by Marion Nestle

Currently browsing posts about: Obesity-in-kids

Oct 8 2014

Some thoughts on military might: obesity, candy, and the USDA’s arms race

Mission: Readiness versus obesity

As I noted in an earlier post, Mission: Readiness, an organization of former high-ranking military officials concerned about obesity and other health problems in military recruits and personnel, has issued a hard-hitting defense of USDA’s school nutrition standards.

New Picture (1)

But the military loves giving candy to kids

Dr. Karen Sokal-Gutierrez, who is engaged in international programs to reduce sugar-induced tooth decay among children, sends the results of her Google search for “US Military give children candy.”

Halloween candy buy back: To prevent tooth decay in US children, this program is having us send our candy to servicemen. Do they eat it themselves, or do they give it to local children where they serve?

A historical perspective on generations of military candy practices

US troops endanger Afghan children by giving them with candy

Images for US soldiers giving children candy

Dr. Sokal-Gutierrez notes that it’s not just the military that give children in developing countries candy—it’s also tourists and aid workers in developing countries and refugee camps.

She understands why it feels good to do this, but points out that the children might not have toothbrushes or dental treatment.  Candy, she emphasizes, contributes to severe tooth decay, mouth pain, malnutrition, problems in school, etc.

Why is the USDA Buying Submachine Guns?

Another reader, Kris Gilbertson, asks this question based on an article in Modern Farmer.

According to a USDA press rep, the guns are necessary for self-protection.

“OIG [USDA’s Office of the Inspector General] Special Agents regularly conduct undercover operations and surveillance. The types of investigations conducted by OIG Special Agents include criminal activities such as fraud in farm programs; significant thefts of Government property or funds; bribery and extortion; smuggling; and assaults and threats of violence against USDA employees engaged in their official duties,” wrote a USDA spokesperson.

One can only resort to cliche: food for thought.

May 9 2014

Opening today: Fed Up! See it!

This ad was in last Sunday’s New York Times.  It appears again today with blurbs added.

Full disclosure: I’m one of the many people interviewed for the film and appear in three 10-second clips.

Fed Up! is a stunningly hard-hitting exposé of the food industry’s role in promoting unhealthy diets and childhood obesity.  It spares nothing in showing the devastating effects of obesity on kids (I found those parts painful to watch).

The film’s main message is that the food industry, in collaboration with government, is responsible for creating a food environment that promotes poor health.

It is especially tough on food company marketing and industry-sponsored research.

It is also—I think, unfortunately—tough on Michelle Obama and her Let’s Move! campaign.

Mrs. Obama is not the problem.  The food industry’s marketing and co-opting practices are the problem.

We can debate whether it was wise or useful for Let’s Move! to partner with the food industry, but the campaign has done much to bring issues of childhood obesity to public attention.

It’s ironic that the accomplishments of Let’s Move!—the White House garden, the Healthy Hunger-Free Act of 2010, the new school food nutrition standards, the new nutrition standards for WIC, and the new food label, for example—are at this very moment under fierce attack by food companies, their trade associations, and their friends in Congress.

With that said, the film is well worth seeing.  Don’t miss it.  Get your friends to see it.  Let the debates begin.

How to see Fed Up!

  • Watch the trailer here.
  • Find out where it’s playing here.
  • Share it on social media here.
  • See Katie Couric’s excellent ABC News interview here.
  • Read the New York Times review here.

As for the debate, please enjoy:

Additions

Mar 31 2014

New book: Childhood Obesity

Kristin Voigt, Stuart G. Nicholls, Garrath Williams.  Childhood Obesity: Ethical and Policy Issues.  Oxford University Press, 2014.

 

 

I gave this one a blurb:

A well-researched, highly critical, but carefully balanced examination of everyday assumptions about childhood obesity and its prevention from an intensely moral perspective.  Although the authors demonstrate that no intervention is without ethical complications or effective entirely on its own, they call for immediate actions to reduce the stigma of childhood obesity, support parents, and create food environments healthier for children, adults, and the environment.    

