- Breakfast cereals loaded with too much sugar for U.S. kids
- NCCOR Connect & Explore webinar on childhood obesity declines happening June 12
PUBLICATIONS & TOOLS
- New CDC report finds most American kids are physically unfit
- Majority of states have ‘head start’ on Smart Snacks nutrition standards
- Families on food assistance are purchasing more fruits and vegetables
CHILDHOOD OBESITY RESEARCH & NEWS
- First lady rebuts effort to weaken school lunch rules
- Kids, parents are embracing the walking school bus
- A new prescription: Eat your veggies
Breakfast cereals loaded with too much sugar for U.S. kids
May 15, 2014, Reuters
By Carey Gillam
U.S. children are consuming more than 10 pounds (4.5 kgs) of sugar annually if they eat a typical morning bowl of cereal each day, contributing to obesity and other health problems, and cereal makers and regulators are doing little to address the issue, according to a study released on May 15.
The Environmental Working Group (EWG), a Washington, D.C. based health information nonprofit, said its report covers more than 1,500 cereals, including 181 marketed to children.
As part of the report, the group re-examined 84 cereals it studied in a similar report in 2011, and found that the sugar content of those cereals remained on average at 29 percent. Some cereals had increased sugar content now compared to 2011, and none of the 181 cereals marketed to children were free of added sugars, the group found. On average, children’s cereals have more than 40 percent more sugars than adult cereals, EWG said.
“Obviously we know cereals have a lot of sugar in them,” said Dawn Undurraga, an EWG consultant and a co-author of the report. “But there is a lot that manufacturers can be doing and [the Food and Drug Administration] FDA can be doing, to protect kids.”
The group said one of the worst offenders is Kellogg Co.’s Honey Smacks, with 56 percent sugar by weight.
A child eating an average serving of a typical children’s cereal eats more than 10 pounds of sugar a year from that source alone, and the average daily intake of added sugar for children is two to three times the recommended amount, the EWG said.
A Kellogg official said the company has cut sugar in its top-selling kids’ cereals by 20 percent to 30 percent over time. The company said the EWG report ignores the benefits provided by a cereal breakfast, including pre-sweetened cereals.
“When you consider what constitutes a good breakfast, cereal and fat-free milk pack a powerful nutritional punch, lower in fat and calories than many other breakfast choices, and including many nutrients that people might otherwise miss,” said company spokeswoman Kris Charles.
The report is the latest in a push by consumer and health groups to convince food companies and regulators to cut unhealthy ingredients from packaged food products.
In March, the FDA proposed that added sugar content be listed in nutrition facts panels on packaged foods. But the serving sizes need to be more accurately labeled, the EWG said.
Cereal maker General Mills also has already cut the sugar content in its cereals advertised to children, on average by 16 percent since 2007, according to spokeswoman Kirstie Foster. The company’s cereals advertised to children have 10 grams or less of sugar per serving, with some at 9 grams, Foster said.
The EWG said companies should not market cereals containing 6 grams of sugar or more per serving to children.
NCCOR Connect & Explore webinar on childhood obesity declines happening June 12
Recent data has shown that childhood obesity rates are falling in many communities across the nation. In the latest installment of its Connect & Explore Webinar Series, the National Collaborative on Childhood Obesity Research (NCCOR) is examining the implications of this research, discussing lessons learned from public health leaders in communities experiencing these declines, and considering how these findings can be applied.
For those registered, this is a reminder to join us at 2 pm, Eastern, on Thursday, June 12, for Connect & Explore: A Deeper Dive into Childhood Obesity Declines, the second of three webinars planned this year.
We have reached capacity for this event and registration has closed. However, there are still spots available for those who want to listen to the conversation (no video). You can access the call-in information for the audio portion of the webinar here. A recording will also be made available on www.nccor.org after the webinar.
Publications & Tools
New CDC report finds most American kids are physically unfit
According to a new report by the Centers for Disease Control and Prevention, more than half of adolescents aged 12 to 15 are considered physically unfit. The authors of the report tested more than 600 young teenagers on treadmills to measure cardiorespiratory fitness, a measure of how well the heart and lungs can move blood to supply muscles during exercise.
They found that just half of all boys and only a third of all girls in the study met the minimum threshold of being called “fit.” Taken as a whole, this meant that only 42 percent of kids were fit. In 2000, by comparison, this figure was 52 percent. Overweight and obese children were less fit than those who had a healthy weight; only 30 percent of overweight children and 20 percent of obese passed the minimum standards to be called fit. But even so, only 54 percent of children with normal weight — barely half — had adequate levels of cardiorespiratory fitness.
