October 2024

There’s Still Time to Register for OPUS II: Join the Conversation about the Future of Childhood Obesity Research

October 2024, October

Join NCCOR on October 9–10 for the upcoming Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) virtual workshop. Building on the valuable insights from the previous OPUS workshop, OPUS II will focus on the next generation of equity-centered, community-engaged policy, systems, and environmental (PSE) interventions for childhood obesity prevention. The workshop agenda will explore critical methodological considerations, innovative research approaches, and practical strategies for evaluating PSE interventions. Highlights include:

• Keynote addresses and panel discussions featuring distinguished experts from academic institutions, community organizations, and federal agencies.
• Exploration of advanced methodologies for evaluating PSE interventions that go beyond traditional randomized controlled trials.
• Insights into balancing implementation fidelity with local tailoring and authentically engaging community members to ensure sustainability and equitable impact.

Featured experts include:

• Ashlesha Datar, PhD, MA, University of Southern California
• Bill Dietz, MD, PhD, George Washington University
• Christina Economos, PhD, Tufts University
• Deborah Parra-Medina, PhD, MPH, University of Colorado
• Jennifer Roberts, DrPH, University of Maryland
• And many more!

Don’t miss this opportunity to engage with leading researchers and practitioners in the field of childhood obesity prevention. Register now to secure your spot and contribute to meaningful discussions that will shape the future of obesity research: http://bit.ly/4gccrUz

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NCCOR Toolbox: OPUS I Executive Summary Now Available

October 2024, NCCOR

The executive summary for part one of NCCOR’s Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) workshop series is now on our website! The workshop explored best practices in obesity prevention research, with a focus on community engagement and systems change through an equity lens. Check out the full summary for a recap of keynote speeches, panel discussion presentations, and key themes.

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New CDC Data Show Adult Obesity Prevalence Remains High

September 12, 2024, Center for Disease Control and Prevention

New CDC population data from 2023 show that in 23 states more than one in three adults (35%) has obesity. Before 2013, no state had an adult obesity prevalence at or above 35%. Currently, at least one in five adults (20%) in each U.S. state is living with obesity.

“This new data highlight the need for obesity prevention and treatment options, which start with building healthier communities where people of all ages have safe places for physical activity, and where health care and healthy food options are accessible and affordable for all,” said Karen Hacker, MD, MPH, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. “Obesity prevention at young ages is critical, because we know that children with obesity often become adults with obesity. This is one of the reasons why we prioritize state and community investments in effective child care and family healthy weight programs.”

The 23 states with the highest adult obesity rates (35% or higher) include: Alabama, Alaska, Arkansas, Delaware, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, West Virginia, and Wisconsin. Guam and Puerto Rico also had an obesity rate of at least 35%. State-based adult obesity prevalence by race, ethnicity, and location uses self-reported height and weight data from the Behavioral Risk Factor Surveillance System (BRFSS).

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Pennington Biomedical's Greaux Healthy Initiative Takes Aim at Childhood Obesity

September 4, 2024, EurekAlert!

Pennington Biomedical Research Center is formally launching Greaux Healthy, a public service initiative designed to help improve kids’ health at every age. Developed with funding from the State of Louisiana, Greaux Healthy implements 35 years of Pennington Biomedical research and discoveries to inform tools, resources and programing for children, parents, physicians and educators throughout the state.

The Greaux Healthy initiative is developing a wide variety of educational materials distinctly tailored to four priority populations, including expectant families and parents of infants, preschool age children, school age children, and adolescents and young adults. In its inaugural year, Greaux Healthy is partnering with 4th grade classrooms in Caddo and East Baton Rouge parishes, providing classroom lessons and educational materials addressing childhood obesity, with more parishes and school systems to come.

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A Simple Blood Test Warns of Possible Cardiometabolic Complications for Children with Obesity

September 20, 2024, EurekAlert!

The number of children and teens with obesity is increasing worldwide, with over 250 million expected to be affected by 2030. It is a major public health crisis, as children with obesity risk developing insulin resistance, fatty liver, and high blood pressure, which may lead to diseases such as cardiovascular disease, type 2 diabetes and liver disease, later in life.

Scientists think these diseases can be triggered by changes in the body’s lipids – a wide range of fats and oils in the body including triglycerides and cholesterol that serve many purposes including energy storage and cellular signalling. But it is still not well understood how lipid species change in children with obesity, and how they are linked to early cardiometabolic complications.

Now, scientists at the University of Copenhagen have discovered that lipid species linked to cardiometabolic disease in adults are strongly associated with cardiometabolic risk factors in children and teenagers with obesity. The findings could pave the way for tests that serve as an early warning system for cardiometabolic disease.

