August 2009





Weight of the Nation Conference Exceeds First-Year Expectations

Aug. 5, 2009, NCCOR

Childhood obesity “is the number one public health problem in the country, putting the younger generation at risk of being the first in the history of our country to have a shorter lifespan than their parents,” former president Bill Clinton told attendees of the first Weight of the Nation (WON) Conference.

Clinton, representing the Alliance for a Healthier Generation, spoke at the three-day conference, which served as the first gathering on obesity organized by the Centers for Disease Control and Prevention (CDC).

Not including guests and press staff, 1127 attendees participated.

“The CDC expected approximately 600 attendees to the inaugural event but to our delight, this estimate was exceeded by nearly double,” said Laura Kettel Khan, MIM, Ph.D., and senior scientist within CDC’s Division of Nutrition, Physical Activity and Obesity.

Via presentations and panels, experts at the conference stressed that Americans need to change the way they live if they want to beat the obesity epidemic that is robbing the United States of millions of dollars every year and threatening a generation with shorter lives.

Two-thirds of U.S. adults are now overweight or obese, and the rising rate of obesity in the United States has had a debilitating effect on healthcare spending, not to mention on health.

CDC officials outlined two dozen steps – ranging from banning televisions from children’s bedrooms to making it easier for people to buy fresh food – to help beat obesity and bring down related medical costs, which have nearly doubled since 1998.

NCCOR Reception fuels discussion

The National Collaborative on Childhood Obesity Research (NCCOR) – a collaborative between CDC, the National Institutes of Health (NIH), and the Robert Wood Johnson Foundation (RWJF) – hosted a private evening reception on the second day of the WON Conference.

Addressing the U.S. childhood obesity problem, NCCOR aims to improve the efficiency, effectiveness and application of childhood obesity research and to halt—and reverse—the U.S. childhood obesity problem through enhanced coordination and collaboration.

With leaders in government, professional associations, and nonprofit organizations present, the event allowed NCCOR members to engage attendees in the four areas of need that NCCOR focuses: 1) common measures and methods; 2) evaluating and identifying effective interventions; 3) rapid assessment of promising policies and environmental changes; and, 4) faster application to speed progress.

“The reception was a great success, attended by key researchers, including many nationally and internationally known scientists and administrators,” said Denise Simons-Morton, M.D., Ph.D, and senior scientific advisor at the National Heart, Lung, and Blood Institute.

Simons-Morton was one of four NCCOR members who gave brief presentations on NCCOR’s mission and range of planned activities over the next several years.

“There were numerous questions and comments, indicating support and interest for our future work,” she said.

Administration vows to tackle problem

Concurring with the Conference’s take-home points, Health and Human Services Secretary Kathleen Sebelius said that a national focus on childhood obesity is “overdue.”

She said the administration, including first lady Michelle Obama, plans to take on the health of children. Currently about one-third of kids are overweight or obese, putting them at risk for type 2 diabetes, high blood pressure, sleep apnea, asthma, depression and a whole host of other health problems that used to predominantly be thought of as adult conditions.

“We are killing ourselves, and more importantly, we are killing our children,” Sebelius said, citing that changes need to be made in schools and communities across the country.

“Some say kids won’t eat healthy foods. I don’t think that’s the case,” Sebelius said. She pointed out that half the kids at one school in California eat at the salad bar because they like the fresh produce rather than “vegetables that looked like they have been saved for a month or so.”

And there are too many schools that don’t offer physical education or even recess, she said. “That’s not only bad for their health, but bad for their minds.”

Sebelius said that the government needs to start offering healthier meals in public schools, child care centers, recreation centers and other government institutions. She also stressed that they need to be served at prices people can afford.

The secretary also advocated building more supermarkets that serve fresh produce in both urban and rural areas so that consumers have easier access to fruits and vegetables. She added that a study showed that “the amount of fruits and vegetables eaten in African-American neighborhoods went up by a third for each supermarket” built in those areas.

“This isn’t rocket science,” she said. “People want to eat healthy diets, but they tend to eat whatever’s convenient and affordable. If we want to reduce obesity, we need to make eating fruits and vegetables convenient and affordable for all Americans.”

Obesity a top cause of rising medical costs

Eleven years ago, the medical costs associated with obesity were at around 78 billion dollars a year; in 2006, they had climbed to around 147 billion dollars annually, a study lead-authored by Eric Finkelstein, Ph.D., showed.

The steep rise in medical costs was blamed on obesity, which “raises your risk for many health conditions,” said Finkelstein who gave a cost-burden presentation at the WON Conference. A normal-weight person’s annual healthcare expenditures are around 41 percent lower than those of obese individuals, he said.

“The normal weight individual will spend around $3,400 per year in medical expenditures and that rises to around $4,870 if that individual is obese,” said Finkelstein.

The bulk of obesity-related medical spending is not linked to clinical procedures such as bariatric surgery to ward off overeating, but rather to treating diseases caused by obesity, such as diabetes.

“Obesity is costly … the only way to show real savings in health expenditures in the future is through efforts to reduce obesity and related health conditions,” Finkelstein said.

“Obesity is a public health issue that cannot be dealt with entirely in the confines of a medical office,” Clinton told the conference.

“We have to change what goes on in our homes, in our communities, in our schools,” he said. William Dietz, director of the CDC DNPAO, told a group of schoolchildren from Pennsylvania that 65 percent of U.S. children have a television in their bedroom.

