SPOTLIGHT
- NCCOR Highlights the Importance of Schools during National Childhood Obesity Awareness Month
- Register Today for the Next OPUS Workshop, October 9-10
PUBLICATIONS & TOOLS
- NCCOR Toolbox: September is National Childhood Obesity Awareness Month
- Modernizing SNAP: Colorado Launches New Healthy Incentive Project
- NIFA Invests $4.3M in Diet, Nutrition and the Prevention of Chronic Diseases
- Physical Education and Physical Activity
CHILDHOOD OBESITY RESEARCH & NEWS
- Kids Now See Fewer TV Ads for Unhealthy Food and Drinks, but Exposure Remains High
- Reliability of Anthropometric Measurement of Young Children with Parent Involvement
- [Children with Obesity]* Are More Likely to Develop Skin Conditions Related to the Immune System
- Two-Thirds of Baby Foods in US Grocery Stores Are Unhealthy, Study Shows
- Sugary Drink Intake by Children and Adolescents Increased by Almost a Quarter Between 1990 and 2018
Spotlight
NCCOR Highlights the Importance of Schools during National Childhood Obesity Awareness Month
It’s National Childhood Obesity Awareness Month, and this year, NCCOR will spotlight the link between schools and children’s health. Children spend approximately five days a week, ten months a year in school. As a result, researching school environments is critical for designing effective interventions. NCCOR offers valuable resources highlighting the role of physical activity, healthy eating, and the built environment in and around schools.
Promoting Physical Activity:
- Recess encourages physical activity: Up to 70 percent of weekly physical activity can occur during recess. A well-organized, quality recess can be associated with lower BMI, increased play, and better emotional control, among other positive outcomes. The CDC recommends 20 minutes or more of recess daily for students from grades K to 12. However, disparities exist in recess, with variations in time and adherence to recommendations across the United States. Learn more about research related to recess.
- Creating active school environments through Active Travel to School (ATS): Promoting biking or walking to and from school can help students move more throughout the day. ATS initiatives can increase children’s daily physical activity levels. However, environmental, program, and policy supports are needed to support ATS, such as ensuring traffic safety and implementing Safe Routes to School
Promoting Healthy Eating Behaviors:
- Benefits of healthy school meals: School meals are critical in promoting healthy eating among children. These meals help improve children’s dietary quality, as measured by the Healthy Eating Index (HEI). Healthy school meals can also benefit students’ physical health, with an observed association between school breakfasts and lower BMI, as well as the probability of obesity.
- Dietary assessment of school-aged children: NCCOR’s Measures Registry offers a selection of measures to evaluate students’ diets. One such tool is the “24-Hour Dietary Recall for Fourth Graders,” which can be used to assess school meals.
Built Environment:
- Building sustainable schools: Green Health environmental design research examines how the design of school environments can help prevent childhood obesity. Schools play a significant role in the everyday lives of community members, families, and their children. Therefore, school environmental design can influence social norms and behaviors, such as dietary choices and daily physical activity.
- Local school wellness policies: Local school wellness policies help ensure that a school environment supports student health and well-being. These policies must include components such as nutrition promotion, physical activity goals, food and beverage standards, and marketing policies. Dr. Jamie Chriqui has discussed the impact these school policies can have on student health.
Please join us during National Childhood Obesity Awareness Month to spread the word about our free resources related to school health and the importance of prevention research. Check out NCCOR’s social media for helpful content on childhood obesity-related topics.
Register Today for the Next OPUS Workshop, October 9-10
Join us for OPUS II, the second installment of the popular Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) workshop series on October 9–10. Building on the insights from OPUS I, this virtual workshop will focus on advanced methodologies and innovative approaches for equity-centered, community-engaged interventions to address childhood obesity. Attendees will gain valuable insights into new strategies for evaluating policy, systems, and environmental (PSE) interventions that may not fit traditional randomized controlled trials.
The workshop will feature keynote addresses and panel discussions with distinguished experts, including 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; and Jennifer Roberts, DrPH, University of Maryland, among others. Discussions will cover critical topics such as balancing implementation fidelity with local adaptation, authentic community engagement, and integrating social drivers to ensure equitable impact.
