August 2010





USDA Says Soda Tax Would Cut Obesity

July 8, 2010, The Washington Post

By Jane Black

Politically, soda taxes have never taken off. A DC tax that would have funded more healthful school lunches was killed by the Council in May. In early July, New York legislators, who had pioneered the idea, caved in to the powerful beverage lobby. Yet, evidence continues to mount that taxing sugary beverages could help to stem or even reverse the American obesity epidemic.

According to a study released by the U.S. Department of Agriculture’s Economic Research Service, a 20 percent increase in the price of high-calorie, sweetened beverages, such as soda and sports drinks, could result in a decrease in the daily calorie intake of beverages by 37 calories for an average adult and 43 calories for children. That translates into an average reduction of 3.8 pounds over a year for an adult and 4.5 pounds for a child.

In the country where “The Biggest Loser” is a hit show, that may not sound like a lot. But it is enough to significantly reduce the number of overweight adults and children. Within one year, the study predicts, the prevalence of overweight adults could fall from 66.9 percent to 62.4 percent; the prevalence of obese adults could drop from 33.4 percent to 30.4 percent. The number of overweight children could decrease from 16.6 percent of the population to 13.7 percent.

The study points to two reasons for the dramatic shift. First, many people are overweight or obese by only a few pounds, and a small reduction in calorie intake could change their weight classification. Second, many overweight and obese Americans consume large amounts of high-calorie beverages. For example, 10.6 percent of overweight adults consumed more than 450 calories per day from sugary liquids. That’s nearly three times the average amount of 152 calories consumed by adults.

Moreover, the study notes, a soda tax could prevent many Americans who are currently at a healthful weight from tipping the scales.

The ERS report is not the first to suggest that a soda tax would be effective. A review conducted by Yale University’s Rudd Center for Food Policy and Obesity suggested that for every 10 percent increase in price, consumption decreases by 7.8 percent. The National Academy of Science and Institute of Medicine also believe a tax could help slash obesity rates.


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Publications & Tools

How Transportation Policy Can Prevent Childhood Obesity Fact Sheet

July 2010, Robert Wood Johnson Foundation

“Keeping Kids Moving: How Equitable Transportation Policy Can Reverse Childhood Obesity,” a Washington, DC, roundtable, took place in July. The national roundtable – sponsored by the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity, Transportation for America, The Convergence Partnership, and PolicyLink – explored the vital connections between transportation policy and childhood obesity, especially for low-income children and children of color.


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Childhood Obesity Research & News

Rand Corp. Researchers to Study Effects of Pennsylvania District Grocery Store

July 20, 2010, Pittsburgh Post-Gazette

By Diana Nelson Jones

A thousand households in Pittsburgh’s Hill District will be the subject of a study that researchers say would be the first of its kind in the country to track a grocery store’s impact on food-buying habits in a particular neighborhood over time.

Researchers from the Rand Corp., with a $2.7 million grant from the National Institutes of Health and help from the University of Pittsburgh Center for Social and Urban Research, will begin tracking food-buying and eating histories this year in anticipation of the proposed 2011 opening of a Shop ‘n Save on Centre Avenue near Dinwiddie Street.

Researchers met with neighborhood representatives to discuss the five-year study, which includes hiring 15 data collectors from or familiar with the Hill. One in every five households will be chosen at random in a door-to-door campaign, said lead researcher Tamara Dubowitz.

All information will be measured against household distance from the store.

Dubowitz said the Hill has become a “food desert” mainly because it hasn’t had a grocery for more than 30 years and because many residents depend on public transportation to get to the nearest one.

It is generally known that people who live near groceries that sell healthy food have better health outcomes than people who do not, she said.

“But we have not been able to track 1,000 households over time before and after [the coming of a nearby grocery] to establish a causal relationship,” she said.

Victor Roque, president and CEO of Hill House Association, said that Hill House “is excited to partner with Rand on this significant study and, more importantly, to learn of its findings. The study will serve as a national model for understanding the health benefits of residents of urban communities having access to a full-service grocer.”

