March 2010





Childhood Obesity Research Collaboration Welcomes USDA

March 5, 2010, NCCOR

USDA has joined the National Collaborative on Childhood Obesity Research (NCCOR), a public-private research collaboration to accelerate progress on preventing and reversing the childhood obesity epidemic. The National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC) and the Robert Wood Johnson Foundation (RWJF) launched NCCOR in February 2009.

“As a leader in studying the role of foods and nutrition in childhood obesity, USDA can strengthen this collaboration and add valuable knowledge and considerable resources to combat this epidemic,” Vilsack said. “USDA welcomes this important opportunity for a dynamic research partnership that exemplifies President Obama’s vision of federal and nonprofit leaders working together to improve the health of all Americans.”

Through the Office of the Chief Scientist, USDA will coordinate its research programs with NIH, CDC and RWJF to ensure effective and efficient use of resources for solving the childhood obesity epidemic.

The announcement continues the commitment of the Obama Administration to address childhood obesity within a generation and follows the launch of first lady Michelle Obama’s Let’s Move! campaign. The Let’s Move! campaign will combat the epidemic of childhood obesity through a comprehensive approach that builds on effective strategies, and mobilizes public and private sector resources. The Collaborative – and USDA’s new commitment to it – exemplifies the Administration’s vision – federal and non-profit leaders on health, physical activity, and foods/nutrition working together for the good of the American people.

“NCCOR is a positive example of how federal agencies are working with each other and with private funders to bring synergy and innovation to efforts to address childhood obesity,” said Senior Scientist C. Tracy Orleans, RWJF’s distinguished fellow and a founding NCCOR member. “NCCOR welcomes USDA to the table,” she added.

“Integrating USDA representatives’ expertise will benefit the projects we’re moving forward on, such as our registry of measures and webinar series, as well as our future strategic planning,” said Senior Scientist Laura Kettel Khan, who works within CDC’s Division of Nutrition, Physical Activity and Obesity, and is a founding NCCOR member.

In addition to joining NCCOR, other USDA research efforts to reduce childhood obesity include:

  • The National Institute of Food and Agriculture (NIFA) will fund approximately $25 million in competitive research grants in 2010 that focus on childhood obesity prevention.
  • The Agricultural Research Service’s (ARS) Human Nutrition Research Program annually commits approximately $28 million to obesity prevention research, and two internationally recognized ARS research centers focus on children’s nutrition with an emphasis on childhood obesity prevention.
  • The Economic Research Service (ERS) recently released the Food Environment Atlas (an online mapping tool) and the “Household Food Security in the United State, 2008” report.

NCCOR is motivated by a sense of urgency to reverse the tide of childhood obesity, especially in those populations and communities at highest risk, and strives to improve the efficiency, effectiveness and application of research findings on childhood obesity by building upon member organizations’ strengths. Efforts are focused on strengthening the nation’s research tools and infrastructure, discovering what works and communicating and spreading effective interventions more rapidly. For more information about NCCOR, please visit


With reporting from the USDA Office of Communications:!ut/p/_s.7_0_A/7_0_1OB?

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Childhood Obesity Linked to Heart Risk

March 1, 2010, The Wall Street Journal

By Shirley S. Wang

Obese children as young as age 3 show signs of an inflammatory response that has been linked to heart disease later in life, researchers said, in a finding that is likely to further stoke concerns about childhood obesity.

The results suggest that obesity-related disease processes may start earlier than previously believed. Nearly 30 percent of obese 3-to-5-year-olds had elevated blood levels of C-reactive protein—a widely studied marker for inflammation—compared with 17 percent of healthy-weight kids of the same age. The disparities widened as children aged, according to the study, published in the journal Pediatrics.

“It’s really important to be concerned about childhood obesity and to even be concerned when they are quite young,” said Asheley Skinner, a professor of pediatrics at the University of North Carolina School of Medicine, who was the first author of the study. “We can’t wait until they’re adolescents or adults.”