Majority of states have ‘head start’ on Smart Snacks nutrition standards
Twenty-six states have laws that fully or partially meet at least one provision of the U.S. Department of Agriculture’s (USDA) updated nutrition standards for school snacks and drinks, according to a new study published in Childhood Obesity. The study, which was funded by the Robert Wood Johnson Foundation through its national research program, Bridging the Gap, is the first to examine how existing state laws align with USDA’s “Smart Snacks in School” guidelines that go into effect on July 1.
Families on food assistance are purchasing more fruits and vegetables
Efforts are paying off to increase consumption of fruits and vegetables among women and young children receiving food assistance, according to a study recently published by the Rudd Center for Food Policy & Obesity in Public Health Nutrition. Purchases of fruits and vegetables have increased among families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) after revisions were implemented in 2009 to offer foods that better reflect dietary recommendations for Americans.
Rudd Center researchers examined fruit and vegetable purchases made at a New England supermarket chain by households participating in WIC over a two-year period. Fruit and vegetable spending and volume purchased by these households were compared before and after the WIC revisions. Purchases of fresh vegetables increased by nearly 18 percent, and purchases of frozen vegetables increased by nearly 28 percent. The biggest improvements were for fresh fruit, with an increase of almost 29 percent, adding over 2 pounds of fresh fruit per household per month.
Childhood Obesity Research & News
First lady rebuts effort to weaken school lunch rules
May 27, 2014, The New York Times
By David S. Joachim
Michelle Obama turned uncharacteristically political on May 27, pushing back against a measure pending in the Republican-controlled House that would let some schools opt out of federal dietary standards for school lunches.
The standards, approved by Congress and the president in 2010, set limits on sodium, fat and calories, and require that unhealthy menu items be replaced with fruits, vegetables, and whole grains.
Some big food companies and Republican lawmakers have criticized the rules, calling them inflexible, ineffective, and expensive. Representative Robert B. Aderholt, Republican of Alabama, has attached language to a spending bill that would waive the requirements for financially ailing school districts.
In response, Mrs. Obama met with a half-dozen school officials on May 27 from New York, California, Virginia, Maryland, Georgia, and Tennessee who attested to the success of the new standards in their school systems. The standards have been introduced gradually over the last two years.
“The last thing that we can afford to do right now is play politics with our kids’ health, especially when we’re finally starting to see some progress on this issue,” Mrs. Obama told the group, adding, “It’s unacceptable to me not just as first lady, but as a mother.”
Sam Kass, the director of Mrs. Obama’s Let’s Move! campaign to reduce childhood obesity, acknowledged “legitimate challenges” for some districts in carrying out the standards. Last week, Mr. Kass said, the U.S. Department of Agriculture (USDA) said that some districts could delay serving whole-grain pastas because “the product didn’t hold up well over time.”
Mr. Kass said the administration was working with food suppliers to help fix the problem. But he cited academic studies showing that, over all, children were eating healthier foods because of the standards.
“Let’s remember that before this, there were no standards,” he said. “Schools could serve candy bars and sugary drinks in vending machines and in lunch lines.”
The School Nutrition Association, which represents cafeteria administrators, issued a statement on Tuesday calling the rules “overly prescriptive” and citing USDA data showing a drop in school-lunch participation since the standards were adopted.
It said the organization was “disappointed that the first lady is only going to speak with a handful of preselected school nutrition directors today.”
Last week, the president of the National Parent Teacher Association, Otha Thornton, wrote a letter to members of Congress urging them to reject Mr. Aderholt’s effort to scale back the standards. “At a time when families are working hard to live healthy lives, school meals should be supporting families’ efforts, not working against them,” he wrote.
Brian Rell, a spokesman for Mr. Aderholt, who is chairman of a subcommittee with jurisdiction over nutrition programs for children, countered that the rules were unnecessarily costly.
“These new federal regulations should not drive local school lunch programs under water,” Mr. Rell said.
Mr. Kass, who is also a White House chef, said that schools should not be able to opt out of food standards any more than students should be allowed to opt out of math class.
“From the beginning, we’ve looked to set standards that put our kids’ health and well-being first, giving them the nourishment they need to perform in school,” he said. “For so many kids, the nutrition they get at school is the only nutrition they get.”