Television sets should be banned from the bedroom and youngsters encouraged to be physically active instead, he said.

Only one of the kids had a T.V. in their bedroom, none of them liked the idea of taxing soft drinks, but, then again, none was overweight or obese.


Original Sources:
1) AFP, K. Zeitvogel, 7/27/09, “Americans Need Lifestyle Change to Fight the Fat: Experts,”

2) RTTNews, Staff, 7/28/09, “Sebelius Stresses Preventing Childhood Obesity at CDC Conference,”

3) USA Today, N. Hellmich, 7/28/09, “Sebelius: Focus on Childhood Obesity ‘Overdue,'”

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Childhood Obesity Research Poll Shows Environment, Physical Activity Matter

July 29, 2009, Robert Wood Johnson Foundation News

Recently, the Robert Wood Johnson Foundation asked Web site visitors and subscribers to choose the most influential childhood obesity research for the past year. The results are in, and the five articles receiving the most votes demonstrate the perceived importance of environment.

The article receiving the most votes, “Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity,” indicated that adolescents with fast-food restaurants within one half mile of schools were more likely to be overweight or obese and less likely to consume fruits and vegetables. Two other articles in the top five emphasized the need to explore approaches for improving the availability and access to healthy eating options within school and neighborhood environments, while two more highlighted the importance of physical activity for prevention.

In particular, the article receiving the fifth highest number of votes, “Cost Effectiveness of Community-Based Physical Activity Interventions,” found that four types of community-based physical activity programs were cost-effective, reduced new cases of certain chronic diseases, and improved the quality of life. This article also won the 2009 Centers for Disease Control and Prevention Shepard Award for Best Paper in Prevention and Control.

The top five articles with the highest number of votes (in descending order) are:

1) Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity

2) Influences of Physical and Social Neighborhood Environments on Children’s Physical Activity and Obesity

3) Association between School Food Environment and Practices and Body Mass Index of U.S. Public School Children

4) Creating Healthy Food and Eating Environments: Policy and Environmental Approaches

5) Cost Effectiveness of Community-Based Physical Activity Interventions

Many thanks to everyone who voted.

Over 900 people cast votes in the selection of the most influential childhood obesity articles from a list of 20. Voters came from all 50 states, the District of Columbia, and Puerto Rico. The largest percentage of voters was from California (16.8 percent); followed by Texas (5.5 percent); and Connecticut (4.4 percent). Thirty-one percent of voters were academics while the remaining voters represented nonprofits or associations, government, health institutions, health providers, foundations and the media.

Read the five articles above, as well as other nominated articles, here.


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Publications & Tools

Report Finds Obesity Epidemic Increases, Mississippi Weighs in as Heaviest State

July 1, 2009, RWJF Childhood Obesity News Digest

Adult obesity rates increased in 23 states and did not decrease in a single state in the past year, according to F as in Fat: How Obesity Policies Are Failing in America 2009, a report released by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). In addition, the percentage of obese and overweight children is at or above 30 percent in 30 states.

“Our health care costs have grown along with our waist lines,” said Jeff Levi, Ph.D., executive director of TFAH. “The obesity epidemic is a big contributor to the skyrocketing health care costs in the United States. How are we going to compete with the rest of the world if our economy and workforce are weighed down by bad health?”

View the executive summary and full report.

Mississippi had the highest rate of adult obesity at 32.5 percent, making it the fifth year in a row that the state topped the list. Four states now have rates above 30 percent, including Mississippi, West Virginia (31.2 percent), Alabama (31.1 percent) and Tennessee (30.2 percent). Eight of the 10 states with the highest percentage of obese adults are in the South. Colorado continued to have the lowest percentage of obese adults at 18.9 percent.

Adult obesity rates now exceed 25 percent in 31 states and exceed 20 percent in 49 states and Washington, D.C. Two-thirds of American adults are either obese or overweight. In 1991, no state had an obesity rate above 20 percent. In 1980, the national average for adult obesity was 15 percent. Sixteen states experienced an increase for the second year in a row, and 11 states experienced an increase for the third straight year.

Mississippi also had the highest rate of obese and overweight children (ages 10 to 17) at 44.4 percent. Minnesota and Utah had the lowest rate at 23.1 percent. Eight of the 10 states with the highest rates of obese and overweight children are in the South. Childhood obesity rates have more than tripled since 1980.

“Reversing the childhood obesity epidemic is a critical ingredient for delivering a healthier population and making health reform work,” said Risa Lavizzo-Mourey, M.D., M.B.A., RWJF president and CEO. “If we can prevent the current generation of young people from developing the serious and costly chronic conditions related to obesity, we can not only improve health and quality of life, but we can also save billions of dollars and make our health care systems more efficient and sustainable.”

