Prevention Matters

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

Breast-Feeding May Counter Some Effects of Childhood Cancer

Breast-feeding may help reduce some long-term negative side effects of cancer treatment in women who survived childhood cancer, according to a new study.


The findings suggest that making women aware of the benefits of breast-feeding should be part of routine recommendations for a post-cancer healthy lifestyle, said Susan W. Ogg and colleagues from St. Jude Children's Research Hospital in Memphis, Tenn.

WORST

Smoking, Obesity Slowing U.S. Life Expectancy Gains: Report


Longevity isn't increasing as fast in the United States as it is in other developed countries, says a new report that points a finger at high rates of smoking and obesity.


For 25 years, U.S. life expectancy at age 50 has increased, but more slowly than in most of the other 21 countries studied, including Japan and Australia, notes the report from the National Research Council, an arm of the U.S. National Academy of Sciences.


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/.

The bill introduced in California to require schools to provide free drinking water in eating areas was named the “Best News for Prevention” while the new report showing the high price of obesity was named the “Worst News for Prevention.”

BEST

Bill seeks to add free water to school menus

In many California school cafeterias, there's no free water to drink. Surprised?

"Everyone I talked to says, 'You're kidding,' " said state Sen. Mark Leno (D- San Francisco).

Leno has introduced legislation to change that. His bill requiring schools to offer drinking water at no charge to students has passed the Senate and Assembly and awaits the governor's signature — a fairly sure thing because the governor sponsored the bill.

"As we all know, young people are constantly bombarded by advertisements and pressure from their peers to consume junk beverages that are high in calories and sugar. Yet many students do not have access to free, fresh drinking water at lunchtime," Leno said in material promoting his bill.


WORST

Obesity hurts your wallet and your health


Obesity puts a drag on the wallet as well as health, especially for women.

Doctors have long known that medical bills are higher for the obese, but that's only a portion of the real-life costs.

George Washington University researchers added in things like employee sick days, lost productivity, even the need for extra gasoline — and found the annual cost of being obese is $4,879 for a woman and $2,646 for a man.

That's far more than the cost of being merely overweight — $524 for women and $432 for men, concluded the report being released last Tuesday, which analyzed previously published studies to come up with a total.


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/.

A new study in the American Journal of Preventive Medicine showing that the construction of a light-rail system (LRT) resulted in increased physical activity and subsequent weight loss was named the “Best Prevention Idea of the Week,” while the recent report from Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) that 28 US states saw obesity rates increase last year was 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

New Study Finds Public Transit Systems Contribute To Weight Loss and Improved Health

Increasing the availability of public transit systems is one among a number of modifications to the built environment that offers opportunities for increasing physical activity and reducing the prevalence of obesity and its associated problems. In a study published in the August issue of the American Journal of Preventive Medicine, researchers from the University of Pennsylvania, Drexel University and the RAND Corporation found that construction of a light-rail system (LRT) resulted in increased physical activity (walking) and subsequent weight loss by people served by the LRT. These findings suggest that improving neighborhood environments and increasing the public's use of LRT systems could improve health outcomes and potentially impact millions of individuals.

WORST

Adult Obesity Rates Rose in 28 States and Fell in Just One


28 US states saw obesity rates still rising last year, while the only place to experience a decline was the District of Columbia (D.C.), F as in Fat: How Obesity Threatens America's Future 2010, according to a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). In 38 US states more than 25% of the adult population is obese. 19 years ago the number of US states with an obesity rate of over 20% was zero.

The USA has had the highest adult obesity rate in the world for several years.

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

Food companies committing to take 1.5 trillion calories out of their products by 2015 was named the “Best Prevention Idea of the Week,” while teens mistaking smokeless tobacco products for candy was 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

Food makers to trim 1.5 trillion calories

Several of the nation's largest food companies say they will take 1.5 trillion calories out of their products by 2015 in an effort to reduce childhood obesity.

The companies made the announcement through the Healthy Weight Commitment Foundation, a coalition of retailers, food and beverage manufacturers and industry trade associations. They pledged to reduce the calories as part of an agreement with a group of nonprofit organizations concerned with childhood obesity, first lady Michelle Obama said last Monday.

