January 2023

SPOTLIGHT

PUBLICATIONS & TOOLS

CHILDHOOD OBESITY RESEARCH & NEWS

Spotlight

NCCOR’s 2022 Year in Review

NCCOR will celebrate its 15th anniversary in 2023. We are proud that each year we continue to produce new research, tools, and opportunities for collaboration. The past year was no different. While we look ahead to the new year, here are a few of our top highlights from 2022.

  • Garnering nearly 200,000 page views for NCCOR’s newest tool
    Last year, NCCOR launched an innovative tool to demonstrate how economic benefits can support investments in physical activity. Create Thriving, Activity-Friendly Communities equips users with ready-made, customizable tools to facilitate conversations with local leaders, while the Economic Indicators Library contains 10 quality of life measures to help communities plan for local improvements. These new resources expand NCCOR’s tools by offering practical, accessible guidance for putting research into practice, making it one of our most visited pages in 2022.
  • Understanding how COVID continues to affect the youngest children
    A new publication from September 2022 continues NCCOR’s work to understand how the COVID-19 pandemic and the subsequent response and recovery efforts affected early childhood education centers. Working with the Gretchen Swanson Center for Nutrition, NCCOR identified strategies for improving nutrition and opportunities for physical activity for both children and staff. Learn more about the COVID-19 research initiative.
  • Returning to in-person conferences
    After two years of virtual meetings, NCCOR returned to in-person conferences in 2022. The NCCOR booth showcased our resources at the annual meetings for the American Public Health Association (APHA) and the American Academy of Pediatrics (AAP). In addition, NCCOR members authored posters and presented during APHA, AAP, the International Society of Behavioral Nutrition and Physical Activity, the SHIFT Summit, and the American College of Sports Medicine. NCCOR also hosted a public walk during APHA with physical activity expert Mark Fenton, who demonstrated how to put our new activity-friendly resources into action.
  • Making an impact with online learning
    NCCOR hosted four Connect & Explore webinars with leaders in childhood obesity research. This year, our sessions 1) highlighted a new research paradigm for the cultural context of childhood obesity, 2) reviewed unexpected findings about recess and children’s health, 3) discussed how to create activity-friendly communities, and 4) offered guidance on how to use NCCOR’s resources to achieve program goals. NCCOR also sponsored a successful 3-hour virtual workshop discussing implementation science and childhood obesity. Nearly 1,300 people registered for NCCOR’s online learning events in 2022 and all recordings are now available online.
  • Publishing new interdisciplinary research
    In 2022, NCCOR advanced novel ideas for interdisciplinary collaboration between researchers in health promotion, public safety, transportation, and community design with the publication of two research papers, one published in Preventive Medicine Reports and the other in Translational Behavior Medicine. Access NCCOR’s complete research library.
  • Making history at the White House
    In September, the Biden-Harris administration hosted the White House Conference on Hunger, Nutrition, and Health. This historic event—the first White House nutrition conference in over 50 years—ushered in a major new public health focus on addressing our nation’s intersecting challenges of food insecurity and diet-related diseases. NCCOR’s member organizations (CDC, NIH, USDA, and RWJF) attended the conference and continue to plan for how to address the five conference pillars established by the White House’s national strategy. Learn how NCCOR’s tools can help support this important work.

Stay tuned for the 2022 NCCOR Annual Report for more details on these and other accomplishments. In the meantime, please share any successes you had using NCCOR’s tools last year. You may be featured in a case study to help others

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Publications & Tools

NCCOR Toolbox: Upcoming NCCOR Connect & Explore Webinar

On January 11, 2023, from 3:00-4:00 pm ET, NCCOR is hosting its latest Connect & Explore webinar titled, “Does Breastfeeding Initiation Vary by WIC Participation and Race/Ethnicity? An Examination of Long-Term Trends from 2009-2017.” Inspired by “Breastfeeding Initiation Trends by WIC Participation and Race/Ethnicity Among Medicaid Births,” a research study soon to appear in the Journal of Nutrition Education and Behavior, the webinar will provide a first hand look at the long-term breastfeeding initiation trends by prenatal WIC participation. The paper uses birth certificate data from a sample of 24 states over the period 2009-2017 to examine trends in breastfeeding initiation among WIC-participating women on Medicaid compared to those not on WIC. The large number of women included in the dataset allowed the assessment of trends among different population groups including American Indian/Alaska Natives and Asian/Pacific Islanders. This unique information supports current efforts to improve breastfeeding—a protective factor against childhood obesity—among women from diverse groups that participate in WIC programs. Dr. Amanda Reat, with the USDA Food and Nutrition Service, will also discuss how WIC is working to promote breastfeeding and reduce breastfeeding disparities.

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CDC Extended BMI-for-Age Growth Charts

December 15, 2022, Centers for Disease Control and Prevention

In the United States, the prevalence of obesity and severe obesity has increased since 1980, and in 2017-2018, more than 4.5 million children and adolescents had severe obesity. The 2000 CDC BMI-for-age growth charts, based on data from 1963 to 1980 for most children, do not extend beyond the 97th percentile. So, CDC developed new percentiles to monitor very high BMI values. These extended percentiles are based on data for children and adolescents with obesity—including from 1988 to 2016—thus increasing the data available in the reference population. See the report on alternative BMI metrics for more information.

