PUBLICATIONS & TOOLS
- Americans Do Not Meet Federal Dietary Recommendations
- Flow of Empty Calories into Children's Food Supply Must Be Reduced
- Presentation Resource for Local Governments, Communities
- RWJF Center Releases New Toolkit
CHILDHOOD OBESITY RESEARCH & NEWS
- Child Nutrition Bill Stalls in House
- USDA Awards Bonuses to States for SNAP, Grants for WIC
- Survey: Marketers Play Role in Childhood Obesity
- White House Gives Out $60,000 for Healthy Apps
NCCOR-Supported Program Among NIH-Funded Efforts
Sept. 9, 2010, NHLBI Office of Communications
The National Institutes of Health is launching two major research efforts, totaling $72.5 million, to examine ways to curtail the nation’s childhood obesity epidemic.
One will examine community efforts to reduce childhood obesity rates, and the other will study long-term approaches to prevent or treat childhood obesity.
“Childhood obesity is a major public health concern. If we don’t curb this widespread problem, our country will see a substantial increase in cardiovascular disease and other health issues in the years ahead,” said Susan B. Shurin, M.D., acting director of the National Heart, Lung, and Blood Institute (NHLBI), the lead sponsor for both programs. “Childhood is the optimal time to encourage healthy habits that kids can practice the rest of their lives.”
A large research study will evaluate existing community efforts to reduce local childhood obesity rates. The NIH has awarded a five-year, $23 million contract to Battelle Memorial Institute (Principal Investigator: Howard Fishbein, MPH., Ph.D.) in Columbus, Ohio, to examine community programs and policies in 300 demographically diverse communities across the nation. The community efforts to be evaluated are those designed to decrease local childhood obesity rates in areas where childhood obesity rates are highest. Investigators will examine how effective such efforts are in changing behaviors and reducing body weight.
“Over the past several years, communities across the United States have been implementing programs and policies to encourage healthier eating, increase opportunities for physical activity, and other steps to reverse increasing rates of childhood obesity,” noted Denise Simons-Morton, Ph.D., director of the NHLBI’s Division for the Application of Research Discoveries. “This study will evaluate such community programs to determine which of them or their components are the most promising approaches for improving children’s obesity-related health behaviors and weight.”
The NHLBI is the lead sponsor of the community evaluation study, which also receives support from the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Cancer Institute (NCI), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the Office of Behavioral and Social Sciences Research (OBSSR).
The project is also part of a robust set of activities to address childhood obesity in the United States conducted with the National Collaborative on Childhood Obesity Research (NCCOR). Members of the NCCOR are the NIH, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the United States Department of Agriculture.
The other project is NIH’s $49.5 million Childhood Obesity Prevention and Treatment Research (COPTR) program that is among the first long-term obesity prevention and treatment research studies in children. Two obesity prevention and two obesity treatment randomized clinical trials will be conducted over seven years. COPTR is sponsored by the NHLBI, the NICHD and OBSSR.
COPTR will test methods for preventing excessive weight gain in non-overweight and moderately overweight youth, and methods for reducing weight in obese and severely obese youth. Investigators will collaborate with local, state, and national organizations on these efforts.
The two obesity prevention trials will develop and test approaches that target home, community, and primary care settings for preschool children living in low income and ethnically diverse neighborhoods. The two obesity treatment trials will examine obesity therapies on overweight and obese children 7 to 14 years old in school and home settings in collaboration with local youth organizations.
COPTR differs from previous childhood obesity research programs as the new studies will test long-term intervention approaches and target multiple levels of influence – community youth organizations, schools, primary care providers, home, and families – and do not focus solely on individuals’ behaviors.
COPTR studies will be conducted at:
- Vanderbilt University School of Medicine, Nashville (Principal Investigator: Shari L. Barkin, M.D., MSHS)
- Case Western Reserve University, Cleveland (Principal Investigator: Leona Cuttler, M.D.)
- Stanford University, Palo Alto, Calif. (Principal Investigator: Thomas N. Robinson, M.D., M.P.H.)