Fourteen percent of U.S. 2-to-5-year-olds are considered overweight, or at the 85th percentile or greater of weight for height in their age group.

C-reactive protein, or CRP, has been shown to help predict risk of heart disease, stroke and death under certain conditions, according to the American Heart Association. Previous studies have found that overweight and obese adults show elevated levels of CRP, but less has been known about CRP in children.

The study examined three markers that measure different aspects of inflammation, including CRP, in more than 16,000 children nationwide between the ages of 1 and 17. By ages 15 to 17, CRP was elevated in about 60 percent of obese teens, compared with 18 percent of teens of healthy weight. The increase was even more pronounced for very obese kids, with nearly 43 percent of young children and 83 percent of teens showing CRP elevation.

A similar pattern of elevation was observed for the other two inflammatory markers, though one of the markers wasn’t elevated in obese children until age 6.

It isn’t known whether elevated CRP in young children will predict heart disease in adulthood. Such a study, which would involve following overweight and obese children until adulthood, hasn’t been done, Skinner said. But, she said there wasn’t any evidence to suggest that CRP response would be different in children than in adults; its response in the body is the same regardless of age. Inflammation is the body’s immune response to infection or injury.

The concern of finding CRP elevation in such young children is that its effects could be cumulative. Future research is needed to investigate whether that is the case, and also whether losing weight could reduce CRP response in kids, according to Skinner. This study was funded by the National Institutes of Health.


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Publications & Tools

NCCOR Featured on Podcast

Feb. 26, 2010, NIH Research Radio (Episode #0104)

NIH Research Radio recorded a podcast interview titled “Research to Health Fight Childhood Obesity: NCCOR.” Dr. Rachel Ballard-Barbash, associate director for the Applied Research Program at the National Cancer Institute and National Collaborative on Childhood Obesity Research Steering Committee member spoke about the NCCOR initiative.

“Welcome to episode 104 of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health—the nation’s medical research agency. I’m your host Joe Balintfy. Coming up in this episode, researching medications for kids; fighting childhood obesity; getting health information on a mobile device and the impact of globalization on health. …”

You may listen and/or access the rest of the show notes on the NIH Radio 2010 Podcast Archives here. If you would like to skip straight to the NCCOR segment, simply move the bar to 7:20.


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Reedy J, Krebs-Smith SM, Bosire C. Evaluating the Food Environment: Application of the Healthy Eating Index-2005, Am J Prev Med 2010, available online.

Background: The Healthy Eating Index-2005 (HEI-2005), a tool designed to evaluate concordance with the 2005 Dietary Guidelines, has been used to monitor the quality of foods consumed by Americans. Because the HEI-2005 is not tied to individual requirements and is scored on a per 1000 kcal basis, it can be used to assess the overall quality of any mix of foods.

Purpose: The goal of this paper is to examine whether the HEI-2005 can be applied to the food environment.

Methods: Two examples were selected to examine the application of the HEI-2005 to the food environment: the dollar menu displayed at a fast-food restaurant (coded and linked to the MyPyramid Equivalents Database and the Food and Nutrient Database for Dietary Studies) to represent the community level and the 2005 U.S. Food Supply (measured with food availability data, loss-adjusted food availability data, nutrient availability data, and Salt Institute data) to represent the macro level.


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Krebs-Smith SM, Reedy J, Bosire C. Healthfulness of the U.S. Food Supply: Little Improvement Despite Decades of Dietary Guidance, Am J Prev Med 2010, available online.

Background: Every five years for the past several decades, the USDHHS and the U.S. Department of Agriculture have issued and updated the Dietary Guidelines for Americans, which form the basis of federal nutrition policy and have shown remarkable consistency across various editions among the major themes.

Purpose: This paper examines whether the U.S. food supply is sufficiently balanced to provide the recommended proportions of various foods and nutrients per the amount of energy, whether this balance has shifted over time, and which areas of the food supply may have changed more than others.