The F as in Fat report contains rankings of state obesity rates and a review of federal and state government policies aimed at reducing or preventing obesity. Some additional key findings from F as in Fat 2009 include:

  • The current economic crisis could exacerbate the obesity epidemic. Food prices, particularly for more nutritious foods, are expected to rise, making it more difficult for families to eat healthy foods. At the same time, safety-net programs and services are becoming increasingly overextended as the numbers of unemployed, uninsured and underinsured continue to grow. In addition, due to the strain of the recession, rates of depression, anxiety and stress, which are linked to obesity for many individuals, also are increasing.
  • Nineteen states now have nutritional standards for school lunches, breakfasts and snacks that are stricter than current USDA requirements. Five years ago, only four states had legislation requiring stricter standards.
  • Twenty-seven states have nutritional standards for competitive foods sold a la carte, in vending machines, in school stores or in school bake sales. Five years ago, only six states had nutritional standards for competitive foods.
  • Twenty states have passed requirements for body mass index (BMI) screenings of children and adolescents or have passed legislation requiring other forms of weight-related assessments in schools. Five years ago, only four states had passed screening requirements.
  • A recent analysis commissioned by TFAH found that the Baby Boomer generation has a higher rate of obesity compared with previous generations. As the Baby Boomer generation ages, obesity-related costs to Medicare and Medicaid are likely to grow significantly because of the large number of people in this population and its high rate of obesity. And, as Baby Boomers become Medicare-eligible, the percentage of obese adults age 65 and older could increase significantly. Estimates of the increase in percentage of obese adults range from 5.2 percent in New York to 16.3 percent in Alabama.

Key report recommendations for addressing childhood obesity within health reform include:

  • Ensuring every adult and child has access to coverage for preventive medical services, including nutrition and obesity counseling and screening for obesity-related diseases, such as type 2 diabetes; and
  • Increasing the number of programs available in communities, schools, and childcare settings that help make nutritious foods more affordable and accessible and provide safe and healthy places for people to engage in physical activity.

The report also calls for a National Strategy to Combat Obesity that would define roles and responsibilities for federal, state and local governments and promote collaboration among businesses, communities, schools and families. It would seek to advance policies that

  • Provide healthy foods and beverages to students at schools;
  • Increase the availability of affordable healthy foods in all communities;
  • Increase the frequency, intensity, and duration of physical activity at school;
  • Improve access to safe and healthy places to live, work, learn, and play;
  • Limit screen time; and
  • Encourage employers to provide workplace wellness programs.

State-by-state obese and overweight children ages 10-17 rankings

Note: 1 = Highest rate of childhood overweight, 51 = lowest. Rankings are based on the National Survey of Children’s Health, a phone survey of parents with children ages 10-17 conducted in 2007 by the U.S. Department of Health and Human Services. Additional information about methodologies and confidence intervals is available in the report. Children with a body mass index, a calculation based on weight and height ratios, at or above the 95th percentile for their age are considered obese and children at or above the 85th percentile are considered overweight. States with statistically significant (p < 0.05) increases in combined obesity and overweight since the NSCH was last issued in 2003 are noted with an asterisk (*).

1. Mississippi* (44.4%); 2. Arkansas (37.5%); 3. Georgia (37.3%); 4. Kentucky (37.1%) 5. Tennessee (36.5%) 6. Alabama (36.1%); 7. Louisiana (35.9%); 8. West Virginia (35.5%); 9. District of Columbia (35.4%); 10. Illinois (34.9%); 11. Nevada* (34.2%); 12. Alaska (33.9%); 13. South Carolina (33.7%); 14. North Carolina (33.5%); 15. Ohio (33.3%); 16. Delaware (33.2%); 17. Florida (33.1%); 18. New York (32.9%); 19. New Mexico (32.7%) 20. Texas (32.2%) 21. Nebraska (31.5%); 22. Kansas (31.1%); 23. (tie) Missouri (31.0%) and New Jersey (31.0%) and Virginia (31.0%); 26. (tie) Arizona (30.6%) and Michigan (30.6%); 28. California (30.5%); 29. Rhode Island (30.1%); 30. Massachusetts (30.0%) 31. Indiana (29.9%) 32. Pennsylvania (29.7%); 33. (tie) Oklahoma (29.5%) and Washington (29.5%); 35. New Hampshire (29.4%); 36. Maryland (28.8%); 37. Hawaii (28.5%); 38. South Dakota (28.4%); 39. Maine (28.2%); 40. Wisconsin (27.9%); 41. Idaho (27.5%); 42. Colorado (27.2%); 43. Vermont (26.7%); 44. Iowa (26.5%); 45. (tie) Connecticut (25.7%) and North Dakota (25.7%) and Wyoming (25.7%); 48. Montana (25.6%); 49. Oregon (24.3%); 50. (tie) Minnesota (23.1%) and Utah (23.1%)


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School Meal Program Participation and Its Association with Dietary Patterns and Childhood Obesity

July 2009, USDA Contractor and Cooperator Report No. 55

ABSTRACT: This study used data from the School Nutrition Dietary Assessment III Study to examine the dietary patterns of school meal program participants and nonparticipants and the relationship between school meal participation and children’s Body Mass Index (BMI). School Breakfast Program (SBP) participants ate more low-nutrient energy-dense (LNED) baked goods and more calories at breakfast than did nonparticipants. National School Lunch Program (NSLP) participants had lower intake of sugar-sweetened beverages and a lower percentage of calories from LNED foods and beverages than did nonparticipants. Overall, NSLP participation was not significantly related to students’ BMI, although participants were less likely to be overweight or obese than nonparticipants among black students but more likely to be so among “other race” students. SBP participants had significantly lower BMI than did nonparticipants, possibly because SBP participants are more likely to eat breakfast and eat more at breakfast, spreading calorie intake more evenly over the course of the day.


