November 2015

SPOTLIGHT

PUBLICATIONS & TOOLS

CHILDHOOD OBESITY RESEARCH & NEWS

Spotlight

Advancing research on youth energy expenditure: Call for article submissions

Oct. 20, 2015, NCCOR

For approximately 25 years, researchers have used the adult Compendium of Physical Activities as a standardized system to code the energy expenditure, or Metabolic Equivalent of Task (MET) intensity, of adult physical activities. Until recently, those interested in studying youth often relied on the adult Compendium and adult MET values as a proxy for youth values. However, the resting metabolic rate and activity energy expenditure are different in youth than in adults and can vary significantly across ages as youth mature physically and improve motor skills. Therefore, an updated, comprehensive youth Compendium is needed to expand on this previous work.

The National Collaborative on Childhood Obesity Research invites investigators to contribute original research articles that will directly inform the further development of a Youth Compendium of Physical Activities. Articles will be published in a special, open-access supplemental issue of the Journal of Physical Activity and Health in 2016. The deadline for submissions is Dec. 21, 2015.

Investigators who have conducted research measuring the energy cost of physical activities in children aged 2 to 18 years are invited to submit a brief manuscript on topics that include, but are not limited to, the energy cost of:

  • Playground activities (including games like 4-corners, hopscotch, or free play)
  • Youth sports (e.g., soccer, basketball, baseball, kickball, dodgeball)
  • Outdoor activities (e.g., bicycling [not ergometer], scooter/skateboard riding)
  • School activities
  • Household activities

Compiling a comprehensive and standardized list of the measured energy cost of youth activities will provide significant value to the assessment of youth energy expenditure and contribute to the development of intervention strategies to improve youth health and reduce childhood obesity.

For further details, please visit: http://ow.ly/TtQP5.

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Original source: https://www.nccor.org/blog/advancing-research-on-youth-energy-expenditure-call-for-article-submissions/

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NCCOR seeks input on datasets to include in the Catalogue of Surveillance Systems

Nov. 9, 2015, NCCOR

The National Collaborative on Childhood Obesity Research (NCCOR) is seeking recommendations for datasets to be considered for inclusion in its Catalogue of Surveillance Systems, a tool that provides one-stop access to more than 100 publicly available data sources relevant to childhood obesity research.

The Catalogue aims to increase efficiency, effectiveness, and innovation in obesity research by enabling researchers to:

  • Identify data resources related to childhood obesity
  • Compare attributes across systems
  • Link to other resources of interest

Datasets in the Catalogue include information on obesity-related health behaviors, outcomes, and determinants as well as policies and environmental factors.

To be included, surveillance systems must: be relevant to childhood obesity research; provide access to publicly available raw data gathered in the United States; and provide access to data that has been released in the past 10 years.

To submit your suggestions, please visit https://www.nccor.org/nccor-tools/catalogue/feedback.

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Original source: https://www.nccor.org/blog/nccor-seeks-input-on-datasets-to-include-in-the-catalogue-of-surveillance-systems/

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Publications & Tools

New report on health-related practices in U.S. secondary schools

The nation’s secondary schools have made substantial improvements in the foods and beverages offered, but little improvement in promoting physical activity. The findings were released in a comprehensive report by Bridging the Gap. The report examines secondary school policies and practices related to nutrition, physical activity, and obesity prevention among students in grades 8, 10, and 12.

VIEW THE REPORT

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Preliminary data on Farm to School efforts show significant benefits

Farm to School Census data for school year 2013-2014 indicate strong farm to school programs can increase the number of students purchasing school breakfast and lunch, improve consumption of healthier foods at school, and reduce plate waste. Census data also indicate that schools purchased nearly $600 million worth of food locally in school year 2013-2014, a 55 percent increase over school year 2011-2012 when the first Farm to School Census was conducted.

VIEW THE PRELIMINARY RESULTS

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New tool examines health impacts of transportation systems

The recently developed Transportation and Health Tool enables practitioners to examine the health impacts of transportation systems. The tool was launched by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Transportation (DOT) in partnership with the American Public Health Association.

