March 2011 Infomonthly

Colleagues, friends,

Here is the “Info Monthly” for March 2011 in four parts:

A.    Announcements: e.g. announced Meetings, Conferences, Resources
B.    News, i.e. print and electronic media stories, usually bylined
C.    Reports, Essays, Commentaries, Policy Briefs, now including the National Academy of Sciences pubs
D.    Research and Reviews: peer-reviewed journal articles

We trust that you will skim these contents for the pieces that matter to you most. All Monthlies from January 2008 may be found archived at http://www.une.edu/mhprc/infomonthly/index.cfm by the way.

Thanks for all you do.

Robert H. Ross, PhD
Scientific Director, Maine-Harvard Prevention Research Center at the University of New England
April 4, 2011


 
A.    Announcements

1. Announcement: Epi Info Training May 26--28, 2011. full text. Emory University's Rollins School of Public Health and CDC's Office of Surveillance, Epidemiology, and Laboratory Services will cosponsor Epi Info training, to be held May 26--28, 2011, at Emory University. Tuition is charged. This course is designed for public health professionals who wish to develop software applications using Epi Info for Windows. This basic level course covers MakeView, Analysis, Enter, Epi Map, and Epi Report modules.Additional information and applications are available by mail (Emory University, Rollins School of Public Health [Attn: Pia], 1518 Clifton Rd. NE, CNR Bldg. Rm. 7038, Atlanta, GA 30322); by fax (404-727-4590); online (http://www.sph.emory.edu/epicourses); or by e-mail (pvaleri@sph.emory.edu).
2. Announcement: World Water Day --- March 22, 2011. Bringing clean water to cities is critical to achieving a healthier and more prosperous world. Globally, residents of rural areas are moving into cities in record numbers. By the year 2050, an estimated 70% of the world's population will be living in urban areas (1). To highlight the water-related needs of these fast-growing cities and the subsequent challenges faced by governments and utility companies, the theme for this year's World Water Day, March 22, 2011, is Water for Cities: Responding to the Urban Challenge. Many of the world's water systems are poorly maintained. More than half of the water might be lost to leakages and construction of illegal connections by nonpaying users (2). Even in cities with well-developed public water networks, the water might not always be safe to drink because of poor disinfection practices or because the water becomes contaminated once it is in the distribution network (3). Water plays a key role in many goals of international development programs (2,4). Recent cholera outbreaks in Zimbabwe and Haiti highlight the potentially devastating consequences of deficiencies in urban water supplies (5,6). In addition to the physical health of the population, water availability and quality is fundamental for agricultural production, food safety, economic growth, educational opportunities, and environmental management. Additional information about World Water Day activities and CDC's efforts to improve water quality and prevent disease is available at http://www.unwater.org/worldwaterday/index.html and http://www.cdc.gov/healthywater/global.
3. WellSteps, LLC. 935 East 900 North, Mapleton, UT 84664.
   
   • Broker Wellness Training Webinar Series for Brokers Only. The Broker Webinar series got off to a great start on February 24.  Missed it?  You can still join us April 7th for the second webinar in the series: How to use wellness strategies to improve employee health.  By attending the training series, you will Gain a competitive advantage over your competition; Help your clients improve employee health; Help your clients reduce employee related costs;  Become a trusted business consultant. Dr. Steven Aldana and Dr. Troy Adams, nationally known wellness experts and researchers, will share with you the evidence that supports worksite wellness and will show you how to implement effective worksite wellness programs. The first four webinars will cover the why, what and how. The last two webinars are for you AND your clients. Your clients will be impressed when you invite them to learn why and how to create an effective wellness program.  Best of all, this entire webinar series is FREE. Watch the recorded webinars here. Click here to learn more about the Broker Training Webinar Series.
   • Not Your Mother’s Wellness Program... Gone are the days of ineffective, traditional wellness programs.  With the WellSteps Turnkey Solution the future is here. Effective wellness programs help employees create and live in a culture of health. The WellSteps Turnkey Solution creates a new workplace culture. Watch the Turnkey video to see the future of wellness. Contact us to start creating a healthy workplace culture.
     
4. Please join The Robert Wood Johnson Foundation Center to Prevent Childhood Obesity and your colleagues in the field for our new webinar series, "Hand in Hand, Together We Can: Working with Communities to Improve America's Health." Webinars will be held every other week on Thursdays at 2 p.m. Eastern (1 p.m. Central, 12 p.m. Mountain, 11 a.m. Pacific). Register for upcoming webinars: http://www.reversechildhoodobesity.org/content/hand-hand-together-we-can-working-community-make-federal-and-local-change
   
