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August 2024

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CHILDHOOD OBESITY RESEARCH & NEWS

Spotlight

NCCOR’s Catalogue of Surveillance Systems (CSS) Expands with Four New Studies

NCCOR’s Catalogue of Surveillance Systems (CSS) has grown to include four significant studies, each offering unique insights into public health:

The Hispanic Community Health Study/Study of Latinos: This study explores the health and disease patterns in Hispanic/Latino populations in the United States, aiming to understand the role of lifestyle and genetic factors in their health outcomes.

The Framingham Heart Study: Initiated in 1948, this ongoing study investigates cardiovascular disease risk factors, contributing significantly to our understanding of heart health across generations.

The Future of Families and Child Wellbeing Study: This longitudinal study examines the conditions and outcomes of American families and children, focusing on factors influencing their well-being and development.

The Jackson Heart Study: Focused on African American populations, this study researches the genetic and environmental factors contributing to cardiovascular disease to improve prevention and treatment strategies.

Within the CSS, users can explore these comprehensive data sets and resources to support research on childhood obesity. These four new studies provides researchers, practitioners, and students with valuable data and insights to advance their work.

This update follows the recent addition of sleep variables to the CSS, which streamlines finding data to study the intersection of sleep and childhood obesity.

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Publications & Tools

NCCOR Toolbox: Part I of Popular NCCOR Workshop is Now Available Online

August 2024, NCCOR

On June 4–5, 2024, NCCOR hosted part one of the Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) workshop featuring presentations from leading obesity-prevention and public health experts. The workshop examined best practices in obesity prevention research with specific attention to community engagement and systems change through an equity lens. View the OPUS I presentations and slides here.

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Food is Medicine: A State Medicaid Policy Toolkit

July 2024, Food is Medicine Coalition

Poor diets are the leading cause of death in the United States, costing the economy roughly $1.1 trillion each year and accounting for 85% of healthcare spending. Food is Medicine (FIM) interventions have emerged as an important component of state and federal strategies to respond to these troubling trends. A recent consensus-based document defined these FIM interventions as including two core components: (1) “the provision of food that supports health,” and (2) “a nexus to the healthcare system.” Under this definition, FIM interventions encompass a spectrum of nutrition services—ranging from medically tailored meals to medically tailored groceries, and produce prescriptions—all of which are tailored to patient needs and integrated into the healthcare system through referrals from medical providers.

Notably, these interventions are primarily designed to provide access to specific foods as part of medical treatment. While FIM interventions can also help to address social determinants of health (SDOH) and health related social needs (HRSNs) such as food insecurity, the primary intent behind these programs is to meet the medical nutrition needs of individual patients. In doing so, FIM interventions build upon broader nutrition security programs such as the Supplemental Nutritional Assistance Program (SNAP) and population-level healthy food policies and programs to provide access to nutritious food as part of a patient’s treatment plan.

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Total Participation in USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Continued to Increase in FY 2023

July 16, 2024, U.S. Department of Agriculture

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has provided supplemental food packages, nutrition education, breastfeeding support, and health care referrals at no cost to low-income pregnant and postpartum women, infants younger than 1 year old, and children 1 to 5 years old who are at nutritional risk since 1974. More than half of WIC participants are children (55.0 percent), followed by women (22.6 percent), and infants (22.4 percent). Total participation in WIC increased for the first time in more than a decade in fiscal year (FY) 2022, and this increase continued in FY 2023. Participation averaged 6.57 million people a month in FY 2023, a 5-percent increase from 6.26 million in FY 2022. This was the second increase in overall participation since the record high of 9.18 million people in FY 2010 and resulted from increased numbers of participants in all three groups (women, infants, and children). FY 2023 was the first year since 2009 that the number of infants participating in WIC increased. This chart appears on the WIC Program topic page and in the USDA, Economic Research Service’s Food and Nutrition Assistance Landscape: Fiscal Year 2023 Annual Report, released June 12, 2024, and was discussed in a recorded webinar.

[Source]

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Childhood Obesity Research & News

Study Evaluates Treatment Interventions for Severe Obesity in Adolescents

July 23, 2024, EurekAlert!

Adolescents with severe obesity who received meal-replacement therapy plus financial incentives experienced a greater reduction in body mass index compared to those who received meal replacement therapy alone, according to recent findings published in JAMA Pediatrics.

Justin Ryder, PhD, Vice Chair of Research for the Department of Surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and Associate Professor of Surgery and Pediatrics at Northwestern University Feinberg School of Medicine, was a co-author of the study.

Severe obesity currently affects about one in five children and adolescents in the U.S., according to the Centers for Disease Control and Prevention, and is defined as having a body mass index, or BMI, either at or above the 95th percentile for age and sex. The condition is associated with an increased risk of adult obesity, cardiovascular disease, type 2 diabetes and other conditions.

Previous research has found that meal replacement therapy (MRT), rather than traditional lifestyle modifications, is more effective in helping reduce BMI in adolescents with severe obesity.

In the current study, the investigators sought to determine if MRT paired with financial incentives to adolescents with severe obesity would increase the efficacy of MRT and lead to a greater reduction in BMI, when compared to MRT alone.

