August 2015

FDA says consumers should have details about ‘added sugars’ in foods

July 24, 2015, The Washington Post

By Brady Dennis

On July 24, the Food and Drug Administration (FDA) moved forward with a controversial proposal requiring food nutrition labels to include the amounts of “added sugars,” meaning sugar not already in the food before it was produced and packaged.

But rather than merely requiring information about the amount of added sugars, the FDA said it also will require manufacturers to include what percentage the sugar adds to a person’s daily recommended intake. Agency officials said the move would add much-needed context and help consumers better understand how the sugar they eat contributes to the total calories they consume each day.

“The FDA has a responsibility to give consumers the information they need to make informed dietary decisions for themselves and their families,” said Susan Mayne, director of the agency’s Center for Food Safety and Applied Nutrition, noting that food labels have long contained similar information for dietary fiber, sodium, and saturated fat. “Without information like this about a nutrient, it’s hard to know if you’re eating too much or too little in a given day.”

The measure is part of a broader overhaul of the ubiquitous Nutrition Facts label, which has remained unchanged for two decades. The FDA first proposed the new requirements last year when it unveiled a host of suggested changes to current food labeling. At the time, it proposed only that companies list the amount of added sugar in each product. The new proposal expands that requirement to include additional information about the daily intake percentage.

FDA officials said their decision is “now further supported by newly reviewed studies suggesting healthy dietary patterns, including lower amounts of sugar-sweetened foods and beverages, are strongly associated with a reduced risk of cardiovascular disease. When sugars are added to foods and beverages to sweeten them, they add calories without providing additional nutrients.”

The World Health Organization and American Heart Association are among the organizations that have warned about the health risks of excess sugar intake, saying it contributes to a wide range of diseases, such as diabetes and heart disease.

The FDA said it will receive comments on its latest proposal for 75 days. But it didn’t take nearly that long for sharply divided reactions to roll in from consumer and public health experts, who see the move as critical in helping combat the nation’s obesity epidemic, and from major food industry associations, which argue the disclosures are misguided.

The Sugar Association, which represents some of the nation’s largest sugar producers, said in a statement that the FDA’s latest proposal is based on “limited and weak scientific evidence” that doesn’t meet the agency’s own standards. “The fact is that the preponderance of science and the data on caloric sweeteners do not support a suggested limit on sugars intake,” the group said, adding that it plans to “oppose this proposal and examine the level of scientific evidence at the basis of the misguided recommendation.”

Other industry groups, including the American Beverage Association, the Corn Refiners Association, International Food Information Council and the Grocery Manufacturers Association, also have questioned the push to label added sugars, suggesting that the change could be onerous to implement and likely to confuse consumers rather than help them.

Michele Simon, a public-health attorney and consultant who has been an outspoken critic of the nation’s food industry, called such complaints a “smoke screen.”

“The reality is [the industry is] worried consumers will see there’s all this [added] sugar in food that they didn’t know about, and will make decisions accordingly,” Simon said. “This will finally give consumers the information they need to make more informed choices.”

In addition to the requirements around added sugars, the overhauled Nutrition Facts label unveiled last year would include more than a half dozen significant changes, including more prominent calorie counts and more realistic serving sizes. The labels are found on roughly 700,000 products.

The move comes a month after the FDA said it will give manufacturers three years to remove artificial trans fat from the nation’s food supply, which the agency estimated could reduce coronary heart disease and prevent thousands of heart attack deaths each year. The FDA began requiring the addition of trans fat to labels in 2006, and the use of the substance afterward fell dramatically across the food supply.

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Original source: http://www.washingtonpost.com/news/to-your-health/wp/2015/07/24/should-consumers-have-details-about-added-sugar-in-foods-fda-says-yes/

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Watch Connect & Explore: Childhood Obesity Declines and Disparities—A Complicated Relationship

NCCOR’s Connect & Explore Webinar on July 14 provided a closer look at childhood obesity declines, disparities, and opportunities to reconsider the design and impact of policies and interventions. The webinar recording and slides are now available to view on the NCCOR website.

The webinar featured Shiriki Kumanyika, emeritus professor of epidemiology at the University of Pennsylvania Perelman School of Medicine; chair of the African American Collaborative Obesity Research Network (AACORN); and president of the American Public Health Association (APHA) and Tim Lobstein, director of policy at the World Obesity Federation. Dr. Kumanyika’s presentation on the childhood obesity declines and the potential causes of disparities was complemented by Dr. Lobstein’s presentation on trends in Europe and implications for intervention design.

