatric nephrology and hypertension at the University of Texas Health Science Center at Houston, said that studies such as these will become increasingly important as the childhood obesity epidemic continues.

“Childhood obesity is the largest single risk factor for hypertension in childhood,” Dr. Samuels said. “Most kids who have high blood pressure have the same kind as adults, which carries the same kinds of risk factors.”

Hypertension can lead to blindness, heart disease, kidney damage, and other deadly conditions. And while doctors used to think that kids with high blood pressure didn’t experience these conditions, they now know that’s not the case, Samuels said.

“The more we look at it, the more we see that the disease is the same as in adults,” he said. “Many of them are already showing signs of heart muscle thickening, which is a precursor to heart disease.” The epidemic is only getting worse, Samuels said, and as children begin to experience the trend, it could overburden the health care industry.

“Everybody sees the trend,” he said, “and we’re all worried about how we’re going to pay for all these complications.”

But for many parents, it will be a matter of paying for a funeral, not medication, Samuels added.

“Unless something is done, we may be looking at the situation where we’re raising the first generation of kids that won’t outlive their parents,” he said.

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Original source: http://www.everydayhealth.com/hypertension/obese-kids-at-four-times-higher-risk-of-high-blood-pressure-7033.aspx

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Forget the food: Fast food ads aimed at kids feature lots of giveaways

Aug. 29, 2013, TIME

By Alexandra Sifferlin

There’s nothing like a picture of a steaming, juicy burger to send hungry folks to the nearest drive-thru, right? Not if you’re a kid. For them, toys and other giveaways are just as effective — which is why such marketing tactics are so troubling.

A new study published in journal PLOS ONE revealed that compared to nationally televised advertisements from leading fast food restaurants targeted at adults, those that marketed kids’ meals were more likely to include toy and other giveaways, and less likely to feature the food products sold at these chains. Between 2009-2010, when the scientists conducted their analysis, nearly all of the fast food ads –99 percent–that were aired nationally on children’s TV channels such as Cartoon Network and Nickelodeon, were from McDonald’s and Burger King, and 70 percent of them included toy giveaways, frequently linked to child-friendly movies, to promote their product.

According to the Federal Trade Commission, food marketing cannot be false, deceptive, or unfair. But there are other, more specific, self-regulations out there for ads related to kids. The Beverage Business Bureau (BBB) runs a Children’s Advertising Review Unit (CARU) that provides marketing guidelines for companies on how they should advertise products to kids, and many volunteer to self-regulate their campaigns based on these guidelines. One of these bedrocks asks companies to recognize that children do not easily discern between products like toys and games that are associated with a company’s primary products — in this case, fast food. That means that the toys may actually hold more allure for younger consumers than the food itself. While that’s certainly a boon for corporations, it may not be so benign for kids, who could end up developing life-long unhealthy eating habits.

“Research shows that when companies are promoting brand-oriented messages to children, [kids] make very long-lasting and deeply held emotional connections to the brand,” says Andrew Cheyne, a researcher at the Berkeley Media Studies Group. “So this form of marketing allows for kids to make lifelong brand preferences at a very early age. Not only are the fast food companies making lifelong customers out of children, but they have the ability to go after the childrens’ children as well through intergenerational brand preferences. This form of marketing is a very serious concern.”

In a 2011 study of Santa Clara County in California, which banned toys and other non-food items from fast food restaurants’ kids meals, researchers found that food options in that county became healthier after the ban compared to counties that didn’t have to follow the rule. When they couldn’t offer toys with high calorie, high-fat meals, Santa Clara restaurants began offering more healthier options to go with the giveaways.

“Kids cannot recognize the intent of advertising. When you add in popular cartoon characters, you are further blurring the line,” says study author Cara Wilking of the Public Health Advocacy Institute (PHAI). Processed food packaging that display images of popular culture characters kids like and recognize. “Unilever (a consumer goods company) says they are going to improve their marketing to children, but they have a loophole for packaging. When they put Dora the Explorer on Popsicle boxes, it certainly seems like advertising to kids. If that’s not, what is?” says Cheyne.