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Childhood Obesity Research & News

Ag Secretary Addresses School Nutrition Association

March 3, 2010, USDA Office of Communications

Agriculture Secretary Tom Vilsack spoke to the School Nutrition Association and highlighted the Obama Administration’s priorities for the reauthorization of the Child Nutrition Act and issued a call to stakeholders to improve the health and nutrition of our nation’s children.

To highlight the nexus between nutrition and physical activity and USDA’s collaboration with first lady Michelle Obama’s Let’s Move! initiative, Secretary Tom Vilsack issued a call to action to parents, community leaders, schools and elected officials to improve the nutrition and physical activity habits of our children by working together to double the number of HealthierUS Schools across the country.

“The reauthorization of the Child Nutrition Act is an important opportunity to improve the health of our children and reduce hunger in this country but the federal government cannot do it alone because it’s people who work in our schools that are on the front line of providing healthier meals, nutrition education and enabling more physical activity,” said Vilsack.

“I am challenging parents, educators, nutrition experts, and community leaders to join us in doubling the number of HealthierUS Schools across the country in the next year because we all have a stake in improving the health and nutrition of our children.”

The Obama Administration has proposed a historic investment of an additional $10 billion over 10 years starting in 2011 that will allow for the improvement of the quality of the School Lunch and School Breakfast Programs, increase the number of kids participating, and ensure schools have the resources they need to make program changes, including training for school food service workers, upgraded kitchen equipment, and additional funding for meal reimbursements for schools that are enhancing nutrition and quality.

Additionally, this investment will allow additional fruits, vegetables, whole grains, and low-fat dairy products to be served in our school cafeterias and an additional one million students to be served the healthy diets in school.

Already, the administration has announced its plans to improve school meals, a financing initiative to reduce food deserts, new research tools that detail local food environments and health outcomes, including grocery store access and disease and obesity prevalence, and a broad range of public/private partnerships to solve America’s childhood obesity epidemic.

The HealthierUS School Challenge recognizes schools that do an exceptional job promoting meal participation, meal quality, nutrition education, and physical activity. To highlight this program as the gold standard that we should expect of all our schools, last fall USDA expanded the HealthierUS School Challenge to middle and high schools. And in announcing the Let’s Move! initiative, the first lady called on stakeholders to double the number of participating schools in the next year and to reach 3,000 within the next three years. USDA is working with administering state agencies and a range of other partners, from professional sports leagues and youth associations to promote the program and meet this goal.

“USDA is committed to promoting nutrition standards and providing our children well-balanced, healthy meals during their school day,” said Vilsack. “Lunches provided by the National School Lunch Program (NSLP) are a vital resource that help children develop healthy eating and lifestyle choices that will be with them for a lifetime. Only by working together can we improve school meals and work to eliminate childhood obesity in a generation.”

The HealthierUS School Challenge (HUSSC) was established to recognize schools that are creating healthier school environments through their promotion of good nutrition and physical activity. Four levels of superior performance are awarded: Bronze, Silver, Gold, and Gold of Distinction. Schools can participate in this model program by going to the HealthierUS School Challenge web page to learn about the range of educational and technical assistance materials that promote key aspects of the Dietary Guidelines. The website includes a menu planner for healthy school meals, and provides tips on serving more whole grains, fruits, and vegetables, and lower amounts of sugar, sodium, and saturated and trans fats in school menus.

Operating in more than 101,000 public and nonprofit private schools and residential child care institutions nationwide, the NSLP works in concert with FNS’s other nutrition assistance programs to form a national safety net against hunger. It provides school children of all economic backgrounds with a well-balanced, healthy meal that is designed to meet the Dietary Guidelines for Americans. In some cases, the school lunch is the main daily meal for a needy child.