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New York City Department of Health and Mental Hygiene. Childhood Obesity Is a Serious Concern in New York City: Higher Levels of Fitness Associated with Better Academic Performance. NYC Vital Signs, 2009;8(1).

To better understand the prevalence of childhood obesity and how physical fitness may be associated with academic performance in New York City, the NYC Department of Health and Mental Hygiene and the NYC Department of Education reviewed academic and fitness records of public school students in grades K-8 who participated in the NYC FITNESSGRAM program during the 2007–08 school year. The results of this study will be used to inform strategies to continue raising student achievement levels. Page four provides recommendations for improving student wellness through increased physical activity and improved nutrition.


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Childhood Obesity Research & News

Cholesterol Drugs Recommended for Some 8-year-olds

July 7, 2009, Associated Press

By Lindsey Tanner
AP Medical Writer

For the first time, an influential doctors group is recommending that some children as young as age 8 be given cholesterol-fighting drugs to ward off future heart problems.

It is the strongest guidance ever given on the issue by the American Academy of Pediatrics, which released its new guidelines in early July. The academy also recommends low-fat milk for 1-year-olds and wider cholesterol testing.

Dr. Stephen Daniels, of the academy’s nutrition committee, says the new advice is based on mounting evidence showing that damage leading to heart disease, the nation’s leading killer, begins early in life.

It also stems from recent research showing that cholesterol-fighting drugs are generally safe for children, Daniels said.

Several of these drugs are approved for use in children and data show that increasing numbers are using them.

“If we are more aggressive about this in childhood, I think we can have an impact on what happens later in life … and avoid some of these heart attacks and strokes in adulthood,” Daniels said. He has worked as a consultant to Abbott Laboratories and Merck & Co., but not on matters involving their cholesterol drugs.

Drug treatment would generally be targeted for kids at least 8 years old who have too much LDL, the “bad” cholesterol, along with other risky conditions, including obesity and high blood pressure.

For overweight children with too little HDL, the “good” cholesterol, the first course of action should be weight loss, more physical activity and nutritional counseling, the academy says.

Pediatricians should routinely check the cholesterol of children with a family history of inherited cholesterol disease or with parents or grandparents who developed heart disease at an early age, the recommendations say. Screening also is advised for kids whose family history isn’t known and those who are overweight, obese or have other heart disease risk factors.

Screening is recommended sometime after age 2 but no later than age 10, at routine checkups.

The academy’s earlier advice said cholesterol drugs should only be considered in children older than age 10 after they fail to lose weight. Its previous cholesterol screening recommendations also were less specific and did not include targeted ages for beginning testing.

Because obesity is a risk factor for heart disease and often is accompanied by cholesterol problems, the academy recommendations say low-fat milk is appropriate for 1-year-olds “for whom overweight or obesity is a concern.”

Daniels, a pediatrician in the Denver area, agreed that could include virtually all children. But he said doctors may choose to offer the new milk advice only to 1-year-olds who are already overweight or have a family history of heart problems.

The academy has long recommended against reduced-fat milk for children up to age 2 because saturated fats are needed for brain development.

“But now we have the obesity epidemic and people are thinking maybe this isn’t such a good idea,” said Dr. Frank Greer of the University of Wisconsin, co-author of the guidelines report, which appears in the July edition of Pediatrics, the group’s medical journal.

Very young children are increasingly getting fats from sources other than milk and Greer said the updated advice is based on recent research showing no harm from reduced-fat milk in these youngsters.

With one-third of U.S. children overweight and about 17 percent obese, the new recommendations are important, said Dr. Jennifer Li, a Duke University children’s heart specialist.

“We need to do something to stem the tide of childhood obesity,” Li said. Li said that 15 years ago most of her patients with cholesterol problems had an inherited form of cholesterol disease not connected to obesity.

“But now they’re really outnumbered” by overweight kids with cholesterol problems and high blood pressure, she said.

Dr. Elena Fuentes-Afflick, a pediatrics professor at the University of California at San Francisco, also praised the new advice but said some parents think their kids will outgrow obesity and cholesterol problems, and might not take it seriously.

“It’s hard for people to really understand” that those problems in childhood can lead to serious health consequences in adulthood, Fuentes-Afflick said.


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South Carolina Case Looks on Child Obesity as Child Abuse. But Is It?

July 29, 2009, USA Today

By Ron Barnett

Jerri Gray was doing all she could to help her son lose weight, her attorney says. But something had gone terribly wrong for the boy to hit the 555-pound mark by age 14.

Authorities in South Carolina say that what went wrong was Gray’s care and feeding of her son, Alexander Draper. Gray, 49, of Travelers Rest, S.C., was arrested in June and charged with criminal neglect. Alexander is now in foster care.

The case has attracted national attention. With childhood obesity on the rise across the United States, according to the Centers for Disease Control and Prevention, Gray’s attorney says it could open the door to more criminal action against parents whose children have become dangerously overweight.

“If she’s found guilty on those criminal charges, you have set a precedent that opens Pandora’s box,” Grant Varner says. “Where do you go next?”

State courts in Texas, Pennsylvania, New York, New Mexico, Indiana, and California have grappled with the question in recent years, according to a 2008 report published by the Child Welfare League of America.

In all of those cases, except the one in California, courts expanded their state’s legal definition of medical neglect to include morbid obesity and ruled that the children were victims of neglect, the report says. Criminal charges were filed only in the California and Indiana cases, but the parents weren’t sentenced to jail time in either.

