December 2018

NCCOR Year in Review: 2018

December 27, 2018, NCCOR

It’s been a busy year for the National Collaborative on Childhood Obesity Research! This year, NCCOR updated some of our one-of-a-kind tools, accelerated outreach efforts to disseminate information, and strengthened alliances and partnerships to promote childhood obesity research. Here are some of our accomplishments and moments from the year.

• NCCOR’s tools and resources help researchers and practitioners conduct research and evaluation activities. This year, we expanded outreach to new audiences who may benefit from our tools including creating new materials geared towards students, and physical education teachers.
• We added 188 new measures to the Measures Registry & User Guides, for a total of more than 1300 articles on diverse tools and methodologies that can be used to assess diet and physical activity at the individual and environmental levels.
• NCCOR updated more than 70 systems in the Catalogue of Surveillance Systems and added five new systems including NCI’s Family Life, Activity, Sun, Health and eating (FLASHE) study and USDA’s National Household Food Acquisition and Purchase Survey (FoodAps).
• This year, NCCOR created additional fact sheets and case examples for the Youth Compendium of Physical Activities, for physical education teachers and public health practitioners to help them determine how best to use this resource for their goals.
• Last year, NCCOR released a paper that provided an overview of behavioral design and potential applications to promote better health among children. This year, this white paper was turned into a chapter called “Behavioral Design as an Emerging Theory for Dietary Behavior change” for Food and Public Health, a book published by Oxford University Press.
• NCCOR held six Connect & Explore webinars in 2018. Topics included:
  • Preventing Childhood Obesity in Latin America: An Agenda for Regional Research and Strategic Partnerships
    Experts: Juan Rivera, PhD; Camila Corvalan, MD, PhD, MPH; Rafael Perez-Escamilla, PhD; Michael Pratt, MD, MSPE, MPH
  • Collaborating for Impact: Lessons Learned from NCCOR
    Experts: C. Tracy Orleans; PhD; Laura Kettel Khan, PhD; Rachel Ballard, MD, MPH; Jay Variyam, PhD, Jasmine Hall Ratliff, MHA
  • Examining Declines in Childhood Obesity in Four Communities: Highlights from Six Papers Published in Childhood Obesity
    Experts: Tina Kauh, PhD; Nicola Dawkins-Lyn, PhD, MPH, Laura Kettel Khan, PhD; Deborah Young-Hyman, PhD
  • The Healthy Communities Study: How Community Programs and Policies are Related to Children’s Health
    Experts: Sonia Arteaga, PhD; Stephen Fawcett, PhD, MA; Russell Pate PhD; Lorrene Ritchie, PhD, RD
  • Innovations in Behavioral Design to Enhance Active Living and Healthy Eating
    Experts: Jeri Brittin, PhD; Joel Kimmons, PhD, Kim Rollings, PhD
  • America’s Eating Habits: Food Away From Home
    Expert: Michelle Saksena, PhD
• NCCOR also attended several annual conferences relating to physical activity and childhood obesity this year. This allows NCCOR to engage with the field and highlight new tools through presentations and at NCCOR conference exhibit booths. These conferences included: Active Living Research Annual Conference, SHAPE America, Society of Behavioral Medicine Annual Meeting, Society for Prevention Research Annual Meeting, American College of Sports Medicine Annual Meeting, and the American Public Health Association Meeting.

Learn more about our accomplishments from the last decade on our website!

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CDC Virtual Healthy School

This is an online, interactive school that provides innovative learning experiences to help make your school healthier. While the Virtual Healthy School’s major themes are nutrition, physical education and physical activity, and the management of chronic health conditions (e.g., asthma, diabetes) in schools—the tool also includes examples of how to incorporate all 10 components of the Whole School, Whole Community, Whole Child (WSCC) model.

