July 2018

Utility of the Youth Compendium of Physical Activities

July 31 2018, NCCOR

Available on the NCCOR website, the Youth Compendium of Physical Activities and related materials facilitate measurement of the energy cost of nearly 200 physical activities in children and youth. The Youth Compendium provides a way to standardize energy costs in children and youth and can be used in numerous ways, such as:

• To summarize energy expenditures from diverse activities
• To help inform the design of physical activity interventions
• To assist in creating physical education lesson plans
• To help with physical fitness testing

The Youth Compendium is intended for widespread use. Recently, several NCCOR members published a research article in Research Quarterly for Exercise and Sport titled “Utility of the Youth Compendium of Physical Activities” to highlight its practical application for various audiences. The article describes the rationale and development of the Youth Compendium of Physical Activities and discusses its utility for audiences in research, education, community, health care, public health, and the private sector.

To learn more about the Youth Compendium and how it can be used by several audiences, access the article or visit the Youth Compendium of Physical Activities webpage.

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CDC’s Division of Nutrition, Physical Activity, and Obesity Updates the Interactive Database Data, Trends, and Maps

CDC’s Data, Trends, and Maps provides the most recent state-level behavior, environmental, and policy indicators on obesity, nutrition, physical activity, and breastfeeding. CDC added 3 new early care and education indicators and updated 10 current indicators including: existence of state-level Food Policy Council, number of farmers markets per 100,000 residents, percent of youth with parks or playgrounds in their neighborhood, and many more.

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Safe Routes to School National Partnership Publishes the 2018 State Report Cards

Making Strides: State Report Cards on Support for Walking, Bicycling, and Active Kids and Communities rank states on their policy approaches on a range of areas, including Complete Streets, school siting, physical activity planning, and more.

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Commentary on CDC’s Active People, Healthy NationSM: Creating an Active America, Together

The CDC developed Active People, Healthy Nation^SM, an aspirational initiative to improve physical activity in 2.5 million high school youth and 25 million adults, doubling the 10-year improvement targets of Healthy People 2020. Active People, Healthy Nation^SM will implement evidence-based guidance to improve physical activity through five action steps centered on core public health functions: (1) program delivery, (2) partnership mobilization, (3) effective communication, (4) cross-sectoral training, and (5) continuous monitoring and evaluation. To achieve wide-scale impact, Active People, Healthy Nation^SM will need broad engagement from a variety of sectors working together to coordinate activities and initiatives.

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Academy of Nutrition and Dietetics Released a Position Statement on Early Care and Education (ECE) Nutrition Benchmarks

This position paper presents current evidence and recommendations for nutrition in ECE and provides guidance for registered dietitian nutritionists, registered nutrition and dietetics technicians, and other food and nutrition practitioners working with parents and child-care providers. This position paper targets children ages 2 to 5 years attending ECE programs and highlights opportunities to improve and enhance children’s healthy eating while in care.

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Food for Thought: How the Brain Reacts to Food May be Linked to Overeating

July 19, 2018, Penn State University

The reason why some people find it so hard to resist finishing an entire bag of chips or bowl of candy may lie with how their brain responds to food rewards, leaving them more vulnerable to overeating.

In a study with children, researchers found that when certain regions of the brain reacted more strongly to being rewarded with food than being rewarded with money, those children were more likely to overeat, even when the child wasn’t hungry and regardless of if they were overweight or not.

Shana Adise, a postdoctoral fellow at the University of Vermont who led the study while earning her doctorate at Penn State, said the results give insight into why some people may be more prone to overeating than others. The findings may also give clues on how to help prevent obesity at a younger age.

“If we can learn more about how the brain responds to food and how that relates to what you eat, maybe we can learn how to change those responses and behavior,” Adise said. “This also makes children an interesting population to work with, because if we can stop overeating and obesity at an earlier age, that could be really beneficial.”

Previous research on how the brain’s response to food can contribute to overeating has been mixed. Some studies have linked overeating with brains that are more sensitive to food rewards, while others have found that being less sensitive to receiving food rewards makes you more likely to overeat.

