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July 2009

SPOTLIGHT

PUBLICATIONS & TOOLS

CHILDHOOD OBESITY RESEARCH & NEWS

Spotlight

CDC Hosts Inaugural Obesity Prevention and Control Conference

The Center for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity (CDC DNPAO) is hosting its inaugural conference on obesity prevention and control – Weight of the Nation (WON) – at the Omni Shoreham Hotel in northwest Washington, DC, from July 27-29. The National Collaborative on Childhood Obesity Research (NCCOR) will host an invite-only reception for leadership in the fields of advocacy, policy, and research at the Omni Shoreham on the second night of the Conference.

Weight of the Nation will provide a forum to highlight progress in the prevention and control of obesity throughout the lifecycle through policy and environmental strategies. Moving away from the typical presentation format, WON aims to encourage discussion between plenary and concurrent session panelists, and the audience. Focused on four intervention settings – community, medical care, school, and workplace – WON will present case studies on the use of strategies within settings and sectors, and in specific contexts.

Woven throughout the Conference’s four objectives and presented in case studies are issues relevant to NCCOR members and childhood obesity researchers. The listed objectives are to:

  • Highlight strategies that overcome barriers to the primary prevention of obesity for youth and adults in communities, medical care, schools, and workplaces;
  • Provide economic analysis of obesity prevention and control efforts (e.g., cost burden of obesity on healthcare system and employers, cost effectiveness of prevention);
  • Provide forum to share promising, emerging, and best practices for setting specific policy and environmental initiatives impacting obesity; and
  • Highlight the use of law-based efforts to prevent and control obesity (e.g., legislation, regulation and policies).

On July 28, concurrent sessions that will interest childhood obesity researchers include: overcoming challenges to school-based policies; obesity prevention in the early years; school nutrition policy; and, addressing social determinants of health. Some sessions on July 28 address improving equity and access to food, issues pertaining to menu labeling, and achieving high physical activity and physical education standards. And finally, sessions on the last day of WON include building communities for healthy lifestyles, and social marketing to reduce adolescent obesity.

For more information on the Weight of the Nation inaugural conference, please visithttp://www.weightofthenation.org

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Help RWJF Choose the Most Influential Childhood Obesity Research by July 10

Nominate the articles that you think will have the most impact.

It’s been two years since the Robert Wood Johnson Foundation announced that we would award $500 million in grants to reverse the childhood obesity epidemic by 2015. To accomplish our goal, we have been building the evidence about the problem and what interventions work, as well as turning the evidence into action.

Now, we want to know what you think. After conducting a thorough literature search and consulting with childhood obesity experts, we selected 20 recently published articles that we believe have the potential to influence the field in the coming years. We would like you to nominate the five you think are the most influential.

View the nominees and vote.

Voting ends July 10, so vote now, and feel free to pass this e-mail along to your colleagues and encourage them to vote.

We will publish the voting results in mid-July. Thank you for your participation, and we look forward to seeing your selections.

David C. Colby, Vice President Research and Evaluation

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Publications & Tools

Huang TT, Drewnowski A, Kumanyika SK, Glass TA. A Systems-Oriented Multilevel Framework for Addressing Obesity in the 21st Century. Preventing Chronic Disease 2009;6(3).

http://www.cdc.gov/pcd/issues/2009/jul/09_0013.htm

Effective or sustainable prevention strategies for obesity, particularly in youths, have been elusive since the recognition of obesity as a major public health issue 2 decades ago. Although many advances have been made with regard to the basic biology of adiposity and behavioral modifications at the individual level, little success has been achieved in either preventing further weight gain or maintaining weight loss on a population level. … Because of the complex system that affects obesity, researchers need to use a systems-oriented approach to address the multiple factors and levels. Whereas multidisciplinary research consists of teams with different expertise that can contribute to the understanding of particular aspects of a larger research question, truly cross-disciplinary research asks a priori questions and poses hypotheses that cut across disciplines and across levels of influence.

