August 2022


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NCCOR to Host a Webinar on Reframing Childhood Obesity: Cultural Insights on Nutrition, Weight, and Food Systems

NCCOR is partnering with the Vanderbilt Cultural Context of Health & Wellbeing Initiative and Robert Wood Johnson Foundation to host a Connect & Explore webinar on their recently released report, Reframing Childhood Obesity: Cultural Insights on Nutrition, Weight, and Food SystemsThe report focuses on three key areas where cultural insights and global examples can improve health policy around childhood obesity by understanding how historical and structural factors frame food and weight beyond individual choice.

Join us on Wednesday, September 7, 2:00-3:00 p.m. ET to explore how public health programs can work with, not against, cultural traditions and norms and harness local creativity to change nutritional outcomes. Leading experts featured in this report will discuss how the intersectionality of complex physiological, cultural, and commercial systems contributes to childhood obesity.


  • Karabi Acharyam, DrPh, MHS, Robert Wood Johnson Foundation
  • Jamie Bussel, MPH, Robert Wood Johnson Foundation
  • Ted Fischer, PhD, Vanderbilt University

For more information about NCCOR Connect & Explore webinars and to sign up for the September 7 webinar, please visit the NCCOR website at

You must register for each webinar to receive access. The event is free, but attendance is limited, so tell a colleague and register today!

Please consider sharing this information on your social networks using the hashtag #ConnectExplore. We will live-tweet the events, so be sure to follow the conversation at @NCCOR. For those who cannot attend, the webinar will be recorded and archived on

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Publications & Tools

NCCOR Toolbox: Catalogue for Surveillance Systems Helps Advance Breastfeeding Research

August is National Breastfeeding Month, which highlights research, advocacy, and educational initiatives supporting breastfeeding. NCCOR’s Catalogue of Surveillance Systems (CSS) now offers 14 datasets related to infant health and nutrition, which can help facilitate research on breastfeeding. Visit the CSS page and enter “breastfeeding” in the search field to find relevant resources. For those new to CSS, this video offers a brief introduction to its features.

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New Study Shows Increase in Childhood Obesity during the Last Decade

A new research letter in JAMA Pediatrics shows childhood obesity rates increased from 17.7% in 2011 to 2012 to 21.5% in 2017 to 2020. Based on NHANES data, this cross-sectional study looked at changes in BMI among 14,967 children between the ages of 2-19 years old, and found significant increases among children of all races and ethnicities. The authors urge further research to identify risk factors that may be driving the increase. (Note: Access to the full text research letter requires a free sign up).

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New Nutrition and Physical Activity Recommendations for Children Published

The Obesity Medicine Association (OMA) released a new Clinical Practice Statement with detailed recommendations for childhood nutrition and physical activity. OMA offers guidance based on children’s ages and tailored to their current weight. The authors also consider the impact of food insecurity on health outcomes and provide guidance for obesity-related complications, including type II diabetes, hypertension, and non-alcoholic fatty liver disease.  Click here to access the complete OMA guidelines and several high-res images for download.

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Childhood Obesity Research & News

Study Finds Childhood Obesity Occurring at Greater Frequency, with More Severity and at Younger Ages

July 5, 2022, Emory University

Obesity in childhood and early adolescence can be linked to poor mental health and are often precursors to chronic diseases in adulthood, including diabetes and cardiovascular disease. A new study published in Pediatrics and led by Solveig A. Cunningham, PhD, found that, despite numerous public health efforts to promote healthy behaviors and to improve living environments, the rates of new cases of obesity in elementary school are higher and are occurring earlier in childhood than they were even a decade earlier. The multidisciplinary Emory team includes co-senior authors Michael R. Kramer, PhD, K.M. Venkat Narayan, MD, and postdoctoral fellow Rebecca Jones, PhD.

The researchers analyzed at what ages children are most likely to develop obesity and which children are at highest risk. They compared data on children entering kindergarten in 1998 and in 2010 and followed them through fifth grade. The data are nationally representative, so findings can be generalized to children growing up in the United States.

