August 2012





Study establishes link between screen time and specific measures of physical fitness

July 16, 2012, Time

By Alexandra Sifferlin

The more TV kids watch in early life, the thicker they get around the waistline and the weaker their muscle strength, a new study finds.

It’s no secret that watching TV is linked with some unhealthy outcomes in kids—previous studies have found that children who watch more television are more likely to eat junk food, have trouble sleeping and become obese—but the new study, published in BioMed Central’s open access journal International Journal of Behavioral Nutrition and Physical Activity, establishes a link between screen time and specific measures of physical fitness.

“We already knew that there is an association between preschool television exposure and the body fat of fourth grade children, but this is the first study to describe more precisely what that association represents,” said senior author Dr. Linda Pagani, a researcher at the Sainte-Justine University Hospital Research Center, in a statement.

The researchers looked at 1,314 kids who were participating in the Quebec Longitudinal Study of Child Development. The parents of the kids reported the number of hours they spent watching TV each week: at the start of the study, when the kids were 2.5 years old, they were watching about 8.8 hours of TV per week on average. Over the next two years, TV time increased by six hours to 14.8 hours weekly on average. By age 4.5, about 15 percent of the kids in the study were watching more than 18 hours of television each week.

The more time kids spent in front of the TV, the larger their waistlines, the researchers found: each additional hour of weekly TV logged between age 2.5 and 4.5 was linked with an increase of waist size of slightly less than half a millimeter by the time the kids were in grade school. So, a child who watches 18 hours of television at 4.5 years old will have gained an extra 7.6 millimeters (0.3 in.) around his middle by age 10.

Fractions of inches may not sound like much to worry about, but even small increases are significant on child-size bodies, and over time, these little changes add up. Waist size in particular is known to be associated with overall obesity and also with measures of visceral fat, the type of fat that hides around the organs deep in the gut and is especially risky to health.

“Our study is the first to look specifically at waist measurements,” says lead author Dr. Caroline Fitzpatrick. “The weight around the waist is particularly dangerous in terms of cardiovascular and metabolic health.”

The researchers measured both waist size and another indicator of physical fitness: explosive leg strength. When the kids were 8.5 years old, the researched gauged their performance on the standing long jump in order to measure their leg-muscle power, a key contributor to sports ability. Kids who watched more TV as preschoolers were more likely to end up in the bottom 5 percent of long-jump performance: each hour spent watching TV per week at age 2.5 corresponded to about a third of a centimeter loss in jumping distance.

That’s important for all kids, not just those who want to play soccer or basketball. Muscle power is associated with other markers of health and fitness: according to Fitzpatrick, if you have good muscle fitness, you’ll also have better cardiovascular fitness and be less susceptible to injuries. The authors write:

This suggests that for some children, excessive television exposure was associated with the experience of a substantial level of impairment. This finding is of concern given that explosive leg strength is a robust indicator of individual general muscular strength. Eventually, reduced muscular strength that persists into adulthood can predict a number of negative health outcomes.

“Kids who watch more TV are known to be less involved in physical activity and less inclined to play sports, but we found there is actually a potential risk in decreasing their athletic performance with too much television,” says Fitzpatrick. “This can influence their health as adolescents and adults.”

Fitzpatrick says the findings are concerning since young kids are still undergoing through muscular and skeletal development. “It’s a move it or lose it problem,” she says.

The American Academy of Pediatrics recommends that children over age 2 watch no more than two hours of television per day; younger kids should watch no TV at all. Each hour a kid spends planted in front of the tube is an hour he or she isn’t exercising, playing or doing any other constructive activity like reading. “When it’s cold outside, you want a kid to throw on their snow gear and go play instead of preferring to stay inside to watch hockey on TV,” says Fitzpatrick.


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NCCOR members selected to receive NIH Merit Award

Aug. 2012, NCCOR

At the end of the year, a number of NCCOR members will be recognized for their contributions to the field of childhood obesity research. The Department of Health and Human Services (DHHS) Energy Balance Provider Survey Collaborative Working Group has been selected to receive a 2012 National Institutes of Health (NIH) Merit Award. The working group includes 11 NCCOR members.

The group, nominated by NCCOR Senior Leadership member Dr. Robert Croyle, will receive the award in recognition of their outstanding leadership in the development and implementation of a nationally representative assessment of primary care physicians’ practices related to energy balance.

The NIH Merit Award recognizes individuals or groups whose achievements warrant special recognition.

NCCOR members in the working group include Tanya Agurs-Collins, Rachel Ballard-Barbash, Karen Donato, Emily Dowling, Deborah Galuska, Mary Horlick, Terry Huang, Laura Kettel-Khan, Sue Krebs-Smith, Deborah Olster, and Susan Yanovski.

