The report, “F as in Fat: How Obesity Threatens America’s Future 2010”, released by the Trust for America’s Health and the Robert Wood Johnson Foundation (RWJF), documents disturbing racial, ethnic, and economic disparities, too. Obesity rates for blacks and Latinos were higher than whites in at least 40 states; and 35.3 percent of adults earning less than $15,000 a year ranked as obese, compared with 24.5 percent of Americans making $50,000 or more. A lot of statistics. A lot to worry about.
NPR, Patti Neighmond, July 28, 2010
The health effects of being overweight or obese are well documented. Extra pounds add extra risk for diabetes, heart disease and certain cancers, even among children. But new research also documents significant social and economic consequences of being overweight since high school.
A group of teenagers take a morning jog at the Wellspring Academy in Reedley, Calif., in 2009. The school specializes in helping teens and college students lose weight. A new study shows teens who remain obese risk a lifetime of chronic health problems and poverty.
Philippa Clarke, an epidemiologist at the University of Michigan, wanted to know what happens to people who’ve been overweight since adolescence. So, she used national data that tracked 5,000 high school graduates for two decades. She compared one group of 40-year-olds who were normal weight at high school graduation but gained weight gradually over time with another group of 40-year-olds who were chronically overweight since age 19.
Weight And Poverty
“We found that those people who were persistently overweight were more likely to not have gone on to have any further education beyond their high school [diploma]; to be receiving welfare or unemployment compensation at age 40 and to have no current partner,” said Clarke.
Clarke says the chronically overweight were 50 percent more likely to be unemployed, on welfare and single. Her study didn’t address why, but Clarke suggests these adults probably experienced discrimination as children that diminished their self-esteem and, in turn, their aspirations.
Yale psychologist Kelly Brownell directs the Rudd Center for Food Policy and Obesity at Yale University, where research, by Rebecca Puhl, has found overweight people are 26 times more likely to report discrimination than their normal-weight counterparts. And, Brownell says, overweight kids are far are more likely to report being teased.
“Teasing that comes directly from teachers in some cases, certainly from peers and even sometimes from their families. This gets internalized so overweight children feel inferior, feel like there’s something defective with themselves and therefore they tend not to aspire. This isn’t true in all cases, but a lot of them tend not to aspire to such heights because they don’t believe they deserve it,” he said.
Brownell says discrimination against overweight individuals has increased 66 percent over the past decade despite the fact that more adults are becoming overweight.
One of the reasons, Brownell says, may be that people think overweight adults have only themselves to blame. They should eat less and exercise more. But, he says blame is simply unreasonable, when it comes to children and weight, especially in low-income neighborhoods where markets are often inadequate and places to exercise are nearly nonexistent.
“The social climate and our toxic food environment is so disastrous that more and more people are having trouble resisting it,” Brownell says. “That’s really what’s explaining the high prevalence of obesity. So it’s unfair to put people in an environment where weight gain is a very strong possibility and then to blame them for having the problem.”
Changing the environment is key to solving the problem.
Pediatrician Joe Thompson is a specialist in childhood obesity at the University of Arkansas College Of Medicine. Thompson is also director of the Robert Wood Johnson Foundation Center To Prevent Childhood Obesity. He says Arkansas has made inroads into the obesity problem by offering more healthful choices in school cafeterias and vending machines and that those efforts have paid off in the battle against obesity.
The rate of the epidemic has slowed nationwide and Arkansas has actually managed to stop the rate of increase among children, Thompson says.
]]>
The Huffington Post, John Whyte, July 19, 2010
It’s always somebody else’s problem. Even when it comes to our own health, we always think the latest risks never apply to us. Most patients know that being overweight predisposes them to diabetes. But nine times out of 10, when I tell my patients with diabetes that if they lost weight, they might be able to improve their diabetes control, the response back to me is “Dr. Whyte, I’ve been overweight for 20 years… and I’ve only been diabetic for a year.” They either simply do not make the connection or they just do not want to see it.
Unfortunately, that ignorance is no longer restricted to their own health; research also shows that many patients have wrong perceptions of their children’s weights. What do I mean?
The majority of parents recognize childhood obesity as a serious health problem. Yet, nearly 85 percent of parents of overweight children think their child as being at a healthy weight. If you consider that a third of children are overweight or obese, it’s obvious that the numbers don’t add up. In some ways, this is no surprise: no parent wants to admit that their child is overweight. Doing so can damage a child’s self-esteem at a tender age when image and self-concept are being developed. Parents also shrug it off as “baby fat” that children will lose in their older years.
