February 2015





Connect & Explore Webinar on Feb. 23: Rethinking Obesity Prevention—The Second Lancet Series on Obesity

Feb. 9, 2015, NCCOR

NCCOR’s Connect & Explore Webinar unpacks The Lancet special issue, discussing how public support for policy actions and new thinking can move the needle on obesity

Despite reported areas of decline, no country has reversed its obesity epidemic. Researchers increasingly believe that governments and stakeholders should act urgently to decrease the prevalence of obesity, including childhood obesity. Papers in the new Lancet series review the growing consensus on core policy actions, reasons for patchy progress, and opportunities to aid obesity prevention by reframing the issue.

The Lancet Series, available Feb. 19, examines the competing perspectives on the causes and solutions for obesity and why rethinking our approaches is critical to reversing the epidemic. From regulatory action to empowering the public, the authors highlight opportunities to break the cycle of demand for foods of poor nutritional quality and move the focus toward changing food environments.

To date, the public health approach has been education first, and calls for policy change have largely stayed as an exchange between public health professionals and decision-makers, said Dr. Terry Huang, a Lancet Series lead author. “However, more is needed to advance and sustain political and institutional action by focusing on increasing public support and popular demand for obesity prevention,” said Huang, who serves on the National Collaborative on Childhood Obesity Research (NCCOR) External Scientific Panel.

Connect & Explore will give you the first chance to hear from authors and ask them questions. Learn how reframing the issues and mobilizing the public can foster progress in obesity prevention. Guest speakers will break down actions that can be taken by governments and efforts from industry and civil society to create a Culture of Health.

Join us at 2 pm, Eastern, on Monday, February 23, for the one-hour event. Speakers include:

• Terry T-K Huang, PhD, MPH, CPH, Professor, School of Public Health, City University of New York

• Boyd Swinburn, MBChB, MD, FRACP, Professor, Population Nutrition and Global Health, University of Auckland; and Alfred Deakin Professor, Co-Director, WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne

• C. Tracy Orleans, PhD, Senior Scientist, Robert Wood Johnson Foundation

You must register to receive webinar access. The event is free but attendance is limited, so tell a friend and register today!

Register for Connect & Explore: Rethinking Obesity Prevention—The Second Lancet Series on Obesity

Please consider sharing this information on your social networks using the hashtag #ConnectExplore. We will also be live tweeting the event so be sure to follow the conversation at @NCCOR. For those who cannot attend, the webinar will be recorded and archived on www.nccor.org.

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NCCOR publishes white paper to complement Healthy Eating Index photo series

Jan. 22, 2015, NCCOR

By visualizing the quality of the American diet and exploring findings from the Healthy-Eating Index-2010 (HEI-2010), researchers and the public can both benefit, according to a new white paper.

“Visualizing Diet Quality at Multiple Levels of the Food Stream” uses the HEI-2010 – a scoring metric developed by the U.S. Department of Agriculture (USDA) and National Cancer Institute (NCI) – to assess diet quality in relation to the Dietary Guidelines for Americans (DGA). It is the latest installment in a series of communication products developed by the National Collaborative on Childhood Obesity Research in conjunction with NCI.

The products, which include a video, infographic series, fact sheet, and photo series, each help translate findings published online in the November issue of the Journal of the Academy of Nutrition and Dietetics.

The photo series and companion white paper closely examine the U.S. food stream, or the flow of foods from agricultural production, through processing, and distribution channels, to the food that ends up on our plates. They depict “current” and “improved” diet quality at the national, community, and individual levels. At the individual level, the photo series illustrates changes in diet quality for meals consumed over the course of a day. The highest scoring menu, is designed to reflect what each meal would look like if it met the DGA recommendations.

“The photo series can serve as an educational tool to help the general public distinguish between higher and lower quality diets,” said lead author Julia Strasser of the Milken Institute School of Public Health at The George Washington University. By highlighting the disconnect between the DGA and the availability of healthy foods within the food stream, the photo series may also help policy makers identify opportunities for improvement related to food availability, food production, and food importing and exporting.

