May 2019


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NCCOR at Nutrition 2019

May 2019, NCCOR

Next month, NCCOR will attend Nutrition 2019, held by the American Society for Nutrition (ASN), for the first time. This annual meeting will convene 3,600 of the top scientific researchers, practitioners, global and public health professionals, policy makers, advocacy leaders, media, and other related professionals to discuss the latest nutrition research.

NCCOR will be holding a presentation on ASN’s Science Stage in the Hub on Sunday, June 9 at 2:00 p.m, called “Towards improved measurement of individual diet behaviors and food environment exposures: Resources from the National Collaborative on Childhood Obesity Research.” NCCOR we will provide an overview of key challenges and considerations in selecting measures of diet behaviors and food environments and demonstrate the use of the resources, the Measures Registry, User Guides and Learning Modules.

NCCOR will also host a poster presentation on its resources on Sunday, June 9 from 12:45-1:45 p.m. The poster presentation is a great opportunity to speak one on one with leading research experts on the measurement of diet-related behaviors.

We hope that both researchers and practitioners will be able to use this suite of resources to support selection of the most appropriate measures of diet behaviors and food environment exposures for a given study/evaluation. We’re also aiming to foster greater standardization of measures across studies.

Learn more! Even if you can’t make the presentations, NCCOR will be showcasing our tools at a booth in the exhibition hall. Stop by to learn more about NCCOR and the resources available for your research and evaluation projects!

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Publications & Tools


If you’re thinking about using the Youth Compendium of Physical Activities but need some guidance, check out NCCOR’s helpful factsheet “Youth Compendium of Physical Activities for Public Health Practitioners.” This guide includes case studies that detail how to use the Compendium, which can be translated to your research!

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Public Health Engagement in Complete Streets Initiatives: Examples and Lessons Learned

Researchers at the Illinois Prevention Research Center’s Physical Activity Policy Research Network+ (PAPRN+) Collaborating Center at the University of Illinois at Chicago School of Public Health and Institute for Health Research and Policy have released a new report. It shares strategies, lessons learned, and case studies of how public health agencies, practitioners, and advocates have successfully engaged with their planning, transportation, and public works’ counterparts on Complete Streets policy making and related initiatives.

Read the report here

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Measurement of External Food Cue Responsiveness in Preschool-Age Children: Preliminary Evidence For the Use of the External Food Cue Responsiveness Scale

New research from the Dartmouth-Hitchcock Medical Center shows that children’s snacking behavior is largely influenced by external food cues. This study offers insights into how external food environments factor into the development of eating habits at young ages.

See the study here

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Implementing Strategies to Enhance Public Health Surveillance of Physical Activity in the United States

With support from the Department of Health and Human Services, the National Academies of Sciences, Engineering, and Medicine convened a committee to develop strategies to support the implementation of recommended actions to improve national physical activity surveillance. The resulting report, outlines the committee’s 22 strategies and supporting actions for implementation.

Read the report

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Recommendations For Data Collection, Analysis and Reporting on Anthropometric Indicators in Children Under Five Years Old

A new report from the World Health Organization provides guidance to personnel involved in surveys, including anthropometric measurements. It proposes a set of recommendations to enhance quality reporting for global nutrition targets.

Read the report

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Childhood Obesity Research & News

Early Psychosocial Environment and Cardiometabolic Risk

June 2019, Journal of Pediatrics

There is increasing interest in the concept that early life exposures, including adverse childhood experiences, may be associated with later obesity, metabolic syndrome, and increased risk for atherosclerotic cardiovascular disease. In this volume of The Journal, Doom et al utilized a longitudinal study in Chile to study these potential relationships. Because this was a retrospective cohort study, there were some limitations in what was measured and when measurements were made. They used maternal depressive symptoms, stressful life events, poor support for child development, absence of the father, and socioeconomic status as measures of the child’s psychosocial environment. They found that a poorer psychosocial environment was associated with greater risk of higher body mass index and cardiometabolic risk in adolescence. The results of this and other studies of the same questions do not give us a clear sense of the pathophysiologic mechanisms underpinning these relationships. Is it poorer diet, less physical activity, higher levels of stress hormones, or other factors that are important? These results also do not clarify what kinds of interventions would be best to try to alter these trajectories. Nevertheless, this study emphasizes the importance of factors early in life in the long-term development of cardiovascular risk and suggest an important research agenda to better understand these associations.

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Neighborhood Food Environment and Physical Activity Among U.S. Adolescents

May 26, 2019, American Journal of Preventative Medicine


Few U.S. adolescents meet physical activity guidelines. Although several neighborhood characteristics influence physical activity, the role of food-related features as potential drivers of adolescent physical activity remains understudied. Using representative U.S. data, authors examined the effect of the neighborhood food environment on adolescents’ out-of-school physical activity.


The Family Life, Activity, Sun, Health, and Eating (FLASHE) study was conducted in 2014. Secondary data analysis occurred in 2018. Multinomial logistic regression models examined associations between neighborhood availability of (1) convenience store; (2) supermarket; (3) farmer’s market; (4) fast food; (5) non–fast food restaurant and adolescent out-of-school physical activity (tertile-based, low as referent). An additional association between a total aggregate neighborhood food environment score was assessed.


