February 2025

New Year, New Look: NCCOR Unveils an Updated Identity and Mission

February 2025, NCCOR

The field of childhood obesity research is evolving. After years of promising declines, obesity rates are once again rising. The COVID-19 pandemic disrupted effective community-level interventions and slowed the momentum of critical prevention efforts. Now, there is an urgent need to reinvest in proven strategies and advance new, scalable approaches.

NCCOR recognizes this moment as an opportunity for innovation. As the field works to regain ground lost during the pandemic, NCCOR is committed to providing tools, resources, and collaborative opportunities to help shape the future of childhood obesity research. With this in mind, we have made important updates to our logo, tagline, and mission that reinforce our dedication to this work.

You may have noticed our updated look. Our logo is now bolder and more streamlined, and we are officially embracing the name that most people already use—NCCOR. These changes reflect our growth and experience as a trusted leader in the field.

These updates also reaffirm our commitment to advancing childhood obesity research and identifying promising new implementation strategies. Our tagline captures this vision: Building Evidence and Advancing Practice for Healthy Children, Families, and Communities.

In addition, our mission statement affirms our commitment:
NCCOR’s mission is to build evidence and advance practice to reduce childhood obesity in the United States, creating a healthier future for all children, their families, and communities.

Our updated logo, tagline, and mission symbolize NCCOR’s ongoing effort to drive innovation and support the field with essential tools and resources. By fostering collaboration among researchers, practitioners, and community leaders, we will continue working toward a healthier future for all children.

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NCCOR Toolbox: Popular NCCOR Webinar Now Available Online

February 2025, NCCOR

On January 30, 2025, NCCOR kicked off the year with its first Connect & Explore webinar, “Understanding Weight Stigma: Impacts on Families and Youth.” This one-hour session featured experts discussing the psychosocial and health effects of weight stigma and bias on children and adolescents, emphasizing the role of family interactions and communication in shaping these outcomes. Presentations explored recent research on weight bias in public health, the impact of parent-child conversations about weight, and the broader mental health implications for youth. Watch the webinar recording and explore past Connect & Explore sessions at www.nccor.org/webinars.

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Expanding Access to Free School Meals: Growth of the Community Eligibility Provision in 2023–2024

February 2025, NCCOR

The Food Research & Action Center’s December 2024 report, “Community Eligibility: The Key to Hunger-Free Schools,” analyzes the adoption of the Community Eligibility Provision (CEP) during the 2023–2024 school year. CEP allows high-need schools to offer free breakfast and lunch to all students. The report highlights a significant increase in participation, with 7,717 school districts (74.3% of those eligible) implementing CEP in one or more schools—an increase of 1,298 districts from the previous year. Additionally, 47,766 schools adopted CEP, serving over 23.6 million students, up from 19.9 million in the 2022–2023 school year. The report underscores CEP’s benefits, including improved student health and educational outcomes, reduced administrative burdens for schools, and the elimination of school meal debt.

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Healthy Eating Research Announces New Beverage Recommendations for Children  

NCCOR, 2025

Healthy Eating Research has released expert recommendations for beverage consumption in children aged 5-18. This collaboration with top health organizations ensures consistent, evidence-based guidance for parents, caregivers, and health professionals. Key takeaways: water and plain milk are top choices; limit 100% juice, plant-based milk alternatives, and flavored milk; and avoid sweetened and caffeinated beverages. Learn more and access the full recommendations and additional tools for caregivers and health care professionals here.

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Guided Self-Help Makes Treating Children with Obesity Easier and More Affordable

January 29, 2025, EurekAlert!

Family-based behavioral treatment (FBT) is a clinically-proven approach to treating children with obesity in which a health care professional works with the family to help children lose weight by promoting physical activity, encouraging healthy eating habits, and teaching age-appropriate behavioral skills. While FBT is traditionally led by clinicians, researchers at University of California San Diego’s Center for Healthy Eating and Activity Research (CHEAR) have now found that self-guided FBT is just as effective in helping children lose weight compared to traditional approaches. It is also more flexible in terms of scheduling, costs significantly less and requires fewer contact hours with a provider. The results were recently published in Pediatrics.

“Traditional FBT is an effective treatment for children with obesity, but it can be time-intensive, can only be offered at specific times, and is expensive, which makes families facing difficult financial circumstances less likely to seek treatment,” said senior author Kerri Boutelle, Ph.D., director of CHEAR and professor in the Departments of Pediatrics and Psychiatry at UC San Diego School of Medicine and the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science. “By providing the same core skills as traditional FBT in a more flexible and condensed format, we can increase access to treatment for families who may not be able to participate in traditional group-based programs.”

