December 2011





Johns Hopkins Global Center for Childhood Obesity Established

Nov. 10, 2011, Johns Hopkins Bloomberg School of Public Health Public Health News Center

The Johns Hopkins Bloomberg School of Public Health has been awarded a $16 million U54 cooperative agreement from the National Institutes of Health (NIH) to establish a global center of excellence to address the childhood obesity epidemic. The new Johns Hopkins Global Center for Childhood Obesity will emphasize the integration of geospatial analysis with a systems science and transdisciplinary approach to childhood obesity, bringing together basic science, epidemiology, nutrition, medicine, engineering and environmental and social policy research, among other fields, in an unprecedented, innovative way.

Based at the Johns Hopkins Bloomberg School of Public Health, and in collaboration with scientists at the NIH, the Center will involve more than 40 investigators from 15 domestic and international institutions, including faculty from five Johns Hopkins schools, namely Whiting School of Engineering, School of Medicine, School of Nursing and the Krieger School of Arts and Sciences.

The $16 million grant, provided by the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and Office of Behavioral and Social Sciences Research (OBSSR), will fund research and training initiatives over the next five years. The Johns Hopkins University and several other institutions are providing an additional $4 million in funding support.

The Global Center for Childhood Obesity is a key new initiative under the auspices of the National Collaborative on Childhood Obesity Research (NCCOR), which coordinates childhood obesity research across the NIH, Centers for Disease Control and Prevention (CDC), the Robert Wood Johnson Foundation (RWJF) and the United States Department of Agriculture (USDA). In addition to studying the drivers of the childhood obesity epidemic and environmental and policy interventions, the Center will also provide rapid-response grants to investigators in the field worldwide to obtain time-sensitive data on environmental and policy changes relevant to childhood obesity.

“The new Center will address many needs in the prevention and study of childhood obesity. This initiative will help create research and training opportunities that go beyond traditional methods, and on an unprecedented global scale,” said Youfa Wang, MD, MS, PhD, founding director of the Center and associate professor in the Bloomberg School’s Department of International Health.

“The Center’s focus on systems science will help train a new generation of researchers and public health professionals to help fight the growing global epidemic of childhood obesity and non-communicable chronic diseases. We are going to bring together a large number of investigators from many different disciplines and from different countries to address the complexity of childhood obesity,” said Layla Esposito, PhD, program director from the NICHD. Terry Huang, PhD, MPH, senior scientific advisor to NCCOR, concurs.

The new Center will provide a research and training infrastructure for building the capacity for integrating systems science into obesity and chronic disease research. Study results are expected to inform policy design and future empirical research.

“Childhood obesity is a pressing issue in both the United States and developing countries. The Global Center for Childhood Obesity will seek answers to this challenge, which is in line with the Bloomberg School’s fundamental mission of protecting health and saving lives—millions at a time,” said Michael J. Klag, MD, MPH, dean of the Bloomberg School of Public Health.

“The Global Center for Childhood Obesity will draw upon resources from across Johns Hopkins University to focus our diverse scientific and academic resources on addressing the obesity epidemic in new ways,” said Lloyd Minor, MD, provost and senior vice president for academic affairs of Johns Hopkins University.

According to the World Health Organization, worldwide obesity has more than doubled since 1980. In 2008, 1.5 billion adults aged 20 and older, were overweight or obese, and 65 percent of the world’s population lives in countries where overweight and obesity kill more people than underweight. Nearly 43 million children under age 5 were overweight in 2010. According to the CDC, childhood obesity in the U.S. has more than tripled in the last 30 years. In 2008, more than one-third of American children and adolescents were overweight or obese, which greatly increases the risk of obesity-related illnesses, such as type 2 diabetes, hypertension and heart disease. Prevention of obesity in children is a key to fighting the global epidemic.


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Publications & Tools

NCCOR Catalogue of Surveillance Systems New Additions

Two new Data Resources Have Been Added to the Catalogue of Surveillance Systems.

  • National Survey on Recreation and the Environment NSRE
  • Census Transportation Planning Package CTPP

Access the NSRE

Access theCTPP

Access the Catalogue at

Please visit for more information about the CSS, a full list of NCCOR-led projects, upcoming events, and childhood obesity research highlights.

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Study Finds that Obesity in Childhood May Not Lead to Elevated Health Risks if Nonobese as an Adult

A new study reports that obese children who lose weight and become nonobese adults have the same risk of diseases such as type 2 diabetes and hypertension as those who have never been obese. Meanwhile, obese adults who were also obese as children have a greater risk of suffering from these health risks. This study was principally funded by the Academy of Finland, and appeared in the New England Journal of Medicine.