Additionally, other studies have shown that people who are willing to work harder for food than other types of rewards, like money, are more likely to overeat and gain weight over time. But the current study is the first to show that children who have greater brain responses to food compared to money rewards are more likely to overeat when appealing foods are available.

“We know very little about the mechanisms that contribute to overeating,” Adise said. “The scientific community has developed theories that may explain overeating, but whether or not they actually relate to food intake hadn’t yet been evaluated. So we wanted to go into the lab and test whether a greater brain response to anticipating and winning food, compared to money, was related to overeating.”

For the study, 59 children between the ages of 7 and 11 years old made four visits to the Penn State’s Children’s Eating Behavior Laboratory.

During the first three visits, the children were given meals designed to measure how they eat in a variety of different situations, such as a typical meal when they’re hungry versus snacks when they’re not hungry. How much the children ate at each meal was determined by weighing the plates before and after the meals.

On their fourth visit, the children had fMRI scans as they played several rounds of a game in which they guessed if a computer-generated number would be higher or lower than five. They were then told that if they were right, they would win either money, candy or a book, before it was revealed if they were correct or not.

The researchers found that when various regions of the brain reacted more to anticipating or winning food compared to money, those children were more likely to overeat.

“We also found that the brain’s response to food compared to money was related to overeating regardless of how much the child weighed,” Adise said. “Specifically, we saw that increased brain responses in areas of the brain related to cognitive control and self control when the children received food compared to money were associated with overeating.”

Adise added that this is important because it suggests there may be a way to identify brain responses that can predict the development of obesity in the future.

Kathleen Keller, associate professor of nutritional sciences, Penn State, said the study — recently published in the journal Appetite — backs up the theory that an increased brain response in regions of the brain related to rewards is associated with eating more food in a variety of situations.

“We predicted that kids who had an increased response to food relative to money would be the ones to overeat, and that’s what we ended up seeing,” Keller said. “We specifically wanted to look at kids whose brains responded to one type of a reward over another. So it wasn’t that they’re overly sensitive to all rewards, but that they’re highly sensitive to food rewards.”

Keller said the findings give insight into how the brain influences eating, which is important because it could help identify children who are at risk for obesity or other poor eating habits before those habits actually develop.

“Until we know the root cause of overeating and other food-related behaviors, it’s hard to give good advice on fixing those behaviors,” Keller said. “Once patterns take over and you overeat for a long time, it becomes more difficult to break those habits. Ideally, we’d like to prevent them from becoming habits in the first place.”

This work was supported by a Childhood Obesity Prevention Training grant and Penn State’s Social, Life, and Engineering Sciences Imaging Center.

Charles F. Geier, associate professor of human development and family studies, Penn State; Nicole J. Roberts, doctoral candidate in human development and family studies, Penn State; and Corey N. White, Missouri Western State University, also participated in this research.

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Self-Control and Obesity: Gender Matters in Children

July 16, 2018, The Ohio State University

A toddler’s self-regulation – the ability to change behavior in different social situations – may predict whether he or she will be obese come kindergarten, but the connection appears to be much different for girls than for boys.

Self-regulation is something all children must develop, and poorer self-control in childhood is associated with worse adult health, economic and social outcomes. However, a new study from The Ohio State University found that more self-regulation may not necessarily reduce the risk of obesity, especially in girls.

Girls who scored at either the low or the high end on measures of self-regulation when they were 2 years old were more likely than girls with average self-regulation to be obese at age 5, while boys with high self-regulation were less likely to be obese than their peers with low or average self-regulation, found the study, which appears in the journal JAMA Pediatrics.

The difference raises important new questions about the role of gender in the development of childhood obesity, said lead author Sarah Anderson, an associate professor in Ohio State’s College of Public Health.

“Although we tend to assume that more self-regulation is always a positive, it may not be,” she said.

Those seeking answers about how to prevent childhood obesity should be mindful of the possibility that interventions to improve self-regulation might not play out the same way for boys and girls, she said.