What the court can order

The New York case in 2007 involved an adolescent girl who weighed 261 pounds, the report says. The court ordered nutritional counseling, cooking classes and gym workouts. Criminal charges should be a last resort, says Linda Spears, vice president of policy and public affairs for the Child Welfare League of America.

“I think I would draw the line at a place where there are serious health consequences for the child and efforts to work with the family have repeatedly failed,” she says.

What’s more often needed is a structured plan of action that’s accountable to a court, she says.

Most of the time, the health problems tied to childhood obesity don’t become chronic until adulthood, which makes it difficult to charge parents with child abuse, Spears says.

In the South Carolina case, Gray followed nutritional guidelines set for her son by the state Department of Social Services, Varner says, but Alexander apparently got other food on his own while not under his mother’s supervision.

The boy has been placed in foster care, and Varner says he hasn’t been allowed to speak to him. Gray has signed an agreement with a film documentary company for exclusive rights to her story and couldn’t comment for this article, Varner says.

“There’s a strong likelihood that this kid is going to school and could eat whatever he wanted to at school, because you’ve got friends who will help him buy food or will give him their leftovers,” Varner says. “The big question is: What is this kid doing when he’s not in Mom’s care, custody and control?”

Greenville County School District spokesman Oby Lyles declined to comment.

“This is not a case of a mother force-feeding a child,” Varner says. “If she had been holding him down and force-feeding him, sure, I can understand. But she doesn’t have the means to do it. She doesn’t have the money to buy the food to do it.”

Slippery slope ahead?

The case could have ramifications beyond parental control over obesity to other eating disorders, and even other behaviors not related to weight, Varner says.

“What about the parents of every 16-year-old in Beverly Hills who’s too thin? Are they going to start arresting parents because their child is too thin?” he asks.

Jolene Puffer, a personal trainer in Asheville, N.C., says the problem often is parents “loving their kids to death,” especially in low-income families where food is one of the few things they can afford to give their children.

But school officials and doctors are “not sounding the alarm” when they should, she says. Puffer took a local family on as a volunteer project and helped a 16-year-old boy who weighed 434 pounds lose 110 pounds, while his mother lost more than 80 and his sister shed nearly 50.

A social services counselor had recommended that the boy apply for Medicare, which Puffer says could have set him up as a lifelong disability case.

A comparison to drugs

Ron Jones, a corporate wellness expert based in Atlanta and Los Angeles, uses the phrase “child obesity is child abuse” in his promotional materials and says the nation has turned its head the other way when it comes to accepting that concept.

“If you gave your child a drug, you’d be held in the court. But if you kill them with food, that seems to be acceptable,” he says.

The difficulty with prosecuting such cases is that most state laws require that the child’s health be in imminent danger for criminal charges to be filed, and the parent must be capable of helping the child but hasn’t taken the necessary action, says Richard Balnave, a professor at the University of Virginia School of Law.

Obesity, although potentially dangerous, does not generally put a child in imminent danger, he says.

Supreme Court rulings have recognized the right of parents to raise their children how they see fit, Balnave says, but not to the point that the child’s health is endangered.

The arrest warrant in the Gray case alleges that her son’s weight was “serious and threatening to his health” and that she had placed him “at an unreasonable risk of harm.” Virginia Williamson, counsel for the South Carolina Department of Social Services, says her agency sought custody of Alexander “because of information from health care providers that he was at risk of serious harm because his mother was not meeting his medical needs.”

The department “would not take action based on a child’s weight alone,” she says. Gray failed to appear at a family court hearing in which her child was to be turned over to foster care, according to a warrant issued in May.

Police later found her with the boy in Baltimore County, Md., and took her back to South Carolina, where she was released on a $50,000 bond, her attorney says.

Barnett reports for The Greenville (S.C.)


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USDA to Oversee School Snack Food: Senate Ag Chair

July 7, 2009, Reuters

The U.S. Agriculture Department would be given the power to regulate all food sold in schools (including vending machine snacks) when Congress renews child nutrition programs, the chairman of the Senate Agriculture Committee said in early July.

Chairman Tom Harkin said he hopes the committee will start work on legislation to reauthorize school lunch programs in October or November, with a goal to conclude the work by the end of the year.

“I can tell you it won’t be this month,” Harkin told reporters who asked when work would begin. He said precedence must go, for now, to his work on health care reform and on drafting the annual federal spending bills.

Agriculture Committee work on child nutrition will begin with a draft that gives the USDA the authority to oversee all food in schools, so nutrition programs are not “undermined” by junk food in vending machines, Harkin said at a confirmation hearing for the head of the USDA’s nutrition programs.

Earlier this year, Harkin co-sponsored a bill focused on setting nutritional standards for food in school vending machines and stores to combat childhood obesity rates. Kevin Concannon, the Obama administration’s nominee to run USDA’s food and nutrition programs, told Harkin he wants to work with other federal and state agencies to address health issues caused by poor eating habits.

“It’s a cultural thing. We’ve evolved to this over the past 30 or 40 years, and it’s going to take efforts on a number of fronts,” Concannon said.

Roughly 17 percent of school-age children are obese, triple the rate in 1980 and “an epidemic in the United States,” says the Centers for Disease Control and Prevention. Obesity increases the risk of diabetes, heart disease, arthritis and other chronic illnesses. At present, USDA oversees the contents of school lunches and bars the sale of foods with minimal nutritional value, such as soda in the lunchroom. It does not control food sold in a la carte lines or school stores.