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First Lady Says ‘Let’s Move’ and Work on Childhood Obesity Problem

Feb. 10, 2010, Washington Post

By Robin Givhan

In front of a packed audience in the State Dining Room at the White House, first lady Michelle Obama rolled out her national initiative to combat childhood obesity with a show of force that included medical, business and government leaders, grassroots activists, celebrity public service announcements, cartoon characters as nutrition experts, as well as those most directly affected – the kids themselves.

Dubbed “Let’s Move,” the project also received a presidential nod of support, to be backed up with as much as $1 billion a year in federal funds for 10 years. Earlier in the day, President Obama signed a formal memorandum establishing for the first time a national task force on childhood obesity, one that draws from the departments of the Interior, Health and Human Services, Agriculture and Education and is charged with turning the first lady’s ambitious list of proposals into action.

At its core, the initiative has four pillars: more nutrition information, increased physical activity, easier access to healthy foods and, ultimately, personal responsibility. It has bipartisan support, as demonstrated by the presence of two mayors, one a Republican from Hernando, Miss. (population 10,000) and the other a Democrat from Somerville, Mass. (population 77,478). Hernando’s Chip Johnson described how he established a soccer league in his town by leasing a parcel of land from a local resident for $1 a year. And Somerville’s Joseph Curtatone noted that his job as mayor is not to legislate diets but to create an “atmosphere and opportunity for good health.”

Obama’s national campaign purposefully and adamantly steers clear of defining itself as in favor of foodie proselytizing and against French fries, burgers and cookies. This is neither the canonization of slow cooking nor a war on fast food.

“This isn’t about trying to turn the clock back to when we were kids or preparing five-course meals from scratch every night. No one has time for that,” the first lady said in her remarks. “And it’s not about being 100 percent perfect, 100 percent of the time. Lord knows I’m not. There’s a place for cookies and ice cream, burgers and fries. That’s part of the fun of childhood.”

Obama also quickly swatted away criticism that her campaign is one driven by vanity, social pressures or misperceptions about weight, beauty and fitness. “This isn’t about inches and pounds or how our kids look,” she said. “It’s about how our kids feel and how they feel about themselves.”

‘Not about politics’

It took more than an hour for the many bells and whistles in Obama’s initiative to be even cursorily detailed and for her five guests – each symbolic – to be duly recognized and allowed a few words. …

About a dozen students in “Let’s Move” T-shirts who sat with the first lady. Among them were members of the 2009 championship pee-wee football team, the Watkins Hornets. They served as a tableau vivant of silent motivation. “This isn’t about politics,” the first lady said. “I don’t want our kids to live diminished lives because we failed to step up today. I don’t want them looking back decades from now and asking us, ‘Why didn’t you help us when you had a chance? Why didn’t you put us first when it mattered most?’ “

Obama’s initiative challenges the Food and Drug Administration to work with food and beverage producers, who have announced their support of Obama’s proposals, to improve package labeling. Ingredients would be more prominent and easier to understand, and deciphering calorie counts per serving would not require higher math.

Schoolhouse nutrition would be addressed by pushing for the reauthorization of the Child Nutrition Act, and the administration is requesting $10 billion over 10 years to improve school meals. As part of the initiative, companies such as Sodexo, Chartwells School Dining Services and Aramark, which supply food to schools, have agreed to cut salt and fat content, and offer more whole grains and more fresh fruits.

Wake-up call

The 2011 budget includes something called the Healthy Food Financing Initiative. It would invest $400 million to help bring grocery stores into areas dubbed “food deserts” or, more accurately, healthy-food deserts. It would also offer incentives for convenience stores to carry more nutritious food options. The goal is to eliminate these produce-free wastelands throughout the country within seven years.

