August 2014





Severe childhood obesity shows a decline in New York City

July 10, 2014, Reuters

By Sharon Begley

Appearing to buck national trends, the prevalence of severe obesity among school children in New York City was down by almost 10 percent in the 2010-2011 school year from 2006-2007, researchers reported on July 10.

Earlier research had shown a decline in overall obesity among New York City public school children, but the prevalence of severe obesity had not been studied. Public health experts have worried that while “easy” cases of obesity were being addressed, more and more children might be moving from being merely obese to extremely so, putting them at risk for heart disease, diabetes, and other illnesses.

In New York City, at least, that appears not to be happening.

The study, published in the journal Preventing Chronic Disease, was based on height and weight measurements of 947,765 children attending public schools in kindergarten through eighth grade.

Severe obesity fell from 6.3 percent of the children in the 2006-2007 school year to 5.7 percent in 2010-2011, according to the researchers, who were led by Sophia Day of the New York City Department of Health and Mental Hygiene. The change represents a 9.5 percent decrease.

“I think there is potentially a glimmer of hope here,” said Asheley Cockrell Skinner, Ph.D., of the University of North Carolina School of Medicine. [Skinner is a childhood obesity researcher who was not involved in the study.]

Childhood obesity is based on body mass index (BMI), which is weight (in kilograms) divided by height (in meters) squared. But unlike adult obesity, which starts at a BMI of 30, and extreme obesity (a BMI of 40 or more), childhood obesity is not defined by a set number.

Extreme or severe childhood obesity, for instance, is understood as having a BMI at least 20 percent greater than 95 percent of children. For a boy standing 4 feet, 6 inches (1.4 meters) tall, 95 pounds (43 kilograms) is obese and 115 pounds (52 kilograms) is severely obese.

In the New York study, the prevalence of severe obesity was highest among boys, minorities, and low-income children. Although prevalence declined in every group, the greatest decrease was among white students and wealthy students.

“Wealthier families have access to things poor families do not,” said Skinner — everything from soccer camp to safe neighborhood playgrounds.

Last month, Skinner and Dr. Joseph Skelton of Wake Forest School of Medicine in Winston-Salem, North Carolina, reported in JAMA Pediatrics that 8 percent of 2-to-19-year-olds are severely obese, according to data from 2011-2012. That was up from 6 percent in 2005-2006.

It is not clear what might explain the progress against severe childhood obesity in New York, but “the city likes to be out in front in trying new things” such as healthier school lunches, Skinner said.

“There’s not a lot of evidence for most of these policies, so it’s good to see that at least they’re not doing harm,” such as causing kids dissatisfied with healthy school lunches to wolf down pizza and ice cream on their way home, she added.


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Publications & Tools

Only about one in four young teens meet screen-time guidelines

Only 27 percent of kids and teens ages 12-15 meet the recommended limit of two hours or less of TV plus computer use daily, new government statistics show. Seven percent of youth these ages reported watching five hours or more a day of TV, while 5 percent said they used a computer for five hours or more, according to the 2012 data analyzed by the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention. At the other end of the spectrum, just less than 2 percent reported no daily TV viewing, and 9 percent reported no computer use.

Using data from the 2012 National Health and Nutrition Examination Survey (NHANES) and the 2012 NHANES National Youth Fitness Survey, the new report also shows that as kids’ weight increased, the percentage of those who reported watching two hours or less of TV viewing and computer use declined.

One-third (31 percent) of youths classified as underweight or normal weight reported two hours or less of TV viewing and computer use daily, compared with 23 percent of overweight kids, and 20 percent of obese kids.


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Physical activity among adults and teens varies by state

A report recently released by the Centers for Disease Control and Prevention shows that physical activity among adults and high school students is higher in some states than others.

Overall, most states have some supports in place that encourage physical activity, but more work is needed to increase opportunities for people to be physically active in their communities and schools. These supports may include state-level guidance on recess and physical activity policies in schools, walking or biking to and from school, joint-use agreements, and complete streets policies.

This report can be used to learn what states across the nation are doing to encourage and support physical activity and to identify opportunities for improving community supports in each state. Individual state Action Guides summarize each state’s data and provide suggested actions that state health departments can take to encourage and increase physical activity in their states.