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Community Development and Public Health

It has long been understood that many factors beyond health care actually influence health. Social and economic determinants of health include income, education, physical environment, social isolation, and concentration of poverty. Given this reality, there is a growing realization of the potential for synergies between work to revitalize low-income communities and the need to promote and improve health.

Community development encompasses a range of efforts to improve the physical, economic, and social environment by promoting affordable housing, small-business development, job creation, and social cohesion in low-income neighborhoods. The field of community development is diverse. It includes real estate developers, financial institutions and other investors, community organizations, and local governments. These players have unique assets, as well as a network of connections that can be used to address the root causes or “upstream factors” that affect health.

This policy brief describes the potential for the community development sector to work more closely with the public health and related health-focused sectors, which may be useful for NCCOR-funded community interventions. It discusses the potential impact of their efforts on health outcomes, and the challenges they may face.


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Childhood Obesity Research & News

Congress Blocks New Rules on School Lunches

Nov. 15, 2011, The New York Times

By Ron Nixon

In a victory for the makers of frozen pizzas, tomato paste and French fries, Congress on Nov. 14 blocked rules proposed by the Agriculture Department that would have overhauled the nation’s school lunch program.

The proposed changes — the first in 15 years to the $11 billion school lunch program — were meant to reduce childhood obesity by adding more fruits and green vegetables to lunch menus, Agriculture Department officials said.

The rules, proposed last January, would have cut the amount of potatoes served and would have changed the way schools received credit for serving vegetables by continuing to count tomato paste on a slice of pizza only if more than a quarter-cup of it was used. The rules would have also halved the amount of sodium in school meals over the next 10 years.

But lawmakers drafting a House and Senate compromise for the agriculture spending bill blocked the department from using money to carry out any of the proposed rules.

In a statement, the Agriculture Department expressed its disappointment with the decision. “While it is unfortunate that some in Congress chose to bow to special interests, USDA remains committed to practical, science-based standards for school meals that improve the health of our children,” the department said in the statement.

Food companies including ConAgra, Del Monte Foods and makers of frozen pizza like Schwan argued that the proposed rules would raise the cost of meals and require food that many children would throw away.

The companies called the Congressional response reasonable, adding that the Agriculture Department went too far in trying to improve nutrition in school lunches.

“This is an important step for the school districts, parents and taxpayers who would shoulder the burden of USDA’s proposed $6.8 billion school meal regulation that will not increase the delivery of key nutrients,” said John Keeling, executive vice president and chief executive of the National Potato Council.

The Agriculture Department had estimated that the proposal would have cost about $6.8 billion over the next five years, adding about 14 cents a meal to the cost of a school lunch. Corey Henry, a spokesman for the American Frozen Food Institute, said the proposed rules simply did not make sense, especially when it came to pizza.

The industry backs the current rules which say that about a quarter-cup of tomato paste on a slice of pizza can count as a vegetable serving. The Agriculture Department proposal would have required that schools serve more tomato paste per piece of pizza to get a vegetable credit, an idea the industry thought would make pizza unappetizing.

The department said the change would have simply brought tomato paste in line with the way other fruit pastes and purees were credited in school meals.

Nutrition experts called the action by Congress a setback for improving the nutritional standards in school lunches and addressing childhood obesity.

“It’s a shame that Congress seems more interested in protecting industry than protecting children’s health,” said Margo G. Wootan, director of nutrition policy at the Center for Science in the Public Interest, a nonprofit research group. “At a time when child nutrition and childhood obesity are national health concerns, Congress should be supporting USDA and school efforts to serve healthier school meals, not undermining them.”


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U.S. Food Lobby Fighting Hard to Defend Kid Ads

Nov 7, 2011, Reuters

By Diane Bartz

Some of the world’s biggest food companies won a partial victory in a battle over junk food advertising for children and now they are going for the kill.

Food giants such as Coca-Cola, Pepsi and Kraft and advertising companies successfully pressed U.S. regulators to acknowledge they may weaken proposed guidelines that bar junk food advertisements aimed at children and younger teens. Their success alarmed campaigners fighting obesity.

The Federal Trade Commission signaled in mid-October it would likely drop a plan for voluntary guidelines banning junk food ads to children 17 and under, instead lowering the age limit to 11 and under. Final guidelines are expected by year’s end.

