Maine Prevention Research Center

M-HPRC Infomonthly February 2011

Colleagues, friends,

Here is the “Info Monthly” for February 2011 (will it EVER stop snowing?) 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.

Thanks for all you do.

Robert H. Ross, PhD
Scientific Director, Maine-Harvard Prevention Research Center at the University of New England
February 28, 2011

A. Announcements

  1. Child Obesity Research Demonstration FOA Amended. ACA Publication Notice: NCCDPHP RFA-DP-11-007. The Childhood Obesity Research Demonstration Funding Opportunity Announcement. The following is notice that RFA-DP-11-007, “Affordable Care Act (ACA): Childhood Obesity Research Demonstration,” has been published on Grants.gov. The National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity and partners are pleased to send to you information on a Funding Opportunity Announcement related to Childhood Obesity Research. http://www.grants.gov/search/search.do?mode=VIEW&oppId=65553
    Background: The objective of the research demonstrations is to determine whether an integrated model of primary care and public health approaches in the community can improve underserved children’s risk factors for obesity.  These approaches may include policy, systems, and environmental supports that encourage nutrition and physical activity for underserved children and their families. Approach: Grantees will develop, implement, and evaluate multi-sectoral (i.e., childcare, school, community, health care), multi-level (i.e. child, family, organization, community, policy) intervention demonstration projects for underserved children ages 2-12 years and their families utilizing the  Obesity Chronic Care Model and other similar models. The Obesity Chronic Care Model provides a framework to integrate primary care and public health approaches with an intent to guides the design of strategies, approaches, systems, and/or tools to ultimately prevent and reduce childhood obesity. Component A: Demonstration Project funded grantees will design, implement, and evaluate the demonstration interventions, with evaluation support from the Component B Evaluation Center funded grantee. Standardized measures across sites will be collected to determine  whether the demonstration research project led to changes in preventive services, policy, systems, and environment (e.g. setting, community), and individual outcomes including health (nutrition, physical activity, weight), satisfaction, health care utilization and quality of life. The results of the Demonstration projects will be used to generate a recommendation that determines whether program components, similar to the awarded demonstration projects, should be implemented nationally for the general population of children who are eligible for child health assistance under Title XXI (CHIP) of the Social Security Act. The Component B funded grantee, the Evaluation Center, will design and conduct the overarching evaluation that will support this recommendation, in collaboration with the Component A Demonstration Project funded grantees and CDC. RFA-DP-11-007, “Affordable Care Act (ACA): Childhood Obesity Research Demonstration” The closing date for this FOA is April 8, 2011.
  2. National Collaborative on Childhood Obesity Research Launches Surveillance Resource. A compilation of 75+ U.S. surveillance systems provides researchers with a one-stop resource on childhood obesity data. News Release, NCCOR, Feb 4, 2011. WASHINGTON, DC, Feb. 4, 2011 –The National Collaborative on Childhood Obesity Research (NCCOR) announced today the launch of a new, free online resource to help researchers and practitioners more easily investigate childhood obesity in America. NCCOR's Catalogue of Surveillance Systems describes in detail existing surveillance systems that collect data related to childhood obesity. It provides one-stop access to more than 75 surveys and other data sets, allowing users to search and select surveys that provide a wealth of data at the national, state, and local levels on a range of variables, including school policies and health outcomes, as well as eating and exercise behaviors. Health officials at the city and state level also can find data related to their programs. Using the Catalogue, researchers can:
    • identify surveillance systems to meet their research and program needs
    • compare attributes across systems
    • find information about the systems
    • link directly to the systems to download data or other information.
    "NCCOR's Catalogue of Surveillance Systems is a valuable tool for any researcher focused on childhood obesity," said NIH Director, Dr. Francis Collins. "Searching for information on data in these systems now takes a matter of minutes rather than hours, or even days. It is also now possible to see which data systems can be linked in order to study these health behaviors at the individual and environmental levels." The Catalogue of Surveillance Systems is available at www.nccor.org/css. To register for upcoming webinars on the features and uses of the Catalogue, please send an e-mail to css@aed.org. Please visit www.nccor.org for more information about the Catalogue, a full list of NCCOR-led projects, upcoming events, and childhood obesity research highlights. for more information about the Catalogue, a full list of NCCOR-led projects, upcoming events, and childhood obesity research highlights. http://nccor.org/press/index.php