WORST

One out of Three Teens Mistook Smokeless Tobacco Products for Candy


According to a survey administered by the Virginia Foundation for Healthy Youth, one out of three teenagers younger than 18 mistakenly identified a new type of smokeless tobacco product as candy or gum. The survey of about 1,400 Virginia residents, including 728 younger than 18, asked them to identify package images for several types of new, smokeless tobacco products, as well as package images of mints and gums. About 39 percent of the respondents younger than 18 identified Camel Orbs, an oral tobacco product that dissolves in the mouth and delivers nicotine to the user, as mints or gum. Of the teenagers younger than 18 surveyed who do not currently use tobacco, 27 percent said they would try Camel Orbs based on packaging alone.

A new study published this week in Nature Neuroscience adds to the evidence that food addiction is real and similar in some ways to drug addiction. The study of rats, high calorie food consumption, and obesity revolves around brain reward systems and what provides pleasure. The study’s findings are outlined in BusinessWeek.

“The results of this study could provide insight into a mechanism for obesity,” Paul Kenny, an author on the study and professor at Scripps Research Institute, said in a statement. “It’s possible that drugs developed to treat addiction may also benefit people who are habitual overeaters.”

Obesity-related diseases cost the United States an estimated $150 billion each year, according to U.S. federal agencies. An estimated two-thirds of American adults and one-third of children are obese or overweight.

David Zauche
Senior Program Officer
Partnership for Prevention

US Surgeon General, Regina Benjamin told Congress yesterday that obesity “may dramatically impact the quality and longevity of life for an entire generation of children.” In forceful testimony before the Senate Committee on Health, Education and Pensions, Benjamin noted “the prevalence of obesity has increased dramatically in the United States, tripling among children and doubling among adults. Today, two-thirds of adults and nearly one in three children are overweight or obese.” She explained that from 1980 to 2008, obesity among adults rose from 13.4% to 34.3% and among children, rates rose from 5% to 17%.

The solution isn’t easy or quick but it is obvious and encouraging that the Obama administration is engaged. The Surgeon General explained that last month the President established a new Task Force on Childhood Obesity and charged it with reviewing all Federal programs dealing with child nutrition and physical activity and developing a national action plan. The National Action Plan is scheduled to be completed by May 9. Perhaps no less important, is the very visible role and support to this effort being given by First Lady Michelle Obama and her commitment to end “childhood obesity within a generation.” Her “Let’s Move” campaign is being supported by an innovative series of new web-based tools including the next generation Food Pyramid and USDA’s Food Environmental Atlas. These projects will help families make healthier food and physical activity choices and better understand national and local trends on food decisions.

Benjamin concluded her testimony with a simple but powerful message. “Instead of bombarding people with lists of what not to do, we need to empower them with what to do to promote health. Healthy eating and physical activity should be something all Americans want to do, not something they feel they have to do. We need to encourage people to take up activities that they enjoy, like swimming, dancing, or biking. We need to show them how healthy foods can be affordable, accessible, and delicious.”

Sage advice from the nation’s Family Doctor.

Posted by:
Ripley Forbes
Director, Government Affairs, Partnership for Prevention

An article in the 2-5-10 issue of National Journal by Neil Munro says “The campaign against fat has failed, even backfired. Maybe it’s time to emphasize fitness instead of weight.”

The Journal notes “The XXXL-sized failure by government-funded public health professionals is demonstrated by the federal Healthy People 2010 education program, which in 2000 set a goal of reducing the obesity rate from 30 percent to 15 percent by this year. The rate has since stretched…to 33.8 percent of the adult population...”

Clearly the growth in obesity over the past decade suggests the need for a new approach. The article quotes a number of public health experts advocating that “government policy should shift away from condemning obesity and fatness toward promoting healthy lifestyles for everyone – fat and thin, slim and obese. Evidence is mounting that making people feel bad about their weight can lead to serious medical and lifestyle problems”


The article notes that “Michele Obama’s childhood-obesity campaign envisions government playing a larger role in getting people to live healthier lives.”


