September 2019

Now Live: NCCOR’s Measures Registry Learning Modules

NCCOR, September 26, 2019

Washington, DC –This month, the National Collaborative on Childhood Obesity Research (NCCOR) unveiled an exciting new resource to help researchers, practitioners, students, and faculty understand key measurement concepts for research and evaluation projects related to nutrition and physical activity. The Measures Registry Learning Modules includes an introductory module and four modules for each domain of the Measures Registry. This project was funded by The JPB Foundation.

NCCOR’s goal in introducing the Measures Registry Learning Modules is to provide a useful resource for those in the field to better understand how to use the Measures Registry for their work. The Modules highlight key concepts in the Measures Registry User Guides in four 15-minute videos, making it easier to understand measurement issues in the four major domains of the Measures Registry: individual diet, food environment, individual physical activity, and physical activity environment. They also help walk users through use of the Measures Registry—a searchable database of diet and physical activity measures relevant to childhood obesity research. These trusted tools will save time and ultimately accelerate progress in childhood obesity research.

To learn more about the new Learning Modules and hear from the experts who created them– Dr. Jordan Carlson, Dr. Sharon Kirkpatrick, Dr. Leslie Lytle, and Dr. Gregory Welk, check out this interactive webinar titled “Measures Registry Learning Modules: Helping You Understand Measurement Concepts and Approaches for Diet and Physical Activity Research.” Be on the lookout for upcoming webinars on the Measures Registry Learning Modules that can show you how to make use of this resource in your next research project.

If you use NCCOR’s new Measures Registry Learning Modules, be sure to let us know on social media—we may even feature you in our next webinar!

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Toolbox

This month, NCCOR released the new Measures Registry Learning Modules—but have you seen the Measures Registry and Measures Registry User Guides? The Measures Registry is a searchable database of diet and physical activity measures relevant to childhood obesity research. The four User Guides are designed to complement the Measures Registry and provide an overview of measurement, describe general principles of measure selection, and share additional resources. Find the full suite of tools at nccor.org!

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Adult Obesity Prevalence Maps

These maps from the Centers of Disease Control show self-reported adult obesity prevalence by race, ethnicity, and location. The data comes from the Behavioral Risk Factor Surveillance System, an on-going state-based, telephone interview survey conducted by CDC and state health departments.

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State of Obesity: Better Policies for a Healthier America Report

Newly released data from Trust for America’s Health show that obesity rates are at 35 percent or higher in nine states –- up from seven last year –- and that racial, ethnic, gender, and geographic disparities in obesity rates continue to persist. The report includes 31 recommendations for policy action by federal, state, and local government, across several sectors, designed to improve people’s access to healthy food and opportunities for physical activity.

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New Healthy Beverage Recommendations for Kids Aged 0-5

This report shares new recommendations from Healthy Eating Research on which drinks are best for the healthy growth and development of kids aged five and under. These recommendations were developed by experts at the Academy of Nutrition and Dietetics, the American Academy of Pediatric Dentistry, the American Academy of Pediatrics, and the American Heart Association under the leadership of Healthy Eating Research and with funding from the Robert Wood Johnson Foundation.

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Obesity Risk Increases with Sleeplessness, Study Says

International Business Times, September 18, 2019

An individual who lacks sleep is at increased risk of becoming obese than the person who gets proper rest at night, a study stated. According to the research, sleeplessness can make a person feel less satisfied and full even after having a heavy meal.

The study, published in the Journal of Lipid Research earlier this month, added on to the earlier research that focused on the harmful effects of sleep deprivation. While most of the previous studies focused on the association of sleep restriction with glucose metabolism, the latest research looked into the digestion of lipids from food.

The research, led by a group of researchers from Pennsylvania State University, examined a total of 15 healthy male participants who were in their 20s. All the participants were observed for 10 days.

During the first five days of the study period, the participants were not allowed to sleep for more than five hours at night. The research team kept them engaged by playing games, interacting and talking to them about various subjects. The participants were also offered a standardized high-fat meal, consisting of a bowl of chili mac, during the study period.

“It was very palatable–none of our subjects had trouble finishing it–but very calorically dense,” lead researcher Kelly Ness said in a statement.

The researcher further revealed that most of the participants felt less satisfied after finishing up the rich meal. But when the participants were allowed to sleep for 10 hours at night, they were feeling full after having the same rich meal.