But the sad truth is that school-age children and teenagers aren’t babies; carrying extra weight can’t always be blamed on the growth process. Some parents may also feel that extra weight on their kids is proof that they are providing for them sufficiently, which is a rewarding feeling for parents. On the other hand, it’s possible that a lot of parents just don’t know what a “healthy weight” is. Ask yourself: Do I know how fat is too fat?
Parents aren’t the only ones at fault. Doctors also are to blame. Many pediatricians hesitate to bring up a child’s weight to the parents. Interestingly, data show that parents are more likely to misclassify their child’s weight if their pediatrician fails to comment on it. In fact, less than 8 percent of parents recalled being told by their pediatrician that their child was overweight.
Even though pediatricians have a responsibility to intervene for the good health of the patient, it isn’t always this clear. Some pediatricians are not aware of the latest guidelines, other others are worried about offending parents by suggesting that their child is overweight or obese.
So what’s my advice to parents of overweight children?
Well, it’s important that you don’t feel discouraged if your child is overweight – most kids are nowadays. But at the same time, don’t neglect it. You can actually help curb the rise in childhood obesity. Your children’s generation is the first to have a shorter life expectancy than their parents! No parents want this for their kids.
So, get educated. Learn about what obesity is, what dangers accompany it, and how to detect it in your children. Then take action. Ask your pediatrician about your child’s weight, and keep track of your child’s BMI-for-age in between visits. Learn how to prepare healthier foods at home. Promote more physical activity. Maybe even lead by example and join your kids in getting active.
It’s important to be honest with yourself early: one study shows that 73 percent of the heaviest nine-year olds will still be obese at age 50. Much of the focus on the fight against obesity has been on school lunches, vending machines, fast food marketing, and video games. And kudos to Mrs. Obama for raising awareness of childhood obesity.
But if we all acknowledge childhood obesity as a problem, but think it doesn’t apply to our kids (and chances are it does!), then we will never solve the problem.
Parents are central to that solution. Loving your kids isn’t about spoiling them with their favorite junk foods and turning them into couch potatoes. It’s about caring for their health. Show your kids how much you love them by being honest with yourself about their weight and looking out for their healthy future.
REFERENCES
“F as in Fat: How Obesity Threatens America’s Future 2010″. Trust for America’s Health, 2010: http://healthyamericans.org/reports/obesity2010/Obesity2010Report.pdf
“Parents’ Healthy Weight Perceptions and Preferences Regarding Obesity Counseling in Preschoolers: Pediatricians Matter;” Raquel G. Hernandez, MD, MPH; Tina L. Cheng MD, MPH; and Janet R. Serwint, MD; Clinical Pediatrics; June 3, 2010.
John Whyte, M.D., MPH: Childhood Obesity: What We Don’t Know Can Hurt Us.
]]>
The Huffington Post, Michelle Locke, July 15, 2010
It’s not hard to figure out that stocking school vending machines with sugary sodas and salty, fatty snacks is a bad idea. Replacing those culinary culprits with something more nutritious is tougher.
But a growing number of school districts around the country are trying anyway.
“I can’t say enough for what it does for the kids to have the junk out of the machines,” says Patricia Gray, who as former principal of San Francisco’s Balboa High School oversaw a switch to healthier snacks.
“It was not an easy task,” says Gray, now an assistant superintendent with the district, “it was a re-education process.”
Efforts to get empty calories out of students’ hands are being made in almost every state, according to the Centers for Disease Control. A 2008 School Health Profiles Survey found that fewer secondary schools were selling less nutritious snacks compared with two years before.
Among the findings: Across 34 states, the median percent of secondary schools that ditched non-nutritious snacks increased from 46 percent in 2006 to 64 percent in 2008.
Still, the report found more progress needs to be made.
How big a deal is what kids eat at school?
According to the Institute of Medicine and the National Center for Health Statistics, the average young person gets more than 10 percent of his or her calories from saturated fat, takes in less than two-thirds the recommended intake of calcium and more than double the recommended amount of sodium. And for boys and girls ages 9 to 13, 21 percent get more than one-fourth of their energy intake from added sugars.