The families that participate will be paid $40 and undergo a one-hour interview to begin the process.

“One thing we’re trying to get is a deeper understanding of cultural issues that may be involved in food purchasing” and whether choices are based on lack of knowledge of how to prepare healthy food, lack of tools and/or lack of time, said Dubowitz.

“We are hoping to see that this [store] makes a difference,” she said, “but we anticipate it may not make a difference to some people.”

A British study assessed a neighborhood before and after a grocery store moved in and “found it didn’t make that big a difference” in food choice, she said.

Before and after the new Hill District store opens, the research team will conduct a physical audit of the neighborhood, “going up and down every street of the Hill and every outlet that sells any type of food,” noting the shelf space given to healthy items.

The household questionnaire will include information about daily life activities; the level of social support for healthy eating; transportation use; social-cultural factors such as perceived attitudes toward eating a healthy diet; knowledge of fat and fiber content; perceived barriers to eating healthily; and the cost and perceived cost, she said.

“We’re hoping people will recognize the importance of this study for the Hill District and for other neighborhoods around the country. This is a big deal for Pittsburgh. It will put us on the [food study] map.”

She said the timing is right, too, as the local food movement is gaining acceptance in minority communities.


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Tobacco Funds Shrink as Obesity Fight Intensifies

July 27, 2010, The New York Times

By Duff Wilson

When the Robert Wood Johnson Foundation decided in 1991 to take on Joe Camel, it became the nation’s largest private funding source for fighting smoking. The foundation spent $700 million to help knock the cartoon character out of advertisements, finance research and advocacy for higher cigarette taxes and smoke-free air laws and, ultimately, to aid in reducing the nation’s smoking rate almost by half.

But a few years ago, RWJF, based in Princeton, N.J., added another target to its mission, pledging to spend $500 million in five years to battle childhood obesity. As the anti-obesity financing rose to $58 million last year, a new compilation from the foundation shows, the organization’s antismoking grants fell to $4 million.

The steep drop-off in private funds illustrates the competition under way for money as public health priorities shift. In the race for preventive health care dollars, from charities and from federal and state government sources, the tobacco warriors have become a big loser. And the nation’s battle to shed pounds has in its corner the White House, with Michelle Obama leading a new campaign against childhood obesity. Shortly after the first lady kicked off the “Let’s Move” program, the administration awarded more funds to fight obesity than tobacco through two big new money sources for preventive health. The funds, totaling $1.15 billion, came from economic stimulus and health care reform legislation. They still provided more than $200 million for tobacco-use prevention, but much more to grapple with obesity.

The changes in financing are also evident across the country. State governments have used tobacco’s billions to balance their budgets while cutting $150 million from antitobacco programs over the last two years. On the airways, obesity public service announcements are lining up while a “Truth” campaign about tobacco languishes for lack of money.

“Don’t forget tobacco,” pleaded a July commentary in The New England Journal of Medicine.

One in five Americans still smokes.

But one in three is obese.

And competition for attention is growing between the two biggest issues in public health.

“I don’t see anybody else rushing into the vacuum,” says Dr. Steven A. Schroeder, former president of the Johnson foundation. “The sad thing is, smoking, despite all the harm it does, is left pretty much an orphan.”

Dr. James S. Marks, senior vice president of the foundation, said it had to pick its targets. “When we made the commitment to spend $500 million in obesity, we made the commitment to see if we could do for childhood obesity what we did in tobacco,” he said.

The decline in state funding to prevent smoking has distressed advocates. The 1998 Tobacco Master Settlement Agreement between 46 states and cigarette companies provided more than $200 billion through 2025. For a while, it financed preventive programs like the “Truth” media campaign from the antismoking group American Legacy Foundation. But as states used money elsewhere, “Truth” spending declined, to a low of $35 million last year from $104 million in 2000.

“The industry outspends us in a day what we spend in a year,” said David Dobbins, chief operating officer of Legacy.