  3. HHS Announces $750 Million Investment in Prevention. New health care law provides new funding to reduce tobacco use, obesity and heart disease, and build healthier communities. News Release, HHS Press Office, Feb 9, 2011. Department of Health and Human Services Secretary Kathleen Sebelius today announced a $750 million investment in prevention and public health, funded through the Prevention and Public Health Fund created by the new health care law. Building on $500 million in investments last year, these new dollars will help prevent tobacco use, obesity, heart disease, stroke, and cancer; increase immunizations; and empower individuals and communities with tools and resources for local prevention and health initiatives.The Prevention and Public Health Fund, part of the Affordable Care Act, is designed to expand and sustain the necessary capacity to prevent disease, detect it early, manage conditions before they become severe, and provide states and communities the resources they need to promote healthy living.  In FY2010, $500 million of the Prevention Fund was distributed to states and communities to boost prevention and public health efforts, improve health, enhance health care quality, and foster the next generation of primary health professionals.  Today, HHS posted new fact sheets detailing how that $500 million was allocated in every state. Those fact sheets are available at www.HealthCare.gov/news/factsheets/prevention02092011a.html. This year, building on the initial investment, new funds are dedicated to expanding on four critical priorities:
    • Community Prevention ($298 million): These funds will be used to help promote health and wellness in local communities, including efforts to prevent and reduce tobacco use; improve nutrition and increase physical activity to prevent obesity; and coordinate and focus efforts to prevent chronic diseases like diabetes, heart disease, and cancer.
    • Clinical Prevention ($182 million): These funds will help improve access to preventive care, including increasing awareness of the new prevention benefits provided under the new health care law.  They will also help increase availability and use of immunizations, and help integrate behavioral health services into primary care settings.
    • Public Health Infrastructure ($137 million): These funds will help state and local health departments meet 21st century challenges, including investments in information technology and training for the public health workforce to enable detection and response to infectious disease outbreaks and other health threats.
    • Research and Tracking ($133 million): These funds will help collect data to monitor the impact of the Affordable Care Act on the health of Americans and identify and disseminate evidence-based recommendations on important public health challenges. 
    For more information about the FY2011 Prevention and Public Health Fund investments, visit http://www.HealthCare.gov/news/factsheets/prevention02092011b.html
    http://www.hhs.gov/news/press/2011pres/02/20110209b.html
    https://list.nih.gov/cgi-bin/wa.exe?A2=ind1102&L=HHSPRESS&P=R400
  4. Let’s Move! Resources Available. Let’s Move! A First Lady initiative dedicated to solving the problem of obesity within a generation has made available a variety of resources for use in organizations and communities.  Some of these are specific to physical activity including a First Lady Column on Physical Activity.
  5. Shape Up America! Newsletter. Shape Up America! is a national initiative involving a broad-based coalition of industry, medical/health, nutrition, physical fitness, and related organizations and experts to promote healthy weight and increased physical activity in America.  They publish an electronic newsletter.
  6. P.E.4LIFE Newsletter. P.E.4LIFE is a national advocacy organization established to promote quality, daily physical education programs for our nation’s children in grades K-12.  Newsletters are sent to subscribers with the latest information.
  7. New NIH Cookbook Encourages Families To Eat Healthfully. Keep the Beat Recipes: Deliciously Healthy Family Meals. NIH News, Feb 14, 2010. Nutritious meals can be tasty and easy to prepare, according to a new family cookbook from the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
    Keep the Beat Recipes: Deliciously Healthy Family Meals has more than 40 kid-tested recipes featuring a variety of healthy entrees, side dishes, and snacks that parents and children can enjoy together. The free cookbook also offers time-saving tips and helpful resources for busy families. "Good food choices made early in life can support a lifetime of healthy habits. This cookbook can help parents make good decisions about the foods they serve their families," said NHLBI Acting Director Susan B. Shurin, M.D., a board-certified pediatrician. "With a healthy approach to cooking, families learn to enjoy the taste of heart-healthy meals that can help lower their risk of heart disease and other conditions." The recipes in the cookbook were designed and created for the NHLBI by David Kamen, a professor in Culinary Arts at the Culinary Institute of America, trained chef/instructor, and father of two. All of the recipes are based on heart-healthy principles from the NHLBI, include nutrition analysis, reflect the principles of the 2010 Dietary Guidelines for Americans, and provide guidance for preparing meals that are low in saturated fat, trans fat, cholesterol, sodium, and added sugars. The recipes also adhere to the NHLBI's Dietary Approaches to Stop Hypertension (DASH) diet, which supports an overall healthy eating plan. Keep the Beat Recipes: Deliciously Healthy Family Meals was developed in collaboration with the NIH's We Can! (Ways to Enhance Children's Activity and Nutrition) program. We Can! is a national education program supported by four NIH institutes and led by the NHLBI. The program is designed to provide parents, caregivers, and entire communities with strategies, tactics, and tools to help children stay at a healthy weight by eating healthfully, being active, and reducing screen time.  The cookbook can be used by the We Can! community sites as they implement programs for both parents and youth. The cookbook as well as individual recipes are available for free on the Keep the Beat: Deliciously Healthy Eating website, and hard copies can be ordered through the NHLBI Health Information Center. The site also features a searchable database, family resources, healthy shopping and cooking tips, videos, and information for the media. Visitors are also invited to engage in an online community through the Keep the Beat Facebook page, which contains information about upcoming events and cookbook highlights.  Log on at http://hin.nhlbi.nih.gov/healthyeating or contact the NHLBI Health Information Center at 301-592-8573 for more information.
    RESOURCES:

B.    News

  1. Kids Fed Unhealthy Foods Learn to Prefer Them. HealthDay News, Jan 27, 2011. Most preschool children develop a taste for salt, sugar and fat at home, and quickly learn which types of brand-name fast foods and sodas meet these preferences, U.S. researchers say. In one experiment, the mothers of 67 children, aged 3 to 5, were asked to list their youngsters' taste preferences and listed foods high in sugar, fat and salt. The researchers tested the children and found that the parents' answers were accurate. In a second experiment, the researchers looked at the association between the taste preferences of 108 preschool children and their emerging awareness of brands of fast food and sugar-sweetened beverages. The children were shown 36 randomly sorted product cards -- 12 related to each of two popular fast-food chains, six related to each of the two leading cola companies, and six depicting non-related products. All of the children were able to place some of the product cards with the correct companies, which demonstrated that they recognized these brands. The results "suggest that fast food and soda brand knowledge is linked to the development of a preference for sugar, fat and salt in food," the researchers reported. Parents need to carefully consider the types of foods they give to young children at home and in restaurants, said study co-author T. Bettina Cornwell, a professor of marketing at the University of Oregon Lundquist College of Business. "Repeated exposure builds taste preferences," she said in a university news release. The study findings were released online ahead of publication in an upcoming print issue of the journal Appetite.
  2. Obesity Tied to Education, Income, but Not Suburbia: Study. HealthDay News, Feb 10, 2011. Low levels of education and income, but not suburban sprawl, are associated with higher rates of obesity, researchers report. The finding challenges the widely held view that people who live in cities tend to be thinner because they have more opportunities to walk, while people in suburban and rural areas have to drive most everywhere they go. For this study, researchers analyzed data from about 7 million people in rural and urban counties in Illinois, including residents in the metropolitan Chicago area. Within zip codes, increased rates of obesity were associated with being older and being male, along with the percentage of people who commute by car, are black or Hispanic, or own their homes, said the researchers at the Urban Transportation Center at the University of Illinois at Chicago. Rates of obesity were lower in zip codes with higher median income and more residents who had attended college. The findings could prove helpful in urban planning, according to research assistant professor Paul Metaxatos. "Ambitious land use policies to address obesity may have little success with the low-income ethnic minorities who are most in need of assistance," he said in a university news release. "Those in marginal, transportation-disadvantaged communities would benefit from better access to medical help, better food markets and information about lifestyle modification." 
  3. Obesity Rates Weigh Down Cities' Budgets. Trimming Obesity Would Save U.S. Cities Billions in Health Care Costs, Study Finds. Jennifer Warner, WebMD Health News, Jan. 28, 2011. Cities searching for ways to trim the fat and stretch their budget dollars may want to start looking at residents’ waistlines. A new study suggests that trimming high obesity rates in the nation’s most overweight cities could help local governments save more than $32 billion annually nationwide in associated health care costs. New information from the Gallup-Healthways Well-Being Index shows more than 6 in 10 or 62.9% of American adults were either overweight or obese in 2010, slightly more than the 62.2% reported in 2008. Researchers estimate that direct health care costs associated with obesity are about $50 million each year per 100,000 residents in U.S. cities with the highest obesity rates. That means if the nation’s 10 most overweight cities -- each with more than a third of its residents classified as obese with a body mass index (BMI) over 30 -- reduced their obesity levels to the 2009 national average of 26.5%, they could collectively save nearly $500 million in health care costs each year. Researchers say communities can help curb the cost of obesity by encouraging healthy behaviors.
