May 2024

Register Today! Upcoming NCCOR Workshop Examines Obesity Prevention Research, Community Engagement, and Systems Change

NCCOR, May 2024

Join NCCOR for the Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) workshop! The virtual workshop will take place from 12:00–5 p.m. ET on June 4–5 and will include keynote addresses and moderated panel discussions with distinguished speakers from academic institutions, global research projects, and federal agencies.

Twelve years ago, the Institute of Medicine’s Accelerating Progress in Obesity Prevention report highlighted the importance of policy, systems, and environmental (PSE) changes to address obesity. However, progress toward implementing such approaches and reducing obesity rates and associated disparities has been limited. Coordinated intervention on a wide range of systemic drivers may be needed to achieve progress and advance equity. This workshop will explore lessons learned from PSE efforts to date and identify potential next steps for addressing childhood obesity.

Featuring presentations from leading obesity-prevention and public health experts, the workshop will examine best practices in obesity prevention research with specific attention to community engagement and systems change through an equity lens. The workshop aims to advance the field by highlighting opportunities for the design and rigorous evaluation of both proximal and distal PSE interventions. This is the first installment of two workshops that aim to spur innovation in childhood obesity research. The second workshop will take place in the fall of 2024.

The OPUS workshop is co-chaired by Dr. Jamie Chriqui, University of Illinois at Chicago School of Public Health; Dr. Tamara Dubowitz, University of Pittsburgh School of Public Health; and Dr. Shiriki Kumanyika, Drexel University Dornsife School of Public Health. Featured experts include:

• Dolores Acevedo-Garcia, PhD, Brandeis University Heller School for Social Policy and Management
• William Dietz, PhD, MD, George Washington University Milken Institute of Public Health
• Christina Economos, PhD, Tufts University Friedman School of Nutrition
• Steve Gortmaker, PhD, Harvard T.H. Chan School of Public Health
• Angela Odoms-Young, PhD, Cornell University College of Human College
• Deborah Salvo, PhD, University of Texas at Austin College of Education
• Boyd Swinburn, MBChB, MD, FRACP, FNZCPHM, University of Auckland School of Population Health
• And more!

Register for the Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) workshop here: https://fhi360-org.zoom.us/webinar/register/WN_u4E_hhjPRm-Y-XDLrFkc7Q

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NCCOR Toolbox: NCCOR Workshop Resources for Advancing Measurement

May 2024, NCCOR

NCCOR, in partnership with The JPB Foundation, conducted three workshops in 2019 and early 2020 to enhance the quality and standardization of measurements in childhood obesity prevention and research. Standardized methods enable researchers to compare results across various studies and accelerate scientific progress. Today, the “Advancing Measurement for Childhood Obesity Workshop Series” project page links to each session’s executive summaries and white papers. These resources document the innovative ideas presented through these workshops for advancing measurement related to individual behaviors, high-risk populations, and the impact of environmental and policy influences on childhood obesity.

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Social and Behavioural Change Communications for Prevention of Childhood Overweight and Obesity

April 17, 2024, UNICEF

The toolkit is designed for UNICEF staff and partners who are developing Social Behaviour Change Communications (SBCC) for the prevention of overweight and obesity in children. The objectives of the toolkit are:

1. To provide a brief introduction to the prevention of overweight and obesity in children and adolescents;
2. To introduce SBCC (the strategic use of communications to bring about positive social and behaviour change) and outline how it has been used as one tool to prevent overweight and obesity in children;
3. To provide a practical, step-by-step methodology for UNICEF staff and partners for designing, implementing, monitoring, and evaluating SBCC initiatives to prevent overweight and obesity in children.

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Child Obesity Toolkit

April 16, 2024, University of Texas School of Public Health

The Michael & Susan Dell Center for Healthy Living is developing a series of toolkits to accompany the reports, Healthy Children, Healthy State, to raise awareness of child health risk factors in order to develop new programs and actions, and to build on current initiatives in Texas.

The Child Obesity Toolkit below is based on evidence, best-practices, and findings from an external messaging campaign conducted in 2019 for the Michael & Susan Dell Center for Healthy Living. This toolkit consists of resources, data, tools, and guides. Use this toolkit to learn about the current obesity crisis in Texas and how you can impact our state’s health as a parent, school, community member, or policymaker. Resources relating to COVID-19’s impact on child obesity are included in all categories.