Concannon, who ran food stamp and public nutrition programs in Iowa, Maine and Oregon during his career, noted he has seen “pushback” from schools that count on revenue from vending machines to pay for student activities. Concannon also said he wants people who rely on USDA food programs to be able to buy more food from farmers’ markets.

Food stamps, school lunch programs, and other nutritional assistance account for more than $75 billion, or two-thirds of USDA’s annual spending.

One in nine Americans uses food stamps to buy groceries, a record number due to recession and job losses, and more than 30 million children count on USDA-funded school programs for lunch. The Obama administration, which has a goal of eliminating childhood hunger by 2015, proposed a $1 billion a year increase in child nutrition programs but has provided few details of how it would spend the money.

(Reporting by Roberta Rampton; Editing by Walter Bagley)


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Newsom's Fresh Idea: Mandates on Healthier Food

June 9, 2009, San Francisco Chronicle

By Heather Knight

He’s already banned spending city money to buy bottled water and mandated composting citywide. Now, San Francisco Mayor Gavin Newsom is taking on something as basic as water and trash: food. In early July, Newsom issued an executive directive he hopes will dramatically change how San Franciscans eat.

All city departments have six months to conduct an audit of unused land – including empty lots, rooftops, windowsills and median strips – that could be turned into community gardens or farms that could benefit residents, either by working at them or purchasing the fresh produce. Food vendors that contract with the city must offer healthy and sustainable food. All vending machines on city property must also offer healthy options, and farmers’ markets must begin accepting food stamps, although some already do.

The mayor will send an ordinance to the Board of Supervisors within two months mandating that all food served in city jails, hospitals, homeless shelters and community centers be healthy.

And effective immediately, no more runs to the doughnut shop before meetings and conferences held by city workers. Instead, city employees must use guidelines created by the Health Department when ordering food for meetings.

Examples include cutting bagels into halves or quarters so people can take smaller portions and serving vegetables instead of potato chips.

“We have an eating and drinking problem in the United States of America,” Newsom said, adding “it’s impacting our health, and it’s impacting our economy.”

The directives are the product of an “urban-rural roundtable” of food experts from around California convened by Newsom last year. The group was charged with finding ways to get more of the food grown on farms within 200 miles of San Francisco onto the plates of city residents, especially those who depend on government meals.

The idea is to decrease the need to import food, reconnect people to homegrown food rather than processed food, and to provide more options in neighborhoods like Bayview-Hunters Point that lack easy access to grocery stores.

Plan still lacks details

Many of the details have yet to be worked out, including how much it will cost. Newsom bristled when asked how it would be funded because there’s no money to implement the food policy in the budget agreed to by the mayor and the board’s budget committee just last week.

“We have plenty of resources,” he said. “This is not a budget buster.”

Supervisor Ross Mirkarimi, a member of the budget committee, said he likes the idea – and in fact, supervisors have been calling for the creation of an urban farm in San Francisco for years. He said that he wanted one included in the redevelopment of the former UC Berkeley Extension site on Laguna Street, but that the idea was never embraced by the mayor’s administration.

“Even if it’s a good idea, the timing’s a little odd,” Mirkarimi said of the unfunded proposal coming just days after California’s July budget compromise. “I like the notion if we’re able to get this at a very low cost.”

It’s also unclear how much land could be converted into community farms. The Public Utilities Commission has thousands of acres outside San Francisco that could be used, and the Real Estate Division and the Recreation and Park Department own some unused parcels in the city.

Model farm in Oakland

Newsom made the announcement at a junkyard-turned-farm in West Oakland that could serve as a model for how land could be converted in San Francisco. A stone’s throw from BART, it used to be home to old cars and one angry dog, but now is run by the nonprofit City Slicker Farms.

With a handful of staff members and scores of volunteers from the neighborhood, the nonprofit operates six small farms in West Oakland and sells the produce, along with honey and eggs, on a sliding scale to local residents at a Saturday farm stand.

The 2,000-square-foot former junkyard now produces 2,000 pounds of food every year, including lettuce, squash, tomatoes, parsley, sage, collard greens, grapes, cherries and plums.

“This speaks to people’s soul,” said Barbara Finnin, director of City Slicker Farms. “It’s a place people can relax, be outside, and nourish themselves and their families.” Newsom toured the farm, biting off a piece of kale to taste, munching on an apricot and admiring sunflowers taller than him.

Back in San Francisco, it was apparent Newsom’s idea may take some getting used to. Michael Summers, who operates a hot dog stand in Civic Center Plaza that contracts with the city, said the dogs made of tofu don’t sell nearly as well as the old-fashioned meat kind. That was evidenced by the line of people ordering hot dogs just after noon – and not a tofu order among them.

New food rules

San Francisco Mayor Gavin Newsom is calling for city-funded food to be healthy and sustainable. His administration provided the following directives for what this means:

  • Safe and healthy: Avoids excessive pesticide use and has high nutritional value.
  • Culturally acceptable: Acceptable culturally and religiously to San Francisco’s diverse population. An example would be providing Chinese seniors with bok choy and other vegetables they’re familiar with at local farmers’ markets.
  • Sustainable: Grown in a way that maintains the health of agricultural lands and advances self-sufficiency among farmers and farm workers. An example would be using manure as a fertilizer rather than chemicals.