“People are trying ways to prevent obesity in young children, and some of those approaches involve improving self-regulation. Our study suggests that could have an unintended impact for some girls,” Anderson said.

“This study leads one to think about how young children are potentially responding differently to messages and expectations based on whether they are boys or girls. We should be cautious about assuming that increases in self-regulation are optimal for everyone.”

The study analyzed data from a nationally representative sample of 6,400 U.S. children born in 2001 to see whether a child’s ability to self-regulate when they were 2 years old was associated with their risk of obesity in kindergarten – and to look for any differences between genders. The data came from the National Center for Education Statistics.

Self-regulation was measured using a four-part in-home assessment that looked at a child’s adaptability, persistence, attention and frustration tolerance. Each child received from one point to five points on each measure, for a possible score of 20 – a very high level of self-regulation.

“Observers were looking at things like how readily a child gave up a block when an adult said it was time to play with something else, how difficult it was to hold their attention and how easily frustrated they became when things weren’t going their way,” Anderson said.

“Going in, we thought what many people think – that we would see lower rates of obesity as self-regulation increased.”

But when they looked at their data, in which they separated children into quartiles ranging from “least regulated” to “most regulated,” the researchers found that girls in the least and most self-regulated groups were more likely to be obese at kindergarten age than their female peers in the middle categories.

There was little difference in boys’ risk of obesity except for among the most-regulated, who were least likely to be obese. Obesity was determined by measuring height and weight and defined as a body mass index greater than or equal to the 95th percentile.

“We should not assume that interventions to increase self-regulation will necessarily lead to benefits for both genders – it may be different for boys and girls,” Anderson said.

The researchers said there are many ongoing efforts to promote self-regulation in children for a variety of desired outcomes, including obesity prevention and improved school readiness.

In neither gender did the researchers see a clear step-wise pattern where increased self-regulation meant decreased rates of obesity.

Researchers believe that a variety of factors may contribute to links between self-regulation and obesity, including physiological differences and behavioral responses to demands in a child’s environment that could affect appetite, food intake, sleep and activity level.

“Obesity prevention is a complex and humbling task. Gender is another social influence that may affect the success of obesity prevention efforts,” said Anderson’s co-author, Robert Whitaker of Temple University.

This study adds to other obesity research that has found important differences between genders, Anderson said.

“All we can do based on this research is speculate, but it’s possible that girls and boys are reacting differently to social expectations and that could play a role in childhood obesity,” Anderson said.

“If you’re a boy and if the people around you are more OK with you getting easily frustrated and not paying attention, the social stress from your environment may be less than it is for a girl.”

It’s also possible that girls are rewarded more than boys for “good” behavior, propelling them to put themselves under added stress in the interest of appeasing adults, the researchers wrote.

“These stresses might result in differences in energy balance and metabolism between girls and boys, especially in the group observed to have high self-regulation.”

The National Institutes of Health supported this study.

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Mothers Who Follow Five Healthy Habits May Reduce Risk of Obesity in Children

July 5, 2018, Harvard T.H. Chan School of Public Health

Children and adolescents whose mothers follow five healthy habits—eating a healthy diet, exercising regularly, keeping a healthy body weight, drinking alcohol in moderation, and not smoking—are 75% less likely to become obese when compared with children of mothers who did not follow any such habits, according to a new study led by Harvard T.H. Chan School of Public Health. When both mother and child adhered to these habits, the risk of obesity was 82% lower compared with mother and children who did not.

The study was published online in BMJ on July 4, 2018.

“Our study was the first to demonstrate that an overall healthy lifestyle really outweighs any individual healthy lifestyle factors followed by mothers when it comes to lowering the risk of obesity in their children,” said Qi Sun, associate professor in the Department of Nutrition and senior author of the study.

One in five children in the U.S aged 6-19 have obesity, putting them at risk of diabetes, heart disease, and other metabolic conditions later in life. While it is known that genetics play a role in obesity, the rapid increase of the disease in recent years is likely due to changes in lifestyle and diet, indicating that “nurture” more than “nature” is fueling the current obesity epidemic.