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Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025

December 2022, National Academies of Sciences

In response to a request from Congress, the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine conducted a study comparing the process to develop the Dietary Guidelines for Americans, 2020-2025 (DGA 2020-2025) to recommendations included in the previously published National Academies report, Redesigning the Process for Establishing the Dietary Guidelines for Americans. This report describes the findings of the committee and conclusions related to this assessment. Notably, this report does not evaluate the merits of the DGA 2020-2025 but evaluates the process by which they were created relative to the recommendations made in the previously published National Academies report.

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Childhood Obesity Research & News

Adults’ Interactions at Mealtimes Influence Children’s Future Relationships with Food

December 7, 2022, EurekAlert!

Two University of Houston researchers are developing strategies to help parents artfully sidestep showdowns at the family table. The goal is to reign in mealtime angst early in children’s lives so they can nurture positive relationships with food that can carry them into healthy adulthood.

In an article in the journal Appetite, the research team reveals that guiding children in recognizing their innate sense of fullness and helping them understand the importance of responding to its cues are two key elements in what is referred to as responsive feeding practices. The term is used by psychologists and other experts to describe parental attentiveness and engagement during feeding that affect children’s overall attitudes and behavior around food.

By way of clarifying the concept of responsive feeding practices, you might bring to mind its opposites – the nonresponsive feeding practices: Enforcing the ‘clean plate club,’ for example, whether a young eater is hungry or not. Or offering yummy dessert as a bribe for trudging through yucky vegetables or tedious chores.

Such unfortunate directions can encourage lifelong overeating, explained Leslie A. Frankel, associate professor in the Human Development and Family Sciences Program at the College of Education, and Ritu Sampige, a biomedical sciences senior in the UH Honors College, and the article’s first author.

“We consider those types of nonresponsive feeding practices to be less optimal because they override children’s ability to internally regulate how much food they should consume,” Sampige said.

In addition to paying attention to hunger and fullness cues, adults guide the mealtime atmosphere with attitudes they bring to the family table, even when they do not realize it. Staying positively involved with their children throughout family meals can make lasting differences.

“It’s not a black-and-white issue. Parents tend to use a lot of tactics to get their children to eat and behave and do all the things we need them to do. The key difference is the level to which parents are engaged at mealtime and how successful they are in avoiding nonresponsive eating behaviors and food rewards,” Frankel said.

Frankel and Sampige, with fellow research colleague and co-author Caroline Bena Kuno, of the Department of Psychology at the Virginia State University, are uncovering an unrecognized tie-in with parents’ mental health status.

Previous research has noted that children of parents who suffer from anxiety or depression are, themselves, more likely to experience general mental health issues. But until now, few studies have linked the issue specifically with children’s resiliency around the temptations of food.

“Parents who are more able to be responsive in the moment tend to be more successful in guiding their children on good paths to healthy eating. Helping parents get the support they need is crucial for many reasons. And now we know one more, that success at the family table involves the parents’ ability to be engaged with children and provide in-the-moment responses to each child’s fullness cues,” Frankel explained.

But take it all in balance, she stressed. “Food is often at the center of celebration, and that’s a beautiful thing. So are family trips out for ice cream and the joyful times children have with their families and friends. The important factor is not to adhere too strictly to rules – or expect every mealtime to go smoothly – but to help parents steer toward feeding practices that appreciate children’s innate sense of when to stop eating and regular mealtime rituals that honor everyone around the table,” she said.

Click here for the full article in Appetite.

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USDA Launches New Virtual Nutrition Center of Excellence

December 5, 2022, U.S. Department of Agriculture

The U.S. Department of Agriculture (USDA) today announced its new Agricultural Science Center of Excellence for Nutrition and Diet for Better Health (ASCEND for Better Health) in support of President Biden’s Cancer Moonshot effort to end cancer as we know it.

This new virtual center will accelerate research on diet-related chronic diseases, including cancer. A long-term goal of the center is to translate research into impactful solutions that improve public health and wellbeing, particularly in underserved communities.

“ASCEND will bring together scientists, partner organizations, and communities to develop and deliver science-based solutions that improve the health and well-being of all Americans, particularly in underserved communities,” said Agriculture Secretary Tom Vilsack. “The virtual center will connect existing resources, including people and programs, to leverage expertise and increase coordination and cooperation.”

USDA is enhancing its research focus on precision nutrition science to allow us to better understand the needs of underserved communities. This research complements our programmatic efforts to advance food and nutrition security – which means consistent and equitable access to healthy, safe and affordable foods essential to optimal health and well-being.

As part of today’s announcement, USDA convened a panel of experts that discussed the role that nutrition plays in improving overall health and reducing risks for diet-related chronic diseases.

