Task Force Releases Report on Childhood Obesity

To rollback childhood obesity in one generation.

Ambitious goal - to get the prevalence of childhood obesity down to 5% by 2030. No society has ever succeeded in undertaking such an enormous task - one that is complicated by deeply ingrained norms around diet and exercise, a well-financed commercial industry (not only fast/junk food, but also when it comes to diet and weight loss), and a general distrust of government-led initiatives.

The White House Task Force on Childhood Obesity released its report (commissioned by President Obama on February 9, 2010) and it combines the best evidence for tackling weight gain among our nation's kids.

It quickly lays out the facts: our children are fatter than ever and it is impacting their health.

Allentown High School Student Wins Top Public Health Honors!

Two girls from *near* my hometown in Pennsylvania won top honors from the Robert Wood Johnson Foundation in the YES Competition for high school students.

According to the news release,

"Shoshanna Goldin, a 17-year-old student at Moravian Academy in Bethlehem, Pennsylvania, won for her research project entitled, Energy Epidemic: Teen Perception and Consumption of Energy Drinks."

Not only is she interested in public health, but also the epidemic of obesity. Overconsumption of energy (i.e. calories) is what leads to obesity, right?!

Way to go Shoshanna!

Jamie Oliver (Naked Chef) Takes on Child Obesity at Ted

Jamie Oliver gives a Ted Prize speech on childhood obesity at the Ted Conference in southern California. He believes that the food reality in America is awful and that action must be taken.  Oliver is a food ambassador that commands attention, even of our nations tech leaders!

This is not a research presentation; it's a passionate, moving talk on the realities of death and the TRUE costs of a poor food culture.

Let's Move! ...to Prevent Childhood Obesity

It's no surprise that childhood obesity is drawing more public attention than ever before. Evidence is growing on the ill-effects and complicated origins of childhood obesity, making inaction impossible both for public health programs and politicians.

We can prevent childhood obesity. And that's precisely what the White House initiative, Let's Move!, intends to do.

Slimming Down School Milk: Did it have an impact?

Schools are getting smart and thinking more about where kids are getting their calories from in school. With childhood obesity continuing to rise (even though adult obesity seems to have slowed down), the implementation of sound school wellness policies is imperative to curbing unhealthy habit forming behaviors in kids' lives.

There is not a ton of data on how school nutrition policies have impacted student health or changed children's consumption of certain foods. (Though if you're interested, I've done a ton of research in this area on sugar-sweetened beverages). But now we have data on one common policy: switching school cafeterias over to serving kids lower-fat milk (1% or fat-free).

Have American Waistlines Stopped Growing?

Pam Belluck of the New York Times reported today that obesity rates have been seen to stabilize (for some groups like blacks and whites, but not Mexican-Americans) over the past 5 years. I've heard this data in several classes, and it does appear to be true. But this shouldn't be taken to mean that obesity rates are declining -- they certainly are not.

What puzzles me and other obesity researchers is: Why?

Leisure Time in Bavaria -- Germany, that is.

Snow capped mountains and miles of farmland lined the streets and highways on my way through the Bavarian Alps last week. I was on a vacation with my family in southern Germany where we spent a few days in Stuttgart and a few more in Garmisch with family who have lived there for the past six years.

What struck me most during my days was not least the cold but that despite the cold if you walked anywhere you saw at least a dozen Germans walking outside, as well.

Top 3 Public Health News of 2009

This year public health undeniably became a part of our national consciousness. In order to ring in the New Year and reflect on the past year at Veritas Health, I've highlighted below what I believe to be the top three issues in public health of 2009. For those interested, the headlines link to my previous posts on the topic.

Is "Healthier" Healthy Enough for School Vending?

Early on a Tuesday morning, while walking the halls of Winter Hill Elementary School in Somerville, Massachusetts, I was struck by the absence of an item that has become nearly ubiquitous in schools across Massachusetts: vending machines. Vending machines are the most convenient source of exactly what you tell your kids not to eat.

Debunking American Nutrition Myths

Darya Pino of Summer Tomato (an amazing blog with lots of health and nutrition information) promoted this video. It's amazing -- Dr. Lustig of UC San Francisco debunks popular nutrition myths, particularly related to sugar consumption by tying together the science of public health, nutrition, and biochemistry.