To raise awareness of the journal findings and all of the NCCOR Healthy Eating Index communication products, NCCOR conducted targeted outreach in late 2014 to key influencers. The products were shared on a number of websites, blogs, and newsletters including Robert Wood Johnson Foundation’s Childhood Obesity Weekly Policy Update, Healthy Eating Research, Salud Today!, Active Living Research, Center for Science in the Public Interest, and the U.S. Food Policy Blog. Approximately 4,800 individuals were reached via social media.

In fall 2015, USDA and the U.S. Department of Health and Human Services will publish the updated DGA. Once the guidelines are published, NCI scientists will update the Healthy Eating Index to continue tracking the impact of the food stream on diet quality in the United States.

Check out all of the Healthy Eating Index products on the NCCOR project page.


Original source: https://www.nccor.org/blog/nccor-publishes-white-paper-to-complement-healthy-eating-index-photo-series/

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Publications & Tools

New recommendations on responsible food marketing to children

Brands marketed to children should only contain healthy foods, according to a national panel of experts convened by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation. The report, Recommendations for Responsible Food Marketing to Children, provides a comprehensive set of model definitions for food marketing practices directed to children that are intended for a broad range of stakeholders, including the food and beverage industry, media companies, policy makers, advocates, and researchers.


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Fact sheets, data compare state and national school snack policies to USDA standards

Half of secondary students consume at least one snack food a day at school. While 43 states have policies determining the types of snacks schools may sell to students, the policies vary widely in content and strength. New fact sheets and data tables from Pew Charitable Trusts compare snack food and beverage policies of each state and the District of Columbia with the U.S. Department of Agriculture’s Smart Snacks in Schools standards. The standards, which took effect in the 2014-2015 school year, allow schools to offer healthier snacks to children, while limiting junk food.


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UNESCO guidelines recommend improved physical education in schools

Physical education is in decline around the world. Recently released guidelines from the United Nations Educational Scientific and Cultural Organization (UNESCO) – produced in partnership with several international and intergovernmental organizations – aim to inform policy makers on the provision of quality physical education. The guidelines include benchmarks, checklists, best practices, and a matrix to guide policy makers and practitioners in reshaping physical education policy.


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School policies, practices to improve health and prevent obesity: National survey results

Continued disparities across socioeconomic levels and little to no progress on physical activity among students are two key findings highlighted in a comprehensive report by Bridging the Gap. The report examined U.S. secondary school policies and practices related to nutrition, physical activity, and obesity prevention including new information from the 2012-2013 school year. Earlier reports in the series have helped inform and track USDA standards for competitive foods and beverages in schools.


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Childhood Obesity Research & News

Obese preschoolers may slim down with Head Start

Jan. 12, 2015, The New York Times

Head Start programs have been shown to help poor children do better in school, but they may also help them fight obesity, a study suggests.

During a year of Head Start preschool, obese and overweight children were much more likely to slim down than comparison groups of kids.

The study involved almost 44,000 preschool-aged children in Michigan and the researchers, from the University of Michigan, acknowledge it has weaknesses. But they say the potential benefits are important because obesity is so hard to treat and affects low-income children disproportionately.

Five things to know about the research, published online Monday in Pediatrics:

    • Head Start is a federal pre-kindergarten program offered free in every state to low-income families. It often involves full-day preschool, focusing on school readiness, healthy eating, and physical activity. Many programs provide children two daily meals, and give families health and nutrition advice. More than 1 million U.S. children participate.
    • Almost 44,000 children participated, including about 19,000 Head Start kids. They were compared with children from Medicaid families and with those from wealthier, privately insured families. Health records and Head Start data provided height and weight measurements for those ages 2-6.
    • About 16 percent of kids entering Head Start were obese, versus 12 percent of Medicaid kids and 7 percent of the others. After a year, almost 11 percent of initially obese Head Start kids became normal weight, compared with none of the Medicaid kids and less than 2 percent of the others. The improvements lasted through the end of the study, or when the kids entered kindergarten.