   • New York City Active Design Guidelines: A Model for Promoting Physical Activity April 7 -- 2 p.m. Eastern (1 p.m. Central, 11 a.m. Pacific) In January 2010, New York City released innovative Active Design Guidelines, a set of evidence-based and best-practice strategies to guide public and private sector architects, designers, planners, owners, and managers on how to promote physical activity in the design, construction, and operation of buildings, streets, and neighborhoods. These model guidelines are the result of a unique multi-agency, inter-disciplinary collaboration. This webinar will highlight some of the most promising strategies including urban design, building design, and synergies between active and sustainable design as well as offer concrete steps for promoting active living through the built environment.
   • New York City Active Design Guidelines: A Model for Promoting Physical Activity April 7 -- 2 p.m. Eastern (1 p.m. Central, 11 a.m. Pacific) In January 2010, New York City released innovative Active Design Guidelines, a set of evidence-based and best-practice strategies to guide public and private sector architects, designers, planners, owners, and managers on how to promote physical activity in the design, construction, and operation of buildings, streets, and neighborhoods. These model guidelines are the result of a unique multi-agency, inter-disciplinary collaboration. This webinar will highlight some of the most promising strategies including urban design, building design, and synergies between active and sustainable design as well as offer concrete steps for promoting active living through the built environment.
   • Farm Bill 101 April 21 -- 2 p.m. Eastern (1 p.m. Central, 11 a.m. Pacific) The Farm Bill is a massive piece of federal legislation that authorizes billions of dollars for nutrition and agriculture programs across the country. It governs a wide range of federal farm and food policy and programs including vital domestic food and nutrition programs such as the Supplemental Nutrition Assistance Program (SNAP). The bill is reviewed and renewed every five years on average, with the next reauthorization slated for 2012. This webinar will give a brief overview of the current legislation and the political climate surrounding the pending reauthorization. It will also highlight how policies authorized through the Farm Bill are related to childhood obesity, and offer potential strategies for combating this epidemic through changes to our national, state, and local food policy.
   • Portraits of Success: The Farm Bill in Action May 12 -- 2 p.m. Eastern (1 p.m. Central, 11 a.m. Pacific) While the Farm Bill is is shaped at the federal level, its policies are implemented at the state and local levels. Initiatives such as EBT access at farmersâEUR^(TM) markets, assistance for local farmers to produce and distribute fresh fruits and vegetables, and programs that help make healthy food available to low-income children year-round are all funded through the Farm Bill. This session will highlight some of the community-based promising strategies that are currently underway to help improve access to affordable, healthy food choices for all.
   • Stay Informed: http://reversechildhoodobesity.us1.list-manage1.com/track/click?u=0dbac5f26ad18ac67959e871d&id=2b84b91b9c&e=2dd6cb8b4b Sign-up for RWJF Center Updates.
     
   
   

B.    News

1. CDC Report: Americans Feel Healthy. Americans Rate Their Health as 'Good' Despite Hikes in Obesity, Diabetes. Katie Moisse, ABC News, Mar 23, 2011. Despite rising rates of obesity and diabetes, 90 percent of Americans still rate their health as "good" or better, according to a report from the Centers for Disease Control and the National Center for Health Statistics. The report details the results of a national survey that probed 15 health indicators including obesity, diabetes, smoking, vaccinations and insurance coverage. Responders also rated their overall health as excellent, very good, good, fair or poor. Although the percentage of people who rated their health as excellent or very good decreased from 69 in 1997 to 66 in 2010, the proportion of Americans who rate their health as good or better is surprisingly high given the nine-point boost in obesity to 28.2 percent and the three-point rise in diabetes to 8.4 percent. "I think it just demonstrates the challenges we face in making people aware at the difference between how they feel right now and what their health risks are," said Dr. Jim Jirjis, director of the Adult Primary Care Center at Vanderbilt University Medical Center in Nashville, Tenn. Jirjis said health care providers would not rate an obese person's health as good because of the increased risk for other conditions like heart disease, stroke and diabetes. "Just because you're not in the middle of an acute health complication doesn't mean your health is good." Dr. Albert Levy, assistant professor of medicine at Mount Sinai School of Medicine in New York City, said multiple factors play into a person's subjective view of his health -- factors no less important than weight and blood sugar levels. "The doctor may see measures of unhealthiness, like weight and blood sugar. But good health is not only physical; it's psychological and emotional. It depends on family, work, economics, spirituality." Levy cautioned that the increase in rates of obesity and diabetes may also be a result of better detection, which is a good thing. However, the report also drew attention to the growing population of Americans who can't afford health care when they need it. The percentage of people who failed to obtain medical coverage because of cost increased from 4.5 percent in 1997 to 7 percent in 2010. "I think number one barrier to wellness and illness management is cost," Jirjis said. "I see people who, because of the economy and not having affordable health care, are gambling with their health care." Jirjis said he recently saw a married couple who refused to take their medications because they could only afford the drugs for one. "Society does not have an answer to provide affordable health care, so there's an increasing number of citizens who just don't have a safety net," Jirjis said. But other health indicators are moving in the right direction. More people are getting vaccinated, with flu shot rates climbing nine points to 40.7 percent and pneumococcal vaccination rates rising 18 points to 60.6 percent. "In the past I had to really explain the benefits of vaccination," Jirjis said. "I think public efforts to inform people have been successful." Jirjis, who is also assistant chief medical officer for electronic medical records, said improvements in recordkeeping make it more likely that patients will be offered vaccines their eligible for. In another change for the better, Americans are also smoking less. The proportion of adults who smoke decreased five points to 19.5 percent. "I think public policies that make it more and more difficult for people to smoke combined with the message that smoking is ugly and bad for your health is really taking effect, and that's good news" Jirjis said. And physical activity is up, rising five points to 34.8 percent. "If you are mobile -- if you can walk and move your arms -- you must exercise," Levy said. "You can start exercising at 60, 70, whatever age you are." Levy said among his patients, those who exercise regularly are "far better in every measure of health compared to those who don't." Levy said people who like to eat should exercise even more. "You don't have to go to a gym," he said. "You can walk, you can run, you can play ball with your children."
   