The event will take place virtually from 12:00–5:00 p.m. ET on October 9 and 12:00–3:30 p.m. ET on October 10. For more information and to register, visit http://bit.ly/4gccrUz. Don’t miss this opportunity to explore innovative approaches and collaborate on advancing childhood obesity prevention.
Publications & Tools
NCCOR Toolbox: September is National Childhood Obesity Awareness Month
This National Childhood Obesity Awareness Month, help us spread the word about NCCOR! By offering essential tools, resources, and expert insights, NCCOR supports researchers in developing effective strategies to address the pressing issue of childhood obesity. Our workgroups meticulously review scientific literature and datasets to ensure our offerings align with the latest research. Do you know someone who could benefit from NCCOR’s free resources and research tools? This new booklet is a conversational guide and provides a great starting point to learn about NCCOR. Also, please encourage them to join our mailing list to stay updated on our latest offerings.
Modernizing SNAP: Colorado Launches New Healthy Incentive Project
August 14, 2024, U.S. Department of Agriculture
On Aug. 1, Colorado launched their SNAP Produce Bonus program, thanks to a $7.9 million grant from USDA’s Food and Nutrition Service. This initiative is part of a broader effort to test a new delivery model for healthy food purchase incentives offered to SNAP participants. In June 2023, Colorado, Louisiana, and Washington were awarded a total of $25 million to test Electronic Healthy Incentives Projects, or eHIP.
eHIP aims to streamline incentive delivery and make it easier for SNAP households to access the healthy foods necessary for lifelong health and well-being. Participating state projects focused on upgrading SNAP systems to make incentive dollars available to participants via their EBT cards, targeting a variety of small and independent stores, farmers markets, retail chains and locally grown foods.
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NIFA Invests $4.3M in Diet, Nutrition and the Prevention of Chronic Diseases
August 14, 2024, U.S. Department of Agriculture
The AFRI Diet, Nutrition, Prevention of Chronic Diseases (A1344) program area priority, part of the Food Safety, Nutrition and Health program area within AFRI’s Foundational and Applied Science program. The focus of this program is to invest in integrated projects that help prevent and control chronic disease equitably across the lifecycle by supporting and encouraging culturally relevant, healthy dietary choices through data-driven, flexible, customer-focused approaches.
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Physical Education and Physical Activity
Centers for Disease Control and Prevention
Schools are in a unique position to help students attain the nationally recommended 60 minutes or more of moderate-to-vigorous physical activity daily. Regular physical activity in childhood and adolescence is important for promoting lifelong health and well-being and preventing various health conditions.
To learn more about benefits of physical activity, physical activity behaviors of young people, and recommendations, visit Physical Activity Facts. For more information on the Physical Activity Guidelines, 2nd edition, visit Physical Activity Guidelines for School-Aged Children and Adolescents. Find out what CDC is doing nationwide to help more adults, children, and adolescents become physically active.
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Childhood Obesity Research & News
Kids Now See Fewer TV Ads for Unhealthy Food and Drinks, but Exposure Remains High
August 23, 2024, EurekAlert!
Children’s exposure to food and drink ads during kids’ TV shows has dropped substantially since food and beverage makers pledged to stop advertising unhealthy fare during children’s TV shows. Yet, according to research from the University of Illinois Chicago, children under 12 still see more than 1,000 food-related ads a year, most of them for unhealthy products.
For the study, published in JAMA Network Open, researchers analyzed television ratings and advertising data from 2013 through 2022. The study authors found that a dramatic decline in food and drink advertisements during kids’ shows did not fully eliminate children’s exposure to ads for products high in saturated fat, trans fat, total sugars and sodium.
“Kids are still seeing about a thousand ads per year on other programs, and the majority of ads that kids see are still for unhealthy products,” said Lisa Powell, distinguished professor and director of health policy and administration in the UIC School of Public Health. “This is important as the World Health Organization has recognized that reducing children’s exposure to unhealthy food and beverage advertisements is a key strategy for improving both children’s diets and health.”
In 2006, a group of food, beverage and restaurant companies pledged to only advertise healthy products on children’s television programming, defined as shows where at least 35% of viewers are under the age of 12. Later revisions in 2014 and 2020 established nutritional criteria for what qualifies as unhealthy and therefore should not be advertised to young audiences.