In a paper published in PLOS Medicine, Cheyne, who is unaffiliated with the latest study, argues that such blending strategies are becoming more widespread; soda manufacturers sponsor social responsibility campaigns that promote community service, and advertising in schools is another way that companies enhance brand awareness among kids without actually promoting their product. “They’re sponsoring fundraisers, they’re promoting themselves through score boards and other signage. When they promote the brand, they promote the entire product line,” he says.

For example, PepsiCo was criticized by public health advocates for the Refresh Project promoted during the 2010 Superbowl. The company offered $20 million to consumer-voted community projects such as improving parks and reinvigorating local arts programs, and allowed voters who bought specially marked cans of soda to have greater voting power. Not surprisingly, the bulk of participants were young people. “PepsiCo considers millennials — those aged 11 to 31 — a ‘key cohort’ for the Pepsi Refresh initiative. The company applied specific marketing metrics to measure the positive effect the campaign had on the intent of millennials to buy PepsiCo products,” Cheyne, in 2010, told TIME.

The concerns about these marketing tactics prompted at least one major child-friendly company to take action. Walt Disney Co. pledged to ban all junk food advertising from its TV channels, websites, and radio programs catering to children by 2015. All companies that advertise food and beverages during Disney programming will have to meet the company’s nutritional guidelines. The candy company Mars is also credited with having one of the most comprehensive and strict pledges to avoid catering to kids younger than age 12 in its marketing campaigns.

Whether such moves will change children’s eating behaviors, and make unhealthy foods less appealing, won’t be clear for a few more years. But if these pioneering efforts to redirect advertising aimed at kids toward healthier and more nutritious options prove successful, then they could set a precedent for advertising that’s truly kid-friendly.

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Original source: http://health.usnews.com/health-news/news/articles/2013/08/12/obesity-risk-factors-may-vary-for-boys-girls  

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How physical fitness may promote school success

Sept. 18, 2013, The New York Times

By Gretchen Reyonlds

Children who are physically fit absorb and retain new information more effectively than children who are out of shape, a new study finds, raising timely questions about the wisdom of slashing physical education programs at schools.

Parents and exercise scientists (who, not infrequently, are the same people) have known for a long time that physical activity helps young people to settle and pay attention in school or at home, with salutary effects on academic performance. A representative study, presented in May at the American College of Sports Medicine, found that fourth- and fifth-grade students who ran around and otherwise exercised vigorously for at least 10 minutes before a math test scored higher than children who had sat quietly before the exam.

More generally, in a large-scale study of almost 12,000 Nebraska schoolchildren published in August in the journal Pediatrics, researchers compiled each child’s physical fitness, as measured by a timed run, body mass index, and academic achievement in English and math, based on the state’s standardized test scores. Better fitness proved to be linked to significantly higher achievement scores, while, interestingly, body size had almost no role. Students who were overweight but relatively fit had higher test scores than lighter, less-fit children.

To date, however, no study specifically had examined whether and in what ways physical fitness might affect how children learn. So researchers at the University of Illinois at Urbana-Champaign recently stepped into that breach, recruiting a group of local 9- and 10-year-old boys and girls, testing their aerobic fitness on a treadmill, and then asking 24 of the most fit and 24 of the least fit to come into the exercise physiology lab and work on some difficult memorization tasks.

Learning is, of course, a complex process, involving not only the taking in and storing of new information in the form of memories, a process known as encoding, but also recalling that information later. Information that cannot be recalled has not really been learned. Earlier studies of children’s learning styles have shown that most learn more readily if they are tested on material while they are in the process of learning it. In effect, if they are quizzed while memorizing, they remember more easily. Straight memorization, without intermittent reinforcement during the process, is tougher, although it is also how most children study.

In this case, the researchers opted to use both approaches to learning, by providing their young volunteers with iPads onto which several maps of imaginary lands had been loaded. The maps were demarcated into regions, each with a four-letter name. During one learning session, the children were shown these names in place for six seconds. The names then appeared on the map in their correct position six additional times while children stared at and tried to memorize them.

In a separate learning session, region names appeared on a different map in their proper location, then moved to the margins of the map. The children were asked to tap on a name and match it with the correct region, providing in-session testing as they memorized. A day later, all of the children returned to the lab and were asked to correctly label the various maps’ regions.

