The Academy of Nutrition and Dietetics' position paper, “Interventions for the Prevention and Treatment of Pediatric Overweight and Obesity,” was published in the October issue of the Journal of the Academy of Nutrition and Dietetics and is available on the Academy Journal's website. The position paper provides guidance and recommendations for levels of intervention targeting overweight and obesity prevention and treatment from preschool through adolescence. The Academy's position is that prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitian nutritionists, as well as consistent and integrated messages and environmental support across all sectors of society to achieve sustained dietary and physical activity behavior change. The position paper recommends ways in which registered dietitian nutritionists can help consumers achieve healthy weights for their children, including (1) education programs that teach people food planning, purchasing, and preparation, parenting practices, and environmental changes to make healthy food and activity choices easier, (2) educational and environmental interventions that promote and support sustainable healthy lifestyles, and (3) treatment to help overweight and obese youth achieve a healthier weight, be more fit, and improve overall health. These should involve family members, be appropriate for the child's age and culture, and include nutrition education and strategies to improve eating habits and physical activity. Treatment of childhood overweight and obesity should emphasize sustained family-based, developmentally and culturally appropriate approaches that include nutrition education, dietary counseling, parenting skills, behavioral strategies, and physical activity promotion, according to the Academy. Registered dietitian nutritionists and dietetic technicians should be an integral part of research studies, as well as treatment teams, to guarantee the best possible outcomes for children.
David L. Katz, MD, MPH, Director of the Yale-Griffin Prevention Research Center and Editor-in-Chief of Childhood Obesity, with coauthor Stacey Colino, has released a new book on the tremendous effects of human behavior on overall health, titled Disease-Proof: The Remarkable Truth About What Makes Us Well (Hudson Street Press, 2013). The book lays out the, perhaps revelatory, statement that people can reduce their risk of any chronic disease by 80% through behavior-related actions—this is much more than any available drug or medical intervention. The book relies on credible scientific evidence, coupled with Dr. Katz’ decades of clinical experience, to provide readers with the knowledge to manage weight, improve immune function, reprogram genes, and prevent and reverse life-altering illnesses. Uniquely, the book focuses not on what constitutes healthy living, because that is well established, but on how to apply what Dr. Katz calls skill power and get there from here.
With funds from the MetLife Foundation, the American Academy of Family Physicians program, Americans in Motion–Healthy Interventions (AIM-HI) awarded grants between $10,000 and $30,000 to eight family medicine residency programs to develop and implement family-centered projects that will help reduce childhood obesity in their communities. Residencies were selected across the nation in rural, urban, and suburban locations with high obesity rates. Grant recipients will conduct a diverse range of projects, targeting community members at homeless shelters, community centers, and schools, among other settings. Participants will design obesity prevention activities in collaboration with other healthcare professionals, including dieticians, psychologists, and nurses. For some of the residency programs, the AIM-HI childhood obesity grant will help them to launch their first obesity project. For others, the grant will serve to expand the reach and effectiveness of their obesity interventions. In an effort to both curb childhood obesity and its effect on the family, and advance the skills and competencies of family physicians, the AIM-HI childhood obesity grants will help residencies incorporate obesity-related topics in their graduate curriculum as part of their community health training. By serving the community at large, residents will be able to apply evidence-based public health strategies, theoretical frameworks, and clinical approaches to help prevent overweight and obesity and promote healthy lifestyle behaviors among their patients. More information is available at www.americansinmotion.org/.
Marion Nestle, PhD, MPH, is the Paulette Goddard Professor in the Department of Nutrition, Food Studies, and Public Health and Professor of Sociology at New York University. She recently published a book, Eat Drink Vote: An Illustrated Guide to Food Politics (Rodale Books, 2013). Dr. Nestle teamed up with The Cartoonist Group syndicate and pulled together more than 250 of her favorite cartoons that range from issues such as dietary advice to genetic engineering to childhood obesity. She then wrote a commentary summarizing some of the most pressing issues in food politics. She is the author of several books, including the 2006 What To Eat (North Point Press/Farrar, Straus & Giroux) and Why Calories Count: From Science to Politics (University of California Press, 2012). Her research focuses on how science and society influence dietary advice and practice.
Ellen Granberg, PhD, is an Associate Professor in the College of Business and Behavioral Science at Clemson University. Her research focuses on health and mental health with two primary issues: (1) how do individuals deal with dramatic changes in health identities such as overweight or obesity and (2) how can families help children deal with the transition from childhood to adulthood. She is the coauthor of a recent article published in Obesity Reviews titled “Factors associated with development of excessive fatness in children and adolescents: A review of prospective studies.” (Pate RR, O'Neill JR, Liese AD, et al. 2013;14(8):645–658). The authors reviewed 61 studies and found that there were thousands of published studies, but a fairly small number actually helped increase an understanding of the causes of increased childhood obesity. Ultimately, they concluded that the field would benefit from large-scale, long-term prospective studies that used state-of-the-art measurements in a diverse sample of children and adolescents.
