E-Newsletter
February 2014


SPOTLIGHT

PUBLICATIONS AND TOOLS

RESEARCH HIGHLIGHTS

CHILDHOOD OBESITY NEWS


SPOTLIGHT

NCCOR members contribute to new research that shows major food companies have cutback on calories

Jan. 13, 2013, NCCOR

Sixteen of the nation’s leading food and beverage companies have cut 78 calories out of an American’s daily diet according to a new study funded by the Robert Wood Johnson Foundation (RWJF). This is the result of a five-year (2007-2012) reduction in sales of food and beverages totaling 60.4 trillion calories. The data collection and analysis of this study was overseen by a handful of national experts including members of the National Collaborative on Childhood Obesity Research (NCCOR).

The companies involved, including Campbell Soup, Nestlé, Coca-Cola and PepsiCo, acted together as part of the Healthy Weight Commitment Foundation (HWCF). The companies pledged to remove 1 trillion calories from the marketplace by 2012, and 1.5 trillion by 2015. The study found that, thus far, the companies have exceeded their 2015 pledge by more than 400 percent.

“These are very promising results. Research has shown that average increases of only 130-170 calories in children’s daily energy gap, that is an excess of calories consumed over those expended through physical activity and normal growth, were sufficient to explain the rise of childhood obesity in the United States, ” said C. Tracy Orleans, Ph.D., senior scientist at RWJF and NCCOR Steering Committee member. “This makes the average reduction of 78 calories in daily calories sold per capita quite meaningful.”

To determine the impact of the pledge, researchers at the University of North Carolina at Chapel Hill (UNC) combined data on foods and beverages sold by participating companies with nutritional information for those products. They then determined which individual products were included as part of the pledge and tracked sales of those products over time. The UNC team was advised by a roster of leading experts including Orleans and NCCOR members: Laura Kettel Khan, M.I.M., Ph.D., and Jennifer Seymour, Ph.D., of Centers for Disease Control and Prevention; Susan Krebs-Smith, Ph.D., of National Institutes of Health; Jay Variyam, Ph.D., of U.S. Department of Agriculture (USDA); and recent NCCOR member Molly Kretsch, Ph.D., of USDA.

“The evaluation itself is a stunning accomplishment based on truly pioneering work by the UNC team to develop a system which could actually track food system changes from factory to forks,” said Orleans. “Never before, in any nation, have we had the ability to track food stream changes in this way. This will be an enduring product of the evaluation.”

Public health experts hope that the success of the HWCF will catalyze similar changes by other companies.

“We are seeing the beginning of essential efforts to reduce the production, sale, and marketing of excess calories from sugar and fat that have contributed so much to childhood obesity levels globally, and to track food industry changes.

Given the strong business case for these food industry changes, these results reflect a triple win – a win for business, a win for the public’s health, and a win for science. And, overall, a win for the culture of health, ” said Orleans.

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Reminder: NCCOR’s Connect & Explore webinar series

In celebration of its five-year anniversary in February, NCCOR is launching Connect & Explore, an external webinar series for researchers, practitioners and others interested in improving the application of childhood obesity research and growing the knowledge base.

For those registered, this is a reminder to join us at 2 pm, Eastern, on Thurs., Feb. 13, for Connect & Explore: Five Years of Accelerating Childhood Obesity Research, the first of three webinars planned this year.

We have reached capacity for this event and registration has closed. However, a recording will be made available on www.nccor.org after the webinar.

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PUBLICATIONS AND TOOLS

Restaurant food is nearly a quarter of salt in U.S. diet

According to a new report, “From Menu to Mouth: Opportunities for Sodium Reduction in Restaurants,” from the Centers for Disease Control and Prevention (CDC), restaurant food accounts for nearly a quarter of the sodium in the U.S. diet. Americans eat out at fast food or dine-in restaurants four or five times a week and just one of those meals might contain more than an entire day's recommended amount of sodium — 2,300 milligrams a day for the general population.

The report said it is a challenge for consumers to control the sodium content in restaurant food since sodium is already added to meals before it reaches the table. However, restaurants can work with public health officials to provide consumers with lower levels of sodium.

READ THE FULL REPORT

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American adults are choosing healthier foods, consuming healthier diets

American adults are eating better, making better use of available nutrition information, consuming fewer calories coming from fat and saturated fat, consuming less cholesterol, and eating more fiber, according to a new report “Changes in Eating Patterns and Diet Quality Among Working-Age Adults, 2005-2010” from the U.S. Department of Agriculture's Economic Research Service.

The researchers found that use of nutrition information, including the nutrition facts panel found on most food packages, increased in recent years. Forty-two percent of working age adults and 57 percent of older adults reported using the nutrition facts panel most or all of the time when making food choices. When asked about nutrition information in restaurants, 76 percent of working-age adults reported that they would use the information if it were available.