      Similar trends were seen in kids who started out overweight but not obese.

Nationwide, about 8 percent of preschoolers are obese, but the rate was mostly higher during the 2005-2013 study.

  • The study found a reverse benefit for underweight children. Those in Head Start were more likely to gain weight and achieve a healthy weight after a year than other underweight kids.
  • The Head Start group had fewer blacks and more whites than the Medicaid group; the non-Medicaid group had the fewest number of minority kids.

    A more rigorous test would have compared more similar groups, randomly assigning only some children to attend Head Start. But that would be unethical because of Head Start’s educational benefits, said lead researcher Dr. Julie Lumeng. It’s likely that many kids in the comparison groups attended some kind preschool, perhaps including Head Start. That means it’s not certain that participation in Head Start explains the weight improvements, she said.

But Dr. David Ludwig, a Harvard Medical School pediatrics professor and director of an obesity prevention center at Children’s Hospital Boston, called the results impressive and encouraging despite the limitations.

He said the researchers chose a “very reasonable” alternative study design, and that the results make sense, given the services Head Start programs provide.


Original source: http://www.nytimes.com/aponline/2015/01/12/health/ap-us-med-head-start-obesity-5-things.html?_r=1

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10,000 steps per day? It’s more complicated for kids

Jan. 6, 2015, Fox News

By Tia Ghose

To be healthy, adults should take 10,000 steps per day or at least that’s the popular notion.

For kids, though, the picture is fuzzier. Research on children has lagged behind that of adults, and most common devices that can track a daily step count, such as pedometers and fitness trackers, have not been designed with little ones in mind.

But in the face of high childhood obesity rates and with the advent of increasingly sophisticated fitness trackers, step counters, and other devices more scientists are trying to determine just how many steps little ones should take to stay active.

“We recommend that kids get 60 minutes a day of moderate to vigorous physical activity daily and its fine if children’s activity is broken up throughout the day,” said Dr. Stephen Daniels, the pediatrician in chief at the Children’s Hospital Colorado in Denver. But translating that into a number of steps is difficult.

“For preschoolers, many public health organizations suggest about 3 hours of physical activity at any level,” Daniels said. But before any guidelines on a step count can gain widespread acceptance, scientists need to figure out a way to reliably translate the sometimes-toddling, sometimes-boisterous activity of preschoolers into an ideal step count.

Researchers are beginning to see advantages to giving people a step count to aim for, rather than traditional activity guidelines, which often recommend how much time people should spend exercising.

Step counts have the advantage of being potentially less confusing and subjective than recommendations for “moderate to vigorous physical activity.”

In addition, children tend to get their activity in short bursts, according to a 2007 paper in the Journal of Sports Medicine. And pedometers that can unobtrusively track steps throughout the day could theoretically add up these short stints of activity better than self-reporting could, the researchers hypothesized.

Adult guidelines, such as the now well-known recommendation to take 10,000 steps a day, don’t translate to children. In early attempts to measure children’s step counts, researchers simply tracked children and then assumed that the norm was the ideal, said Timothy Brusseau, a sports physiologist at the University of Utah.

But there are problems: Boys consistently log more steps than girls, and overall, kids are less active than they should be, Brusseau said. Children also tend to log more activity at school (especially during recess and physical education class), and during the weekdays in general, than on weekends, Brusseau has found. But none of these patterns indicate what the ideal activity pattern is for youngsters’ health.

As a result, newer approaches to measuring kids’ activity involve measuring kids activity levels with accelerometers, and then calculating out a step count based on the data, Brusseau said.

It’s even tougher to count steps in the littlest kids, who toddle, move back and forth erratically, and generally have more ambiguous movements to track.