2. Local Health Departments Cut 29,000 Since 2008. Food Safety News, 03/22/2011. Budget reductions have forced local health departments to cut programs and staff, resulting in the loss of 6,000 public health jobs last year alone, according to survey released Monday by the National Association of County and City Health Officials (NACCHO).
3. Type 2 Diabetes Surges in People Younger Than 20. The Washington Post, Susan Brink, 03/21/2011. Today, about 3,700 Americans of 20 receive a diagnosis annually of what used to be called “adult-onset” diabetes, according to the Centers for Disease Control and Prevention. That relatively small number makes it a rare disease in children, but it represents a trend with larger ramifications.
4. Calorie counts on menus not meant to solve America's obesity crisis. Nicole Brochu, Sun-Sentinel, Mar 16, 2011. Calorie counts on chain restaurant menus were devised to help the health-conscious consumer - you know, the type who already cares about eating right -make more informed choices when eating out. The information was not meant, or realistically expected, to rescue America from the jaws of an overgrown obesity epidemic. So recent studies showing the nutritional labels are having minimal impact on certain populations should be greeted with a gaping yawn. The demographics studied - namely low-income kids and adults - historically indulge in eating habits that have proven particularly resistant to change. In fact, the only surprising thing about such studies is that anyone would find their results surprising. Take the study led by Brian Elbel, assistant professor of medicine and health policy at New York University School of Medicine, and published last month in the International Journal of Obesity. Elbel surveyed the purchases of 349 customers - kids aged 17 and younger, mostly accompanied by their parents - frequenting Burger King, Wendy's, McDonald's and Kentucky Fried Chicken restaurants in low-income neighborhoods in Newark, N.J., and New York City. He gathered his data both before the city required calorie counts on menus and after the law's 2008 mandate. The results: More than half of the adolescents and adults said they'd noticed the calorie information, but only 9 percent of adolescents and 16 percent of adults making choices for their children said it mattered in their purchases, according to a USA Today story. Those modest numbers are about all you can expect to see in fast food joints. If you're going to eat a Big Mac and Super-Size-me fries, or a bucket of Extra-Crispy dark-meat chicken from KFC, either you already know the food - as yummy as it may be - is unhealthy and don't care, or you don't want to know. So laying it all out in black and white is going to have limited impact. That said, I'm impressed that one out of six adults - and one in 11 adolescents - found the information influential. Because let's face it, people who frequent fast food restaurants aren't generally looking for nutritious food. They're looking for something quick, easy - and cheap. That is all the more true in neighborhoods with fewer resources to eat healthy on a daily basis. The occasional trip to Wendy's isn't likely to be the one healthy meal in the schedule, no matter how informative those calorie counts are. Elbel himself noted in the USA Today article that it is "harder to see an impact on these groups because they're also choosing based on availability and price of food." He said he specifically targeted low-income neighborhoods because this demographic is at greater risk of obesity, and fast-food chains tend to be their restaurant of choice. But expecting something as simple as menu calorie counts to have any meaningful impact on such entrenched eating habits smacks more of wishful thinking than any realistic prospect. That doesn't mean nutritional labels are not important. Plenty of people, me included, struggle to stay on a healthy eating plan, and dining out can become the greatest foil to a well-choreographed strategy. Even choosing a "healthy" entrée like Applebee's oriental chicken salad can mean ingesting more than half of an average person's recommended daily calorie intake. In such instances, nutrition counts can help a predisposed diner choose not just for taste, but for health. That makes for a more informed, better educated consumer. And, I suspect, empowering an educated consumer is what the architects of health reform had in mind when they mandated that all chain restaurants with 20 or more locations post calorie counts on menus beginning the first of this year. As for making a dent in the obesity rate, that is a more complicated challenge that will take a more comprehensive approach. Elbel says such a strategy should include asking restaurant owners to reformulate their menus, and there are many who would agree with him. Personally, I feel such a recommendation goes too far down the road to a nanny state. Give consumers more choices. Tell them what their choices mean to their health. And most of all, make healthy choices more available and affordable. Then, get out of the way. At the end of the day, good nutrition is a personal decision. And Americans should be free to make their choices however they see fit. If it's a juicy, fattening, artery-clogging Whopper with cheese, so be it - whether the diner is obese, or splurging on a rare treat. That's what freedom is all about. http://www.sun-sentinel.com/health/fl-nbcol-calorie-counts-broch0316-20110316,0,1293402.column. See section D. 1.4.1. below for B Ebel, Gyamfi, R Kersh. Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment. Conclusions: Adolescents in low-income communities notice calorie information at similar rates as adults, although they report being slightly less responsive to it than adults. We did not find evidence that labeling influenced adolescent food choice or parental food choices for children in this population. http://www.nature.com/ijo/journal/vaop/ncurrent/full/ijo20114a.html 
5. Americans Have Worse Health Than English Peers, Study Finds. This held true from birth to old age, researchers report. Jenifer Goodwin, HealthDay News, Mar 9, 2011. From birth through old age, Americans have poorer health than their British counterparts, a new study finds. Researchers used data on nearly 40,000 residents of the United States and 70,000 residents of England taken from nationally representative health surveys of the respective countries. After all the numbers were crunched, Americans had higher rates of nearly all chronic diseases and markers of diseases than people of a similar age in England. Those diseases and signs of poor health included: obesity, low HDL (good) cholesterol, high overall cholesterol, high C-reactive protein (a sign of inflammation), diabetes and asthma. American women had significantly higher rates of high blood pressure, stroke, heart attack or angina than English women of a similar age. For males, heart attack or angina is higher in the United States only at younger ages. High blood pressure is the one measure that was higher in England than in the United States at young ages among males. Taken together, the worse health of Americans by nearly every measure should be a wake-up call for the public and policymakers, said study author Melissa Martinson, a postdoctoral research associate in the Office of Population Research at Princeton University. … http://health.usnews.com/health-news/family-health/boomer-health/articles/2011/03/09/americans-have-worse-health-than-english-peers-study-finds.  For more on life expectancy, go to  http://www.oecd.org/dataoecd/22/36/45270718.pdf.  
6. Southeastern States Mired in the 'Diabetes Belt': CDC Report. HealthDay, Serena Gordon, 03/08/2011. People living in certain areas of the United States are more likely to develop diabetes, according to a new government analysis. Researchers from the U.S. Centers for Disease Control and Prevention have discovered that a wide swath across mostly southern U.S. states has diabetes rates above 11 percent, compared to 8.5 percent for the rest of the country.
7. From the Yale Rudd Center for Food Policy and Obesity March 2011 Health Digest (archives at http://www.yaleruddcenter.org/newsletter/archive.aspx)
   
