March 2025

OPUS II Executive Summary Now Available Online

March 2025, NCCOR

March is National Nutrition Month®, a time to focus on healthy eating and policies that support wellbeing. In that spirit, the executive summary for the second Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) workshop, held virtually on October 9–10, 2024, is now available on the NCCOR website. This event featured over 25 esteemed speakers who delved into critical methodological considerations for planning, designing, and evaluating the next generation of policy, systems, and environmental (PSE) interventions for childhood obesity prevention.

Building on insights from the first OPUS workshop, OPUS II was structured as three comprehensive sessions:

1. Planning and Engaging Across Sectors and Settings for PSE Interventions: This session emphasized the importance of a systems approach in PSE interventions, highlighting strategies for effective planning and multi-sector engagement.

2. Applying Rigorous Designs to the Evaluation of PSE Interventions: This session focused on methodological advancements and the application of robust evaluation designs to assess the effectiveness of PSE interventions.

3. Adapting, Scaling, and Sustaining Whole-of-Community PSE Interventions: This session explored strategies for ensuring the adaptability, scalability, and sustainability of PSE interventions within diverse community contexts.

The OPUS II executive summary captures key discussions and actionable insights for researchers, practitioners, and policymakers. As we celebrate National Nutrition Month®, we invite you to explore these findings and consider how PSE strategies can drive meaningful change in nutrition and obesity prevention.

To access the executive summary and gain valuable insights from the workshop, please visit the NCCOR website.

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NCCOR Toolbox: Leverage NCCOR’s Measures Registry for National Nutrition Month®

March 2025, NCCOR

March is National Nutrition Month®, making it the perfect time to explore NCCOR’s Measures Registry, a valuable tool for researchers and practitioners working to assess diet, physical activity, and related health outcomes. The registry provides a searchable database of high-quality measurement tools to support nutrition and obesity research, helping users select the best methods for evaluating dietary intake and behavioral interventions. Whether you’re planning a study or developing community programs, the Measures Registry can enhance your efforts to promote healthy eating and active living.

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The California Fruit and Vegetable EBT Pilot Project at Farmers’ Markets

February 2025, Nutrition Policy Institute

In 2023, the California Department of Social Services initiated the California EBT Fruit and Vegetable Pilot Project (CF&V), testing a new approach for increasing access to fruits and vegetables (FV) among Supplemental Nutrition Assistance Program (SNAP) shoppers. California nutrition incentive programs typically provide SNAP shoppers purchasing SNAPeligible items with dollar-for-dollar matching funds that must be used to purchase FV at farmers’ markets. In contrast, the CF&V pilot provided SNAP shoppers using their EBT card to purchase FV at participating pilot sites with a dollar-for-dollar match as a supplemental benefit. The benefit could be spent at the site or placed back on SNAP shoppers’ EBT cards to be used just like regular EBT funds at any SNAP authorized retailer. CF&V also offered shoppers the option of earning the entire monthly benefit in one visit, rather than weekly installments. CF&V was implemented from February 2023-January 2024, at 7 farmers’ markets (FMs) throughout California and 87 other retail outlets (OROs) such as grocery stores, 78 of which began implementation after October 1, 2023.

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New Toolkit Empowers Healthcare Providers with Evidence-Based Strategies for Childhood Obesity Prevention and Treatment

February 19, 2025, Pennington Biomedical Research Center

Greaux Healthy—a public service initiative powered by Pennington Biomedical Research Center, in partnership with the State of Louisiana—is proud to announce the release of the Childhood Obesity Prevention, Evaluation and Treatment Toolkit, a comprehensive resource designed to equip healthcare providers with practical, evidence-based guidance for preventing, evaluating, and treating childhood obesity and its related comorbidities.

Developed in alignment with the 2023 American Academy of Pediatrics (AAP) clinical practice guidelines, the toolkit synthesizes the latest scientific evidence and real-world strategies to support pediatric care in all potential healthcare settings across Louisiana. This free resource offers a quick reference for evaluating obesity, as well as actionable treatment approaches for children and adolescents dealing with overweight and obesity.