The team will receive their award at the NCI Director’s Awards Ceremony on Nov. 15th at Masur Auditoriumin, Clinical Center (Building 10), from 1-3 p.m.

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Publications & Tools

Population-level intervention strategies and examples for obesity prevention in children

July 18, 2012, Annual Review of Nutrition

The purpose of this review is to provide a summary of population-level intervention strategies and specific intervention examples that illustrate ways to help prevent and control obesity in children through improving nutrition and physical activity behaviors. Researchers and practitioners may use this review as they set priorities and promote integration across settings and to find research- and practice-tested intervention examples that can be replicated in their communities for childhood obesity prevention.


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Childhood Obesity Research & News

Despite obesity concerns, gym classes are cut

July 10, 2012, The New York Times

By Al Baker

More than a half-century ago, President Dwight D. Eisenhower formed the President’s Council on Youth Fitness, and today Mayor Michael R. Bloomberg and Michelle Obama are among those making childhood obesity a public cause. But even as virtually every state has undertaken significant school reforms, many American students are being granted little or no time in the gym.

In its biennial survey of high school students across the nation, the Centers for Disease Control and Prevention reported in June that nearly half said they had no physical education classes in an average week. In New York City, that number was 20.5 percent, compared with 14.4 percent a decade earlier, according to the C.D.C.

That echoed findings by New York City’s comptroller, in October, of inadequate physical education at each of the elementary schools that auditors visited. Researchers at the University of California, San Francisco, found just 20 percent of elementary schools in San Francisco’s system were meeting the state’s requirements: 20 minutes per day.

At Anatola Elementary School in Van Nuys, Calif., not only are there no gym teachers, but there is also no gym. The principal, Miriam King, has relied on $15-an-hour aides to oversee once-weekly exercise regimens for her 450 students at an outside playground.

“Sometimes, when it is raining, we just cancel,” Ms. King said.

In the Miami-Dade School District in Florida, physical education classes for middle school students were threatened by state legislation last year, in the face of anemic local tax collections and dropping property values. But the district’s top health educator, Jayne D. Greenberg, watched in thankful relief as a grass-roots effort mounted enough political pressure to beat back the proposed cuts.

Still, Dr. Greenberg said, she has had to “double up some of the elementary physical education classes.”

In East Harlem, at TAG Young Scholars, an elementary and middle school for gifted students, there was no gym teacher for elementary students, according to Patricia Saydah, whose son Mitchell Deutsch just finished the first grade there. Art teachers and guidance counselors oversaw the classes, and students were sometimes called on to demonstrate stretching, Mitchell said. Next year threatens more hardship: One of the four schools that share TAG’s building is expanding, further straining the sole gym.

Ms. Saydah said she was concerned with Mitchell’s ability to focus in class without physical activity most days.

“He comes out of school and he is bouncing off the walls,” she said.

Senator Tom Harkin, Democrat of Iowa, has proposed injecting language into the federal budget creating incentives for schools to report how much physical activity students are getting. He also asked the Government Accountability Office to look into the issue and, in February, it released a survey showing that while schools appeared more aware of the benefits of physical education, “they have reduced the amount of time spent” on such classes.

Principals most frequently blame budget cuts, and in New York, they also cite pressures to devote resources to test preparation, and what one union leader called a lack of interest from the department headquarters.

“There does not appear to be a promotion, or support, from the Department of Education for daily physical education in many of our high schools,” said Jeff Engel, a vice principal at Long Island City High School, in Queens, who is a member of the executive board of the principals’ union. He said that his own school provided daily physical education, but that many did not. “We have a huge obesity epidemic in the city, yet we see many of our high schools going to nondaily physical education.”

According to the city comptroller’s audit, none of the 31 elementary schools that auditors visited were holding physical education classes as frequently as required: every day for kindergarten through third grade and three times a week for grades four through six, for a minimum of 120 minutes weekly; and at least 90 minutes a week for grades seven and eight. In grades 7 through 12, state guidelines call for physical education three times a week in one semester and twice a week in another.

Kathleen Grimm, New York City’s deputy schools chancellor for operations, said the Bloomberg administration required adequate physical education in schools, but acknowledged it had work to do. Since principals face challenges in providing space and time for those classes, she said, the administration hoped to put a plan in place by summer’s end to provide them “better support” across all areas of education, including physical education.

The department has not filed a physical education plan with the state since 1982, though state officials recommend a new one every seven years. A spokeswoman for the city schools says one will be presented in September.

Besides its value in fighting obesity, physical education has also been linked in some studies to good academic outcomes. Dr. John J. Ratey, a Harvard professor and author of “Spark: The Revolutionary New Science of Exercise and the Brain” cited a 2010 study on the topic from the federal Health and Human Services Department.