The results, published last week in PLOS ONE, show that, overall, the children performed similarly when they were asked to recall names for the map when their memorization was reinforced by testing.

But when the recall involved the more difficult type of learning — memorizing without intermittent testing — the children who were in better aerobic condition significantly outperformed the less-fit group, remembering about 40 percent of the regions’ names accurately, compared with barely 25 percent accuracy for the out-of-shape kids.

This finding suggests that “higher levels of fitness have their greatest impact in the most challenging situations” that children face intellectually, the study’s authors write. The more difficult something is to learn, the more physical fitness may aid children in learning it.

Of course, this study did not focus specifically on the kind of active exercise typical of recess, but on longer-term, overall physical fitness in young children. But in doing so, it subtly reinforces the importance of recess and similar physical activity programs in schools, its authors believe.

If children are to develop and maintain the kind of aerobic fitness that amplifies their ability to learn, said co-author Charles Hillman, a professor of kinesiology at the University of Illinois and a fellow at the university’s Beckman Institute for Advanced Science and Technology, they should engage in “at least an hour a day” of vigorous physical activity. Schools, where children spend so many of their waking hours, provide the most logical and logistically plausible place for them to get such exercise, he said.

Or as he and his co-authors...note in the study: “Reducing or eliminating physical education in schools, as is often done in tight financial times, may not be the best way to ensure educational success among our young people.”

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Original source: http://well.blogs.nytimes.com/2013/09/18/how-physical-fitness-may-promote-school-success/?_r=0

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Changing up family routines can help kids shed pounds

Sept. 9, 2013, dailyRX News

There is more to combating obesity than ensuring that children eat healthy food. There are other factors that can increase children’s risk of obesity — and they can be addressed within a family.

A recent study found that adjusting a couple household routines in low-income, racially diverse families could help reduce children’s weight.

The most successful routines involved increasing the amount of time that children sleep and decreasing the time they spend watching TV on weekdays.

Children in families making these changes saw a small but significant drop in their average body mass index (BMI). BMI is a ratio of a person’s height to weight that is used to determine if they are a healthy weight or not.

This study, led by Jess Haines, Ph.D., M.H.Sc., R.D., of the Department of Family Relations and Applied Nutrition at the University of Guelph in Ontario, Canada, looked at whether improving children’s home routines reduced their risk of obesity.

The researchers focused on 121 low-income families comprised of racial/ethnic minorities for the study.

The families all had children aged 2 to 5 who also had a television in the room where they slept, which is a risk factor for obesity.

Nearly all of these families (111 of them) were tracked for six months, with 55 families participating in a specific program and 56 families servings as a “control” comparison group.

The average age of the children involved was age 4, and 45 percent of them were overweight or obese. Almost 60 percent of the families had household incomes of $20,000 or less.

In addition, 52 percent of the families were Hispanic, 34 percent were black, and 14 percent were white/other.

During the six-month study, the program for the 55 “intervention” families focused on four household routines that targeted known obesity risk factors.

These routines included having family meals together, ensuring that children got adequate sleep, limiting children’s TV time, and removing the TV from the children’s bedrooms.

The families were supported through motivational coaching at home and by phone, mailed educational materials, and text message reminders.

Meanwhile, the 56 comparison families were mailed materials that focused on child development. These families’ outcomes would be compared to those of the families participating in the household routines program.

The researchers measured the effectiveness of the program in two main ways: how well the families adhered to the new routines and whether there was a change in the children’s BMI.

The researchers found that the intervention families improved routines and that the children’s BMI decreased compared to the comparison families.

Children in the families receiving the household routine coaching increased their sleep by about 0.75 additional hours each night compared to the comparison families’ children.

The intervention families’ children also decreased their television viewing by about an hour more each weekday compared to the families not receiving household routine coaching.

The children in the families with household routine changes had an average decrease in their BMI of about 0.4 points.

For reference, a BMI of 18.5 to 24.9 is considered normal/healthy. A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 or higher is considered obese.

The researchers did not find that the frequency of family meals differed between the two groups or that there was a difference in the number of children with a TV in their rooms.

“Our results suggest that promoting household routines, particularly increasing sleep duration and reducing TV viewing, may be an effective approach to reduce body mass index among low-income, racial/ethnic minority children,” the researchers wrote.

