September 2022

SPOTLIGHT

PUBLICATIONS & TOOLS

CHILDHOOD OBESITY RESEARCH & NEWS

Spotlight

White House to Host National Conference on Hunger, Nutrition, and Health

The Biden-Harris Administration announced it will host the White House Conference on Hunger, Nutrition, and Health on Wednesday, September 28, 2022. This landmark event—the first White House nutrition conference in more than 50 years—will gather a diverse group of experts, policy makers, and community leaders to address the nation’s intersecting challenges of food insecurity and diet-related diseases. During the Conference, the White House will release a new national strategy detailing the public and private sector approaches to reduce hunger and improve nutrition and health, especially among communities most affected.

When announcing the Conference, the White House set five pillars for mutual action:

  • Improve food access and affordability.
  • Integrate nutrition and health.
  • Empower all consumers to make and have access to healthy choices.
  • Support physical activity for all.
  • Enhance nutrition and food security research.

Learn more about the conference pillars and how your organization can view the livestreamed event. You can also sign up to receive e-mail updates about the White House Conference on Hunger, Nutrition, and Health.

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There Is Still Time to Register for September’s Connect & Explore Webinar!

Join us on Wednesday, September 7, 2:00-3:00 p.m. ET for a Connect & Explore webinar, Reframing Childhood Obesity: Cultural Insights on Nutrition, Weight, and Food Systems. Based on a recently published report from the Vanderbilt Cultural Context of Health & Wellbeing Initiative and the Robert Wood Johnson Foundation, the webinar will explore how public health programs can work with, not against, cultural traditions and norms and harness local creativity to change nutritional outcomes. Leading experts Karabi Acharya, Jamie Bussel, Tatiana Paz Lemus, and Ted Fischer will discuss how the intersectionality of complex physiological, cultural, and commercial systems contribute to childhood obesity. This event is free, but attendance is limited, so tell a colleague and register today!

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Publications & Tools

NCCOR Toolbox: National Childhood Obesity Awareness Month

September is National Childhood Obesity Awareness Month (NCOAM), an important time to raise awareness about childhood obesity research and prevention. Help NCCOR spread the word about our work and the value of evidence-based interventions by sharing the tools and resources available on the NCCOR website. Our social media toolkit contains ready-made graphics and content to help start the conversation. Please tag @NCCOR in your posts and thank you for helping us promote NCCOR and NCOAM!

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USDA Offers Free Booklet on Smart Snacks in School

USDA’s Food and Nutrition Service program recently published A Guide to Smart Snacks in School to help educators, staff, and administrators implement the Smart Snack program. Children consume nearly a quarter of their calories from snacks. The Smart Snacks program ensures that the food and beverages students purchase at school meet nutrition guidelines, which includes food sales from fundraisers, vending machines, or snack bars. The new USDA publication offers practical, easy-to-understand guidance to help schools chose foods and beverages that align with the Smart Snacks program.

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Two New Publications Advance Policy Ideas ahead of the White House Conference on Hunger, Nutrition, and Health

The Task Force on Hunger, Nutrition, and Health, a private, multi-sector, non-partisan expert group, published two new papers in preparation for the White House Nutrition Conference. The first publication, which has been shared with the White House, is a comprehensive report that contains 30 high-priority policy recommendations, 200 specific actions for the federal agencies, and 12 recommended actions and commitments for the private sector to end hunger, advance nutrition, and reduce diet-related diseases. Several Task Force leaders also published a commentary in Nature Food, which identifies six policy areas to improve health and create a more equitable and sustainable food system.

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Active Living Conference Now Accepting Presentation Proposals

Co-hosted by the National Cancer Institute, the 2023 Active Living Conference is currently accepting abstract submissions for its March 13–16, 2023 event to be held in Bethesda, MD. The theme, Expanding Active Living Applications beyond Chronic Diseases to Synergistic Epidemics, explores the role of active living in addressing multiple intersecting crises, such as coronavirus disease (COVID-19), mental health, climate change, and structural racism. Focus will also include integrations with community-led built and natural environments and related programming, such as parks, recreation, libraries, and other quality of life public assets management. Proposals can be submitted under the following three categories: 1) Practice/Policy; 2) Research; or 3) Workshop.