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US Infant Formulas Contain Primarily Added Sugars: An Analysis of Infant Formulas on the US Market

February 22, 2025, Journal of Food Composition and Analysis

Added sugar consumption is contraindicated for infants < 2 years old; however added sugars are present in many US infant formulas. [The authors of this study] examined whether US formulas contain primarily added sugars, or whether formulas contain primarily naturally occurring lactose (the sugar in human milk). Data were obtained from the Nutrition Data System for Research and included formulas available on the US market in 2022 (N = 73). Formulas were categorized as: standard (n = 31), gentle (n = 27), and lactose-free (n = 15). Differences across formulas were examined using Bayesian modeling. The median percent added sugars were high in standard (M=59.7 %; IQR=22.0), gentle (M=85.0 %; IQR=39.5), and lactose-free formulas (M=90.0 %; IQR=54.3). Gentle formulas had significantly lower proportional lactose (OR=0.22, 95 % HDI=[0.11,0.44], pd=99.3 %) and > 2 fold higher proportional added sugars compared to standard formulas (ORs=2.11–2.57, HDI>0, pd=99.1–99.99 %). Lactose-free formulas had 4–8 times higher proportional sucrose (OR=8.92, HDI=[3.86,20.8], pd=100 %) and maltose (OR=4.91, HDI=[2.51,9.56], pd=100 %) relative to standard and gentle formulas. Five formulas contained primarily (70–90 %) naturally occurring lactose. In conclusion, most US infant formulas contain primarily added sugars. However, the presence of five formulas containing primarily naturally occurring lactose demonstrates that such formulations are feasible to produce; such formulas should be made more widely available to help promote infant health.

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The National Physical Activity Plan Early Childhood Education Strategy: State Policy Surveillance

February 18, 2025, Childhood Obesity

The importance of establishing national surveillance systems to monitor physical activity promotion is well recognized. This article outlines the methodological process undertaken to develop an evaluation rubric for assessing state licensing regulations alignment with the National Physical Activity Plan Education Sector Early Childhood Education (ECE) strategy. This tool offers a cost-effective mechanism for ongoing surveillance of ECE physical activity policies, with the potential to inform modifications that promote uniform standards and establish consistent, high-quality opportunities for the nation’s youngest children.

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Biological Clock Plays Critical Role in Driving Teens’ Late-Day Eating Habits

February 17, 2025 EurekAlert!

The causes of obesity are complex and influenced by many factors. While research has highlighted connections between sleep, eating patterns and weight gain, scientists remain uncertain of the role of the circadian system — the biological clock — in shaping eating patterns.

But a new study from researchers at the Warren Alpert Medical School of Brown University and Mass General Brigham reveals a distinct relationship between circadian rhythms, weight and eating habits in adolescents, a vulnerable age group whose eating patterns influence their lifelong health. The study found that adolescents whose weight was classified as “overweight” or “obese” consumed more calories later in the day compared to participants with healthy weights.

The results demonstrate that circadian rhythms play an important role in explaining later caloric intake in individuals at risk for obesity, said lead investigator Mary Carskadon, a professor of psychiatry and human behavior at Brown’s medical school.

“The critical nature of adolescent development to set the stage for a lifetime of health highlights the need to understand the roles played by sleep/wake and circadian timing processes for eating behavior,” said Carskadon, who also directs the Bradley Hospital Sleep Research Laboratory. “The knowledge gained here opens a door to potential interventions that can enhance teen health moving forward.”

The results were published in the Proceedings of the National Academy of Sciences.

Isolating Circadian Influences 

The circadian system is composed of trillions of “clocks” present in virtually all organs, tissues and cells, which prepares biology and behavior to adapt to the changing demands across the day/night cycle. The influence of the circadian system is known to differ between people due to a combination of genetic, behavioral and environmental factors.

Previous studies have analyzed sleeping and eating behavior using measures of self-reported hunger and other variables, said study author David Barker, an associate professor of psychiatry and human behavior (research) at Brown. Some factors that set this study apart, Barker said, were the meticulous measuring of food before and after meals and the fact that environmental and behavioral influences were controlled for while the participants remained in the lab.