- University of Minnesota, Twin Cities (Principal Investigator: Simone French, Ph.D.)
The coordinating center for the program is University of North Carolina, Chapel Hill (Principal Investigator: June Stevens, Ph.D.).
Obesity rates have increased four-fold among children in the past 40 years. Today, 17 percent of U.S. children and adolescents are obese. Factors behind this increase are believed to include increased consumption of high-calorie food and drinks and less physical activity during and after school. Overweight and obese children are at higher risk of chronic diseases during childhood and adulthood, including heart disease, stroke, asthma, type 2 diabetes, and several cancers. Cardiovascular conditions associated with obesity, such as high blood pressure and high blood cholesterol, are increasingly being diagnosed during childhood, as is type 2 diabetes.
Original Source: http://www.nih.gov/news/health/sep2010/nhlbi-09.htm
Publications & Tools
Americans Do Not Meet Federal Dietary Recommendations
The Journal of Nutrition
ABSTRACT: A longstanding goal of dietary surveillance has been to estimate the proportion of the population with intakes above or below a target, such as a recommended level of intake. However, until now, statistical methods for assessing the alignment of food intakes with recommendations have been lacking.
The purposes of this study were to demonstrate the National Cancer Institute’s method of estimating the distribution of usual intake of foods and determine the proportion of the U.S. population who does not meet federal dietary recommendations. Data were obtained from the 2001–2004 NHANES for 16,338 persons, aged 2 years and older. Quantities of foods reported on 24-hour recalls were translated into amounts of various food groups using the MyPyramid Equivalents Database. Usual dietary intake distributions were modeled, accounting for sequence effect, weekend/weekday effect, sex, age, poverty income ratio, and race/ethnicity.
The majority of the population did not meet recommendations for all of the nutrient-rich food groups, except total grains and meat and beans. Concomitantly, overconsumption of energy from solid fats, added sugars, and alcoholic beverages (“empty calories”) was ubiquitous. Over 80 percent of persons aged 71 years and older, and over 90 percent of all other sex-age groups had intakes of empty calories that exceeded the discretionary calorie allowances.
In conclusion, nearly the entire U.S. population consumes a diet that is not on par with recommendations. These findings add another piece to the disturbing picture that is emerging of a nation’s diet in crisis. J.Nutr. doi: 10.3945/jn.110.124826.
Flow of Empty Calories into Children's Food Supply Must Be Reduced
Oct. 1, 2010, Elsevier News Release
With over 23 million children and adolescents in the U.S. overweight or obese, the risks for many chronic diseases continue to increase. An article in the October issue of the Journal of the American Dietetic Association examines the diets of American youth and finds some disturbing results.
“The epidemic of obesity among children and adolescents is now widely regarded as one of the most important public health problems in the U.S.,” commented Jill Reedy, PhD, MPH, RD, and Susan M. Krebs-Smith, PhD, MPH, RD, both of the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD. “Most experts agree that the solution will involve changes in both diet and physical activity, in order to affect energy balance. For diet, this means a reduction in energy from current consumption levels. …This paper identifies the major sources of overall energy and empty calories, providing context for dietary guidance that could specifically focus on limiting calories from these sources and for changes in the food environment. Product reformulation alone is not sufficient— the flow of empty calories into the food supply must be reduced.”
For 2-18 year olds, the top sources of energy were grain desserts, pizza, and soda. Sugar-sweetened beverages (soda and fruit drinks combined) provided almost 10 percent of total calories consumed. Nearly 40 percent of total calories consumed by 2-18 year olds were in the form of empty calories from solid fat and from added sugars. Half of empty calories came from six foods: soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk.
Researchers examined data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative survey with a complex multistage, stratified probability sample. Trained interviewers conducted in-person 24-hour dietary recalls with all eligible persons, using automated data collection systems that included multiple passes. Calories from solid fats and added sugars were calculated from the USDA MyPyramid Equivalents Database (MPED). Empty calories were defined as the sum of energy from solid fats and added sugars.