Final analytic sample was 1,384 adolescents (mean age=14.5 years, SD=1.6). Controlling for free/reduced-price lunch, age, sex, race/ethnicity, and neighborhood physical activity and social environments, the aggregate food environment score was significantly associated with high physical activity (versus low tertile; OR=1.2, 95% CI=1.1, 1.3). Most individual categories of food retail outlets were significantly and directly associated with out-of-school moderate- to vigorous-intensity physical activity in the single food environment variable models. However, when fully adjusting for all food retail outlet categories plus confounders, they were no longer significant.


The availability of a diverse combination of retail food destinations within walking distance from home may provide opportunities for adolescents to achieve more physical activity, likely because of transport-based physical activity. Pending future research, these findings suggest that the role of the food environment on health extends beyond its influence on dietary behaviors to other health behaviors like physical activity.

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Cholesterol Improves Despite High Obesity Rates

May 21, 2019, Associated Press

Cholesterol levels in children and teens improved in the latest analysis of U.S. health surveys, yet only half of them had readings considered ideal.

Overall, 7% of kids had high cholesterol in surveys from 2009 to 2016. That was down from 10% a decade earlier. In children, high levels mean 200 or above and ideal measures are below 170.

The results were published Tuesday in the Journal of the American Medical Association.

The researchers say the mixed bag of results could reflect stubborn rates of childhood obesity, offset by U.S. kids eating fewer snack foods containing unhealthy trans fats. Manufacturers began phasing those out before a 2018 U.S. ban.

In the analysis, researchers used 1999-2016 government surveys of 26,000 kids aged 6 to 19 who had home interviews, physical exams and lab tests.

About 1 in 4 teens and 1 in 5 younger children had unhealthy levels of at least one of type of blood fat, including cholesterol and triglycerides.

High cholesterol in childhood can lead to changes that cause blood vessels to narrow, said Dr. Amanda Perak, the study’s lead author and a heart specialist at Chicago’s Lurie Children’s Hospital. Those changes put kids at risk for heart attacks and other heart trouble in adulthood, she said.

In most cases, kids can improve cholesterol levels by adopting healthier habits — eating more fruits, vegetables, whole grains and less processed food, and exercising more, Perak said.

”Lifestyle contributes in the vast majority of cases,” she said.

Obesity contributes to unhealthy cholesterol levels yet rates have remained stagnant for U.S. kids and adults. In 2015-16, 21% of teens, 18% of children aged 6-11, and 40% of adults were obese, according to the most recent data from the U.S. Centers for Disease Control and Prevention.

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Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake

May 16, 2019, Cell Metabolism


[The study] investigated whether ultra-processed foods affect energy intake in 20 weight-stable adults, aged (mean ± SE) 31.2 ± 1.6 years and BMI = 27 ± 1.5 kg/m2. Subjects were admitted to the NIH Clinical Center and randomized to receive either ultra-processed or unprocessed diets for 2 weeks immediately followed by the alternate diet for 2 weeks. Meals were designed to be matched for presented calories, energy density, macronutrients, sugar, sodium, and fiber. Subjects were instructed to consume as much or as little as desired. Energy intake was greater during the ultra-processed diet (508 ± 106 kcal/day; p = 0.0001), with increased consumption of carbohydrate (280 ± 54 kcal/day; p < 0.0001) and fat (230 ± 53 kcal/day; p = 0.0004), but not protein (−2 ± 12 kcal/day; p = 0.85). Weight changes were highly correlated with energy intake (r = 0.8, p < 0.0001), with participants gaining 0.9 ± 0.3 kg (p = 0.009) during the ultra-processed diet and losing 0.9 ± 0.3 kg (p = 0.007) during the unprocessed diet. Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.

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Miriam Hospital Gets $2.4 Million Grant for Childhood Obesity Program

May 8, 2019, Providence Journal

The federal Centers for Disease Control and Prevention has awarded Miriam Hospital a five-year, $2.4-million grant to study the value of a program designed to “help children from low-income families whose health is challenged by obesity,” according to a media release from the hospital.

Based on UnitedHealth Group’s “Join for Me” initiative, the Rhode Island program will involve Miriam’s Weight Control and Diabetes Research Center and will be led by Elissa Jelalian, a Miriam research scientist and professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University.

“Although evidence-based interventions have been developed to address obesity in children, the vast majority of youth do not have access to such programs,” Jelalian said.

Yet children from low-income families “are at greatest risk for obesity and least likely to have access to care,” Jelalian said. “Delivering interventions through community settings offers one strategy for increasing access. This work extends our research on healthy weight, nutrition, and physical activity that has been funded as part of the Hassenfeld Child Health Innovation Institute.”

According to Hassenfeld Institute data cited in Rhode Island Kids’ Count’s 2019 Factbook, 15 percent of children in the state age 2 to 17 are overweight and 20 percent are obese.

The Miriam program “will help children and their families to adopt a healthier lifestyle, with greater consumption of nutritious foods and beverages, increased physical activity, and decreased screen time,” according to the hospital.

For the trial, the hospital will recruit 128 children ages 6 to 12. The trial will evaluate the success of basing the program at “two community settings that provide services to low-income families, housing authorities and physician offices that have been designated ‘patient-centered medical homes,’” according to Miriam, a Lifespan hospital.

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