Reduced consumption of food away from home (such as food from restaurants and fast food) accounted for 20 percent of the improvements in diet quality. The report also indicates changing attitudes toward food and nutrition. Compared with 2007, the percentage of working-age adults who believed they have the ability to change their body weight increased by three percentage points in 2010. During the same time period, the report shows there was little change in the importance that price played when making choices at the grocery store, but working-age adults placed increased importance on nutrition when choosing items to purchase.

READ THE FULL REPORT

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Obesity rates growing faster in poorer countries than in richer ones

According to a new report from the Overseas Development Institute, obesity rates are climbing around the world; they are climbing faster in developing countries than in wealthy ones. The report titled “Future Diets,” states that obesity rates tripled in developing countries between 1980 and 2008, while rates only climbed 1.7 times in high-income countries during the same period.

Researchers found that North Africa, the Middle East, and Latin America now have almost the same percentage of overweight or obese people as Europe. The authors studied the costs of "typical" and "healthy" diets around the globe and found that, in poorer countries, the healthier diets were unaffordable for much of the population.

READ THE FULL REPORT

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RESEARCH HIGHLIGHTS

Obesity is found to gain its hold in earliest years

Jan. 29, 2013, The New York Times

By Gina Kolatajan

For many obese adults, the die was cast by the time they were 5 years old. A major new study of more than 7,000 children has found that one-third of children who were overweight in kindergarten were obese by eighth grade. And almost every child who was very obese remained that way.

Some obese or overweight kindergartners lost their excess weight, and some children of normal weight got fat over the years. But every year, the chances that a child would slide into or out of being overweight or obese diminished. By age 11, there were few additional changes: Those who were obese or overweight stayed that way, and those whose weight was normal did not become fat.

“The main message is that obesity is established very early in life, and that it basically tracks through adolescence to adulthood,” said Ruth Loos, a professor of preventive medicine at the Icahn School of Medicine at Mount Sinai in New York, who was not involved in the study.

These results, surprising to many experts, arose from a rare study that tracked children’s body weight for years, from kindergarten through eighth grade. Experts say they may reshape approaches to combating the nation’s obesity epidemic, suggesting that efforts must start much earlier and focus more on the children at greatest risk.

The findings, published Jan. 30 in The New England Journal of Medicine, do not explain why the effect occurs. Researchers say it may be a combination of genetic predispositions to being heavy and environments that encourage overeating in those prone to it. But the results do provide a possible explanation for why efforts to help children lose weight have often had disappointing results. The steps may have aimed too broadly at all schoolchildren, rather than starting before children enrolled in kindergarten and concentrating on those who were already fat at very young ages.

Previous studies established how many children were fat at each age, but not whether their weight changed as they grew up. While valuable in documenting the extent of childhood obesity, they gave an incomplete picture of how the condition developed, researchers said. “What is striking is the relative decrease in incidence after that initial blast” of obesity that occurs by age 5, said Dr. Jeffrey P. Koplan, the vice president of the Emory Global Health Institute in Atlanta. “It is almost as if, if you can make it to kindergarten without the weight, your chances are immensely better.”

Dr. Koplan, a former director of the Centers for Disease Control and Prevention, was not associated with the new study, although its lead author, Solveig A. Cunningham, is an assistant professor in the School of Public Health at Emory.

The study involved 7,738 children from a nationally representative sample. Researchers measured the children’s height and weight seven times from kindergarten to eighth grade.

When the children entered kindergarten, 12.4 percent were obese — defined as having a body mass index (BMI) at or above the 95th percentile — and 14.9 percent were overweight, with a BMI at or above the 85th percentile. By eighth grade, 20.8 percent were obese and 17 percent were overweight. Half of the obese kindergartners were obese when they were in eighth grade, and nearly three-quarters of the very obese kindergartners were obese in eighth grade. The risk that fat kindergartners would be obese in eighth grade was four to five times that of their thinner classmates, the study found.

Race, ethnicity, and family income mattered in younger children, but by the time the overweight children were 5 years old, those factors no longer affected their risk of being fat in later years.

The study did not track the children before kindergarten, but the researchers had their birth weights. Overweight or obese children often were heavy babies, at least 8.8 pounds, something other studies have also found.

The study’s results, Dr. Koplan and others said, “help focus interventions.”

Most efforts to reduce childhood obesity concentrate on school-age children and apply the steps indiscriminately to all children, fat and thin — improving meals in schools, teaching nutrition and the importance of physical activity, getting rid of soda machines.

“This suggests that maybe one reason it didn’t work so well is that by the time kids are 5, the horse is out of the barn,” said Leann L. Birch, a professor in the department of foods and nutrition at the University of Georgia, who was not involved with the study.

The most rigorous studies of efforts for school-age children, conducted in the 1990s, randomly assigned thousands of children to either participate in intensive programs that encouraged them to exercise and improve their diets, or go on as usual.

One study involved 1,704 third graders in 41 elementary schools in the Southwest, where most of the students were Native Americans, a group that is at high risk for obesity. A second study included 5,106 children in 96 schools in California, Louisiana, Minnesota, and Texas.