Children of different ages get their energy from different sources. For example, the top five sources of energy for 2-3 year olds included whole milk, fruit juice, reduced-fat milk, and pasta and pasta dishes. Pasta and reduced-fat milk were also among the top five sources of energy for 4-8 year olds. Top contributors of energy also varied by race/ethnicity. For example, major contributors for 2-18 year old Non-Hispanic Blacks included fruit drinks and pasta and pasta dishes, while Mexican-Americans’ top sources included Mexican mixed dishes and whole milk. Non-Hispanic Blacks and Whites consumed more energy from sugar-sweetened beverages (combining soda and fruit drinks) than from milk (combining all milks), whereas Mexican-Americans consumed more energy from milk than from sugar-sweetened beverages.
The need for better data across all levels from the individual to individual food purveyors to the entire food supply is a surveillance research priority that resonates with the National Collaborative on Childhood Obesity Research (NCCOR) and are explored throughout the JADA October issue.
In an accompanying commentary, Rae-Ellen W. Kavey, MD, MPH, University of Rochester Medical Center, Department of Pediatrics, Division of Cardiology, Rochester, NY, discusses how sugar-sweetened beverages are replacing fats in the diets of children, leading to increased obesity and an increase in cardiovascular risk factors in the young.
Dr. Kavey writes, “High added sugar consumption which occurs most commonly in the form of sugar-sweetened beverages is associated with a constellation of cardiovascular risk factors, both independently, and through the development of obesity. Multiple studies have shown that presence of these risk factors in childhood is associated with accelerated atherosclerosis and early cardiovascular disease.
Randomized trials of nutritionist-guided interventions show us that diet change can be accomplished and is associated with important cardiovascular benefits. This combined body of evidence suggests that reducing consumption of sugar-sweetened beverages should be considered a critical dietary approach to reducing cardiovascular risk in childhood.”
A study of how school vending machines can influence the dietary choices of students is presented in the same issue. Researchers from the CDC and the Florida Department of Health found that the availability of vending machines in middle schools was associated with buying snacks or beverages instead of buying school lunches. They also found that although healthier choices were available in school vending machines, the most common choices by students were less healthy snacks and beverages.
- “Dietary Sources of Energy, Solid Fats, and Added Sugars Among Children and Adolescents in the United States” by Jill Reedy, PhD, MPH, RD, and Susan M. Krebs-Smith, PhD, MPH, RD.
- “How Sweet It Is: Sugar Sweetened Beverage Consumption, Obesity, and Cardiovascular Risk in Childhood” by Rae-Ellen W. Kavey, MD, MPH.
- “The Impact of the Availability of School Vending Machines on Eating Behavior During Lunch: The Youth Physical Activity and Nutrition Survey” by Sohyun Park, PhD, MS, William M. Sappenfield, MD, MPH, Youjie Huang, MD, DrPh, Bettylou Sherry, PhD, RD, and Diana M. Bensyl, PhD, MA.
All appear in the Journal of the American Dietetic Association, Volume 110, Issue 10 (October 2010) published by Elsevier.
Presentation Resource for Local Governments, Communities
Common Community Measures for Obesity Prevention Project and Centers for Disease Control and Prevention (CDC) developed a slide presentation for local governments and communities based on the CDC’s Recommended Community Strategies and Measures. Titled “Healthy Communities: What Local Governments Can Do to Reduce and Prevent Obesity,” the tool is intended for local government staff who want to build the case for investing in obesity prevention at the community level. It provides the audience with an understanding of the prevalence, disease burden, and economic cost of the U.S. obesity epidemic and how local government is part of the solution. The presentation provides clear and specific examples of what the CDC intended for policy and environmental change initiatives to address obesity locally. It also briefly discusses the advantages and impact of population based approaches to address obesity. The document highlights the development and release of CDC’s Recommended Strategies and Measurements to Prevent Obesity in the U.S. and explains the project methodology and how local governments can use the Implementation and Measurement Guide.
RWJF Center Releases New Toolkit
The “Making Schools the Model for Healthier Environments Toolkit” provides information to help make schools the model for healthier environments, and provides tools and resources to help ensure that school environments become the standard for healthy eating and active living. The information offers promising solutions to problems that schools face in providing healthy food and opportunities for physical activity. Browse each section for complete information. Click here to view the toolkit.