CLICK HERE TO DOWNLOAD A PDF OF THIS PUBLICATION

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Haemer MA, Huang TT, Daniels SR. The Effect of Neurohormonal Factors, Epigenetic Factors, and Gut Microbiota on Risk of Obesity. Preventing Chronic Disease 2009;6(3).

http://www.cdc.gov/pcd/issues/2009/jul/09_0011.htm

ABSTRACT: Molecular, cellular, and epidemiologic findings suggest that neurohormonal, epigenetic, and microbiologic mechanisms may influence risk for obesity by interacting with socioenvironmental factors. Homeostatic and nonhomeostatic neural controls of energy predispose people to obesity, and this predisposition may be exaggerated by the influence of media, marketing, and sleep patterns. Epigenetic gene regulation may account for the influence of modifiable early life or maternal exposures on obesity risk. Alterations in gut flora caused by infant feeding practices or later diet may influence the absorption and storage of energy. Further exploration of how these molecular-cellular mechanisms might increase obesity risk in response to modifiable socioeconomic factors requires the partnership of laboratory and public health researchers.

CLICK HERE TO DOWNLOAD A PDF OF THIS PUBLICATION

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Esposito L, Fisher JO, Mennella JA, Hoelscher DM, Huang TT. Developmental Perspectives on Nutrition and Obesity from Gestation to Adolescence. Preventing Chronic Disease 2009;6(3).

http://www.cdc.gov/pcd/issues/2009/jul/09_0014.htm

ABSTRACT: Obesity results from a complex combination of factors that act at many stages throughout a person’s life. Therefore, examining childhood nutrition and obesity from a developmental perspective is warranted. A developmental perspective recognizes the cumulative effects of factors that contribute to eating behavior and obesity, including biological and socio-environmental factors that are relevant at different stages of development. A developmental perspective considers family, school, and community context. During gestation, risk factors for obesity include maternal diet, overweight, and smoking. In early childhood, feeding practices, taste acquisition, and eating in the absence of hunger must be considered. As children become more independent during middle childhood and adolescence, school nutrition, food marketing, and social networks become focal points for obesity prevention or intervention. Combining a multilevel approach with a developmental perspective can inform more effective and sustainable strategies for obesity prevention.

CLICK HERE TO DOWNLOAD A PDF OF THIS PUBLICATION

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Huang TT, Yaroch AL. A Public-Private Partnership Model for Obesity Prevention [Letter to the Editor]. Preventing Chronic Disease 2009;6(3).

http://www.cdc.gov/pcd/issues/2009/jul/09_0034.htm

TO THE EDITOR: … In a societal approach to combating obesity, every participant, including the food industry, has a role. Public-private partnerships can enhance rather than hinder the development of effective and sustainable solutions.

CLICK HERE TO DOWNLOAD A PDF OF THIS PUBLICATION

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Braveman P. A Health Disparities Perspective on Obesity Research. Preventing Chronic Disease 2009;6(3).

http://www.cdc.gov/pcd/issues/2009/jul/09_0012.htm

ABSTRACT: Obesity is a major risk factor for chronic disease and can decrease longevity, quality of life, and economic pro¬ductivity. Compelling ethical, human rights, and practical reasons exist for addressing social disparities in obesity, which requires systematically applying a disparities per¬spective to obesity research and relevant policy. A dispari¬ties perspective guides us to consider multiple dimensions and levels of social advantage and disadvantage and how those advantages and disadvantages produce disparities in obesity and its consequences.

CLICK HERE TO DOWNLOAD A PDF OF THIS PUBLICATION

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Hammond RA. Complex Systems Modeling for Obesity Research. Preventing Chronic Disease 2009;6(3).

http://www.cdc.gov/pcd/issues/2009/jul/09_0017.htm

ABSTRACT: The obesity epidemic has grown rapidly into a major public health challenge, in the United States and world¬wide. The scope and scale of the obesity epidemic motivate an urgent need for well-crafted policy interventions to prevent further spread and (potentially) to reverse the epidemic. Yet several attributes of the epidemic make it an especially challenging problem both to study and to com¬bat. This article shows that these attributes — the great breadth in levels of scale involved, the substantial diver¬sity of relevant actors, and the multiplicity of mechanisms implicated — are characteristic of a complex adaptive sys¬tem. It argues that the obesity epidemic is driven by such a system and that lessons and techniques from the field of complexity science can help inform both scientific study of obesity and effective policies to combat obesity. The article gives an overview of modeling techniques especially well suited to study the rich and complex dynamics of obesity and to inform policy design.