Using television ratings data from The Nielsen Company, UIC researchers found that following changes in companies’ self-regulation, the number of general food and beverage commercials seen during children’s programs fell by over 95%. However, they found that 60% of the remaining food and beverage ads were still for unhealthy products.
And overall, kids under the age of 12 still saw more than 1,000 food-related advertisements per year, on average. Because of the steep decline in food and beverage ads during children’s shows, as much as 90% of this exposure came from watching shows with lower child-audience shares.
That shift suggests that regulations against advertising unhealthy food and beverages during hours when children are likely to watch television would be more effective than focusing restrictions specifically on children’s shows, the authors write.
The researchers also found a persistent racial difference in exposure to food-related advertisements. While the number of these ads seen by both Black and white children declined from 2013 to 2022, Black children saw significantly more advertisements than their white counterparts, due in part to more time spent watching television.
In general, children’s time watching television has declined, indicating the need for research on their exposure to advertising on other media. Powell’s group is in the early stages of launching a new project to measure the ads children encounter through social media platforms and digital entertainment.
“We know that the media kids consume is changing. They’re spending more time on their mobile devices, whether it be a tablet or a phone, and they’re seeing a lot of ads,” Powell said. “We really need to understand where else the food companies target kids and what they’re seeing.”
In addition to Powell, UIC co-authors include Julien Leider, Rebecca Schermbeck and Aline Vandenbroeck, along with University of Connecticut co-author Jennifer Harris. The study was supported by grants from Bloomberg Philanthropies and the Robert Wood Johnson Foundation.
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Reliability of Anthropometric Measurement of Young Children with Parent Involvement
August 22, 2024, Childhood Obesity
Background: The purpose of this study was to determine the reliability of anthropometric measurements between two trained anthropometrists working in a team and one trained anthropometrist working with a child’s parent/caregiver in a primary health care setting.
Study Design: An observational study to determine measurement reliability was conducted in a primary care child research network in Canada. In total, 120 children 0–5 years old had their anthropometric measurement taken twice by two trained anthropometrists working in a team and twice by one trained anthropometrist working with a child’s parent/caregiver. Inter- and intra-observer reliability was calculated using the technical error of measurement (TEM), relative TEM (%TEM), and the coefficient of reliability (R).
Results: The %TEM values for length/height and weight were <2%, and the R coefficient values were >0.99, indicating a high degree of inter- and intra-observer reliability. The TEM values demonstrated a high degree of reliability for inter- and intra-observer measurement of length/height in comparison with other anthropometric measurement parameters. However, there was greater variation seen in the length measurement for children 0 to <2 years of age and in arm circumference measurement across both age-groups.
Conclusion(s): This study suggests that anthropometric measurement taken by one trained anthropometrist with the assistance of a parent/caregiver is reliable. These findings provide evidence to support inclusion of a child’s parent/caregiver with anthropometric measurement collection in clinical setting(s) to enhance feasibility and efficiency and reduce the research costs of including a second trained anthropometrist.
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[Children with Obesity]* Are More Likely to Develop Skin Conditions Related to the Immune System
August 21, 2024, EurekAlert!
Childhood obesity can contribute to the development of common immune-mediated skin diseases (IMSDs), such as alopecia areata, atopic dermatitis, and psoriasis, new research finds. Maintaining a healthy weight could potentially help lower the chances of developing these skin conditions. A novel study in the Journal of Investigative Dermatology, published by Elsevier, details the findings of an analysis of 2,161,900 Korean children from 2009 to 2020 to investigate the relationship between obesity or dynamic changes in body weight and the development of IMSDs.
IMSDs have detrimental effects on quality of life, including emotional, physical, social, and functional wellbeing, in children and their families. Although several biologics have proven effective for treating children with atopic dermatitis or psoriasis, limited treatment options and a lack of clinical trials for systemic therapy still present considerable challenges in treating children with IMSDs. Childhood obesity rates have surged over the past years, transforming it into an undeniable public health crisis, which was compounded by the effects of the pandemic and national lockdowns. The precise mechanisms responsible for the involvement of obesity in the development of chronic inflammatory skin diseases, including psoriasis, atopic dermatitis, and skin malignancies, remains uncertain.
