April 2018

NCCOR Updates the Catalogue of Surveillance Systems and Seeks System Recommendations

April 26, 2018, NCCOR

The National Collaborative on Childhood Obesity Research (NCCOR) recently updated the Catalogue of Surveillance Systems, a free, online tool that provides one-stop access to publicly available data sources relevant to childhood obesity research.

The Catalogue is a premier tool that allows childhood obesity researchers to easily identify data resources related to childhood obesity, compare attributes across systems, and link to other resources of interest. To streamline the process of identifying an appropriate data set, researchers can filter their search by level, scope, key variables, age groups, racial and ethnic groups, design, and cost. Watch a video on how to use the Catalogue.

NCCOR recently updated more than 70 systems in the Catalogue, including:

• National Health and Nutrition Examination Survey (NHANES)
• The NPD Group – National Eating Trends® (NET)
• Behavioral Risk Factor Surveillance System (BRFSS)
• GlobalData Product Launch Analytics

NCCOR is also seeking recommendations for new surveillance systems to be considered for inclusion in the Catalogue. To be included, a surveillance system must:

• Be relevant to childhood obesity research and at least one level within the social-ecological model
• Provide access to publicly available raw data gathered in the United States
• Provide access to data that has been released in the past 10 years, generally

Please submit your recommendations at https://nccorstg.wpengine.com/nccor-tools/catalogue/feedback/.

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Examining Declines in Childhood Obesity in Four Communities: Highlights from Six Papers Published in Childhood Obesity

April 26, 2018, NCCOR

The National Collaborative on Childhood Obesity Research (NCCOR) published six papers in Childhood Obesity highlighting findings from the Childhood Obesity Declines project. The supplement details the strategies and policies implemented in four diverse communities—Anchorage, AK; Granville County, NC; New York City, NY; and Philadelphia, PA—that experienced declines in childhood obesity prevalence from 2003 to 2011.

The supplement details the rationale, aims, and overall study design of a 2-year project that systematically studied and documented the community-based obesity strategies applied in four distinct communities across the nation. Findings suggest simultaneous public health messaging and multi-layered initiatives—including cross-sector partnerships and active, high-level champions—were likely important contributors to success in attaining declines in the prevalence of childhood obesity. To learn more about The Childhood Obesity Declines Project and to read the supplement, visit nccor.org/projects/obesity-declines.

On April 30, NCCOR is hosting a Connect & Explore webinar “Examining Declines in Childhood Obesity in Four Communities: Highlights from Six Papers Published in Childhood Obesity.” The webinar will examine the multi-level approaches, including policies, across all jurisdictions to improve the nutrition and physical activity environments through a socio-ecological lens. Speakers will discuss research and evaluation implications and provide guidance for future studies of community-based childhood obesity prevention.

Join us on Monday, April 30, at 1:00 p.m. ET, for the one-hour webinar. Guest speakers will include:

• Tina Kauh, PhD, Program Officer, Robert Wood Johnson Foundation
• Nicola Dawkins-Lyn, PhD, Vice President for Public Health, ICF
• Laura Kettel Khan, PhD,Senior Scientist and Advisor, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention
• Deborah Young-Hyman, PhD, Health Scientist Administrator, Office of Behavioral and Social Sciences Research, National Institutes of Health

Register today to receive webinar access. The event is free, but attendance is limited.

Invite a colleague, and please consider sharing this information on your social networks using the hashtag #ConnectExplore. We will live tweet the event at @NCCOR. For those who cannot attend, the webinar will be recorded and archived on nccorstg.wpengine.com.

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WIC Infant and Toddler Feeding Practices Study 2: Second Year Report

USDA’s Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study 2, also known as the Feeding My Baby study, captures data on caregivers and their children over the first 5 years of the child’s life after WIC enrollment. The study addresses a series of research questions regarding feeding practices, associations between WIC services and those practices, and the health and nutrition outcomes of children receiving WIC. The study previously produced two reports, the Intentions to Breastfeed Report and the Infant Year Report.  The current report focuses on caregivers’ employment, school, and childcare circumstances, as well as the feeding progressions, dietary intake, and weight status of children from birth through 24 months.

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USDA Whole Grain-Rich Memo and NCA Training Guide

USDA’s Food and Nutrition Service recently released a memo that includes updates to the criteria for identifying whole grain-rich foods which meet the Child and Adult Care Food Program (CACFP) meal pattern requirements. A one page at-a-glance handout highlights how CACFP operators can identify whole grain-rich foods under this new guidance.

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Lack of Sleep Leads to Obesity in Children and Adolescents

April 16, 2018, University of Warwick

Children who get less than the recommended amount of sleep for their age are at a higher risk of developing obesity.

Research at the University of Warwick has found that children and adolescents who regularly sleep less than others of the same age gain more weight when they grow older and are more likely to become overweight or obese.

One of the co-authors, Dr Michelle Miller, Reader of Biochemical Medicine, Health Sciences, Warwick Medical School said: “Being overweight can lead to cardiovascular disease and type-2-diabetes which is also on the increase in children. The findings of the study indicate that sleep may be an important potentially modifiable risk factor (or marker) of future obesity.”

