August 2013





NIH study: Some children can 'outgrow' obesity

July 30, 2013, The Information Daily

The new model, published in The Lancet Diabetes & Endocrinology, indicates that some children may be able to ‘outgrow’ obesity during key periods of rapid growth, particularly between the ages of 11 and 16, and without the need to actually lose weight.

Led by Dr. Kevin Hall from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health (NIH), the model is the first to actively differentiate between the healthy weight gain that is normal in childhood, and the excessive levels, which result in obesity. [Hall is also a contributor to the National Collaborative on Childhood Obesity Research Envision project.]

The model accurately represents how energy balance in children is responsible for weight gain. This is the difference between the total consumed energy and the amount which is actually expended.

Current models may have hugely underestimated the amount of calories which overweight or obese children are eating. For example, models currently used by clinicians predict that a girl who was a healthy weight at age 5, but is now about 22 pounds overweight at age 10 has an excess calorie intake of around 40 calories per day. This is measured as being the approximate caloric content of a small apple.

However, the new model is based upon a more sophisticated understanding of how metabolic function, growth, and energy expenditure change as children gain weight. This estimates that in actuality, the same overweight 10-year-old is consuming closer to 400 calories per day more than her healthy peers. In contrast, this is measured as being the approximate caloric content of a beef burger or medium portion of fries.

This model also suggests that due to the aforementioned interaction between growth rate, metabolism, and energy expenditure it may be possible for some children to actually ‘outgrow’ obesity during periods of rapid growth, most exhibited between 11 and 16 years of age.

Boys who are obese over this period will tend to normalize their body fat levels while continuing to grow taller and add lean tissue mass. However, this effect is less pronounced in girls, primarily because they lose less body fat during this period and do not have as high a growth potential.

By testing this model against real-world data from studies assessing the effect of various weight-loss interventions, the research team was able to show that their model is so far the most accurate tool developed to predict the effect of calorie intake on child weight loss.

With roughly one-third of children in the United Kingdom and United States estimated to be overweight or obese, the new model may provide clinicians and policy makers with a vastly improved understanding of how calorie-controlled dieting and physical exercise regimes can be utilized effectively in order to address the epidemic of childhood obesity.

Dr. Hall said: “One of the most disconcerting aspects of the global obesity epidemic is the high prevalence of childhood obesity, which carries both health and economic consequences. “The model we have developed is a substantial step forward in fighting this rising tide of childhood obesity. It allows us to accurately predict how a child’s energy intake affects his or her likelihood of becoming overweight or obese.

“Though the model doesn’t apply perfectly to all children — for instance, those who start adolescence late, or who undergo particularly rapid weight gain — it provides an accurate representation of the average effect of reducing or increasing calorie intake on the weight of children.

“Our future research will adapt the model to individual children as well as study the effects of increasing physical activity along with diet changes.”

Also commenting on the research, Professor Claudio Maffeis from the University of Verona, Italy, suggests that the best time for implementing weight loss plans in children is likely to be before puberty, particularly in order to further prevent obesity in girls, since they do not have as great a capacity to regulate their fat levels.

However, if childhood obesity is to be effectively tackled, awareness of correct portion sizes and calorific intakes must be instilled in both parents and children.

“The accuracy of parents’ awareness of children’s portion sizes and reporting of children’s food intake is only moderate,” says Professor Maffeis.

He added that: “To translate into practice these desired changes in energy balance, it will be necessary to increase families’ knowledge and awareness of energy content and composition of children’s diets by designing effective and sustainable educational programs about nutrition.”



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NCCOR member helps brings healthier food to the nation’s national parks

Aug., 5, 2013, NCCOR

In June the National Park Service (NPS) announced the Healthy Parks, Healthy People initiative, which includes healthy food standards and sustainable food guidelines designed to increase the number of healthy menu items available at national parks across the nation. National Collaborative on Childhood Obesity Research (NCCOR) member, Heidi Blanck, along with her colleagues at the Centers for Disease Control and Prevention (CDC) helped to develop these new standards.