However, they noted that longer studies are needed to see if the behavioral changes can be maintained over a longer period of time than just six months.

This study was published Sept. 9 in the journal JAMA Pediatrics. The research was funded by the National Center for Chronic Disease Prevention and Health Promotion part of the Centers for Disease Control and Prevention. The authors declared no conflicts of interest.

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Original source: http://www.dailyrx.com/healthy-household-routines-children-improved-body-weight-when-followed-families

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CHILDHOOD OBESITY NEWS

Physical education: How innovative school programs can boost kids' fitness

Sept. 2, 2013, The Huffington Post

By Dorene Internicola

Physical education in the United States has come a long way since the one-size-fits-all regimen of jumping jacks and rope climbing that was the bane of the baby boomer generation.

Today, where children learn can determine the type of fitness lessons they receive.

"We have schools with rock climbing walls, Zumba classes, inline skating – amazing stuff that I would have loved to have when I was a kid," said Carly Braxton, senior program manager for advocacy at the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD), a nonprofit group that promotes physical activity and education.

Even in schools constrained by local budgets or indifference, Braxton said, imaginative physical education teachers are finding innovative ways to get kids moving, from snow shoeing in cold climates to treasure hunting in warm ones.

"Where there's a big Native American population, they'll bring in tribal games, hunting and fishing," said Braxton, whose organization is one of the managing partners of first lady Michelle Obama's Let's Move! Active Schools program.

"Physical education people are among the most flexible people in the world when it comes to using the community and the environment," she added.

Federal guidelines recommend children and adolescents, aged 6-17 years old, get at least one hour of physical activity daily, but in the schools where they spend much of their day, mandates for movement vary greatly.

Thirty-eight U.S. states mandate physical education in elementary, middle/high, and high school, according to the “2012 Shape of the Nation Report: Status of Physical Education in the USA,” which is released by the National Association for Sport and Physical Education (NASPE) and the American Heart Association.

But most states do not require a specific amount of instructional time and more than half allow exemptions, waivers, and/or substitutions, the report showed.

"Education is such a local issue," said Braxton. "You see this variation. Even in states with stricter mandates, these mandates don't have a whole lot of teeth."

Physical inactivity is associated with obesity, which affects 17 percent of children and adolescents in the United States – triple the rate from just one generation ago, according to the Centers for Disease Control and Prevention.

Braxton said physical activity translates to lower absenteeism and higher academic performance.

"Research shows if you're sitting for more than 17 minutes, your brain activity starts to slow down," said Braxton. "If you're sitting in a math class, even just a one-minute brain break, where maybe the kids play rock/paper/scissors with their legs instead of their hands (can help)."

Dr. Jacalyn Lea Lund, professor at the Georgia State University and past president of NASPE, believes physical education is undervalued in classrooms increasingly driven by testing.

"Our kids get squirmy and stressed out. We know activity can relieve a lot of stress," Lund said.

"There's a really good program called Take 10, where children take little activity breaks to do anything from dance to music to throwing bean bags at targets," she said. "People found it makes a huge difference."

Jessica Matthews, a spokesperson for the American Council on Exercise, a nonprofit group that educates people about fitness, applauds teacher-initiated activity breaks, as well as the introduction of cutting edge programs such as yoga and martial arts, to local school districts.

She said physical activity and physical education are not interchangeable.

"Both are important," said Matthews, an exercise physiologist and former teacher.

With physical education, she said, children refine their motor skills, acquire specific abilities, and set a foundation for lifelong fitness.

"The physical education teacher does more than just have kids run around the gym," she said.

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Original source: http://www.huffingtonpost.com/2013/09/02/physical-education-kids-fitness_n_3854776.html

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Serving a school diet kids can live on

Sept. 2, 2013, The Oregonian

By Elizabeth Flock

From kindergarten through high school, from fingerpainting through calculus, more than half a million Oregon students will start school this week, with a single appointment they'll all have scheduled: lunch.