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Biden-Harris Administration Announces New School Meal Standards to Strengthen Child Nutrition

April 24, 2024, U.S. Department of Agriculture

Today, U.S. Department of Agriculture Secretary Tom Vilsack announced major steps to promote the health of America’s children through school meals. Nutrition standards for school meals will be gradually updated to include less sugar and greater flexibility with menu planning between Fall 2025 and Fall 2027. The Department arrived at these changes after listening closely to public feedback and considering the latest science-based recommendations from the Dietary Guidelines for Americans. The new rule continues the work of the Biden-Harris Administration to address both food and nutrition security.

K-12 schools serve nutritious breakfasts and lunches to nearly 30 million children every school day. These meals are the main source of nutrition for more than half of these children and help improve child health.

“We all share the goal of helping children reach their full potential,” said Agriculture Secretary Tom Vilsack. “Like teachers, classrooms, books, and computers, nutritious school meals are an essential part of the school environment, and when we raise the bar for school meals, it empowers our kids to achieve greater success inside and outside of the classroom. Expanding on this major milestone, the Biden-Harris Administration will continue to partner with schools, districts, states, and industry to build on the extraordinary progress made to strengthen school meals.”

The final rule previewed today, is a significant step toward advancing the Administration’s national strategy to end hunger and reduce diet-related disease by 2030 set forth at the historic White House Conference on Hunger, Nutrition and Health in September 2022.

“The new standards build on the great progress that school meals have made already and address remaining challenges – including reducing sugar in school breakfasts. These updates also make it easier for schools to access locally sourced products, benefiting both schools and the local economy,” said USDA’s Food and Nutrition Service Administrator Cindy Long.

Key updates to the nutrition standards to support healthy kids include:

Added Sugars

• For the first time, added sugars will be limited in school meals nationwide, with small changes happening by Fall 2025 and full implementation by Fall 2027. USDA heard concerns from parents and teachers about excessive amounts of added sugars in some foods, which factored into this new limit. Research shows that these added sugars are most commonly found in typical school breakfast items. Child care operators will also begin limiting added sugars in cereals and yogurts – rather than total sugars – by Fall 2025.

Milk

• Schools can continue to offer flavored and unflavored milk, which provide essential nutrients that children need, such as calcium, vitamin D and potassium. There will be a new limit on added sugars in flavored milk served at breakfast and lunch by Fall 2025. Thirty-seven school milk processors – representing more than 90% of the school milk volume nationwide – have already committed to providing nutritious school milk options that meet this limit on added sugars.

Sodium

• Schools will need to slightly reduce sodium content in their meals by Fall 2027. In response to public comments, USDA is only requiring one sodium reduction, and not the three incremental reductions that were proposed last year. This change still moves our children in the right direction and gives schools and industry the lead time they need to prepare. The sodium limits in this final rule will be familiar to schools, as they were supported by leading school nutrition and industry stakeholders during previous rulemaking activities in 2017 and 2018.

Whole Grains

• Current nutrition standards for whole grains will not change. Schools will continue to offer students a variety of nutrient-rich whole grains and have the option to offer some enriched grains to meet students’ cultural and taste preferences.

Supporting Other Food Preferences

• While not a new requirement, starting in Fall 2024 it will be easier for schools to serve protein-rich breakfast foods such as yogurt, tofu, eggs, nuts, and seeds, which can help reduce sugary food options, while also supporting vegetarian diets and other food preferences.

Supporting Local Food Purchases

• Also starting in Fall 2024, schools have the option to require unprocessed agricultural products to be locally grown, raised or caught when making purchases for school meal programs, making it easier for schools to buy local foods.Additionally, starting in Fall 2025, schools will have limits on the percentage of non-domestic grown and produced foods they can purchase, which will enhance the role of American farmers, producers, fishers, and ranchers in providing nutritious foods to schools.

For more information about how school meals will be strengthened, see these resources:

• Infographic – Overview of Key Updates to School Nutrition Standards
• Infographic – Implementation Timeline for Key Updates to School Nutrition Standards

What’s Staying the Same

School meals will continue to emphasize fruits and vegetables; whole grains; and give kids the right balance of many nutrients for healthy, tasty meals. School nutrition professionals are local experts in their communities and will continue serving meals that their students want to eat, while also prioritizing cultural and religious food preferences.

