Prevention Matters

The defeat of the Johanns Amendment was named the “Best News for Prevention” while the report showing that Americans are not eating enough fruits and veggies was named the “Worst News for Prevention.”

BEST

Senate Defeats Effort to Eliminate Prevention and Public Health Investment Fund

On a procedural vote of 46 to 52, the Senate today defeated an effort to eliminate the Prevention and Public Health investment fund; one of the signature initiatives Partnership and other prevention advocates worked to include in the recently passed health reform legislation.

“We are grateful the Senate has affirmed the value of investing in evidence-based programs to help individuals and families live healthier lives. The passage of health reform represented an important compact with the American people to transform our current sick care system into a health care system that places value on keeping people healthy,” said Robert J. Gould, President and CEO of Partnership for Prevention.

The Johanns (R-NE) Amendment was offered to HR 5297, the “Small Business Jobs and Credit Act.” The amendment proposed to offset the costs of eliminating a tax code reporting requirement by eliminating funding Congress reserved to support community-based programs to reduce chronic disease rates, address health disparities and strengthen the “evidence-base for effective prevention programming.” Had the amendment passed, over $10 billion in prevention funding would have been cut from vital public health and prevention programs.


WORST

Americans still skipping fruits, veggies


Most Americans still don't eat vegetables often enough, and fruit consumption is actually dropping a little, according to a new government report released Thursday.

The Centers for Disease Control and Prevention found that last year about one-third of U.S. adults consumed fruit or fruit juice at least twice a day. That's down slightly from more than 34 percent in 2000.

Only about 26 percent ate vegetables three or more times a day, the same as in 2000. The statistics come from a national telephone survey of hundreds of thousands of Americans..


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

President Barack Obama issued a Proclamation from the White House earlier this month declaring September “National Childhood Obesity Awareness Month.” He said childhood obesity was a national crisis “with nearly one in every three of America's children being overweight or obese” and noted that obesity affects children in every state, that “particular racial and ethnic groups are more severely impacted” and that “obesity can be influenced by a number of environmental and behavioral factors, including unhealthy eating patterns and too little physical activity at home and at school.”

The President acknowledged that more must be done “to halt and reverse this epidemic, as obesity can lead to severe and chronic health problems during childhood, adolescence and adulthood, including heart disease, diabetes, cancer, and asthma.” Nearly $150 billion is spent annually on obesity-related medical conditions. “This is not the future” he added “to which we want to consign our children, and it is a burden our health care system cannot bear.

Partnership believes the Proclamation is a timely and important opportunity to remind Americans of the goals and accomplishments of the First Lady’s "Let's Move!" initiative to combat childhood obesity. “Let’s Move” is an historic public health campaign guided by the recommendations of a Task Force on Childhood Obesity which was charged with review of all programs and policies relating to child nutrition and physical activity and development of a national action plan to maximize federal resources and set concrete benchmarks that can end childhood obesity in a generation. The Task Force has produced a report containing a comprehensive set of recommendations and “strategies to address childhood obesity, including providing healthier food in schools, ensuring access to healthy affordable food, increasing opportunities for physical activity, empowering parents and caregivers with better information about making healthy choices, and giving children a healthy start in life.”

Reducing the incidence of childhood obesity will not be easy or quick. While this crisis has been building for three decades growing awareness and resolve across all sectors of our country provide hope that the President’s goal of reducing childhood obesity to 5% by the year 2030 is achievable.

“Our history shows that when we are united in our convictions, we can safeguard the health and safety of America's children for generations to come. When waves of American children were stricken with polio and disabled for life, we developed a nationwide immunization program that eradicated this crippling disease from our shores within a matter of decades. When we discovered that children were going to school hungry because their families could not afford nutritious meals, we created the National School Lunch Program. Today, this program feeds more than 30 million American children, often at little or no charge. When we work together, we can overcome any obstacle and protect our Nation's most precious resource -- our children. As we take steps to turn around the epidemic of childhood obesity, I am confident that we will solve this problem together, and that we will solve it in a generation.