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Philadelphia’s Database for Beverage Tax

As part of an on-going effort to increase transparency around how the city spends tax dollars, the City Controller’s Office is releasing information about the revenue and spending for the Philadelphia Beverage Tax. This release offers an update on the Beverage Tax through the end of the first quarter of Fiscal Year 2019 (September 30, 2018).

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School-Based Nutrition Programs Reduce Student Obesity

December 17, 2018, EurekAlert

In-school nutrition policies and programs that promote healthier eating habits among middle school students limit increases in body mass index (BMI), a new study led by the Yale School of Public Health finds.

The five-year trial, conducted in conjunction with the Rudd Center for Food Policy and Obesity at the University of Connecticut, followed nearly 600 students from 12 schools in New Haven.

In schools with enhanced nutrition policies and programs, students had healthier body mass index trajectories (a measure of obesity) over time, and by the end of the study they reported healthier behaviors than their peers in schools without the nutrition policies and programs. Students in schools with enhanced support to implement nutrition policies had an increase in BMI percentile of less than 1%, compared with students in schools without enhanced support for these policies and programs who demonstrated increases of 3% to 4%. The study is published in the American Journal of Preventive Medicine.

“These findings can guide future school and community interventions. Childhood obesity is a serious health threat, and schools are a vital way to reach children and their families to reduce risks and promote health,” said lead author Jeannette Ickovics, the Samuel and Liselotte Herman Professor of Social and Behavioral Sciences at the Yale School of Public Health. “These findings strongly support previous administration policies that provided healthier food for all children in public schools.” These policies were rolled back last week by the U.S. Department of Agriculture.

The study is one of the first school-based policy intervention studies that followed students through middle school. The researchers analyzed both behavioral and biological indicators. Results are among the most compelling to date, said the researchers, perhaps because of the strong community-university partnership, and the recognition that health and academic achievement often go hand-in-hand.

“This is some of the strongest evidence we have to date that nutrition education and promoting healthy eating behaviors in the classroom and cafeteria can have a meaningful impact on children’s health,” said Marlene Schwartz, director of the Rudd Center and senior study author. “These findings can inform how we approach federal wellness policy requirements and implementation in schools to help mitigate childhood obesity.”

The nutritional interventions in the schools studied included ensuring that all school-based meals met federal nutritional criteria; providing nutritional newsletters for students and their families; school-wide campaigns to limit sugary drinks and encourage the use of water; and limiting the use of food or beverages as rewards for academic performance or good behavior.

Researchers also tested whether a series of policies to promote physical activity would impact adolescent body mass index. They determined that the physical activity policies alone had little or no impact on body mass index.

In the study authors said that more than one in five American teenagers are currently obese, and as many as one in two are overweight or obese. Being overweight or obese early in life affects health across the lifespan, contributing to a range of chronic diseases such as hypertension, diabetes, and depression that reduce productivity and shorten life expectancy.

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Our Nation’s Health: Obesity Rate at an All-Time High; Childhood Poverty Continues to Decline

December 12, 2018, Associated Press

The nation’s obesity rate has reached the highest-ever level this year, according to the United Health Foundation’s 2018 America’s Health Rankings Annual. Obesity is a leading contributor to cardiovascular disease, cancer and other conditions. Additionally, an increase in drug deaths, suicides and cardiovascular disease deaths is contributing to an increase in premature death.

In its 29th year, the America’s Health Rankings Annual Report also reveals bright spots, including the reduced rate of childhood poverty and an increased number of mental health providers and primary care physicians per 100,000 people. Key findings include:

Obesity Prevalence Reaches All-Time High; Premature Deaths Continue to Increase

The obesity rate exceeded 30 percent of the adult population for the first time in America’s Health Rankings history, up 5 percent in the past year (from 29.9 percent to 31.3 percent). Premature deaths increased 3 percent (from 7,214 to 7,432 years lost before age 75 per 100,000 people).

