July 2022


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NCCOR Publishes a New Commentary about Active Travel to School: An Overlooked Opportunity in Health Promotion and Chronic Disease Prevention

A new commentary published this month in Translational Behavioral Medicine offers insights into strengthening surveillance and data collection about active travel to school (ATS). It also describes the need for the environmental, policy, and program supports that make this option easier for children and their families. The new paper, titled Improving Active Travel to School and Its Surveillance: An Overlooked Opportunity in Health Promotion and Chronic Disease Prevention, is the third in a recent series of NCCOR publications advancing research on this topic.

The Physical Activity Guidelines for Americans, 2nd edition, recommend that youth aged 6-17 complete 60 minutes or more of moderate-to-vigorous physical activity daily. Unfortunately, national surveys show that only about one-quarter of U.S. youth self-report meeting this recommendation. ATS could help reduce this deficit in youth physical activity participation, and ATS programs are implementable options to help increase youth physical activity.

Surveillance for ATS is limited, however. Only four North American surveillance systems track youth ATS behaviors and a few ATS-related built environment features, but no systems concurrently monitor policies and programs. Data exists at the local level but cannot provide a comprehensive look at ATS.

The new NCCOR commentary synthesizes findings from a workshop on active travel to school surveillance held in 2020, metric prioritization activities, and post-workshop conversation and consultation, to offer insights to strengthen surveillance and data collection of ATS behavior as well as ATS environmental, policy, and program supports. Visit the NCCOR website for more information about the NCCOR ATS initiative, including the white paper, manuscript, and key summary points.

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Publications & Tools

NCCOR Toolbox: Be a Champion for Activity-Friendly Communities with NCCOR’s Factsheet

Healthy community development means different things for different people. NCCOR can help you start the conversation, set goals, and engage community members. Our new toolkit, Create Thriving, Activity-Friendly Communities, provides a quick factsheet to share at a community town hall or during meetings with decision makers. This two-pager includes an overview of 10 measurable benefits of activity-friendly places, popular approaches to creating activity-friendly places, examples, and case studies.

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Workshop on Housing and Obesity: Gaps, Opportunities, and Future Directions for Advancing Health Equity

Join the National Institutes of Health for a multi-agency workshop exploring housing and obesity-related disparities across the lifespan. This free, two-day, online event will take place from November 14-15, 2022. The goal is to accelerate research on the role of housing on risk factors for developing obesity and will feature presentations, panel discussions, poster sessions, and interactive discussions. Leaders in research, health equity, housing, public health, and other related fields are encouraged to attend. The event is free, but registration is required. Click here to learn more.

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New Report from USDA Documents the Impact of Nutrition Support Programs During the Pandemic

The U.S. Department of Agriculture (USDA) published The Food and Nutrition Assistance Landscape: Fiscal Year 2020 Annual Report, which details how the agency’s 15 domestic food and nutrition assistance programs mobilized in response to the COVID-19 pandemic from October 2020 to September 2021. The report documents the increased utilization and investment in their nutrition security programs and outlines policy changes that USDA implemented to address pandemic-related food insecurity. The full report and a summary factsheet can be downloaded from the USDA website.

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New Video Explains Updates to the SNAP-Ed Toolkit

Last month, the U.S. Department of Agriculture they would be adding 13 new evidence-based interventions to the SNAP-Ed toolkit. Those interventions are now live on the SNAP-Ed website. In addition, the program released a helpful introductory video that offers a quick summary of the new interventions and context for how they improve nutrition education. The video concludes with a glimpse at future directions for additions to the toolkit. View the video and access the toolkit on the USDA website.

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Childhood Obesity Research & News

New Research Suggests Center-Based Childcare May Bring Health Benefits

June 14, 2022, EurekAlert!

A new study conducted in Canada found that children who attended center-based childcare between 1 and 4 years of age had a lower body mass index (BMI) and were less likely to be overweight or obese in later childhood than children who had non-parental childcare that was home-based or provided by relatives or nannies. These associations were stronger for children from lower income families.

“Although more research is needed, our findings suggest that center-based childcare may help level socioeconomic-related health disadvantages for children from low-income families,” said Michaela Kucab, a graduate student at St. Michael’s Hospital, a site of Unity Health Toronto, and the University of Toronto, both in Canada.

Kucab will present the findings online at NUTRITION 2022 LIVE ONLINE, the flagship annual meeting of the American Society for Nutrition held June 14-16.