VIEW THE TOOL

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Childhood Obesity Research & News

Study links sugar to conditions that lead to diabetes, heart disease in children

Oct. 27, 2015, The Wall Street Journal

By Betsy McKay and Mike Esterl

Researchers offered new evidence Tuesday linking sugar consumption with conditions that can lead to diabetes and heart disease in children, fueling the debate over the causes of health problems related to obesity.

The study was designed to isolate the effect of added sugar in particular, as opposed to calories.

Researchers from the University of California, San Francisco, and Touro University California took soda, pastries, sugary cereals and other foods and beverages sweetened with added sugar away from 43 Latino and African-American children and teens for nine days. They replaced those foods with pizza, baked potato chips, and other starchy processed foods.

The children were patients at a UCSF obesity clinic who had symptoms of metabolic syndrome, a cluster of conditions such as high cholesterol that can lead to diabetes. The change reduced sugar in their diets to 10% of overall calories from 28%, the researchers said.

Despite the short period of time and a diet still heavy on processed food, the researchers said they found striking results. The children’s cholesterol and other lipid levels improved, and their insulin levels dropped, they said.

“We reversed virtually every aspect of their metabolic syndrome,” said Robert Lustig, a pediatric endocrinologist at UCSF Benioff Children’s Hospital San Francisco and lead author of the paper, published Tuesday in the journal Obesity. Of note, he said, triglycerides, high levels of which can contribute to a hardening of the artery walls and cause acute pancreatitis, showed a “very, very large improvement.”

The results are in keeping with Dr. Lustig’s long-held belief that sugar—specifically fructose, one of its components—stands out as a culprit in the obesity epidemic. Added sugar causes metabolic problems in the liver, interfering with the normal mechanisms that keep people from overeating, he says.

His provocative views have led him to clash with food and beverage makers, who argue that obesity is the result of excess calories overall and too little exercise, and that sugar should not be singled out.

The Grocery Manufacturers Association, which represents food and beverage companies, questioned the study’s size and said because it focused on individuals with metabolic disorders, it is “irresponsible” to generalize results to the entire U.S. population.

“The broad conclusions and policy recommendations in this study only serve to further the author’s policy agenda without a sufficient scientific foundation,” said Leon Bruner, the group’s chief science officer.

The American Beverage Association, which represents beverage companies including Coca-Cola Co. and PepsiCo Inc., said the study didn’t demonstrate causation. “That’s the problem with studies like this. They raise an alarm without the proof,’’ said William Dermody, the association’s vice president of policy. “There’s nothing unique” about sugars or the calories in sugary products, he added.

Some other researchers who study the effects of sugar on health praised the study. But they said more research is needed. The study didn’t have a control group of children, noted David Ludwig, director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital. “Because of the study’s design, we can’t be completely certain that the changes are fully attributable to changes in sugar intake,” said Dr. Ludwig. “It’s possible that other aspects of the diet or lifestyle changed.”

Still, he called the study “an interesting and useful step forward in assessing the effects of added sugar in children.”

Health authorities in the U.S. and elsewhere increasingly are targeting sugar. The World Health Organization recommended in March that adults and children cut sugar to less than 10% of their daily caloric intake. In July the Food and Drug Administration proposed that U.S. nutrition labels list added sugar amounts and a recommended maximum daily sugar intake of 200 calories—40 fewer calories than a 20-ounce Coca-Cola. Voters in Berkeley, Calif., in November approved a sugary drink tax, becoming the first U.S. city to pass such a measure.

Consumers also are backing away. In a nine-country survey this summer by Euromonitor International, 41% of respondents said they looked for limited or no added sugar on food labels. In the U.S., 71% said they were concerned about the amount of sugar they consumed, according to a March survey by the International Food Information Council. U.S. soda consumption has declined for 10 straight years.