    SOURCES: 2010 Gallup-Healthways Well-Being Index. News release, Gallup. http://www.webmd.com/fitness-exercise/news/20110127/obesity-rates-weigh-down-cities-budgets
  4. Healthy Lifestyle Newsletter. Division of Nutrition, Physical Activity and Obesity. February 8, 2011. CDC survey: 27% of grocery shoppers support small, local fruit and vegetable markets if they are convenient . Alternative markets are economically viable, improve food environment. When small fruit-and-vegetable stands or markets are available in the neighborhood, more than 25 percent of Americans say they stop by and shop at least once a week, especially when fresh items are in season. More than a quarter of U.S. food shoppers constitutes a viable market share for farmers, and it also has the potential to help Americans improve their fruit-and-vegetable-starved diets, according to a recent CDC study.  More Information:
  5. The difference between fructose and glucose: it's not all in your mind. Melissa Healy, Los Angeles Times, February 10, 2011. Many food activists and public health researchers are ready to pin a substantial portion of blame for the nation's obesity epidemic on the skyrocketing consumption of high-fructose corn syrup, widely used to sweeten processed foods and beverages in the U.S. since the 1980s. But food and beverage makers are fighting back. Glucose and fructose are both simple sugars--and equal parts of each is the recipe for table sugar. (High-fructose corn syrup is a bit more intensely sweet because it's made up of 55% fructose.) But scientists have long suspected there are differences in the way the human body processes these two forms of carbohydrate. But much of that research has been conducted on animals, leading many to question whether the human body makes any distinction between glucose and fructose. More research on humans would help. And while a study published online in the March issue of the journal Diabetes, Obesity and Metabolism raises more questions than it answers, it's a start. Researchers at Oregon Health and Science University scanned the brains of nine healthy, normal-weight  subjects in the minutes after each got an infusion of equal volumes of glucose, of fructose and of saline. The brain scans aimed to capture activity in a relatively small swath of the human brain in and around the hypothalamus, which plays a key but complex role in setting appetite levels and directing production of metabolic hormones. The researchers, led by Dr. John Purnell, found that "cortical control areas"--broad swaths of gray matter that surrounded the hypothalamus -- responded quite differently to the infusion of fructose than they did to glucose. Across the limited regions of the brain they scanned, Purnell and his colleagues saw that glucose significantly raised the level of neural activity for about 20 minutes following the infusion. Fructose had the opposite effect, causing activity in the same areas to drop and stay low for 20 minutes after the infusion. Saline--the control condition in this trial--had no effect either way. The researchers saw small changes in the same direction within the hypothalamus, where they had expected to see most of the action. But that didn't rise to the level of statistical significance. What does a different response in "cortical control areas" mean? At this point, said Purnell in a phone interview, it means nothing more than that the two substances did prompt different responses in the brain--that the brain did not respond to them identically. Within some of the "cortical control areas" where differences were seen, lie some important neural real estate, including regions where notions of reward and addiction are processed. As scientists have a closer look in future studies, they should be able to zero in on which specific areas are affected differently by the two forms of sugar, he said. As those studies look more closely at the hypothalamus, said Purnell, they also may perceive differences not picked up by his team's brain scans. "This is provocative data: humans respond to these two nutrients differently," said Purnell. But how differently, and differently how--remain to be explored, he added. http://www.latimes.com/health/boostershots/la-heb-fructose-021011,0,4216365.story