CLICK HERE TO DOWNLOAD A PDF OF THIS PUBLICATION

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Keeping Children Healthy in California's Child Care Environments: Recommendations to Improve Nutrition and Increase Physical Activity

Sacramento, 2009; California Department of Education, California Health and Human Services Agency

We are pleased to introduce Keeping Children Healthy in California’s Child Care Environments: Recommendations to Improve Nutrition and Increase Physical Activity, and we want to extend our thanks to the Strategic Assessment of the Child Care Nutrition Environment Advisory Group, which guided the report’s development. California’s children face a future limited by chronic disease and, for the first time in history, shorter life spans than their parents. Children’s early years are critical in shaping their physical, emotional, and social well-being. One-third of California’s low-income children enter school overweight or obese. Interventions to curb this epidemic must begin before children enter school and before they develop poor health habits that lead to overweight and obesity. Child care settings are ideal environments for promoting healthy eating habits and physical activity.

CLICK HERE TO DOWNLOAD A PDF OF THIS PUBLICATION

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Childhood Obesity Research & News

The National Initiative for Children's Healthcare Quality Receives $3.25 Million Grant from RWJF to Fight Childhood Obesity

June 16, 2009, MarketWire

The National Initiative for Children’s Healthcare Quality (NICHQ) today announced it has been awarded a $3.25 million grant from the Robert Wood Johnson Foundation (RWJF) to reverse the childhood obesity epidemic trend across the nation by training, supporting and providing technical assistance to healthcare professionals in becoming advocates for change within their communities.

As part of the grant, NICHQ will partner with the American Academy of Pediatrics (AAP), the California Medical Association Foundation (CMA-F) and the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity (CPCO) to facilitate healthcare professionals becoming community advocates for local change, and to build an online network serving as the “go to resource” for healthcare providers looking for solutions to the childhood obesity epidemic.

“We are pleased to support NICHQ in its effort to help clinicians become advocates for policy and environmental changes that will help us reverse the childhood obesity epidemic,” remarked Dwayne Proctor, director of the RWJF Childhood Obesity Team. “Health is not just something that happens in the doctor’s office. It happens in the places where all of us live, learn, work and play, and NICHQ’s work will advance efforts to make all of these settings healthier.”

Prevention, screening and treatment of childhood obesity are at the top of NICHQ’s Agenda for Improvement. The rise in the prevalence of obesity in children and adolescents is one of the most alarming public health issues facing the world today. Over the past three decades, the prevalence of childhood obesity in the United States has more than tripled. Children in low socioeconomic status families and children in the country’s southern region tend to have higher rates of obesity than that of the general population. The current increase is especially evident among African-American, Hispanic, and American Indian populations.

“As a leader in the children’s healthcare quality movement in the United States, we are committed to tackling this complex issue,” said Dr. Charles Homer, president and chief executive officer of NICHQ. “We look forward to working closely with the AAP and CMA-F, as well as with RWJF, to expand our efforts and make significant changes at the community level so that childhood obesity is no longer an epidemic threatening our children’s current and future health and welfare.”

NICHQ has long been a leader in the fight against childhood obesity. Since 2003, NICHQ staff and faculty worked directly with practices and programs to facilitate the engagement of clinicians in community change and improve clinical practice in Maine, New Mexico, Delaware, New York, Washington and Massachusetts. In 2007, NICHQ launched the Childhood Obesity Action Network (COAN) to link clinicians and policy makers together, provide tools and materials for clinical and policy change, and promote innovation through social networking.

“Childhood overweight and obesity lead to serious health problems,” said David Tayloe MD, FAAP, president, American Academy of Pediatrics. “This program will help us empower pediatricians and families to take action in their homes, offices and communities to prevent childhood obesity and improve the health status of children,” Tayloe said.