And even as states were raising taxes on cigarettes to record levels — a proven way to deter smoking — they were shifting that revenue to general funds. Both tobacco industry analysts and antismoking groups say that states have become addicted to tobacco money but are using less of it for prevention efforts.

“Overall funding on tobacco control is down because of dramatic cuts in state spending in recent years,” Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, said in an interview. “In the last several years we’ve seen the rapid progress in both adult and youth smoking rates slow to a crawl largely because of a decline in overall spending at the state level on tobacco prevention and cessation.”

State funding for antitobacco programs dropped to $567 million last year, from $717 million two years earlier, a 21 percent cut, according to an advocacy groups’ report titled A Broken Promise to Our Children.

While the federal government has made up for some of the state decline in antitobacco funding, it is spending even more on anti-obesity efforts. And despite politic statements, there is undeniable competition for public health money.

“In our reaction to the obesity epidemic, sometimes we have taken our eye off other issues,” Terry F. Pechacek, of the Centers for Disease Control and Prevention office on smoking and health, said in a recent interview.

But Dr. Howard K. Koh, assistant secretary for health, focused on what he said was unprecedented funding from the federal government for both issues.

“Rather than pitting one disease against another, we want to uphold comprehensive prevention policies,” he said in a phone interview. Dr. Koh said the administration was directing $722 million to tobacco control and research this year and $821 million to obesity control and research.

The tobacco funding includes industry fees to set up a new regulatory office in the Food and Drug Administration. About half of the tobacco funding and most of the obesity funding is in research financed by the National Institutes of Health, illustrating the relative newness of obesity research.

In addition, the 2009 economic stimulus package included $650 million for “prevention and wellness strategies.” In February, state smoking quit lines received more than $44 million. In March, obesity programs received 62 percent of a $372 million award while tobacco programs received 38 percent.

Kathleen Sebelius, secretary of health and human services, made the awards in March a month after joining with Mrs. Obama to help kick off the first lady’s campaign against childhood obesity.

Stanton A. Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, asked, “Given that tobacco kills four times as many people as obesity does, why is the government putting more money into obesity?”

Kenneth E. Thorpe, a professor of health policy and obesity researcher at Emory University in Atlanta, defended the shifting resources, noting that obesity rates had doubled since 1985. And health problems related to being overweight now account for about 30 percent of the increase in health care spending, he said.

“The smoking rate, fortunately, has been coming down. Not far enough, but that’s moving in the right direction. Obesity is moving in the wrong direction,” he said.

Congress also created a $15 billion, 10-year Prevention and Public Health Investment Fundas a part of health care reform.

The first $250 million went in June to increase the number of primary care doctors, nurses and other health care workers — more to battle sickness than promote wellness, critics said. Jeff Levi, executive director of the Trust for America’s Health, a nonprofit advocacy group, said he was disappointed that the money was “diverted.”

Dr. Koh, the assistant secretary, an oncologist and formerly a Harvard professor and Massachusetts state health chief, said, “It was a one-time investment and we need those providers to deliver preventive services.”

Out of the second $250 million, $16 million went in June to obesity prevention and $16 million to tobacco cessation. Parts of other funds could be used for those purposes. But the nation’s leading antismoking groups had written Ms. Sebelius in April asking for about 30 percent of the total, which would have been $150 million.

Next year the prevention fund from health care reform rises to $750 million and to $1 billion after that, so the dueling organizations fighting smoking or obesity will be competing for a much larger pot of money.


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Ad Rules Stall, Keeping Cereal a Cartoon Staple

July 23, 2010, New York Times

By William Neuman

Lucky Charms. Froot Loops. Cocoa Pebbles. A ConAgra frozen dinner with corn dog and fries. McDonald’s Happy Meals.

These foods might make a nutritionist cringe, but all of them have been identified by food companies as healthy choices they can advertise to children under a three-year-old initiative by the food industry to fight childhood obesity.