   • Calories on Front of Beverages. The American Beverage Association recently announced that soft drink companies will display calorie information on the front of their bottles, cans, and other containers by the end of the year. Read more.
   • Massachusetts Limits Junk Foods in Schools. Public health regulators in Massachusetts have approved regulations to limit the sale of sugar-sweetened beverages, junk food, and white bread from all public schools. Read more.
   • Calorie Ranges Needed for Effective Menu Labels. An ideal range of calories is needed on menus with calorie listings to lower children’s consumption, according to the lead researcher of a study recently published in the International Journal of Obesity. A longer follow-up after repeated exposures to menu changes may also be needed to see a difference, noted the researcher. Read more.
   • First Lady Focuses on Restaurant Nutrition. First Lady Michelle Obama and her team of advisers have reportedly been meeting with the National Restaurant Association to get restaurants to adopt her goals of creating smaller portions and healthier children’s meals. Read more.
   • California Soda Tax Bill Introduced. A bill was introduced in California that would tax consumers one cent per teaspoon of added sugar on sugar-sweetened beverages. The excise tax could generate $1.5 billion in revenue a year and could be used for city and school health programs, according to the California Center for Public Health Advocacy. Read more.
   • Group Challenges Ronald McDonald. Advocates with the Corporate Accountability International group asserted that Ronald McDonald helped cause a massive rise in childhood obesity and compared the clown to tobacco’s Joe Camel – both deceptively lovable symbols used to lure in children. Read more.
   • Sports Celebrities Linked to Increase in Junk Food. Parents are more than twice as likely to buy junk food for their children if it is endorsed by a sports celebrity, according to an article recently published in the journal Public Health Nutrition. Read more.
   • America’s New School Lunches. Forty-six states currently have farm-to-school programs, an initiative in schools to create healthier meals for children using produce from local farmers, or in some cases, gardens the students create and maintain. Read more.
   • Soda Politics. The American Beverage Association has created commercials to sway consumers’ opinions about the beverage industry. One commercial states that the government is too involved in our personal lives while the other aligns itself with the First Lady. Read more.
8. Smart food: An ingenious way to get kids to eat healthy: Give cafeterias a psychology lesson. Margot Sanger-Katz, boston.com, Feb 27, 2011. Brian Wansink first became interested in the school lunchroom when he was asked to help a group of New York schools boost fresh fruit consumption among students. The state wanted to know how much they’d have to drop the price of apples to sell 5 percent more of them. But Wansink, a Cornell professor of applied economics, feared the schools could make the fruit free and students still wouldn’t eat more. He had a different idea: He told the school lunchroom managers to buy an attractive bowl from T.J. Maxx, and use the bowl to display the fruit in a prominent, well-lit place in the lunchroom. The schools saw fruit sales double. More remarkable still were the results of one school that misunderstood the “well lit” instruction. Managers there found a desk lamp in the back office and set it up to shine directly on their fruit bowl. At that school, sales of fresh fruit increased 186 percent. … http://www.boston.com/lifestyle/health/articles/2011/02/27/smart_food/?page=full9.    