Major findings from the study include:

  • Approximately 40 percent of today’s high school students and young adults had experienced obesity or could be categorized as overweight before leaving primary school.
  • Children born in the 2000s experienced rates of obesity at higher levels and at younger ages than children 12 years earlier, despite public health campaigns and interventions aimed at preventing obesity.
  • Non-Black Hispanic kindergartners had a 29 percent higher incidence of developing obesity by fifth grade compared to non-Black Hispanic kindergartners 12 years earlier.
  • Risk of developing obesity in primary school among the most economically disadvantaged groups increased by 15 percent.

“These worrying data indicate that the childhood obesity epidemic in the United States continues to grow and get more serious. Our knowledge about effective interventions to fight this also seems limited,” says Narayan. “We urgently need an aggressive national strategy for interdisciplinary research and public health to stem the tide of childhood obesity and its consequences in the U.S. and worldwide.”

Cunningham adds, “For decades, we have seen the number of children with obesity increasing, in spite of extensive efforts from many parents and policy makers to improve children’s nutrition, physical activity and living environments. Have these efforts worked? Is obesity finally receding? Our findings indicate that no, obesity must continue to be a public health priority.”


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Emotional Patterns a Factor in Children's Food Choices

July 12, 2022, Elsevier

The emotional context in which eating occurs has been thought to influence eating patterns and diet, with studies finding negative emotions predict excessive calorie intake and poor diet quality. A research article featured in the Journal of Nutrition Education and Behavior, published by Elsevier, discusses how children’s unhealthy food choices, especially over weekends, are related to emotion.

“Children are more likely to consume unhealthy foods on weekends when meals and snacks are less structured and supervised than on school days,” said Christine Hotaru Naya, MPH, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA. “We also focused on snack choices where children often make their own decisions.”

This study sampled 195 ethnically diverse children currently in third through sixth grades who lived in the greater Los Angeles metropolitan area. Children used a mobile phone app and were contacted seven times per day to answer questions. When contacted, they were asked if they were feeling stressed, mad or sad and to report if they had made any unhealthy eating choices from among fried foods, sweets, and sugary beverages over the previous two hours.

Across all food types sampled, sweet food consumption was reported the most often. Children reported eating sweets or pastries at least once daily on 40% of the days. Chips or fries were eaten at least once a day on nearly 30% of days, and sugar-sweetened beverages were consumed at least once per day on 25% of days.

The researchers also identified three negative mood patterns during a day: stable low; early increasing and late decreasing; and early decreasing and late increasing. In the study, on 90% of the days, children reported stable low negative mood, but the reminder had varying moods throughout the day.

“We found fried food consumption to be higher on days with more variable emotional patterns than days with consistent low negative mood,” says Naya. “These results align with other studies that have found the negative mood to positively predict children’s fatty food intake.” Sweet food and soda consumption did not follow the same patterns in this study.

Coauthor Daniel Chu, MPH, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA, notes, “This study has several strengths, including the ability to be repeated in the family home, and we were able to test a population of healthy children so results can be widely applied.”

These findings add to the evidence for incorporating mood and emotion-based components into interventions aiming to improve children’s dietary outcomes and eating behaviors. Specifically, results highlight mornings and evenings as two possible vulnerable periods when the change in negative emotions could influence food choices.

“More studies are needed for us to understand the relationship between a child’s emotions and their food choices, but this is a good start on that path to recognizing how to approach food choices with a person’s mood and emotions in mind,” concludes Naya. “We could improve our current interventions to be individually tailored to the environmental, social, emotional, and cognitive contexts in which unhealthy eating occurs.”

The article is “Children’s Daily Negative Affect Patterns and Food Consumption on Weekends: An Ecological Momentary Assessment Study,” by Christine H. Naya, MPH; Daniel Chu, PhD; Wei-Lin Wang, PhD; Michele Nicolo, PhD; Genevieve F. Dunton, MPH, PhD; and Tyler B. Mason, PhD ( It appears in the Journal of Nutrition Education and Behavior, volume 54, issue 7 (July 2022), published by Elsevier.

It is openly available at


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Study Links Insulin Resistance, Advanced Cell Aging with Childhood Poverty

July 25, 2022, University of Illinois

Black adolescents who lived in poverty and were less optimistic about the future showed accelerated aging in their immune cells and were more likely to have elevated insulin resistance at ages 25-29, researchers found.