Co-lead investigator of the study, Seong Rae Kim, MD, Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea, explains, “Previously, many studies have looked at the link between childhood obesity and IMSDs. However, most of these studies only looked at data from one point in time or compared groups with and without the condition (i.e., obesity or overweight), and they had small sample sizes. Very few studies have followed children over a long period to see how their body weight affects the development of these skin conditions. This means we still don’t know for sure whether being obese or overweight causes atopic dermatitis and psoriasis or if the opposite is true. Also, no studies have yet looked at the effect of body weight on alopecia areata or how dynamic changes in a child’s weight affect development of common IMSDs.”
Co-lead investigator Hyunsun Park, MD, PhD, Department of Dermatology, Seoul National University College of Medicine; Laboratory of Intestinal Mucosa and Skin Immunology; and Department of Dermatology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea, adds, “Our research team is very interested in the skin-gut access. We think that various factors, including diet, obesity, or other lifestyles can affect gut environment and contribute to the development of IMSDs. We are trying to find the puzzle pieces to demonstrate how they are connected, and our current research is a step towards that understanding. We conducted a large study using data from a national database in Korea, which includes information on almost all infants and children across the country. Our goal was to see how a child’s weight and changes in their weight are related to the development of alopecia areata, atopic dermatitis, and psoriasis.”
The study revealed that children [with obesity]* were more likely to develop common IMSDs compared to children with a normal weight. Among the three most common IMSDs, atopic dermatitis demonstrated the most obvious trend; children who gained weight (normal to overweight) had a higher risk of developing atopic dermatitis than children who maintained their normal weight, and children who lost weight (overweight to normal) had a lower risk of developing atopic dermatitis than children who maintained their overweight.
Co-lead investigator Seong-Joon Koh, MD, PhD, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine; and Laboratory of Intestinal Mucosa and Skin Immunology, Seoul, Republic of Korea, concludes, “Our findings support the importance of promoting weight maintenance among children who are already within the normal weight range because it may help reduce the risk of developing atopic dermatitis. In addition, prevention of excessive weight gain and purposeful weight loss, including adopting healthy diet strategies in children with obesity to prevent atopic dermatitis, particularly before school age, should be promoted. Implementing purposeful interventions, including nutritional strategies, to decrease body weight may aid in reducing the risk of developing IMSDs in children.”
*Edited to reflect person-first language standards for discussing obesity.
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Two-Thirds of Baby Foods in US Grocery Stores Are Unhealthy, Study Shows
August 21, 2024, EurekAlert!
A staggering 60 percent of infant and toddler foods fail to meet nutritional recommendations, and none meet promotional requirements set by World Health Organization (WHO) guidelines, according to new research published today in the scientific journal Nutrients.
In the absence of US-specific nutrition or promotional guidelines for these foods, researchers at The George Institute for Global Health assessed data on 651 infant and toddler food products sold in the top ten US grocery chains held in the Institute’s FoodSwitch database against this international benchmark.
Among all products, 70 percent failed to meet protein requirements and 44 percent exceeded total sugar requirements. A further one in four products did not meet calorie requirements and one in five exceeded recommended sodium limits.
Dr. Elizabeth Dunford, Research Fellow at The George Institute, and Adjunct Assistant Professor, Department of Nutrition at the University of North Carolina said that the rising popularity of processed convenience foods for infants and young children was concerning.
“Early childhood is a crucial period of rapid growth and when taste preferences and dietary habits form, potentially paving the way for the development of chronic diseases such as obesity, diabetes and some cancers later in life,” she said.
“Time-poor parents are increasingly choosing convenience foods, unaware that many of these products lack key nutrients needed for their child’s development and tricked into believing they are healthier than they really are.”