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Childhood Obesity Research & News

Childhood Weight Tied to Timing of Puberty

August 23, 2022, Kaiser Permanente

Boys and girls who develop obesity at a young age are more likely than children with a normal, or healthy, weight to start puberty earlier, new Kaiser Permanente research shows.

The study, published August 23 in the American Journal of Epidemiology, is one of the first to study a large racially and ethnically diverse group of boys and girls from age 5 to 6 through puberty. The findings highlight the ongoing need to address the socioeconomic inequalities that increase risk for childhood obesity in the U.S.

“Childhood obesity has been known to be a risk factor for early puberty in girls, but this is the first large population-based study to show this relationship in boys,” said the study’s senior author Ai Kubo, PhD, MPH, a cancer epidemiologist and research scientist at the Kaiser Permanente Division of Research. “This is significant because we know that in adolescents early puberty is tied to an increased risk for depression and other mental health and behavioral problems. In adults, early puberty is a cancer risk factor, and it’s also been associated with an increased risk for cardiovascular disease and diabetes.”

The new study included 129,824 racially and ethnically diverse boys and girls born at a Kaiser Permanente Northern California (KPNC) hospital between 2003 and 2011 and followed through 2021. The research team reviewed electronic medical record data to determine each child’s weight and height at age 5 to 6 and then the age they started puberty. KPNC physicians routinely record in children’s medical records signs of sexual maturity — testicular size, growth of pubic hair, breast development, and start of menstruation — which allowed the researchers to determine puberty onset.

The researchers found that at age 5 to 6, 3.6% of the girls were underweight, 14.9% were overweight, 9.3% were obese, and 2.6% were severely obese. Those with severe obesity had a 63% greater risk of showing earlier breast development and an 88% higher risk of earlier pubic hair development than girls with a normal, or healthy, weight. The start of menstruation was even more closely tied to weight. Girls with severe obesity were 2.6 times more likely and girls with obesity were 2.2 times more likely to have their periods start before the age of 12 than girls with normal, or healthy, weight.

Among boys ages 5 to 6, 3.9% were underweight, 14.3% were overweight, 10.6% were obese, and 3.2% were severely obese. The study showed that the boys with overweight or obesity had a greater risk of experiencing earlier testicular development than the boys who had a normal, or healthy, weight, with the risk ranging from 23% higher for boys with severe obesity to 15% higher for boys who were overweight. Similarly, the boys with severe obesity had a 44% higher risk of showing pubic hair growth earlier than the boys with a normal, or healthy, weight.

“Our finding that boys have a similar relationship with obesity to puberty contradicts some other smaller studies that showed obesity is protective against early puberty in boys,” said Kubo. “This is important because we had a large enough group of boys to have a category of extreme obesity, and we were able to look at obesity in a very granular way and to see a clear dose-response relationship between weight and puberty onset.”

The study also found racial and ethnic variations in weight and signs of sexual maturity. For example, white boys with severe obesity showed signs of pubic hair about 7 months earlier than boys with normal, or healthy, weight whereas Black boys with obesity showed signs of pubic hair about 6 months earlier. Among girls with severe obesity, Black girls showed signs of pubic hair about 12 months earlier; Asian Pacific Islander girls about 11 months earlier; and white girls about 8 months earlier than normal, or healthy, weight girls. The study also showed that white and Asian and Pacific Islander girls with severe obesity were 3 times more likely to start menstruation before age 12 than normal, or healthy, weight girls, while there was little association seen between childhood weight and age of menstruation in Black girls. The researchers said these differences are likely related to socioeconomic and psychosocial factors rather than genetic factors.

“Our study adds to the evidence that obesity is a marker of an environment that can lead to metabolic changes in kids,” said study co-author Louise Greenspan, MD, a pediatric endocrinologist with The Permanente Medical Group. “We don’t know that obesity is directly causing the early puberty, but we do know that both obesity and early puberty can lead to a lifetime of higher health risks.”

Certain intergenerational factors may also be contributing to both early obesity and early puberty, said Kubo. “There are exposures that children may have in utero that contribute to their increased risk for both obesity and early puberty,” she said. “These could include the mother’s diet during pregnancy, prenatal depression, or stress. It is important for clinicians to be aware that what happens in pregnancy can affect a child’s development and that we learn how to intervene to help the moms before their kids are born.”