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Original source: http://www.wsj.com/articles/study-links-sugar-to-conditions-that-lead-to-diabetes-heart-disease-in-children-1445938753

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Schools report varying results in their efforts to comply with nutrition guidelines

Oct. 6, 2015, The New York Times

By Ron Nixon

As students lined up for lunch at the Washington Technology Magnet School cafeteria here on a recent late morning, taco pizza was available along with the fresh fruits and vegetables.

Angie Gaszak, a school system nutritionist, said the school tries to offer a mix. “We want to make sure they eat healthy, but we also want to serve things that they will eat,” Ms. Gaszak said.

It is a balance that is hard to achieve as school systems try to comply with legislation signed in 2010 by President Obama that required schools to update their nutritional standards to cut back on sugar and sodium in foods and add more fruit and vegetables for the 30 million children they serve. Michelle Obama, the first lady, championed the law as part of her “Let’s Move!” campaign.

In some schools, fewer children are participating in the school meals program and food waste is increasing because students are not eating the healthier alternatives. The schools have asked Congress to delay some of the rules, a move that some public health advocates, school officials and even former military officials say would set back efforts to fight childhood obesity. According to the Centers for Disease Control and Prevention, about 12.7 million children and adolescents, about 17 percent of American children, are overweight.

Jessica Donze Black, a child nutrition expert at the Pew Charitable Trust, said that making sure children eat healthier at school is crucial to reducing obesity.

“When you consider that a significant number of students are overweight or obese, the new guidelines are a vital step in helping make kids healthier,” she said.

Although a number of studies have shown that the revised menus are working to reduce the obesity trends, the new school lunch regulations have been a source of criticism from some Republican lawmakers and school officials who say the healthier meals are not appetizing to children and are also driving up costs for schools by requiring them to buy new equipment and more expensive items like fresh produce.

Tom Vilsack, the agriculture secretary, acknowledges that some schools are struggling to meet the new standards. But Mr. Vilsack said Agriculture Department data showed that the new school nutrition standards were being met by over 95 percent of schools.

“There are just a small number of schools that aren’t meeting the standards, and we are working to help them,” he said in an interview.

The Agriculture Department is helping schools meet the standards by partnering schools that are doing well with those that are not. In addition, Mr. Vilsack said the department had provided $98 million to help schools buy equipment and pay for training. But the latest data from the Agriculture Department show that about $28 million of the money remains unspent. It is unclear why states are not spending money, he said.

Jean Ronnei, chief operations officer for the St. Paul Public Schools, said the money provided by the Agriculture Department was “just a drop in the bucket.”

“It looks like it’s a lot,” she said, “but when you look at the amounts available to schools across the country, it’s just not enough to cover all the new costs we have as a result of these new regulations. We have lost money and could be forced to cut into education funds to cover meal program losses.”

Ms. Ronnei said the St. Paul schools had long prided themselves on providing healthy meals, including fresh fruit and vegetables, for their students. The district also worked with food companies to come up with foods with less salt and sugar.

“We want to see our kids eat better, and I think we’ve shown that,” she said. “But these rules have given us less options, less choice and less creativity in what we do.”

Ms. Ronnei is also president of the School Nutrition Association, which represents food service workers at school districts around the country and gets the majority of its funding from food companies.

Chief among her complaints are the final sodium reductions set by the Obama administration, which school nutritionists like Ms. Gaszak say are virtually impossible to meet.

Ms. Gaszak said schools in the St. Paul system would have to remove common items like banana peppers and pickles from their menus. A mandarin chicken salad the school previously served, which was popular with students, has already been dropped because the salad dressing was high in sodium.

“Schools are committed to reducing the sodium in school meals and snacks, but the later sodium reduction mandates are unrealistic for schools, let alone families,” Ms. Ronnei said.

In Congress, several lawmakers have introduced legislation that would prevent the Agriculture Department from requiring sodium reductions in school meals below the current level, which took effect in July 2014, but it is unclear when those measures will come to a vote.

Not all schools are struggling to meet the new guidelines.