Neither study found any effect on children’s weights.

Some obesity researchers said the new study following kindergartners over the years also hinted at another factor: the powerful influence of genetics on obesity, something that can be a challenge to overcome.

Genetic influences tend to show up early in life, said Dr. Stephen O’Rahilly, an obesity researcher who is a professor of clinical biochemistry and medicine at the University of Cambridge.

“We have known for 50 years that BMI is highly heritable,” he said. “Surprise, surprise, if you tend to be fat, you tend to be fat at an early age.”

Body mass index is not quite as heritable as height, Dr. Loos said. But genes are not necessarily destiny. Exercise and a healthy diet can often reduce, but not completely overcome, the effects of genes.

Steven L. Gortmaker a professor of the practice of health sociology at the Harvard School of Public Health and [NCCOR Envision member], said he saw a bright side to the findings. Young children, he said, can cross a line between being fat or normal weight by gaining or losing just a few pounds. For adults, it can be 20 to 30 pounds, or even 40 to 50 pounds.

“It can take a long time to turn that around,” said Dr. Gortmaker, who wrote an editorial accompanying the new study.

And, he said, a number of randomized studies involving young children have shown that it is possible to stop or reverse excess weight gain. One, for example, had some overweight children ages 4 to 7 reduce their television and computer viewing time, and had others keep theirs the same. Children in the intervention group — especially those from poorer families — consumed fewer calories, and their body mass index fell.

But effective programs for young children involve time and effort, and the costs are not reimbursed by health insurers, said Denise Wilfley, an obesity researcher at Washington University in St. Louis.

“We can effectively treat these children,” Dr. Wilfley said. But other than entering children in research studies, parents can get help only by paying out of their pocket — about $1,500 to $3,000 for an intervention that usually lasts a year.

Advice offered by a family doctor — if it is given at all — is usually ineffective, Dr. Wilfley said. All too often, parents tell her, their worries about a child’s weight are dismissed. “I just saw a mom who was in tears because her little girl, who is 11 years old, weighs 212 pounds,” Dr. Wilfley said. The child has been fat since she was a toddler, but, Dr. Wilfley said, “the provider told her mom she would outgrow it.”

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Original source: http://www.nytimes.com/2014/01/30/science/obesity-takes-hold-early-in-life-study-finds.html?hpw&rref=health&_r=0

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Just one in four young teens meet U.S. fitness guidelines

Jan. 8, 2013, ABC News

By Lindsey Tanner

Young teens are not exactly embracing the government's Let's Move! mantra, the latest fitness data suggest.

Only one in four U.S. kids aged 12 to 15 meet the recommendations — an hour or more of moderate to vigorous activity every day.

The results are based on about 800 kids who self-reported their activity levels and had physical exams as part of the 2012 National Youth Fitness Survey.

Government researchers will not call the results disappointing, but lead author Tala Fakhouri of the Centers for Disease Control and Prevention (CDC) said, "There's always room for improvement."

The CDC released partial results Jan. 8 from the fitness survey, which involved kids aged 3 to 15. Other results from the same survey are pending and include fitness data based on more objective measures including treadmill tests.

Fakhouri said the nationally representative results provide useful information for initiatives that aim to increase kids' fitness, including the Let's Move! anti-obesity campaign launched by first lady Michelle Obama in 2010.

Kids in the survey reported on which physical activities they did most frequently outside of school gym class — basketball for boys and running for girls.

While few met guidelines established in 2008 for activity that raises the heart rate and makes you breathe harder, most said they did at least an hour of exercise at that level during the previous week. Overall, about 25 percent said they got an hour of that kind of exercise every day.

Obese kids were less active than normal-weight girls and boys. Overweight girls were slightly less active than normal-weight girls, but levels were similar among overweight and normal-weight boys.

"It's definitely very concerning to see that our kids are engaging in such a limited amount of physical activity each day when we are still battling" an obesity epidemic, said Dr. Stephen Pont, an Austin, Texas, pediatrician and chairman of the American Academy of Pediatrics Section on Obesity.

Data suggest obesity may have decreased slightly among some kids, but the overall rate for children aged 2 to 19 is 17 percent, or about 12.5 million obese kids.

Pont said schools can do more to help by not cutting recess and giving kids more time for physical activity. He said research suggests kids who get physical education at school may do better academically.

Recent national data on kids' fitness levels is limited. A 2009-2010 CDC survey involving kids ages 6 to 11 found about 70 percent met the physical activity guidelines, although levels dropped off among older kids in that age group. The results came from parents, who may be inclined to over-report how active their kids are because of "social desirability," the researchers said.

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Original source: http://abcnews.go.com/m/story?id=21456849&sid=26&ts=true  

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Most children get food and beverage marketing at school, study says

Jan. 13, 2013, Los Angeles Times

By Mary MacVean

Most students are exposed in school to efforts by food and beverage companies to sell food or gain brand loyalty, despite a decline in some kinds of commercial enterprises, including soda machine contracts, researchers reported Jan. 13.