About one-in-five children in the U.S. has obesity, according to 2017–2018 data from the National Health and Nutrition Examination Survey (NHANES). Obesity is associated with a wide range of negative health outcomes in children, such as increased risk of developing type 2 diabetes, high blood pressure and asthma. Obesity in children is also associated with mental health concerns such as depression, anxiety, low self-esteem and social isolation. Unlike obesity in adults, which is often managed individually, helping children lose weight is a family effort.

The researchers developed a guided self-help version of FBT that can be delivered through 20-minute biweekly visits, providing written educational materials for families to work through in between sessions. Traditional FBT is more time intensive, and is offered in weekly 60-minute parent and child separate group sessions in addition to 20-minute biweekly sessions. To determine whether the self-guided approach was as effective as standard FBT, the researchers randomly assigned 150 parent/child pairs to receive either traditional or self-guided FBT. They then compared the children’s weight loss during treatment and at follow-up visits six, 12 and 18 months later.

The researchers found that self-guided FBT resulted in similar child weight losses to traditional FBT, but with much less contact time with a provider: 5.3 hours for self-guided versus 23 hours for traditional FBT. The cost of self-guided FBT was also significantly lower than traditional FBT: $1,498 per family for self-guided versus $2,775 per family for traditional FBT.

By demonstrating the efficacy of self-guided FBT, the study offers a more accessible solution to the growing crisis of obesity among children and throws a wrench in the idea that helping children lose weight requires substantial clinical resources.

“Previous studies suggest that outcomes are improved with more contact hours, but our findings show that it may not be so simple,” said Boutelle. “We’re finding that the most important thing is working with parents, which can be done without a trained clinician. While some families may benefit from the standard approach, providing more flexible and accessible alternatives like self-guided FBT can help us make a wider impact on the epidemic of childhood obesity.”

To learn more about pediatric obesity treatment studies and other CHEAR research, please visit https://chear.ucsd.edu/.

Coauthors of the study include Kyung E. Rhee, Rebecca S. Bernard, Dawn M. Eichen and Natacha Akshoomoff and Michael A. Manzano at UC San Diego School of Medicine; David R. Strong and Cheryl A.M. Anderson at UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science; Bess H. Marcus at Brown University and Scott Crow at University of Minnesota.

The study was funded by the National Institutes of Health (grants R01DK10868, UL1TR001442).

[Source]

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Tracking Physical Activity and Nutrition Policies and Practices in Early Childhood Education and Care: Five Years Post-Implementation of a Provincial-Level Active Play Standard

January 22, 2025, Childhood Obesity

Background: Early childhood education and care (ECEC) settings are key for improving health behaviors, including physical activity (PA) and nutrition. In 2017, the province of British Columbia (BC) implemented a provincial-level Active Play policy supported by a capacity-building intervention. Significant improvements in all PA policies and practices and the majority of nutrition policies were observed post-implementation. The purpose of this study was to understand if PA and nutrition policies and practices were maintained at 5+ years post-provincial policy implementation.

Methods: This study employed a repeated cross-sectional design to distribute surveys querying about PA and nutrition policies and practices to ECEC centers across BC at three time points: time 1, prior to implementation of the Active Play standard (2016–2017) and capacity-building intervention, time 2, 1–2 years post-implementation (2018–2019), and time 3, 5+ years post-implementation (2022–2023).

Results: The majority of PA and all nutrition policies were maintained from time 2 (n = 378) to time 3 (n = 639). Prevalence of policies related to the provision of activities that address fundamental movement skills (odds ratio [OR] = 0.30) and total amount of active play (OR = 0.56) significantly decreased from time 2 to time 3. All reported PA practice prevalence levels decreased to time 1 levels.

Conclusions: Center-level health behavior policies were largely maintained 5 years post-implementation, except some PA policies and practices returned to pre-implementation levels. Staff capacity and turnover as well as change in implementation support may explain these changes. Ongoing implementation support is needed to ensure maintenance of health promoting policies and practices in ECEC.

[Source]

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Associations Between Coparenting Quality, the Home Food Environment, and Child’s Body Mass Index

January 22, 2025, Childhood Obesity

Background: Although positive coparenting, or how parents relate during childrearing, is known to support children’s socioemotional development, the role of coparenting in supporting children’s healthy eating and growth is poorly understood. This study examined associations between coparenting quality, the home food environment, and young children’s body mass index (BMI).

Methods: Cross-sectional data were obtained from 290 mothers and their 3-year-old children who participated in the Sprout study. Mothers who indicated they had a coparent in their household completed surveys to assess coparenting quality, food parenting practices, family mealtime routines and structure, and home food availability. Mothers also reported the foods served at two typical meals, and a healthy meal index (HMI) score was calculated to assess the nutritional quality of meals. Children’s height and weight were measured and used to calculate BMI z-scores (BMIz).