It is mainly because “the lipids weren’t evaporating–they were being stored,” senior author Orfeu Buxton explained. Faster clearance of lipids from the blood after consuming food can increase the risk of obesity and overweight, the researchers noted.

“This study’s importance relies on its translational relevance. A high-fat meal in the evening, at dinnertime–and real food, not something infused into the vein? That’s a typical exposure. That’s very American,” Buxton added.

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NIH-Funded Study Suggests Teen Girl ‘Night Owls’ May be More Likely to Gain Weight

NIH, September 16, 2019

What

Teen girls—but not boys—who prefer to go to bed later are more likely to gain weight, compared to same-age girls who go to bed earlier, suggests a study funded by the National Institutes of Health. The findings by researchers at Kaiser Permanente in Oakland, California, and other institutions appear in JAMA Pediatrics.

A total of 804 adolescents (418 girls and 386 boys) ages 11 to 16 took part in the study. The children responded to questionnaires on their sleep habits and wore an actigraph—a wrist device that tracks movement. Researchers measured their waist size and calculated their proportion of body fat using a technique called dual-energy x-ray absorptiometry. They also estimated the children’s social jet lag—the difference between their weeknight and weekend bedtimes. Those who stayed up far later on weekends than weeknights were considered to have high social jet lag. The authors noted that previous studies had found that adults who preferred to stay up late and had high social jet lag were more likely to gain weight than those who went to be earlier and did not have social jet lag. The researchers undertook the current study to determine if the same associations would be seen in young people.

For girls, staying up later was associated with an average .58 cm increase in waist size and a .16 kg/m² increase in body fat. Each hour of social jet lag was associated with a 1.19 cm larger waste size and a 0.45 kg/m² increase in body fat. These associations were reduced—but still remained—after the researchers statistically adjusted for other factors known to influence weight, such as sleep duration, diet, physical activity and television viewing. Although the researchers found slight associations between these measures and waist size and body fat in boys, they were not statistically significant. The researchers concluded that improving sleep schedules may be helpful in preventing obesity in childhood and adolescence, especially in girls.

Funding was provided by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Diabetes and Digestive and Kidney Diseases, National Cancer Institute, and National Heart, Lung and Blood Institute.

Who

Andrew Bremer, M.D., Ph.D., chief of the NICHD Pediatric Growth and Nutrition Branch and who oversaw funding of the study, is available for comment.

Article

Cespedes Feliciano EM, et al. Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence. JAMA Pediatrics. 2019

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Trouble for the Pentagon: The Troops Keep Packing on the Pounds

The New York Times, September 4, 2019

The United States Navy has eliminated fried food and sugary drinks on its ships. It is keeping base gyms and fitness centers open all night. But its sailors keep getting fatter: A new Defense Department study found that 22 percent of them — roughly one in every five — now qualifies as obese.

The Navy’s figure is the highest, but the study found striking rises in obesity rates in the other armed services as well, even though the Pentagon has rolled out one strategy after another in recent years to try to keep the troops trim. And the increases have military leaders worried.

“Obesity negatively impacts physical performance and military readiness and is associated with long-term health problems such as hypertension, diabetes, coronary heart disease, stroke, cancer, and risk for all-cause mortality,” the study’s authors wrote in the August issue of the Defense Department’s Medical Surveillance Monthly Report, where the data was first published.

The study used the body mass index, a simple, widely known metric that is calculated from height and weight measurements, which the military stores in its vast electronic health database. Using 2018 data, all troops who scored higher than 30 on the index were considered obese.

The Marine Corps, which has the youngest force and maintains the toughest physical fitness standards, was the leanest in the study, with 8.3 percent of Marines over the obesity threshold. The Army came in at 17.4 percent — the same as the military wide average — and the Air Force was at 18.1 percent.

The authors cautioned that body mass index is not a perfect yardstick. It can be thrown off by extremely fit troops who score high because they have a lot of lean muscle, rather than a lot of fat. But even so, the study showed a clear trend: The obesity rate of all the military branches has been rising steadily.

A decade ago, when the military began to see weight as a growing problem, it started deploying countermeasures. Gym hours at bases were expanded. More unitwide workouts were scheduled. French fries were curtailed in the mess halls.

But the problem has only worsened. In 2011, 6.4 percent of the Army, 9 percent of the Air Force and 2.3 percent of the Marine Corps was obese, according to Defense Department health data. In less than a decade, the rates in those branches have more than doubled — and in the Navy, obesity has risen sixfold.