“The Healthy and Sustainable Food Program was developed through a collaboration between the National Park Service and park food and beverage operators, concession industry leaders, and health experts to describe the current food and beverage offerings and to develop the standards, which will be integrated into all new concessions contracts and applied on a voluntary basis to existing contracts,” said Blanck, of the CDC’s Division of Nutrition, Physical Activity, and Obesity.

The standards will apply to more than 250 food and beverage operations in U.S. national parks. The healthy food standards include requirements that fruits and vegetables be offered with all entrees, or offered a la carte as side dishes; low-fat and low-sodium options are to be available; half-servings or other reduced-portion sizes are to be offered when possible. As for drinks, at least 30 percent of those offered should have no added sugar, and low-fat and fat-free milk should be available.

As part of creating the standards, scientists from the CDC and state health departments used nutrition and beverage audit tools, adapted from tools such as the Nutrition Environment Measurement Survey, which were funded by U.S. Department of Agriculture (an NCCOR funder) to provide baseline data on food, beverages and drinking water availability, pricing, and promotion in 44 parks across the nation. The tools assessed park stores, snack shops, restaurants, vending (beverage and food), and free drinking water sources.

“The new program includes incentives and recognition opportunities for concession companies that exceed the standards and demonstrate leadership in improving the visitor experience,” said Blanck. “This type of program has the ability to not only affect the park food consumer but make changes to the food system such that healthier items are produced and available to other retail venues such as workplace cafeterias and schools.”

One of the reasons this policy is so important is because of its potential to influence the eating habits of so many Americans. NPS manages 397 national parks, employs 22,000 staff, has 221,000 volunteers and offers activity opportunities, snacks, and meals to over 280 million visitors annually, making it a major employer and one of the largest tourist destinations and food providers in the United States.

“Access to parks, trails, open spaces, and recreational facilities not only provide increased opportunities for children and adults to play and be physically active but these venues also influence other behaviors including nutrition through water, beverages, snacks, and in some cases meals,” said Blanck. “As the health and wellbeing of our children is impacted by the daily environment in which they live, learn, and play, the utility of parks and other recreation spaces are important to consider in a comprehensive view of childhood and family obesity prevention.”

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Publications & Tools

Declining childhood obesity rates—where are we seeing signs of progress?

In recent years, the national childhood obesity rate has leveled off. Some cities, counties, and states have even reported modest declines in their rates, but progress to reduce racial, ethnic, and socioeconomic disparities in obesity rates has been more limited. The places that are reporting declines have taken their own unique approaches to addressing childhood obesity. Many of these places have made broad, sweeping changes to make healthy foods available in schools and communities and integrate physical activity into people’s daily lives.

More efforts are needed to implement these types of sweeping changes nationwide and to address the health disparities gap that exists among underserved communities and populations.

This Health Policy Snapshot examines where and why progress is being made to address the childhood obesity epidemic.


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Foods advertised on popular children's websites do not meet nutrition standards

Despite food company pledges to advertise only healthier foods to children, a Yale Rudd Center for Food Policy & Obesity study finds that companies place billions of advertisements for unhealthy foods and beverages on children’s websites. The study is the first to evaluate banner and other display advertising on websites that are popular with children, such as and The study is published online in Pediatric Obesity and was funded by the Robert Wood Johnson Foundation.


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How can healthier school snacks and beverages improve student health and help school budgets?

Today, more than 23.5 million children and adolescents in the United States are overweight or obese, putting them at greater risk for serious health problems and straining the health care system. Students consume 35 percent to 50 percent of their daily calories at school, where they often are exposed to junk foods and sugary drinks that offer little nutritional value.


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Salud America! releases set of materials exploring active spaces and physical activity among Latino children

This summer, the Robert Wood Johnson Foundation’s Salud America! is releasing six packages of research materials—each with a research review, issue brief, video, and infographic—on different aspects of Latino childhood obesity issues and potential solutions.

