PUBLICATIONS & TOOLS
- A review of food marketing to children and adolescents: Follow-up report
- Study examined association between household behaviors, youth BMI
- SaludableOmaha aiming to increase community readiness for obesity prevention
CHILDHOOD OBESITY RESEARCH & NEWS
- USDA to allow more meat, grains in school lunches
- Expanding young students' role in nutrition
- Nickelodeon targeted in fight over food marketing guidelines
Obesity in young is seen as falling in several cities
Dec. 10, 2012, The New York Times
By Sabrina Tavernise
After decades of rising childhood obesity rates, several American cities are reporting their first declines.
The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.
“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.
The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.
The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.
Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth-graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”
Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth-, seventh-, and ninth-graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.
Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.
Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch, and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.
Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.
But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth-grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.
“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”
Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention (CDC), which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.
Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.
“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”
Obesity affects poor children disproportionately. Twenty percent of low-income children are obese, compared with about 12 percent of children from more affluent families, according to the CDC. Among girls, race is also an important factor. About 25 percent of black girls are obese, compared with 15 percent of white girls.
Some experts note that the current declines, concentrated among higher income, mostly white populations, are still not benefiting many minority children. For example, when New York City measured children in kindergarten through eighth grade from 2007 to 2011, the number of white children who were obese dropped by 12.5 percent, while the number of obese black children dropped by 1.9 percent.
But Philadelphia, which has the biggest share of residents living in poverty of the nation’s 10 largest cities, stands out because its decline was most pronounced among minorities. Obesity among 120,000 public school students measured between 2006 and 2010 declined by 8 percent among black boys and by 7 percent among Hispanic girls, compared with a 0.8 percent decline for white girls and a 6.8 percent decline for white boys.
“The needle is actually moving,” said Gary D. Foster, director of the Center for Obesity Research and Education at Temple University. He first noticed the change while conducting a study of middle school students. Even children who made up the control group that did not take part in anti-obesity measures had a weight drop of nearly 4 percent, compared with 5.5 percent for those who did.
Here at William H. Ziegler Elementary in Northeast Philadelphia, where most students qualify for free or reduced-price lunch, the day begins with a nutrition tip over the loudspeaker. Teachers give out colorful erasers and stickers instead of Tootsie Rolls. Fund-raising events feature fruit smoothies instead of chocolate.
Some students had never seen broccoli or cauliflower, so Jill Dogmanits, a sixth-grade teacher, started taste tests to acquaint students with those vegetables and healthy snacks like hummus, fresh pineapple, and whole-wheat bagels.
But school is only part of the day. Children buy an average of 350 calories worth of snacks in corner stores every day, according to a study by Dr. Foster’s center at Temple University. About 640 corner stores are now part of a program of stocking healthier food, according to the Food Trust, a nonprofit group that runs it.
“Parents tell their kids, ‘Take this money and go buy a snack,’ ” said Josh, as children streamed into a store across from his school where crayon-colored sugar drinks called Hugs sell for 25 cents and generic soda is 40 cents.
Dr. Donald F. Schwarz, a pediatrician who is the city’s health commissioner, said: “I think we are beginning to turn the tide with the many things that have gone on now for a decade.”
It is too early to tell whether the trend will hold.
“I’d like to see another year of measurement before I go out and party over this,” said Mary Currier, Mississippi’s state health officer.
And some public health experts say that without broader policy actions like a soda tax, which Philadelphia tried but failed to pass in 2010 and 2011, deeper change will be difficult. Still, new data from Philadelphia — from more than 20,000 children in first through sixth grades — show a further 2.5 percent obesity decline from 2011 to 2012, Dr. Foster said.
Josh lost weight this summer, exercising outside with his stepfather, an Army reservist. But now that it’s cold he has gained some back. Still, he believes he can influence others. His 2-year-old cousin now asks for bananas instead of chips at the corner store. Josh takes full credit.