“We hope this work draws much-needed attention to prioritizing center-based childcare while also encouraging future research on the impact of center-based childcare on growth and other important health and developmental outcomes in children,” said the study’s senior author Jonathon Maguire, MD, from St. Michael’s Hospital.

Previous studies evaluating the relationship between childcare attendance and obesity have primarily focused on comparing parental care with non-parental childcare settings.

“Given the increase in dual-income families and the fact that many families are faced with making decisions about childcare, our work aimed to evaluate non-parental childcare settings,” said Kucab. “We hope that our findings might help parents and policy makers advocate for and prioritize the best childcare environments for children.”

The researchers analyzed data collected from a large, multicultural sample of healthy Canadian children using The Applied Research Group for Kids (TARGet Kids!) primary care research network based in Toronto. They compared the BMI of children at age 4 to 10 years old for those who had attended center-based childcare between 1 and 4 years of age versus those who attended other non-parental childcare environments.

“One advantage of using data from TARGetKids! is that it began in 2008 and is ongoing, whereas many previous studies have used data collected decades ago,” said Kucab. “This may have allowed us to capture the effects of the many improvements implemented by modern childcare programs.”

The detailed questionnaire data collected in TARGetKids! made it possible for the researchers to account for numerous variables and to explore important factors such as socioeconomic status and the number of hours per week that each child spent in a childcare environment.

The researchers found that children who attended center-based care full-time had a 0.11 lower BMI at ages 4 and 7 and were less likely to be overweight or obese at 4 years old compared to children who attended non-center-based care. Children from lower-income families who attended center-based care full-time had a 0.32 lower BMI and were less likely to be overweight or obese at 10 years of age compared to those who attended non-center-based care.

“Our findings make sense because health behaviors are developed in early childhood and may be influenced by the environments that children encounter,” said Kucab. “There may be underlying factors and care practices that differ between childcare arrangements that help explain the effects on childhood growth.”

For example, childcare centers in both Canada and the U.S. must follow nutrition guidelines and adhere to other health-behavior guidelines related to physical activity and rest. They also have licensed early childhood educators who supervise childcare practices and make sure programs provide routines appropriate for growing children. Although these factors may contribute to the findings, the researchers note that the study was observational and not designed to assess cause-and-effect relationships, adding that clinical trials would be needed to confirm causality.

The researchers are now expanding on their work by studying the relationship between center-based childcare in young children and later nutritional risk, dietary intake and eating behaviors. They are also working to implement a clinical trial, called Nutrition Recommendation Intervention Trials in Children’s Health Care (NuRISH), that will leverage the methods used by TARGet Kids! to evaluate whether connecting families with center-based childcare through the primary health-care system can improve the physical, mental, nutritional and developmental health of children from low-income families. Researchers say findings from the trial could be used to inform policy decisions about using center-based childcare as an intervention to improve health and productivity over the life course.

Kucab [presented] this research on-demand starting at noon on Tuesday, June 14, during the NUTRITION 2022 LIVE ONLINE Precision Nutrition in the Exemplary Student Abstracts in Obesity Science session.

Please note that abstracts presented at NUTRITION 2022 LIVE ONLINE were evaluated and selected by a committee of experts but have not generally undergone the same peer review process required for publication in a scientific journal. As such, the findings presented should be considered preliminary until a peer-reviewed publication is available.


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Study Finds an Association Between Consuming More Ultraprocessed Foods and Lower Levels of Physical Fitness in Children

June 15, 2022, American Society for Nutrition

A new study found that children ages 3 to 5 who consumed more ultraprocessed foods had poorer locomotor skills than children who consumed less of these foods. It also showed lower cardiovascular fitness in 12- to 15-year-olds who consumed more ultraprocessed foods.

Although previous research has shown that consuming ultraprocessed foods is linked with a higher risk for cardiovascular disease in adults, this is one of the first studies to show a link between consumption of these foods and lower levels of physical fitness in children.

Ultraprocessed foods were categorized in this study as including packaged snacks, breakfast cereals, candies, soda, sweetened juices and yogurts, canned soups and prepared foods like pizza, hotdogs, burgers and chicken nuggets.

“Healthy dietary and exercise behaviors are established at a very young age,” said research team leader Jacqueline Vernarelli, PhD, associate professor and director for the Master of Public Health program at Sacred Heart University. “Our findings point to the need to educate families about cost-effective ways to reduce ultraprocessed food intake to help decrease the risk for cardiovascular health problems in adulthood.”