The third and fourth packages, “Active Spaces” and “Active Play” explore how to increase physical activity among Latino kids. “Active Spaces” explains that while Latino kids often lack access to safe “active spaces” shared use of gyms, athletic fields, and playgrounds, as well as street-level safety improvements, can increase access to recreational facilities at schools and other sites. “Active Play” demonstrates the benefits of structured school- and community-based programs that are culturally relevant which can increase physical activity among Latino children.


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Childhood Obesity Research & News

West Virginia slowly curbing childhood obesity epidemic

July 11, 2013, West Virginia Gazette

It has a long way to go, but West Virginia is starting to turn around the epidemic of childhood obesity.

More than 27 percent of the state’s fifth-graders were considered obese in 2011. But at a recent Voices for Health Kids Conference, officials said that’s a decline from 8.6 percent since 2005.

That makes West Virginia one of only five states showing a reversal.

The conference was organized by the Robert Wood Johnson Foundation and the American Heart Association.

West Virginia Public Broadcasting says Nebraska, California, North Carolina, and New Mexico have also seen drops in childhood obesity.

Though the rates are still high in West Virginia, experts say any improvements are worth celebrating.

“Considering childhood obesity has been a virtual tsunami, any reversal in any community is an exciting development,” said Bill Roach, chairman of an advisory committee to the Voices for Healthy Kids initiative.

“That’s really why we wanted to bring these communities together in Washington,” he said, “to educate others as to how they’ve been able to do it. Now is an 8.6 percent reduction significant? We’d love to see a 90 percent reduction. But the point is we’re seeing a reversal in the trend.”

The Voices for Healthy Kids initiative aims to reverse the nation’s childhood obesity epidemic by 2015.

Dr. Jamie Jeffrey of Charleston Area Medical Center said she wasn’t trained in how to treat type 2 diabetes 20 years ago, so she had to re-educate herself and learn how to tackle adult diseases in children.

“I had a 2-year-old patient that weighed over 100 pounds,” she said.

The child was too obese to walk, and she was on medication for sleep apnea.

“So it’s really not only the number of kids affected but the severity of the disease,” Jeffrey said.

West Virginia has taken several approaches to the problem, including requiring healthier meals in public schools, building parks and walking or biking paths, and supporting community gardens to grow more vegetables.

“This is the first sign that we have at least stabilized the epidemic,” Jeffrey said, “and now we need it to make a big U-turn.”


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Kids have fun getting fit

July 28, 2013, The Buffalo News

By Amy Moritz

Jillian Huber watched as her son, Jeffrey, ran down the inflatable track and sprinted over to the bounce house. The 2½-year-old was filled with toddler energy and he was using every morsel of it. Some days, when Huber is mentally debating whether to get up and go to the gym for her workout, Jeffrey is pestering her with the question: “Are we going to the gym today?”

Yes, her son has become one of the key motivators in Huber’s workout routine. She joined Fitness 360 in North Buffalo, N.Y., and when the facility opened up its kids’ only Jungle Gym, it became perfect for the Hubers. She could introduce her son and her 7-year-old daughter Anna to a healthy, active lifestyle while she worked on her own pieces of a healthy, active lifestyle.

In North Tonawanda, a similar scene plays out at CrossFit 716 where Holly Simons watches her 5-year-old son Luke perform tuck-ups and burpees (squats) in a kids-only class. Simons had started taking classes at the gym and loved the workout, the philosophy, and the family atmosphere. When they added a kids’ class, she was eager to sign up her son, who loves the workouts so much he does burpees at home for fun.

The reasons both women involved their children in their typically adult gym are fairly standard – they wanted to share something active as a family and find different ways to teach their children lifelong healthy habits. They are well aware of the phrase “childhood obesity epidemic” and are looking for ways to help keep their kids on the other side of that equation.

While research continues to demonstrate the increasing problems created by childhood obesity and the public’s awareness on the topic increases, traditional sources of physical activity and health education are decreasing. And that’s where the private sector has stepped in to help fill the increasing demand for children’s health programming.