Gavin Sandercock, PhD, is the Director of MSc Cardiac Rehabilitation and Ethics Officer at the School of Biological Sciences at the University of Essex (UK). He is also a Senior Lecturer in Clinical Physiology (Cardiology). Dr. Sandercock is the principal investigator of the East of England Healthy Hearts Study, the largest health and fitness survey of UK children and adolescents, which currently has over 10,000 participants ages 10–16 years. He is the author of a study recently presented at the annual conference of The British Association of Sports and Exercise Sciences, which will be published in the December issue of the Journal of Sports Sciences. The study tracked 8500 children from 24 schools in eastern England, who were measured for BMI and performed a 20-meter shuttle run to test cardiovascular fitness. The study found that whereas more than 1 in 10 of the children were obese, a higher percentage, 1 in 5, were unfit. The study suggests that an overall focus on obesity may be leading society away from a more widespread problem of lack of fitness.
Sarah Gollust, PhD, is an Assistant Professor in the Department of Public Health and Policy at the University of Minnesota's School of Public Health. Her research focuses on public opinion and news media influence in health policy, health disparities, childhood obesity, and ethical issues in public health practice and policy. Dr. Gollust is the lead author of a study recently published in the American Journal of Public Health titled “Framing the consequences of childhood obesity to increase public support for obesity prevention policy.” (Gollust SE, Niederdeppe J, Barry CL. 2013;103(11):e96–e102). The study evaluated the strength of 11 messages about the need for government action to deal with the consequences of childhood obesity. The authors compared groups' attitudes toward obesity prevention, stratified by political ideology. Moderates and liberals tended to accept political action as a result of public health consequences, whereas conservatives responded more if it was framed on the basis of military readiness.
Elsie M. Taveras, MD, is an Associate Professor of Population Medicine at Harvard Pilgrim Healthcare, an Associate Professor of Pediatrics at the Massachusetts General Hospital, and Associate Professor in the Department of Nutrition at the Harvard School of Public Health. She is also the Co-Director of the Obesity Prevention Program in the Department of Population Medicine. Her research focuses on epidemiologic studies of diet, physical activity, and weight determinants in childhood. Dr. Taveras coauthored a recent article in JAMA Pediatrics titled “Healthy habits, happy homes: Randomized trial to improve household routines for obesity prevention among preschool-aged children.” (Haines J, McDonald J, O'Brien A, et al. 2013 Sep 9. Epub ahead of print). The study focused on racial, ethnic, and socioeconomic disparities across risk factors for childhood obesity. It examined the effectiveness of a home-based intervention to improve household routines associated with childhood obesity among low-income, racial/ethnic minority families. The study found that modifying some routines, such as sleep duration and reduction of television viewing, may be an effective approach to reducing BMI.
Brady Kaucic is a junior at Notre Dame–Cathedral Latin School in Munson Township, Ohio. Her research project, which was part of The Cleveland Clinic Office of Civic Education Initiatives Summer Internship Program, was on display at the Great Lakes Science Center in Cleveland in late September and early October. Ms. Kaucic's research project is titled “Outcomes for a multidisciplinary tertiary care pediatric obesity clinic: The pediatric preventative cardiology and metabolic clinic.” She was one of five Northeast Ohio students whose research was on display. Fifteen students were selected to participate in the clinic's programs over the last 5 years. These are paid internships that offer students throughout northeastern Ohio a chance to work and learn with nationally renowned healthcare professionals.
David Ludwig, MD, PhD, is a Professor of Pediatrics at Harvard Medical School, a Professor of Nutrition at the Harvard School of Public Health, The John Fielding Crigler, Jr. & Mary Adele Sippel Crigler Chair in Pediatric Endocrinology, Director of the Optimal Weight for Life (OWL) Clinic, and Director of the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital. He is the author of a study recently published in PLOS Medicine titled “Pregnancy weight gain and childhood body weight: A within-family comparison.” (Ludwig DS, Rouse HL, Currie J. 2013;10(10):e1001521). In this population-based cohort study, Dr. Ludwig and his team matched records of all live births in Arkansas with state-mandated data on childhood BMI recorded in public schools from August 2003 to June 2011. This included 42,133 women and their 91,045 offspring. They found that high pregnancy weight gain is associated with increased body weight of the offspring in childhood.
Anna Prats-Puig is a researcher with the Pediatrics Research Group and Department of Diabetes, Endocrinology, and Nutrition at the Institut d-Investigacio Biomedica de Girona in Girona, Spain. She coauthored an article featured in The Journal of Clinical Endocrinology & Metabolism titled “Changes in circulating microRNAs are associated with childhood obesity.” (Prats-Puig A, Ortega FJ, Mercader JM, et al. 2013;98(10):E1655). The study's objective was to define the circulating pattern of miRNAs in childhood obesity. It was assessed in 10 boys (5 lean and 5 obese). The most relevant miRNAs were cross-sectionally validated in 85 lean versus 40 obese children (boys and girls) and then evaluated in the children when they were approximately 7 and 10 years of age. They isolated 15 specific circulating miRNAs that were significantly deregulated in prepubertal obesity. The conclusion of the study was that very early detection of an abnormal circulating miRNA profile might be a promising strategy for identifying obese children who may suffer from metabolic abnormalities.