Food in the lunch and breakfast programs must meet nutritional standards to qualify for federal reimbursement, but food sold in other school venues, including vending machines, aren’t subject to those requirements.
Some states have passed their own laws regulating vending machines, including California, which forbids some non-nutritious snacks. In San Francisco, the school board has a stricter policy, passing a wellness policy implemented in the 2003-04 year that banned sodas (this is now part of the state standard, too) and nixed snacks like baked potato chips.
“It may be less bad for you, but that doesn’t mean that it’s good for you,” says Dana Woldow, a leader in the push for better snacks and co-chair of the district’s Student Nutrition and Physical Activity Committee.
Things aren’t perfect now, but they’re “a million times better,” than the past when sodas, candy and fried chips were the rule, Woldow said.
Starting this fall, one machine is being piloted in a San Francisco high school that will offer full, reimbursable, meals – fruit, vegetable, milk, sandwich. The “smart” machine will tally up when a student has selected enough items to qualify as reimbursable.
Drinks allowed in San Francisco school vending machines include water, juice, milk and juice/water blends with no added sweeteners, caffeine or herbal supplements. Snacks include yogurt bars, tuna salad and crackers, fruit bars and sunflower seeds.
Healthier snack machines are showing up all over. Jolly Backer, CEO of San Diego-based Fresh Healthy Vending, says the company has machines in 1,700 locations, including schools, across the United States. Offerings include items such as yogurts and fresh fruit. “All the top-selling drinks and snacks that you’d find in a Whole Foods Market you’ll find in our machines,” says Backer.
Some, like food activist Marion Nestle, say the idea of healthier vending machines is flawed.
“It depends how you define healthy,” she said. “If you define healthy as slightly better for you than junk food, they’re doing a really good job.”
She advocates taking out vending machines and focusing on improving school lunch options.
But Woldow notes that the school day is long with extracurricular activities that can go on for hours after the cafeteria closes, which means students might dash out to corner stores for high-fat, high-sugar snacks. “Isn’t it better to offer them healthy choices which are also convenient?” she says.
For those working to boost the nutrient value of vending machines, one issue is that machines are often under independent contract, perhaps to the PE department or the English department, making it hard to centralize control.
Bringing about change requires a comprehensive approach, says Gray. In addition to working on vending machine content she stopped the sale of candy for fundraisers, a very unpopular decision for a while, and curtailed bringing in junk food from home. “If you don’t have a principal that’s totally committed to (healthier snacks), it won’t work.”
And be patient, she says. Passing out fresh fruit started out as a novelty and turned into a treat. “They will eat it if it’s available and you don’t have the bad stuff. Kids get hungry. They’re going to eat one way or the other.”
]]>
The New York Times, Gina Kolata, July 9, 2010
If you had to choose one public health problem to attack, which would it be: teenage smoking or childhood obesity?
To answer that question, you might want to pose another. Who will have the harder road in life, or indeed the longer one: the teenage puffer or the chubby child?
Pitting smoking against obesity is tricky because it can mean comparing apples and bonbons, but there is some suggestion that a kind of weird zero-sum game is actually going on. And some smoking opponents fear that a choice has been made — with obesity the winner, quite possibly for the wrong reasons.
“Obesity is the new kid on the block, relatively speaking,” said Kenneth E. Warner, dean of the University of Michigan’s school of public health. “Tobacco is old news.”
When it comes to smoking, said Stanton A. Glantz, director of the University of California at San Francisco’s Center for Tobacco Control Research and Education, “we really haven’t had anyone pushing it to the top of the agenda.” That is a problem. “It’s not that I am for obesity,” he said, but he finds it less than encouraging, for example, that the hugely influential Robert Wood Johnson Foundation is pulling back from its anti-smoking efforts while directing its money and resources to preventing childhood obesity.
Then there is Michelle Obama’s campaign, Let’s Move, to prevent childhood obesity. And in May, the White House Task Force on Childhood Obesity announced its goal — reduce the rate of childhood obesity, now 17 percent, to 5 percent by 2030.
With all this effort directed at childhood obesity, along comes a report saying that progress against teenage smoking has stalled. The report, from the Centers for Disease Control and Prevention, showed smoking among high school students at 19.5 percent in 2009. The goal had been to reduce it to 16 percent by 2010.
There are a variety of estimates for the death toll from obesity, Dr. Warner said, but, whatever it is, “the death toll from smoking is higher.”