Researchers found that baby food pouches are the fastest growing products in the sector, with a 900 percent increase in the proportion of sales deriving from pouches in the last 13 years. Concerningly, pouches ranked among the unhealthiest products assessed, with fewer than 7 percent meeting total sugar recommendations.*
The study also revealed the extent of misleading marketing practices, with almost all (99.4 percent) products featuring at least one prohibited claim on their packaging. On average, products displayed four prohibited claims, with some displaying as many as 11. Common claims included ‘non genetically modified (GM)’ (70 percent), ‘organic’ (59 percent), ‘no BPA’ (37 percent), and ‘no artificial colors/flavors’ (25 percent).
Dr. Daisy Coyle, Research Fellow and Dietitian at The George Institute said that claims like these create a so-called ‘health halo’ around these products.
“The lack of regulation in this area leaves the door wide open for the food industry to deceive busy parents,” she said.
“We saw this not only in the use of misleading claims but also in the use of misleading names, where the product name did not reflect the main ingredients found on the ingredient list.”
“For example, snack and finger foods often referred to fruit or vegetables in the product name, despite primarily being made of flour or other starches,” Dr. Coyle added.
Obesity in children aged two to five has more than doubled in the US since the 1970s, with approximately 13% of preschool children living with obesity. This has only worsened since the COVID-19 pandemic.
“While reducing childhood obesity was a priority under the Obama administration, the issue appears to have fallen by the wayside in recent years,” added Dr. Dunford.
“Our findings highlight the urgent need for better regulation and guidance in the infant and toddler foods market in the United States – the health of future generations depends on it.”
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Sugary Drink Intake by Children and Adolescents Increased by Almost a Quarter Between 1990 and 2018
August 7, 2024, EurekAlert!
Children and adolescents across the world consumed on average 23% more sugar sweetened beverages (SSBs) in 2018 than they did in 1990, show the results of a study published in The BMJ today.
Over the same period, a corresponding rise was seen in the prevalence of obesity among young people.
Unhealthy diets, especially intake of sugar sweetened beverages, play a crucial role in obesity. Although tracking the consumption of these drinks by children and adolescents is essential to understanding their impact on disease and the effectiveness of policies to control their consumption, recent national estimates of young people’s intake are unavailable for most countries.
To address this, researchers used data collected for the Global Dietary Database, which incorporated over 1,200 national and subnational dietary surveys representing 185 countries, and from which 450 surveys form 118 countries included data on SSB intakes.
Data were analysed for children and adolescents aged 3-19 years in 185 countries between 1990 and 2018 and grouped by age, sex, parental education, and rural or urban residence. Mathematical modelling was used to estimate the average consumption of SSBs for each group.
SSBs were defined as any beverage with added sugars and at least 209 kJ (50 kcal) per 237 g serving. These included commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch and lemonade, but excluded 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk.
The results show that intakes of SSBs among children and adolescents increased by an average of 23% (0.68 servings/week) from 1990 to 2018, with the largest increases in sub-Saharan Africa (2.17 servings/week).
In 2018, the average global intake was 3.6 standard servings per week, ranging from 1.3 in south Asia to 9.1 in Latin America and the Caribbean. Yet 56 (30%) of the 185 countries included in the analysis – home to 238 million children and adolescents or 10.4% of the global population of young people – had an average SSB intake of 7 or more servings/week.
Globally, SSB intakes were higher in older versus younger children and adolescents, those resident in urban versus rural areas, and those of parents with higher versus lower education, with variations by world region.
The increase in intake of SSBs among children and adolescents between 1990 and 2018 was nearly twice the increase seen among adults over the same period, note the authors, who say measures specifically targeting marketing of SSBs to children and adolescents are critical.
They acknowledge some limitations that could have affected the accuracy of estimates, such as the limited availability of dietary survey data (particularly for lower income nations in south Asia and sub-Saharan Africa) and time periods, and the potential for underreporting or overreporting by relying on self-reported survey data.
But they say overall their findings “should be taken as the best currently available, but nonetheless imperfect, estimates of SSB intake worldwide.”
“Policies and approaches at both a national level and a more targeted level are needed to reduce intakes of SSBs among young people worldwide, highlighting the larger intakes across all education levels in urban and rural areas in Latin America and the Caribbean, and the growing problem of SSBs for public health in sub- Saharan Africa,” they write.
“Our findings are intended to inform current and future policies to curb SSB intakes, adding to the UN’s 2030 Agenda for Sustainable Development,” they add.
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