Partnership for Prevention, the Congressional Prevention Caucus and the Preventive Cardiovascular Nurses Association are sponsoring two Capitol Hill briefings on September 21 to broaden the awareness of legislators and congressional staff about the threat childhood obesity poses to our nation. The briefings, “Eliminating Childhood Obesity: Developing National Consensus on a Prescription for Change” will include presentations by some of the nation’s most distinguished medical leaders including:

Ursula Bauer, PhD, Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention

Joe Thompson, MD, MPH, Surgeon General for the State of Arkansas and Director of the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity

Laura Hayman, PhD, RN, Associate Dean for Research and Professor of Nursing in the College of Nursing and Health Sciences, University of Massachusetts, Boston

These briefings are open to the public. Anyone interested in attending can send their contact information and indicate whether they will attend the House or Senate briefing to meetings@prevent.org

Doctors in Massachusetts prescribing produce to their patients as a way to fight childhood overweight was named the “Best News for Prevention” while hands-free headsets are proven to be no safer than holding the cell phone while driving was named the “Worst News for Prevention.”

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best/Worst News for Prevention” polls are snapshots taken during a brief period of time that reflect the views of Partnership for Prevention staff. The polls are not designed or intended to reflect a statistically valid representation of the population and should not be used as such. More information is available at http://www.prevent.org/.


BEST

Eat an Apple (Doctor’s Orders)

The farm stand is becoming the new apothecary, dispensing apples — not to mention artichokes, asparagus and arugula — to fill a novel kind of prescription.

Doctors at three health centers in Massachusetts have begun advising patients to eat “prescription produce” from local farmers’ markets, in an effort to fight obesity in children of low-income families. Now they will give coupons amounting to $1 a day for each member of a patient’s family to promote healthy meals.

“A lot of these kids have a very limited range of fruits and vegetables that are acceptable and familiar to them. Potentially, they will try more,” said Dr. Suki Tepperberg, a family physician at Codman Square Health Center in Dorchester, one of the program sites. “The goal is to get them to increase their consumption of fruit and vegetables by one serving a day."

WORST

Hands-Free Headsets Aren't Safer for Drivers Than Holding Cell Phone


Ditch the phone if you drive. That's the bottom line of a new study that found using hands-free headsets while driving doesn't result in fewer accidents, echoing the results of many previous studies.

''When you are on the phone, you are only using part of your brain to drive," says researcher David Schwebel, PhD, vice-chair and professor of psychology at the University of Alabama, Birmingham, who presented the findings today at the annual meeting of the American Psychological Association in San Diego.

''My advice is not to talk on the phone while you are driving, ever," he says.

As a nation we are concerned about childhood/adolescent obesity and overweight, yet state and district-level policies regarding physical education, physical activity, and nutrition are significantly lacking, especially at the middle and high school level. Students at the middle and high school level have the highest rates of obesity among all children and adolescents. Judging by these facts, you would think that more state- and district-level policies would be in place to help counter the growing obesity epidemic among this age-group. However, a recent publication by the National Association of State Boards of Education (NASBE) titled “Obesity Prevention for Middle and High Schools: Are We Doing Enough?,” reviewed state-level and district-level policies regarding physical activity and nutrition and found a strong paradox: “while adolescents have the highest rates of obesity, are the least physically active, and consume more junk food and sugary beverages, both state- and district-level policies addressing these issues in the school environment are often more frequent and restrictive at the elementary level. In addition, in many areas, policies are simply not addressing critical components of school nutrition and physical activity at any level.”

The 2008 Physical Activity Guidelines for Americans recommends that children and adolescents obtain at least 30 minutes of the required 60 minutes per day of physical activity at school. Despite this guideline, NASBE’s survey found that only three states required time in minutes outside of physical education, only 20% of states had a required time and/or frequency for physical education at the high school level, and only 34% of states requiring physical education at the middle school level had a time frequency requirement. In addition, no states and only 8% of districts had a high school requirement for a percentage of class time to be spent in moderate-to-vigorous physical activity and only 6% of states and 9% of districts had this requirement at a middle school level. Finally, 82% of states had a high school physical education requirement but 28% of these states had liberal exemption policies.