“There is shrinking P.E. and recess time for our kids,” Dr. Ratey wrote. “P.E. teachers are fighting like cats and dogs to hold the line on their jobs and worth, at the same time as there is a dawning awareness that we have missed the boat.”

Despite the shortcomings in physical education, Mr. Bloomberg has received high marks from public health advocates for his anti-obesity policies, including calorie disclosures in chain restaurants, a proposed ban on large sugary drinks in certain settings, and limits on the calorie and sugar contents of food sold in school vending machines.

In the meantime, the city has promoted several school health initiatives, including 10-minute “fitness breaks” in classrooms and before- and after-school recreation for middle school students. And Ms. Grimm said that the city had been honored, nationally, for a program to assess students’ fitness and that 850,000 pupils had completed the program this year. In December, the city said that annual fitness exams given to most of the city’s kindergarten though eighth-grade students showed a 5.5 percent drop in the number of obese schoolchildren over five years, the biggest decline reported by any large city. Despite the improvements, the study showed that 21 percent of the children were still considered obese.

One elementary school making an effort is Sheridan Academy for Young Leaders, in the Bronx, where Ronny Rodriguez, a physical education instructor, ran 12 students through a rigorous 50-minute class one day last month.

Each student gets class once a week, far short of state requirements. During fitness breaks, students in science class stand and clap to the beat of a heart, and in social studies, they move as if navigating a rain forest.

Still, Mr. Rodriguez and Vicki Weiner, co-chairwoman of the school’s wellness program, wish more days had gym class.

As his perspiring first graders, some visibly overweight, poured out of the gym for the last time, Mr. Rodriguez addressed his “young leaders” and asked what they would do over the summer.

“Exercise!” came the choral reply.

“One day, or every day?” he asked. They replied, in unison: “Every day!”


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New York City's proposed ban on big sugary sodas draws heated debate

July 24, 2012, Reuters

By Jonathan Allen

New York Mayor Michael Bloomberg’s proposed ban on large sodas is expected to pass in September, but that didn’t deter hundreds who showed up on July 24 to either to praise the measure as a way to battle obesity or oppose it as pointless and unfair.

The proposal before the city Board of Health, the first of its kind in the nation, would limit servings of sugary drinks to 16 ounces (473 ml) at most restaurants, theaters, delis, vending carts, and stadium concessions.

With the Board of Health filled with Bloomberg appointees, the proposal is expected to pass when it is put to a vote on Sept. 13.

Many opponents view the measure as unwelcome government intervention—a further incursion of Bloomberg’s “nanny state”—while supporters call it crucial to fighting obesity.

The hearing drew hundreds of participants, from public health officials to local politicians and a dentist who reminded the audience that sugary drinks cause cavities.

Opponents such as Melissa Mark-Viverito, a City Council member who represents low-income neighborhoods in East Harlem and the Bronx, said the proposal would unfairly harm small and mid-sized restaurants that sell drinks in large containers.

Critics also say the law would punish lower-income people who rely on the cheaper fare of fast-food restaurants.

“After speaking face to face with restaurant owners, I’m convinced that this ban will have an adverse economic impact on our community’s small businesses and could result in job losses,” Mark-Viverito said.

“We need to get to the root of the problem, which goes much deeper than the size of a cup of soda,” she said, calling upon the city to expand and renovate parks and playgrounds to give residents more opportunities to exercise.

The ban would not apply to convenience, grocery or drug stores, which mostly sell beverages in bottles and cans, and it would exclude diet and dairy-based coffee drinks.

Coca-Cola Co has called the Bloomberg proposal an insult to New Yorkers, and the American Beverage Association, which represents that company as well as PepsiCo Inc and other soda makers, is fighting the measure.

“We believe it is misguided, unscientific, arbitrary and, if adopted, unlawful,” said Jim McGreevy of the American Beverage Association at the hearing.

He said Americans are drinking less full-calorie sweetened drinks, yet obesity continues to rise.

Speaking in favor was Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University, who said sodas are the greatest source of added sugar in typical American diets and have no nutritional value.

“If people are served larger portions, they generally consume more,” he said. “This to me is a bold and constructive policy completely supported by scientific evidence.”

City officials cite statistics showing 58 percent of New York City adults and nearly 40 percent of public school students are obese or overweight.

During Bloomberg’s three terms in office, the city has banned smoking in bars, restaurants and public places, banned artificial trans fats in restaurant food and required calorie counts to be posted at fast-food outlets. Bloomberg also has led a campaign to cut salt in restaurant meals and packaged food.

Opponents accuse the mayor of trying to run a “nanny state.” An advocacy group backed by the food and restaurant industries took out a full-page ad recently in The New York Times, depicting Bloomberg as a nanny in a purple dress.

If the measure is approved, the regulations would take effect in March.


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