Dec 13 2012

Good news: cities report declines in childhood obesity

I don’t get many fan letters (as you can tell from reading the comments to posts).  When I do, they mean a lot.  Here’s an especially lovely one from a reader this week:

I cannot help but think of you and the work that you do having a great impact on the first signs of child/youth obesity declining.  Although the “researchers” indicate they are not sure of the reasons for the decline, I think many within the food / food politics community know that the work you do, the awareness you spread and the advertising you expose, greatly affects the way we feed our children.  As a real food advocate and parent, thank you for the work you do.

Thanks but I can take no credit (much as I would love to).

The writer is referring to a front-page, right-hand column story—the most important of the day—in the December 11 New York Times.   The article said that several cities are reporting drops in childhood obesity rates.

The drops may be small, just 3% to 5%, but any reversal in obesity trends is excellent news.

Last September, the Robert Wood Johnson Foundation first reported such drops.

It noted that the declines were occurring in places that had taken comprehensive action to address childhood obesity.

New York City, for example, has engaged in major efforts to make healthy dietary choices the easy choices.  Health Commissioner Tom Farley recently reported a 5.5% decline in childhood obesity.

The Foundation says that Philadelphia:

has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.

Broad policies like these are exactly what the Institute of Medicine recommends (me too).

And now, it seems, these actions are actually having the intended effect.

That’s the best news ever.

And I don’t care who gets credit for it.

 

Nov 12 2012

Kids don’t need kids’ food

I did an interview for Childhood Obesity with Jamie Devereaux, its features editor.

Here are the first and last questions.  For the entire interview, click here:

The issue of access to healthy food is a major topic in the overall childhood obesity discussion in America. How important do you think it is to focus on solving the problems of food access as an objective in addressing childhood obesity?

I was impressed with Michelle Obama’s choice of targets for reducing childhood obesity—improving access to food in inner cities and improving school food. Both are excellent targets and, in a rational world, should attract widespread bipartisan support. It’s self-evident that it is more difficult to make healthier food choices  when no healthy food choices are available or when healthier foods are relatively expensive.

Some years ago I lived in a low-income Washington, D.C., neighborhood and was appalled at the poor quality of the supposedly fresh foods offered in the single grocery store within walking distance. I wouldn’t buy it and wouldn’t expect anyone else to want it either. Some studies report that inadequate access is a huge problem in inner cities and rural areas; others say the opposite. Without getting into arcane details about how the studies differ, the access problem just seems obvious and obviously needs to be fixed.

Finally, if you could shape the discussion of healthy food access for children in America—how would you frame it and what would you focus on?

Kids don’t need kids’ food. If adults are eating healthfully, kids should be eating the same foods that adults eat. Babies don’t need commercial baby food. Older kids don’t need kids’ products. Families can all eat the same foods, and that should make life easier for all concerned. If you don’t want your kids drinking sodas, don’t bring them home from the supermarket. Teach kids to eat real foods early on, and they will be great eaters throughout life.

Sep 24 2012

Do sugar-sweetened beverages promote obesity? Yes, say papers in the New England Journal.

 The New England Journal of Medicine has just published a series of articles on sugar-sweetened beverages to  coincide with presentations at The Obesity Society’s annual meeting.  Here are links to the articles.  I’ve extracted brief quotes from some of them.  And here’s a summary in the New York Times.

Perspective: J.L. Pomeranz and K.D. Brownell, Portion Sizes and Beyond — Government’s Legal Authority to Regulate Food-Industry Practices.

Regulations that affect “ordinary commercial transactions” (such as the sale of a product) are presumed to be constitutional if they have a rational basis and if the government body enacting them has the appropriate knowledge and experience to do so.

In the case of New York City’s portion-size restrictions, for example, the health department is an expert public health body that reviewed relevant scientific evidence on the health hazards associated with consumption of sugar-sweetened beverages and the effect of portion sizes on consumption patterns. The proposed policy thus has a rational basis….

Original Article: Q. Qi and Others, Sugar-Sweetened Beverages and Genetic Risk of Obesity

The study concludes: “the genetic association with adiposity appeared to be more pronounced with greater intake of sugar-sweetened beverages.”