“The CMA Foundation is honored to work with NICHQ, RWJF, AAP, and CPCO to use this grassroots approach to bring healthcare providers out of the office where the focus is on treating disease and into the community in a public health role, with a focus on prevention,” said Dexter Louie MD, chair, CMA Foundation board of directors and physician champion.

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Original Source: http://uk.sys-con.com/node/1003977

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Ky. Schools' Healthy Example Could Shape a National Policy

June 29, 2009, The Washington Post

By Jane Black

It didn’t seem like a radical idea at the time. First, Ginger Gray, the food service director for Kenton County, Ky., schools, took away fried potato chips, offering students baked versions instead. Next, she phased out fruit drinks such as Kool-Aid in favor of 100 percent juices. She considered serving baked French fries. But they got soggy and unappetizing fast. And there’s one thing that every school food service director knows: You don’t mess with the fries.

It was a calculated effort to encourage students to eat more healthfully. A registered dietician, Gray believes her job isn’t just to feed students but also to teach good eating habits.

But there was a risk. The salty snacks and sugary drinks, sold in cafeteria a la carte lines and vending machines, were reliable moneymakers for the 17 schools in Gray’s district, where one-third of students eat federally subsidized lunches.

But a funny thing happened. When the numbers came in, Gray found she was making more money, not less. With fewer junk foods available, more students opted for the traditional lunch line, where Gray offers items such as salads, submarine sandwiches and make-your-own tacos. At Simon Kenton High School, revenue rose 61 percent between 2005 and 2007 without a price increase for school meals.

The results in Kentucky could reverberate in Washington. As Congress moves to reauthorize childhood nutrition programs this summer, it is again taking up the issue of whether sugary sodas, chips and candy should be allowed in schools. Legislators have tried to limit junk food in schools since 1994. But each time the measures were blocked by powerful food lobbies, and conventional wisdom has long held that such snacks are a necessary evil because they provide key revenue to supplement the federal school-lunch program and help pay for sports and arts programs.

The result: Foods sold outside the lunch line currently are required only to have “minimal nutritional value,” giving tacit federal approval to peanut M&Ms, Flaming Cheetos and Twinkies.

This year could be different. Bills have been introduced in both houses to mandate new standards. President Obama has declared childhood nutrition an integral part of health-care reform, a point first lady Michelle Obama emphasized in a speech at the White House garden.

“To make sure that we give all our kids a good start to their day and to their future, we need to improve the quality and nutrition of the food served in schools,” she said on June 16.

Even the food industry is supporting tighter standards in the face of reports that obesity rates have tripled in children and adolescents over the last two decades. One study from the National Bureau of Economic Research concluded that one-fifth of the increase in teenagers’ average body mass index was attributable to an “increase in availability of junk foods in schools.” And in a year when the country faces a historic deficit, implementing standards may be an economical way to tackle childhood obesity.

Despite such support, history shows that efforts to establish new standards could fail yet again. The measure is likely to be included in the reauthorization of federal child-nutrition programs, which are scheduled to expire at the end of the year. The first step is clearing the Senate Committee on Agriculture, Nutrition, and Forestry, where 10 Democrats have signed onto the bill as co-sponsors.

Kentucky is the seventh-fattest state in the nation, but it has been a pioneer in improving school food. In 2005, following the lead of food service directors such as Gray, Kentucky became one of the first states to impose strict standards for foods sold in cafeteria a la carte lines, school stores and vending machines, not just in the main lunch line as federal mandates require. The new regulations banned soda and sugary drinks, such as Hawaiian Punch, with more than 10 grams of sugar per serving. Twinkies and packaged cinnamon rolls were removed in favor of foods with limited fat, sugar and sodium.

“Everyone told us, ‘You just can’t do this. Schools won’t survive. We won’t have sports programs,’ ” said Anita Courtney, a consultant for child-nutrition programs who lobbied for the state law. “There was so much fear and in reality, it didn’t make much difference.”