Even if it were possible to calculate the lifetime health risks a fat child faces, combating obesity is not so easy. Jeffrey Friedman, an obesity researcher at Rockefeller University, notes that there are many assumptions about what will work — more healthful foods in schools, a soda tax, getting children to be more active. Yet no interventions, when tested in large studies, have caused a big difference in children’s or teenagers’ weights.
Suppose, though, there were a method, and suppose the nation had to make a choice between proven anti-obesity programs and proven anti-smoking programs. What would be best for a child with a predisposition to be obese and to smoke? Should you have programs that would prevent the child from gaining weight? Or should you wait until the child is a teenager and institute programs to prevent smoking?
“That’s a hard call,” said Kelly D. Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University. When it comes to health, “it’s hard to think that anything could be worse than smoking,” he said. But obesity has a social stigma attached, which “carries a cost no matter what the medical consequences are.”
It’s an even harder call than that, Dr. Friedman says, because it is so difficult to assemble a group of children in whom obesity was actually prevented. Without such a group, investigators cannot rigorously assess long-term health benefits. Maybe someone with a genetic predisposition to be fat and get high blood pressure, for example, would get high blood pressure even if obesity were prevented. It might be like taking an aspirin when you have the flu — your fever might go down, but the infection is unchanged.
On the other hand, Dr. Friedman noted, the question of health benefits is answered for smoking. A person who stops will almost immediately substantially reduce the risk for heart disease. The person’s risk for lung cancer will be nearly frozen at whatever it was at the time smoking stopped. Half of teenage smokers quit.
But if smoking continues, heart disease risk remains high, and the risk of lung and other cancers continues to increase.
“I certainly don’t want to go on record as saying too much money is going into obesity prevention,” Dr. Friedman said. Yet “smoking very clearly represents a substantial health risk.”
Of course, no one wants to set up a contest for which is worse, smoking or obesity. They are the two main culprits when it comes to preventable deaths, Dr. Warner said. He also said that he did not think a shortage of money was an excuse to favor one prevention program over the other. “Yes, in some objective conceptual world there is tradeoff,” he said. But “let’s face it, there’s an awful lot of useless stuff we spend money on.”
James S. Marks, a vice president at Robert Wood Johnson, said the foundation was spending less on anti-smoking efforts but had not abandoned them. The foundation’s role, he said, is to get efforts started — as it did with smoking prevention. “Now we are doing it with obesity.”
]]>
The Philadelphia Inquirer, Jon Sapatkin, July 5 2010
How do you prevent a deadly disease that is projected to afflict one third of all Americans born today and is caused largely by hard-to-change habits such as too much soda and snacks and too little physical activity?
You could combine the broccoli and cauliflower in the school cafeteria for more colorful eye appeal. Put out 30 basketballs in gym class instead of two. Teach the wonders of water for 15 weeks straight (and remove everything else from vending machines).
Those changes – along with hundreds of others, large and small – signficantly reduced several major risk factors for type 2 diabetes, researchers concluded last week after studying the most comprehensive attempt yet to attack the epidemic through the schools.
Lifestyle prescriptions – you should eat a balanced diet – are notoriously difficult to stick with. But these limits were impossible to avoid.
“Instead of selling candy for a fund-raiser, they were selling carnations. And those are the sort of things that made it holistic across the environment,” said Wayne Grasela, senior vice president for food services in the Philadelphia School District, where six middle schools took part in the three-year national program.
The plan was to intervene early, before diabetes develops – and at a young enough age to learn new habits that could prevent or reduce obesity, a major risk factor for the disease. Numerous physicians helped craft the program, but all the action took place in the schools.
“They are already there. They already take physical education and they already eat lunch in the school,” explained Barbara Linder, who oversaw the study for the National Institutes of Health.
So researchers set about changing the school.
In gym, for example, “instead of doing layups, with most kids standing in line, we had things set up so balls were being passed back and forth while they waited,” said Gary D. Foster, director of Temple University’s Center for Obesity Research and Education, who chaired the national study.
Dumbbells, jump ropes, and medicine balls were distributed to groups, with rotations every 45 to 90 seconds to keep everyone moving. Pop music was played so that gyms were seen as “fun places to be with cool things to do,” Foster said.
In the cafeteria, the standard pizza was replaced with the same manufacturer’s whole-grain, lower-fat version. That shaved nearly 100 calories per slice and the kids didn’t notice, said Amy Virus, a registered dietician at Temple who coordinated the study’s nutrition component.