Suicide Rate Increases

The suicide rate has increased 16 percent since 2012 (from 12.0 to 13.9 deaths per 100,000 people). The suicide rate is 3.5 times lower in New Jersey – the state with the lowest rate for this measure – with 7.5 deaths per 100,000 people, compared with Montana, the most at 26.0 deaths per 100,000. The suicide rate is much higher among males: 22.2 deaths per 100,000 compared with females at 6.2 deaths per 100,000.

Childhood Poverty Percentage Decreases; Number of Health Care Providers Increases

Childhood poverty – a key indicator of socioeconomic status and overall health – decreased 19 percent in the past five years from 22.6 percent in 2013 to 18.4 percent in 2018, and decreased 6 percent since 2017. The number of mental health providers per 100,000 people increased 8 percent and the number of primary care physicians increased 5 percent nationwide in the past year.

“This year’s Annual Report spotlights an obesity problem that continues to grow. This means more people will likely develop obesity-related chronic diseases like cardiovascular disease, diabetes and cancer,” said Dr. Rhonda Randall, chief medical officer of UnitedHealthcare National Markets, and an adviser to America’s Health Rankings. “We encourage health professionals, public health officials and elected leaders to use these findings to explore opportunities to better support people in their communities in all aspects of their health.”

State Rankings in 2018: Hawaii Ranks No. 1, Louisiana Ranks No. 50 The Annual Report ranks Hawaii as the healthiest state in 2018, followed by Massachusetts (2), Connecticut (3), Vermont (4) and Utah (5). Louisiana ranks as the most challenged state this year, while Mississippi (49), Alabama (48), Oklahoma (47) and Arkansas (46) round out the states with greatest opportunities for improvement.

Maine, California and North Dakota experienced the largest rank improvements since last year, with Maine rising seven places to No. 16, and California and North Dakota jumping five places to No. 12 and 13, respectively. Oklahoma experienced the largest rank decline, falling four places to No. 47.

In an effort to continually improve its offerings and capabilities, America’s Health Rankings now offers a new “Adjust My Rank” tool. This feature enables users to better understand their community’s and state’s diverse public health needs and challenges, to gain insights on how to improve their state’s rank.

America’s Health Rankings America’s Health Rankings Annual Report is the longest-running annual assessment of the nation’s health on a state-by-state basis. For 29 years, the report has analyzed a comprehensive set of behaviors, community and environmental conditions, policies, clinical care and outcomes data to provide a holistic view of the nation’s health. This report looks at 35 core measures across these categories.

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$3.9M Project to Address Obesity in Rural Eastern Oklahoma

December 10, 2018, Associated Press

Oklahoma State University has a $3.9 million plan to address obesity in two rural counties, one of which includes the town with the lowest life expectancy in the U.S.

The Curbing Obesity program will use a five-year federal grant to offer cooking classes and distribute healthy food options in Muskogee and Adair counties in eastern Oklahoma, The Tulsa World reported.

More than 40 percent of residents in those counties are obese. Stilwell in Adair County has the lowest life expectancy in the country, with residents living an average of just 56.3 years.

The university’s Center for Health Systems Innovation will run the program in partnership with local organizations. Primary-care physicians will be asked to identify patients at risk of obesity-related health problems and refer them to the program. Officials hope to apply the information gathered from the pilot program to other rural areas in Oklahoma, said William Paiva, CHSI’s executive director.

“It will take decades or generations to see a change in life expectancy,” he said. “But it starts with curbing obesity.”

The Community Food Bank of Eastern Oklahoma will participate by offering classes that it says will show people how to make delicious, low-cost, healthy meals.

“Ironically, poverty and obesity can go together,” said David Parrack, director of finance and accounting at the food bank. “The most affordable meals are not necessarily the healthiest.”

Many families don’t have a history of having home-cooked meals and changing such eating habits may take generations, he said.

“If you can reach one family, you can make a difference in the quality of life of that family,” Parrack said. “And it doesn’t take many families, one by one, to begin making a difference for the community.”