WATCH THE WEBINAR

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New report offers insight from 49 community partnerships tackling childhood obesity

The Healthy Kids, Healthy Communities national program, which is funded by the Robert Wood Johnson Foundation, supported 49 partnerships to increase children’s access to healthy foods and opportunities for physical activity. The program focuses on changes in policies, systems, and environments in communities at greatest risk for childhood obesity based on race, ethnicity, income, and geographic location. The new report, Growing a Movement, shares common themes, key findings and brief vignettes, along with implications for the field that are valuable for local leaders, partners, and funders alike.

ACCESS THE REPORT

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Marketing Matters toolkit offers strategies to reduce unhealthy food marketing to children

A toolkit released by ChangeLab Solutions aims to help local jurisdictions understand how to regulate the marketing of unhealthy foods and beverages to kids, particularly those younger than age 5. The comprehensive Marketing Matters toolkit includes several resources that describe the issue, provide important legal background, and review the policy options within retail, child care, school, government, and community settings.

READ THE WHITE PAPER

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Standing desks at schools: The solution to the childhood obesity epidemic?

July 21, 2015, The Washington Post

By Ariana Eunjung Cha

Being told to “sit still” in the classroom may soon be a thing of the past.

Schools in a growing number of jurisdictions are experimenting with the once-faddish, now commonplace tool of the modern office dweller: the standing desk.

For generations raised on the idea that in order to learn you need to sit down and sit still, standing desks represent a paradigm shift. Researchers who specialize in the ergonomics of learning spaces are now beginning to talk about how these desks will transform classrooms into “activity-permissive environments.”

The interest in getting standing desks in schools has its roots in the growing obesity epidemic in the United States and other wealthy countries. The idea is to get school children—who can spend an incredible 65 percent to 70 percent of their waking hours sitting—moving more during the day. It could help them lose weight, improve their cardiovascular health, reduce their risk of type 2 diabetes, and see other physical and psychological benefits.

Many of the standing desks that are being tested at schools are actually “stand-biased desks” that come with stools that are standing height. Some also have what researchers call “fidget bars” in the foot area which allow children who need more movement to get it without disrupting their classmates.

The latest study on the subject comes from researchers at Loughborough University who looked at classrooms in Britain and Australia. In Britain, only some of the desks were replaced with standing desks and in Australia, all were replaced with standing desks.

In both cases, they found that the amount of sitting time dropped dramatically, even outside of the school day. In Britain, the amount of time sitting fell by 9.8 percent or 66.6 minutes each day and in Australia 10 percent or 29.9 minutes each day, according to a paper published in the Journal of Public Health.

“An urgent cultural shift is needed, and we feel that the only way to do this is to target the next generation of workers, particularly while they are still at school. If we can bring about a behavior change, which we learn from a young age, then this will hopefully continue into adulthood and improve people’s overall quality of health,” researcher Stacy Clemes from Loughborough’s School of Sport, Exercise, and Health Sciences, said in a release accompanying the study.

Previous research has shown that this type of movement translates to a lot of burned calories.

One study published in September 2014 in the International Journal of Environmental Research and Public Health looked at 480 students in 24 classrooms in Texas. The children were randomly assigned to either seated or standing desks. Researchers found that not only did the children expend more energy, they increased their step counts as well.

A smaller study published in August 2011 study in the American Journal of Public Health, involving about 80 first-graders in Texas found that those with standing desks burned 17 percent more calories than those at sitting desks. The effect was even more significant for children who were overweight or obese (above the 85th percentile for weight). They burned 32 percent calories more calories than the control group.

Mark Benden, a professor at Texas A&M University and the lead author of both the Texas studies, wrote in an article published earlier this month in The Conversation, a nonprofit site featuring commentary by academics, that a person’s ability to focus on difficult cognitive tasks is directly linked to adequate physical activity.

“Children become more restless and distracted with prolonged sitting. Active workstations reduce disruptive behavior problems and increase students’ attention by providing them with a different method for completing academic tasks and breaking up the monotony of seated work,” Benden said.

Surveys have also shown students, parents, and teachers like standing desks. At Vallecito Elementary School in Marin County, Calif., for instance, parents have been so enthusiastic that they paid for the standing desks themselves through fundraising campaigns.

“The sedentariness is the problem,” Kelly Starrett, a parent who donated the school’s first standing desks told the Marin Independent Journal.

Fourth-grade teacher Maureen Zink, in an interview with KPIX 5, the CBS affiliate in San Francisco said that she believes standing desks are “the wave of the future.”

“You know, you can roll your eyes all you want,” she added, “but you need to come and see it.”