Nothing but water – not even 100 percent fruit juice – was stocked in vending machines. “Did they miss the juice? Sure, in the beginning,” Virus said, “but they got used to it. And they were buying the water.”
Supporting the effort were posters in classrooms (kids dancing, kids eating fruit), decals sent home over Christmas (TAKE THE FAMILY TV TURNOFF CHALLENGE!) and postcards in summer (“Be active for 60 minutes every day.”), even a healthy version of Jeopardy!, with 25 cards in English and Spanish.
An estimated 24 million Americans have diabetes, a chief cause of kidney failure, limb amputations, blindness, heart disease, and stroke. Although type 1 diabetes is caused by an auto-immune disorder, type 2 – more than 90 percent of the cases – is often linked to lifestyle factors that lead to weight gain and a gradual loss of the ability to control blood sugar.
Once rare before adulthood, type 2 diabetes has been rising steadily in children. Blacks and Hispanics are at particularly high risk; the government now projects that half of all babies born in those minority groups will develop diabetes later in life.
The new program was designed by researchers at seven major universities and targeted schools that enrolled high percentages of poor and minority students.
They began the interventions in 21 schools – three in each city – in the fall of 2006, when the students were in sixth grade; another 21 schools were designated as controls. A total of 4,603 students completed the study in June 2009, at the end of eighth grade.
Analysis showed that there were significantly greater reductions in several diabetes risk factors – body-mass index scores, average insulin levels, and the percentage of students with the largest waists – at the intervention schools vs. the controls.
All those differences were more pronounced among the 50 percent of students who were overweight or obese to begin with. Within that group, the interventions were associated with 21 percent lower odds of being obese at the end of eighth grade, the researchers reported.
The results were published last week online in the New England Journal of Medicine.
via Battling the bulge | Philadelphia Inquirer | 07/05/2010.
]]>
As obesity rates hit record levels, a new study finds that many adults don’t recognize weight problems in their children. The consequences can be severe.
Newsweek, Claudia Kalb, July 1, 2010
The obesity alarm bells are ringing again. A new report out this week finds that more than two thirds of states (38 total) have adult obesity rates above 25 percent—a striking increase since 1991, when no state had an obesity rate above 20 percent. Hardest hit: Mississippi, which weighed in at 33.8 percent, followed by Alabama and Tennessee (tied at 31.6 percent), West Virginia (31.3 percent), and Louisiana (31.2 percent).
Why are Americans getting fatter? As we reported in our March cover story, there are a host of factors, from the ubiquity of high-fat, mega-calorie foods to lack of exercise and too much TV. But another, more complicated, trigger appears to be at work as well: grave misperceptions about weight.
This is especially true of parents who mistakenly believe their kids are leaner than they are. A new poll included in the report finds that the majority of Americans believe that childhood obesity is a “significant and growing challenge for the country,” and yet 84 percent say their children are at a healthy weight—despite national stats showing that nearly one third of children and teens are overweight (their body mass index, or BMI, falls between the 85th and 95th percentile for their age and sex) or obese (at or above the 95th percentile). Americans understand there’s a problem; they just don’t think their kids are a part of it. The consequences are dire. “We’re in danger of raising the first generation of children who could live sicker and die younger than the generation before them,” says Dr. James Marks, RWJF’s senior vice president.
Skewed weight perception is a well-known phenomenon in the research world. In one study, only one third of parents of overweight kids recognized their child’s weight status accurately and few were worried that it might be a problem. In another, 60 percent of parents of overweight children inaccurately identified their child as healthy weight or even underweight. African-American parents were more likely to underestimate than white parents. And in a study of a low-income Latino population, mothers preferred a plumper figure for their children than themselves. This is especially worrisome given the trends in black and Latino obesity rates and the health problems—diabetes, heart disease, cancer—that can ensue.
Parents may not recognize a weight problem in their child for any number of reasons, says Dr. Judith Palfrey, president of the American Academy of Pediatrics. Weight can increase subtly and parents may not notice a change. The global rise in obesity means kids are bigger, so overweight kids look more like the norm than they used to. Parents also take pride in feeding their children. “We are naturally nurturing and nourishing, and we want our kids to have everything they possibly need,” says Palfrey. And there is the plump baby factor as well. There has long been the perception, says Palfrey, that if your child looked like the pudgy happy Gerber baby, “you were doing great.”