Childhood Obesity Research & News
Child Nutrition Bill Stalls in House
Sept. 29, 2010, The Associated Press
By Mary Clare Jalonick
First lady Michelle Obama’s campaign for healthier school lunches has stalled in Congress after anti-hunger groups and more than 100 Democrats protested the use of food stamp dollars to pay for it.
Passage of the child nutrition bill, which would improve lunches in schools and expand feeding programs for low-income students, has been a priority for Democrats and hunger groups for years. But the groups and many members of the House switched sides when leaders proposed a vote on a Senate-passed version of the legislation that uses future funding for food stamp programs to pay for part of the $4.5 billion cost.
One hundred and six Democrats wrote House Speaker Nancy Pelosi, D-Calif., in August calling the move egregious, saying it was not a vote they would take lightly. Labor unions, anti-poverty groups and even New York City Mayor Michael Bloomberg also urged the speaker to reconsider using the food stamp money.
“It’s just plain wrong,” said Rep. Jim McGovern, D-Mass., a longtime advocate for childhood nutrition programs. “The way you are going to pay for a child nutrition bill is by dipping into people’s food stamps? Give me a break.”
The first lady has lobbied aggressively for the legislation as part of her “Let’s Move” campaign to combat childhood obesity. A spokeswoman for Mrs. Obama said Wednesday that she had “made extensive outreach” to Pelosi and other members of House leadership over the past several weeks.
To no avail. Democrats declined to take up the bill before the November elections, citing many of their members’ concerns about the food stamp dollars. Many Republicans opposed the bill as well, saying it was too expensive.
Supporters had hoped to pass the bill before Thursday, when many of the child nutrition programs in the bill are scheduled to expire. An extension of those programs was included in a stopgap bill that will keep the government operating for the next two months, and supporters will try again to pass the nutrition bill when Congress returns to Washington after the elections.
If passed, the new nutrition standards would not remove popular foods like hamburgers from schools completely, but would make them healthier, using leaner meat or whole wheat buns, for example. Vending machines could be stocked with less candy and fewer high-calorie drinks.
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 public pressure to remove junk foods from schools increased.
Congressional passage of the bill would be only the first step. Decisions on what kinds of foods could be sold — and what ingredients may be limited — would be left up to the Agriculture Department.
Supporters said they were hopeful the bill could be passed after the elections. McGovern said he was working with the White House to find a new way to pay for it.
Jim Weill, president of the Food Research and Action Center, said he doesn’t buy the argument that the House should use the food stamp money for child nutrition because it will just be used for something else. Lawmakers have been eyeing the dollars for other priorities if it isn’t used for the bill.
“If people fight back, it’s not inevitable,” Weill said.
Copyright 2010, The Associated Press. All rights reserved.
USDA Awards Bonuses to States for SNAP, Grants for WIC
Oct. 1, 2010, Robert Wood Johnson Foundation Center to Prevent Childhood Obesity
The U.S. Department of Agriculture recently awarded $18 million in bonuses to states that provided outstanding and timely customer service for the Supplemental Nutrition Assistance Program (SNAP). Awards were given to 12 states and the District of Columbia for meeting criteria on best access, most improved access, and best application processing timeliness. Read more here.
In addition to the SNAP grants, the USDA also awarded Special Project Grants to several states to shore up the quality of nutrition services for the Women, Infants and Children program. These grants fund projects designed to help states develop, implement, and evaluate new or innovative methods of service to meet changing needs of WIC participants. Read the full press release here.
Survey: Marketers Play Role in Childhood Obesity
Sept. 30, 2010, MediaPost, Marketing Daily
By Karlene Lukovitz
We all read frequent references to growing concerns about nutrition/health issues among consumers, but just how pervasive are these?
Ongoing, in-depth attitudinal surveys conducted by Resonate Networks, Inc. confirm not only that such issues are on the minds of significant percentages of U.S. adults, but that many believe that companies and government are key in addressing them.