Publications & Tools
A review of food marketing to children and adolescents: Follow-up report
This study from the Federal Trade Commission (FTC) gauges the progress industry has made since first launching self-regulatory efforts to promote healthier food choices to kids. It serves as a follow-up to the Commission’s 2008 report on food marketing requested by Congress.
The report provides a picture of how food companies allocated $1.79 billion on marketing to youth ages 2-17 in 2009. The FTC found that overall spending was down 19.5 percent from 2006, with most of that decrease coming from less spending on television ads to youth. At the same time, food companies stepped up their spending to market to children and teens in new media, such as online, mobile, and viral marketing, by 50 percent. The analysis suggests that industry self-regulation resulted in modest nutritional improvements from 2006 to 2009 within specific food categories heavily marketed to youth, such as cereals, drinks, and fast food kids’ meals.
According to the report, food company participation in self-regulation has increased, but some companies with significant marketing to children still have not joined the effort. The entertainment industry lags farther behind. With a few exceptions, media companies have not limited licensing of children’s characters and placement of ads during children’s programming to more nutritious foods.
Study examined association between household behaviors, youth BMI
This study sought to determine whether children (aged 9–18 years) who live in households that have healthful practices related to behaviors associated with obesity have a lower body mass index (BMI).
Researchers analyzed data from the 2005 Styles mail panel survey and found that children watched more television if they had a television in their bedrooms, were less active as a family, and had no junk food restrictions at home. Children in less active families participated in about half as much vigorous physical activity as children in more active families. Children purchased more sodas and snacks at school if they had a television in their bedrooms and their family consumed more meals at fast-food restaurants. Children whose families were less active were more likely to have a self-reported BMI at or above the 85th percentile. In addition, children who watched more television were more likely to have a self-reported BMI at or above the 85th percentile.
SaludableOmaha aiming to increase community readiness for obesity prevention
Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified.
Researchers developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. Researchers used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments.
Researchers used CRM to assess supply and demand for health programs, engage the community, determine the community’s baseline readiness to address childhood obesity, and guide youth advocacy program development. The project was conducted in two phases. In the first, researchers trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities.
At baseline, the community studied was at a low stage of readiness for change. The program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention.
CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs.
Childhood Obesity Research & News
USDA to allow more meat, grains in school lunches
Dec. 8, 2012, Yahoo News
By Mary Clare Jalonick
The U.S. Department of Agriculture (USDA) is responding to criticism over new school lunch rules by allowing more grains and meat in kids’ meals.
Agriculture Secretary Tom Vilsack told members of Congress in a letter Dec. 7 that the department will do away with daily and weekly limits of meats and grains. Several lawmakers wrote the department after the new rules went into effect in September saying kids aren’t getting enough to eat.
School administrators also complained, saying set maximums on grains and meats are too limiting as they try to plan daily meals.
“This flexibility is being provided to allow more time for the development of products that fit within the new standards while granting schools additional weekly menu planning options to help ensure that children receive a wholesome, nutritious meal every day of the week,” Vilsack said in a letter to Sen. John Hoeven, R-N.D.
The new guidelines were intended to address increasing childhood obesity levels. They set limits on calories and salt, and phase in more whole grains. Schools must offer at least one vegetable or fruit per meal. The department also dictated how much of certain food groups could be served.
While nutritionists and some parents have praised the new school lunch standards, others, including many conservative lawmakers, refer to them as government overreach. Yet many of those same lawmakers also have complained about hearing from constituents who say their kids are hungry at school.
Though broader calorie limits are still in place, the rules tweak will allow school lunch planners to use as many grains and as much meat as they want. In comments to USDA, many had said grains shouldn’t be limited because they are a part of so many meals, and that it was difficult to always find the right size of meat.
The new tweak doesn’t upset nutritionists who fought for the school lunch overhaul.
Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, says the change is minor and the new guidance shows that USDA will work with school nutrition officials and others who have concerns.
“It takes time to work out the kinks,” Wootan said. “This should show Congress that they don’t need to interfere legislatively.”