Results: Mothers who reported more positive coparenting also reported providing children more guidance for healthy eating (β = 0.15, p < 0.001), less use of food to control children’s emotions (β = −0.15, p < 0.01), less use of food as a reward (β = −0.27, p < 0.01), more structured mealtimes (β = 0.22, p < 0.001), and more household availability of fruits and vegetables (β = 0.11, p < 0.01). Mothers who reported greater coparent agreement on childrearing also had children with lower BMIz (β = −0.11, p = 0.03). Mothers who reported greater endorsement of their partner’s childrearing competency had a higher mean HMI score (β = 1.82, p < 0.01).

Conclusion: Among dual-parent, highly resourced families with young children, stronger coparenting practices were associated with several food-related parenting practices that support healthy eating and weight among young children.

[Source]

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Effect of Pediatric Obesity Treatment on Long-Term Health

January 21, 2025, EurekAlert!

This cohort study demonstrated that good response to pediatric obesity treatment was associated with reduced long-term morbidity, such as type 2 diabetes, dyslipidemia, and hypertension. Additionally, a link between pediatric obesity treatment effectiveness and lower incidences of mortality in young adulthood was observed; however, effective pediatric obesity treatment was not associated with adult depression or anxiety, highlighting their distinct nature despite frequent coexistence.

[Source]

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Moving Beyond Research to Public Health Practice: Spread and Scale of Interventions that Support Healthy Childhood Growth

January 10, 2025, Childhood Obesity

In 2023, the American Academy of Pediatrics (AAP) published its first Clinical Practice Guideline (CPG) for the Evaluation and Treatment of Children and Adolescents with Obesity. A healthy lifestyle including good nutrition, optimal sleep, and physical activity continues to be the foundation of pediatric obesity prevention and treatment. However, equitable access to affordable, effective, and safe prevention and treatment remains a problem.

The CPG1 and the 2024 US Preventive Services Task Force Grade B Recommendation for Child Obesity guide clinicians to offer or refer children with obesity to family-centered, comprehensive, intensive behavioral programs [also called Family Healthy Weight Programs (FHWP)]. Over the last 5 years, CDC supported the adapting, testing, and packaging of existing effective FHWPs. Currently, at least six programs can be implemented in clinical and community settings nationwide.

To effectively support healthy child growth, appropriate screening and diagnostic tools are required. Currently, BMI percentile is the core measure for monitoring child growth. BMI percentile is a ratio of weight to height (kg/m2), standardized by age and sex to a reference population. Decades of study find that high BMI percentiles correlate with worsened health risk in diverse populations globally. BMI is well-correlated with body fatness and is less invasive and costly than other anthropometric tools. Thus, BMI percentile continues to be the best-available measure for screening children for obesity. In 2022, the CDC released extended BMI-for-age growth charts, including updated and accurate z-scores and BMI percentiles for children with very high BMIs (above the 97th percentile).

BMI, alone, does not diagnose obesity nor assess the distribution of body fat. In clinical settings, BMI percentiles are best used in tandem with assessments (e.g., physical exam, health-related social needs) to determine the appropriateness of a FHWP or other treatments. Additional tools and laboratory tests (e.g., staging algorithms, inflammatory markers) are needed to help diagnose obesity.

Family programs, such as FHWPs, can help parenting skills and improve child self-esteem, quality of life, behaviors, and BMI. Appropriate training of FHWP staff is important to ensure child wellness and avoid stigma and disordered eating. Achieving equitable access to guideline-recommended FHWPs, medications, and, for some, metabolic and bariatric surgery is part of a comprehensive strategy for reducing the effects of obesity on health.

CDC, AAP, the National Association of Community Health Centers (NACHC), the YMCA of the USA, and other national partners are coordinating the movement of research-tested FHWPs into public health practice. As of 2023, CDC is funding and providing technical support to implement FHWPs in over 60 communities. Efforts by the CDC, NACHC, AAP, the American Psychological Association, and others are facilitating national-level infrastructure improvements, such as updates to medical billing and diagnosis codes, updated clinical quality measures, and online resources with FHWPs to select the best-fit program. Examples are emerging of reimbursement pathways for FHWPs, such as Medicaid state plan amendments and employer-sponsored insurance benefits. The CDC is eager to engage new partners, including newly funded public health recipients and their communities to scale proven FHWPs, so that all US children grow up healthy and strong.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

[Source]

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A Scoping Review of Tailoring in Pediatric Obesity Interventions

January 10, 2025, Childhood Obesity

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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