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Original source: http://www.washingtonpost.com/news/to-your-health/wp/2015/07/21/standing-desks-at-schools-the-solution-to-the-childhood-obesity-epidemic/

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Screening teens for obesity may not help them lose weight

July 3, 2015, Reuters

By Madeline Kennedy

Weight screenings in high school were not enough to get overweight and obese kids on track toward a healthier weight, a recent U.S. study found.

With obesity rates soaring among Arkansas teenagers, the state implemented a screening program in schools in 2003 with alerts sent to parents of kids with weight problems. But kids screened by the program in early high school and again in their junior and senior years did not seem to benefit compared to kids exempt from screening, the study found.

While the screening and reporting measures in Arkansas have been both popular and controversial, there is no evidence to support their use, said study author Kevin Gee of the University of California, Davis School of Education, in an email to Reuters Health.

Rates of teenage obesity have more than quadrupled in the last 30 years and now more than one in five teens is obese, according to the U.S. Centers for Disease Control and Prevention.

Schools play an increasingly important role in addressing child health issues because of their control over what kids eat and their activities throughout the day, Gee writes in the Journal of Adolescent Health.

But it isn’t clear which parts of school-based interventions are most helpful and cost-effective, he notes. Gee wanted to assess the effects weight screenings intended to alert parents that their child has a problem, in the hope that will lead to changes in behavior.

The data came from nearly 1,100 students who participated in the Youth Risk Behavior Survey, which was administered annually between 2003 and 2009. The students answered questions and estimated their own height and weight, allowing for calculation of their body mass index (BMI), a ratio of weight to height.

The survey also asked students about their exercise habits and their diets.

Gee analyzed how students’ weight and health habits changed between 10th grade and 12th grade, among kids who had BMI screenings in 10th, 11th and 12th grades. He compared this change to the pattern of weight changes among students who opted out of the screening over the same period.

More than half of all teens were a healthy weight in both groups. The percentage of obese teens decreased and the percentage of overweight teens increased over the two years.

The changes in the two groups were not significantly different for weight gain, exercise level, or dietary habits.

Overall, most teens did not eat one or more servings of fruits or vegetables per day.

Dominique Ruggieri, a faculty fellow for the University of Pennsylvania’s Center for Public Health Initiatives, noted that childhood obesity is a serious health condition that can cause many other health problems.

“Moreover, children who suffer from weight health issues are significantly more likely to suffer from obesity in adulthood,” Ruggieri said in an email.

Although screenings did not have a significant effect on weight in this study, Gee said that they may be useful to parents who do not have access to health checkups for their children.

Ruggieri also said that BMI screenings can be useful because most parents tend to underestimate their child’s weight status. She added that the screenings could be improved by telling parents, “why and how the measurements were taken, what parents can do to help their children, and what the schools are doing to help their children.”

Gee noted, however, that BMI information alone may not be enough to help parents in high poverty areas where fresh produce and safe playgrounds to encourage exercise may not be available.

He cautioned that screening and reporting alone is not enough to make a dent in the problem of teenage obesity and recommended a more holistic approach. “We need to consider ways to have communities, parent groups, youth groups, churches, hospitals, etc. work in tandem,” he said.

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Original source: http://www.reuters.com/article/2015/07/03/us-health-obesity-high-school-idUSKCN0PD21P20150703

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Experts provide insight on causes of child obesity, tactics to end it

July 27, 2015, MedicalXpress

Encouraging more social interaction for children rather than just limiting TV time and enforcing strong nutritional policies in schools are two of the ways to decrease child obesity rates, according to researchers from the Michael & Susan Dell Center for Healthy Living at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health Austin Regional Campus.

UTHealth researchers published eight new articles, including an introduction from the regional dean, as part of a special obesity issue of the International Journal of Behavioral Nutrition and Physical Activity. The issue, titled “The Science of Childhood Obesity: An Individual to Societal Framework,” provides insights into how to solve the child obesity epidemic and close the gap in the current understanding of its causes.

“Ongoing scientific updates of our understanding of the childhood obesity epidemic are important and urgent due to the rapid increase in the prevalence of obesity in both developed and developing countries during the last 30-40 years, despite countless initiatives to address childhood obesity,” said Cheryl Perry, PhD, regional dean and Rockwell Distinguished Chair in Society and Health at UTHealth School of Public Health Austin Regional Campus.

According to national data, approximately 32 percent of children ages 6 to 19 are overweight or obese in the United States and these rates are even higher in Texas. The Michael & Susan Dell Center for Healthy Living is a public-private partnership that was developed between UTHealth School of Public Health and the Michael & Susan Dell Foundation to address child health issues through research, service and education.