The World Health Organization previously called for mandatory rules to limit children’s exposure to junk food ads and the American Academy of Pediatrics in September urged regulators “in the strongest possible terms to make the nutrition principles and marketing definitions mandatory.”

But the food companies have waged a powerful campaign to avoid any restrictions. The industry took its complaints as high as the White House, just as Michelle Obama has been making a issue of growing vegetables to encourage children to eat better.

Ten major corporations and trade organizations list the issue as something they are lobbying hard on and some have millions of dollars to spend, according to lobby disclosures. “This is the kind of issue that has many, many, many people in the food and beverage industry … very concerned,” said Dan Jaffe, spokesman for the Association of National Advertisers.

The loss of ads have worried companies such as Coca-Cola Co, which has spent $4.74 million to lobby so far this year; Kraft Food Inc, which has spent $2.09 million; and PepsiCo Inc, which has spent $2.61 million, among others.

Trade groups such as the Grocery Manufacturers Association, which spent $2.98 million so far this year, and the National Restaurant Association, which spent $2.1 million, say ditching the guidelines is important to their members.

The issue is expected to come up on November 15, when the Senate Commerce Committee holds hearings to consider the nomination of Jon Leibowitz to remain head of the FTC.

The Agriculture Department similarly signaled it was likely to shift nutritional standards for foods that could be advertised to children, dropping a requirement that they contain a healthy element such as whole grains. It has instead lauded a proposal from the Children’s Food and Beverage Advertising Initiative, a food industry group, that puts limits on salt, fat and sugar.

Both the CFBAI and the Agriculture Department say the same foods that would be banned for advertising to children under one standard, would also be banned under the other while the CFBAI standard is easier to implement, according to both the Agriculture Department and the CFBAI.

A long list of foods satisfy the CFBAI, but would fail the original federal standard — including SpaghettiO’s Meatball, several flavors of Pepperidge Farm Goldfish, Cocoa Puffs and Lucky Charms, says Margo Wootan of the Center for Science in the Public Interest.

Pester power

Although the administration has signaled it will likely weaken the guidelines, food manufacturers and their lobbyists are pressing for a total scrapping of the federal plan.

“There’s no bigger priority for the food sector,” said Scott Faber of the Grocery Manufacturers Association.

One food industry official, said corporate lobbying had reached well into the White House and that his CEO had talked to officials there about the issue.

Health groups have also lobbied the White House hard; a dozen met with the administration last week.

“We stressed that they should not put a White House/administration stamp of approval on the CFBAI standards as they are,” said Wootan. Under pressure, some companies have reduced the sugar, salt and fat in foods made for children. General Mills Inc’s Lucky Charms and Cinnamon Toast Crunch both have 10 grams of sugar in a 3/4 cup serving, while Cheerios has 1 gram of sugar in a 1 cup serving.

Kraft’s Cadbury, Hershey Co, Mars and Nestle Ltd have already stopped advertising to children. Kraft stopped advertising Kool-Aid and Oreos to children in 2005 and has reduced sugar and salt in some foods, but denied this was done to head off potential government action. Kraft has spent $2.09 million on lobbying this year.

But there are still plenty of high-sugar cereals to tempt children. While Kellogg’s Rice Krispies has just 4 grams in a 1-1/4 cup serving, Frosted Flakes has 11 grams of sugar in 3/4 cup. A cup of Froot Loops Marshmallow has 14 grams.

Kellogg, which did not respond to email or telephone requests for an interview, has liberally rewarded its friends in Congress. Rep. Fred Upton, who harshly criticized the administration effort at a recent hearing, has received $58,052 from Kellogg since 1989, according to the Center for Responsive Politics, which tracks corporate influence in politics.

A total of $5,000 of that came during this election cycle, according to their data. The National Restaurant Association also gave him $5,000, while Coca-Cola donated $2,500.

Kellogg gave another IWG skeptic, Rep. Marsha Blackburn, $1,000 in this election cycle. Blackburn also received $2,000 from Campbell Soup Co and $1,000 from PepsiCo.

The money spent lobbying does not erase the fact that children are ill-equipped to distinguish fact from marketing fiction, says Dr. Steven Abrams, a nutrition expert with the American Academy of Pediatrics.

“I personally would suggest that we should make it easier for kids to make the right choices. Kids are easily influenced by what they see,” said Abrams.

But food and advertising companies consider even the watered-down proposal a threat. Not all U.S. food companies have signed onto the industry initiative, but all would be subject to the guidelines.

“We made some progress,” said ANA’s Dan Jaffe. “Victory is far from where we are.”