New Strategic Plan For NIH Obesity Research Seeks To Curb Epidemic. Researchers, health care professionals, the public create comprehensive plan. NIH News, Mar 31, 2011. To combat the obesity epidemic, the National Institutes of Health is encouraging diverse scientific investigations through a new Strategic Plan for NIH Obesity Research. More than one-third of adults in the United States and nearly 17 percent of the nation's children are now obese, which increases a person's chance of developing many health problems, including type 2 diabetes, heart disease, high blood pressure, fatty liver disease, and some cancers. In 2008, obesity-related medical costs were an estimated $147 billion. Government, nonprofit and community groups, businesses, health care professionals, schools, families, and individuals are taking action to address this public health problem -- and research can provide the foundation for these efforts. NIH funds research to reduce the prevalence of obesity and its health consequences, an investment of $824 million in fiscal year 2010, plus awards totaling $147 million made in the same year through the Recovery Act. This NIH strategic plan, developed by the NIH Obesity Research Task Force, recognizes that eating less and exercising more is easier said than done. Highlighting the crucial role of research in efforts to reduce obesity, the plan emphasizes moving science from laboratory to clinical trials to practical solutions, and is designed to help target efforts and resources in areas most likely to help. "Obesity has many causes and contributing factors. This plan is a bold blueprint that will encourage the research community to examine the epidemic of obesity from diverse perspectives," said NIH Director Francis S. Collins, M.D., Ph.D. "Through the scientific opportunities outlined in the strategic plan, researchers can work together toward the goals of preventing and treating obesity, to help people lead healthier and more fulfilling lives." The task force is co-chaired by Griffin P. Rodgers, M.D., director of the National Institute of Diabetes and Digestive and Kidney Diseases; Susan B. Shurin, M.D., acting director of the National Heart, Lung, and Blood Institute; and Alan E. Guttmacher, M.D., director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. These three institutes, along with the National Cancer Institute, led in the plan's development.While research continues, NIH resources can help people achieve or maintain a healthy weight now. Find tips and tools from the Weight-control Information Network at www.win.niddk.nih.gov, from Aim for a Healthy Weight at http://healthyweight.nhlbi.nih.gov, and from We Can! -- or Ways to Enhance Children's Activity & Nutrition -- at http://wecan.nhlbi.nih.gov. The Let's Move campaign, led by the White House, also provides valuable ways to prevent childhood obesity at www.LetsMove.gov. Learn more about obesity research at NIH, see a video about the plan from Collins, and view or request a free copy of the summary or complete Strategic Plan for NIH Obesity Research at www.obesityresearch.nih.gov. This NIH News Release is available online at: http://www.nih.gov/news/health/mar2011/niddk-31.htm.
9. Researchers discuss sugar’s highs, lows.  2011-03-23. By Ariel Rubissow-Okamoto. America's growing sweet tooth is super-sizing waistlines and the nation's health care price tag, warn University of California researchers. People in the U.S. are eating 21 times more sweet stuff today than the pilgrims and pioneers did, according to data presented by scientists at a symposium on sugar and other sweeteners, sponsored by the Center for Obesity Assessment, Study and Treatment (COAST) at UCSF, the UC Office of the President, UC Berkeley and UC Davis. The result of Americans' appetite for sugary foods is a spiraling number of people with "metabolic syndrome," a litany of ailments that includes diabetes, fatty liver, high blood pressure, heart disease and obesity. Some 50 million people in the U.S., including 35 percent of adults, now suffer from metabolic syndrome, according to the American Heart Association. And the annual medical costs for cardiovascular disease and type 2 diabetes alone have soared to $400 billion. The problem is now so weighty that one researcher urges the government to act aggressively to help alter diets. …
   