The article also highlights CDC’s 2009 recommended community strategies and measurements to prevent obesity. The RECOMMENDATIONS are especially useful in light of Partnership’s growing work to introduce health considerations into transportation policy. Nat’l Journal writes that the CDC recommendations: “…included a call for local government to … promote the rebuilding of neighborhoods and towns that encourage people to walk, bike, or take public transportation rather than drive.”


Ripley Forbes
Director, Government Affairs
Partnership for Prevention
rforbes@prevent.org

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.

"What this particular study shows is, obesity is going to cause excess premature death," says study co-author Dr. William C. Knowler, who is chief of the Diabetes Epidemiology and Clinical Research Section of the National Institute of Diabetes and Digestive and Kidney Diseases.

Knowler and his colleagues evaluated 4,857 American Indian children who were born between 1945 and 1984, then followed them long-term. Most participants were at least half Pima or Tohono O'odham Indian. They lived in the area of the Gila River Indian Community in Arizona.

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.

A new study in the American Journal of Preventive Medicine suggests that people respond well to free counseling programs on weight loss or smoking cessation, but participation falls dramatically when services are no longer free. The cost of counseling also appears to make a difference to the doctors or health-care providers who refer patients to the programs, according to the study.

The authors reviewed a program that used an electronic database system to suggest health-care counseling for adults with unhealthy behaviors. For a time, free counseling was provided until funding ran out. Under the free program, 1,860 of 5,679 people who were evaluated were determined to have at least one unhealthy habit, and 407 of them were given referrals for intensive counseling, the study reported.

After the funding ceased, 729 of 2,510 people who were evaluated were determined to have unhealthy habits and just five were referred for counseling -- a 97 percent decrease in the referral rate, according to the study. Even when clinicians did offer a referral, 81 percent fewer patients followed through and got counseling when the counseling was not free.

The pediatrician wife of New Hampshire’s governor is backing legislation that would require the state’s schools to record children’s body mass index. Dr. Susan Lynch is a strong advocate for preventing and addressing childhood obesity, and says schools are a good place to screen children because not all have doctors to take the measurement. She believes that the measurement is more helpful than simply looking at a child’s weight to determine health risks of being under- or overweight.

Surgeon General Regina M. Benjamin is calling for the establishment of a "new normal" in the war on obesity and overweight, in which the goals transcend the current fixation on numerical targets associated with weight or the body-mass index (BMI). Benjamin was joined by First Lady Michelle Obama and HHS Secretary Kathleen Sibelius in releasing her first official report, entitled The Surgeon General’s Vision for a Healthy and Fit Nation 2010.

"The real reward has to be something that people can feel and enjoy and celebrate," Benjamin writes. "That reward is invigorating, energizing, joyous health. It is a level of health that allows people to embrace each day and live their lives to the fullest—without disease, disability, or lost productivity."


Benjamin's report seeks to update, strengthen and expand the 2001 Surgeon General’s Call to Action on obesity and overweight issued by then-Surgeon General David Satcher. She identifies opportunities for prevention to make a difference in numerous settings - the home, the community, child care settings, schools, work sites and the medical community.

The first lady recently announced that she will launch a major initiative on childhood obesity in the next few weeks and has asked HHS to play a key role.

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Barry Levinson, the Academy Award-winning director of Diner and Rain Man, announced today from the Sundance Film Festival that he will direct a new documentary on America's burgeoning obesity crisis. The film is part of The Spotlight Initiative, a series of independent films with messages that make a positive difference in the world.  

"The evolution of the obesity crisis in America is a fascinating and compelling human story. It's the hidden enemy within our borders that no one talks about," said Mr. Levinson.

Michelle Obama says she will launch a major initiative in February to combat the problem of childhood obesity. She mentioned the upcoming effort at a meeting of the U.S. Conference of Mayors, saying she wanted "to put in place commonsense initiatives and solutions that empower families and communities to make healthy decisions for their kids."

Under the initiative, she says, the federal government will work with local officials and leaders in the foundation, business and non-profit sectors to increase the number of schools that serve nutritious food, provide more opportunities for kids to be physically active and give more communities access to affordable healthy food.

"One third of American adults are now obese. In fact, one-third of Americans adults are now one-half of American adults."

- Steven Colbert, "The Colbert Report"