  6. Physical Exercise Helps Reduce Cancer Risk - WHO. http://www.dailytelegraph.com.au/news/breaking-news/physical-exercise-helps-reduce-cancer-risk-who/story-e6freuyi-1226000040145?from=public_rss. The Daily Telegraph, February 4, 2011. The World Health Organization is advising people to engage in at least 150 minutes of "moderate'' physical exercise a week to reduce the risk of breast and colon cancers, in new recommendations published today.   "Cancer is preventable and many cancers are avoidable,'' said Dr Eduardo Cazap, president of the Union for International Cancer Control (UICC) and one of the authors of the joint "Global Recommendations on Physical Activity for Health''.  UICC and WHO experts estimate based on scientific evidence that around 25 percent of breast and colon cancers could be prevented by undertaking physical activity, while exercise can also affect other types of cancers. 
  7. California lawmaker introduces soda tax bill. Lisa Baertlein, Reuters, Feb 18, 2011. LOS ANGELES (Reuters) - A California lawmaker introduced legislation on Thursday that would tax sodas and other sugar-sweetened drinks and use the proceeds to bankroll programs to fight childhood obesity. The bill, introduced by Democratic Senate Majority Leader Dean Florez, would slap a 1-cent levy on every teaspoon of added sugar and other caloric sweeteners in commercial beverages sold. The tax would be paid by companies that bottle soda and make finished beverages or syrup for fountain drinks, sponsors said. Initial projections from the California Center for Public Health Advocacy estimated the excise tax on beverage distributors could raise $1.5 billion a year, with funds going directly to cities and schools to pay for childhood obesity prevention programs throughout the state. California has been a pioneer of public health initiatives -- it was the first state to pass menu-labeling rules and implemented bans on artery-clogging trans-fats in restaurants and on soda sales in public schools. Bill Dombrowski, president of the California Retailers Association, said the bill introduced by Florez was more about raising revenue than improving health. "We view it as the first of what's going to be a series of attempts to raise revenue by the state, given its current budget crisis." Cash-strapped California isn't the only state turning to soda taxes as the U.S. economy remains weak. New York Gov. David Patterson, also a Democrat, for the second year in a row has proposed taxing sugary soft drinks. The American Beverage Association, whose members include Coca-Cola and numerous Coca-Cola bottlers and Kraft Foods, and its allies have strongly, and thus far successfully, opposed efforts to tax soda. Critics say soda taxes demonize some industries, hurt business, threaten an already weak economy and place an unfair burden on low-income shoppers. Public health advocates are increasingly vocal in their calls for taxes on soft drinks and other sweetened beverages to offset obesity-related medical costs and to fund public health efforts. Obesity rates have soared among U.S. children, along with rates of early heart disease, including high blood pressure, high cholesterol and type 2 diabetes. Nearly a third of U.S. children currently are obese or overweight and likely to stay that way for their entire lives. Obesity-related diseases account for nearly 10 percent of all medical spending in the United States, or an estimated $147 billion annually. The American Heart Association last year recommended that Americans dramatically cut sugar consumption. The group took aim at the estimated $115 billion U.S. market for soft drinks, which researchers said represented the No. 1 source of added sugars in the American diet. But, so far, industry is winning the battle. A soda tax was considered as an option to help pay for U.S. health care reform, but was quickly dropped. California in 1991 introduced the first snack tax in the United States to help eliminate its budget deficit. The tax legislation was unclear -- it applied to doughnut "holes" but not whole doughnuts and salted crackers but not those without salt. It was unpopular, causing such an uproar that it was repealed a year later. http://www.reuters.com/article/2010/02/18/us-california-sodatax-idUSTRE61H6KW20100218 
  8. Study Warns Against Energy Drinks for Kids, Teens. Washington Post “The Checkup”, Jennifer LaRue Huget, 02/15/2011  Caffeine in moderation can provide benefits, enhancing cognition, attention and physical endurance, for instance. But it's not clear to what degree, if any, those benefits extend to young people. Although the FDA limits the amount of caffeine in a soda to 71 mg per 12-ounce serving, energy drinks have so far eluded such restrictions because they are classified as dietary supplements.