Military leaders once had the opposite problem. During World War II, recruiters and draft boards were flooded with undernourished candidates who were too puny to qualify for service. After the war, generals urged the federal government to create a school lunch program as a matter of national security.

Today, about one-third of potential recruits are too heavy to enlist. And many recruits who are trim when they get to boot camp gain weight once they have access to Uncle Sam’s all-you-can-eat base dining facilities.

Experts say the trend mirrors the growth of American civilian waistlines — though the civilian obesity rate is more than twice as high, at nearly 40 percent of adults, according to the most recent figures from the Centers for Disease Control and Prevention.

“The Department of Defense is a microcosm of the nation — we recruit from the nation,” said Laura Mitvalsky, the director of health promotion and wellness at the Army Public Health Center. “So the nation’s problems are ours as well.”

The Navy’s obesity rate was not helped in recent years when the service decided to retain thousands of overweight sailors because they were valuable to Navy operations.

Increasingly, the military is shifting its focus away from trying to get individuals to lose weight and toward a servicewide public health approach that commanders hope will keep the force slim, Ms. Mitvalsky said. The military has enormous control over what troops are given to eat and where they shop, so it has the power to erect what Ms. Mitvalsky called a “healthy choice architecture” that goes far beyond what could be imposed in civilian life.

Chow halls across the military now have color-coded labels. The Marine Corps version is called “Fueled to fight.” While troops can eat what they want, healthy foods, including fruits, vegetables and whole grains, get a green label for “engage at will.” Fatty junk foods get a red label for “check fire.” Foods that should only be consumed occasionally are labeled yellow for “well-aimed shots.”

Many dining facilities have been redesigned to push salad bars and other healthy options up front and fries and burgers to the rear. Base convenience stores have replaced candy and chips at the checkout counter with fruit and nutrition bars.

The physical layouts of bases, which often resemble sprawling suburbs, are slowly being redesigned to be more walkable and bikeable. Base gyms are staying open around the clock, and wellness centers are being set up, staffed with nutritionists and other fitness experts.

Ultimately, Ms. Mitvalsky said, fitness comes down to individual choice, but the military can push the choices it desires. “We want the healthy choice to be the easy choice,” she said.

Even so, change in the nation’s largest bureaucracy comes slow, and American military bases around the world still dish out plenty of traditionally heavy Department of Defense red-label chow.

On Wednesday, the galley at Naval Base San Diego featured beef potpie. Thursday there will be turkey à la king, and on Friday, chili conquistador.

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Overweight Kids Actually Eat Less Right After Stressful Events

EurekAlert!, September 3, 2019

People often react to stress by binging on sweets or fattening comfort foods, cravings fueled by the appetite-stimulating stress hormone cortisol.

But overweight adolescents–considered particularly susceptible to stress eating–actually ate less when exposed to a lab stressor, and the foods they eschewed were the high fat and sugar options, according to a University of Michigan study.

Even more surprising, kids who produced the most cortisol after the stressor saw the biggest appetite reduction, eating about 35% fewer calories in the two hours after the stressor, said principal investigator Rebecca Hasson, associate professor of movement science at the U-M School of Kinesiology.

Results were similar whether adolescents in the study were monitoring their food intake or not. This matters because people who restrict calories are more likely to stress eat.

That didn’t happen among these dieters, and the results suggest that a biological response–such as the flood of cortisol or the satiety hormone leptin–drove the adolescents’ reduced appetite.

Hasson and colleague Matthew Nagy, the study’s first author and an alumnus of the U-M School of Public Health, wanted to understand how biology and behavior impacted the eating patterns of overweight kids.

“These are really exciting findings because they give us a chance to observe eating patterns when adults are exposed to stress, which is a very important factor in childhood obesity, long-term cardiovascular risk and type 2 diabetes risk,” said Hasson, who also leads the U-M Childhood Disparities Research Lab and is an associate professor of nutritional sciences in the School of Public Health.

“This doesn’t mean stress kids out and they’ll lose weight. This is in the short term only. They may eat more calories later. Typically, many kids did say they turned to food when stressed, so maybe this was a time effect.”

Also, even if the cortisol spike didn’t cause overeating, it’s still metabolically unhealthy, she said.

The study, which appears in Psychosomatic Medicine, involved about 60 kids.