The paper, Sleep duration and incidence of obesity in infants, children and adolescents: a systematic review and meta-analysis of prospective studies, has been published in the journal Sleep. The paper’s authors reviewed the results of 42 population studies of infants, children and adolescents aged 0 to 18 years which included a total of 75,499 participants. Their average sleep duration was assessed through a variety of methods, from questionnaires to wearable technology.

The participants were grouped into two classifications: short sleeper and regular sleepers. Short sleepers were defined as having less sleep than the reference category for their age. This was based on the most recent National Sleep Foundation guidelines in the U.S. which recommends that infants (4 to 11 months) get between 12-15 hours of nightly sleep, that toddlers (1-2 years) get 11-14 hours of sleep, children in pre-school (3-5 years) get 10-13 hours and school aged children (6-13 years) between 9 and 11 hours. Teenagers (14-17 years) are advised to get 8-10 hours.

Participants were followed up for a median period of three years and changes in BMI and incidences of overweight and/or obesity were recorded over time. At all ages short sleepers gained more weight and overall were 58% more likely to become overweight or obese.

Dr Miller said: “The results showed a consistent relationship across all ages indicating that the increased risk is present in both younger and older children. The study also reinforces the concept that sleep deprivation is an important risk factor for obesity, detectable very early on in life.”

Co-author Professor Francesco Cappuccio added: “By appraising world literature we were able to demonstrate that, despite some variation between studies, there is a strikingly consistent overall prospective association between short sleep and obesity.

“This study builds on our previous analysis of cross-sectional data published in 2008. The importance of the latest approach is that only prospective longitudinal studies were included, demonstrating that short sleep precedes the development of obesity in later years, strongly suggesting causality.”

The prevalence of obesity has increased world-wide and the World Health Organization has now declared it a global epidemic. The paper’s authors stress that whilst healthy eating and exercise are important this study demonstrates that getting enough sleep is equally important. They suggest that educational programmes could be used to empower parents and children to maximise their sleep quantity.

Research study

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Pathways of Association from Stress to Obesity in Early Childhood

April 14, 2018, Obesity Journal

Abstract

Objective

The objective of this study is to critically review the literature on early life stress in relation to obesity in humans, including the multiple biological and behavioral mechanisms through which early life stress exposure (birth to the age of 5 years) may associate with obesity risk during childhood.

Methods

A review of the literature was conducted to identify studies on associations between early childhood stress and risk for obesity and the mechanisms of association. Multiple databases (PubMed, PsycInfo, Google Scholar) were used in the search as well as a “snowball” search strategy. All study designs were included.

Results

Early life stress and adverse childhood experiences are associated with obesity and overweight in adults. Evidence is less consistent in children. Studies vary in the nature of the stress examined (e.g., chronic vs. acute), sample characteristics, and study designs. Longitudinal studies are needed, as the effects of early life stress exposure may not emerge until later in the life‐span. Early life stress exposure is associated with biological and behavioral pathways that may increase risk for childhood obesity.

Conclusions

There is evidence that early life stress is associated with multiple biological and behavioral pathways in children that may increase risk for later obesity. Little work has detailed the interconnections among these mechanisms across development or identified potential moderators of the association. Mapping the mechanisms connecting early life stress exposure to obesity risk in young children longitudinally should be a priority for obesity researchers. Recommendations for developmentally sensitive approaches to research that can inform obesity prevention strategies are presented.

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$3.2 Million Grant Supports SF State Study of Childhood Obesity Disparities

April 5, 2018, San Francisco State University

Associate Professor of Health Education Emma Sanchez-Vaznaugh has been awarded a $3.2 million grant from the National Institutes of Health to study how federal and state nutrition policies and community environments affect childhood health.

Over the next five years, Sanchez-Vaznaugh and her team, including researchers at the University of Michigan, will investigate whether the policies — which attempt to improve school nutrition standards and reduce childhood obesity — are effective across different racial/ethnic populations. The study will also evaluate whether the policies are more effective when children attend school in neighborhoods with healthier food options than in neighborhoods with more fast food outlets.

“We hypothesize that the [federal and state nutrition] policies will be associated with improvements in body weight outcomes among children, but we know from our prior research that some schools have more healthy food in their communities and others do not. So these differences could enhance or undermine the effects of those policies,” said Sanchez-Vaznaugh.

The researchers will compare the body weights of fifth, seventh and ninth graders who attended California public schools during the periods before and after the policies were implemented. The study will link that data to the food outlets or restaurants located near the children’s schools during the same time frame to assess the role of the surrounding food environment. Geographic Information Systems (GIS) researchers in SF State’s Department of Geography & Environment will help collect data and map the location of food outlets near the schools.

Sanchez-Vaznaugh says socioeconomic status and race/ethnicity are important determinants of child health and related disparities. “One of the policies we are looking at could have the potential to reduce disparities in childhood obesity,” said Sanchez-Vaznaugh. “Given that two of our major public health goals are to eliminate health disparities and prevent obesity, there is a need for effective interventions that can prevent obesity early in life.”