In Elbert County, Ga., Bridgette Matthews, the school nutrition director, said the five schools in her district serving 3,100 students had been able to meet the requirements while still getting children to eat the new foods. What is more, she said, the school has not seen a drop in participation.

The key in her district, Ms. Matthews said, is that food workers have learned to balance healthy foods with those that children are used to eating and still stay within the guidelines.

“The sodium levels, for example, are weekly averages so you can serve something with somewhat high sodium one day and come back and balance that out with something with less sodium,” she said. “It’s a matter of playing with the menu.”

Amy Droegemeier, director of student nutrition at the Unified School District 232 in De Soto, Kan., said her district of 7,000 students had found success by working with food manufacturers. Ms. Droegemeier said her district had not had a decline in students in the meal programs.

“We worked with one of our manufacturers to come up with a different breadstick that meets the new health guidelines while also meeting the high expectations of our kids,” she said. “No one is saying that it’s easy. There is short-term pain, but it can be done without delaying the rules.”

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Original source: http://www.nytimes.com/2015/10/07/us/politics/schools-report-varying-results-in-their-efforts-to-comply-with-nutrition-guidelines.html

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Testimony on U.S. nutrition guidelines reflects a complex debate

Oct. 7, 2015, The New York Times

By Christine Hauser

Many Americans struggle with questions over what makes a healthy diet: skim or whole milk? Lean meat or no meat at all? Is there such a thing as “good fat”?

Amid a national conversation about high rates of diabetes, obesity and heart disease, uncertainty over what to eat has unnerved many Americans trying to sift through marketing and dieting trends.

The latest tussle over the next edition of the government’s nutrition guidelines may not help much.

Federal officials and experts are drawing up the 2015 Dietary Guidelines, a series of recommendations updated every five years that will be released in December.

The guidelines are meant to be used as general recommendations for what to put on your plate, but they also affect policies on school lunches, food stamps and other issues.

A congressional committee veered on Wednesday from health to politics, highlighting worries that what ends up on American tables could be affected by special interest groups, environmental concerns and private sector bias as much as by science.

In his opening remarks, the chairman of the House Committee on Agriculture, Representative K. Michael Conaway, Republican of Texas, noted that the heightened public interest in the guidelines was evident from more than 29,000 comments related to an advisory report that is to be partly used to draft them.

Mr. Conaway urged Agriculture Secretary Tom Vilsack and Sylvia Mathews Burwell, the secretary of health and human services, during the testimony to be transparent about the science behind the recommendations, especially “at a time when consumers are already subjected to conflicting and often contradictory nutrition and health information.”

Take butter and eggs. During testimony, Representative Collin C. Peterson, Democrat of Minnesota, said Americans were once told they were bad for you and now they were O.K. “People may be losing confidence in these guidelines,” he said. Others mentioned a debate over whole versus low¬fat milk.

Mr. Vilsack and Ms. Burwell said factors such as sodium consumption and cholesterol were part of the conversation while drafting the latest guidelines. “The reality is that science changes,” Mr. Vilsack said.

“All of this is evolving,” he said added later.

The more than 500-page advisory report, released in February, repeated some recommendations from the 2010 guidelines.

It said Americans should be encouraged to eat a diet rich in vegetables, fruit, whole grains, seafood, beans and nuts, with a moderate intake of low and nonfat dairy products and alcohol, and a lower intake of red and processed meat, as well as sugar-sweetened items.

In a blog post published before their testimony on Wednesday, Mr. Vilsack and Ms. Burwell said the 2015 guidelines would be similar in many respects to those of past years, saying lean meats and low-fat dairy items were among “building blocks of a healthy lifestyle.”

But during his testimony Mr. Vilsack gave no further insight into what the final guidelines would say, or how, if at all, any recommendations would be modified. He emphasized that the guidelines were still a work in progress; the advisory report would help inform rather than dictate a drafting process that would still bring in interdepartmental opinions, the public comments, other experts and scientific studies.