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Cost Constraints and Students' Palates Influence Healthfulness of School Lunches

July 5, 2009, The Columbus Dispatch

By Jennifer Smith Richards

Pizza, tater tots, hot dogs and tacos are on school lunch menus even though those kid-friendly staples might not be the most healthful choices.

One reason: Kids like them. Another: They can be made cheaply.

“We have a big, big problem,” said Susan Rubin, nutritionist and founder of an advocacy group called Better School Food, based in New York. School lunch programs in Ohio and the nation are “a dumping ground for these poor-quality commodity foods.”

Most school food comes frozen. It is usually not whole-grain, low-fat or low-sodium. And it is cheap because school districts need it to be: On average, local districts spend less than $1.50 per lunch to buy the food.

The federal government and school districts say they know that most school lunches aren’t healthful enough and that more must be done to improve them.

Food-service workers say they do the best they can with what they have. Choosing a menu, buying the food and getting kids to eat cafeteria offerings is a difficult juggling act.

“It’s pretty hard to feed somebody healthfully on $1,” said Rubin, who is featured in a documentary about school food called Two Angry Moms. But she and other critics say kids would welcome more healthful lunches with fewer processed foods.

More frozen than fresh

A school lunch is supposed to provide at least one-third of a child’s nutritional requirements for the day. But that doesn’t mean it’s healthful.

In July 2008, a U.S. Department of Agriculture report said that students who eat school lunches consume high levels of fat and sodium and fewer fruits, vegetables and whole grains. Even amid the current battle against childhood obesity, school lunches remain high-calorie.

In 2005, for example, 95 percent of the students who ate school lunches ate too much sodium, compared with 88 percent of the children who didn’t. A federal study found that two-thirds of schools offered lunches where at least two-thirds of the calories came from fat. That’s partly because the federal National School Lunch Program was initially designed to battle malnutrition.

On a Friday last school year, Columbus’ elementary-school students were offered a grilled-cheese sandwich that cost the district 42 cents, an 11-cent bag of pretzels, some canned fruit, juice and milk. The whole lunch, the cheapest of February, cost the district barely more than $1. The full price for students: $1.75.

For that month, students were offered vegetables other than potatoes three times – raw carrots with ranch dressing twice and mixed vegetables once. Similar menus were offered all year. Schools that participate in the federal lunch program receive inexpensive (and sometimes free) commodities such as raw chicken and bulk cheese.

Although USDA nutrition rules say schools must offer a certain number of items from each food group, they don’t go beyond that. The rules don’t dictate that chicken must be skinless or roasted or that cheese must be low-fat.

That’s how items such as Cheetos Cracker Trax and pretzels can be counted as grains and tater tots as vegetables.

At least two servings of fruits or vegetables must be served per meal. But frozen vegetables and canned fruit tend to be more cost-effective than fresh produce.

“We try” to order fresh fruits and vegetables, said Brenda Wolf, head cook at Whitehall-Yearling High School. But often, cost dictates that “we get frozen instead of canned.” The most popular commodity items bought by the state are chicken, which the state sends for processing into nuggets, patties and strips; ground beef for tacos and sloppy joes; and mozzarella cheese for pizza, stuffed breadsticks and breaded cheese sticks.

The federal lunch program does offer some lower-fat options and whole grains such as dried beans, whole-wheat flour and brown rice. But these aren’t kids’ favorites, so the state doesn’t buy many of those items.

Some districts bypass the state to offer more healthful foods, and many have sought more health-conscious ways to prepare them.

In South-Western schools, cooks are serving ultra-grain, reduced-fat macaroni and cheese. It has about 100 fewer calories and 200 fewer grams of sodium per serving and is slightly lower in fat.

“We really work at sneaking (healthful) things in,” said Beth Glitt, food-services director there. The cafeterias often serve soy products on Fridays and have ditched traditional mini corn dogs for turkey dogs. All of those items are bought by the district using commodity dollars.

Likewise, many kitchens nationally have traded in their deep-fryers.

“Everything is bakeable,” said Connie Fatseas, food-services director in Reynoldsburg schools, where nothing is fried anymore.

Quality costs

Many school districts have little more than $1 to cover the cost of each child’s lunch, a figure dictated in large part by the federal government’s reimbursement formula.

Children from low-income families can qualify for a free or reduced-price lunch. Last school year, for children on a free lunch, districts received $2.57 from the government; districts get $2.17 for a reduced-price lunch and 24 cents for a paid lunch. That reimbursement amount is expected to rise slightly for next school year, but the new figures aren’t available yet.

After districts pay for labor, plates and forks, they often are left with less than $1.50 to cover food costs, which are on the rise.

“We’re hearing it’s harder for them to make ends meet,” said Todd Barnhouse, who oversees health, safety and nutrition for the state Education Department. The state receives almost $500 million in federal food programs annually.

Nationally and in central Ohio, food-service departments in public schools must run a tight ship. They operate separately from their districts’ general funds, meaning they have to make enough money to cover their costs.

That’s why school districts – even small ones – buy in bulk. And many have switched from planning menus week-by-week to planning them in cycles.

For example, there might be five weeks’ worth of menus that repeat all year. It makes planning easier for food workers and also works well with the commodity program because schools can order more food at once, cutting delivery costs.