Kids, parents are embracing the walking school bus
May 26, 2014, The Colorado Springs Gazette
By Jennifer McDermott, Associated Press
As a group of children walked home together from school in Providence, R.I., they held hands and played the “I Spy” guessing game. When they reached a busy intersection, an adult accompanying them prodded, “What’s the rule?”
“Behind the line!” they said in unison, as they stepped back from the edge of the curb and waited for the walk signal.
Shortly after, the group stopped in front of 8-year-old Jaiden Guzman’s house. He said goodbye to his friends and raced to his front door. His mother waved and the rest of the walking school bus continued on its way.
For a growing number of children in Rhode Island, Iowa, and other states, the school day starts and ends in the same way — they walk with their classmates and an adult volunteer to and from school. Walking school buses are catching on in school districts nationwide because they are seen as a way to fight childhood obesity, improve attendance rates, and ensure that kids get to school safely.
Ten-year-old Rosanyily Laurenz signed up for the Providence walking school bus this school year. Before, she said, she was sometimes late to school when her grandmother didn’t feel well enough to walk with her.
But now, “I get to walk with my friends,” Rosanyily said. “Plus, I get snacks.”
Many programs across the country are funded by the federal Safe Routes to School program, which pays for infrastructure improvements and initiatives to enable children to walk and bike to school.
Robert Johnson, of the Missouri-based PedNet Coalition, a nonprofit that advocates for transit alternatives, said the success of the programs reflects a growing interest in getting kids more active.
“Every parent is looking for ways to make their child a little healthier, and walking to school is one,” he said.
In 2012, about 30 percent of students living within a mile of school walked there in the morning and 35 percent walked home in the afternoon, according to the National Center for Safe Routes to School. Those numbers have increased by about 6 percentage points since 2007.
Organizers in Providence are also motivated by high rates of chronic absenteeism. Thirty-seven percent of Providence students missed 10 percent or more of the 2010-2011 school year.
The nonprofit agency Family Service of Rhode Island targeted Mary E. Fogarty Elementary School for its first walking school bus in 2012 because it is located in one of the city’s poorest neighborhoods. Children who live within a mile of school do not qualify for the bus.
In Sioux City, Iowa, nearly 1,000 children in 10 elementary schools use walking school buses during the spring and fall, said Alison Benson, spokeswoman for the district. Benson said the program has helped the schools incorporate fitness into the morning routine and build a sense of community.
Elementary schools in Columbia, Missouri, were among the first in the nation to have walking school buses. Piloted in 2003, the program, at its height, involved 450 children, 13 schools and about 200 volunteers. It was canceled this year because of funding issues, according to the PedNet Coalition.
Johnson said he is working with 15 school districts in Kansas on what may become the largest walking school bus project in the United States.
Some districts have been able to cut school bus routes and save money because of the program, he said.
On the mile-long route in Providence, the program’s manager, Allyson Trenteseaux, and another volunteer recently led Jaiden, Rosanyily and six other children through busy intersections and around broken glass littering the sidewalks.
On the walks, Trenteseaux said, she mends relationships among the kids, builds relationships, and intervenes when there are problems. During the winter, a walk leader noticed some of the children were wearing slippers and bought them all boots.
Last year, 11 of the 14 students who participated and completed a survey attended school more often. The program now has a waiting list, and Family Service plans to expand into more schools next year.
A new prescription: Eat your veggies
May 12, 2014, Minnesota Star Tribune
By Jeremy Olson
One of Minnesota’s largest health care providers is going to a new extreme in its struggle to combat the epidemic of childhood obesity.
It has started writing prescriptions for vegetables.
For now, it’s just a pilot project at HealthPartners clinics in Hugo and White Bear Lake, Minn. But if the experiment succeeds, the Bloomington-based health organization could expand the project across the Twin Cities to address the high — and rising — rate of childhood obesity. Nearly a quarter of the state’s ninth-graders are overweight or obese, according to last year’s Minnesota Student Survey — a trend mirrored in skyrocketing youth obesity rates nationwide.
“What we’re doing hasn’t been working,” said Dr. Thomas Kottke, HealthPartners’ medical director for population health. “Obesity in kids has taken off in the last 20-25 years. And so we need to do something differently.”
Emily Miller was a skeptic. The Forest Lake mom tried cutting junk food and putting out healthier snacks with the only results being whining children and rotting fruit.
But after her 12- and 10-year-old daughters got their veggie prescriptions at checkups earlier this year, they demanded to go straight to the grocery store.