Increasingly, we're understanding how important that moment is as an approach to deal with both child hunger and obesity, and as both the federal government and the state sharpen strategies for this school year. The federal government is raising their health requirement for school lunches (and breakfasts and snacks). Oregon, in some ways ahead of the national trends, is expanding efforts in areas such as school gardens and local farm-to-school supplying, seeking to teach its kids that food isn't created in a vending machine.

The year marks another advance, with both nutritional and educational impact, against the idea of a student lunch consisting of a slice of pizza, a candy bar, and a soda.

"Last year was a transition year. It was a significant change," says Kevin Concannon, U.S. undersecretary of agriculture for nutrition and former head of the Oregon Department of Human Services. The transition continues this year, as the National School Lunch Program — feeding 31 million students a day — continues to implement the Healthy, Hunger-Free Kids Act of 2010, raising the emphasis on fruits and vegetables, whole grains, low-fat or non-fat milk, and fruit juices. It also includes a change in what's available in school vending machines.

An Associated Press story in The Oregonian on Aug. 28 cited student resistance to the changes, which some saw as offering too many vegetables and not enough calories. The feds say the new program may take some getting used to, and have moved to add some flexibility.

In Oregon, Heidi Dupuis, manager of the state school nutrition program, says the shifts haven't encountered that kind of resistance here. "Kids are getting exposed to a wider variety of fruits and vegetables," says Dupuis, "and they are eating more."

Many Oregon schools offer what Dupuis calls "variety bars," allowing students to go back for more vegetables or fruits. She sees a lasting impact to sampling the altered menu with other students, which she calls "a passive education of what a healthy diet looks like."

This year's legislature expanded Oregon's Farm to School program, and grants have been awarded to 21 school districts. Hillsboro is building an alliance with Hillsboro Farmer's Market; Future Farmers of America students at Mountain View High School in Bend-LaPine are teaming with a local farm to raise hogs for the school menu; and Rainier offers Food Tastings at lunch.

The program is a match to Oregon's highly successful school gardens effort, with 394 gardens around the state, from 74 in Multnomah County to one in Harney. The Joseph School District, with a total of 248 students, grew about six tons of produce last year.

These patterns are a considerable advance from 20 years ago, when Oregon school districts dug for revenue by selling vending machine rights to soft drink companies. Some of those contracts are still around, but the machines are more likely to contain water or sports drinks.

To fuel students and maintain focus, school breakfasts are now widespread through Oregon. The state's school districts could still increase their nutritional output by increasing participation in the federal afternoon snack program.

This year's efforts reflect the deepening understanding of the connection between nutrition and education. We're never entirely sure how much algebra or French a student will remember, but we know what part of their school day will unquestionably stay with them.

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Original source: http://www.oregonlive.com/opinion/index.ssf/2013/09/serving_a_school_diet_kids_can.html

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Los Angeles County tries to enlist restaurants in obesity fight

Sept. 12, 2013, Southern California Public Radio

By Jed Kim

If a new L.A. County plan works as hoped, people who got out to eat may soon have fewer leftovers to put in the refrigerator — or eat on the way home.

A new program launched on Sept. 12 by the Los Angeles County Department of Public Health aims at fighting obesity by getting restaurants to offer smaller versions of entrees and healthier kids' meal options.

"We, on average in Los Angeles, eat out four times a week, and we spend more than 40 percent of our food budget on meals away from home," said Dr. Jonathan Fielding, director of the public health department. "This is a great way to expand choices when dining out to reduce caloric consumption and to have healthier choices available."

The program, which is called Choose Health LA Restaurants, is part of a larger push by the county to educate the public on the benefits of healthier food choices and physical activity.

Restaurants that meet county guidelines for the program will receive a decal with the Choose Health LA Restaurants designation. They will also eventually be included in listings and maps at the Choose Health LA website.

To qualify, restaurants must have a minimum number of smaller-sized entrees that contain the same ingredients but weigh at least one-third less than their full-sized counterparts. The number of smaller offerings they must offer depends on the total number of items on their menus.

A handful of restaurants have already qualified to be part of the program. The largest is Subway, which offers half-sized versions of its sandwiches.

The county has provided a worksheet to determine whether restaurants are eligible to be part of the free program. It also offers consultation services for restaurant owners interested in qualifying for the program.