“Our study shows that the impact of cardiometabolic associated lipid species emerges early in life in children with obesity, particularly affecting liver function and glucose metabolism. These risk lipid species could potentially be explored further as biomarkers for diagnosing or predicting cardiometabolic risk in children at high risk, offering new insights for early detection and intervention,” says Postdoc Yun Huang from the Novo Nordisk Foundation Center for Basic Metabolic Research at the University of Copenhagen, and co-first author of the study in Nature Medicine.

[Source]

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Early Intervention Reverses Cardiometabolic Disease Risk

September 20, 2024, EurekAlert!

The scientists made their discoveries by drawing on the HOLBAEK Study biobank of more than 4,000 children with and without obesity. at the Children’s Obesity Clinic at Holbaek Hospital. Together with scientists at Steno Diabetes Center Copenhagen, they harnessed powerful mass spectrometry technology to map hundreds of individual lipid species, each with distinct structures and functions, providing a detailed picture of lipid metabolism. By analyzing the differences in the lipid profiles of 958 children with overweight or obesity and 373 who had normal weight, they gained deep insight into obesity altered lipid profiles and their link to cardiometabolic risk, and the ability to detect excessive fat in the liver.

To see how the lipid profiles of the children and teenagers would respond to a lifestyle intervention, 186 participants who underwent a one-year obesity management program at the Children’s Obesity Clinic were examined before and after the treatment. The clinic is an accredited European Centre for Obesity Management that practices the Holbaek Obesity Treatment method, which comprises a range of lifestyle recommendations. Eighty-three percent of participants reduced their weight, and the scientists discovered that levels of harmful lipids had clearly reduced alongside the weight loss. These changes in lipid species play a role in explaining the link between weight loss and improvements in cardiometabolic traits.

“This study reinforces the need to treat childhood obesity far more seriously, as it increases the risk of developing a range of diseases that lower quality of life. Thankfully, we have shown that early intervention can reverse the risk and allow children and teenagers the possibility of living long disease-free lives as adults,” says Professor Torben Hansen from the Novo Nordisk Foundation Center for Basic Metabolic Research at the University of Copenhagen, and co-senior author of the study.

[Source]

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Medical Home Access Among Children with Obesity: The Role of Family-Centered Communication

September 20, 2024, Childhood Obesity

Objective: The American Academy of Pediatrics recommends all children receive care in a patient-centered medical home. With weight stigma potentially hampering family-centered communication in the care of children with overweight or obesity, we aimed to determine how children’s weight status was associated with access to a medical home and its components.

Methods: We analyzed 2016–2021 data on children age 10–17 years in the National Survey of Children’s Health. Children’s weight status was classified as underweight/normal weight, overweight, or obese, based on caregiver-reported height and weight. Outcomes included receiving care in a medical home and each category of the medical home definition (personal health care provider, usual source of health care, family/patient-centered care, care coordination, and assistance with referrals).

Results: Based on the study sample (n = 105,111), we estimated that 16% of children were overweight and 16% were obese, while 42% had access to a patient-centered medical home. On multivariable analysis, obesity compared to normal weight was associated with lower access to a medical home (odds ratio: 0.87; 95% confidence intervals: 0.80, 0.95; p = 0.003) and, specifically, with lower access to family-centered care and assistance with care coordination.

Conclusions: Children with obesity encounter barriers to accessing care meeting medical home criteria, with one plausible mechanism being that weight stigma disrupts family-centered communication. Lower access to care coordination among children with obesity may also indicate a need to improve the integration of obesity-related specialty care with pediatric primary care services.

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Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity

September 16, 2024, JAMA Network

Importance Limited access to healthy foods, resulting from residence in neighborhoods with low food access, is a public health concern. The contribution of this exposure in early life to child obesity remains uncertain.

Objective To examine associations of neighborhood food access during pregnancy or early childhood with child body mass index (BMI) and obesity risk.

Design, Setting, and Participants Data from cohorts participating in the US nationwide Environmental Influences on Child Health Outcomes consortium between January 1, 1994, and March 31, 2023, were used. Participant inclusion required a geocoded residential address in pregnancy (mean 32.4 gestational weeks) or early childhood (mean 4.3 years) and information on child BMI.

Exposures Residence in low-income, low–food access neighborhoods, defined as low-income neighborhoods where the nearest supermarket is more than 0.5 miles for urban areas or more than 10 miles for rural areas.

Main Outcomes and Measures BMI z score, obesity (age- and sex-specific BMI ≥95th percentile), and severe obesity (age- and sex-specific BMI ≥120% of the 95th percentile) from age 0 to 15 years.