No one debates that children should be active, but research increasingly suggests they aren’t. The Centers for Disease Control and Prevention (CDC) says that obesity prevalence in children and teenagers has nearly tripled since 1980 with about 17 percent of 2- to 19-year-olds considered obese. Locally when you combine obesity and overweight statistics, the picture looks even worse.

In Erie County, 27.7 percent of all students qualify as obese or overweight. In Niagara County, it’s 33.6 percent. Wyoming leads the eight counties of Western New York at 34.6 percent.

Disease and lifestyle

The health effects of carrying significant extra weight are well-documented and as more and more children are dealing with serious weight issues, the discussion about disease has even changed.

“We’ve seen more kids diagnosed with type 2 diabetes,” said Dr. Karl Kozlowski, assistant professor of kinesiology at Canisius College. “We used to call that ‘adult onset diabetes’ because it largely happened later in life and as a result of diet and exercise factors. We’re seeing the impact of those lifestyle factors in 12-year-olds now.

“Children are dealing with high blood pressure and high cholesterol. Those are health issues we typically see in adults and seeing them now routinely in children is alarming.”

Research linking childhood obesity to a range of health problems, from type 2 diabetes to asthma, has been well-documented along with one of the causes of those problems – lack of physical activity.

But the research also shows other benefits of physical activity and a healthy weight for children when it comes to the classroom. In studies, after bouts of physical activity, children perform better in an academic assessment. That means a body of research is starting to back up what exercise enthusiasts have believed for decades – that academic performance can be enhanced through physical activity.

Traditionally, the thinking has been that kids would get much of their activity during physical education class and recess at school. But the amount of time kids spend in structured physical education has decreased over the years.

Daily physical education is considered the gold standard, but few schools meet those needs. In a national survey from CDC, only about 52 percent of students attended a physical education class weekly and only 31.5 percent had daily class.

So opportunities to learn about, and practice, a healthy, active lifestyle are declining in school while the adverse health effects of obesity are increasing in children. While nonprofits and grants help to counterbalance those cuts, this is the time in economic models when the private sector steps in.

“This is where you get into the marketplace,” said Phil Habestro, founder and CEO of the Wellness Institute of Greater Buffalo and WNY who has worked in the private and nonprofit sector. “With cutbacks to programs, cutbacks to physical education and health education programs, you end up with the marketplace picking up the slack and increasing efforts to keep children healthy.

“It’s kind of the perfect storm, the marketplace looks for issues and opportunities to address. And many of them already have the space, they’re just finding new ways to optimize their space, time and profit.”

The private sector has discovered not just a new marketing opportunity that makes good business sense but a chance to feel part of the solution to creating a healthy community and future consumers. One of the newer demands of parents for their children is turning away from the traditional youth sports model and looking for different ways to teach lifelong fitness habits.

Take the parent who wanted his child to try CrossFit because he succeeded at every other sport he played. He told Jenn Lesniak, owner and coach of CrossFit 716, that he “wanted him to get used to losing because he’s really good at everything.”

CrossFit is defined as constantly varied, high-intensity, functional movement with workouts that are always changing so the body never has a chance to adapt. Because the workout challenges individuals where they are at in their fitness level, each person has the opportunity to work to their maximum effort and capacity, basically competing against themselves.

“When you do CrossFit, that’s the thing: Even if you’re the best, you lose to yourself,” Lesniak said. “Cross Fit is the only avenue where the loudest cheers are for the person who’s last, not for the person who’s first. That’s a huge thing. They’re not cheering for the first person who’s done. It was easy for them. They’re cheering for the person who is really, really laying it out there.”

In North Buffalo, Glenn Kaifas took some open space and created a kid-friendly workout zone called Jungle Gym complete with bounce houses, a foam pit, climbing wall, and zip line.

Kaifas developed Jungle Gym when he realized that there was no place to take his children for an active afternoon on a bad weather day in Buffalo. As a fitness professional, he has seen clients come to him in their 40s suffering from health problems which could have been eased, or even avoided, if he was able to work with them 10 or 20 years earlier. Why not try to target an even younger population to be part of the solution?