Vernarelli will present the findings online at NUTRITION 2022 LIVE ONLINE, the flagship annual meeting of the American Society for Nutrition held June 14-16.

To examine the association between physical fitness and ultraprocessed foods during various stages of childhood, the researchers analyzed data from the National Health and Nutrition Examination Survey (NHANES) National Youth Fitness Survey.

This 2012 survey used interviews and fitness tests to collect data on physical activity, fitness levels and food intake for more than 1,500 U.S. children aged 3 to 15. Ultra-processed foods were identified using NOVA, which categorizes food and beverage items according to the level of food processing.

For children 5 years old and under, the researchers used locomotor development as a measure of physical fitness. The analysis revealed that children with the lowest locomotor development scores consumed 273 calories more per day of ultraprocessed foods than children with the highest locomotor development scores.

Cardiovascular fitness was used as a physical fitness measure in the older children. The study showed that teens and preteens with good cardiovascular fitness consumed 226 fewer calories daily from ultraprocessed foods than those who did not have healthy cardiovascular fitness.

“Though highly processed convenience foods are easy to throw into a school bag, our research shows the importance of preparing healthy snacks and meals,” said Vernarelli. “Think of it like saving for retirement: You’re making decisions now that will influence your child’s future.”

As a next step, the researchers plan to look more closely at consumption patterns for ultraprocessed food by age group. For example, do kids eat more of these foods for breakfast, at lunch or for snacks? A better understanding of how and when these foods are consumed could help inform future interventions designed to encourage healthy eating.


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30-Year Study Links Childhood Obesity and Fitness to Midlife Cognition

June 15, 2022, EurekAlert!

The world’s first study of the impact of childhood fitness and obesity on cognition in middle age, followed over 1,200 people who were children in 1985 for over 30 years, has found that better performance on physical tests is related to better cognition later in life and may protect against dementia in later years.

Importantly these findings are not impacted by academic ability and socioeconomic status at childhood, or by smoking and alcohol consumption at midlife.

Led by Dr. Jamie Tait and Associate Professor Michele Callisaya from the National Centre for Healthy Ageing, based at Peninsula Health and Monash University in Melbourne, along with investigators from the Childhood Determinants of Adult Health study from the Menzies Institute for Medical Research at the University of Tasmania, the landmark study is published today in the Journal of Science and Medicine in Sport.

It is known that children who develop muscular strength, cardiorespiratory fitness and endurance due to sport and activity have better health outcomes later in life. Higher adult fitness is also associated with better cognition and reduced risk of dementia later in life.

Following over 1,200 people from 1985 when they were between 7 and 15 years old all the way to 2017-19, this is the first significant study to look for links between objectively measured fitness and obesity in childhood with cognition in middle age, with the idea that early activity levels, fitness and metabolic health may protect against dementia in our older years.

In 1985, 1,244 participants aged 7–15 years from the Australian Childhood Determinants of Adult Health study were assessed for fitness (cardiorespiratory, muscular power, muscular endurance) and anthropometry (waist-to-hip ratio).

These participants were followed up between 2017 and 2019 (aged 39–50, average age 44) in respect to their cognitive function using a series of computerised tests.

According to Associate Professor Callisaya this is the first study demonstrating a relationship between phenotypic profiles of objectively measured fitness and obesity measures at childhood, with midlife cognition.

The researchers found that children with the highest levels of cardio-respiratory and muscular fitness and lower average waist-to-hip ratio had higher midlife scores in tests of processing speed and attention, as well as in global cognitive function.

Because a decline in cognitive performance can begin as early as middle-age, and lower midlife cognition has been associated with a greater likelihood of developing mild cognitive impairment and dementia in older age, Associate Professor Callisaya states that it is important to identify factors in early life that may protect against cognitive decline during later life.

“Developing strategies that improve low fitness and decrease obesity levels in childhood are important because it could contribute to improvements in cognitive performance in midlife,” she said.

“Importantly the study also indicates that protective strategies against future cognitive decline may need to start as far back as early childhood, so that the brain can develop sufficient reserve against developing conditions such as dementia in older life.”

The 1985 Australian Schools Health and Fitness Survey was a nationally representative sample of 8,498 Australian children aged 7–15 years. Participants have been followed up at three time points in 2004-06, 2009-11 and 2014-19 as part of the Childhood Determinants of Adult Health study (CDAH), a prospective cohort study based on the Survey participants. The study has been funded by the National Health and Medical Research Council and the Heart Foundation.


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