Hasson said much work remains to see who’s susceptible to big cortisol spikes and the long-term effects of stress. Previous studies have found that overweight adults with high cortisol responses after stress also experience short-term calorie reduction.

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WSU Study to Examine Health Benefits of Outdoor Preschools

EurekAlert!, September 3, 2019

As preschoolers across the nation head into classroom buildings for the start of the school year, more than 300 Seattle area children enrolled in the Tiny Trees Preschool will get to spend their time learning outside — rain or shine. Part of a growing trend toward nature-based early learning, outdoor preschools could very well hold the key to combatting childhood obesity. It’s why one Washington State University Health Sciences researcher is partnering with Tiny Trees to study the impact of an outdoor preschool model on children’s health outcomes.

“One third of children in the U.S. are overweight or obese,” said Amber Fyfe-Johnson, a researcher in the WSU Institute for Research and Education to Advance Community Health and an assistant research professor in the Elson S. Floyd College of Medicine. “And those who become overweight or obese in childhood are very likely to stay on that trajectory through their adult lives, increasing their risk of heart disease — the nation’s leading cause of death — and other health issues later in life.”

Though genetics and where a child lives play a role, up to 90 percent of childhood obesity can be explained by lifestyle factors such as physical activity, which is what piqued Fyfe-Johnson’s interest in outdoor preschools. She noted that previous studies have suggested that kids are twice as physically active outside as they are inside, even when they have open play areas and opportunities for active play while indoors. However, more data are needed to get legislators, educators, and parents on board to change policies about outdoor time in childhood, which she said is critical for childhood health and is disappearing from preschool- and elementary school environments.

Supported by funding from the National Institutes of Health and the George B. Storer Foundation, Fyfe-Johnson is embarking on a five-year project to measure physical activity, body mass index, sleep, and gut microbiome — microorganisms that live in the digestive track — in 200 children. Half of the children will be enrolled at Tiny Trees, while the other half will be children who are on the school’s waitlist and enrolled in a more traditional preschool setting.

The largest outdoor preschool in the country, Tiny Trees runs 12 open-air classrooms located in nine public parks spread out across Seattle’s King County, where kids are engaged in a play-based curriculum that has them learning while they explore the natural world around them.

Fyfe-Johnson will follow each child for two years, collecting data at the beginning and end of each academic year. In addition to comparing data across the two groups, she will also conduct cost-benefit and cost effectiveness analyses to help determine the feasibility and sustainability of the outdoor preschool model.

Influencing policies to make kids healthier

Fyfe-Johnson first developed the desire to address childhood obesity during her prior career as a pediatrician.

“I saw kids getting unhealthier, and I didn’t feel like I could do anything about it within the structure of a medical system,” she said.

Changing kids’ lifestyles is difficult and time-consuming, and though Fyfe-Johnson understood the limitations faced by hard-working parents, it still left her feeling frustrated and powerless. It fueled her decision to pursue a career in science so she could contribute to policies that make it easier for kids to lead healthy, active lifestyles.

“We as a society need to collectively shoulder the responsibility of taking care of our kids, figuring out how to make them healthier and how to prioritize that,” Fyfe-Johnson said.

Preschool, she said, is an opportune moment to intervene in children’s lifestyles. It’s when kids are actively growing and developing, and it’s still relatively easy to influence their food intake and physical activity levels. It’s also a point in time just before rates of overweight and obesity start to spike up, which starts happening in elementary school.

Fyfe-Johnson’s study is likely to draw attention from across the country, as states are seeking data to help them consider whether to allow licensing of outdoor preschools. This fall, Washington State will be the first state in the nation to license a small number of outdoor preschools — including Tiny Trees — that participated in a pilot program ordered by the state legislature in 2017. The pilot helped establish new licensing guidelines for outdoor preschool programs. Prior to this, licensing requirements were geared specifically toward indoor school environments, and outdoor preschools could only operate part-day programs, which are not required to meet licensing standards.

Washington State’s move toward licensing outdoor preschools clears the way for full-day programs to be established and gives parents access to state-sponsored childcare subsidies, helping to put outdoor preschools within the reach of more families.

“Having the room to move around, express yourself, and test your balance and the laws of nature is hugely beneficial to young kids,” said Kellie Morrill, executive director of Tiny Trees. “It’s really important to us to invest in the research to show why we believe outdoor preschools or access to nature is a right that every kid should have, which is why we are excited to be a part of WSU’s study.”

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