May 2023

Introducing the New and Improved NCCOR Website!

NCCOR, May 2023

NCCOR is thrilled to announce the launch of our new website, www.nccor.org. With new resources and search options, our redesigned website makes it easier and more convenient to find what you need for your research, program planning, coursework, and grant applications. Highlights include the:

• Resource Library: Your One-Stop Shop 
  Quickly find the information you need with the new NCCOR Resource Library. This comprehensive resource contains over 170 journal articles and publications in one central location. Use the search and filter options to customize your search and find everything NCCOR has produced on a specific topic, tool, or publication type, such as infographics, reports, factsheets, and Spanish language resources. You can also filter by year.
• Social Media Library: Engage with Your Audience 
  Our Social Media Library is perfect for anyone looking to share trusted information about childhood obesity research and NCCOR tools. It contains a selection of graphics and social content. With just a click you can easily share messages and engage with your audience. We will continue to add new content to the social media library so be sure to check back for updates.
• Webinar Library: Learn from Experts
  Access the entire library of NCCOR’s workshops and Connect & Explore webinars. Each webinar page contains a recording, slides, and often links for more information.
• Project Page: Stay Informed 
  Our Project Page documents all NCCOR’s past and current initiatives. Each project page also links to the workgroup’s research articles and publications.
• Student Hub: Your Source for Learning 
  The Student Hub offers customized support to help graduate students in nutrition, public health, medicine, or kinesiology get the most out of NCCOR’s tools and resources.

We welcome your feedback on the site! Please contact us at nccor@fhi360.org with your suggestions.

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NCCOR Toolbox: Popular NCCOR Webinar Now Available Online

May 2023, NCCOR

On April 27, 2023, NCCOR hosted a Connect & Explore webinar, “Cooperative Extension’s National Framework for Health Equity and Well-Being: Implementation and Intersections with NCCOR Partners.” Launched in 2021, the updated Framework addressed the contextual factors that impact a person’s health outcomes, including social determinants of health, policies, and practices. The USDA National Institute of Food and Agriculture has a Letter of Cooperative Agreement with Extension Foundation to help accelerate the implementation of this updated Framework as part of their efforts to advance the USDA’s core priority to tackle food and nutrition insecurity and accelerate progress on the White House Conference on Hunger, Nutrition, and Health and corresponding National Strategy goals to end hunger, improve nutrition and physical activity, and reduce diet-related diseases and disparities.

This session provided an overview of the Framework and discussed initial strategies for implementation by academics, practitioners, and decision makers. The session also discussed how Extension Foundation works with other NCCOR members, particularly the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation. Visit the webinar webpage on the NCCOR website to view the recording and access the slides.

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Anti-Poverty Programs May Help Reduce Disparities in Brain Development and Mental Health Symptoms in Children

May 2, 2023, National Institutes of Health

States that provide stronger social safety nets have lower socioeconomic disparities in the brain development and mental health of children 9 to 11 years old, according to research supported by the National Institute on Drug Abuse (NIDA) at the National Institutes of Health. The disparity in brain structure between children from high- versus low-income households was more than a third lower in states with greater cash assistance than in those offering less, and the disparity in mental health symptoms was reduced by nearly a half.

The study, published in Nature Communications, highlights the impact that socioeconomic inequities can have on a child’s brain development, but demonstrates that this gap can be mitigated through state anti-poverty programs, such as Earned Income Tax Credit, Temporary Assistance for Needy Families, and Medicaid.

[Source]

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American College of Lifestyle Medicine Releases Statement Calling for Compassionate, Evidence-Based Lifestyle Intervention as First Treatment for Overweight and Obesity

April 20, 2023, EurekAlert!

The American College of Lifestyle Medicine (ACLM) has published an official position statement for the treatment of overweight and obesity, affirming the role of compassionate, evidence-based lifestyle interventions as the foundation of comprehensive treatment, with or without surgeries or medications as adjunctive therapies.

The statement says that the patients’ best interests call for treatment to address the six lifestyle pillars as defined by ACLM: regular physical activity, whole-food, plant-predominant nutrition, restorative sleep, stress management, positive social connection, and avoidance of risky substances. However, the statement acknowledges each individual’s lived environment and genetic predisposition, as many people live in a home or societal environment that promotes and exacerbates weight gain.

[Source]

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TOS Endorses Global Editorial on People-First Language and Pediatric Obesity

April 5, 2023, EurekAlert!

The Obesity Society (TOS) has joined several European, US and Canadian obesity organizations in an editorial statement published in the journal Pediatric Obesity championing the use of people-first language for pediatric overweight and obesity to address weight stigma and bias.