C. Reports, Essays, Commentaries, Policy Briefs

  1. Investing in Communities to Improve Health. There is growing attention to the link between a person’s health and the health of their community. As a result, the community development field is beginning to consider health as a factor in decisions about how its investments are made – from grocery stores and schools to sidewalks and parks. The Winter Issue of Community Investments, published by the Federal Reserve Bank of San Francisco, examines the relationship between health and community development and the rich opportunities for partnerships between the two fields. Read the latest issue of Community InvestmentsMeasuring the impact of these investments in community health presents a unique challenge, write RWJF Vice President of Research and Evaluation David Colby and Research Assistant Sarah Pickell in a second publication of the Federal Reserve Bank of San Francisco. Colby and Pickell point out that because health is “priceless,” it cannot be measured by financial performance. Using examples such as health insurance coverage and childhood obesity, Colby and Pickell explain how the Foundation measures the impact of “priceless” investments and discuss how the community development field could benefit from this approach. Read “Investing for Good: Measuring Nonfinancial Performance” in Community Development Investment Review
  2. 10 States With the Deadliest Eating Habits. Charles B. Stockdale, Douglas A. McIntyre and Michael B. Sauter, 24/7 Wall St., February 9, 2011. http://finance.yahoo.com/family-home/article/112083/10-states-with-the-deadliest-eating-habits
    10. New Mexico. New Mexico's worst rankings occur in two metrics. It has the 44th-greatest percentage of households without a car that are more than 10 miles from a supermarket or grocery store and the 44th-greatest percentage of population that has low income and is more than 10 miles from a supermarket or grocery store, according to the United States Department of Ag1riculture. These metrics are significant because they suggest a lack of access to affordable and nutritious food. Residents may rely on fast food restaurants and convenience stores instead. New Mexico has the eighth-greatest amount of money spent on fast food per capita among all the states considered. 9. Arizona. Arizona has the second-fewest grocery stores per person, with only 0.17 for every 1,000 people. This illustrates a major restriction on healthy food access for one of the country's fastest growing states. One of the ways in which residents of Arizona are supplementing their diets is with fast food. Arizonans spent an average of $760.50 each on fast food in 2007, the fourth-greatest amount among the states. 8. Ohio. Because a large part of Ohio's poor population is located in major urban centers like Cleveland and Cincinnati, the state ranks well in regards to access to grocery stores among the poor. However, the state ranks third-worst in store availability across all income classes at 0.18 locations per 1,000 people, compared to 0.6 in first place North Dakota. Ohio's population has the 11th-greatest consumption of soft drinks, and top-10 highest consumption of both sweet snacks and solid fats. As a result of these poor diets, Ohio has an adult diabetes occurrence of over 10%, which is the 11th-worst rate in the country. 7. South Dakota. South Dakota has the fifth-smallest population in the country, and yet, it is the 17th-largest state in terms of geographic area. As a result, many residents have limited access to affordable and nutritious food. In fact, South Dakota has the greatest percentage of households with no car and which are more than 10 miles from a supermarket or grocery store, as well as the greatest percentage of low-income households which are more than 10 miles from a supermarket or grocery store. Only 10.1% of adults in South Dakota consume the U.S. Department of Health and Human Services' recommended two or more fruits and three or more vegetables per day, compared to the national average of 14%. This is the fifth-worst rate in the nation. 6. Nevada. Nevada spends the most per capita on fast food -- nearly $940 per person per year. This is roughly 25% more than Texas, the second-worst state, and well more than twice what Vermont residents spend. As might be expected, the state ranks in the bottom 10 for both households with no cars and low-income populations, defined as people with income less than 200 percent of the federal poverty thresholds, and proximity to grocery stores. Nevada's obesity and diabetes rates, are above average. 5. Oklahoma. The rate of household-level food insecurity, including households with food access problems as well as households that experience disruptions in their food intake patterns due to inadequate resources for food, is 15.2% in Oklahoma. The national rate is 13.5%. Oklahoma also has the third-lowest rate of adults who meet the recommended two fruit/three vegetable daily intake, with only 9.3% of adults doing so. Perhaps this is part of the reason Oklahoma's obesity rate is 31.4%, the fifth-worst in the country. 4. Kansas. Kansas has some of the easiest access (seventh-best) to stores where cheap and healthy food is available. It is clear, however, that most residents do not take advantage of this, as the state has one of the worst diets in the country. Residents consume the 12th-most sweet snacks per person as well as the 12th-most solid fats -- more than 20 pounds per person. The state ranks 28th in adult diabetes and 31st in obesity -- 28% of the state's adults are considered overweight. 3. Missouri. Missouri does not rank especially poor in any of the metrics considered, however it does rank badly in about almost every one. It has the 11th-lowest rates of adults eating the recommended amount of fruits and vegetables, the eighth-greatest rate of food insecurity, and relatively high rates of soft drink, sweet snack and solid fats consumption. Missouri has the ninth-worst rate of obesity among adults, with 30% having a body mass index greater than 30. 2. Alabama. Alabama residents consume 77 gallons of soft drinks per capita per year, the fourth-highest amount in the country. This is roughly 33% more than Oregon, which consumes the least. Soft drinks like cola have more sugar per ounce than nearly any other food we regularly consume, and it is clear that soda has helped contribute to Alabama's poor health outcomes. The state has the seventh-highest obesity rate and, predictably, the second-worst diabetes rate. More than 12% of the state's adult population has the disease. 1. Mississippi. Mississippi has the worst eating habits in the country. Only 8.8% of the adult population eats the recommended amount of daily fruits and vegetables, the lowest rate in the country. Residents consumed just under 82 gallons of soft drinks per capita in 2006, the greatest amount reported. Furthermore, the state has the third-highest rate of household-level food insecurity, with 17.1% of households being affected. It is perhaps unsurprising, then, that the state has the highest rates of both adult diabetes (12.8%) and adult obesity (34.4%).

