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January 2019

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CHILDHOOD OBESITY RESEARCH & NEWS

Spotlight

5 Ways Graduate Students and Faculty Can Use the Measures Registry User Guides

January 30, 2019, NCCOR

The start of a new year also means the start of a new semester. Are you a graduate student or faculty member? Do you know anyone who is? Make it a new year’s resolution to explore NCCOR’s Measures Registry and User Guides to help support your next research project or classroom activity.

The Measures Registry is a searchable database of diet and physical activity measures relevant to childhood obesity research. The four User Guides are designed to complement the Measures Registry and provide an overview of measurement, describe general principles of measure selection, and share additional resources. The User Guides align with the domains of the Measures Registry and present case studies that walk researchers through the process of using the Measures Registry to select appropriate measures.

Here are 5 ways to use NCCOR’s Measures Registry and User Guides:

  1. Bolster your curriculum with new research measures and tools from trusted experts. NCCOR has even done the heavy lifting for you and created slide decks!
  2. Showcase key considerations for measurement in each of the following four domains: individual diet, food environment, individual physical activity, and physical activity environment.
  3. Assess which tools are most appropriate for your topic using the overview of measure types for each domain.
  4. Decide which measure to use for an end-of-semester study design project, drawing on the questions provided to walk you through how to choose.
  5. Determine which measures are most applicable and how to use them using the Q&A and case studies. There is even a case study geared towards a capstone or practicum project!

Have an idea for something that would be helpful? Want to partner with NCCOR to bring our tools to your program? Connect with us via email or social media to send feedback on the User Guides for graduate students or to learn how to take advantage of even more resources.

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Publications & Tools

Current Status and Response to the Global Obesity Pandemic: Proceedings of a Workshop in Brief

The workshop examined the status of the global obesity pandemic and explored approaches used to manage the problem in different settings around the world. This Proceedings of a Workshop–in Brief highlights presentations which discussed the importance of understanding the obesity epidemic in global context and shared perspectives on the implications of obesity as a global problem for prevention and treatment efforts in the United States, with an emphasis on reducing disparities.

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Increasing Disparities in Unhealthy Food Advertising Targeted to Hispanic and Black Youth

A new report from the University of Connecticut’s Rudd Center for Food Policy & Obesity analyzes the targeted advertising efforts of 32 restaurants and food and beverage companies to reach children and teens.

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Childhood Obesity Research & News

Change in Children’s Physical Activity: Predictors in the Transition from Elementary to Middle School

January 15, 2019, American Journal of Preventative Medicine

Introduction

Interventions to promote physical activity in children should be informed by knowledge of the factors that influence physical activity behavior during critical developmental transitions. The purpose of this study is to identify, from a comprehensive, multidomain set of factors, those that are associated with change in objectively measured physical activity in children as they transition from elementary to middle school.

Methods

The study used a prospective cohort design, with children observed in fifth, sixth, and seventh grades. Growth curve analyses were used to examine associations between exposure variables measured at baseline and children’s physical activity across three observations. A total of 828 children, aged 10.6 (SD=0.5) years at baseline provided physical activity data in fifth grade and at one or both follow-ups. Exposure variables assessed child characteristics, parent characteristics, home characteristics, social factors, school environment, and community characteristics. Physical activity was measured via accelerometry. Data were collected in two school districts in South Carolina in 2010–2013 and analyzed in 2017.

Results

Variables measured within the child, parent/home, and community domains were positively associated with children’s physical activity as they transitioned from fifth to seventh grade. These included parent encouragement of physical activity, parental support for physical activity, child sports participation, parent’s report of the child’s physical activity level, the child’s time spent outdoors, social spaces for physical activity in the community, and the number of physical activity facilities that were proximal to the child’s home.

Conclusions

Interventions designed to increase children’s physical activity should include strategies that target multiple domains of influence.

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Advertising Susceptibility and Youth Preference for Consumption of Sugar-Sweetened Beverages: Findings from a National Survey

January 9, 2019, Journal of Nutrition Education and Behavior

Objective

This study investigated variables that may mediate the relationship between advertising susceptibility and adolescent preference for and consumption of sugar-sweetened beverages (SSBs), with the goal of informing inoculation-based mitigation approaches grounded in media literacy and messaging resistance.

Design

The study utilized data from a nationally representative sample of US adolescents (ages 12–17 years, n = 1,657) from the National Cancer Institute’s Family Life, Activity, Sun, Health, and Eating survey.

Main Outcome Measure

Variables of interest were SSB preference and consumption, advertising susceptibility, perceived self-efficacy to make good nutritional choices, perceived SSB consumption by peers, and attitude toward SSBs. Exposure to obesogenic environments was examined as a moderator.

Analysis

Direct and mediated associations between advertising susceptibility and SSB preference were estimated through a series of regression and mediation analyses.

Results

Advertising susceptibility was a strong predictor of SSB preference (unstandardized B = .29, SE = .026,  P < .001), which, in turn, was a strong predictor of consumption (unstandardized B = .10, SE = .01, P < .001), controlling for potential mediators. The only statistically significant mediator of this association was perceived peer consumption (unstandardized B = .38, SE = .08, P < .001), which was stronger for adolescents with higher exposure to obesogenic environments.

Conclusions and Implications

This study offers developers of inoculation-based strategies additional insight into levers that could be targeted for building adolescent resistance to advertising effects.

