PUBLICATIONS & TOOLS
- NCCOR Toolbox
- The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2021
- The Association of WIC App Usage and WIC Participants’ Redemption Outcomes
CHILDHOOD OBESITY RESEARCH & NEWS
- Glickman, Veneman, Andrés, Sarasin Launch BPC’s Food and Nutrition Security Task Force
- Involving Parents in Promoting Healthy Energy Balance-Related Behaviors in Preschoolers: A Mixed Methods Impact and Process Evaluation of SuperFIT
- Obesity During Adolescence Linked to Increased Risk of Stroke as an Adult
- Effectiveness of Programs Aimed at Obesity Prevention Among Indigenous Children: A Systematic Review
Upcoming NCCOR Webinars Take an International Focus
NCOOR, together with the Fogarty International Center’s Center for Global Health Studies (CGHS), will host a summer webinar series titled Childhood Obesity Research Across Borders. These Connect & Explore events will identify the synergies between childhood obesity research conducted in Latin America and among Latino populations in the United States. Speakers will share their research results and lessons learned, while identifying common research questions and strategies.
The two sessions will complement each other but are standalone webinars. Please join us for one or both of the following sessions:
Part 1—Childhood Obesity Across Research Borders: Social Determinants of Health
June 17 from 12:00–1:00 p.m. ET
Discover the role that social determinants of health play in childhood obesity in the United States and Latin America, specifically in terms of migration and the social environment. Speakers include Rafael Perez-Escamilla, Yale University; Mireya Vilar-Compte, Universidad Iberoamericana; and Guadalupe X. Ayala, San Diego State University.
Part 2—Childhood Obesity Research Across Borders: The Physical Environment
July 20 from 12:00–1:00 p.m. ET
Explore how children’s physical environments and food environments impact their risk of childhood obesity. Speakers will identify opportunities for cross border learning. They include Abby King, Stanford University; Olga Lucia Sarmiento Dueñas, Universidad de los Andes, Universidad de los Andes; Ana Clara Duran, University of Sao Paulo; and Lindsey Smith-Taillie, University of North Carolina at Chapel Hill.
The speakers for this summer’s Connect & Explore webinar series authored a newly published May 2021 special issue of Obesity Review titled Childhood Obesity Prevention Across Borders: The Promise of US-Latin American Research Collaboration. This special issue explores nine cross-cutting themes and presents a shared research agenda to promote childhood obesity prevention in Latin America and among Latino populations in the United States. Speakers will expand on the themes they addressed in the Obesity Review series and take audience questions.
In addition, please consider sharing this information on your social networks using the hashtag #ConnectExplore. We will live-tweet both webinars, so be sure to follow the conversation at @NCCOR. For those who cannot attend, the webinar will be recorded and archived on https://www.nccor.org/webinars/.
Publications & Tools
American Trails released the recording of its recent webinar “Effective Programs to Improve Access and Use of Trails for Youth from Under-Resourced Communities.” The webinar, which is eligible for free CEUs, features content from the NCCOR trail use working group. American Trails also released a detailed question and answer document based on audience questions that emerged during the session. Visit the American Trails website to access the webinar and learn more about the available CEUs.
The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2021
Chronic underfunding of the public health system was a key contributing factor in the nation’s flatfooted response to the COVID-19 pandemic, according to a new report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2021, released today by Trust for America’s Health.
The Association of WIC App Usage and WIC Participants’ Redemption Outcomes
The United States Department of Agriculture (USDA) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the largest federally funded nutrition assistance programs in the nation. It provides free, nutritious food packages, nutrition education, and health interventions to women who are low income or food insecure and are pregnant, breastfeeding, or post-partum; infants; and children up to five years of age. Since WIC was established in 1972, it has been playing a critical role in improving the health and developmental outcomes of its participants.
Childhood Obesity Research & News
Glickman, Veneman, Andrés, Sarasin Launch BPC’s Food and Nutrition Security Task Force
May 4, 2021, Bipartisan Policy Center
The COVID-19 pandemic has revealed the urgent need to reduce food insecurity in the United States. With the upcoming congressional reauthorizations of the Child Nutrition programs and the Farm Bill, the Bipartisan Policy Center today launched the Food and Nutrition Security Task Force to improve access to healthy foods and diet quality for all Americans. Leading this one-year effort are co-chairs former Agriculture Secretaries Dan R. Glickman and Ann M. Veneman; world renowned chef and founder of the humanitarian food relief non-profit World Central Kitchen José Andrés; and FMI – The Food Industry Association President and CEO Leslie Sarasin.