Fresh food is more expensive.

South-Western is one of a handful of school districts in Ohio that participate in a federal program that provides money to buy fresh produce. That’s how the district is able to buy more healthful fruits and vegetables such as green peppers, cantaloupe and strawberries. Still, commodities money can stretch only so far.

Carole Smith, head cook at Park Street Intermediate School in Grove City, said she knows exactly what she’d buy with more money.

“Kids like grilled chicken, and it’s healthy,” she said. It’s also more expensive, so it hasn’t joined breaded versions on the school’s menu yet. Chicken nuggets often contain other, less expensive chicken parts.

Having a shoestring budget shouldn’t limit school cafeterias to serving chicken nuggets and fries, some argue.

“It’s largely a state of mind. They’ve been told by everybody from the USDA to school-nutrition associations and food-and-beverage agencies that it’s easier and cheaper to serve the processed and convenience foods,” said Kate Adamick, a chef and food-systems consultant based in New York City. “They bought into that.”

That belief became ingrained in the 1960s and ’70s, Adamick said, when convenience foods became popular and the food-and-beverage industry started to influence school cafeterias.

“It wasn’t too difficult for school administrators to say, ‘Hey, look at all these new products, we can just pop those in the oven and heat and serve,'” she said. “Now we’re in the fourth decade of relying on a system that may be inexpensive but is extremely costly in terms of the health of our children.”

Adamick thinks a few small changes – such as taking advantage of some of the more healthful commodities offerings and accepting raw chicken from the government instead of sending it to a processor – could reverse the trend. And that wouldn’t cost a dime, she says.

Rubin thinks it might take a little more money to buy fresh, local food.

“I’m not going to lie. I think this is an investment,” she said. “I think you could do it for $3.”

Will kids eat it?

One of the hottest-selling items in cafeterias right now is a cheese-filled breadstick, served with a side of marinara sauce.

It comes from a food processor but in many districts is made from their commodity flour, cheese and tomato-sauce purchases.

Kids love it, the breadstick isn’t very expensive for districts (73 cents in Columbus), and it counts for a bread, cheese and vegetable. So food managers love it, too.

Most central Ohio school districts let kids sample new menu items over the summer before they are added to a regular rotation.

The bottom line for any school food is this: If kids won’t eat it, a new choice is wasted money. Likewise, foods that don’t meet USDA nutrition guidelines also don’t make the cut. That’s why many districts, including Columbus, have cut cookies out of the menu. Some schools have found options that are more healthful and are popular with students.

An Oriental chicken salad — iceberg lettuce with breaded popcorn chicken and crispy chow mein noodles on top – does well in Whitehall, cafeteria workers say. New Albany-Plain and South-Western schools report that salads also are popular among older students.

“Kids will say, ‘Which would be healthier for me?'” when going through the Park Street lunch line, Smith said. “They will ask.”


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Federal Program to Receive More Funding to Increase Schools' Access to Fresh Produce

June 30, 2009, RWJF Childhood Obesity News Digest

The federal government has pledged its support for two measures seeking to improve the nutritional content of foods sold in schools, the Packer reports. Funding for the Fresh Fruit and Vegetable Program, which aims to provide schoolchildren with free healthy snacks daily, is set to increase from $49 million during the 2008-2009 school year to $150 million in the 2011-2012 school year. The funding will be awarded to a pre-determined number of schools in each state. Produce availability in schools is expected to be further bolstered by the 2009 Child Nutrition Reauthorization Act, which will update nutrition standards for foods sold under the National School Lunch Program and the School Breakfast Program. Changes suggested as part of the reauthorization include implementing a national school salad bar policy that would encourage and train schools to offer salad bars to increase produce consumption. The measure also would seek to increase federal reimbursement for foods served under the program, a move that Lorelei DiSogra, vice president of nutrition and health for the United Fresh Produce Association, suggests would make schools more inclined to purchase fresh fruits, vegetables and other healthy foods (Shee, Packer, 6/29/09).


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Alabama School System Receives Grant to Enhance Physical Education

July 16, 2009, RWJF Childhood Obesity News Digest

The U.S. Department of Education has awarded the Alabama-based Boaz City School System a multiyear $975,232 grant to enhance its physical education and nutrition programs, the Gadsen Times reports. The Boaz City School System is one of 73 public schools and community-based organizations in 25 states to receive a portion of the $26.5 million in awards provided by the Carol M. White Physical Education Program, which helps initiate, expand and improve physical education programs for students in kindergarten through 12th grade.

Specifically, the school system will use the grant to develop a physical education curriculum that includes lessons on skills students need to meet the Alabama state physical education standard and establish healthy living habits. According to Community Education Director

Jeana Ross, the curriculum will focus on individual development in an effort “to downplay the team sport model for students [who] aren’t stellar athletes.” The school system also will use the funding to furnish an exercise science lab with fitness equipment for older students and to create a playground that will feature 100 developmental games and activities painted on the school-yard surfaces.

A director will be hired to train the system’s physical education teachers and guide the program’s implementation, which could take three years, according to Ross. Noting that a random survey found that only 10.5 percent of Boaz City School System students are physically active on a daily basis, the superintendent notes that the new program will “work on changing their habits,” adding that it could help curb childhood obesity within the school system (Yencer, Gadsen Times, 7/15/09).


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