Sanchez-Vaznaugh hopes her study will inform future policies. “We will look at interventions that aim to make changes in schools and that could even inform policy making at all levels,” she said. “Compared with interventions that encourage individuals to change their dietary behaviors, policies have the potential to make a large impact on many children by improving their food environments. The obesity epidemic is one of those types of issues that require effective policy-level interventions.”

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Obesity Impacts Liver Health in Kids as Young as 8 Years Old

April 4, 2018, New York Presbyterian

A new study published today in The Journal of Pediatrics is the first to show that weight gain may have a negative impact on liver health in children as young as 8 years old. The study found that bigger waist circumference at age 3 raises the likelihood that by age 8, children will have markers for nonalcoholic fatty liver disease.

“With the rise in childhood obesity, we are seeing more kids with nonalcoholic fatty liver disease in our pediatric weight management practice,” said Jennifer Woo Baidal, MD, MPH, assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons and lead author of the paper. “Many parents know that obesity can lead to type 2 diabetes and other metabolic conditions, but there is far less awareness that obesity, even in young children, can lead to serious liver disease.”

Nonalcoholic fatty liver disease occurs when too much fat accumulates in the liver and triggers inflammation, causing liver damage. The condition affects an estimated 80 million people in the U.S. and is the most common chronic liver condition in children and adolescents. While the disease is generally symptomless, progression of nonalcoholic fatty liver disease can lead to cirrhosis (scarring) of the liver and, in some instances, liver cancer.

Previous studies have focused on fatty liver disease in adolescents and young adults. In the current study, Woo Baidal and colleagues looked for fatty liver risk factors in younger children.

The researchers measured blood levels of a liver enzyme called ALT—elevated ALT is a marker for liver damage and can occur in individuals with nonalcoholic fatty liver disease and other conditions that affect the liver—in 635 children from Project Viva, an ongoing prospective study of women and children in Massachusetts.

By age 8, 23 percent of children in the study had elevated ALT levels. Children with a bigger waist circumference (a measure of abdominal obesity) at age 3 and those with greater gains in obesity measures between ages 3 and 8 were more likely to have elevated ALT. Approximately 35 percent of 8-year-olds with obesity had elevated ALT versus 20 percent of those with normal weight.

“Some clinicians measure ALT levels in at-risk children starting at around 10 years old, but our findings underscore the importance of acting earlier in a child’s life to prevent excess weight gain and subsequent liver inflammation,” says Woo Baidal, who is also director of pediatric weight management and a pediatric gastroenterologist in the Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children’s Hospital. “Currently, the best way for kids and adults to combat fatty liver disease is to lose weight, by eating fewer processed foods and getting regular exercise. We urgently need better ways to screen, diagnose, prevent, and treat this disease starting in childhood.”

The study is titled, “Associations of Early to Mid-Childhood Adiposity with Elevated Mid-Childhood Alanine Aminotransferase Levels in the Project Viva Cohort.” Additional authors are Erin Elbel (CUIMC), Joel Lavine (CUIMC), Sheryl Rifas-Shiman (Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA), Matthew Gillman (National Institutes of Health, Bethesda, MD, and Elsie Taveras (Massachusetts General Hospital, Boston, MA).

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Obesity, Underweight and BMI Distribution Characteristics of Children by Gross National Income and Income Inequality: Results From an International Survey

April 2, 2018, Obesity Journal

Summary

Background

Economic wealth and income inequality may impact on childhood BMI distribution by affecting overconsumption of food and sedentary forms of transportation and entertainment across the whole or some of the population.

Objectives

To determine whether BMI distribution of children differs by gross national income (GNI) per capita and Gini index derived from World Bank data.

Methods

Secondary analysis of largely self‐reported height and weight data from a multi‐country, cross‐sectional study (ISAAC), of 77,963 children aged 6‐7 (from 19 countries) and 205,388 adolescents aged 13‐14 (from 36 countries), were used to examine underweight vs obesity prevalence and BMI distribution skewness, median and dispersion.

Results

Children and adolescents from ‘lower’ GNI countries had higher prevalence of underweight than those from ‘higher’ GNI countries (6% vs 3%, p=0.03; 2% vs 1%, p=0.05 respectively), but the prevalence of obesity was not different (2% vs 5%, p=0.29; 2% vs 2%, p=0.66). BMI distribution of participants from ‘higher’ GNI countries had higher median, without significant difference in skewness or dispersion compared to ‘lower’ GNI countries (higher medians +1.1kg/m2 for 6‐7 year olds, and +0.7kg/m2, +1.2kg/m2 for 13‐14 year old girls and boys respectively). Gini index was not associated with underweight or obesity prevalence in either children or adolescents, nor with any BMI distribution characteristics with one exception. Adolescent girls from higher income inequality countries had a greater median BMI (+0.7kg/m2) and a less skewed BMI distribution.

Conclusions

It appears that the obesogenic impact of economic prosperity affects all children similarly. Income inequality may have a gender specific effect affecting BMI distribution in adolescent girls.

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