You may be putting your children in danger, instead. Dr. Elsie Taveras, an assistant professor of population medicine and pediatrics at Harvard Medical School, found that babies who gain weight rapidly in the first six months of life are at a higher risk for obesity at age 3. “A lot of families think that weight gain early on is just baby fat and it’s going to go away,” says Taveras. Plump babies may well slim out, which is why pediatricians aren’t necessarily worried, either. But when a baby who gains excessively turns into an obese toddler, he may be on track to become an obese adult, too. Unfortunately, pediatricians often sidestep the issue in the very young, says Taveras. “We don’t want to label children too early or we don’t know what to do,” she says.
This could lead to a delay in pinpointing a problem early on and allow an ongoing perception among parents that everything is fine. Even when children become preschoolers, most parents are unable to identify their weight problems, according to a study published in early June inClinical Pediatrics. Lead author Dr. Raquel Hernandez, an assistant professor of pediatrics at the University of South Florida, found that almost three quarters of parents thought their overweight or obese toddler (between the ages of 2 and 5) was a healthy weight. Most alarming: when asked to point to a sketch most resembling their child’s weight (seven body images were presented, ranging from very slim to obese), 20 percent of parents of overweight or obese kids pointed to a body image that was actually lighter than a healthy weight.
Measuring a child’s BMI routinely can help identify unhealthy weight gain early; the American Academy of Pediatrics recommends doctors start taking these measurements at age 2. But tracking numbers isn’t enough. Pediatricians must also be more forthright about discussing a child’s weight with her parents, says Hernandez. In her study, only 7 percent of parents recalled ever being told that their child was gaining weight too fast or was overweight. And yet, when a pediatrician did raise a concern, parents were much less likely to misperceive reality. Bottom line: doctors, your patients are listening. It’s never too soon to start educating them.
A National Institutes of Health sponsored school-based, healthy living intervention did not significantly reduce obesity in high risk middle-school children, researchers have found.
But while the HEALTHY Study missed its primary endpoint of reducing combined rates of overweight and obesity compared with control schools, the intervention significantly reduced other measures of adiposity compared with controls, according to Gary D. Foster, PhD, of Temple University, and colleagues.
They reported their findings online in the New England Journal of Medicine and at a session during the American Diabetes Association meeting here.
“Surprisingly, to us at least, that means control schools in which no intervention happened reduced their rates of combined overweight and obesity,” Foster said during a press briefing. “It did, however, produce a nearly significant reduction — about 2% — in rates of obesity, and indeed a significant reduction in BMI z-score, waist circumference, and insulin resistance.”
Data indicate that 16% of children ages 6 to 19 are overweight and 19% are obese, with higher rates in minority groups. With that excess weight comes the risk of type 2 diabetes.
Since schools have so much contact time with children, they provide a suitable environment for interventions, researchers say.
For that reason, a school-based program seemed the intuitive solution for combating childhood obesity and its concurrent health risks.
The HEALTHY Study was conducted in 42 schools totaling 4,603 students. For schools to be eligible, at least 50% of children had to be black or Hispanic, or at least 50% had to be eligible for free or reduced-price lunch. Such children are considered high risk for obesity and type 2 diabetes.
The intervention consisted of four components: nutrition, physical activity, behavioral knowledge, and communications. Nutrition targeted school food quality, while time devoted to physical education was increased.
The education component consisted of teaching self-awareness and behavioral skills such as goal-setting, while communications such as newsletters attempted to hold kids’ interest in the program. All the children knew they were participating in the HEALTHY Study.
Their mean age was about 11 years, and 54.2% were Hispanic and 18% were black. Just over half of the students were girls.
At the beginning of sixth grade and at the end of 8th grade, students had measurements of body mass index (BMI), waist circumference, and fasting glucose and insulin levels.
The primary outcome was a decrease in the combined prevalence of overweight and obesity.
By the end of the study, the researchers found no significant difference in this primary outcome between intervention schools and control schools.
Both groups reduced the prevalence of overweight and obesity –- by 4.5% in the intervention group and 4% in the intervention group.
“This signals potentially good news,” Foster said. “Rates of obesity among high-risk children … appear to be declining.”
Cynthia Ogden, PhD, of the CDC, said during the briefing that there has been a leveling off of childhood obesity within the last few years, after a rapid increase in the early 1990s, which may signal that public health messages about the importance of health have been working.