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Print and online educational games tackle childhood obesity

Behavioral-based print and digital tools aimed at tackling childhood obesity interactively have been unveiled by a company called Fitwits, developed by designers at the Carnegie Mellon University School of Design.

Part of the university’s Center for Technology Transfer and Enterprise Creation, the company offers three product groups: Fitwits Games, for parents and children to learn together; Fitwits Educator, for teachers; and Fitwits MD, for physicians, with flash cards to use during visits.

Backed by $1 million in investments, including grants from The Heinz Endowments, Eat ’n Park Hospitality Group, Innovation Works, and Carnegie Mellon University, Fitwits was developed with input from physicians, nutrition specialists, families in weight management clinics, and school personnel. It is now in a national trial with a global health insurance provider.


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Childhood Obesity Research & News

New USDA nutrition guidelines focus on healthier kids

July 23, 2014, Highlands Today

By John Buchanan

As public interest in healthier food for school children continues to increase, the U.S. Department of Agriculture (USDA) continues to strengthen its federal nutrition standards.

Updated guidelines for the USDA Meal Pattern program that took effect in 2012 and a specialized Smart Snack program set basic nutritional standards for school lunch and snack programs and focus on improving the nutrition levels of all food sold on school campuses.

For example, last year a requirement was added to the Meal Pattern that a fruit or vegetable be placed on a child’s tray to make the meal reimbursable under the National School Lunch Program.

The key change this year is a requirement for the first time that all grain items must be whole grains, which USDA defines as having at least 51 percent whole grain content.

The USDA guidelines also place limits on things like sodium levels, total calories of a snack item, and the percentage of calories that can come from saturated fat.

The Smart Snack program, funded by Congress under the Reauthorization Act of 2010, gave USDA the authority for the first time to regulate all food sold during the school day by schools that participate in the National School Lunch Program. The school day is defined as lasting from 12:01 a.m. until 30 minutes after the bell that ends the school day.

That means that organizations that are doing things like serving food at a football or basketball game or social event in the evening are exempted from the guidelines, explained Robin Safley, director of the division of food, nutrition and wellness at Florida Department of Agriculture and Consumer Services (FDACS).

The guidelines only refer to food that is sold during the school day.

That means, however, that vending machines are affected by the new guidelines. Some items that do not meet the federal standards must be removed.

“But because we as a society are moving toward healthier food, there are already items in vending machines, such as baked potato chips or granola bars, that are healthier and do meet the guidelines,” Safley said.

One challenging issue lately, however, has been the fact that the new USDA rules prohibit fundraisers that involve food that does not meet the strict federal standards unless the state provides an exemption.

In May, FDACS held three public workshops to develop a state-level rule that allows for limited exemptions for fundraisers that do not meet USDA standards. Safley stressed that the issue is limited to food sold on campus during the school day, as defined by the guidelines.

On July 11, FDACS published a new rule that allows high schools to hold such fundraisers for up to 15 days each year. The limit is 10 days for middle schools and five days for elementary schools.

“So for example,” Safley said, “a high school can say, every Thursday afternoon for the next 15 weeks, we’re going to hold a fundraiser that does not meet the USDA guidelines.”

The good news, in terms of public policy, Safley said, is that more and more parents are interested in healthier food being served to their children in schools.

Beverly Girard, director of food and nutrition services at Sarasota County Schools, noted that a commitment to healthier food for students is nothing new in Florida. Sarasota County and other counties have been at the leading edge of progressive school nutrition for years.

For example, Girard said, Sarasota County has worked with FDACS for a long time to bring healthier foods such as more fruits and vegetables into schools.

“This is not new territory for Sarasota County,” Girard said. “We have been working to make sure children eat more fruits and vegetables for years now. And now, we are embracing the latest USDA changes, because for the most part these are things we’ve already been doing. In fact, I’d say that in many cases the USDA rules have just caught up to what many of us have been doing in Florida for years.”


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Produce from school gardens increasingly ends up in school cafeterias

July 27, 2014, The Denver Post

By Colleen O’Connor

This year, another Colorado school district will join the growing national movement to bring fresh vegetables from school gardens into school cafeterias, directly onto the plates of the students who grew them.