“I didn’t realize how much it would spark an interest in my girls,” Miller said.
Participating doctors issue the prescriptions to children ages 5 to 12 who could use healthier diets and encourage them to make their own choices and try something new; area supermarkets accept the prescriptions and track the varieties of produce purchased. The prescriptions are actually just vouchers funded by HealthPartners, rather than formal scripts billed to health insurance companies. But the idea is to make them look official so they send the message to children that good eating is good health care.
While braced for critics, who might object to “medicalizing” diet and using health care dollars for family food budgets, health system officials think it’s a sound investment.
“It could save us a huge amount of money down the road in our cholesterol-lowering drugs, in our heart-saving procedures,” assuming that healthy children grow into healthy adults, said Dr. Elsa Keeler, a pediatrician at the White Bear Lake clinic.
And those costs can be staggering. A study late last month estimated that an obese child will incur $19,000 in additional lifetime medical costs, given the elevated risks for diabetes and heart disease as adults.
“Obesity … affects our communities. It’s raising our health care costs,” said Dr. Ed Ehlinger, Minnesota’s state health commissioner. “I think physicians should be very concerned about it.”
Miller’s daughters differ in their eating habits, though both craved treats like Nutty Bars and gummy snacks as much as the next kid.
Her oldest girl, Alena, is picky. She tolerates apples, though, so she used her prescription to buy multiple varieties and took a chance on spinach. Now the family uses her favorite apples in applesauce and to make a substitute for cooking oil. She even liked the spinach and soon progressed to zucchini in salads and bread.
“If I had even said that before,” Miller said, “it was like, ‘Ewwww, egh!’ ”
Her younger daughter, Amelia, is more adventurous. She used her prescription on tropical fruits such as kiwi and papaya for a yogurt-based fruit “pizza.”
“I think it was [successful] because it was their thing,” Miller said. “It wasn’t me encouraging them to do it. It was their choice.”
Whether a one-time opportunity to test new fruits or vegetables will be equally transformative for other families is unclear. HealthPartners will study that question after the two clinics use up their 100 trial prescriptions.
Research on the issue has been inconclusive. Last month, a British study of fruit and vegetable prescriptions for 1,184 people in a low-income neighborhood found that most were used, but that they didn’t change long-term habits because people still considered fresh produce too expensive.
Ehlinger said such strategies will work only in conjunction with broader efforts to make healthier choices easier. Some lower-income parents, for example, find it hard to choose fresh produce when it is more expensive than high-calorie packaged foods that fill their families up for less money.
Junk food marketing and fast-food availability — compared to the scarcity of produce markets in some communities — also present challenges, he said. “We have to change the policies and systems in an environment, in a community, if we are going to get people to move and eat properly. It’s not just about an individual choice.”
The prescription trial is part of Bear Power, a collaboration of HealthPartners, Children’s Hospitals and Clinics of Minnesota, and schools and civic groups in White Bear Lake to improve community health.
School “move-a-thons” and Bear Power bracelets are among the tools to spread awareness. Local grocers have already been participating in a variety of ways, such as putting healthy options in the “impulse buy” shelves next to the registers.
This “is about being proactive about health,” said Tom Clasen, a vice president for Knowlan’s Supermarkets, which has three Festival Foods stores that accept the prescriptions. “Our medical system is so built around a reactive stance to problems.”
Clasen said children have used prescriptions to buy everything from cilantro to mangoes to jicama.
While cost is a barrier to healthier eating, Kottke said there are other barriers that the prescription program might address. Even doctors tiptoe around subjects such as personal diet and weight with patients, so the prescriptions give them an excuse to be more direct. The prescriptions also appeal to the American desire to sample foods first, and to children’s love of gifts and opportunities to pick things out for themselves “without having to put 10 bucks at risk,” Kottke said.
“One $10 coupon every year or two isn’t going to change things,” he added. “That … is trivial to the annual grocery bill. So this is about sampling and it’s about signaling the parents that we are serious about this.”
Miller is left with a chicken-and-egg question: Did she spur her children’s junk food cravings with her own purchases, or did their cravings push her to buy foods she never really wanted?
Snack times and dinners at the Miller home still aren’t perfect, but they have improved.
Miller’s 13-year-old son grumbled about the changes — he had no say because he didn’t receive a prescription — and loathed the lack of pop in the fridge. But he was OK with the new foods on his plate.
“He eats whatever is put in front of him,” Miller said. “He’s kind of a human garbage disposal.”