This year, an estimated 42 million Americans, including 13 million children, are at risk of not having enough to eat. At the same time, the nation is facing rising obesity rates that highlight the need to enhance diet quality through strengthening evidence-based nutrition standards and increasing access to healthy foods in federal food and nutrition programs.
Task force members include:
- Claire Babineaux-Fontenot, CEO, Feeding America
- Rochelle Davis, President and CEO, Healthy Schools Campaign
- Zippy Duvall, President, American Farm Bureau Federation
- Ihuoma U. Eneli, M.D., Director, Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital
- Douglas Greenaway, President and CEO, National WIC Association
- Nadine Gracia, M.D., MSCE, Executive Vice President and COO, Trust for America’s Health
- Luis Guardia, President, Food Research & Action Center
- Gen. Mark Hertling, DBA, Advisor and Board Member, Mission Readiness
- Dariush Mozaffarian, M.D., Ph.D., Dean, Friedman School of Nutrition Science and Policy, Tufts University
- Robert Paarlberg, Ph.D., Professor Emeritus, Wellesley College; Associate, Sustainability Science Program, Harvard Kennedy School and Harvard Weatherhead Center for International Affairs
- Pam Schwartz, MPH, Executive Director, Community Health, Kaiser Permanente
- Tom Stenzel, President and CEO, United Fresh Produce Association
The goal of the task force will be to assess both legislative and administrative policy opportunities and issue recommendations that will: 1) improve food and nutrition security during COVID-19 and the economic recovery, 2) strengthen the Child Nutrition Programs, including the Child Nutrition Reauthorization, and 3) enhance the Supplemental Nutrition Assistance Program (SNAP) and other food assistance programs, including through the Farm Bill. The group will also develop ideas for public and private sector collaboration to address food and nutrition security.
“There is an urgent need to develop solutions to address both food and nutrition security in the context of COVID-19 and beyond,” said Glickman, who is also a BPC senior fellow. “Poor nutrition and diet-related diseases and conditions, such as obesity, lead to poor health outcomes and higher health care costs. Our aim is to design solutions that not only help Americans get enough calories but also the right kind of calories. A commitment to health equity will also be central to the task force’s recommendations.”
“Supporting the health and well-being of children and families must be a priority,” said Veneman. “Our task force seeks to inform federal policy that will address the long-term health, educational, and economic impact of food and nutrition insecurity throughout the country. This is a crisis that can’t wait.”
“The COVID-19 pandemic has exposed the gaps in our collective ability to combat nutrition insecurity as millions of American families have gone without enough to eat,” said Andrés. “Now more than ever, we must seek bold solutions that bring the power of the federal government together with the nonprofit and private sectors to end hunger and make food an opportunity to create a better tomorrow. I am proud to co-lead this critical effort.”
“FMI and its members representing the business of food—wherever it is bought, sold or produced—recognize the important role we play in ensuring access to affordable, safe, and healthy foods for all Americans,” said Sarasin. “We look forward to working with leaders across all sectors to identify innovative policy solutions to eliminate food insecurity—one of America’s leading challenges.”
Over the next year, the task force will hold several public events and issue a series of policy briefs with recommendations.
Involving Parents in Promoting Healthy Energy Balance-Related Behaviors in Preschoolers: A Mixed Methods Impact and Process Evaluation of SuperFIT
May 11, 2021, Nutrients
Parental involvement is an essential component of obesity prevention interventions for children. The present study provides a process and impact evaluation of the family component of SuperFIT. SuperFIT is a comprehensive, integrated intervention approach aiming to improve energy balance-related behaviors (EBRBs) of young children (2–4 years). A mixed methods design combined in-depth interviews with parents (n = 15) and implementers (n = 3) with questionnaire data on nutritional and physical activity-related parenting practices (CFPQ and PPAPP), the physical home environment (EPAO_SR) (n = 41), and intervention appreciation (n = 19). Results were structured using the concepts of reach, adoption, implementation, and perceived impact. Findings indicated that the families reached were mostly those that were already interested in the topic. Participants of the intervention appreciated the information received and the on-the-spot guidance on their child’s behavior. Having fun was considered a success factor within the intervention. Parents expressed the additional need for peer-to-peer discussion. SuperFIT increased awareness and understanding of parents’ own behavior. Parents made no changes in daily life routines or the physical home environment. Translating knowledge and learned strategies into behavior at home has yet to be achieved. To optimize impact, intervention developers should find the right balance between accessibility, content, and intensity of interventions for parents.