In a study in the January 2015 issue of the journal Preventive Medicine, researchers tracked the activity level and steps of 916 preschool-age kids in Portugal by having the kids wear accelerometers. They found that three hours of physical activity translated roughly to about 9,099 steps per day, and concluded that children who take fewer steps may be considered “insufficiently active.”

In another study, published Dec. 23 in the Journal of Sports Science, researchers looked at 535 Flemish preschoolers and found that 180 minutes of physical activity per day could translate to anywhere from 4,653 steps per day to 13,326 steps per day, depending on how output from the accelerometer was measured.

The researchers noted that kids are more likely than adults to lose, remove, or just not wear their fitness trackers.

However a child’s activity is measured, it’s important for parents to nurture a healthy, active lifestyle early on in children, Brusseau told Live Science.

Most kids are as active as they’ll ever be in elementary school, and their activity level slowly declines until they reach adulthood. Therefore, making sure they’re getting in enough activity from the get-go is a good way to ensure they stay healthy as they grow, Brusseau said.


Original source: http://www.foxnews.com/health/2015/01/06/10000-steps-per-day-it-more-complicated-for-kids/

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Menu calorie counts may mean less fattening meals for kids

Jan. 26, 2014, HealthDay

By Randy Dotinga

Parents might order fewer calories for their children if menus included calorie counts or information on how much walking would be required to burn off the calories in foods, a new study suggests.

The new research also found that mothers and fathers were more likely to say they would encourage their kids to exercise if they saw menus that detailed how many minutes or miles it takes to burn off the calories consumed.

“Our research so far suggests that we may be on to something,” said study lead author Dr. Anthony Viera, director of health care and prevention at the University of North Carolina Gillings School of Global Public Health. New calorie labels “may help adults make meal choices with fewer calories, and the effect may transfer from parent to child.”

Findings from the study were published online Jan. 26 and in the February print issue of the journal Pediatrics.

As many as one in three children and teens in the United States is overweight or obese, according to background information in the study. And, past research has shown that overweight children tend to grow up to be overweight adults. Preventing excess weight in childhood might be a helpful way to prevent weight problems in adults.

Calories from fast food restaurants comprise about one-third of U.S. diets, the researchers noted. So adding caloric information to fast food menus is one possible prevention strategy. Later this year, the federal government will require restaurants with 20 or more locations to post calorie information on menus.

The hope behind including calorie-count information is that if people know how many calories are in their food, it will convince them to make healthier choices. But “the problem with this approach is there is not much convincing data that calorie labeling actually changes ordering behavior,” Viera said.

This prompted the investigators to launch their study to better understand the role played by calorie counts on menus.

The researchers surveyed 1,000 parents of children aged 2 to 17 years. The average age of the children was about 10 years. The parents were asked to look at mock menus and make choices about food they would order for their kids.

Some menus had no calorie or exercise information. Another group of menus only had calorie information. A third group included calories and details about how many minutes a typical adult would have to walk to burn off the calories. The fourth group of menus included information about calories and how many miles it would take to walk them off.

The information about a generic double burger, for instance, noted that it had 390 calories and would require 4.1 miles of walking to be burned off, Viera explained. “Some examples of other menu items were grilled chicken salad (220 calories and 2.3 miles), large french fries (500 calories and 5.2 miles), small chocolate milk shake (440 calories and 4.6 miles), and a large regular cola (310 calories and 3.2 miles),” Viera said.

The researchers found that parents mock-ordered slightly less food, calorie-wise, when their menus included the extra information. With no calorie numbers, they ordered an average of 1,294 calories worth of food for their kids. When calorie or exercise information was included, parents ordered 1,060 to 1,099 calories per meal for their kids, according to the study.

Meanwhile, about 38 percent of parents said they’d be “very likely” to encourage their kids to exercise if they saw labels with information about minutes or miles of activity required to burn off calories. Only 20 percent said they’d be moved to encourage exercise if they just saw calorie numbers alone.