Professor David Thivel, president of the European Childhood Obesity Group and coordinator of the joint statement, said, “This paper emphasizes the importance of considering the use of people-first language when it comes to pediatric obesity, by all who work with, care for or support children and adolescents, in order to avoid stigmatization and to create an appropriate and optimal context to optimize their development, health and well-being. Importantly, this is the first time that the main international organizations and scientific societies working in the field of obesity have collaborated on such a joint statement.”

Aaron Kelly, PhD, co-chair of the TOS Pediatric Obesity Treatment Task Force and professor of pediatrics at the University of Minnesota in Minneapolis, agrees with the importance of this topic. “The issue of obesity and weight can be so highly stigmatizing and damaging to young people; so, it is imperative that we use proper language that engenders empathy and conveys compassion. Using people-first language is a seemingly small, yet powerful way, to set the right tone for kids and their families.”

[Source]

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As Inflation Squeezed Family Budgets, Food Insecurity Increased Between 2021 and 2022

March 21, 2023, Urban Institute

With significant food price inflation in 2022 and the expiration of COVID-19 pandemic aid, food hardship has increased for many households across the country. In this brief, we examine trends in food insecurity and receipt of charitable food using data from the Urban Institute’s Well-Being and Basic Needs Survey (WBNS), a nationally representative survey of more than 7,500 adults ages 18 to 64. We estimate the shares of adults reporting household food insecurity and charitable food receipt in 2022 and compare those shares with estimates from 2019, 2020, and 2021. In light of the rapid rise in food price inflation, we also assess households’ use of financial coping methods to deal with rising grocery costs in 2022.

[Source]

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Increasing Diversity, Equity, and Inclusion in the Fields of Nutrition and Obesity: A Roadmap to Equity in Academia

April 2023, Science Direct

Abstract

Research shows that a diverse faculty improves academic, clinical, and research outcomes in higher education. Despite that, persons in minority groups, usually categorized by race or ethnicity, are underrepresented in academia (URiA). The Nutrition Obesity Research Centers (NORCs), supported by the NIDDK, hosted workshops on five separate days in September and October 2020. NORCs convened these workshops to identify barriers and facilitators for diversity, equity, and inclusion (DEI) and provide specific recommendations to improve DEI within obesity and nutrition for individuals from URiA groups. Recognized experts on DEI presented each day, after which the NORCs conducted breakout sessions with key stakeholders who engage in nutrition and obesity research. The breakout session groups included early-career investigators, professional societies, and academic leadership. The consensus from the breakout sessions was that glaring inequities affect URiA in nutrition and obesity, particularly related to recruitment, retention, and advancement. Recommendations from the breakout sessions to improve DEI across the academe focused on six themes: (1) recruitment, (2) retention, (3) advancement, (4) intersectionality of multiple challenges (e.g., being Black and a woman), (5) funding agencies, and (6) implementation of strategies to address problems related to DEI.

[Source]

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New Study Reveals That Childhood Adversity is Linked to an Increased Risk of Developing Type 2 Diabetes as Young Adults

April 20, 2023, EurekAlert!

A new study published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD])finds that individuals who experienced childhood adversity are at increased risk of developing type 2 diabetes (T2D) in early adulthood.

The research was conducted by Assistant Professor Leonie K. Elsenburg and colleagues at the Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark and aimed to determine whether there was a link between childhood adversity and the development of T2D in early adulthood (16-38 years) among men and women.

The worldwide prevalence of T2D among adolescents and young adults has increased substantially over the past century, primarily driven by changes in lifestyles and obesity rates. This is of particular concern because early onset of the disease (before 40 years of age) appears to have a more aggressive pathology, and the individuals affected are of working age, may require lifelong treatment and face an increased risk of complications. These factors combined make identifying the risk factors for T2D in early adulthood a matter of crucial important to public health.

Childhood adversity can involve experiences such as maltreatment, physical or mental illness in the family, and poverty and has been associated with the development of diabetes even in young adults. Adverse events and circumstances can trigger physiological stress responses and affect the behaviour of the nervous system, hormones and the body’s immune response. They can also impact mental wellbeing and lead to behavioural changes that negatively impact health such as poor sleep, smoking, reduced physical activity and sedentary behaviour, increased alcohol use, and unhealthy eating which can lead to obesity and an elevated risk of developing T2D.

Previous research has revealed an association between maltreatment in childhood and the development of T2D in young adulthood, but evidence for a link with other types of adversity is scarce and sex-specific estimates are lacking. The authors also note: “There is a need for methodological improvements in this research area, including a need for prospective studies using objective and more comprehensive measures of childhood adversity.”