Watching television has typically been viewed as one of the causes of obesity in children. However, according to UTHealth researchers, overweight or obese children may spend more time in front of the television because of social factors and friendship dynamics that lead them to spend less time with friends.

The authors of this paper examined data from the Child Development Supplement to the Panel Study of Income Dynamics, which included information about the health, development, and time use of 2,908 students ages 5 to 18. According to the study results, the more time children spent with friends, the more they engaged in physical activity, which in turn lowered rates of obesity.

“Efforts to reduce child obesity could benefit from careful attention to peer and friendship dynamics rather than simply focusing on time spent watching television,” said Elizabeth A. Vandewater, PhD, lead author and associate professor in the Department of Health Promotion and Behavioral Sciences at the School of Public Health.

Many states across the United States have banned the sale of soda in high schools and some schools have chosen to substitute soda with other sugar-sweetened beverages in vending machines.

Daniel Taber, PhD, and co-authors examined how these policies that regulate the sale of sodas in high schools affect alternate sugary drink consumption, such as tea, coffee, energy, and sports drinks. The researchers drew their data from the National Youth Physical Activity and Nutrition Study, conducted in 2010 with 10,887 participants.

In schools and states that regulated both vending machines and soda sales, there was no increase in alternate sugary drink consumption. However, states and schools that regulated either the sale of soda or the availability of vending machines, but not both, saw the highest increases in alternate sugary drinks consumption.

“Banning soda, but allowing sports drinks and coffee drinks in vending machines, just shifts sugary drink consumption from soda to the alternatives,” said Taber, assistant professor in the Department of Health Promotion and Behavioral Sciences at the School of Public Health.

Obese children are more likely to have school absences, school problems, and lower school engagement than non-overweight children. This study provides evidence that obesity in children is associated with immediate poorer educational outcomes.

Students in economically disadvantaged schools were 1.7 to 2.4 times more likely to be obese, regardless of their individual family’s income. The causes of child obesity extend beyond the home and schools are an important environmental influence, according to the study authors.

In this study, the home food environment, including mealtime structure and availability of healthy or unhealthy foods, was able to account for the differences in children’s diet quality across socioeconomic and neighborhood factors. Making healthy foods more available, turning off the television during meals, and restricting unhealthy foods could lead to better diets and lower rates of child obesity among these at-risk populations.

The most important barriers influencing healthy food shopping behaviors are the prices of food, and lack of access and poor quality of the available healthy food. Conducting a needs assessment in an area with inadequate access to healthy foods allows the community to offer potential solutions and provide direction for future planning. Solutions could include placing new supermarkets in these communities and developing farmers markets and community gardens.

This study examined the differences between the self-reported and actual heights and weights of 24,221 eighth- and 11th-grade students in Texas using the School Physical Activity and Nutrition (SPAN) study data. When surveyed, teenage boys tended to overestimate their height and teenage girls tended to underestimate their weight. The analyses and correctional equations provided in the article provide child obesity researchers with tools to improve the reliability of self-reported data.

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Original source: http://medicalxpress.com/news/2015-07-experts-insight-child-obesity-tactics.html

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Study: School lunches now healthier at racially diverse schools

July 27, 2015, The Hill

By Lydia Wheeler

First lady Michelle Obama’s prized healthy school lunch standards have given students at smaller and racially diverse schools access to healthier lunches, a new study from a heath and health care advocacy group found.

The study, commissioned by the Robert Wood Johnson Foundation, found that during the 2010-2011 school year, the odds of having both fruits and vegetables, as well as whole grains, available everyday was 2.4 and 2.3 times higher, respectively, for students in predominantly white middle schools than for students in more diverse schools.

At the high school level, the odds of having whole grains available daily was almost twice as high for students attending predominantly white schools as for students attending more diverse schools, the study of 948 schools in 48 states found.

But by the 2012-2013 school year, when schools began implementing the healthier nutrition standards the availability of these nutritious items had increased enough in more diverse schools so that differences were no longer significant, the study said.

In middle schools, the study found that 70 percent of students were attended a school in the 2012-2013 school year that offered whole grains every day, up from the 51 percent who did in 2010-2011.

In high school, 73 percent attended a school that offered whole grains every day in 2012-2013, up from the 62 percent who did in 2010-2011.

“Some states and school districts have been working to offer healthier meals for years. Our study shows that the national standards support those efforts and may be helping to close gaps that were leaving many students without access to nutritious school meals,” University of Michigan Research Associate Yvonne Terry-McElrath said in a statement. Terry-McElrath works with Bridging the Gap, the Robert Wood Johnson Foundation’s research program.

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Original source: http://thehill.com/regulation/249277-school-lunches-now-healthier-at-racially-diverse-schools-study-says

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