In the study, there was, however, a nearly significant reduction in the prevalence of obesity in the intervention schools. These children had 19% lower risk of being obese at the end of the study than did those in the control group (95% CI 0.66 to 1.00,P=0.05). “It would have required a P value of less than 0.05 to reach significance,” Foster said.
Also, those in the intervention had significantly greater reductions in secondary outcomes of BMI z-scores and percentage of students with waist circumference at or above 90th percentile (P=0.04).
There was no difference in mean plasma glucose levels or in the percentage of students who had glucose levels of 100 mg/dL or higher by the end of the study.
Also, both groups had increases in fasting insulin levels between the beginning of 6th grade and the end of 8th grade.
But those in the intervention had significantly lower mean insulin than did students in the control schools (P=0.04).
Philip S. Zeitler, MD, PhD, of the University of Colorado in Denver, who was not involved in the study, said during the press briefing that the changes in measures of adiposity signal an “important suggestion that we’ve decreased diabetes risk at a time when that risk is rising steeply.”
He added that the intervention “is likely to have had substantial effects on the [obese] children who are at high diabetes risk.”
]]>
Los Angeles Times, Sharon Bernstein, June 23, 2010
Weeks after a Silicon Valley county in California became the first in the nation to ban toys from McDonald’s Happy Meals and other food promotions aimed at children, a public health watchdog group called on the fast food giant to remove the playthings from all its meal packages.
Citing toys aimed at promoting the latest “Shrek” movie, the Center for Science in the Public Interest said that the plastic promotions lure children into McDonald’s restaurants where they are then likely to order food that is too high in calories, fat and salt.
The organization on Tuesday served the fast food giant with a letter expressing its intent to sue if toys are not removed. The letter is legally required in several states before lawsuits can be brought under consumer protection statutes.
“McDonald’s is the stranger in the playground handing out candy to children,” Stephen Gardner, litigation director for the advocacy group said in a statement. “McDonald’s use of toys undercuts parental authority and exploits young children’s developmental immaturity.”
McDonald’s disagreed strongly with that characterization, saying that its meals were “right-sized for kids” and that it offered healthful choices. Toys, said spokesman William Whitman, are “just one part of a fun, family experience at McDonald’s.”
The chain’s menu now includes the option of apple slices instead of French fries, he said. And children can order milk or juice with their Happy Meals rather than soda. Since the apple slices, called “Apple Dippers” by the company because they include a caramel sauce for dipping, were introduced in 2008, customers have ordered them more than 100 million times in the U.S., Whitman said.
In April, Santa Clara County, California, supervisors won praise from nutrition advocates but ridicule from many conservatives when they voted to ban toy promotions from fast food meals sold in unincorporated parts of the county. The supervisors gave fast food chains 90 days to voluntarily comply before the ordinance became effective.
Opponents of toys in fast food meals say the promotions are feeding the nation’s obesity epidemic by making unhealthy food seem more desirable to children. But the food industry says that healthier choices are now available to children — and urges parents to take responsibility for what their kids order.
via McDonald’s faces lawsuit over Happy Meals – latimes.com.
]]>
Teeth riddled with cavities could point to other health problems. Among children ages 2 to 5, poor nutrition may be a common thread connecting obesity and tooth decay, a new study finds.
Dental decay in young kids could point to bad nutrition and a higher BMI.
Researchers found that 28 percent of young children who required anesthesia to treat their cavities — either because of the seriousness of the decay or their lack of cooperation — had a BMI indicating they were overweight or obese.
For comparison, data gathered from the National Health and Nutrition Examination Survey a few years back suggests that 21 percent of children from the same age group are overweight or obese.
In the study, presented Tuesday at the annual meeting of the Endocrine Society, 65 children fasted for 8 to 12 hours before their procedures. While the children were getting their teeth fixed, their parents filled out questionnaires about the kids eating habits. The work hasn’t been published in a peer-reviewed journal.
Dr. Kathleen Bethin, a pediatrician at the University of Buffalo who was the lead author of the study, says previous research clashed about a possible association. But she says what makes her research unique was that it looks at kids who were treated in the operating room — as opposed to outpatient dental clinics.
“I think that our data more strongly suggests that there may be an association — that kids with worse dental decay may have bad nutrition and may be fatter,” Bethin tells Shots.