The testimony reflected how political and controversial the food industry has become. The 2015 guidelines have been preceded by sugar and meat industry lobbying, as well as accusations that the panel behind the advisory report was using outdated science and was overly critical of high¬fat, lowcarbohydrate diets, as an article in Fortune noted.

In a petition on Change.org directed at Mr. Vilsack and Ms. Burwell, the North American Meat Institute criticized the advisory report: “We believe the dietitians and nutritionists who make up the committee overstepped their bounds by not focusing on nutrition and instead wandering into environmental issues. In fact, we believe that processed meat products are sustainable because they limit spoilage and waste.”

But Mr. Vilsack and Ms. Burwell said on Wednesday that the drafting of the 2015 guidelines should not include a policy conversation about sustainability, which evaluates the environmental impact of a food source.

Mr. Vilsack also said there was some indication that childhood obesity rates were plateauing or slightly declining. “But we still have work to do,” he added. “This is not about treating disease,” Mr. Vilsack said of the guidelines. “This is about how to prevent chronic diseases.”

Social media reaction to the testimony and the guideline drafting process reflected the politics of the American diet.

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Original source: http://www.nytimes.com/2015/10/08/us/testimony-on-us-nutrition-guidelines-reflects-a-complex-debate.html

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Child care's role in fight against obesity

Oct. 9, 2015, MedicalXpress

By Daniel P. Jones and Beth Krane

Policy changes are needed to address childhood obesity in child care settings and help child care providers to reinforce healthy eating and physical activity, according to new research from the University of Connecticut.

In six studies published today in a special section of the journal Childhood Obesity, titled “Wellness Promotion in Child Care: Evidence to Action;” the UConn researchers offer a variety of recommendations to improve child care policies and practices in order to curb childhood obesity.

Because many young children spend more time in child-care settings than any other place except home, child care is an important opportunity to influence young children’s diets and physical activity.

“The findings from these studies inform how out-of-home child care providers can work together with families to reinforce healthy eating and physical activity,” says Marlene Schwartz, a professor of human development and family studies who is an author on two of the studies and director of the UConn Rudd Center for Food Policy & Obesity.

Five of the six studies identified areas for improvement, and barriers to making progress on healthy diets and adequate physical activity levels in child-care settings. According to the findings of the new research, the following types of support are needed to help child-care providers improve diets and increase physical activity among young children:

 

  • Parent outreach, staff training, funding, space and equipment for physical activity, modifying cultural norms about child feeding and physical activity that are not consistent with a healthy lifestyle, and
  • Assistance with strategies to decrease levels of saturated fat and sodium in meals served in childcare settings, and increase levels of whole grains in the meals served.

 

Two of the studies examined strategies to improve dietary intake, identifying promising approaches to:

 

  • Increase child preferences for healthy foods, and
  • Improve the healthfulness of meals in child-care centers.

 

One of the studies reported findings about a promising new tool to determine what preschoolers actually consume, identify those at risk of poor nutrition, and better inform child-care interventions to promote healthy eating habits.

“Collectively, the articles encourage policymakers to see [early care and education] as a critical partner in the fight against childhood obesity, and represent the current challenges and opportunities to promote nutritious eating and physical activity in young children,” says Myra Jones-Taylor, commissioner of the Connecticut Office of Early Childhood, who contributed an editorial to the journal issue in which the studies are published.“Through smart policy and education of children, providers, families, and policy makers, we can not only address childhood obesity, but help set the stage for healthier adults later on in life.”

Kim Gans, a professor of human development and family studies and a co-author on one of the studies, says the articles highlight the importance of considering the unique needs of different child-care settings, such as family child-care homes, Spanish-speaking providers, and rural providers, when crafting policies and translating them into practice.

Gans has an active National Heart Lung and Blood Institute (NHLBI) grant to help home-based child-care providers in Rhode Island improve the nutrition and physical activity environments of their homes.

“While improved policies are needed to facilitate childhood obesity prevention in child-care settings, there are many different types of child-care settings and one size does not fit all,” she says.

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Original source: http://medicalxpress.com/news/2015-10-child-role-obesity.html

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