According to the World Cancer Research Fund, 30-50% of all cancer cases are preventable by following a healthy diet and lifestyle. USDA is applying an equity lens to our ongoing and new research as we work to understand the connections between diet and diseases like cancer across different populations.

This effort delivers on a commitment made in the Biden-Harris Administration’s National Strategy on Hunger, Nutrition, and Health to end hunger and reduce diet-related diseases by 2030 – all while reducing disparities. The National Strategy was released in conjunction with the first White House Conference on Hunger, Nutrition and Health in over 50 years, hosted by President Biden on September 28, 2022.

USDA touches the lives of all Americans each day in so many positive ways. In the Biden-Harris Administration, USDA is transforming America’s food system with a greater focus on more resilient local and regional food production, fairer markets for all producers, ensuring access to safe, healthy and nutritious food in all communities, building new markets and streams of income for farmers and producers using climate-smart food and forestry practices, making historic investments in infrastructure and clean-energy capabilities in rural America, and committing to equity across the Department by removing systemic barriers and building a workforce more representative of America. To learn more, visit www.usda.gov.

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WHO Calls on Countries to Tax Sugar-Sweetened Beverages to Save Lives

December 13, 2022, World Health Organization

Today, WHO released its first-ever global tax manual for sugar-sweetened beverages (SSBs). Currently, at least 85 countries implement some type of SBB taxation.

The WHO manual highlights the experiences of countries who have successfully implemented the tax, including Mexico, South Africa, and the United Kingdom.

“Taxes on sugar-sweetened beverages can be a powerful tool to promote health because they save lives and prevent disease, while advancing health equity and mobilizing revenue for countries that could be used to realize universal health coverage,” said Dr. Ruediger Krech, Director of Health Promotion at WHO.

SSB, tobacco, and alcohol taxes have proven to be cost-effective ways of preventing diseases, injuries, and premature mortality. SSB tax can also encourage companies to reformulate their products to reduce sugar content.

Regular consumption of SSBs, including soft drinks, flavoured milks, energy drinks, vitamin waters, fruit juices and sweetened iced teas, is associated with an increased risk of dental cavities, type 2 diabetes, weight gain and obesity in both children and adults, heart disease, stroke and cancer.

Evidence shows that implementing taxes on SSBs increases product prices and reduces demand, resulting in less purchases. A one time global SSB tax increase that raised prices 50% could generate additional revenues of US$1.4 trillion over 50 years.

A recent Gallup Poll also found that a majority of people across the United States, Tanzania, Jordan, India, and Colombia supported taxes on SSBs, alcohol and tobacco.

WHO calls on countries to introduce or increase existing SSB taxes to raise the prices of these unhealthy products, lessen demand, and reduce consumption. The manual is a reference guide that provides key considerations and strategies for countries to develop, design, and implement SSB taxes.

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NIH Program Study Links Neighborhood Opportunity and Social Vulnerability to Children’s Body Mass Index

December 22, 2022, National Institutes of Health

Children who lived in higher opportunity or less vulnerable neighborhoods early in life had lower average body mass index (BMI) and lower risk of obesity from childhood to adolescence, according to a new study funded by the Environmental influences on Child Health Outcomes Program at the National Institutes of Health.

“This study bolsters the need for a focus on investments that address the structures that consistently compromise the health of marginalized communities,” said Izzuddin M. Aris, PhD of Harvard Medical School.

Children’s BMI and childhood obesity are significant risk factors for heart disease later in life. To understand how neighborhood-level conditions can affect a child’s risk for these health outcomes, ECHO researchers collected address and weight information from over 20,000 children from birth through 10 years old, and linked the address data to the Child Opportunity Index and Social Vulnerability Index.

In the future, neighborhood indices, such as the ones used in this study, could help inform efforts to reduce neighborhood barriers and improve access to community resources so families can better support their children’s health and well-being.

Dr. Aris led this collaborative research published in JAMA Network Open.

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Healthy Community Design, Anti-Displacement, and Equity Strategies in the USA: A Scoping Review

December 29, 2022, Springer Link

Abstract: Recent investments in built environment infrastructure to create healthy communities have highlighted the need for equity and environmental justice. Although the benefits of healthy community design (e.g., connecting transportation systems and land use changes) are well established, some reports suggest that these changes may increase property values. These increases can raise the risk of displacement for people with low incomes and/or who are from racial and ethnic minority groups, who would then miss out on benefits from changes in community design. This review scanned the literature for displacement mitigation and prevention measures, with the goal of providing a compilation of available strategies for a wide range of audiences including public health practitioners. A CDC librarian searched the Medline, EbscoHost, Scopus, and ProQuest Central databases, and we identified grey literature using Google and Google Scholar searches. The indexed literature search identified 6 articles, and the grey literature scan added 18 articles. From these 24 total articles, we identified 141 mitigation and prevention strategies for displacement and thematically characterized each by domain using an adapted existing typology. This work provides a well-categorized inventory for practitioners and sets the stage for future evaluation research on the implementation of strategies and practices to reduce displacement.

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