For this study, researchers focused on the association between a mother’s lifestyle and the risk of obesity among their children and adolescents between 9 and 18 years of age. They examined data from 24,289 children enrolled in the Growing Up Today Study who were born to 16,945 women enrolled in the Nurses’ Health Study II.

The researchers found that 1,282 of the children, or 5.3%, developed obesity during a median five-year follow-up period. Maternal obesity, smoking, and physical inactivity were strongly associated with obesity among children and adolescents.

While the greatest drop in obesity risk was seen when mothers and children followed healthy lifestyle habits, many of the healthy habits had a noticeable impact on the risk of childhood obesity when assessed individually. Children of women who maintained a healthy body weight (body mass index 18.5-24.9) had a 56% lower risk of obesity compared with children of women who did not maintain a healthy weight, while children of mothers who did not smoke had a 31% lower risk of obesity compared with children of mothers who smoked.

The risk of obesity was also lower among children of mothers who consumed low or moderate levels of alcohol compared with children of mothers who abstained from alcohol. Because so few mothers in the Nurses’ Health Study II were considered heavy drinkers, the researchers could not determine the association between heavy use of alcohol had the risk of obesity in children.

To the surprise of the researchers, mothers’ dietary patterns were not associated with obesity in their children, possibly because children’s diets are influenced by many factors, including school lunches and available food options in their neighborhoods.

The findings of this study highlight the crucial role a mother’s lifestyle choices can have on their children’s health and bolster support for family- or parent-based intervention strategies for reducing childhood obesity risk.

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New Study Pinpoints Ways to Improve Quality of Food and Nutrition Research

July 5, 2018, ILSI North America

In a study published today in PLOS ONE, experts analyzed reams of past food and nutrition research to help identify and spur action in areas where meaningful improvements can be made in the design and execution of future food and nutrition studies. This is one of the first studies to use “Risk of Bias (ROB) domains,” as defined by Cochrane, in this way. Researchers typically use ROB domains to evaluate the relative strengths of individual studies when conducting systematic reviews.

The analysis found a significant improvement in ROB domain measurements across dimensions since 2000. This is when the research community began to adopt detailed guidelines for published research.

“The research community can put insights from this study into action to increase public trust in food and nutrition research,” said lead author Dr. Esther Myers, EF Myers Consulting, Inc., an internationally known author, lecturer, educator and researcher in dietetics and evidence analysis. “Based on our findings, I’d propose these strategies to improve future research: 1) enhance researcher training; 2) publish nutrition specific extension of reporting guidelines to address potential sources of bias; 3) continuously monitor for improvement; and 4) for enhanced transparency, commit to 100% disclosure of study funding source.”

The research community has done particularly well, to date, in minimizing certain ROB domains:

• Attrition bias, or missing data, such as when participants drop out of a study
• Reporting bias, or ensuring study conclusions represent the data

Researchers have not been as successful in minimizing these ROB domains:

• Selection bias, or how participants are chosen and assigned to groups
• Performance bias, or how study interventions are defined, measured and managed
• Detection bias, or how well researchers measure outcomes and account for other factors that might influence the results

Publication year and study design were more consistent predictors of quality than study funding source. Industry-funded studies were not generally found to be lower in quality. Studies with “combined” funding sources – typically the work of public-private research partnerships – were higher in quality, by and large, than studies with single-source funding. It is widely recognized that there is a benefit to collaboration as experts bring different perspectives to the table.

Study findings reflect a statistical review of more than 5,600 published studies on a range of topics — clinical nutrition, food safety, dietary patterns and dietary supplements. Academy of Nutrition & Dietetics, USDA, Rutgers University and Tufts University researchers collaborated on the research. It was funded by the ILSI North America Assembly on Scientific Integrity.

This is the first scientific publication to statistically demonstrate that the guidelines for published research that have been in place since 2000 have been successful. Efforts to improve the quality of food and nutrition research are ongoing. ILSI North America has been working for the past 10 years alongside federal agencies and scientific professional societies to support continual improvement in scientific integrity. For more information, visit http://ilsina.org/our-work/scientific-integrity/.

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