C.    Reports, Essays, Commentaries, Policy briefs

1. Leading Health Indicators for Healthy People 2020: Letter Report. Prepublication Available. Starting in 1990, the Department of Health and Human Services (HHS) has issued a national agenda aimed at improving the health of all Americans over the 10-year span. At the request of HHS, the Institute of Medicine (IOM) identified a set of leading health indicators…. The Report includes (Topic) Healthy Behaviors, (Indicator) Proportion of the population en¬gaged in healthy behaviors, (Objectives) 4. Increase the proportion of adults who meet current federal physical activity guidelines for aerobic physical activity and for muscle-strengthening activity (PA 2). 5. Reduce the proportion of children and adoles¬cents who are considered obese (NWS 10). 6. Reduce consumption of calories from solid fats and added sugars in the population aged 2 years and older (NWS 17). 7. Increase the proportion of adults who get sufficient sleep (SH 4).
2. Hunger and Obesity: Understanding a Food Insecurity Paradigm: Workshop Summary. Prepublication Available. At some point during 2009, more than 17 million households in the United States had difficulty providing enough food for all their members because of a lack of resources. In more than one-third of these households, the food intake of some household members was reduced and normal eating patterns were disrupted due to limited resources. The Workshop on Understanding the Relationship Between Food Insecurity and Obesity was held to explore the biological, economic, psychosocial, and other factors that may influence the relationship between food insecurity, overweight, and obesity in the United States. Hunger and Obesity examines current concepts and research findings in the field. The report identifies information gaps, proposes alternative approaches to analyzing data, recommends new data that should be collected, and addresses the limitations of the available research.
   
3. QuickStats: Average Daily Intake of Kilocalories, by Sex and Age Group, for Adults Aged 20 Years. National Health and Nutrition Examination Survey, United States, 2007—2008. full text. During 2007--2008, on average, men consumed 2,504 kilocalories daily, and women consumed 1,771 kilocalories daily. Men had a significantly higher intake of kilocalories than women in each of the three age groups: 20--39 years, 40--59 years, and ≥60 years. Men aged ≥60 years consumed fewer kilocalories than younger men, and women aged ≥60 years consumed fewer kilocalories than younger women. Source: Wright JD, Wang CY. Trends in intake of energy and macronutrients in adults from 1999--2000 through 2007--2008. NCHS Data Brief no. 49. Available at http://www.cdc.gov/nchs/data/databriefs/db49.htm.
4. QuickStats: Age-Adjusted Kilocalorie and Macronutrient Intake Among Adults Aged 20 Years, by Sex. National Health and Nutrition Examination Survey, United States, 2007—2008. full text. During 2007--2008, the average daily intake of kilocalories was 2,504 kilocalories for men and 1,771 kilocalories for women. Women consumed more energy from carbohydrates than men (50.5% of total daily intake of kilocalories, compared with 47.9% for men). A slight difference was observed in the percentage of kilocalories from protein (15.5% for women and 15.9% for men), and virtually no difference was observed in the percentage of kilocalories from fat (33.6% for men and 33.5% for women).Source: Wright JD, Wang CY. Trends in intake of energy and macronutrients in adults from 1999--2000 through 2007--2008. NCHS Data Brief no. 49. Available at http://www.cdc.gov/nchs/data/databriefs/db49.htm.
5. Most See Role for Government in Reducing Childhood Obesity. Conservative Republicans, Tea Party Supporters Disagree. Pew Research Center for the People & the Press, Mar 8, 2011. Overview. Most Americans say the government should play a significant role in reducing obesity among children. But there is strong opposition to government involvement in this effort among conservative Republicans and Tea Party supporters. The latest national survey by the Pew Research Center for the People & the Press, conducted Feb. 22-March 1 among 1,504 adults, finds that 57% say the government should play a significant role in reducing obesity among children, while 39% say it should not. However, the public does not view the fight against obesity as a major policy priority for the president and Congress. In Pew Research's annual policy priorities poll in January, just 19% rated dealing with obesity in this country as a top priority, the lowest among 22 items tested; nearly as many (14%) said it should not be done at all. (For more, see http://people-press.org/report/696/"Economy Dominates Public's Agenda, Dim Hopes for the Future".) The new survey finds wide partisan and ideological differences regarding the government's role in combating obesity. Overall, about seven-in-ten Democrats (71%) say government should have a significant role, compared with 57% of independents and 41% of Republicans. Four-in-five liberal Democrats (80%) say the government should have a major role tackling this issue, a view shared by just 37% of conservative Republicans.  Just a third (33%) of those who agree with the Tea Party think government should have a significant role in fighting childhood obesity, while about twice as many (65%) say it should not. Hispanics and African Americans are far more likely than whites to say the government should play a role in combating childhood obesity.  Large majorities in both groups (83% of Hispanics, 74% of African Americans) express this view, while just 49% of whites agree. Younger Americans are far more likely to see a significant role for government in cutting childhood obesity than are older Americans: Almost seven-in-ten (69%) of those younger than thirty say government should play a major role, while just 45% of those 65 and older agree.
   