Kenton County isn’t the only district to benefit financially from cutting out junk food. In Hardin County, just south of Louisville, phasing out junk food helped push more students into the school meal program: 83 percent of students participated this year, up from 68 percent in 2000-2001. Meals are more profitable since the federal government kicks in money for every school lunch sold.

In California, where nutrition standards for competitive foods went into effect in 2007, a University of California at Berkeley survey of 20 schools revealed that revenues at 65 percent of schools increased more than enough compensate for the loss of sugary and salty snacks.

Washington politics will have as much to do with a passage of new standards as new evidence emerges in support of restricting unhealthful snacks. Food and beverage companies including Mars and the American Beverage Association support federal standards, which have not been updated in 30 years. Indeed, the association is implementing voluntary standards that cut calories and portion sizes and ban full-calorie soft drinks.

“We recognize that childhood obesity is a complex problem that will take comprehensive solutions. And our industry is stepping up to do our part,” said Kevin Keane, senior vice president of public affairs at the beverage group.

It’s a radical change from 15 years ago, when industry lobbyists opposed even voluntary standards. Several factors have fueled the shift. For one, childhood obesity rates have reached crisis levels.

More practically, large food corporations now have far broader portfolios. So for example, even if Coca-Cola cannot push Coke, it can sell Dasani water, VitaminWater and Powerade. Companies also would rather deal with national standards than patchwork of state and city regulations, which make it difficult for companies to standardize nutritional content and serving sizes.

Only 12 states, none in the D.C. area, have comprehensive rules for foods sold outside the lunch line. In a 2007 school food report card, the Washington-based Center for Science in the Public Interest graded the District of Columbia, Maryland and Virginia C, D-plus and D respectively for their school nutrition policies.

Some lobbies still oppose federal standards. The Alexandria-based National School Boards Association argues that local communities should make decisions about what children are fed in schools. Some public health advocates worry that weaker federal standards could undercut some more stringent state and local regulations.

If Congress mandates new standards, they might look like Kentucky’s. The Agriculture Department official charged with writing new rules would be Undersecretary for Food and Nutrition Services Janey Thornton. Before arriving in Washington, she served as nutrition director for schools in Hardin County, Ky.

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Original Source: http://www.washingtonpost.com/wp-dyn/content/story/
2009/06/28/ST2009062803185.html

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Asian American Childhood Obesity on the Rise

June 12, 2009, Balita Online

The Asian Pacific Fund held a briefing and panel discussion on the dramatic rise in childhood obesity among Asian Americans in California.

According to experts, the percentage of Asian American children in California who are at risk of obesity has risen faster than the rest of the population over the past two years. Nearly 11 percent of California children who are overweight are Asian or Pacific Islander.

The briefing and discussion, featuring experts on nutrition and weight-related diseases, was hosted by the Asian Pacific Fund, a community foundation based in the San Francisco Bay Area, and was held in conjunction with the 5th Biennial Childhood Obesity Conference, organized by the California State Departments of Health and Education. It was the first time the conference included a panel on an issue affecting Asian Americans.

“It’s very important that we address the rapid increase in childhood obesity rates among Asian Americans,” said Associate Professor May Wang of the UCLA School of Public Health. “Obese children are more likely to suffer from sleeping problems, bone joint problems, and to have serious health conditions such as high blood pressure or type 2 diabetes than children of normal weight.” Wang said there is research that suggests that health conditions such as type 2 diabetes may develop at lower levels of fatness among Asians. One national study found that the prevalence of type 2 diabetes is 60 percent higher in Asian Americans than in non-Hispanic Caucasians, she said.

Gail Kong, president and executive director of the Asian Pacific Fund, echoed the importance of the findings, saying, “We want to help Asian parents learn about the serious health problems their children will face if they don’t change some of their daily habits. More time in front of the computer is not necessarily a good thing.”