Congress has already interfered with the rules. Last year, after USDA first proposed the new guidelines, Congress prohibited USDA from limiting potatoes and French fries and allowed school lunchrooms to continue counting tomato paste on pizza as a vegetable.
The school lunch rules apply to federally subsidized lunches served to low-income children. Those meals have always been subject to nutritional guidelines because they are partially paid for by the federal government, but the new rules put broader restrictions on what could be served as childhood obesity rates have skyrocketed.
School kids can still buy additional foods in other parts of the lunchroom and the school. Congress two years ago directed USDA to regulate those foods as well, but the department has yet to issue those rules.
Sen. Hoeven, who had written Vilsack to express concern about the rules, said he will be supportive of the meals overhaul if the USDA continues to be flexible when problems arise.
“This is an important step,” he said. “They are responding and that’s what they need to do.”
Expanding young students' role in nutrition
Dec. 15, 2012, Los Angeles Times
By Teresa Watanabe
At Mark Twain Middle School in Los Angeles, a blooming garden serves as a classroom. Students learn math by measuring the growth of wheat, ancient history by building a Mesopotamian-style irrigation system and the science of evaporation, evolution, and genetics by watching their garden grow.
At lunchtime, they may be found snacking on pasta tossed in a sauce featuring just-picked tomatoes and basil.
Aiming to expand such links between classroom and cafeteria, the Los Angeles Unified School District Board of Education voted this week to further strengthen what is regarded as one of the leading school nutrition programs in the nation. In a resolution passed without opposition, board members directed the district to create a plan to incorporate nutrition education into the curriculum, give students more say in school meal planning and allow them at least 20 minutes to actually eat. Some students say they end up with as little as five minutes for meals because of long cafeteria lines.
The resolution also directs Superintendent John Deasy to report on the financial impact of unauthorized food sales on campus, which include chips, cookies, and other junk food that compete with the district’s meals. Despite districtwide policies promoting healthful food, many individual campuses sell such perennial favorites as baked Flamin’ Hot Cheetos in school stores and vending machines to raise money.
Board member Steve Zimmer, who co-sponsored the resolution with President Monica Garcia, said the district needed to continue pushing forward on the issue, noting that healthful eating is linked to academic achievement and that some students rely on school meals for most of their daily nutrition.
“We have a sacred obligation to make sure we do everything in our power to raise the quality of our nutritional content,” Zimmer said. The resolution is the latest effort to put L.A. Unified in the forefront of a national movement to make school meals more nutritious and reduce childhood obesity and other health problems.
Over the past several years, L.A. Unified has banned sodas and flavored milk on campus, introduced classroom breakfasts to ensure no child starts the day hungry and transformed its menus. Many items high in fat, salt and sugar have been removed — including such popular fare as corn dogs and coffee cake — in favor of more whole grains, fruits, and vegetables.
The changes have not always been popular. The turkey burgers are “nasty” and the Italian flatbread with marinara sauce “makes your breath disgusting,” said Keonta Johnson, a Mark Twain sixth-grader. But Keonta and three of his friends eating lunch this week said they enjoyed such healthful cafeteria fare as rice and beans, salads, and fruits. “We know if we eat too much junk food we’ll get fat and have a greater chance of heart attacks and diabetes,” Keonta said.
Edwin Castro, a seventh-grader, said his friends particularly lamented the loss of the coffee cake and spicy chicken wings; and fewer of them now eat school meals because they don’t like them. But, Castro said, he has cut back on chips, cookies, and candy the last few years after learning about nutrition in school and seeing his parents and grandparents struggle with diabetes.
He and other students said lessons in eating habits, history, and other subjects that employed hands-on work out in the school garden have been far more exciting than just reading textbooks.
The garden was revived three years ago by a couple of volunteer master gardeners, who have helped teachers connect it to the curriculum. Those efforts, Zimmer said, can be a model for other schools.
David Binkle, L.A. Unified’s food services director, said the district would carry out the board’s directive to expand student voices in meal planning through continued campus surveys and plans to build “culinary advisory teams” of food manufacturers, culinary schools and other local partners to work on menu issues at individual campuses. The district is surveying thousands of students, who so far have given a thumbs-up to about half the menu items — including fajitas and chicken teriyaki rice bowls — and rejected others such as the Italian flatbread.