High school students get the most exposure, and for almost 64 percent of elementary school students, the most common type of commercialism is food coupons distributed as incentives, the researchers wrote in the Journal of the American Medical Association Pediatrics.

The study was based on surveys of administrators at a representative sample of schools from 2007-2012, and conducted by Yvonne Terry-McElrath of the University of Michigan and colleagues.

"Schools are desirable marketing areas for food and beverage companies, although many of the products marketed to students are nutritionally poor," the authors wrote.

"School property should be a place where messages to young people strengthen their bodies as well as their minds," Jennifer Harris of the Rudd Center for Food Policy & Obesity wrote in an editorial accompanying the study. Harris noted that while some states and districts had removed unhealthful products from schools, those moves generally did not restrict marketing; only Maine has legislation doing that.

"How can schools effectively teach good nutrition when the products they tell children to limit are featured in school halls, cafeterias, vending machines and athletic fields?," Harris wrote.

The study authors include sponsorship, exclusive contracts, incentive programs, advertising, fundraising, and branded products sold in schools in their definition of commercialism. So a fast food company's weekly lunch for fifth-graders, or ads posted on school fences, or coupons for good grades all would be included.

In 2006, food and beverage companies spent $186 million on youth-directed in-school marketing, the study said. That year and the next, the federal government issued recommendations for changes. By 2009, the spending had fallen to $149 million, the authors said. In 2011, about one-tenth of districts in the United States prohibited unhealthful food and beverage marketing. In fact, many used profits from such relationships to make up for budget shortfalls.

In middle and high schools, the most prevalent commercialism came through exclusive beverage contracts. Almost 70 percent of high school students and nearly half of middle school students went to schools with such contracts in 2012, the researchers wrote.

The researchers said their results showed a need for "at minimum, clear and enforceable standards on the nutritional content of all foods and beverages marketed to youth in school settings."

There was a decrease in students at schools with exclusive beverage contracts; by 2012, it was 2.9 percent of elementary school students, compared with 10.2 percent in 2007; 49.5 percent of middle school students, compared with 67.4 percent in 2007; and 69.8 percent of high school students, compared with 74.5 percent in 2007.

Policy changes and legislation, including in California, have limited the sugary sodas that can be sold on school grounds. In addition, the companies have adopted voluntary restrictions on some drinks. Sports beverages are still sold at many schools.

The U.S. Department of Agriculture recently published standards that would, if they become final, govern "competitive food" sales — those sold aside from the school meals program. Those rules do not address in-school marketing.

The authors note that declines in public funding for schools have left 35 states with 2012 funding below 2008 levels. "School districts must make up the difference, and one possibility is additional revenue through school-based commercialism," they wrote.

But that marketing conflicts with the need to raise children to be critical thinkers who can effectively evaluate a consumer society, they said. "Also, most foods and beverages marketed in any venue toward children and adolescents are high in calories, sugar, salt, and fat, and are low in essential nutrients."

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Original source: http://www.latimes.com/science/sciencenow/la-sn-food-and-beverage-marketing-at-school-study-says-20140113,0,1531866.story#ixzz2qO5qwWbn

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Passing bowls family-style teaches daycare kids to respond to hunger cues, fights obesity

Jan. 13, 2014, Medical Xpress

When children and child-care providers sit around a table together at mealtime, passing bowls and serving themselves, children learn to recognize when they are full better than they do when food is pre-plated for them, reports a new University of Illinois study of feeding practices of children ages 2 to 5 years in 118 child care centers.

"Family-style meals give kids a chance to learn about things like portion size and food preferences. When foods are pre-plated, children never develop the ability to read their body's hunger cues. They don't learn to say, okay, this is an appropriate portion size for me," said Brent McBride, director of the university’s Child Development Laboratory and lead author of the study.

The study found that Head Start centers were in significantly greater compliance with this and other Academy of Nutrition and Dietetics benchmarks than other centers surveyed, including participants in the USDA's supplemental nutrition assistance program CACFP, and non-CACFP state-licensed centers.

The academy's benchmarks were issued in 2011 to combat the problem of child obesity.

One in four preschool children is overweight or obese, and more than 12 million preschoolers consume up to five meals or snacks daily at the nation's child care centers, McBride said.

"The academy also recommends that providers eat with children so they can model healthy behaviors, which Head Start staff are required to do," said Dipti A. Dev, university graduate student in nutritional sciences.

Teachers are also asked not to pressure children to take one or two more bites or finish a serving before another food or activity is offered, she said.

The researchers said that providers need to help children recognize their feelings of hunger and fullness.

"Instead of asking ‘are you done?’ teachers should ask children, ‘are you full?’ Or they should say, ‘if you're hungry, you can have some more,’” explained Dev, who is developing a packet of best feeding practices to share with providers.