In addition to the smaller menu items, restaurants that want to make the list must have kids' meals must offer fruit and vegetable options, as well as milk or soy-based drinks.

Some nutrition experts say that while the program is a step in the right direction, it may not be as successful at curbing obesity as efforts at educating the public on how to eat.

"Even when healthy choices are offered at a restaurant, often you're stress eating, or your food urges take over, and you go for the higher calorie, tastier dishes anyway," said Dr. David Heber, director of the Center for Human Nutrition at UCLA. "So you might be offered a salad at a fast food restaurant, but you're probably going to go for the burger and fries."

Fielding said that the new program is just part of a larger county effort to educate the public.

"There's no single approach that's going to solve that problem, but there are a lot of small things, and this is one that we think could be very important over the long term," he said.

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Original source: http://www.scpr.org/news/2013/09/12/39196/new-program-takes-obesity-fight-to-restaurants/

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Calling obesity a disease may make it easier to get help

Sept. 16, 2013, NPR

By Patti Neighmond

Under the Affordable Care Act, more insurance plans are expected to start covering the cost of obesity treatments, including counseling on diet and exercise as well as medications and surgery. These are treatments that most insurance companies don't cover now.

The move is a response to the increasing number of health advocates and medical groups that say obesity should be classified as a disease.

Not everyone thinks this is a good idea, but this summer, the American Medical Association determined that obesity is a disease. The organization followed in the footsteps of The Obesity Society, a health advocacy group that called obesity a disease back in 2008.

Many overweight or obese individuals are victims of their own genetic history, according to Dr. Lee Kaplan, an obesity specialist and director of the Massachusetts General Hospital Weight Center. "We're all wired in slightly different ways," he says, adding that those subtle differences are reflected in how the body deals with energy stores and fat.

There are thousands of genes in the body, and Kaplan says about 100 of them are involved in making some people more susceptible to weight gain.

Classifying obesity as a disease is long overdue, according to Dr. Osama Hamdy, who directs the Obesity Clinical Program at the Joslin Diabetes Center in Boston. "The reality is, if you have that genetic susceptibility to gain weight, you will gain weight easily, no matter what."

Genetic susceptibility has to do with hormones and chemical systems in the body that direct appetite, metabolism and the absorption of nutrients and fat.

One of those hormones is leptin. It's produced by fat cells and tells the body when it's eaten enough. Hamdy says the majority of people who are obese are resistant to leptin. "The brain is shielded from the information on how much fat you have in your body," he says. "The brain is under the assumption all the time that you need more fat."

Other hormones make some people get hungry more often than others. Then there's another system of brain chemicals, the endocannabinoid system. If it's not functioning properly, it fails to tell the body to stop eating what it really likes. For example, if you've always loved the sugary flavorful taste of ice cream, you may end up eating way too much of it simply because an enzyme in your brain fails to halt the chemical that signals your brain to eat as much of the beloved food as you can.

A 2009 study on the genetic susceptibility of weight gain found that when 12 pairs of identical twins were overfed 1,000 calories a day for about three months, each set of twins gained a different amount of weight. Some only gained about 8 pounds, while others gained nearly 30 pounds. But within the pair of twins themselves, the weight gain was exactly the same.

Defining obesity as a disease should encourage more doctors to offer treatments like surgery and medication, Hamdy says. Two new obesity drugs, Qsymia and Belviq, were recently approved by the FDA.

But not everybody thinks calling obesity a disease will help make people healthier.

Classifying obesity as a disease "sets people who are heavier up to believe there's something wrong with them and they're going to get sick unless they do something about it," according to Linda Bacon, a professor of nutrition at City College of San Francisco and the author of the book, Health at Every Size: The Surprising Truth About Your Weight.

That then is "used as justification for surgery to ward off the potential of future disease," she says, "but that future disease may never exist."

Indeed, research has shown that some people can be overweight or even obese and still fit, whereas their more slender counterparts may be at greater risk for heart disease.

Even so, Kaplan says obese individuals are still at greater risk of high blood pressure, high cholesterol, arthritis, sleep apnea, infertility, depression and diabetes.

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Original source: http://www.npr.org/blogs/health/2013/09/16/222064771/calling-obesity-a-disease-may-make-it-easier-to-get-help

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