The researchers used data from the Danish life course cohort study (DANLIFE) which includes on the backgrounds and childhood adversities of children born in Denmark since 1 January 1980. To enable follow-up from age 16 onwards, the study sample was limited to those individuals born up to 31 December 2001 and excluded individuals diagnosed with diabetes in childhood, those with insufficient data on covariate factors, and anyone who emigrated or died before age 16.

This study population was divided into five childhood adversity groups based on annual counts of exposure (from 0 to 15 years of age) to adversities in each of three dimensions: material deprivation (family poverty and parental long-term unemployment), loss or threat of loss (parental somatic illness, sibling somatic illness, parental death, sibling death) and family dynamics (foster care placement, parental psychiatric illness, sibling psychiatric illness, parental alcohol abuse, parental drug abuse and maternal separation).

In these five groups, children experienced: 1. relatively low levels of adversity across childhood (54%); 2. material deprivation specifically in early childhood (20%); 3. material deprivation throughout childhood and adolescence (13%); 4. relatively high levels of somatic illness or death in the family (9%); and 5. relatively high levels of adversity across all three dimensions (3%).

Out of the study population of 1,277,429, a total of 2,560 women and 2,300 men developed T2D during the follow-up which lasted a mean 10.8 years. The authors found that compared with the “Low adversity” group, the risk of developing T2D in early adulthood was higher in all other adversity groups for both men and women. In the “High Adversity” group, which was characterised by high rates of adversity across all three dimensions, the risk of developing diabetes was 141% higher in men and 58% higher in women, translating into 36.2 and 18.6 additional cases per 100,0000 person-years among men and women, respectively.

After adjusting for parental education level, size for gestational age and preterm birth, the effect estimates were reduced, particularly for women in the “High Adversity” group. Compared to their counterparts who experienced low adversity during childhood, their additional risk of developing T2D was reduced from 58% to 23%, translating into 6.4 additional cases per 100,000 person-years instead of 18.6 per 100,000 person-years. Most of the reduction in the estimated risk was the result of adjusting for parental education level.

The authors found that the relative risks of developing T2D following childhood adversity were lower among women than men across all groups. In addition, the absolute effects (in terms of the number of additional cases of diabetes per 100,000 person-years) were also lower among women than men, except in the case of experiencing material deprivation in childhood, where the absolute effect was comparable between men and women.

The study reveals that individuals exposed to childhood adversity, such as poverty, illness or death in the family, and dysfunctional households are at higher risk of developing type 2 diabetes in young adulthood compared with those who experience low levels of adversity in childhood. These findings are strengthened by the large size of this population-based study, as well as its freedom from selection or recall bias. In addition, the authors point out that there is a close relationship between parental education levels children’s experience of adversity which explains some of the observed association.

The researchers conclude that a share of the T2D cases arising in young adulthood could likely be prevented through early interventions targeting the fundamental causes of childhood adversity, to reduce or even eliminate their negative effect on children’s lives.

[Source]

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Men and Women Have Different Obesity Drivers, Pointing to the Need for Tailored Interventions

April 6, 2023, EurekAlert!

A new study from UCLA researchers finds sex-specific brain signals that appear to confirm that different drivers lead men and women to develop obesity. The study, appearing in the peer-reviewed journal Brain Communications, combined data from several modes of MRI with patients’ clinical features and personal histories to identify sex-specific mechanisms in the brain underlying obesity.

“We found differences in several of the brain’s networks associated with early life adversity, mental health quality, and the way sensory stimulation is experienced. The resulting brain signatures, based on multimodal MRI imaging, may help us more precisely tailor obesity interventions based on an individual’s sex,” said Arpana Gupta, PhD, a brain, obesity and microbiome researcher at UCLA and senior author of the study.

Gupta said this is believed to be the first study using a data-driven approach to predict sex-specific obesity status based on multimodal brain signatures. It builds on an earlier UCLA study in which Gupta and colleagues examined sex-related differences in the prominence and signaling of brain regions in obesity. In addition to finding that emotion-related and compulsive eating appear to play a major role in obesity in women, that study showed that men’s eating behavior tends to be affected by a greater awareness of gut sensations and visceral responses – those related to abdominal discomfort.

The new study supports and corroborates many findings from that and earlier studies and provides MRI evidence of differences in brain structure, function, and connectivity that may help researchers better understand obesity-related drives and behaviors. For example, alterations in certain brain networks suggest that compared to men, women with a high body mass index (BMI) may be more keenly aware of and drawn to highly processed foods, with an increased risk of developing cravings and food addiction.