"Asking the right questions can help children listen to their hunger and satiety signals," she said.

The Illinois research is the first study to evaluate whether child care providers are adhering to the academy's guidelines for feeding practices. Most providers did promote healthy feeding by serving nutritious foods and not pressuring children to eat or restricting them from eating. Head Start programs stood out though as having the best policies and feeding practices.

In fact, Head Start teachers who use family-style meals are strong advocates for them, the researchers said.

"Teachers who don't do family-style meals have all these reasons that they don't: there's too much waste, it's messy, young kids don't have the developmental skills—the fine motor control—to do that," McBride said.

"But Head Start teachers were telling us ways you could help develop those fine motor skills: for instance, using scoops in the sandbox or pouring water in the water table," he added.

"When you first do easel painting with a two-year-old, it's really messy because they don't have fine motor control, but you still do it even though it's messy. The same thing is true for family-style meal service. It may be messy at first until they develop the appropriate skills and learn to pour the right way or hold the cup as they're pouring. It's a developmental progression," he said.

If children don't want to eat, teachers shouldn't urge them to eat anyway out of concern that the kids may get hungry before the next meal or snack is served, he said.

"If a child doesn't eat at one meal, he'll compensate for it over a 24-hour period. Making kids eat when they're not hungry is probably the worst thing you can do. It teaches them not to pay attention to their body's signals," Dev said.

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Original source: http://medicalxpress.com/news/2014-01-bowls-family-style-day-care-kids-hunger.html

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Among kids in United States, the rich get thinner and the poor get fatter

Jan. 13, 2013, Los Angeles Times

By Melissa Healy

From many corners of the United States – Los Angeles, Philadelphia, Mississippi – recent years have brought heartening news about the relentless rise in obesity among American children: Several years into a campaign to get kids to eat better and exercise more, child obesity rates have appeared stabilize, and might be poised for a reversal. But a study published Jan. 13 in the Proceedings of the National Academy of Sciences (PANS) journal suggests that among adolescents, the hopeful signs are limited to those from better-educated, more affluent families. Among teens from poorer, less well-educated families, obesity has continued to rise.

Nationally, rates of obesity among adolescents aged 12 to 19 did not rise between 2003-2004 and 2009-2010. But during that period, obesity rates among adolescents whose parents have no more than a high-school education rose from about 20 to 25 percent. At the same time, the teenage children of parents with a four-year college degree or more saw their obesity rates decline from 14 to about 7 percent. "The overall trend in youth obesity rates masks a significant and growing class gap between youth from upper and lower socioeconomic status backgrounds," the authors of the latest research wrote. That class-gap was not evident in younger children – those between the ages of 2 and 11 years old, the researchers said. But as children neared the cusp of adulthood, the class differences became increasingly stark.

Disparities between rich and poor in obesity rates are not new, and they are only one of many health gaps that make poor patients sicker and more likely to die prematurely than richer ones. But if the public health message on obesity "has not diffused evenly across the population," as the authors of the latest report suggest, this disparity could stymie efforts to stem a tidal wave of costly obesity-related diseases in the years ahead.

In a detailed accounting of youth consumption and exercise patterns, researchers from Harvard University's Kennedy School of Government found that physical activity may account largely for the divergent trend in obesity between rich and poor.

In 2003, 86.6 percent of adolescents living with parents who had college degrees, told survey-takers that they had exercised or played a sport for at least 20 minutes continuously sometime in the last seven days. By 2011, 90.1 percent said they had done so.

By contrast, 79.8 percent of adolescent children with parents who did not go beyond high school said in 2003 that they had exercised or played a sport for at least 20 minutes in the last week. By 2011, the numbers of those adolescents who had done so had barely budged, standing at 80.4 percent.

Asked whether they had engaged in at least 10 minutes of continuous physical activity in the last 30 days, 94.7 percent of adolescents with college-educated parents said yes. But among teens with parents with a high school education or less, 82.1 percent of teens said they had engaged in even that minimal level of exercise.

Kids across the socioeconomic spectrum got the message that they should reduce their intake – and less advantaged kids took in fewer calories to begin with. In the broad period between 1998-2010, the teenaged children of parents with a college degree reduced their average calorie intake from 2,487 calories per day to 2,150. In the same period, less advantaged adolescents went from averaging 2,271 calories per day down to 2,105.

While genetics, metabolism, cultural, and environmental factors all influence our weight, the foundation of it all lies in the energy-balance calculation: If calories consumed outstrip energy expended in physical activity, we will gain weight. In a group where almost one in five adolescents is completely sedentary, obesity is simply a likelier prospect when average calorie intake is about the same.

If public health experts are to prevent childhood obesity and thereby drive down future obesity among adults, they will have to figure out why less advantaged kids do not get as much exercise, the authors of the latest study say. Yes, lack of recreation centers, playgrounds, and streets and sidewalks that encourage walking, biking, and playing are important, they wrote.