Just four years ago, only a few schools in the country were doing this. But after Denver Public Schools (DPS) worked with Slow Food Denver to create food-safety guidelines, the garden-to-cafeteria movement is spreading across the country, and the DPS food safety protocol is now a national model. By May 2013, four states and the District of Columbia had laws to ensure that produce from school gardens could be served in school cafeterias, according to the nonprofit ChangeLab Solutions.

“The kids are really excited about it,” said Emily O’Winter, healthy schools coordinator at Jeffco Public Schools, which tested pilot programs at four of its schools last year. “They’re so proud. At the salad bar, they look for their tomatoes from the garden.”

Experts say the trend is rooted in a convergence of events: the Healthy, Hunger-Free Kids Act of 2010 that targeted childhood obesity; new U.S. Department of Agriculture nutritional requirements that fruits and vegetables be served daily at school lunches; and the growth in consumer demand for foods grown locally.

At first, the idea of serving vegetables from school gardens in school cafeterias was so novel that some school districts wouldn’t allow it, pushback that was “primarily a misunderstanding about food safety policy and rules,” said Andrew Nowak, the Denver-based director of the national school garden program for Slow Food USA. “People thought kids can’t do this because they can’t handle a harvest and handle food safely.”

Now, demand is growing faster than basil.

This spring Nowak — who worked with the Denver Department of Environmental Health to pioneer the DPS food-safety protocols — spoke on a panel about overcoming obstacles to the garden-to-cafeteria movement at the National Farm to Cafeteria Conference.

“The room was packed,” he said. “People were sitting on the floor wanting to hear about these protocols, and how school districts were buying (vegetables) from school gardens.”

In Denver, it all started in 2010 while Congress was still debating the Healthy, Hunger-Free Kids Act. Leo Lesh, then director of DPS Food and Nutrition Services, decided to convert all school kitchens to scratch cooking, and also ordered 85 salad bars for DPS cafeterias.

“The need for produce increased so much, and Steele Elementary ran out of produce, but they had a garden,” recalls Anne Wilson, farm to school coordinator for DPS.

Lesh, wondering if that garden’s produce could be used in its salad bars, called Nowak at Slow Food Denver to ask if that was possible. Finding few examples in the nation, Nowak worked with local health officials to create food-safety protocol for a garden-to-cafeteria program at DPS.

That protocol is now available at all county health departments around Colorado — a template that school districts throughout Colorado can customize.

The general principle remains the same: Students are paid for their crops, with the money going back into the program to help make it sustainable. In Denver, students grew more than 4,500 pounds of vegetables and earned more than $5,260 since 2010.

But it’s not about the money.

Studies show that hands-on gardening, in combination with nutrition education, are an effective way to change children’s attitudes about eating healthy foods: A 2007 study of sixth-graders showed they increased their consumption of fruits and vegetables by 2.5 servings a day, more than doubling their overall consumption.

Bringing this food to the table is added enticement.

“Last year we grew Sun Gold tomatoes that are very sweet, almost like candy,” said Jamie Humphrey, dietitian for Colorado Springs School District 11. “They said, ‘Oh, gosh, that tastes a lot different from what’s in the store.’”

She oversees more than 100 raised beds in the garden at the Galileo School of Math and Science, which this year is expected to yield 5,000 pounds of vegetables.

“We’re trying to expand their palate and try new things,” said Humphrey. “Beets and kale are not as popular as lettuce, tomatoes, and bell peppers.”

In Weld County, at least four schools have garden-to-cafeteria programs.

“It’s definitely a win-win,” said Rachel Hurshman, wellness specialist at Greeley-Evans School District 6.

The school gets another way to promote healthy eating, and the kids — who’ve worked hard to get things to grow from seeds — are more willing to explore adventures in eating.

“It takes a kid 11 times to decide if they like a food or not,” she said. “The more we can get them to try it, and buy into the process, hopefully the more vegetables they will eat in the future.”


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Using M.C.s and M.D.s to promote healthy eating for youths

July 8, 2014, The New York Times

By Winnie Hu

Adrian Harris, known as Easy A.D. to his fans, has rapped about street life in the South Bronx as a member of the Cold Crush Brothers, a group that is among the pioneers of hip-hop.

Now Harris also raps about broccoli.

“If you think you eat healthy, say ‘me,’” Harris called out over a pounding bass that shook the gym at the Future Leaders Institute, a charter school in Harlem, on a recent morning. A photo of a cart laden with fruits and vegetables filled a screen behind him. “Boys and girls,” he added, “there are no Doritos on that cart.”