Regarding nutrition, only three states had policies which aimed at increasing access to fruits and vegetables at the middle and high school level and only three states had a policy restricting food marketing. In addition, only 22% of states required nutrition standards limiting fats, sugar, calories, and/or portion sizes in middle and high schools. 38% of states and 49% of districts had nutrition standard policies in high schools, 46% of states and 51% of districts had these standards in middle schools, and 50% of states had these standards in elementary schools. Finally, only three states and 2% of districts had policies at the middle and high school levels that prohibited all sodas (both regular and diet) and all other sugar-sweetened beverages and 30% of states only prohibited regular sugar-sweetened sodas.

All this data brings up one major question: Why aren’t states and districts pushing for more frequent and stronger policies regarding physical activity and nutrition? After all, we have a growing epidemic on our hands and children and adolescents are at the heart of it. Currently, an estimated 34% of adolescents are overweight or obese and this trend is only increasing. If widespread policies are not adopted soon these overweight children and adolescents will become overweight or obese adults, threatened by preventable chronic diseases since “overweight adolescents have a 70% chance of becoming overweight or obese adults.” While it is true that middle and high schools have many demands including increasing overall student achievement and decreasing drop-out rates, this does not mean that physical activity and nutrition should fall by the wayside. By placing physical activity and nutrition at the bottom of the priority list, schools may in fact be negatively affecting the overall success of their students since “overweight and obese students are more likely to have greater rates of absenteeism and experience more bullying and teasing, which may affect their academic performance and achievement.”

So, are we actually doing enough?

The answer is No. Policies and programs addressing middle and high schools need to be more frequent, more restrictive, and required rather than merely suggested. The promotion of physical activity and nutrition needs to be widespread at all school levels: elementary, middle, and high school. We may gasp at the obesity problem and encourage children and adolescents to exercise and eat healthfully, but if our policies do not match our message then we are failing the students we intend to serve.

Note: All direct quotes come from NASBE’s May 2010 publication, “Obesity Prevention for Middle and High Schools: Are We Doing Enough?” which can be found here.

Kathryn Burggraf
Tobacco Control Intern
Partnership for Prevention

Mayor Michael R. Bloomberg, Deputy Mayor for Health and Human Services Linda I. Gibbs and Health Commissioner Dr. Thomas A. Farley announced the first 16 companies to formally commit to the National Salt Reduction Initiative – a public-private partnership created to reduce Americans’ salt consumption by 20% over five years. New York City began coordinating this voluntary effort two years ago. The National Salt Reduction Initiative partnership now includes 18 national health organizations; 29 cities, states and related entities; and some of the nation’s leading food companies, including: Au Bon Pain, Boar’s Head, FreshDirect, Goya, Hain Celestial, Heinz, Kraft, LiDestri, Mars Food, McCain Foods, Red Gold, Starbucks, Subway, Unilever, Uno Chicago Grill and White Rose.

According to Dr. Robert J. Gould, Partnership’s CEO, “I commend Mayor Bloomberg and the NYC Department of Health for their leadership on this vital public health issue. Over the past 30-40 years the consumption of sodium in the diet has increased to levels that have alarmed clinicians and the public health community. 77% of the sodium in our diets come from processed and restaurant foods. The commitment and national leadership of Mars Foods and other companies to promote public health by reducing the sodium levels of their products is a positive example that other food manufacturers should quickly follow.”

Americans consume roughly twice the recommended limit of salt each day. The sodium in salt is a major contributor to high blood pressure, which in turn causes heart attack and stroke, the nation’s leading causes of preventable death.

Last week, the Institute of Medicine released a report stressing the urgent need to reduce sodium intake in the United States. The report recommends that the U.S. Food and Drug Administration use its regulatory authority to reduce salt in the nation’s food supply, but it also notes that public-private partnerships can “achieve meaningful reductions in sodium intake prior to the implementation of mandatory standards.”

On April 22, Darwin Labarthe, MD, MPH, PhD, Director of the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention, told a briefing of the Congressional Prevention Caucus that “the current level of sodium added to the food supply—by food manufacturers, foodservice operators, and restaurants—is simply too high to be “safe” for consumers. Reducing the sodium content of processed foods is a necessary and urgent public health strategy for reducing blood pressure and preventing hypertension, heart disease, stroke, and other cardiovascular diseases. The time is now.”