Allen W. Barton, a professor of human development and family studies at the University of Illinois Urbana-Champaign is the first author of the study, which tracked the health of 342 African Americans for 20 years, from adolescence to their mid- to late twenties. The researchers’ goal was to explore links between the individuals’ childhood social environment and insulin resistance, a precursor to diabetes where cells don’t respond well to insulin or use blood glucose for energy.

The participants lived in rural Georgia, a region with one of the highest poverty rates and shortest life expectancies in the U.S.

“Once we found some compelling evidence that family poverty during childhood was associated with participants’ insulin resistance in their late 20s, we looked at immune cell aging as a possible mediator, something that transmits the effect,” Barton said. “And we found support for that. Immune cell aging was a pathway, a mechanism through which poverty was associated with insulin resistance.”

Published in the journal Child Development, the findings support the hypothesis that chronic diseases such as diabetes and metabolic syndrome that occur at significantly higher rates among Black adults and low-income populations may partially originate with experiences much earlier in life – even during childhood – and that such disadvantages can influence individuals’ cognition and physiology.

“Understanding these health disparities associated with race and socioeconomic status really requires a developmental perspective, but prospective research with these populations is sparse,” Barton said.

“In addition to focusing on contemporaneous stressors – such as their socioeconomic status in adulthood, where they currently live and their access to health care – prospective studies like this that follow participants into adulthood are important to explore developmental pathways originating in childhood to see associations between individuals’ early social environment and their subsequent health outcomes as adults,” he said.

Recent research cited in the current study also indicates that type 2 diabetes and other diseases are affecting certain populations – especially Blacks – at much younger ages.

Data used in the new study were drawn from the Strong African American Families Healthy Adult Project, also called SHAPE, that enrolled 667 Black fifth-grade students and their caregivers. SHAPE began collecting data in 2001.

Young adults in the sample provided at least one blood sample at age 20 and again between the ages of 25-29. From these samples, researchers assessed participants’ biological age using DNA methylation and compared this age with their chronological age. Participants’ blood samples also were used to quantify their levels of insulin resistance at ages 25, 27 and 29.

At six time points, beginning when the children were 11 and continuing through age 18, the caregivers completed questionnaires about their family’s need-to-income ratios, which were used to calculate their poverty status and the number of years they lived below the federal poverty level.

Three times from the ages of 16-18, the youths completed the Perceived Life Chances Scale, a 10-item inventory that asked them whether they believed they would go to college or obtain a job that paid well, and how likely that was.

In their initial analyses, the researchers found that living in poverty between ages 11-18 was associated with insulin resistance at ages 25-29. The longer participants lived in poverty during adolescence, the higher their risk of insulin resistance and diabetes in adulthood, the researchers found. This risk was calculated using a Homeostatic Model of Insulin Resistance, or HOMA, score. Each additional year of poverty was associated with a greater than one-point higher HOMA score.

When the children reached age 19-20, the researchers examined DNA methylation in a subset of participants. DNA methylation is a natural process associated with aging that can affect gene function

When the researchers also considered whether the teens believed they could reach their goals as adults, they found that more years spent living in poverty was associated with fewer perceived life chances. The team found associations between youths’ perceived life chances and premature immune cell aging at 20 years old, which was then linked to insulin resistance, Barton said.

“We don’t know what may have happened to them prior to age 11, so perhaps there were things put in place that we just can’t assess yet,” Barton said about the study’s limitations.

The researchers continue to follow the sample individuals and are exploring the role of resilience in participants’ health outcomes as they age, he said.

“It’s a tremendous data set and can begin to answer some important public health questions, shed light on some of these racial disparities and help find ways to mitigate them,” Barton said.

Co-authors of the study include research scientist Tianyi Yu and Gene H. Brody, the founder and co-director of the Center for Family Research, both at the University of Georgia; psychology professors Edith Chen and Gregory E. Miller, who co-direct the Foundations of Health Research Center at Northwestern University; and Qiujie Gong, a predoctoral fellow at the U. of I.

The paper, “Childhood poverty, immune cell aging and African Americans’ insulin resistance: A prospective study” is available online or from the News Bureau DOI:  10.1111/cdev.13795


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