Original Article: J.C. de Ruyter and Others,  A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children

We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age. Participants were randomly assigned to receive 250 ml (8 oz) per day of a sugar-free, artificially sweetened beverage (sugar-free group) or a similar sugar-containing beverage that provided 104 kcal (sugar group). Beverages were distributed through schools….Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children.

Original Article: C.B. Ebbeling and Others, A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight

We randomly assigned 224 overweight and obese adolescents who regularly consumed sugar-sweetened beverages to experimental and control groups. The experimental group received a 1-year intervention designed to decrease consumption of sugar-sweetened beverages, with follow-up for an additional year without intervention….Among overweight and obese adolescents, the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention designed to reduce consumption of sugar-sweetened beverages, but not at the 2-year follow-up

Editorial: S. Caprio, Calories from Soft Drinks — Do They Matter?

These randomized, controlled studies — in particular, the study by de Ruyter et al. — provide a strong impetus to develop recommendations and policy decisions to limit consumption of sugar-sweetened beverages, especially those served at low cost and in excessive portions, to attempt to reverse the increase in childhood obesity.

Clinical Decisions: T. Farley, D.R. Just, and B. Wansink, Regulation of Sugar-Sweetened Beverages

This one is a point/counterpoint.  On the basis of the evidence just presented, should government regulate sugary drinks?

New York City Health Commissioner Tom Farley says yes:

If a harmful chemical in schools were causing our children to get sick, people would demand government regulation to protect them. It is therefore difficult to argue against a government response to an epidemic of obesity that kills more than 100,000 persons a year in the United States and has an environmental origin.7

Federal, state, and local governments already regulate the food system, from farm to retail, in many ways and for many purposes, ranging from support of agriculture to prevention of foodborne illness. The question is not whether we should regulate food, but rather whether we should update food regulations to address this new epidemic.

David Just and Brian Wansink say no:

We must also recognize that the universe of foods that contribute to childhood obesity is much larger than sugar-sweetened beverages. Such a narrowly defined approach would have minimal chance for overall success. Rather, we must consider approaches that will involve parents, schools, and pediatricians in leading children toward more healthful eating habits and increased physical activity. In truth, we cannot hope to create regulations that restrict behavior holistically.

I’d say we now have plenty of evidence that habitual use of soft drinks raises risks for obesity, and plenty of evidence for the need for regulation.

Yes, it would be nice if “leading children to eat better” worked, but parents, teachers, and everyone else needs lots of help in coping with today’s food environment.

The New England Journal has done a great public service in publishing these papers as a series, and the authors all deserve much praise for taking on these difficult research projects.

OK city agencies: get to work!

Sep 19 2012

JAMA publishes theme issue on obesity

Yesterday, JAMA released a theme issue on obesity with several articles of particular interest, starting with New York City Health Commissioner Tom Farley’s Viewpoint.  About portion sizes, Dr. Farley notes:

As publicly traded companies responsive to the interests of their shareholders, food companies cannot make decisions that will lower profits, and larger portion sizes are more profitable because most costs of delivering food items to consumers are fixed….The sale of huge portions is driven by the food industry, not by consumer demand….The portion-size studies strongly suggest that, with a smaller default portion size, most consumers will consume fewer calories.  This change will not reverse the obesity epidemic, but it can have a substantial effect on it.

Lots of interesting food for thought here.  Take a look:


Viewpoint

The Role of Government in Preventing Excess Calorie Consumption:  The Example of New York City
Thomas A. Farley, MD, MPH
JAMA. 2012;308(11):1093 doi:10.1001/2012.jama.11623

The Next Generation of Obesity Research:  No Time to Waste
Griffin P. Rodgers, MD; Francis S. Collins, MD, PhD
JAMA. 2012;308(11):1095 doi:10.1001/2012.jama.11853

FDA Approval of Obesity Drugs:  A Difference in Risk-Benefit Perceptions
Elaine H. Morrato, DrPH, MPH; David B. Allison, PhD
JAMA. 2012;308(11):1097 doi:10.1001/jama.2012.10007