“In designing treatment plans for females with high BMI, it may be important to focus on emotional regulation techniques and vulnerability factors,” Gupta said.

The study, conducted through the G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program at UCLA, included 183 participants, ages 18-55. Forty-two males had non-obese BMI, 23 males had high BMI, 63 females had non-obese BMI, and 55 females had high BMI. All participants filled out a battery of self-report questionnaires assessing childhood trauma, anxiety and depression, visceral sensitivity, food addiction, bowel symptoms, personality traits, and many other factors.

Each participant also underwent three different brain MRIs to assess structure, function and connectivity. Data sets from the three scans and from clinical information were analyzed using an analytical tool that seeks to identify a limited number of variables from multiple data sets to predict an outcome.

The results show specific network connectivity changes associated with high BMI, regardless of sex. In females, the study identified brain regions and networks with alterations associated with early life trauma. These appear consistent with previous observations that females with obesity, compared to males, may have greater anxiety, lower resilience and difficulty integrating emotions with action-directed goal planning. Females also may be more susceptible to the sight, smell and taste of ultra-processed foods.

Importantly, the authors said the study identified associations, not cause and effect. Future studies will be needed to determine whether changes in the brain are a factor in the development of obesity or a result of the condition.

“Although causality is unknown, the strong associations between clinical markers, such as anxiety, depression, obesity and neural signatures suggest the importance of the bidirectional mechanistic connection of the gut-brain axis,” the authors said.

[Source]

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Good Physical Fitness Does Not Protect Children from Obesity-Related Low-Grade Inflammation

April 3, 2023, EurekAlert!

The increased prevalence of childhood obesity has resulted in an increased incidence of sustained low-grade inflammation starting from childhood. Obesity is the key factor in the increase of low-grade inflammation. However, high levels of physical fitness are thought to protect against obesity-induced health impairments. A study by the University of Jyväskylä (Finland) and the University of Eastern Finland found that good physical fitness itself does not reduce low-grade inflammation in children.

Sustained low-grade inflammation leads to insulin resistance and arterial dysfunction and promotes the development of heart diseases. A recent study examined how physical fitness affects the incidence of low-grade inflammation.

Children with better results in fitness tests, such as sit-ups, standing long jump, and agility shuttle run, also had a lower risk score for low-grade inflammation. Aerobic fitness, on the other hand, was not associated with low-grade inflammation.

However, higher body fat percentage, body mass index, and waist-to-height ratio had a much stronger connection to a higher low-grade inflammation than any physical fitness measure. The role of physical fitness as a determinant of low-grade inflammation also weakened once body fat percentage was considered in the analyses.

“Physical fitness does not seem to have very much to do with a low-grade inflammation in childhood compared to, for example, body fat percentage or waist circumference,” says Dr Eero Haapala, PhD, from the Faculty of Sport and Health Sciences at the University of Jyväskylä. He continues:

“Based on our study, physical fitness and, for example, the standing long jump can be a useful indirect method to identify children at elevated risk of low-grade inflammation.”

Physical fitness testing in identifying risk groups may be helpful, especially when measuring body composition or waist circumference is too sensitive or if measuring them may be considered to encourage, for example, limiting eating and excessive weight monitoring.

The study examined the links between physical fitness indices and the risk score for low-grade inflammation in 391 primary-school children. The published research was based on the Physical Activity and Nutrition in Children Study conducted at the University of Eastern Finland.

[Source]

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A Call for Consistent Screening and Measurement of Adolescent Food Insecurity

March 27, 2023, JAMA Network

In September 2022, the Biden-Harris Administration hosted the White House Conference on Hunger, Nutrition, and Health. In the accompanying national strategic plan, they called attention to the critical need to better identify and address food insecurity in high-risk populations.

Food insecurity refers to inconsistent access to enough safe and affordable food to live an active, healthy life. In 2016, 6.8 million (16%) US adolescents lived in households experiencing food insecurity. Households with older children and adolescents are more likely to experience food insecurity than households with younger children, and Black and Hispanic adolescents are more likely to experience food insecurity than White adolescents. During clinical visits, few clinicians ask adolescents directly about their experiences with food insecurity. This gap may be partially driven by the lack of consensus surrounding the appropriate tool for assessing adolescent food insecurity in clinical settings. Identifying such a tool, screening adolescents for food insecurity in clinical settings, and supporting those experiencing food insecurity with tailored interventions are critical to achieving the goals of the Biden-Harris Administration’s national strategic plan.

[Source]

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