Now a hard-nosed effort by the federal government to forge tougher advertising standards that favor more healthful products has become stalled amid industry opposition and deep divisions among regulators.

A report to Congress from several federal agencies — expected to include strict nutritional definitions for the sorts of foods that could be advertised to children — is overdue, and officials say it could be months before it is ready. Some advocates fear the delay could result in the measure being stripped of its toughest provisions.

“All of a sudden everything is dead in the water,” said Dale Kunkel, a communications professor at the University of Arizona who is an expert on children’s advertising. “I have heard no arguments to slow this down other than that the industry doesn’t like it.”

Among the requirements under consideration and included in a preliminary proposal by the agencies: Cereals could have only eight grams of sugar per serving, far less than many cereals that are heavily advertised to children (Lucky Charms and Cocoa Pebbles have 11 grams and Froot Loops has 12). The level for saturated fats would be set so low it would exclude peanut butter. And to qualify for advertising, all foods would have to contain significant amounts of wholesome ingredients like whole grains, low-fat milk, fruits or vegetables.

Critics have long complained that standards used by food manufacturers to designate healthy foods suitable for advertising to children are flawed, with ads for foods high in calories, fat, sugar and salt remaining a prominent part of the Saturday morning ritual on television. The Obama administration, as part of its campaign against childhood obesity, has also called on food companies to do more to ensure that advertising aimed at children is for healthier products.

The federal involvement took a step forward last year when Congress ordered the Federal Trade Commission, the Food and Drug Administration, the Agriculture Department and theCenters for Disease Control and Prevention to recommend standards for children’s food advertising.

The agencies released the preliminary proposal in December. It was far tougher than many had anticipated; advocates applauded but the food and advertising industries gave it a swift thumbs-down.

“The proposal was extraordinarily restrictive and would virtually end all food advertising as it’s currently carried out to kids under 18 years of age,” said Dan Jaffe, executive vice president for government regulations of the Association of National Advertisers, which represents companies that advertise their products.

Jaffe said he saw the delay in submitting the final report to Congress as a good sign, suggesting that changes were in the works.

Betsy Lordan, a spokeswoman for the Federal Trade Commission, said she could not predict when the report would be finished. She said the agencies would first release their plan for public comment before submitting it to Congress.

The far-reaching preliminary proposal — and the resistance it encountered — appear to have put the agencies in a bind and created divisions among them, with some federal officials wanting to step back and take a more measured approach.

Restrictions on advertising are problematic in any event, in large part because of free speech issues.

To avoid a showdown, the Federal Trade Commission has said it wants the food and advertising industries to voluntarily accept changes. But the preliminary proposal would have to be substantially modified to gain industry support — and such changes would undoubtedly lead to charges that the government had backed down under pressure.

“With obesity rates the way they are, it’s no longer acceptable for companies to be marketing foods to kids that contribute to obesity and heart disease and other health problems,” said Margo G. Wootan, director of nutrition policy of the Center for Science in the Public Interest, an advocacy group.

At the middle of the debate are questions about the industry’s effort to take steps on its own to improve the way it advertises food to children.

The effort, called the Children’s Food and Beverage Advertising Initiative, began in mid-2007 and now involves 16 large companies that account for about three-quarters of the food and beverage ads on children’s television.

Under the initiative, which is run by the Better Business Bureau, each company sets nutritional criteria for foods it considers suitable to advertise.

The companies agree to feature only foods that meet those criteria in ads that appear during programming predominantly aimed at children younger than12, like Saturday morning cartoons or certain time slots on the Nickelodeon network. The pledge also applies to some print advertising and Web sites intended for use by young children.

But critics say the nutritional standards the companies chose are too loose.

Kellogg’s standards allow it to advertise cereals that are high in sugar, like Froot Loops and Frosted Flakes, to young children. They also allow marketing for a candy called Yogos, which has sugar as its main ingredient.