Obesity During Adolescence Linked to Increased Risk of Stroke as an Adult
May 13, 2021, EurekAlert!
Higher body mass index (BMI) in adolescence is associated with a significantly higher risk of first ischemic stroke in adults under age 50 regardless of whether they had Type 2 diabetes, according to new research published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.
While rates of adolescent obesity and stroke among adults under the age of 50 years continue to rise around the world, the precise link between the two conditions is still not fully understood.
“Adults who survive stroke earlier in life face poor functional outcomes, which can lead to unemployment, depression and anxiety,” said study co-author Gilad Twig, M.D., M.P.H., Ph.D., an associate professor in the Medical Corps of the Israel Defense Forces and the department of military medicine, Faculty of Medicine of The Hebrew University in Jerusalem, Israel. “The direct and indirect costs attributed to stroke prevention and care are high and expected to keep increasing since the rate of stroke continues to rise.”
This study specifically analyzed adolescent BMI and first stroke before the age of 50 among 1.9 million men and women (ages 16 to 20; 58% men; 84% born in Israel) from two nationwide databases: the Israel Defense Forces and the Israeli National Stroke Registry. All the participants in the database had undergone one complete medical exam between 1985 and 2013.
Standard BMI groups are underweight (less than 5th percentile), low-normal BMI (5th to 49th percentile), high-normal BMI (50th to 84th percentile), overweight (85th to 94th percentile), and obese (greater than 95th percentile). Details on percentile BMI measures by gender are in the article.
During the follow-up period, for all 1.9 M participants between 2014 and 2018, researchers found:
Overall, 1,088 strokes occurred (921 ischemic strokes, 167 hemorrhagic strokes), and the average age at the time of the stroke was 41. Adolescent BMI was directly related to the risk of first ischemic stroke.
Compared to participants in the low-normal BMI group, adolescents who were in the overweight category had a 2-times higher stroke risk before the age of 50, and adolescents with obesity had a 3.4-times higher risk.
Even adolescents with BMIs in the high-normal range were more likely to have a stroke before age 50 compared to those in the low-normal BMI group.
After accounting for Type 2 diabetes, adolescents who were in either the overweight or obesity category still had a higher risk of stroke (1.6-times and 2.4-times, respectively) compared to people who had BMI values within the normal range.
Despite overweight and obesity during adolescence being a common problem, researchers were surprised to find that Type 2 diabetes did not explain the higher risk for ischemic stroke, which occurred even before the age of 30 in some cases. Current medical literature has shown that having a stroke early in life may lead to recurrent stroke, heart attack, long-term care and premature death, Twig noted.
“Our findings underscore the importance of effective treatment and prevention of high normal and excessively high BMI during adolescence,” Twig said. “Our study is also the first to show that the risk of stroke associated with higher BMI values is the same for both men and women.”
A major limitation of the study is that BMI data at follow-up were not available for all participants, which meant that researchers were unable to assess the contribution of obesity over time to stroke risk and to determine the independent risk of BMI during adolescence.
Effectiveness of Programs Aimed at Obesity Prevention Among Indigenous Children: A Systematic Review
June 2021, Preventive Medicine Reports
Given the significant health burden of childhood obesity, it is imperative that effective programs be better understood. When evaluating obesity prevention efforts, one must recognize the contextual factors which drive the disproportionate risk of obesity between populations. This systematic review sought to understand if programs aimed at obesity prevention and/or the promotion of healthy lifestyle behaviours for Indigenous children are effective.
We conducted a search using Medline, EMBASE, PsychINFO, ERIC, CINAHL and iPORTAL databases from inception to August 13, 2019. We included experimental and quasi-experimental studies. The main outcomes of interest were change in anthropometrics, nutrition or physical activity. Our narrative synthesis included an assessment of study quality using the Effective Public Health Practice Project Quality assessment tool.
A total of 34 studies met selection criteria. Most studies used a quasi-experimental design (n = 25) and were assessed as low to moderate quality (n = 32). Three studies showed a significant change in anthropometric measures, 14 studies demonstrated at least one significant nutrition-related behaviour or dietary-pattern change, and six studies demonstrated a significant impact on physical activity.
This systematic review of programs to prevent obesity among Indigenous children finds a limited impact on anthropometric measurements. Future studies must prioritize Indigenous knowledge and ways of knowing to lead all phases of development, implementation, and evaluation of programs.