Jungle Gym at Fitness 360 has both structured age-group classes and open gym times available to gym members and on a drop-in basis. This isn’t your typical baby-sitting service while mom or dad get their workout in. This is a way for children to get their introduction to fitness and feed into the family’s healthy lifestyle.

“We want to send a message that fitness is fun. That it’s important to take care of yourself,” Kaifas said. “It’s not vegetables are yucky and exercise is hard. Exercise can be fun. That’s one of our main missions to keep adults motivated, so it’s going to be the same thing for kids. To send that message that ‘look, we just had a blast and it was good for you.’ ”

The importance of nutrition

And it’s not just gyms expanding their demographics that are getting in on the ground floor of building a healthy consumer base. The other piece of a healthy lifestyle is nutrition.

Supermarkets, including Wegmans and Tops, are educating children about healthy food choices.

“All of us who work at Wegmans have families and we all want to be active and healthy,” said Theresa Jackson, consumer affairs manager for Wegmans who also is a registered dietitian. “We’re part of the community and we want to see our communities thrive. Healthy eating is part of that.”

Wegmans offers a range of programs, including in-store “Cooking with Kids” classes based around getting kids to try new foods and make healthy choices. Wegmans also offers “Eat Well, Live Well” fourth-grade tours where students tour the store and learn about eating a rainbow of fruits and vegetables.

“We have kids come to a store on a field trip and then go home and they’ll talk to their families about what they learned,” Jackson said. “We’ve had parents call us up and ask us what jicama is and where they can get it because their child tried it on a field trip to Wegmans and can’t stop asking for it. So we sometimes have kids teaching their parents and being the driving factor to getting their families to eat healthy.”

“Family” and “community” seem to be the key factors when determining success in maintaining a healthy weight.

In his 30 years of researching obesity, Dr. Leonard H. Epstein has seen the best results come from involving the entire family.

“One of the most important things we’ve learned in maintaining weight loss is to treat it as a family problem,” said Epstein, SUNY Distinguished Professor of Pediatrics at the University at Buffalo. “Very often if you have the pediatrician treating an obese child, they look at how to treat the child. If you have an obese parent, they go to their doctor who puts them on a program for their weight loss. But if you treat the parent and child together, treat the entire family, then we see more success in maintaining weight loss.”

All of Epstein’s research is family based, including the newest study (which is currently recruiting family participants) to test the idea that food variety is one cause of obesity.

In three decades of work in the field, Epstein has seen some important changes in the culture of researching, treating and talking about obesity.

“Obesity is seen now more as a public health issue versus some weakness of self control,” he said.

The research and public policy initiatives help shape the health culture for the community. But it doesn’t happen in a vacuum. And for families like the Hubers, finding a local business to support their endeavors becomes another link of positive reinforcement.

“I already belonged to the gym,” Jillian Huber said. “When I saw they were building the Jungle Gym, I thought it’d give the kids a chance to try some different things. They love it. And it helps us. We’re trying to make this our lifestyle.”


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Alabama childhood obesity slowed but still rising

July 21, 2013,

The launch of an initiative aimed at addressing childhood obesity in Alabama has slowed an increase of overweight children compared to other states, but hasn’t improved Alabama’s childhood obesity rate.

The Montgomery Advertiser reported on July 20 that obesity rates in Alabama’s children and teens have increased by nearly 5 percent since 1999 despite an effort by the Alabama Department of Education to control what types of snacks are sold in vending machines on school campuses.

“The thing that I keep reminding myself, that even if the school plays a large part in a child’s life, that child can still go to the fast-food restaurant after school or eat processed food at home,” said Miriam Gaines Alabama Department of Public Health nutrition and physical activity director.

Gaines added that she wishes the state would implement an initiative aimed at showing people that developing healthy eating habits doesn’t have to be as expensive as many people think.

“There is a way that you can be on a healthy diet and have it not be expensive,” she said. “That takes time and planning. But that’s not in our lifestyle yet.”

The newspaper reported Alabama was ranked 14th in terms of child obesity rates in 2010 and has dropped from a higher position because the rates in other states have increased faster than Alabama’s.