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It's an Uphill Climb for Obese Kids and Their Parents

Nov. 29, 2011, USA Today

By Nanci Hellmich

Helping a child lose 100 pounds or more is a brutal, uphill battle even with intense diet and behavior treatment, national childhood obesity experts say.

Interest in the treatment of severely obese children is in the spotlight this week after the news that an 8-year-old Cleveland boy who weighed more than 200 pounds was taken from his family and put into foster care. Social workers said it was necessary because the third-grader’s mother wasn’t doing enough about his weight.

It’s hard for a child to lose that much weight, says Melinda Sothern, co-author of Trim Kids and a professor at Louisiana State University Health Sciences Center in New Orleans. She has treated more than 3,000 obese and severely obese children over the past 20 years.

Even the most well-meaning parents would have a hard time sticking with a diet program that would “erase 100 pounds off a child,” she says.

Still, parents have a responsibility to try to help their overweight children reach a healthy weight, and the kids are more likely to be successful if they are involved in an intense, family-based program that includes guidance from a doctor, registered dietitian, psychologist and exercise physiologist, Sothern says. But it’s costly to do this, and it’s hard find facilities that offer this type of help for families with severely obese children, she says.

Marilyn Tanner, a registered dietitian at Washington University in St. Louis who has worked with overweight children for 20 years, agrees that it’s very difficult to help a child lose 100 pounds. “A lot of time if you can stop children from continuing to gain, you are ahead of the game.”

Nutrition experts might try to help a 200-pound child lose 50 pounds and grow into the 150-pound weight, says Tanner, who is a spokesperson for the American Dietetic Association.

Approximately 17 percent or 12.5 million of children and adolescents are obese. Extremely obese children are a subset of this number.

Some of those children appear to have the deck stacked against them genetically, Sothern says. “They are resistant to treatment. I’ve seen it. Parents can be doing everything correctly, and the child’s weight won’t budge. It may be virtually impossible for the kids to resist food. They are constantly putting food in their mouth to feel satiated.”

Some of them have metabolism issues and a reduced ability to use fat as fuel, Sothern says. Still, all of those issues can be managed with proper diet and exercise and appropriate medical support, she says.

It’s critical that parents try to rein in their child’s weight as soon as possible, she says.

“Even if they don’t develop type 2 diabetes, these children aren’t happy,” Sothern says. “They can’t run. They can’t play because their joints hurt, and they run out of breath. They get fatigued. So they move to sedentary pursuits because they can’t keep up.”

The family has to come together and make a firm commitment on a lifestyle overhaul for the overweight child’s sake, she says. They need to make the changes gradually over time.

Tanner says every member of the family needs to be on board, including grandparents, aunts, uncles and siblings. Sometimes, one member of the family can sabotage the efforts. For instance, grandparents may give the kids candy bars or money that the child uses to buy unhealthy foods.

With severely overweight children, there are often emotional factors that need to be addressed, including depression, possible abuse and family upheaval, Tanner says. Parents or caregivers sometimes inappropriately use food as a reward, she says. For instance, if a child does well in school, they may get treated to pizza or ice cream.

When it comes to helping overweight children, Sothern says, people should stop blaming parents and start helping them. “Parents should be supported. They need to take responsibility, but they need help to do so.”


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Can an App Make Grocery Shopping Fun and Educational?

Nov. 29, 2011, Good Technology

By Nina Lincoff

The next location for story time may not be bedside, but among the bananas and cabbages in the produce aisle at the local market. Taggie, a smartphone app developed by recent Dutch design school graduate Niels van Hoof, allows users to direct a smartphone camera at the barcode of food items to learn about their origin, growth process, and different varieties. After recognizing the scanned barcode, Taggie launches a 3D augmented reality animation to engage children with a short, fun lesson about the food.

While Taggie is still in development, the idea comes at the right moment. Globally, there are more than 1 billion overweight adults, 300 million of whom are clinically obese. By allowing children to engage in the shopping experience, Taggie helps them make informed decisions about what’s not only good to eat, but good for them, too.

Van Hoof developed the app as a graduation project for the Design Academy in Eindhoven, Netherlands after being inspired by Jamie Oliver’s Food Revolution. “He went to schools and tried to find out if kids know where food comes from,” van Hoof says. Perhaps needless to say, most of them didn’t—which set van Hoof’s wheels in motion. Van Hoof hopes that by using the app, children will “discover more about fruits and vegetables and [will not be] afraid of the product anymore, which results in living healthier.”

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