Harris, calling himself a “health M.C.,” aims to reach children who might otherwise tune out nutrition lessons. His vegetable rap is part of a growing public health campaign that has enlisted hip-hop artists such as Doug E. Fresh, Chuck D, and DMC of Run-DMC to work alongside doctors and nutritionists in fighting obesity and related illnesses in poor communities.

The campaign is being rolled out this year in 18 cities, including Atlanta, Chicago, Memphis, Tenn., and San Antonio, after being tested in dozens of schools, community centers, and summer camps in New York City. It was developed by Hip Hop Public Health, a nonprofit group that has also used hip-hop to call attention to strokes and Alzheimer’s disease.

The campaign, which draws upon anti-obesity research conducted at Columbia University Medical Center, seeks to make healthy eating seem cool through original hip-hop songs, comic books, and cartoon-style videos. “It’s about having fun while learning,” said Dr. Olajide Williams, a Nigerian-born neurologist at the medical center and at New York-Presbyterian Hospital, who founded Hip Hop Public Health. “Their minds are unlocked by the entertainment and then we can input the knowledge and skills they need to learn.”

The campaign has won over hip-hop fans like Kellie Terry, who see it as a return to hip-hop’s roots. Once a means for those in the South Bronx to reaffirm and celebrate their culture during tough times, she said, hip-hop eventually became commercialized and associated with violence and drugs. “Bringing it back and connecting it to things we’re still struggling with and using it as a tool to lift us up is very much part of the hip-hop culture,” said Terry, executive director of the Point, a South Bronx youth center that focuses on arts and community.

The health-focused hip-hop was the idea of Dr. Williams, 44, who heard LL Cool J on the radio at an English boarding school in the 1980s and became hooked. In 2005, Dr. Williams was treating stroke patients at Harlem Hospital Center and grew frustrated that so many of them did not know the early warning signs. He was thinking that a catchy rap song might be the way to teach them when he happened to hear a patient rapping.

The patient put Dr. Williams in touch with Doug E. Fresh’s manager. Dr. Williams called every week for months before landing a meeting with the artist at a juice bar in Harlem. Doug E. Fresh came with his son, who coughed incessantly. Dr. Williams, fearing that the son might have a form of asthma (he did), spent the whole time examining him rather than making his own pitch.

Dr. Williams said he was depressed afterward, convinced he had blown his chance. But a few weeks later, Doug E. Fresh called to thank him and agreed to write a song. Three months later, he penned “Stroke Ain’t No Joke,” which spread across the Internet and in schools, and is now played around the world.

The success of that song led Dr. Williams to found Hip Hop Public Health in 2008 with Doug E. Fresh as vice president. Today, the group has a staff of 14 that works out of Harlem Hospital Center and Columbia University Medical Center. It has an annual budget of $500,000, which comes from city funds and grants from private foundations.

The anti-obesity campaign was developed with the help of an advisory board: 16 fifth-graders charged with keeping the material fresh. The students came up with questions, selected the fast-food examples, and even vetted the songs and giveaways, which were upgraded at their suggestion from pencils and shopping bags to water bottles and nylon sports bags printed with “Hip Hop Heals.”

Leslie Mikkelsen, managing director of the Prevention Institute, an advocacy group that promotes community strategies to address obesity, said that hip-hop was a good way to get the attention of young people but the message needed to go hand in hand with changes in their communities — such as improving access to healthy foods in local stores — to make a lasting impact. “When they’re excited about good health, we have to help them in following through on healthy practices by making sure the community supports them,” she said.

At the Future Leaders Institute, the hip-hop campaign has reinforced the school’s own efforts to promote healthy eating through nutrition classes and a garden that produces lettuce, cucumbers, and strawberries for the salad bar, said Tiffany Daley, a teacher.

Armed with microphones, Harris and Arthur Lloyd, a record producer who goes by the name Artie Green, played songs, showed videos, and soon had about 150 children on their feet. Then using a game show format, it was time to take stock of what they ate. Did a burger or an apple pie have more calories? (Burger.) How many calories should you eat? What are calories?

“If it was a real doctor talking about calories, I wouldn’t pay attention because it’d be boring,” said Jaylah Williams, 9. “But it was fun, and that way I got to know more about it. I feel like this helped me get in touch with healthy foods.”