Cardiovascular Risk Assessment in the Development of New Drugs for Obesity
William R. Hiatt, MD; Allison B. Goldfine, MD; Sanjay Kaul, MD
JAMA. 2012;308(11):1099 doi:10.1001/jama.2012.9931

Original Contribution

Exercise Dose and Diabetes Risk in Overweight and Obese Children:  A Randomized Controlled Trial
Catherine L. Davis, PhD; Norman K. Pollock, PhD; Jennifer L. Waller, PhD; Jerry D. Allison, PhD; B. Adam Dennis, MD; Reda Bassali, MD; Agustín Meléndez, PhD; Colleen A. Boyle, PhD; Barbara A. Gower, PhD
JAMA. 2012;308(11):1103 doi:10.1001/2012.jama.10762

Association Between Urinary Bisphenol A Concentration and Obesity Prevalence in Children and Adolescents
Leonardo Trasande, MD, MPP; Teresa M. Attina, MD, PhD, MPH; Jan Blustein, MD, PhD
JAMA. 2012;308(11):1113 doi:10.1001/2012.jama.11461

Health Benefits of Gastric Bypass Surgery After 6 Years
Ted D. Adams, PhD, MPH; Lance E. Davidson, PhD; Sheldon E. Litwin, MD; Ronette L. Kolotkin, PhD; Michael J. LaMonte, PhD; Robert C. Pendleton, MD; Michael B. Strong, MD; Russell Vinik, MD; Nathan A. Wanner, MD; Paul N. Hopkins, MD, MSPH; Richard E. Gress, MA; James M. Walker, MD; Tom V. Cloward, MD; R. Tom Nuttall, RRT; Ahmad Hammoud, MD; Jessica L. J. Greenwood, MD, MSPH; Ross D. Crosby, PhD; Rodrick McKinlay, MD; Steven C. Simper, MD; Sherman C. Smith, MD; Steven C. Hunt, PhD
JAMA. 2012;308(11):1122 doi:10.1001/2012.jama.11164

Health Care Use During 20 Years Following Bariatric Surgery
Martin Neovius, PhD; Kristina Narbro, PhD; Catherine Keating, MPH; Markku Peltonen, PhD; Kajsa Sjöholm, PhD; Göran Ågren, MD; Lars Sjöström, MD, PhD; Lena Carlsson, MD, PhD
JAMA. 2012;308(11):1132 doi:10.1001/2012.jama.11792

Surgical vs Conventional Therapy for Weight Loss Treatment of Obstructive Sleep Apnea:  A Randomized Controlled Trial
John B. Dixon, MBBS, PhD, FRACGP; Linda M. Schachter, MBBS, PhD; Paul E. O’Brien, MD, FRACS; Kay Jones, MT&D, PhD; Mariee Grima, BSc, MDiet; Gavin Lambert, PhD; Wendy Brown, MBBS, PhD, FRACS; Michael Bailey, PhD, MSc; Matthew T. Naughton, MD, FRACP
JAMA. 2012;308(11):1142 doi:10.1001/2012.jama.11580

Dysfunctional Adiposity and the Risk of Prediabetes and Type 2 Diabetes in Obese Adults
Ian J. Neeland, MD; Aslan T. Turer, MD, MHS; Colby R. Ayers, MS; Tiffany M. Powell-Wiley, MD, MPH; Gloria L. Vega, PhD; Ramin Farzaneh-Far, MD, MAS; Scott M. Grundy, MD, PhD; Amit Khera, MD, MS; Darren K. McGuire, MD, MHSc; James A. de Lemos, MD
JAMA. 2012;308(11):1150 doi:10.1001/2012.jama.11132

Editorial

Progress in Filling the Gaps in Bariatric Surgery
Anita P. Courcoulas, MD, MPH
JAMA. 2012;308(11):1160 doi:10.1001/jama.2012.12337

Progress in Obesity Research:  Reasons for Optimism
Edward H. Livingston, MD; Jody W. Zylke, MD
JAMA. 2012;308(11):1162 doi:10.1001/2012.jama.12203

Sep 2 2012

Regulations do change eating behavior

My monthly, first Sunday column in the San Francisco Chronicle:

Q: I still don’t get it. Why would a city government think that a food regulation would promote health when any one of them is so easy to evade?