According to the California Department of Public Health, 43 percent of Asian American teens consume fast food on a daily basis compared to 35 percent of white teens, and only one out of three Asian American children eats the recommended daily portion of fruits and vegetables. In addition to their poor eating habits, Asian American children are not as physically active as their peers. Based on the U.S. Department of Education, only 39 percent of tenth-grade Asian boys participated in after-school sports, the lowest participation rate of any ethnic group. Similarly, only 34 percent of tenth-grade Asian girls participated in sports, second only to Hispanic girls at 32 percent.

Health experts shared their research and findings in a panel called “Childhood Obesity in Asians, a problem or not? Research and Community-based Programs.”

“We are very pleased to be guided in this effort by several Asian health education and medical experts,” said Kong. “We’re also grateful for the support we have received from Kaiser Permanente and The California Wellness Foundation for this work.”

The panel of speakers described the dangerous risks Asian Americans face, which was supported by available data about specific ethnic groups and the habits and customs of some Asian groups that can cause health problems. Speakers included Dr. May C. Wang (Doctor of Public Health and Associate Professor at the Community of Health Sciences at the UCLA School of Public Health); Dr. Patsy Wakimoto (Doctor of Public Health, Assistant Scientist, Co-Director of Community Outreach at National Center for Minority Health Disparities at Children’s Hospital Oakland Research Institute, and Associate Researcher at UC Berkeley’s School of Public Health); Dr. Scott Gee, M.D., from The Permanente Medical Group of Kaiser Permanente; Dr. Gilbert Gee, (PhD, Associate Professor at UCLA School of Public Health; Eliza Chan, a registered dietician at Asian Health Services; and Dr. Jyu Lin Chen (PhD, RN, and Associate Professor at UCSF School of Public Nursing).

Speakers who have been extensively involved in Asian American health education also offered ideas for parents and families to encourage children to have healthier eating habits.

The Childhood Obesity Conference – attended by thousands of healthcare professionals and policymakers, urban and rural planners, civic, parent, and youth leaders and organizers, researchers, parks and recreation personnel, early childhood and after school professionals, business leaders and media professionals from around the nation – took place June 9-12.

***

Original Source: http://www.balita.com/index.php?option=com_content&view
=article&id=849:asian-american-childhood-obesity-on-the-rise&catid
=25:fil-am-news&Itemid=43

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Surgeon Generals Weigh in on Childhood Obesity

June 10, 2009, Flesh and Stone

By Kathlyn Stone

With one-in-five children in the United States considered obese, this generation may be sicker and die younger than their parents. This would be the first time in national history that a coming generation was less healthy than the previous generation.

Acting U.S. Surgeon General Steven Galson and predecessors C. Everett Koop, Antonia Novello, Audrey Manley, Richard Carmona, David Satcher and Kenneth Moritisugu gathered for an unusual joint appearance to address the childhood obesity epidemic before a health care justice summit in Washington, DC, this spring.

They focused on the epidemic’s implications for chronic disease, health care costs and the future of a generation of children with the highest obesity rates in U.S. history. As a group, they called for concerted action by government, communities, business and industry, education and families.

Today, more than 17 percent of children in the United States – 12.5 million – are overweight. Overweight children are at greater risk for many serious health problems. This initiative promotes the importance of healthy eating and physical activity at a young age to help prevent overweight and obesity in this country.

Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation, which sponsored the summit, May 7, said that “circumstances, forces and conditions … dictate and define our lives.” Among those:

  • where you live predicts how well and how long you live;
  • children in the poorest families experience the worst health; and
  • families in poor neighborhoods have no regular access to decent supermarkets and healthy foods.

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Original Source: http://fleshandstone.net/healthandsciencenews/1534.html

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BMI Registries Eyed as Promising Tool for Fighting Childhood Obesity

June 8, 2009, American Medical Association News

By Pamela Lewis Dolan

Data have been collected to show the rise in childhood obesity – to 16 percent of children between the ages of 2 and 19 in recent years, up from 5 percent for the period of 1971 to 1974.

Now a growing number of public health officials see data being useful not just to measure the obesity rate, but as a means to lower it. Body mass index registries are emerging nationwide as the newest tool in the fight against childhood obesity. The latest attempt – and the most ambitious – is in Michigan, where doctors are expected to begin submitting height and weight information on children to the state’s health department. Once funding is secured as expected by year’s end, a date will be set for doctors to begin reporting.