The American Academy of Pediatrics has agreed to work with doctors and health-care providers to ensure that body mass index measurements are standard aspects of medical care and that children whose BMI is high are given a “prescription” for lowering it. That change recalls the empathetic anecdote the first lady often tells of receiving a wake-up call from her daughters’ pediatrician, who alerted her to what could be the beginning of a troubling pattern of weight gain. …

“It wasn’t that long ago that I was a working mom, struggling to balance meetings and deadlines with soccer and ballet. And there were some nights when everyone was tired and hungry, and we just went to the drive-thru because it was quick and cheap, or went with one of the less-healthy microwave options, because it was easy,” she said. “And one day, my pediatrician pulled me aside and told me, ‘You might want to think about doing things a little bit differently.”

And the President’s Council on Physical Fitness and Sports will be revamped so that it no longer focuses on how many sit-ups and push-ups a child can do, or how long they can hang, batlike, from a high bar. Instead of focusing on athleticism or stupid human tricks, it will address health and well-being.

The vast list of proposals also includes a new foundation: Partnership for a Healthier America. Its members include some of the largest organizations engaged in health care and, specifically, obesity issues, such as the Robert Wood Johnson Foundation, Kaiser Permanente and the W.K. Kellogg Foundation.

There will also be sports clinics, community projects such as bike paths and playgrounds, a new website and public service announcements. …

National conversation

There had been weeks of drum rolls and teases, informal remarks, prepared speeches, meetings and briefing books leading to this day. Still, some nutrition advocates don’t believe the first lady has gone far enough. The Center for Science in the Public Interest issued a statement arguing that Obama should use her bully pulpit to remove all junk food from schools and to get all advertisements for junk food out of children’s programming. Others want her to tackle government farm subsidies that can make chips and soda cheaper than healthier alternatives.

Obama got involved in this national conversation modestly enough in March 2009 when she and a group of fifth-graders from the District’s Bancroft Elementary broke ground on an organic garden. The vegetable patch, situated on the sloping South Lawn with the White House rising up in the distance, was the first significant vegetable garden since Eleanor Roosevelt’s Victory Garden during World War II.

The garden was something that good-food advocates had lobbied in support of for years. And the first lady’s patch of produce, with its lettuces and tubers, received widespread attention – both here and abroad – from those interested in sustainable farming, eating locally and supporting a small, agrarian economy. But Obama kept her focus simple. She has used the garden as a way of talking about getting fresh vegetables into kids’ diets and making children more cognizant of their own food choices.

One of the students who helped plant the garden, Tammy Nguyen, 11, who is now in the sixth grade, introduced the first lady. But she did so only after explaining how the lessons of the garden and the importance of a colorful plate have stayed with her. “We picked the peas right of the vine and put almost as many in our mouth as in the bowl,” she said. “My friends and I pledge to keep that color on the plate, and I don’t mean M&Ms.”

Since then, the conversation about healthy food has gone more mainstream and gotten more complex and more diverse. The first lady has linked it to health-care reform, noting that obesity-related diseases put a $147 billion drain on our economy. Obesity affects national security, disqualifying individuals from serving in the military.

And as Will Allen, perhaps this country’s most famous urban farmer and a recipient of a MacArthur Foundation “genius grant,” noted in his remarks, “It’s a social justice issue. Every child in this country, every person in this country, should have access to good food.” …


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National League of Cities Launches Effort to Combat Childhood Obesity in the South

Feb. 18, 2010, PRNewswire

The National League of Cities (NLC) Institute for Youth, Education, and Families launched the Municipal Leadership for Healthy Southern Cities project in partnership with the Foundation for the Mid South (FMS). The project will help communities confront a situation in which more than 23 million children and adolescents are currently overweight or obese, and the associated health problems are expected to cost the nation $14 billion per year. It is supported by the Robert Wood Johnson Foundation through its Leadership for Healthy Communities national program, which is designed to support state and local government leaders nationwide in their efforts to reverse the childhood obesity epidemic.

The project will help local officials advance specific policies that promote healthy eating and active living by providing intensive technical assistance to one large city in each of three Southern states: Arkansas, Louisiana and Mississippi. NLC will also work with FMS to assist up to 30 smaller, more rural communities from these states using a new model of assistance and support.