D. Research and Reviews

1.    Child overweight/obesity

1.1.    Determinants, Risk factors, Co-occurring conditions
1.1.1.    The Relationship Between Sleep and Weight in a Sample of Adolescents. Leslie A. Lytle, Keryn E. Pasch and Kian Farbakhsh. Obesity 2011 19: 324-331; advance online publication, October 14, 2010; 10.1038/oby.2010.242. Abstract | Full Text
1.1.2.    Mediators of Maternal Depression and Family Structure on Child BMI: Parenting Quality and Risk Factors for Child Overweight. Regina L. McConley, Sylvie Mrug, M. Janice Gilliland, Richard Lowry, Marc N. Elliott, Mark A. Schuster, Laura M. Bogart, Luisa Franzini, Soledad L. Escobar-Chaves and Frank A. Franklin. Obesity 2011 19: 345-352; advance online publication, August 26, 2010; 10.1038/oby.2010.177. Abstract | Full Text
1.1.3.    Correlates of Participation in a Pediatric Primary Care–Based Obesity Prevention Intervention. Elsie M. Taveras, Katherine H. Hohman, Sarah N. Price, Sheryl L. Rifas-Shiman, Kathleen Mitchell, Steven L. Gortmaker and Matthew W. Gillman. Obesity 2011 19: 449-452; advance online publication, September 16, 2010; 10.1038/oby.2010.207. Abstract | Full Text
1.1.4.    The Differential Prevalence of Obesity and Related Behaviors in Two- vs. Four-Year Colleges. Melissa N. Laska, Keryn E. Pasch, Katherine Lust, Mary Story and Ed Ehlinger. Obesity 2011 19: 453-456; advance online publication, October 21, 2010; 10.1038/oby.2010.262. Abstract | Full Text
1.1.5.    Morbidity and Mortality Weekly Report (MMWR) Vital Signs: Prevalence, Treatment, and Control of Hypertension–United States, 1999—2002 and 2005—2008. February 4, 2011 / 60(04);103-108. Hypertension affects one in three adults in the United States and contributes to one out of every seven deaths and nearly half of all cardiovascular disease–related deaths in the United States. CDC analyzed data from the National Health and Nutrition Examination Survey (NHANES) on the prevalence, treatment, and control of hypertension among U.S. adults aged ≥18 years. Multivariate analysis was performed to assess changes in prevalence of hypertension, use of pharmacologic treatment, and control of blood pressure between the 1999–2002 and 2005–2008 survey cycles. This report summarizes that analysis. full text
1.1.6.    Morbidity and Mortality Weekly Report (MMWR). Vital Signs: Prevalence, Treatment, and Control of High Levels of Low-Density Lipoprotein Cholesterol — United States, 1999–2002 and 2005–2008. February 4, 2011 / 60(04);109-114. High levels of low-density lipoprotein cholesterol (LDL-C), a major risk factor for coronary heart disease, can be treated effectively. CDC analyzed data from 1999–2002 and 2005–2008 to examine the prevalence, treatment, and control of high LDL-C among U.S. adults aged ≥20 years. Values were determined from blood specimens obtained from persons participating in the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional, stratified, multistage probability sample survey of the U.S. civilian, non-institutionalized population. This report summarizes the findings of the survey. full text
1.1.7.    Parents and Vehicle Purchases for Their Children: A Surprising Source of Weight Bias. Amanda Kraha and Adriel Boals. Obesity 2011 19: 541-545; advance online publication, September 9, 2010; 10.1038/oby.2010.192. Abstract | Full Text
1.1.8.    Identifying Patterns of Eating and Physical Activity in Children: A Latent Class Analysis of Obesity Risk. Jimi Huh, Nathaniel R. Riggs, Donna Spruijt-Metz, Chih-Ping Chou, Zhaoqing Huang and MaryAnn Pentz. Obesity 2011 19: 652-658; advance online publication, October 7, 2010; 10.1038/oby.2010.228. Abstract | Full Text