Greenspan said it is important that parents of children with overweight or obesity recognize that a child’s weight at puberty does not dictate their future health. “The children in our studies have only lived about 10% of their lives,” she said. “They have the whole rest of their lives to start building the habits that help keep them healthy.

“Most importantly,” she added, “we need to destigmatize and really change the conversation around overweight and obesity. They are medical conditions, not a personal deficit or a weakness. We also need to look at kids as part of a big system — and that system is broken. It’s not the parents’ fault.”

This study was funded by the National Institutes of Health.

Co-authors include Sara Aghaee, MPH, Charles P. Quesenberry Jr., PhD, and Lawrence H. Kushi, ScD, of the Division of Research and Julianna Deardorff, PhD, of the University of California, Berkeley.

[Source]

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ECHO Researchers Investigate Child Weight Gain During the COVID-19 Pandemic

August 15, 2022, NIH

Collaborative ECHO research led by Emily Knapp, PhD and Aruna Chandran, MD of Johns Hopkins Bloomberg School of Public Health investigates the effects of the COVID-19 pandemic on children’s body mass index (BMI), an estimation of overall body fat. The study looked at the BMI of 1,966 children ages 2 through 18 years old from 38 ECHO cohorts across the United States during the COVID-19 pandemic. The results of this study suggest that, on average, children gained weight at a higher rate during the pandemic. This research, titled “Changes in BMI during the COVID-19 Pandemic,” is published in Pediatrics.

Childhood obesity is a serious health condition that can affect long-term health and quality of life. At the start of the COVID-19 pandemic, there was concern among researchers and doctors that the closure of schools and the cancellation of recreation and sport activities would cause an increase in childhood obesity.

To understand the pandemic’s impact on children’s weight, researchers analyzed yearly changes in children’s body mass index (BMI) before and during the pandemic, considering each child’s age and sex. The researchers also investigated whether changes in BMI were different across specific sociodemographic traits including race, ethnicity, pre-pandemic BMI, and household income.

The results of this study indicated that on average children gained weight at an increased rate during the pandemic, and children who had obesity before the pandemic gained weight at a faster rate compared to children who were at a healthy weight pre-pandemic. Additionally, children in higher income households were at a lower risk of excess BMI gain during the pandemic.

“This study highlights the need for interventions to mitigate the physical and mental health consequences of the COVID-19 pandemic,” said Dr. Knapp. “The conditions faced by families during the COVID-19 pandemic may have led to an acceleration of weight gain in children. This study highlights the need to support less resourced families, who have borne the worst consequences of the pandemic.”

Future studies can explore strategies to help families and communities thrive amidst the challenges faced during the ongoing COVID-19 pandemic. As the pandemic continues to alter children’s lives, it will be important to monitor changes in health outcomes among children and use these data to build programs to reduce health inequities. Read the research summary.

[Source]

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Pediatric Obesity Is a Complex Condition with Multiple Subtypes

August 4, 2022, EurekAlert!

Note: This article has been edited to include person-first language.
Approximately one third of children in the United States [have] overweight or [obesity]. A study publishing August 4th in PLOS Digital Health by Elizabeth Campbell at Drexel University, Philadelphia, Pennsylvania, United States, and colleagues suggests that childhood obesity may be associated with an array of underlying medical conditions.

Childhood obesity is linked with an increased risk of developing multiple comorbidities including asthma, diabetes, hypertension, and psychological conditions. However, whether obesity is a single condition or is composed of unique phenotypes with different underlying causes is unknown. To identify clinically similar subtypes among a population of [pediatric patients with obesity], researchers conducted a retrospective cohort study, accessing the electronic health records of 49,694 pediatric patients of Children’s Hospital of Philadelphia diagnosed with obesity. Using a pattern mining algorithm, the authors analyzed common condition trajectories surrounding pediatric obesity incidence and compared them to a control group with healthy body mass index.

The researchers found eight classes of health conditions that were highly prevalent among children diagnosed with pediatric obesity, including respiratory and sleep disorders, inflammatory skin conditions, asthma, seizure disorders, gastrointestinal/genitourinary symptoms, and neurodevelopmental disorders. The study had several limitations, however, including the potential for false discovery rate, as well as an arbitrary 10% prevalence threshold for classifying “high prevalence” conditions. Future studies are needed to pinpoint the factors mediating the associations between pediatric obesity and the co-prevalent illnesses identified in the study.