In addition to creating peer networking and learning opportunities, NLC will employ a “train the trainer” approach, with assistance from FMS, to train state-level intermediaries on how to provide technical assistance to rural communities seeking to combat childhood obesity at the local level.

Drawing upon lessons from previous initiatives focused on reducing childhood obesity rates, NLC has identified two areas of policy change – increased access to recreational opportunities and increased access to healthy foods – as key needs and prime opportunities for urban and rural cities and towns in the South. The project will help participating cities create community wellness plans that include the adoption and implementation of local policies to improve access to both recreational opportunities and fresh, nutritious foods.

At the conclusion of the project, NLC will publish an issue brief featuring examples of city-level policy change across the South and highlighting lessons to guide future efforts in both large and small communities. …


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IoM Creates Committee to Address Child Obesity Policies

The Obesity Prevention Policies for Young Children committee was recently formed by the Institute of Medicine. This ad hoc committee will review factors related to overweight and obesity in infants, toddlers, and preschool children (ages 0-5 years), with a focus on nutrition and physical activity. They will also identify gaps in knowledge and make recommendations on early childhood obesity prevention policies.


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Counseling Urged for Obese Kids

Feb. 7, 2010, Manila Bulletin Publishing Corporation

For years, parents, doctors and educators heard little but criticism, judgment and conflicting advice on childhood obesity.

But now experts can offer hope: medical research that shows focused treatment can help kids slim down.

An independent panel of experts has announced that obese children between 6 and 18 years should be steered to weight management programs that provide more than 25 hours of intensive counseling on diet, exercise and behavioral change over six months.

The recommendation, based on a rigorous review of the scientific evidence, comes from the U.S. Preventive Services Task Force, the highly regarded federal panel that recently ignited controversy with its advice that not all women in their 40s need annual mammograms.

“Our recommendation is not to say this is easy,” Dr. Ned Calonge, who as chairman of the task force was dissatisfied with the lack of evidence on treatments when the panel last reviewed the issue in 2005, said. “This really takes dedicated work and it takes a comprehensive program in order for us to get these benefits.”

That won’t surprise South Tampa mother Arlene Asgard, whose 11-year-old daughter, Tori, has struggled with her weight. To fend off a bigger problem down the road, they recently participated in the Why Weight? program at St. Joseph’s Children’s Hospital.

For six weeks, both mother and daughter attended the weekly two-hour sessions that combined diet and nutrition instruction with physical activity. They left the program resolved to make lasting lifestyle changes.

Behavioral therapy for obesity

The task force’s experts in primary care and preventive medicine reviewed 20 studies on childhood obesity treatment. Most involved the behavioral intervention therapy now recommended. Seven studies added drug treatment to behavioral therapies for older children.

The report, published in Pediatrics, the journal of the American Academy of Pediatrics, is geared to obese children, or those with a body mass index at or above the 95th percentile for age and gender. Overweight children, or those between the 85th and 95th percentiles, possibly could benefit, but there wasn’t enough evidence for the task force to include them in the recommendation.

The report said the results still were reason for hope in fighting an epidemic that worries health officials since obese children often become obese adults.

The recommendation should also guide pediatricians to refer patients to programs, rather than trying to handle weight-loss issues during brief checkups.

Make that change

Clinicians often tell parents “your child is overweight, you need to make these changes, and maybe give them a handout on nutrition,” said Jana Butler, manager of community health and weight management at St. Joseph’s Hospital. “Now it’s taking it a step further and saying, ‘Your child is really in a risk category for their weight and it’s time for a referral to a dietitian or to a program?”

Parents may worry about a possible stigma attached to seeking weight-loss help, but experts say they can help children deal with bullying and confidence issues.

The new recommendation isn’t going to solve the obesity epidemic, the task force chairman acknowledged. But neither will faulting parents and children for becoming overweight, without offering them solutions.


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