“There’s literature for adults that supports that tying in financial incentives to weight loss or physical activity programs increases adherence, and so we wanted to see whether or not adding financial incentives to a behavioral/nutrition weight loss program using meal replacement therapy would increase adherence and through adherence, increase the efficacy of the treatment,” Dr. Ryder said.

Of the 126 adolescents enrolled in the study, 63 participants received MRT plus financial incentives and 63 participants received only MRT for one year. MRT included pre-portioned meals totaling 1,200 calories per day, and financial incentives were provided based on reduction in body weight from baseline.

After 52 weeks, the MRT plus financial incentives group had a greater BMI reduction (a reduction of 6 percentage points) and a greater reduction in total body fat mass (a loss of 4.8 kilograms) compared to those who only received MRT therapy.

“Using a cost-effectiveness analysis, we looked at mean fat mass lost between the two treatments and found that despite providing the additional meal replacements for per pound lost, it was cost-effective to do so,” Dr. Ryder added.

Additional work is also needed to develop interventions that extend beyond one year, according to the authors.

“While financial incentives plus MRT appears to be a longer-term strategy than MRT alone, treatment withdrawal will likely result in BMI increase. As such, research is needed to identify strategies that are scalable and feasible in the long term given the chronic nature of obesity,” the authors wrote.

This work was supported by grants R01DK113631, K23DK129721, K23DK125668, and K23DK124654 from the National Institute of Diabetes and Digestive and Kidney Diseases, and UL1TR002494 from the National Institutes of Health National Center for Advancing Translational Sciences. Healthy For Life Meals provided financial assistance with the meal program.

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is a nonprofit organization committed to providing access to exceptional care for every child. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine.

[Source]

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A Scoping Review of Tailoring in Pediatric Obesity Interventions

July 15, 2024, Childhood Obesity

Abstract

Background: Families with children who have or are at risk for obesity have differing needs and a one-size-fits-all approach can negatively impact program retention, engagement, and outcomes. Individually tailored interventions could engage families and children through identifying and prioritizing desired areas of focus. Despite literature defining tailoring as individualized treatment informed by assessment of behaviors, intervention application varies. This review aims to exhibit the use of the term “tailor” in pediatric obesity interventions and propose a uniform definition.

Methods: We conducted a scoping review following PRISMA-ScR guidelines among peer-reviewed pediatric obesity prevention and management interventions published between 1995 and 2021. We categorized 69 studies into 6 groups: (1) individually tailored interventions, (2) computer-tailored interventions/tailored health messaging, (3) a protocolized group intervention with a tailored component, (4) only using the term tailor in the title, abstract, introduction, or discussion, e) using the term tailor to describe another term, and (5) interventions described as culturally tailored.

Results: The scoping review exhibited a range of uses and lack of explicit definitions of tailoring in pediatric obesity interventions including some that deviate from individualized designs. Effective tailored interventions incorporated validated assessments for behaviors and multilevel determinants, and recipient-informed choice of target behavior(s) and programming.

Conclusions: We urge interventionists to use tailoring to describe individualized, assessment-driven interventions and to clearly define how an intervention is tailored. This can elucidate the role of tailoring and its potential for addressing the heterogeneity of behavioral and social determinants for the prevention and management of pediatric obesity.

 [Source]

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Association Between Picky Eating, Weight Status, Vegetable, and Fruit Intake in Children and Adolescents: Systematic Review and Meta-Analysis

July 11, 2024, Childhood Obesity

Abstract

Aim: Picky eating is a common appetitive trait reported among children and adolescents and may have detrimental effects on their weight, vegetable, and fruit intake, impacting health status. However, an updated systematic review of the literature and summary of effect estimates is required. This study aims to explore the association between picky eating with weight, vegetable and fruit intake, vegetable-only intake, and fruit-only intake.

Methods: A systematic literature search of six electronic scientific databases and data extraction was performed between November 2022 and June 2023. Original articles that examined picky eating in association with weight, vegetable and/or fruit intake were included. PRISMA guidelines were followed and meta-analytical and meta-regression analyses were conducted to compute summary effect estimates and explore potential moderators. PROSPERO registration: CRD42022333043.

Results: The systematic review included 59 studies of which 45 studies were included in the meta-analysis. Overall, the summarized effect estimates indicated that picky eating was inversely associated with weight [Cohen’s dz: −0.27, 95% confidence interval (CI): −0.41 to −0.14, p < 0.0001]; vegetable and fruit intakes (Cohen’s dz: −0.35, 95% CI: −0.45, −0.25, p < 0.0001); vegetable-only intake (Cohen’s dz: −0.41, 95% CI: −0.56, −0.26, p < 0.0001), and fruit-only intake (Cohen’s dz: −0.32, 95% CI: −0.45, −0.20, p < 0.0001). Picky eating was positively associated with underweight (Cohen’s dz: 0.46, 95% CI: 0.20, 0.71 p = 0.0008).

Conclusion: Although effect sizes were small, picky eating was inversely associated with weight, vegetable, and fruit intakes, and positively associated with underweight in children and adolescents aged birth to 17 years.

[Source]

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Heritability of Body Mass Index Among Familial Generations

June 28, 2024, EurekAlert!

About The Study: In this study, the weight status of parents at 17 years of age was associated with obesity risk for both female and male offspring, emphasizing that parental factors may influence the next generation’s health outcomes.

[Source]

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