William Tatum
Director of Membership
Partnership for Prevention

The study showing that giving flu shots to children protects a whole community from disease was named the “Best Prevention Idea of the Week,” while pregnant women skimping on fruit and vegetables and gaining too much weight has been named the “Worst Prevention Idea of the Week.”

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

Flu Shots in Children Can Help Community

An unusual study done in 49 remote Hutterite farming colonies in western Canada has provided the surest proof yet that giving flu shots to schoolchildren protects a whole community from the disease. Although previous studies have demonstrated what scientists call “herd immunity,” none have been so incontrovertible, because they were done in less isolated places with more sources of flu passing through. Also, only one other study, done 42 years ago, immunized over 80 percent of a community’s children, as this one did. Success repeated in many separate communities with very high vaccination rates implies that the shots themselves — rather than luck, viral mutations, hand-washing or any other factor — were the crucial protective element.

WORST

Pregnant Women Falling Short On Nutrition

Pregnant women are skimping on fruit and vegetables and gaining too much weight, according to a new Australian study. The research, in the journal Nutrition & Dietetics published by Wiley-Blackwell, found that expectant mothers are eating less than half the recommended servings of fruit and vegetables. And at least one in three put on more than the recommended weight gain for pregnancy.

A new study published online by the Journal Pediatrics (PDF), takes a first-ever look at the prevalence of food brand placements in popular motion pictures and finds a veritable cornucopia. The Dartmouth Medical School analysis of 200 top box office movie hits that appeared in theaters between 1996 to 2005 yielded a bounty of product placements, mostly for "brands that represent energy-dense, nutrient-poor products and/or product lines."

Researchers identified a total of 1,180 brand placements, including 427 food, 425 beverage, and 328 food retail establishment brand placements. Candy/confections (26%) and salty snacks (21%) were the most prevalent food brands, sugar-sweetened beverages (76%) were the most prevalent beverage brands, and fast food comprised two thirds of the food retail establishment brand placements.

Drinking as little as two soft drinks a week appears to nearly double the risk of getting pancreatic cancer, according to a new study. ''People who drank two or more soft drinks a week had an 87% increased risk -- or nearly twice the risk -- of pancreatic cancer compared to individuals consuming no soft drinks," says study lead author Noel T. Mueller, MPH, a research associate at the Cancer Control Program at Georgetown University Medical Center, Washington, D.C. The study is published in Cancer Epidemiology, Biomarkers& Prevention, a journal of the American Association for Cancer Research. The beverage industry took strong exception to the study, calling it flawed and pointing to other research that has found no association between soda consumption and pancreatic cancer.

The U.S. Department of Health and Human Services (HHS) has awarded more than $119 million to states and U.S. territories to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking-the four most important actions for combating chronic diseases and promoting health. This money supports the one of several components in the Department's comprehensive prevention and wellness initiative, Communities Putting Prevention to Work, which is funded under the American Recovery and Reinvestment Act of 2009.

If there were no advertising of unhealthy food on US television, between one in seven and one in three obese American children might not be obese, according a new study in the European Journal of Public Health.

"Limiting the exposure of children to marketing of energy-dense food could be part of a broader effort to make children’s diets healthier, said the study's authors, who built a mathematical simulation model to estimate the potential effects of reducing the exposure of 6- to 12-year-old US children to TV advertising for food on the prevalence of overweight and obesity.

The model was based on body measurements from NHANES 2003–04, the CDC-2000 cut-offs for weight categories, and scientific literature that relates advertising to consumption levels and consumption to body mass.

Oklahoma’s new plan to improve the state’s health system has been named  Partnership for Prevention’s “Best Prevention Idea of the Week,” while school lunches that don’t meet the quality or safety standards of many fast-food restaurants was named “Worst Prevention Idea of the Week.”

The New York City Department of Health and Hygiene raised a lot of eyebrows last summer with a subway advertisement that showed a soda bottle pouring globs of human fat into a drinking glass. The intent was to  shock New Yorkers into choosing low calorie beverages over soda and sweetened juices.