Results  Of 28 359 children (55 cohorts; 14 657 [51.7%] male and 13 702 [48.3%] female; 590 [2.2%] American Indian, Alaska Native, Native Hawaiian, or Other Pacific Islander; 1430 [5.4%] Asian; 4034 [15.3%] Black; 17 730 [67.2%] White; and 2592 [9.8%] other [unspecified] or more than 1 race; 5754 [20.9%] Hispanic and 21 838 [79.1%] non-Hispanic) with neighborhood food access data, 23.2% resided in low-income, low–food access neighborhoods in pregnancy and 24.4% in early childhood. After adjusting for individual sociodemographic characteristics, residence in low-income, low–food access (vs non–low-income, low–food access) neighborhoods in pregnancy was associated with higher BMI z scores at ages 5 years (β, 0.07; 95% CI, 0.03-0.11), 10 years (β, 0.11; 95% CI, 0.06-0.17), and 15 years (β, 0.16; 95% CI, 0.07-0.24); higher obesity risk at 5 years (risk ratio [RR], 1.37; 95% CI, 1.21-1.55), 10 years (RR, 1.71; 95% CI, 1.37-2.12), and 15 years (RR, 2.08; 95% CI, 1.53-2.83); and higher severe obesity risk at 5 years (RR, 1.21; 95% CI, 0.95-1.53), 10 years (RR, 1.54; 95% CI, 1.20-1.99), and 15 years (RR, 1.92; 95% CI, 1.32-2.80). Findings were similar for residence in low-income, low–food access neighborhoods in early childhood. These associations were robust to alternative definitions of low income and low food access and additional adjustment for prenatal characteristics associated with child obesity.

Conclusions Residence in low-income, low–food access neighborhoods in early life was associated with higher subsequent child BMI and higher risk of obesity and severe obesity. We encourage future studies to examine whether investments in neighborhood resources to improve food access in early life would prevent child obesity.

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Liraglutide for Children 6 to <12 Years of Age with Obesity – A Randomized Trial

September 10, 2024, PubMed

Background: No medications are currently approved for the treatment of nonmonogenic, nonsyndromic obesity in children younger than 12 years of age. Although the use of liraglutide has been shown to induce weight loss in adults and adolescents with obesity, its safety and efficacy have not been established in children.

Methods: In this phase 3a trial, which consisted of a 56-week treatment period and a 26-week follow-up period, we randomly assigned children (6 to <12 years of age) with obesity, in a 2:1 ratio, to receive either once-daily subcutaneous liraglutide at a dose of 3.0 mg (or the maximum tolerated dose) or placebo, plus lifestyle interventions. The primary end point was the percentage change in the body-mass index (BMI; the weight in kilograms divided by the square of the height in meters). The confirmatory secondary end points were the percentage change in body weight and a reduction in BMI of at least 5%.

Results: A total of 82 participants underwent randomization; 56 were assigned to the liraglutide group and 26 to the placebo group. At week 56, the mean percentage change from baseline in BMI was -5.8% with liraglutide and 1.6% with placebo, representing an estimated difference of -7.4 percentage points (95% confidence interval [CI], -11.6 to -3.2; P<0.001). The mean percentage change in body weight was 1.6% with liraglutide and 10.0% with placebo, representing an estimated difference of -8.4 percentage points (95% CI, -13.4 to -3.3; P = 0.001), and a reduction in BMI of at least 5% occurred in 46% of participants in the liraglutide group and in 9% of participants in the placebo group (adjusted odds ratio, 6.3 [95% CI, 1.4 to 28.8]; P = 0.02). Adverse events occurred in 89% and 88% of participants in the liraglutide and placebo groups, respectively. Gastrointestinal adverse events were more common in the liraglutide group (80% vs. 54%); serious adverse events were reported in 12% and 8% of participants in the liraglutide and placebo groups, respectively.

Conclusions: Among children (6 to <12 years of age) with obesity, treatment with liraglutide for 56 weeks plus lifestyle interventions resulted in a greater reduction in BMI than placebo plus lifestyle interventions. (Funded by Novo Nordisk; SCALE Kids ClinicalTrials.gov number, NCT04775082.).

[Source]

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Determinants and Facilitators of Community Coalition Diffusion of Prevention Efforts

September 3, 2024, Public Library of Science

Abstract This study examines how individual characteristics and network features of coalition participation in an intervention predict coalition members’ diffusion of Knowledge and Engagement in childhood obesity prevention. The study involved six communities in the U.S. measured across two to five time points from 2018 to 2021. Each community participated in the Stakeholder-driven Community Diffusion theory-informed intervention, a three-phase intervention that employs group model building and technical assistance with convened stakeholders to build Knowledge, Engagement, and utilize research evidence in community-led, childhood obesity prevention actions. Findings indicate that key individual-level characteristics (e.g., years of experience, gender, eigenvector centrality) and network-level features (e.g., hierarchy, clustering) are associated with higher increases in intervention outcomes of Knowledge and Engagement in childhood obesity prevention. We attend to issues of perceived influence and power in community coalitions, finding that younger, less experienced women who are not well connected to other well-connected coalition members experience smaller increases in intervention outcomes. Our discussion focuses on how individual- and network-level characteristics are associated with coalition support for evidence-based practice adoption and implementation.

[Source]

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