Nutritious School Meals Are Invaluable to Everyday Families

• “Free breakfast lunches that my grandkids eat at school are huge relief,” said MomsRising member Mary Beth Cochran, a disabled homemaker raising four grandkids in Canton, North Carolina. “Honestly, I don’t know what we would do without school meals. It gives me so much peace of mind to know that no matter what the kids will eat two balanced meals five days a week at school. So, I’m thrilled the USDA is taking action to raise nutrition standards for school meals. As a grandmother I’ll move mountains to make sure my grandkids get the healthy food they need to learn and grow. I’m proud to support this rule because I know it will make a real difference for the health and well-being of families like mine.”

School Districts Empowered to Meet Updated Standards

Today’s announcement comes a few weeks after the Spring 2024 Healthy Meals Summit in St. Louis, Mo., where hundreds of school nutrition professionals gathered to celebrate and share their innovative efforts to enhance the nutritional quality of school meals. As part of USDA’s Healthy Meals Incentives Initiative, 264 small and rural school districts each received up to $150,000 to equip them with the resources to improve their meal service operations and help them meet these updated nutrition standards.

Through the School Food System Transformation Challenge Grants, the initiative is also supporting innovation in the school meals market by increasing collaboration between schools, food producers and suppliers, and other partners.

Food Industry is Answering the Call to Produce Nutritious School Foods

• “Prior to the Healthy Hunger Free Kids Act, my company JTM food group began reformulating our K 12 product offerings to reduce sodium. During COVID, we continued our R&D efforts in reviewing formulations, especially in our cheese and items to further reduce the sodium in anticipation of the new meal pattern,” said Carole Erb, JTM Executive Director of Education and Governmental Sales. “JTM team members have collaborated in bringing to the market reduced sodium products that will meet the new meal pattern today. We are ready to continue supporting all food service directors across the country and the important work that they and their staff are doing, feeding America’s children and nourishing the nation.”
• “As a mom and an industry member I think it’s important to reduce sugar in school meals. To help schools, we created a sample menu showing how our products fit with the updated standards. We’ve also reduced added sugar by using high quality natural ingredients that ensure our baked goods are healthy and delicious,” said Laura Trujillo Bruno, RDN, SNS, President of Buena Vista Foods.

More Support from a School Nutrition Professional

• “The nutrition standards give us a framework to build on and help us know that the meals we’re serving are nutritious for our students. The standards help us create equity in our food system by ensuring that all kids receive healthy meals at school. And in fact, we know that school cafeterias are the healthiest places that Americans eat. In Boston Public Schools, we’ve already been moving in this direction. We have the same added sugar limits in place and reduce sodium in our menus and we have for many years. So, complying with the new regulations is totally doable. There’s a long implementation runway for others to move in this direction as well.”

Additional Background on School Nutrition Standards

By law, USDA is required to set standards for the foods and beverages served through the school meal programs that align with the goals of the Dietary Guidelines for Americans. Each school develops meals that fit within these standards and reflect tastes and preferences of the students they serve.

The Department proposed updates to the standards in February 2023 and received tremendous feedback during the 90-day public comment period that resulted in more than 136,000 total public comments. These comments were considered in the development of the finalized nutrition standards. Leading up to the proposed standards, USDA held more than 50 listening sessions with state agencies, school districts, advocacy organizations, tribal stakeholders, professional associations, food manufacturers and other federal agencies.

The Biden-Harris Administration and USDA are dedicated to supporting the school nutrition programs. While schools bounced back from the pandemic, the Department provided them more purchasing power to buy American foods and opportunities for enhanced grant programs for updating equipment, product innovation, staff training and farm to school efforts that serve the needs of their local school districts.

To learn about more ways USDA is investing in school meal programs, see the Support for Schools webpage.

USDA touches the lives of all Americans each day in so many positive ways. In the Biden-Harris Administration, USDA is transforming America’s food system with a greater focus on more resilient local and regional food production, fairer markets for all producers, ensuring access to safe and healthy and nutritious food in all communities, building new markets and streams of income for farmers and producers using climate-smart food and forestry practices, making historic investments in infrastructure and clean-energy capabilities in rural America, and committing to equity across the Department by removing systemic barriers and building a workforce more representative of America. To learn more, visit www.usda.gov.

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Choosing Sugary Drinks Over Fruit Juice for Toddlers Linked to Risk of Adult Obesity

April 12, 2024, EurekAlert!

Consuming sugar-sweetened drinks in the first few years of childhood can be linked to poor diet patterns that increase the risk of obesity in later life, according to a new study by the School of Psychology at Swansea University.