But, they added, "This is not the whole story." In research presented in New York this summer at the annual meeting of the American Sociological Association, the same researchers found that, among children with parents who ranked high on the socioeconomic scale, participation in high school sports and clubs has increased. But among their peers from families of lower educational attainment and income, such participation has declined.

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Original source: http://www.latimes.com/science/sciencenow/la-sci-adolescent-obesity-economic-divide-20140113,0,5247266.story#ixzz2qO4PU0Hz

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CHILDHOOD OBESITY NEWS

Subway joins first lady’s healthy eating effort

Jan. 26, 2013, Poughkeepsie Journal (The Associated Press)

By Darlene Superville

Michelle Obama has a new partner in her campaign to get kids to eat more fruits and vegetables.

The Subway sandwich chain will spend $41 million over three years to encourage them to eat more food that does not come from a box, the first lady announced Jan. 23 at one of the Connecticut-based company’s restaurants just north of the White House.

Subway will also offer a kids’ menu that mirrors federal standards for school lunches, including offering apples on the side, and low-fat or nonfat plain milk or water as a default beverage.

Speaking as a parent, Obama said Subway’s commitment will help moms and dads choose healthy food for their kids. Its kids’ menu will help eliminate the worry some parents feel about the choices they have to make when eating out, she said.

“Every single item on the kids’ menu meets the highest nutrition standards,” the first lady said before she went to the counter and ordered a turkey on whole wheat bread with spinach, peppers, and oil and vinegar dressing. She paid the $4.40 tab with a $20 bill and ate her lunch while chatting with a group of local elementary school students who had been invited for the announcement.

Some of Subway’s famous celebrity endorsers also were present, including Olympians Nastia Lukin, who prepared Obama’s sandwich, and Michael Phelps, along with New York Giants defensive end Justin Tuck and Jared Fogle.

Fogle gained fame in a series of TV commercials years ago in which he described losing 245 pounds while eating a steady diet of Subway sandwiches, plus walking.

Subway’s commitment is “a natural extension of what we do,” Tony Pace, Subway’s chief marketing officer, said in a telephone interview.

The chain offers a line of lean-meat and vegetable sandwiches that have been certified by the American Heart Association, as well as a trio of breakfast sandwiches with fewer than 200 calories apiece.

Pace said people are becoming more aware of the importance of eating healthier.

Subway’s announcement follows a summit on food marketing to kids that Obama held at the White House last fall. At the time, she urged food and beverage makers, media, entertainment companies, and others to do more to promote healthier foods to children.

A month after the September gathering, Obama announced that the nonprofit organization that produces TV’s “Sesame Street” had agreed to let the produce industry use Elmo, Big Bird, and its other furry characters free of charge in its kid-focused advertising.

Sam Kass, a White House chef and executive director of the first lady’s campaign against childhood obesity, told The Associated Press that Subway was “raising the bar for what a responsible, quick-service restaurant can do to help support the health of the nation.”

Subway will work with the Partnership for a Healthier America, a nonprofit organization that works with the private sector to help advance the goals of Let’s Move!, the childhood obesity initiative Obama launched in 2010, a year after becoming first lady.

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Original source: http://www.poughkeepsiejournal.com/viewart/20140127/LIFE/301270003/Subway-sandwich-chain-joins-first-lady-s-healthy-eating-effort

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Muppets’ mini-makeover aims to get kids involved in fight against obesity

Jan. 26, 2014, The Telegraph (The Associated Press)

By Marilynn Marchione

Bert and Ernie jump rope and munch apples and carrots, and Cookie Monster has his namesake treat once a week, not every day. Can a Muppets mini-makeover improve kids’ health, too?

A three-year experiment in South America suggests it can. Now, the Sesame Street project is coming to the United States.

Already, a test run in a New York City preschool has seen results: Four-year-old Jahmeice Strowder got her mom to make cauliflower for the first time in her life. A classmate, Bryson Payne, bugged his dad for a banana every morning and more salads. A parent brought home a loaf of bread instead of Doritos.

“What we created, I believe, is a culture” of healthy eating to fight a “toxic environment” of junk food and too little exercise, said Dr. Valentin Fuster, a cardiologist at New York’s Mount Sinai Hospital.

Six years ago, he started working with Sesame Workshop, producers of television’s Sesame Street, on a project aimed at children aged 3 to 5 years old.

“At that age they pay attention to everything” and habits can be changed, he said.

The need is clear: One-third of U.S. children and teens are obese or overweight. Many do not get enough exercise, and a recent study found that kids’ fitness has declined worldwide. They are at high risk for heart and other problems later in life.

“The focus is younger and younger” to try to prevent this, said Dr. Stephen Daniels, a University of Colorado pediatrician and a spokesman for the American Heart Association. The group’s annual conference in November featured Fuster’s experiment as one of the year’s top achievements in heart disease prevention.