BMI traditionally has been measured in schools, using the Centers for Disease Control and Prevention’s statewide Nutrition, Physical Activity and Obesity Program, a system registry backers find to be somewhat inefficient.

Lag time prevents the CDC from getting the most up-to-date data. It also can’t use the data to pinpoint trends in small geographic areas. Public health officials hope physician-reported registries will solve these inefficiencies.

They say their goal is twofold. First, registries will help public health researchers identify societal and environmental issues contributing to childhood obesity, and help them evaluate existing programs aimed at reducing the numbers – right down to the individual physician practice. Second, registries can help physicians keep the problem front and center by using an objective measure to prompt what can sometimes be a difficult conversation with the parents of an overweight child.

“We have done heights and weights for years and years and years. What we have not done, and still are probably not doing well, is also calculating BMIs,” said Karen Mitchell, MD, past president of the Michigan Academy of Family Physicians and the program director for Providence Family Medicine Residency in Southfield, Mich.

“We do need to raise physician awareness of the importance of BMIs, and so [the registry] can become that tool to calculate BMI,” she said.

The registry in Michigan, where the CDC says 12 percent of high school kids were obese in 2007, will be an expansion of the state’s immunization tracking, a registry that includes 4.7 million children.

When physicians in Michigan enter immunization records for patients older than 2, the database will prompt them to enter height and weight, as well. The system, when it is up and running, will calculate BMI rates, assess the child’s risk level, and link to information the physician can use as discussion points with the parents or print out for them to take home.

The registry’s ability to automatically calculate risk levels is one way of prompting doctors to address the issue of obesity head-on at the point of care, said David Share, MD, MPH, who sits on the board of the Michigan State Medical Society and is the medical director of the Corner Health Center, a clinic for teens and the children of teens, in Ypsilanti, Mich.

Share said because there are many issues physicians need to address in the short time span of a typical clinical visit, talking to overweight patients or their parents about risk levels doesn’t always happen.

Arkansas, San Diego County track data

Other states, counties and school districts across the country have created registry programs.

Arkansas started a statewide BMI surveillance program in 2003. It was the first statewide program in the country, but it is facilitated through schools rather than physicians.

Matt Longjohn, MD, MPH, executive director of the Consortium to Lower Obesity in Chicago Children and a consultant to the Michigan Dept. of Community Health, which is heading the state’s BMI registry, said until Michigan’s program is up and running, Arkansas is the best example of how a statewide program can work.

Even though obesity rates have not declined in Arkansas, Dr. Longjohn said the program is important because it demonstrated that statewide data on obesity trends could be collected in real time in a cost-effective way.

San Diego County, where CDC data show that 12 percent of high school kids were obese in 2007, added height and weight fields to its immunization registry to begin BMI surveillance in 2006. Cheryl Moder, director of the San Diego County Childhood Obesity Initiative, said her organization’s goal is to have physicians look at this data, recognize there is an epidemic, and look for changes they can spearhead in their practices and their communities.

San Diego’s immediate goal, said Anne Cordon, manager of the San Diego Regional Immunization Registry, was to create a connected system that would act as a central repository for obesity data. But the challenge has been getting physicians to use the registry, she said.

California does not require physicians to report to the immunization registry, so success will be found when a more simple system for doctors is created, said Philip R. Nader, MD, emeritus professor of pediatrics at the University of California, San Diego, who helped create the registry there.

“Making it easier for physicians is really critical,” Nader said.

Ethan Berke, MD, MPH, assistant professor of community and family health at Dartmouth Medical School in New Hampshire, said registries have the power to measurably improve the population.

“With good, objective measurements, looking at outcomes, seeing how different interventions work, identifying particular parts of your state or your community that require more help, finding out what is working well so you can emulate it elsewhere – then you can really start to effect change.”

***

Original Source: http://www.ama-assn.org/amednews/2009/06/08/bil20608.htm

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