These findings, Bethin says, indicate the dentists office is a good place to talk about nutrition and obesity risk.
One finding that surprised Bethin: There was no difference in total calories consumed by overweight and healthy-weight kids in her study. Thats despite the fact that 71 percent of kids in the study consumed more calories than normal for their age group.
“I had predicted that the overweight kids would have higher calories,” she says. She adds it could be that overweight kids are exercising less or have higher-fat diets. She also said parents of overweight children might think their kids are eating less than they are.
Bethin says the study underscores the importance of teaching young children healthy eating habits — for their teeth and their waistlines.
via Poor Nutrition In Kids Could Tie Obesity And Cavities : NPR.
]]>
Houston Chronicle, Cindy George, June 15, 2010
Pediatricians could save some kids from a lifetime of obesity if they were willing to have uncomfortable, but necessary, conversations with parents of overweight infants, new research shows.
That’s because obesity can be diagnosed as early as 6 months, according to a recent University of Texas Medical Branch at Galveston analysis published online in the Journal of Pediatrics.
Researchers found that 16 percent of 6-month-olds treated at the UTMB pediatric clinic were obese and those children had a greater chance of being overweight 2-year-olds. Still, only a small fraction of the heavy youngsters — just 14 to 23 percent — were ever diagnosed as overweight during checkups.
Childhood obesity is a national crisis on the forefront of the White House health agenda, but there’s been little research and attention to overweight infants. In fact, parents were more likely to receive counseling and careful follow-up for underweight babies, the analysis revealed.
“We looked at the medical records and the doctors were dealing with all the other well-child stuff … such as safety, nutrition and what to do if your child is sick,” said Dr. David McCormick, a veteran pediatrician and the study’s lead researcher. “Up until now, we really haven’t seen it as a problem in children 6 months or younger — as a problem that we need to deal with at birth.”
Those irresistible rolls of baby fat and chubby cheeks appear to foreshadow a toddler who’s too heavy. That baby has an increased chance of an overweight childhood and is prone to lifelong health problems, evidence shows.
Looks alone don’t tell the tale. That’s because each baby is evaluated by a weight-to-length measurement, then compared to other kids to determine the child’s percentile.
52% of Hispanic infants
High marks on the baby growth chart aren’t necessarily a good thing. The UTMB study focused on babies considered obese — at or beyond the 95th percentile — who visited the clinic from April 2005 through December 2007.
Researchers found no statistical difference in infant obesity by breastfeeding history or family financial status, but half of Hispanic infants — 52 percent — were obese, compared with one-third of others.
Amy Partida had no clue her 17-month-old, Ayden Campos, was too heavy until his clinic appointment last week.
“They said he was a little bit overweight but he doesn’t look like it,” said Partida, 27, a Texas City mother of three. “I guess by the chart he’s overweight.”
The analysis of UTMB pediatric records along with the mothers’ obstetrical and gynecological history showed that the problem begins before birth.
“We went back to the mothers’ OB/GYN records and found out that there was a high percentage of mothers that gained excessive weight during pregnancy and the babies were large for gestational age, which means they were overweight when they were born,” McCormick said.
A little bit can be a lot
According to the UTMB report, slight differences add up.
Overweight 2-year-olds were an average 2 pounds heavier and one-third-inch longer at 6 months than their non-obese peers. At their 2-year-old checkups, the heavier children weighed an average 5 pounds more and were two-thirds of an inch longer.
Mothers of the overweight children gained an average 15 more pounds during pregnancy than women who delivered children who weren’t obese at age 2.
McCormick suggests baby doctors confront childhood obesity early and encourage mothers to breastfeed exclusively.
“We can give instruction on nutrition, we can have them wait a little longer to introduce solid food and we can limit the amount of milk they can take,” he said.
Other area children’s health experts agreed that closely monitoring a child’s intake and nutrition will reduce the number of obese babies.
Dr. Johnnie Frazier, a pediatrician with the University of Texas Medical School at Houston, said mothers often arrived for well-child checkups with purses full of “juice boxes, chips and other high-density caloric foods for snacks.”
She recommends breastfed infants receive no other food additives until they’re at least 6 to 8 months old. Other infants should stay exclusively on formula until 6 months. No juice or water is needed.
Ayden’s mom said she started adding cereal to his milk when he was 6 months old.
Now she has started a tough new ritual with him: No bottle at bedtime.
]]>