For Sesame Street, the project offered a chance to improve the lives of young viewers and give a makeover to certain Muppets.

“While Cookie Monster is an engaging figure, we felt there was an opportunity there to really model healthy eating,” said Jorge Baxter, regional director for Latin America for Sesame Workshop.

The new message is that certain things like cookies are “something you can eat sometimes, but there are some foods that you can eat all the time,” like vegetables, he said. The healthy messages have been gradually incorporated into the television show, and its producers even made a doctor Muppet – Dr. Ruster (pronounced “Rooster”) – in Fuster’s image for the preschool project.

It launched in Colombia because U.S. schools that Fuster approached years ago were reluctant, but a wealthy family’s foundation was willing to sponsor the experiment in Bogota.

It involved 1,216 children and 928 parents from 14 preschools. Some were given the program and others served as a comparison group.

Kids had training on healthy habits and how the body works for an hour a day for five months using Sesame Workshop-produced videos, a board game (the “heart game”), songs, posters, and activities. Parents were involved through take-home assignments and workshops that focused on overcoming barriers to good food and exercise. For example, in areas with poor access to parks or play spaces, parents were coached to encourage kids to use stairs instead of elevators and to walk instead of taking a bus.

Children’s weight and exercise habits were measured at the start and 1½ and 3 years later. Although many moved or dropped out by the time the study ended, researchers documented a significant increase in knowledge, attitude, and health habit scores among kids in the program versus the comparison group.

The proportion of children at a healthy weight increased from 62 percent at the start to 75 percent at three years for those in the program. Ironically, in Colombia, that mostly meant that more undernourished kids grew to reach a healthy weight.

In New York, where the program plans to launch in several early childhood and Head Start programs this spring and fall, project leaders will have to tackle under- and overweight kids.

“A lot of the kids are from low-income families, shelters,” and many have poor access to healthy foods, said Rachael Lynch, director of educational services for an Episcopal Social Services preschool, The Learning Center, in Harlem. “It’s a mecca for fast food around here. We’re trying to get them to walk past the Chinese food or pizza or McDonald’s, to go home and make something.”

Her preschool tested the Sesame Street project last summer and “it really took off” with kids and parents, she said.

“They love it. The kids relate, I can’t stress it enough,” to the Sesame Street characters, she said.

The program had kids work in a nearby community garden one day a week to learn about growing vegetables.

They had a “mystery food box” to reach inside, feel, and guess the contents, then use what they found to make a healthy snack such as smoothies, fruit salads, microwaved baked apples, and apple dip.

Children took home a “weekend update” to list and draw pictures of what they ate. Parents were asked to sign it to encourage an adult focus on healthy meals.

Kateshia Strowder said the program had a big impact on her and her daughter, Jahmeice.

“We’d be in the grocery store and she would name every vegetable. It’s amazing. Brussels sprouts – she likes it. Cabbage – she likes it,” Strowder said. “I’m not a vegetable eater, to be honest. But I had to learn to do those things for her.”

Donte Payne said the same for his son, Bryson, a 4-year-old who also was in the Harlem program.

“It made him more interested in eating more healthy things,” Payne said. “He became very interested in salads. He loves salad now.”

In Colombia, the program is now expanding to about 20,000 children, and in Spain, a project is starting in Madrid.

In New York, a foundation Fuster runs at Mount Sinai will sponsor the U.S. launch, aided by private donors.

Dr. Jaime Cespedes, a pediatric and heart specialist who helped lead the project in Colombia believes it will succeed wherever it is tried.

“Sesame [Street] knows kids, knows media, and how to communicate the messages,” he said. “When you get the kids to deliver the message to the family, change will come.”

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Original source: http://www.nashuatelegraph.com/living/health/1027222-469/muppets-mini-makeover-aims-to-get-kids-involved.html#

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Mexico enacts soda tax in effort to combat world's highest obesity rate

Jan. 16, 2013, The Guardian

By Sarah Boseley

A groundbreaking tax on sugar-sweetened beverages recently passed in Mexico could provide the evidence needed to justify similar laws across low- and middle-income countries and cities in the United States, experts believe.

Campaigners and public health experts are watching closely to see what impact Mexico's tax has on consumption. Mexico, where 32.8 percent of the population is obese, is now the country with the biggest weight problem in the world, according to the United Nation’s Food and Agriculture Organization, overtaking the United States. The impact on health has been serious — 14 percent of the population has diabetes. Rates of high blood pressure, which can lead to stroke and heart attacks, are also high.

So far, there is not conclusive evidence from any country in the world that raising the price of sugar-sweetened drinks will affect obesity levels, but the Mexico experiment is on an unprecedented scale. Although the tax was set at 10 percent per liter rather than the 20 percent campaigners wanted, it will affect a huge number of people. Every year, Mexico's 118 million people drink 163 liters of soda each, or nearly half a liter a day. According to the National Institute of Public Health, a 10 percent tax should reduce that to 141 liters per year, preventing up to 630,000 cases of diabetes by 2030.