Published in the European Journal of Clinical Nutrition, the study tracked the influence of diet on 14,000 British children from birth to adulthood and is believed to be the longest of its kind ever reported.

Using the Avon Longitudinal Study of Parents and Children, the research team found:

• Children who drank fizzy drinks such as cola or sugar-sweetened fruit cordials before the age of two gained more weight when they were 24 years old. Girls who had pure fruit juice gained less weight, while the weight of boys remained the same.
• At three years of age, toddlers who drank cola consumed more calories, fat, protein, and sugar but less fibre. In contrast, those given pure apple juice consumed less fat and sugar but higher amounts of fibre.

The study also highlighted corresponding differences in food choices. Children who consumed pure apple juice often followed a diet with more fish, fruit, green vegetables, and salad, whereas those drinking cola ate more burgers, sausages, pizza, french fries, meat, chocolate, and sweets.

Additionally, the team discovered a link between sugar-sweetened drinks and social deprivation, with children from affluent backgrounds more likely to have access to pure fruit juice.

Lead researcher Professor David Benton said: “The early diet establishes a food pattern that influences, throughout life, whether weight increases. The important challenge is to ensure that a child develops a good dietary habit: one that offers less fat and sugar, although pure fruit juice, one of your five a day, adds vitamin C, potassium, folate, and plant polyphenols.”

Dr Hayley Young added: “Obesity is a serious health concern, one that increases the risk of many other conditions. Our study shows that the dietary causes of adult obesity begin in early childhood and that if we are to control it, more attention needs to be given to our diet in the first years of life.”

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Doctors on Front Line of Tackling Childhood Obesity but More Training and Resources Needed

April 2, 2024, EurekAlert!

Doctors are feeling unable to tackle growing problem of childhood obesity due to a lack of training and capacity according to new research.

In a paper published in the British Journal of General Practice, researchers from the University of Birmingham conducted in-depth interviews with healthcare professionals (HCPs) to understand their experiences of supporting families to tackle childhood obesity.

One participant in the study said:

“I had one mum and her child was overweight, but she was a young parent and she actually didn’t know how to cook the dinners and, yeah… we spent a lot of time with her giving her worksheets, how to cook, make potato and beans rather than going to the fish and chip shop.”

Among key themes that were discussed, professionals shared their frustrations with a lack of time and training to support families, including limited availability for specialist services and lack of access to routinely collected data on children’s weight. HCPs also shared their concerns about damaging trust by highlighting weight concerns about children, and many said that they were aware of cultural considerations when bringing up weight.

Miranda Pallan, Professor of Child and Adolescent Public Health in the Institute of Applied Health Research at the University of Birmingham and senior author of the paper said:

“This study brings a fresh awareness about the pressures that healthcare professionals face, including the limitations that they face in trying to provide preventative care for young people. Through the series of interviews with doctors, primary care nurses and school nurses, we have been able to see some clear barriers that prevent effective advice and support for families to tackle the growing epidemic of childhood obesity.

“While we should not expect doctors to be spending lots of time teaching families how to cook healthy, balanced meals, the study does highlight that healthcare professionals need more support and dedicated time to enable them to give practical advice and in some cases refer to more specialist services.”

Case study: “No-one is actually talking about the root causes with parents”

Dr Ellen Fallows is a sessional GP in North Oxfordshire and has a particular interest in supporting families to address childhood obesity. Also holding roles in teaching and as Vice-President of The British Society of Lifestyle Medicine, Dr Fallows regularly works with families who are struggling to understand where to go to get support, but with no specific paediatric weight management services locally often has to draw on her own expertise to provide advice.

Dr Fallows said: “Everyone thinks it is everyone else’s problem, no one is actually talking about the root causes with parents – which is predominantly food quality. This is due to lack of time, knowledge and incentives for healthcare professionals. There are good and free training resources out there that really should be routinely provided as a first port of call.

“Childhood obesity is a really serious problem that could have lifelong implications and GPs could be ideally placed to lead the work to address it. However, without the training and a mandate to support people with self-care to address root causes, it will continue to be a challenge to make a meaningful difference for the many families who are looking for help.”

Lack of trust in BMI

Healthcare professionals also raised the issue of the use of BMI centiles for assessing weight problems in children.

Different healthcare professionals raised different concerns, with doctors and primary care nurses noting that they are less familiar with BMI centiles, and that BMI is not a good measure for younger children.

Another participant said:

“We used to use the [height and weight] centile charts and actually the BMI will put a lot more children in an overweight category than the centile charts will.”

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