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Contribution of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-Eligible Foods to the Overall Diet of 13- and 24-Month-Old Toddlers in the WIC Infant and Toddler Feeding Practices Study-2

January 8, 2019, Journal of the Academy of Nutrition and Dietetics

Background

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides supplemental foods to assist participants in meeting their dietary needs. Few studies have described the extent to which WIC-eligible foods contribute to the overall diet of children who were enrolled in WIC prenatally or in early infancy.

Objective

The aims of this study were to examine commonly consumed foods and estimate the proportion of dietary intake contributed by WIC-eligible foods among 13- and 24-month-old children, and to assess differences by WIC participation status at 24-months.

Design

This was a national observational study.

Participants/setting

Children participating in the WIC Infant and Toddler Feeding Practices Study-2 were included (13 months old [n=2,777] and 24 months old [n=2,450]) from 2013 to  2016.

Main outcome measures

Dietary intakes were assessed using 24-hour dietary recalls at 13 and 24 months. The 10 most commonly consumed foods were described using the What We Eat in America food category classification system. WIC-eligible foods were defined as meeting the WIC nutrient criteria set forth in the Federal regulation.

Statistical analyses performed

The estimated proportion (mean±standard error) of WIC-eligible foods to total daily intake was calculated for energy, macronutrients, and select micronutrients. Multiple linear regression, adjusted for confounders, was conducted to compare the estimated proportion of nutrient intake from WIC-eligible foods by WIC participation at 24 months.

Results

At 13 and 24 months, most (60% and 63%, respectively) of the commonly consumed foods were eligible for purchase as part of the child WIC food package. WIC-eligible foods provided >40% of calories and close to 50% or more of other nutrients, and the contribution of WIC-eligible foods to overall micronutrient intake increased between 13 and 24 months. Children still on WIC at 24 months obtained a larger proportion of calories and most other nutrients from WIC-eligible foods than children no longer on WIC.

Conclusions

WIC-eligible foods could contribute to the overall diet of toddlers who were enrolled in WIC prenatally or in early infancy. Further, there may be additional nutritional benefits of staying on the program through 24 months.

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Exposure to Sugary Breakfast Cereal Advertising Directly Influences Children’s Diets

January 7, 2019, EurekAlert!

High-sugar cereals are heavily promoted to children on TV. The adoption of poor eating habits including excess consumption of sugar can lead to obesity, a known risk factor for 13 cancers. Children’s eating habits develop during the preschool years, and children who are overweight by the age of five are likely to remain overweight into adolescence and adulthood. Unfortunately, many young children have diets of low quality and consume too few fruits and vegetables and too much sugar, salt and fat. A new study led by Jennifer Emond, PhD, member of the Cancer Control research program at Dartmouth’s Norris Cotton Cancer Center and Assistant Professor in the Department of Biomedical Data Science Geisel School of Medicine hits a notable target in the many diet influences that lead to obesity.

“One factor believed to contribute to children’s poor quality diets is the marketing of nutritionally-poor foods directly to children,” says Emond. “Brands specifically target children in their advertising knowing that children will ask their parents for those products.” Laboratory studies have shown that kids will request and prefer brands they have seen recently advertised on TV, but no study has examined the effectiveness of TV food ad exposure on kids’ diets in a real world setting. Emond’s study addresses that gap. “We conducted the first longitudinal study among preschool-age children to see how exposure to TV ads for high-sugar cereals influences kids’ subsequent intake of those advertised cereals. An important and novel aspect of our study is that we were able to look at brand-specific effects. In other words, does advertising for ‘Brand X’ cereal relate to an increased intake of ‘Brand X’ cereal?”

Emond’s study,  ”Exposure to Child-Directed TV Advertising and Preschoolers’ Intake of Advertised Cereals” recently published in the  American Journal of Preventative Medicine. The novel study computed kids’ TV ad exposure based on the TV shows they watched on children’s network TV. Emond’s team purchased an advertising database and actually counted, by brand, the cereal ads that aired on the children’s TV network programs each child watched. Parents were asked about the shows their kids watched and what cereals their kids ate in the past week, every eight weeks, for one year. “We found that kids who were exposed to TV ads for high-sugar cereals aired in the programs they watched were more likely to subsequently eat the cereals they had seen advertised,” says Emond. “Our models accounted for several child, parent and household characteristics, and whether the child ate each cereal before the study started. We were able to isolate the effect of cereal advertisement exposure on kids’ intake of cereals, independent of all of those other factors.” Emond’s study is the first naturalistic study to show a direct and concerning link between kids’ exposure to TV ads for high-sugar cereal and their subsequent intake of that cereal.

“Efforts to promote and support quality diets at a young age are important to foster the lifestyle behaviors needed to maintain a healthy weight and reduce the risk of chronic disease including many cancers,” notes Emond. “Child-targeted marketing of foods high in sugar makes it hard for parents to shape healthy eating habits in our kids. It’s hard to even notice sometimes. But, it is modifiable. There are policy-level actions that could be implemented to reduce children’s exposure to food marketing and to improve the quality of the foods marketed to kids. And we as parents have the choice to switch to ad-free TV for our children and for ourselves.”

Reducing the marketing of high-sugar foods to children may ultimately improve diet quality and reduce the risk of obesity and related chronic diseases among children at the population level.

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