While the study findings suggest that including calorie counts or exercise amounts might prompt parents to order fewer calories per meal for their children, the study has limitations. For one thing, no one actually ordered anything; the study scenario was hypothetical. Also, kids weren’t part of the study, so it didn’t reflect their food preferences and requests.

“There are many factors that come into play such as cost, time pressure, marketing, and the child’s preferences,” Viera said. The hope is that labels with extra information will “provide a simple-to-understand snapshot of calorie content that will make it easier for parents to make healthier choices for themselves and their children in the context of all of these competing factors.”

Lisa Powell is a health researcher and director of the Illinois Prevention Research Center at the University of Illinois at Chicago School of Public Health. She pointed to previous research that found younger children and teens typically consume 126 and 309 extra calories, respectively, on days when they eat fast food.

“Therefore, the results from this study are encouraging,” she said.

“They suggest that menu labeling in physical activity calories equivalents may be a helpful tool to guide parents to order smaller portion sizes or less-energy dense food items in fast food restaurants for their kids. It is important to extend this research to test whether the menu labeling would similarly impact adolescents’ choices since they order and purchase a significant amount of fast food on their own,” she said.

More research is already planned. “Next, we will start examining the effects of this kind of labeling on real world food purchasing and physical activity,” said Viera.

Researchers also want to understand why the most overweight parents appeared to respond more to the labels and order less food for their kids than other parents. “We’re not sure why this is, and it merits further investigation,” Viera said.


Original source: http://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/calorie-counts-on-menus-may-mean-fewer-calories-for-kids-695751.html

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For obesity research, self-reported diet and physical activity data too inaccurate

Jan. 14, 2014, MedicalXpress

By Nicole Wyatt

Asking patients to self-report their nutrition and physical activity is a common data collection method used by obesity investigators. But a newly published expert opinion—signed by leading scientists and led by investigators at the University of Alabama at Birmingham (UAB)—says this often misleading information can lead to disappointing research outcomes.

David B. Allison, PhD, Andrew W. Brown, PhD, and Madeline Jeansonne, MPH, of the UAB Office of Energetics, contributed to the paper “Energy balance measurement: When something is not better than nothing,” which was co-signed by 37 obesity researchers from around the globe and published in the International Journal of Obesity.

The core group of authors argues that self-reported totals of energy intake (EI) and physical activity energy expenditure (PAEE) are regularly used in health research, yet they repeatedly are shown to be so inaccurate that they should be considered unacceptable for scientific research.

Allison, associate dean for Science in the UAB School of Public Health, explains that most of the large-scale nutrition and physical activity surveillance conducted by epidemiologists and the government rely on asking people how much they eat and how active they are, resulting in self-reported energy intake and energy expenditure estimates.

“Using these self-reported values, researchers had concluded for years that individuals with more body mass were eating less food than thinner individuals, which is counterintuitive. Indeed, when using objective, scientific measurements instead of self-reported measurements, it turns out that larger people on average eat more,” Allison said. “Using the flawed self-reported values led to incorrect conclusions about physiology and the etiology of obesity, despite the large quantities of flawed data collected.”

The investigators reviewed previous studies of weight change that relied on self-reported EI and PAEE.

“We went through and looked at some of the strongest evidence that tends to be used to support use of self-reported EI and saw that there was little validity to these methods,” said Brown, a scientist with the Office of Energetics and the Nutrition Obesity Research Center. “Essentially, methods of self-reported energy intake and physical activity are not as accurate as they are assumed to be.”

The authors contend the scientific and medical communities should stop relying on self-reported EI and PAEE and develop objective measures of energy balance.

“Often people have the misconception that more data is better; but if we just have more bad data, we won’t come to correct conclusions,” said Jeansonne, a program coordinator for the UAB Office of Energetics. “Funding for more accurate measurements could give us better advances in knowledge.”

Allison adds that a focus on finding more accurate data collection methods for EI and PAEE could aid in health-related policy, future research, and clinical decisions.