A: Quick answer: because they work.

As I explained in my July discussion of Richmond’s proposed soda tax, regulations make it easier for people to eat healthfully without having to think about it. They make the default choice the healthy choice. Most people choose the default, no matter what it is.

Telling people cigarettes cause cancer hardly ever got anyone to stop. But regulations did. Taxing cigarettes, banning advertising, setting age limits for purchases, and restricting smoking in airplanes, workplaces, bars and restaurants made it easier for smokers to stop.

Economists say, obesity and its consequences cost our society $190 billion annually in health care and lost productivity, so health officials increasingly want to find equally effective strategies to discourage people from over-consuming sugary drinks and fast food.

Research backs up regulatory approaches. We know what makes us overeat: billions of dollars in advertising messages, food sold everywhere – in gas stations, vending machines, libraries and stores that sell clothing, books, office supplies, cosmetics and drugs – and huge portions of food at bargain prices.

Research also shows what sells food to kids: cartoons, celebrities, commercials on their favorite television programs, and toys in Happy Meals. This kind of marketing induces kids to want the products, pester their parents for them, and throw tantrums if parents say no. Marketing makes kids think they are supposed to eat advertised foods, and so undermines parental authority.

Public health officials look for ways to intervene, given their particular legislated mandates and authority. But much as they might like to, they can’t do much about marketing to children. Food and beverage companies invoke the First Amendment to protect their “right” to market junk foods to kids. They lobby Congress on this issue so effectively that they even managed to block the Federal Trade Commission‘s proposed nonbinding, voluntary nutrition standards for marketing food to kids.

Short of marketing restrictions, city officials are trying other options. They pass laws to require menu labeling for fast food, ban trans fats, prohibit toys in fast-food kids’ meals and restrict junk foods sold in schools. They propose taxes on sodas and caps on soda sizes.

Research demonstrating the value of regulatory approaches is now pouring in.

Studies of the effects of menu labeling show that not everyone pays attention, but those who do are more likely to reduce their calorie purchases. Menu labels certainly change my behavior. Do I really want a 600-calorie breakfast muffin? Not today, thanks.

New York City’s 2008 ban on use of hydrogenated oils containing trans fats means that New Yorkers get less trans fat with their fast food, even in low-income neighborhoods. Whether this reduction accounts for the recent decline in the city’s rates of heart disease remains to be demonstrated, but getting rid of trans fats certainly hasn’t hurt.

Canadian researchers report that kids are three times more likely to choose healthier meals if those meals come with a toy and the regular ones do not. When it comes to kids’ food choices, the meal with the toy is invariably the default.

A recent study in Pediatrics compared obesity rates in kids living in states with and without restrictions on the kinds of foods sold in schools. Guess what – the kids living in states where schools don’t sell junk food are not as overweight.

Circulation has just published an American Heart Association review of “evidence-based population approaches” to improving diets. It concludes that evidence supports the value of intense media campaigns, on-site educational programs in stores, subsidies for fruits and vegetables, taxes, school gardens, worksite wellness programs and restrictions on marketing to children.

The benefits of the approaches shown in these studies may appear small, but together they offer hope that current trends can be reversed.

Researchers also suggest other approaches, not yet tried. The Yale Rudd Center has just shown that color-coded food labels (“traffic lights”) encourage healthier food choices.

And Rand Corp. researchers propose initiatives like those that worked for alcoholic beverages: Limit the density of fast-food outlets, ban sales in places that are not food stores, insist that supermarkets put junk foods and sodas where they are hard to see, ban drive-through sales, restrict portion sizes and use warning labels.

These regulatory approaches are worth trying. If research continues to demonstrate their value, cities will have even more reason to use them. If the research becomes compelling enough, the federal government might need to act.

In the meantime, cities are leading the way, Richmond among them. Their initiatives are well worth trying, testing and supporting.

**Marion Nestle is the author of “Why Calories Count: From Science to Politics,” as well as “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at foodpolitics.com. E-mail: food@sfchronicle.com

Page 1 of 912345...Last »