Celeste A. Clark, the senior vice president for global nutrition at Kellogg, said in an e-mail message that the company’s cereals provided nutrients children need. Asked why candy qualified as a healthy choice for children, Clark said, “We believe that with balance and moderation all foods can have a place in the diet.”

McDonald’s and Burger King justify ads for their Happy Meals and Kids Meals by pledging to show lower-calorie versions of the meals in the ads. Those include apple slices instead of French fries and low-fat milk or fruit juice instead of soda. But critics point out that images of those products often appear fleetingly in ads that emphasize movie tie-ins and toy giveaways, and that children might not realize they are being encouraged to choose them because they are healthier.

McDonald’s said in a statement: “Any fair and objective review of our menu and the actions we’ve taken will demonstrate we’ve been responsible, we’re committed to children’s well-being, and we’ll continue to do more.”

Elaine D. Kolish, the industry initiative’s director, said that the program had improved the types of foods featured in children’s advertising and that companies had reformulated dozens of products to reduce sugar, salt and calories.

Four participants in the program, Cadbury, Coca-Cola, Hershey and Mars, have agreed not to aim any advertising to children under 12.

Kolish said the initiative had been getting more rigorous, with companies increasing the types of marketing covered to include things like computer games and cellphone ads.

“It’s moving the needle,” she said. “We’re not saying things are perfect yet. There’s still room for further growth, but it’s making a difference.”


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House Panel Moves Forward with First Lady's Effort to Make School Lunches Healthier

July 15, 2010

By Mary Clare Jalonick

House Democrats are moving forward on first lady Michelle Obama’s vision for healthier school lunches, propelling legislation that calls for tougher standards governing food in school and more meals for hungry children.

A recent bill approved by the House Education and Labor Committee would allow the Agriculture Department to create new standards for all food in schools, including vending machine items. The legislation would spend about $8 billion more over 10 years on nutrition programs.

“This important legislation will combat hunger and provide millions of schoolchildren with access to healthier meals, a critical step in the battle against childhood obesity,” Mrs. Obama said in a statement after committee passage.

Some Republicans on the committee expressed concern about how the bill would be paid for, but three of them ended up voting for it. The legislation was approved on a 32-13 vote.

California Rep. George Miller, the Democratic chairman of the committee, said improving school lunches now will help reduce health care costs in the long term.

“The cost of childhood obesity to the health of our children and our economy is staggering,” he said. “We have to get rid of the junk food, get rid of the endless sugar and empty calories in our schools.”

A Senate committee approved similar legislation earlier this year, but the full chamber has not yet considered the bill.

Creation of new standards, which public health advocates have sought for a decade, has unprecedented support from many of the nation’s largest food and beverage companies. The two sides came together on the issue as a heightened interest in nutrition made it more difficult for the companies to push junk foods in schools.

New standards would not remove foods like pizza or hamburgers from schools completely, but would make them healthier. Vending machines could be stocked with less candy and fewer high-calorie sodas.

Congressional passage of the bill would be only the first step. Many of the most difficult decisions, including what kinds of foods will be sold and what ingredients may be limited, will be left up to the Agriculture Department.

The legislation would also expand the number of low-income children eligible for free or reduced cost meals, a step Democrats say would help President Barack Obama reach his goal of ending childhood hunger by 2015.


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HHS Makes Funds Available for Healthy Weight Collaborative

July 23, 2010, Robert Wood Johnson Foundation Center to Prevent Childhood Obesity

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the availability of funds, through the Health Resources and Services Administration, for a prevention center for healthy weight, as provided in the Affordable Care Act. The prevention center will plan, implement, and manage a nation-wide Healthy Weight Collaborative as well as recruit and support communities and participating teams. The prevention center will also serve as a gateway to quality information on the prevention and treatment of overweight and obesity in the context of integration of public and community health and primary care. A single $5 million award is available to any public or private nonprofit entity, including an Indian tribe or tribal organization. The application deadline is August 16. To learn more about this opportunity click here: Application for Prevention Center for Healthy Weight.


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