“For too long, our field has accepted self-reported measures of energy intake, despite knowing that they are markedly inaccurate, with the justification being they are the best we have in some circumstances,” Allison said. “Nevertheless, ‘best we have’ and ‘adequate for scientific work’ are two different things.”

The authors say new strategies for objectively determining energy balance are in their infancy, and funding for these objectives and better tools are still needed.


Original source: http://medicalxpress.com/news/2015-01-obesity-self-reported-diet-physical-inaccurate.html


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Texas children outweigh national average

Jan. 29, 2015, KXAN

By Sally Hernandez

Childhood obesity is a growing problem nationwide, especially in Texas. The National Survey of Children’s Health says 32.2 percent of Texas children are overweight or obese. That is higher than the national average. Now, organizations like the YMCA are combating the rise with programs aimed to make children make healthier choices.

The MEND (Mind, Exercise, Nutrition, Do It!) program at the YMCA of Austin has helped nearly 1,000 families with children ages 7-13 learn long-term healthy habits over the last six years. Parents and children attend twice weekly sessions over a 10-week period. Families learn how to play sports, exercise, and develop healthy eating habits.

Seven-year-old Antonio Alvarez fits the profile: a child above his ideal weight. Along with his family, Antonio has just completed the MEND program.

“In the beginning, he would see broccoli and tell me, ‘What is this?’” his mother, Maria Alvarez says in Spanish. Doctors once told her Antonio was borderline diabetic.

Maria says Antonio now turns away unhealthy snacks, telling her he wants to lose weight instead.

The MEND program is not just about learning tips for nutrition; they also emphasize healthier habits and encourage participants to have fun during meetings.

“They came, they learned,” says Missy Quintela, YMCA of Austin program director. “He loved playing the class. We do extra physical activity every single class with the kids and its fun games so they don’t even know that they’re running around and sweating and kind of doing physical activity.”

Families are encouraged not to step on the scale while in the MEND program.

“We don’t want them to think it’s about [losing weight],” Quintela says. “As long as we help them to start getting healthy habits and start changing their routines and learning that it’s OK to go out and do like a soccer game as a family because that’s going to give you extra exercise and that’s how we want to introduce the changes.”

Former Austinite Jessie Pavelka, a trainer on NBC’s The Biggest Loser, says children need to learn to develop healthy habits early in life.

“Let them see you being active. One of the greatest things my parents ever did was let me see them go for runs. They surrounded me with that world and I was really lucky, and I think that’s kind of one of the solutions to this whole childhood obesity thing is … surrounding them with the right environment” Pavelka said.

In 2005, the Texas Legislature passed Senate Bill 42. The bill focuses on health education. As a result, school districts created School Health Advisory Councils. The school district appoints members of the community to ensure students learn healthy habits.

Numbers from the Texas Comptroller’s Office show the number of obese adults in Texas is expected to nearly triple between 1990 and 2030—when many of today’s children will be adults.

The Texas Education Agency and Comptroller’s Office track how healthy students in each district, school, grade, and gender are. Through Reshaping Texas, you can see how school districts across the state compare to others on student health.

FitnessGram numbers show Eanes Independent School District (ISD) has the highest percentage, 79 percent, of students whose Body Mass Index (BMI) falls within the “Healthy Fitness Zone.” Eleven percent of Eanes students fall into the “Some Risk” category, meaning they are at a moderate risk to develop medical problems because of a high BMI. Seventeen percent of students fall into the “High Risk” category to develop medical problems.

Austin ISD falls near the middle: 58 percent of students fall into the “Healthy Fitness Zone” category, 12 percent are at “Some Risk” to develop medical problems, and 30 percent are at “High Risk.”

Luling ISD has the lowest percentage of students in Central Texas districts serving students in kindergarten through 12th grade: 45 percent of Luling students are in the “Healthy Fitness Zone,” 13 percent are at moderate risk for developing health problems, and 42 percent fall into the “High Risk” category for developing problems.


Original source: http://kxan.com/2015/01/29/texas-children-outweigh-national-average/

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