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Children Move Less Starting at Age 6

December 6, 2018, New York Times

Most experts believe that physical activity declines as children reach adolescence, but a new study has found that the decline begins as early as age six.

Researchers measured physical activity at ages 6, 8 and 11 in 600 European children wearing arm band activity trackers. After adjusting for body mass index, the scientists found that average time spent in physical activity declined by about 75 minutes a day by the time the children were 11. Light physical activity declined by 45 minutes a day, and moderate to vigorous activity, which remained steady until age 8, declined an average of 31 minutes a day by age 11.

The study, in Pediatrics, found that at age 11, the children were spending an average of almost two more hours a day in sedentary behavior — essentially, sitting still — than they were at 6. Only 63 percent of 11-year-olds were getting the recommended 60 minutes a day of moderate to vigorous exercise, compared with 82 percent of 6-year-olds.

Boys got more moderate to vigorous exercise than girls, and girls more light activity than boys, but the overall decline in exercise was sharper in boys.

“The only major influencing factors were sex, country and body size,” the authors write. “Interventions to prevent inactivity might need to focus more on younger children.”

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High Childhood BMI Linked to Obesity at Age 24 in Women

December 3, 2018, Penn State News

Girls who gain weight more rapidly between the ages of 5 and 15 are more likely to be obese at age 24, according to researchers.

“This highlights the importance of prevention efforts in childhood and adolescence,” said Emily Hohman, assistant research professor of the Center for Childhood Obesity Research. The center is a college-wide collaboration of researchers from Penn State and elsewhere focused on evidence-based research that can be applied to treatment and prevention programs.

The Penn State researchers completed a follow-up study using data collected from a 10-year longitudinal observational study done by other researchers. In the original study, the researchers gathered 197 non-Hispanic white girls all 5 years in age.

The original study found four different BMI trajectory groups based on patterns of growth between the ages of 5 and 15. The four groups were classified as accelerated weight gain from ages 5 to 15; accelerated weight gain from 5 to 9 followed by a leveling-off; weight tracked along the 60th percentile; and weight tracked along the 50th percentile. The previous study had found that the first group — accelerated weight gain from ages 5 to 15 — had higher fasting insulin, blood pressure and triglycerides at age 15 than the other groups.

The follow-up study tracked down 182 of the 197 original participants when they were 24 years old, 10 years after last contact. The researchers sent surveys that asked the women to self-report their weight, height, education level, dieting, relationship, student and work status. The women who reported having a child were excluded from the follow-up.

The researchers found the accelerated weight gain from ages 5 to 15 group had a 93 percent rate of overweight or obesity at age 24 compared to just 20 to 37 percent in the other three groups.

“There is a need for prevention in young adulthood, too,” said Hohman. “Kids are going off to college, getting their first jobs, and leaving home. This is another critical window where long-term health habits can develop, and obesity risk might increase.”

A high BMI throughout childhood is associated with negative health outcomes in adulthood including obesity, cancer, cardiovascular disease and diabetes, according to the paper, which will be published this month in Eating Behaviors.

“We found that about 20 to 30 percent of girls who did not have accelerated weight gain in childhood or adolescence ended up having overweight or obesity at age 24,” said Hohman.

This shows how eating behaviors and lifestyle choices can impact BMI as well.

For future work, the researchers plan to test additional psychological and physiological measures in person.

“We would love to bring the women back in to get additional data on eating behaviors and health,” said Hohman. “We just need to find the funding.”

Penn State researchers on the study included Elizabeth L. Adams, graduate student in health and human development; Michele E. Marini, research technologist III and statistician; and Jennifer S. Savage, assistant professor of nutritional sciences, and director of the Center for Childhood Obesity Research.

Other researchers were Katherine N. Balantekin, clinical assistant professor of exercise and nutrition sciences, State University of New York at Buffalo; Alison K. Ventura, assistant professor of kinesiology and public health, California Polytechnic State University; and Leann L. Birch, professor of foods and nutrition, University of Georgia.

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