Case in point: 35 percent of adults rank childhood obesity as an “extremely serious” societal problem, and 34 percent rank this as a “serious” problem, according to this research.
Furthermore, asked how much responsibility they think corporations – through their product marketing – have for childhood obesity, 23 percent say that corporations have “some” responsibility, and 14 percent say that corporations have the “greatest” responsibility.
Perhaps not surprising, however, 35 percent indicate that they support limiting advertising of “high-sugar/high-fat” foods and beverages to children.
Resonate offers “attitudinal targeting” for online advertisers, using proprietary research (representative of the U.S. adult online population), algorithms, data modeling and analysis to probe consumer attitudes, issue positions, ideologies, engagement levels and voting histories across a wide range of political, social and lifestyle topics and issues. Consumer attitudinal data is then correlated with permission-based data on which sites they visit most frequently. In the high-profile area of nutritional disclosure policies, 40 percent of adults overall say they support requiring fast-food restaurants to display nutritional information, including 44 percent of women and 36 percent of men, reports Resonate.
Asked which types of taxes they would support as a means of reducing the U.S. budget deficit, however, just 22 percent overall say they would support taxes on food and beverages with high-sugar or high-fat content, while 36 percent say they would oppose such taxes. (Among those who support fast-food restaurant nutrition disclosure, 36 percent say they would support such taxes.)
Only taxes on stock dividends (21%), digital downloads (14%) and Internet purchases show lower support among adults as a whole.
Much higher levels of support are indicated for taxes on tobacco (58%), gambling (51%), families with incomes of more than $250,000 per year (50%), luxury goods (45%), alcoholic beverages (43%), “gas guzzling” automobiles (37%) and carbon emissions (36%).
For marketers, one of the clearest and most consistent takeaways from nutrition/health-related attitudes research is consumers’ emphasis on wanting the information and disclosure they need in order to make knowledgeable decisions for themselves and their families, says Resonate CEO Bryan Gernert.
“Basically, the research shows that anything that people view as potentially obfuscating, rather than enhancing, their information about nutrition will ultimately have negative repercussions for marketers,” Gernert says. “Consumers respond positively to transparency and educational approaches that help them understand the health impacts of consuming specific foods and beverages.”
While Resonate has not specifically probed attitudes about high-fructose corn syrup, or the corn manufacturers’ proposal to the FDA to allow a name change to “corn sugar,” Gernert says it’s logical to assume that this is a case where reaching the consumers who care most about nutritional transparency with a straightforward, educational approach would be most effective for the industry if the name-change is approved.
“I would suggest an educational campaign to targeted audiences that clearly acknowledges that ‘Yes, we’ve changed the name, and it’s the same product, but this product was always safe for you and your family – along with the specifics supporting that the corn syrup is no different than table sugar, in terms of metabolism and health considerations.'”
On the targeting point, Gernert adds, attitudinal – as opposed to demographic and/or behavioral (cookie-based) data alone – point to perhaps counter-intuitive findings.
For instance, when it comes to reaching the highest concentrations of people who care most about being provided with nutritional /ingredients information, DiscoveryNews.com out-pulls sites such as Parents.com, BonAppetit.com and USNews.com. Similarly, GQ.com out-pulls sites such as WomensHealth.com and WomansDay.com, he reports.
White House Gives Out $60,000 for Healthy Apps
Sept. 29, 2010, The Associated Press
By Mary Clare Jalonick
The White House is giving out $60,000 to University of Southern California students and other contest winners who created phone apps to encourage exercise and healthy eating. The $20,000 grand prize goes to a team of USC students for their app called “Trainer.” The app gives users a virtual creature that stays alive as the user does real exercise, tracking physical activity with interactive webcam technology.
The Agriculture Department sponsored the digital game and phone ap contest, which received 95 eligible entries. Next up will be a contest to create healthy recipes for school lunches that appeal to kids.
The contests are part of first lady Michelle Obama’s “Let’s Move” campaign to combat childhood obesity.
Copyright 2010, The Associated Press. All rights reserved.