The newspaper reported a 2011-2012 Child and Adolescent Health Measurement Initiative survey found that 35 percent of Alabama’s children were considered overweight.

Michael Briddell, known as Montgomery’s health czar, helped develop the River Region Obesity Task Force, which recently applied for a one-year $7,200 grant that would allow researchers into several schools to measure children’s body mass index.

Briddell says schools are offering more nutritious meals but anecdotal instances — such as groups selling candy to support extracurricular activities — can negate efforts being suggested by the Alabama Department of Education.

“We hear of schools not complying with the state mandate for the minimal amount of activity, and that’s infuriating as well,” Briddell said. “And school is just a portion of a child’s life. We can have great healthy offerings and physical activity at school, and bang, it is washed away.”


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Would taxing high-calorie foods curb obesity?

July 2, 2013, Fox Business

By Kate Rogers

Uncle Sam could make a healthy profit off of Americans’ bad eating habits and at the same time, improve the nation’s obesity rates, according to new research proposing taxing fatty foods.

The National Bureau of Economic Research finds that raising the price of a calorie for home consumption by 10 percent may lower the percentage of body fat in youths by nearly the same amount (8 percent or 9 percent). The research focused on youths and found that raising the prices of high-calorie fatty foods at fast-food chains would help reduce obesity rates, however, the tax could also have consumers skip healthy foods with higher calorie counts.

The nation’s growing waistline has become a top concern among lawmakers and experts, but not everyone agrees that the government should get involved in solving the problem.

Devon Herrick, senior fellow at the National Center for Policy Analysis, says an 8 percent to 9 percent drop in body fat percentages among youths would be substantial, but adds parents might be more effective in eliciting eating habit changes that the government.

Indeed, the study says, “Taxes are blunt instruments that impose significant welfare costs on individuals who consume food in moderation. Moreover, in the case of adolescents, an additional issue is that parents may more easily and immediately affect the choices made by their children than the government.”

“For kids, parents can impact [fat loss] more easily than a tax,” Herrick says. “If you are worried about childhood obesity, parents are the first line of defense.”

Increasing the price of food may decrease calorie consumption, he says, but Americans would need a significant hike in prices to see major fat loss. And like most taxes, there’s always a loophole: Herrick points out raising rates of high-calorie options at fast food restaurants, as the study did, leaves out the dollar menu, and lower-priced options of equally-fatty foods.

“I can still choose from the dollar menu, which negates any impact of throwing the tax in.”

Dr. Leena Khaitan, director or the Bariatric Surgery Program at University Hospitals Case Medical Center, agrees with Herrick’s notion that parents should be policing their children before the government. However, Khaitan says she would prefer to see the prices of healthier foods lowered, rather than a tax placed on high-calorie items.

“From a public health standpoint, we did this [tax] with smoking and it made a huge impact in the country. But people still make choices to buy their food. If you want to get a salad, or shop at Whole Foods, versus fast food, you will always pay more for the healthy stuff. Even at a drive through, you still pay more for salads.”

Obesity, which was just deemed a disease by the American Medical Association in June, is the number two most common preventable death in America, after smoking, says Khaitan.

“We spend hundreds of billions a year [in America] on obesity from dieting to time off work, to hospital visits. It impacts society in huge ways,” she says. “From a business standpoint, [taxes] seems like a reasonable concept and a nice way to offset costs. But ethically, or morally, I feel uneasy about it.”

Also, the government subsidizes calories a great deal through the Supplemental Nutrition Assistance Program, Herrick says.

“If calories are the problem, we go through a lot of effort to subsidize them via public policy,” he says. “That doesn’t make a lot of sense.”

In addition, corn prices have shot up in recent years due to both droughts and ethanol production, Herrick says. The ripple effect of this is that other grains have also increased in price, as have costs associated with livestock production.

“If obesity were highly sensitive to food prices, there should have been a noticeable dip in obesity rates as food and energy prices rose in the past several years. I have not seen evidence of any such dip in obesity rates,” he says.


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