Jaylah added that she hoped to shed a few pounds by staying away from calorie-rich chips, cheesy sauces, and fruit juices.

When Dr. Williams, in a white coat over green scrubs, was called up by the health M.C.s, he greeted the children as “hip-hop public health ambassadors” and urged them to share what they had learned with their friends and family.

The most important thing they could do, he told them, was to save someone’s life. “That’s what I do,” he said. “The way you can do that is to keep them healthy.”


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Boys & Girls Club works with nonprofit to teach children to cook

July 10, 2014, Worcester Telegram & Gazette

By Kärin Radock

Nine-year-old Alex LeBlanc’s classmates erupted into laughter when he tasted his homemade vinaigrette dressing, and made a face like he had just bitten into a lemon.

The children were attending a cooking class, part of eight one-week healthy cooking class sessions being offered at select Boys & Girls Club locations in Massachusetts. The classes are sponsored by a $100,000 grant provided by the Harvard Pilgrim Health Care Foundation. The first session launched a few days prior at the Boys & Girls Club of Worcester [in Massachusetts].

Karen Voci, president of the Harvard Pilgrim Health Care Foundation, said Harvard Pilgrim has been providing funding for evidence-based projects to reduce childhood obesity for seven years.

She said they’ve learned that while family income may play a role in the kinds of food children eat, they often lack the skills to prepare healthy food.

“This grant is for the dying art of cooking, something that is critical in reversing this epidemic,” Voci said.

The classes are offered by ChopChopKids, a Watertown, Mass.-based nonprofit that publishes ChopChop: The Fun Cooking Magazine for Families, named the 2013 Publication of the Year by the James Beard Foundation, and will teach children ages 8-12 how to prepare healthy food.

At the class taught by Sally Sampson, the founder of ChopChop Magazine, and Bill Yosses, former White House pastry chef and the new director of the ChopChop Cooking Lab, eight local children made an emulsion vinaigrette and learned how to chop and assemble a panzanella salad.

The students learned the different steps of creating an emulsion by mixing olive oil and balsamic vinaigrette — discovering that the two wouldn’t completely mix, even if shaken — to which they then added some tahini, mustard, and salt and pepper.

Although Sampson warned them their dressings would be strong, like their friend Alex, many made sour faces when they sampled the mixture.

“Now we’re going to make a salad,” said Yosses, who demonstrated his chopping skills by peeling and slicing an English cucumber.

“We learn now about how sharp these are,” he said, holding up a knife.

The children were split into two groups, the older at a table with big knives, and the younger with small ones.

“I want to chop!” said 11-year-old Kaylani Thompson, showing her classmates how to cut up scallions and red bell peppers.

While they took turns chopping vegetables to add to cubes of day-old bread and their vinaigrette, they reminded one another to “tuck your thumb under,” a trick they were taught to avoid getting cut. Thankfully, only one Band-Aid was needed.

Once they helped clean up, the salad was mixed and everyone was served. Sampson and Yosses told the class to eat using their non-dominant hands. Some found that difficult, while others, like 8-year-old Jaydon Good, enjoyed using his left hand instead of his right.

Overall, the students agreed their favorite part of the salad was the bread. Before they were each given some to take home to their families, they were asked to draw the different stages of their emulsions.

They were also given a mystery fruit and vegetable, to try to determine what kind of tastes they were, an exercise known as a mindfulness session. After tasting what they described as a “bitter vegetable” and a “sweet and sour fruit,” they were told they had tried endive and passion fruit.

“I love this stuff!” 11-year-old Janilsa Salazar said about the passion fruit. “It’s so good!”

Before handing in their aprons for the day, the students were given the challenge of making salads for their families that night, and were supplied with bags containing everything they would need.

When asked what his favorite part of the class was, Alex said, “Trying the vinegar!”

Voci said the pilot program will help Harvard Pilgrim and ChopChopKids determine if the children can learn basic, entry-level cooking skills, and whether — when given the skills, recipes, food, and tools to take home with them — they will be able to recreate with their families what they did in class.

“Cooking is a dying art,” Voci said. “If (people) know how to cook, they should teach children. We need to teach the next generation how to cook so they can be healthy and go forward with those basic skills.”


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