Hope you enjoy!

Going to the Park? Walk or Bike!

Just in case you need a little nudge to ride your bike to work or walk to get groceries here's further evidence that "active" transit (i.e. walking or biking to get somewhere) is associated with better health. In the latest American Journal of Preventive Medicine one year of data was taken from a 20-year follow-up study to assess whether walking or cycling compared to only using a car to get around was associated with Body Mass Index (BMI), waist circumference, and fitness.

Low-Fat Diet Disaster

Saturated fat has historically been the "number one enemy" of dietitians and nutritionists. For decades, popular thought was that the most effective way to lose weight or to prevent weight gain was to eat a diet low in fat. This approach to weight loss and management has had disastrous consequences; however, because of its subsequent timing with the explosion of refined carbohydrates (as opposed to whole grain foods) and sugary beverages.

Indeed, there is little, if no, evidence that eating a diet low in fat will result in weight loss in the long-term. We discussed eating patterns, such as a low-fat diet, in a class I am taking this semester on Obesity Epidemiology with Frank Hu, author of the book by the same title.  In it, he reviews the most current research on the causes of obesity and the health consequences of obesity. Oh, and you thought obesity was itself a disease.

Missing the Health in Health Care Reform

Michael Pollan was preaching to the choir today in his New York Times op-ed piece on "Big Food Vs. Big Insurance." His words were music to my ears:

"...the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained...by our being fatter. ...

That's why our success in bringing health care costs under control ultimately depends on whether Washington can summon the political will to take on and reform a second, even more powerful industry: the food industry."

As excited as I was to hear Obama's rallying cry on health care reform last night, I was disappointed to hear prevention offered as a critical element of reform only one, maybe two, times.  Prevention isn't a sexy or politically inspiring topic, I know. Yet, public health is all about prevention. Public health is about "creating the conditions in which people can be healthy."

The food industry has significantly changed the way Americans (and populations globally) eat. Few countries have been spared. Those that refuse to let huge US-based multinational food manufacturers in, or that limit their reach, have often met much resistance and criticism. Yet, as Barbara Kingsolver would say, these resistant countries are protecting their food culture. They are also consequently protecting their health.

In an effort to get the cheapest, most convenient food we have sacrified quality, nutrition, and health. We have kids in America who are both obese AND malnourished. How have we let that happen?

While I am all in support of health care reform moving forward, it will in no way be a panacea for America's poor health. There are enough players out there who want to profit from sickness, not just the insurance companies. Pollan has brought this to our attention, once again.

Fast Food and Obesity: A Causal Relation??

The New York Times reported on a recent Working Paper that examined changes in obesity among high-school students and excessive weight gain during pregnancy before and after a fast-food outlet opened in several cities across the United States. What did they find? Check out my blog post at Society and Health. 

School Nutrition Programs: Tied to Obesity?

The USDA (US Dept of Agriculture) has stated that there is insufficient evidence to suggest that the public nutrition programs (e.g. food stamps, public school lunches) they oversee are a cause of the obesity epidemic. I commend the USDA for working to improve the nutritional components of its public food programs (which, I believe is in response to evidence that the vast majority of its current food offerings are not very healthy and may in fact lead to excessive weight gain). For instance, the USDA is offering schools more choices such as whole grains, fresh fruits, and lean meats. However, these items are still significantly more expensive than the white, nutrition-less alternatives (white pasta, white bread, muffins, bagels, etc). Additionally, schools can only order a limited quanitiy of the whole-grain items. So when they run out -- they are out for the rest of the month.

There are currently programs in Masschussetts that are working with schools to help them understand the food menu options and train their staff to prepare new items well. For example, anyone who has cooked brown rice knows that it takes a little while longer than white -- and fresh vegetables cook differently than frozen.

Anecdotally, reports are promising that making public lunches nutritious by cutting back the high-sugar, high-salt, high-fat alternatives actually are well received by students. Studies that examine how much of the new nutritious meals are eaten compared to thrown in the trash only to be replaced with sugary soft drinks and soft-baked cookies are currently underway (yes...soft baked cookies were my snack of choice back in high school).

I'm excited to hear how things develop and hope the USDA continues to consider the evidence for providing nutrient-rich foods to low-income children and their families.