General Mills plans to reduce the sugar content in cereals that it markets to children. The company will reduce the sugar content of 10 of its cereals to 11 grams or less per serving. Previously, General Mills has made efforts to reduce sugar in several of its cereals, some by as much as 20 percent, and now fortifies all of its children's cereals with vitamin D and calcium. All of General Mills cereals also now provide eight grams of whole grains or more per serving.

According to HealthDay, the move is part of an industry-wide response to complaints from consumers, health experts and federal regulators regarding the nutritional content of foods marketed to children.

Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University, says that "the reduction ... doesn't represent perfection but it represents improvement." He says children "deserve to be marketed products that are healthier to them than what is being marketed now"

WSJ Health Blogger Jacob Goldstein reports that a little-noticed provision in the health reform bill in both the House (p. 1,515) and Senate (p. 1,233) would require vending machines to display calorie counts for the food they dispense.
The requirement, which wouldn’t apply for people who own fewer than 20 vending machines, is part of sections in both bills that would also require chain restaurants to post calorie counts.

A Missouri program whose healthy snacks for low-income students has improved their academic performance has been named Partnership for Prevention’s “Best Prevention Idea of the Week,” while a misfire by the gun lobby regarding health reform was named “Worst Prevention Idea of the Week.”

“BackSnack" Program Improves Students’ Academic Performance, Behavior
http://www.harvesters.org/WhoWeAre/Index.asp?Reference=BackSnack&~=



WORST

Gun Lobby Attack on Health Care Reform Misfires
http://tpmdc.talkingpointsmemo.com/2009/11/white-house-takes-on-gun-lobbys-health-care-reform-attacks.php

People living in "healthy neighborhoods" that provide easy opportunities for exercise and healthy eating were less likely to be diagnosed with type 2 diabetes in a five-year cohort study, after controlling for such factors as age, income, race, and education. "The strength of the association was considerable and equivalent to a reduction in type 2 diabetes incidence associated with a BMI of 5 [points] lower in this sample," Amy Auchincloss, PhD, MPH, of Drexel University in Philadelphia, and colleagues wrote in the Oct. 12 Archives of Internal Medicine. The analysis covered participants in Baltimore, the Bronx borough of New York City, and the North Carolina county that includes Winston-Salem.

An ordinance to restrict fast-food chain restaurants in South Los Angeles is unlikely to cut obesity, say researchers at Rand Health. In a study published in Health Affairs, the researchers found that the South Los Angeles region has no more fast-food chain establishments on a per capita basis than other parts of the city, but rather many more small food stores and other food outlets. They said these small food stores and outlets are more likely to be the source of high-calorie snacks and soda consumed substantially more often by residents of South Los Angeles as compared to other parts of the city.

U.S. schools have cut back on certain "less nutritious" foods and drinks, the CDC reports. The CDC today released new survey data on the percentage of students in public secondary schools who cannot buy candy, salty snacks, fruit drinks that aren't 100% juice, sports drinks, and soda at school.
The percentage of students who couldn't buy candy or salty snacks increased in the 40 states that participated in the survey, from 46% in 2002 to 64% in 2008. The percentage of secondary school students who couldn't buy soft drinks at school rose in all 34 states that tracked that from 2006 to 2008, while 23 of those states have also nixed sales of sports drinks to students.

Mississippi and Tennessee -- home to some of the nation's highest rates of adult obesity -- made the biggest gains in the percentage of secondary school students who can't buy candy, salty snacks, and soft drinks at school.

The Robert Wood Johnson Foundation has published research on efforts by California school districts to encourage healthy eating and physical fitness among its students.


Findings from online surveys and focus groups, as well as interviews with school board members, leaders of state associations of school boards, state directors of nutrition and school wellness advocates
identified the following as the most significant barriers to effective school wellness policies:

• Inadequate funding, such as for staff and facilities, to implement and monitor a policy.
• Competing priorities and lack of time.
• Lack of support from students, parents and the community.
• A need for tools and training.

New York City's City Planning Commission unanimously approved a proposal to encourage the establishment of new supermarkets in areas where fresh produce is scarce and where poverty, obesity and diabetes run high. As described by the New York Times' Diane Cardwell, the proposal would offer zoning and tax incentives to spur the development of full-service grocery stores that devote a certain amount of space to fresh produce, meats, dairy and other perishables.