6. Report shows which states’ counties are healthiest; obesity, income, education all play a role. Associated Press, Mar 29, 2011. CHICAGO - Startling differences in the health of residents living just a few miles apart are highlighted in a new health rankings report that assesses wellness in nearly all the nation’s 3,000-plus counties. A typical example is in Illinois, where the healthiest of its 102 counties, Kendall, is right next door to the one ranked 65th, LaSalle. Twice as many LaSalle County residents are in poor or fair health and smoking rates are double the national average. Suburban versus rural and proximity to big cities and high-paying jobs partly explain the disparities. Kendall County is on the edge of Chicago’s metropolitan area, while LaSalle County is more farming-based. “Affluent suburbs tend to have higher paying jobs, often in the cities, whereas rural communities often are dealing with loss of businesses” and declining populations of young people, who tend to be healthier, said Dr. Patrick Remington, a researcher at the University of Wisconsin’s Population Health Institute. The institute produced the rankings with the Robert Wood Johnson Foundation and their second annual rankings report was being released online Wednesday. Residents of rural communities also tend to have less education, less access to health care, and higher rates of substance abuse and smoking - all factors that contribute to the rankings. Still, counties encompassing big cities aren’t immune. Wyandotte County, Kansas learned that when the researchers released their widely publicized first county health rankings report last year. The county includes Kansas City and boasts two major medical centers, which officials figured would mean a top ranking. But Joe Reardon, mayor and CEO of Kansas City and county government, said the county’s listing - 96th out of 98 in Kansas - was a wake-up call. It prompted several meetings with county authorities, local institutions and citizens, resulting in plans for more urban grocery stores and public works projects that aim to make sidewalks and roadways safer and more usable for pedestrians and bicyclists. The rankings compare counties within each state. They’re based on data from vital statistics and government health surveys. In many cases, several years of data are used to calculate rankings, Remington said. For that reason, many rankings this year are similar to those from the 2010 report. Premature deaths - people dying before age 75 of preventable diseases; self-reported health status; and the percent of low birth-weight babies contribute to the rankings. Other measures include obesity rates, unemployment, high school graduation rates and pollution. Richard Sewell, a health policy specialist at the University of Illinois at Chicago, praised the report for including a wide array of important measures that affect health. “It’s a call to action” that leaders beyond the medical realm pay attention to, Sewell said. James Marks, director of the Robert Wood Johnson Foundation’s health group, said last year’s report resulted in an impressive amount of action in many counties that fared poorly. With annual rankings planned in the future, he said the reports likely will spur real improvement in Americans’ health.The report being released Wednesday can be found at: www.countyhealthrankings.org.
   

D.    Research and Reviews

1.    Child overweight/obesity

1.1.    Determinants, Risk factors, Co-occurring conditions
1.2.    Disparities
1.3.    Prevalence, Incidence
1.4.    Physical activity and Nutrition
1.4.1.    Elbel B, Gyamfi J, Kersh R. Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment. Int J Obes (Lond). 2011 Feb 15. [Epub ahead of print] PubMed PMID: 21326209. http://www.ncbi.nlm.nih.gov/pubmed/21326209
1.5.    Intervention, Outcomes, including Cost
1.6.    Measurement