Fifty-one volunteers between the ages of 12 and 18 participated in the study, which was conducted at the Bradley Hospital Sleep Research Laboratory. Participants were divided into three groups based on body mass index. They were placed on 28-hour sleep and wake cycles — slightly longer than a typical 24-hour day — and stayed in a controlled dim-light setting while awake and in complete darkness during sleep.

Participants remained in the same space throughout the study, which lasted for 11 days and 10 nights. To control for outside influences on circadian rhythm, researchers removed all external time cues from the lab’s environment, including clocks and access to natural light.

Participants received six opportunities to eat at fixed times across the wake episode, with a standardized menu and could consume as much food during the meal as they wanted. Researchers tracked the food that was eaten as well as caloric intake. During the day, they were monitored by student research apprentices from Brown University and other institutions, who offered opportunities to join in a variety of activities including making crafts, watching movies (with screen lights dimmed) and playing social games.

The results showed that changes in the circadian system throughout the day and night significantly influenced food consumption. In all three groups, food intake peaked in the late afternoon and early evening and was lowest in the morning, even after accounting for behavioral and environmental factors, demonstrating that the body’s biological clock directly impacts how much people eat at different times of the day.

Adolescents in the obesity and overweight groups consumed significantly more calories in the circadian evening compared to those in the healthy weight group. Researchers found no significant differences in total sleep time between or within the groups across sleep cycles.

According to study author Frank Scheer, director of the Medical Chronobiology Program at Brigham and Women’s Hospital, it was already well known that the circadian system affects hunger and metabolism. What remained unclear, he said, was whether the circadian system — when isolated from influences of environmental and behavioral cycles, including light, sleep and activity cycles — directly influences food consumption.

“This study is the first to demonstrate that food intake itself is regulated by our internal body clock,” Scheer said.

Body Clocks, Food Intake and Weight

Future studies are needed to determine whether affecting circadian control of food intake contributes to weight changes, if weight changes impact the circadian control of food intake, or a combination of the two.

Carskadon said that the findings like those from the study could inform clinicians counseling adolescents on ways to manage their weight.

“For example, the influence of circadian timing could be influenced by excluding light late in the day and enhancing bright light in the morning, especially while exercising,” Carskadon said. “That might help pull the rhythms to a better place — and also create healthy habits.”

With future research, the team aims to gain a deeper understanding of the interactions between the circadian system, diet and metabolism, as well as the mechanisms underlying these relationships, and the implications for developing timed dietary interventions to improve health.

The research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK101046), the National Heart, Lung, and Blood Institute (R01HL153969), the National Institutes of Health (R01-HL140574, R01-HL153969, R01-HL167746, R01-HL164454) and the COBRE Center for Sleep and Circadian Rhythms in Child and Adolescent Mental Health funded by the National Institute of General Medical Sciences (P20GM139743).

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Trends in Obesity-Related Measures Among U.S. Children, Adolescents, and Adults

February 13, 2025, EurekAlert!

From 2013-2014 to August 2021-August 2023, there were small increases in the percentage of children and adolescents with obesity, as well as in adults with severe obesity (but not obesity). There were no other significant changes in obesity-related measures, including waist circumference. This period included the COVID-19 pandemic; a study using electronic health records found a small increase in mean weight among adults during the pandemic.

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Ultraprocessed Food Consumption and Obesity Development in Canadian Children

January 31, 2025, JAMA Network

Is ultraprocessed food (UPF) consumption associated with anthropometric adiposity indicators and obesity development among Canadian children? In this cohort study of 2217 children, UPF contributed to almost half of their daily energy intake. Higher UPF intake was positively associated with body mass index, waist to height ratio, subscapular and triceps skinfold thickness, and higher odds of living with overweight or obesity. These findings can inform public health messages directed to educate caregivers on the long-term health impact of UPF in relation to the prevention of obesity and obesity-related comorbidities.

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