Other countries in Latin America, including Ecuador, Peru, and Chile, are working on their own measures to reduce the marketing of soft drinks to children, and to improve labelling so families can know how much sugar and calories they contain. “Mexico will have a domino effect,” said Dr Simon Barquera of the Institute. Public health academics, students, consumer activists, and politicians were all following developments and sharing what they are doing in their own countries on Twitter, he said.

“One of the vice-presidents of the big companies told me they had done their studies and the soda tax will not reduce consumption or solve obesity,” he said. “We know that. My kids know that. But it is an educative tax. It sends a message from the government to the people that we think this is bad for you.”

Tom Farley, health commissioner of New York City, where a proposed ban on large sugary drinks was struck down by the courts, is also watching developments in Mexico. “I am hopeful that with the passage of that in Mexico, when people see the benefits, legislatures around the country [the US] will be supportive of it,” he said.

The tax was passed in October, to the surprise even of many of its supporters, after an unprecedented, hard-hitting advertising campaign from civil society organizations funded by Bloomberg Philanthropies, which has extended its public health work on tobacco prevention into the areas of road safety and obesity.

Billboards across Mexico City ran photographs of a man with parts of his feet missing as a consequence of diabetes. They warned that a 600ml liter bottle of Coca-Cola contained 12 teaspoons of sugar, and asked whether a parent would be happy giving that much to their child. Soft drinks manufacturers retaliated with their own advertisements, urging politicians to reject the tax, claiming that jobs would be lost in their industry and in sugar production, which is important in Mexico. They said that small shops, dependent on soft drinks sales, would close and linked the campaign to former New York mayor Michael Bloomberg's anti-obesity drive. “Michael Bloomberg, [former] mayor of New York, has financed with a $10 million health campaign against sweetened drinks. He wants to do in Mexico what he could not do in New York,” said the adverts.

Campaigners in the coalition, the Nutritional Alliance for Health, tried to buy airtime on the three mainstream television channels, Televisa, TV Azteca, and Milenio TV, but were turned down without explanation and suspect advertising contracts with industry were the issue. None of the channels responded to questions from the Guardian. Cable TV later aired the campaign advertisements.

The tax, proposed by President Enrique Peña Nieto, was brought in as part of a fiscal reform package. The money to be raised, estimated at $15 billion pesos, is intended to be earmarked for drinking water in schools – in some communities there is none, while in others it is not potable and bottled soft drinks are safer. The earmarking of the tax has still to pass a final stage in the senate.

Civil society groups say they will monitor implementation closely, to ensure it does not become part of a general pool of government funding. “It is very, very important not only for Mexico,” said Alejandro Calvillo, director of El Poder del Consumidor (Consumer Power). “It is an issue that has an international resonance. I was very happy [when it was passed] but at the same time with a growing sense of responsibility because we know the reality of this country. We know that there are people who drink a lot of sodas and they don’t have access to drinking water.”

Senator Marcela Torres Peimbert of the opposition PAN (National Action Party), who championed the tax in Congress before the president took it forward, said it was vital the money raised is used to provide drinking water in schools, as promised. “We have suspicions that they are tempted not to do what they are supposed to do, because in the spending budget not all the amount of money expected to be raised was there,” she said. “They say health, but it is not specific.”

She is supporting the setting up of “citizen observatories” to ensure the money goes to pay for drinking water. The president currently has an approval rating of 42 percent, she said. “People don't trust him. Me neither. We have to make a big effort to watch and press really hard for the money to go where we want it to go.”

She agrees that there is an educational aspect to the tax. “The main worry of the industry wasn't the money, it was that these products will be marked as very dangerous. I think we achieved that. The worst part for them was that this special tax for health is like that on tobacco or alcohol.” In the end, a tax of 8 percent was passed also on processed food that contains more than 275 calories per 100g.

Jorge Romo, spokesman for the Asociación Nacional de Productores de Refrescos y Aguas Carbonatadas (ANPRAC), the soft drinks manufacturers, said the tax would just be a burden on the poor, who would end up paying more than the 6 percent of income they spend now on their soft drinks. “They will not consume less. Maybe in the first three, four, or six months but afterwards, it will become exactly the same or maybe a few percentage points difference,” he said.

While he agreed that obesity was a huge problem, and said that the companies were engaging in social programs to try to help, soft drinks were being unfairly blamed, he said. He explained that the main cause was a Latin gene, followed by the eating habits of Mexicans, and the lack of exercise.

Coca-Cola's Latin American president, Brian Smith, appeared on the platform with President Peña Nieto at the launch of a national obesity strategy on the day in October when the tax was passed. He pledged to focus on sales of low-calorie and no-calorie drinks, improve the transparency of labelling, and not market to children under the age of 12.

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Original source: http://www.theguardian.com/world/2014/jan/16/mexico-soda-tax-sugar-obesity-health

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