2.    Adult overweight/obesity

2.1.    Determinants, Risk factors, Co-occurring conditions
2.2.    Disparities
2.2.1.    Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index. L P Palaniappan, E C Wong, J J Shin, S P Fortmann and D S Lauderdale. Int J Obes 2011 35: 393-400; advance online publication, August 3, 2010; 10.1038/ijo.2010.152. Abstract
2.2.2.    Martinson ML, Teitler JO, Reichman NE. Health Across the Life Span in the United States and England. Am J Epidemiol. 2011 Mar 9. [Epub ahead of print] PubMed PMID: 21389038. http://www.ncbi.nlm.nih.gov/pubmed/21389038
2.2.3.    Martinson ML, Teitler JO, Reichman NE. Martinson et al. Respond to "Search for Explanations of the American Health Disadvantage". Am J Epidemiol. 2011 Mar 9. [Epub ahead of print] PubMed PMID: 21389040. http://www.ncbi.nlm.nih.gov/pubmed/21389040
2.3.    Prevalence, Incidence
2.3.1.    Yanovski SZ, Yanovski JA. Obesity prevalence in the United States--up, down, or sideways? N Engl J Med. 2011 Mar 17;364(11):987-9. PubMed PMID: 21410367. http://www.ncbi.nlm.nih.gov/pubmed/21410367. Full text  
2.4.    Physical activity and Nutrition
2.4.1.    Eating out, weight and weight gain. A cross-sectional and prospective analysis in the context of the EPIC-PANACEA study. A Naska, P Orfanos, A Trichopoulou, A M May, K Overvad, M U Jakobsen, A Tjønneland, J Halkjær, G Fagherazzi, F Clavel-Chapelon, M-C Boutron-Ruault, S Rohrmann, S Hermann, A Steffen, J Haubrock, E Oikonomou, V Dilis, M Katsoulis, C Sacerdote, S Sieri, G Masala, R Tumino, A Mattiello, H B Bueno-de-Mesquita, G Skeie, D Engeset, A Barricarte, L Rodríguez, M Dorronsoro, M-J Sánchez, M-D Chirlaque, A Agudo, J Manjer, E Wirfält, V Hellström, D Shungin, K-T Khaw, N J Wareham, E A Spencer, H Freisling, N Slimani, A-C Vergnaud, T Mouw, D Romaguera, A Odysseos and P H M Peeters. Int J Obes 2011 35: 416-426; advance online publication, July 27, 2010; 10.1038/ijo.2010.142. Abstract
2.4.2.    Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, Schwarz P; The IMAGE Study Group. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. Conclusions: This comprehensive review of reviews identifies specific components which are associated with increased effectiveness in interventions to promote change in diet and/or physical activity. To maximise the efficiency of programmes for diabetes prevention, practitioners and commissioning organisations should consider including these components. BMC Public Health. 2011 Feb 18;11(1):119. PubMed PMID: 21333011; PubMed Central PMCID: PMC3048531. http://www.ncbi.nlm.nih.gov/pubmed/21333011.
2.4.3.    Onakpoya IJ, Wider B, Pittler MH, Ernst E. Food supplements for body weight reduction: a systematic review of systematic reviews. Obesity (Silver Spring). 2011 Feb;19(2):239-44. Epub 2010 Sep 2. PubMed PMID: 20814412. http://www.ncbi.nlm.nih.gov/pubmed?term=Onakpoya%20IJ
2.5.    Intervention, Outcomes, including Cost
2.5.1.    Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. C M Friedenreich, C G Woolcott, A McTiernan, T Terry, R Brant, R Ballard-Barbash, M L Irwin, C A Jones, N F Boyd, M J Yaffe, K L Campbell, M L McNeely, K H Karvinen and K S Courneya. Int J Obes 2011 35: 427-435; advance online publication, September 7, 2010; 10.1038/ijo.2010.147. Abstract | Full Text
2.5.2.    The ‘Healthy Dads, Healthy Kids’ randomized controlled trial: efficacy of a healthy lifestyle program for overweight fathers and their children. P J Morgan, D R Lubans, R Callister, A D Okely, T L Burrows, R Fletcher and C E Collins. Int J Obes 2011 35: 436-447; advance online publication, August 10, 2010; 10.1038/ijo.2010.151. Abstract
2.5.3.    Walls HL, Peeters A, Proietto J, McNeil JJ. Public health campaigns and obesity - a critique. Discussion: To date there is little evidence that community-based interventions and social marketing campaigns specifically targeting obesity provide substantial or lasting benefit. Concerns have been raised about potential negative effects created by a focus of these interventions on body shape and size, and of the associated media targeting of obesity. Summary: A more appropriate strategy would be to enact high-level policy and legislative changes to alter the obesogenic environments in which we live by providing incentives for healthy eating and increased levels of physical activity. Research is also needed to improve treatments available for individuals already obese. BMC Public Health. 2011 Feb 27;11:136. PubMed PMID: 21352562; PubMed Central PMCID: PMC3056747. http://www.ncbi.nlm.nih.gov/pubmed/21352562. Free full text. Related citations
2.5.4.    Conn VS, Hafdahl AR, Mehr DR. Interventions to increase physical activity among healthy adults: meta-analysis of outcomes. Am J Public Health. 2011 Apr;101(4):751-8. Epub 2011 Feb 17. PubMed PMID: 21330590. http://www.ncbi.nlm.nih.gov/pubmed/21330590
2.5.5.    Loveman E, Frampton GK, Shepherd J, Picot J, Cooper K, Bryant J, Welch K, Clegg A. The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health Technol Assess. 2011 Jan;15(2):1-182. PubMed PMID: 21247515. http://www.ncbi.nlm.nih.gov/pubmed/21247515.
2.6.    Measurement
2.6.1.    Use of self-reported height and weight biases the body mass index–mortality association. S W Keith, K R Fontaine, N M Pajewski, T Mehta and D B Allison. Int J Obes 2011 35: 401-408; advance online publication, August 3, 2010; 10.1038/ijo.2010.148. Abstract
2.6.2.    Abdominal diameter index and 12-year cardiovascular disease incidence in male bridge and tunnel workers. A C Ehrlich and D A Smith. Int J Obes 2011 35: 409-415; advance online publication, August 17, 2010; 0.1038/ijo.2010.143. Abstract
2.6.3.    Bergman RN, Stefanovski D, Buchanan TA, Sumner AE, Reynolds JC, Sebring NG, Xiang AH, Watanabe RM. A Better Index of Body Adiposity. Obesity (Silver Spring). 2011 Mar 3. [Epub ahead of print] PubMed PMID: 21372804. http://www.ncbi.nlm.nih.gov/pubmed/21372804