Biking for Health

It really was not until we moved to California that I was introduced to a bike culture. Many people we met were committed to traveling by bike; they rode everywhere  - to school, to work, even to sporting events. The roads were wide, the bike lanes were well marked and well maintained (no debris, no dangerous obstacles to maneuver around) and young and old partook in this type of activity. Was it exercise? Yes! Did it necessarily feel like it? No! For many, riding was a lifestyle, not an exercise routine. 

A recent study (reported in the press here) examined modes of transportation across several countries and rates of obesity. Countries where more people walked, cycled, or took mass transit to get around found lower rates of obesity. Obviously this study gives us no insight into why this is the case. While I don't expect that we can just start building bike lanes everywhere and expect communities to up and start riding bikes overnight, I see great promise in each place that I have lived to put in bike lanes to make it easier to get around without needing a car. Especially in the suburbs, where owning a car is assumed to be necessary. 

How do public health professionals, especially in suburban communities, change these transportation norms? What might be the impact for community health? 

R. Shephard provides an excellent article discussing the "active commuting" debate. Another study by scholars in Scotland examined adolescents' walking and biking commuting behaviors (to school, obviously) with regards to distance as a potential barrier. The authors found that adolescents were more likely to walk or bike to school if they lived within 2.5 miles, living farther than that was considered a sufficient barrier to active commuting. I wonder what that threshold would be in active cities in the US. This is a ripe area for future research and public health activity.

U.S. Addictions: High-fructose corn syrup & other artificial sweeteners

Americans have a major sweet tooth. The US has a sugar addiction that is quite unlike most other countries in the world. Rather than using natural sources of sugar minimally, we have increased our consumption of sugar over 250% in the past two decades. An article published in US News & World Report stated "In 2003, each person consumed about 142 pounds of sugar per year. ...[compared to] a dismal 8.3 pounds of broccoli and just over 25 pounds of dark lettuces." Now, this is not in the form of honey, agave nectar, or raw sugar cane. No, most of this is often in the form of highly processed (refined), or artificial sweeteners. One of the most inexpensive and widespread commercially used sugars is high fructose corn syrup (HFCS). 

HFCS is particularly toxic because of its pervasiveness in commercially available foods (ketchup, soup, cookies, crackers, cereal, yogurt, etc.), many of which would be considered "healthy" choices. Please, check your ingredient labels!! Whenever possible, chose an alternative that is made without sugar, or uses natural or minimally processed sugar.

Well, what is so bad about HFCS? ...good question, one I was recently asked...

High-fructose corn syrup has been shown to deplete the amount of chromium in the body. This is dangerous because chromium aids the glucose (sugar) molecules in passing from the bloodstream into the cells. A drop in chromium (like that caused by eating foods containing HFCS) can raise bad (LDL) cholesterol and triglycerides, as well as interfere with immune system functioning. Therefore, not only does it heighten peoples' risk of chronic disease (i.e., heart disease and stroke), but also acute illness (i.e., cold or flu). There are also studies that suggest excess sugar consumption (with HFCS and just generally) may be linked with certain types of cancer.

My general thoughts: the less you consume HFCS in your diet, the better. 

For more information see Mark's blog on the subject.

UPDATE: A good friend reminded me that strong evidence of the impact of HFCS on human health (particularly its effects on overweight/obesity) is relatively scarce. The extent to which HFCS is harmful to one's health is highly controversial and well debated. Yet, I felt a need to address some of the recent advertising from the Corn Refiners Association.  In my opinion, any information equating (or even implying) consuming HFCS with eating actual corn is as silly as equating consuming vegetable oil with eating -actual- vegetables. The statement that there is NO evidence of the effects of consuming substantial quantities of HFCS on health and disease is misguided. Healthful living depends on limiting your intake of refined carbohydrates -- which really means sugar in any of its multiple forms, HFCS being just one of them. If I have a choice between a popsicle made of simple sugar versus HFCS I think I will continue to choose the one made with sugar, better yet, I may choose no popsicle at all!

BlogHer reviews several online sources that examine the role of HFCS on health and wellbeing. I urge those who are more interested in getting information from both sides of the HFCS debate to check it out and make your own -informed- decision!