According to the authors, “Obesity is a complex and socially significant health issue that may affect different clinical and demographic subtypes of pediatric patients differently. Grouping all types of overweight and obesity into one clinical condition may conceal associations between risk factors and specific subtypes of obesity, which has implications for improving prevention, recognition, and treatment of pediatric obesity. Our findings can support the work of public health researchers and practitioners who seek to address the social disparities component of the obesity epidemic.”

Campbell adds, “Electronic Health Records represent valuable sources of data for use in research to investigate pediatric obesity and other pressing health issues. We hope that our findings not only add to ongoing work that is combatting the obesity epidemic, but to methodological advances in using large complex datasets in clinical research.”

[Source]

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Physical Activity Affects Boys and Girls Differently

August 3, 2022, EurekAlert!

Being physically active has major health benefits. But the physical activity affects boys and girls differently. New research has examined the relationship between body fat and physical activity in children.

“We looked at the connection between objectively measured physical activity and the proportion of body fat in girls and boys,” says Silje Steinsbekk, a professor at NTNU’s (the Norwegian University of Science and Technology) Department of Psychology.

The researchers measured participants’ body composition rather than their weight and height. They posed such questions as:

Does increased physical activity lead to a lower percentage of body fat over time? Or is it perhaps the other way around, that people who gain more body fat over time become less physically active?

Body fat and physical activity in girls are unrelated

The researchers examined the children every two years from the age of 6 until they were 14 years old. They found that the level of activity affects the sexes differently.

“In girls, we found no connection between their physical activity and amount of body fat. Increased physical activity didn’t lead to less body fat in the girls, and body fat had no effect on changes in their physical activity,” says Tonje Zahl-Thanem, a former research fellow and first author of the article.

But for boys, it’s different. The amount of body fat influences their physical activity.

More body fat in boys results in less physical activity

“Increased body fat in boys led to less physical activity two years later, when they were 8, 10 and 12 years old,” says Zahl-Thanem.

With one exception, increased physical activity had no effect on changes in body fat.

“We found that boys who are more physically active when they’re 12 years old have a lower proportion of body fat when they’re 14. This wasn’t the case at an earlier developmental stage,” Steinsbekk says.

Several possible reasons for differences between the sexes

The study did not investigate the reasons for these differences, but the researchers point out that large bodies are heavier and require more exertion when exercising, which may explain why boys whose body fat increases become less active over time. But why isn’t this the case for girls?

“Here we can only speculate, but boys are generally more physically active than girls, so when boys reduce their activity level, the physical impact is greater,” Steinsbekk says.

We also know that children with large bodies are less satisfied with their bodies, and body dissatisfaction is associated with less physical activity in boys, but not in girls.

“Boys’ physical activity is probably even more competitively oriented than girls’, and more body fat makes it more difficult to succeed. Both of these conditions can help explain why increased body fat leads to less physical activity in boys, but not girls,” says Lars Wichstrøm, a professor in NTNU’s Department of Psychology and also co-author of the study.

It could also be that girls are more likely to maintain physical activity when their proportion of body fat increases, because more attention is paid to girls’ bodies and appearance.

Body fat affects sedentary activity in boys

The researchers also examined the link between inactivity or a sedentary lifestyle and body fat. In the same way that they objectively measured physical activity, they also measured how long the participants were sedentary during the day.

“The results show that boys who had an increase in the proportion of body fat had a corresponding increase in sedentary activity two years later. This carried through all the age groups studied, from the age of 6 through age 14.

In other words, boys whose proportion of body fat increases become more sedentary.

For the girls, however, there was no link here either. The percentage of body fat did not affect their level of inactivity over time, and they did not become less active by gaining more body fat.

“In sum, we found a link between physical activity, sedentary lifestyle and fat percentage in boys, but not in girls,” Steinsbekk says.

Trondheim Early Secure Study

The researchers used figures from the Trondheim Early Secure Study (TESS). They followed almost 1000 children at two-year intervals from when they were 4 years old. The participants are now 18 years old, and the eighth survey is underway.

In this study, the research group used data at five different times, when the participants were 6, 8, 10, 12 and 14 years old. The Trondheim Early Secure Study has provided data for a number of studies on children’s development and health. 

[Source]

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