The resolution passed this week also directs the district to form a committee of nutrition experts, community members, food service workers, parents and others to annually evaluate and grade the efforts to carry out the board’s school nutrition policy.
Officials with the Associated Administrators of Los Angeles said parts of the resolution, while well-intended, could be challenging to put into practice. Making sure every student has 20 minutes to eat, for instance, could require more cafeteria workers, school supervision and possibly a longer school day, said Dan Isaacs of the administrators’ union.
“I don’t think any human being on Earth would deny a youngster time for lunch, but you have to take a careful look at it,” he said.
Nickelodeon targeted in fight over food marketing guidelines
Dec. 3, 2012, AdWeek
By Katy Bachman
A fight in Washington is heating up again over the effect of food marketing guidelines on curbing childhood obesity. Targeting Nickelodeon, the Food Marketing Workgroup (FMW), a coalition of more than 80 health groups and nutritionists, is hoping to put pressure on the kiddie net and its parent company Viacom to adopt nutrition guidelines for foods marketed to children, especially those foods that license Nickelodeon characters like Sponge Bob.
The fight over whether the government should regulate food ads targeting children has been fought bitterly, and food manufacturers have tightened self-regulation to keep such proposals in draft stage. But nutritionists and health groups haven’t given up.
The FMW, led by the Center for Science in the Public Interest, has been keeping close tabs on the business and particularly Nickelodeon, which places about 25 percent of the ads during children’s programming, including recent ads for Cocoa Puffs, Air Heads candies, Chuck E.Cheese’s, Fruit Roll-Ups, Kraft Macaroni and Cheese, Pez candy, Cheese Nips crackers, and popsicles.
“Nickelodeon lags behind the efforts of other children’s entertainment companies,” noted the group in a letter sent Dec. 3 to Viacom president and CEO Philippe Dauman and Nickelodeon president Cyma Zarghami, referring to Disney and Ion Media, both of which adopted standards for food marketing to children.
The letter is just the start of a broader campaign targeting Nickelodeon, that includes Facebook posts and ads, print ads in ad and media publications, and a letter writing campaign from concerned parents. CSPI is also in the process of conducting a study about food advertising targeting children.
“[Nick] will be hearing from a lot of parents over the next couple of months that responsible programming means responsible advertising. If in the middle of Dora the Explorer, there are ads for Cocoa Puffs or Air Heads candy, the parent can’t feel as good about the programming,” said Margo Wootan, CSPI’s director of nutrition policy.
At the very minimum, the FMW suggested Nickelodeon should follow the standards set by the food industry’s self-regulatory group, the Better Business Bureau’s Children’s Food and Beverage Advertising Initiative (CFBAI). It was the CFBAI’s new standards that averted the government’s proposal to set voluntary federal food marketing guidelines.
But that makes no sense to Nickelodeon, especially since 80 percent of the food companies marketing to children have adopted the CFBAI’s standards, encompassing the vast majority of the company’s advertisers.
“We have proven our commitment over and over, and the vast majority of our advertisers have already signed on to the CFBAI pledge,” Nick said in a statement.
Nick outlined several programs it adopted to fight childhood obesity, including working with the Let’s Move! program and the Alliance for a Healthier Generation. The company also encouraged kids to eat vegetables via a marketing partnership with Birdseye that ran this summer and fall. “No entertainment brand has worked as comprehensively and with more organizations dedicated to fighting childhood obesity over the past decade than Nickelodeon,” said the company, noting it donates 10 percent of its airtime to health and wellness messaging.
That’s still not enough for the FMW, which wrote that the programs are “insufficient” to counter the problem. “Your PSAs, philanthropic activities, and partnerships with children’s groups do not counterbalance the effect of Nickelodeon’s core business and children’s exposure to unhealthy food marketing,” the FMW said.
With both sides digging in, the food fight is far from over.