1.2.    Disparities

1.3.    Prevalence, Incidence
1.3.1.    Pediatric obesity highlights from International Journal of Obesity. The International Journal of Obesity highlights a selection of featured articles by leading scientists and researchers that focus on the management, complications, and epidemiology of pediatric obesity. These pediatric obesity highlight issues are published quarterly in both print and online. Click here to check out the latest highlights.
1.3.2.    Longitudinal Study of Body Weight Changes in Children: Who Is Gaining and Who Is Losing Weight. Donald A. Williamson, Hongmei Han, William D. Johnson, Tiffany M. Stewart and David W. Harsha. Obesity 2011 19: 667-670; advance online publication, September 30, 2010; 10.1038/oby.2010.221. Abstract | Full Text

1.4.    Physical activity and Nutrition
1.4.1.    Cornwell TB, McAlister AR. Alternative thinking about starting points of obesity. Development of child taste preferences. Appetite. 2011 Jan 14. [Epub ahead of print] PubMed PMID: 21238522. http://www.ncbi.nlm.nih.gov/pubmed/21238522
1.4.2.    Preventing Obesity during Infancy: A Pilot Study. Ian M. Paul, Jennifer S. Savage, Stephanie L. Anzman, Jessica S. Beiler, Michele E. Marini, Jennifer L. Stokes and Leann L. Birch. Obesity 2011 19: 353-361; advance online publication, August 19, 2010; 10.1038/oby.2010.182. Abstract | Full Text
1.4.3.    Brennan L, Castro S, Brownson RC, Claus J, Orleans CT. Accelerating Evidence Reviews and Broadening Evidence Standards to Identify Effective, Promising, and Emerging Policy and Environmental Strategies for Childhood Obesity Prevention. Annu Rev Public Health. 2010 Mar 17. [Epub ahead of print] PubMed PMID: 21219169. http://www.ncbi.nlm.nih.gov/pubmed/21219169

1.5.    Intervention, Outcomes, including Cost
1.5.1.    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
1.5.2.    Parent-Only Treatment for Childhood Obesity: A Randomized Controlled Trial. Kerri N. Boutelle, Guy Cafri and Scott J. Crow. Obesity 2011 19: 574-580; advance online publication, October 21, 2010; 10.1038/oby.2010.238. Abstract | Full Text

1.6.    Measurement

2.    Adult overweight/obesity

2.1.    Determinants, Risk factors, Co-occurring conditions

2.2.    Disparities

2.3.    Prevalence, Incidence
2.3.1.    Offer A, Pechey R, Ulijaszek S. Obesity under affluence varies by welfare regimes: the effect of fast food, insecurity, and inequality. Econ Hum Biol. 2010 Dec;8(3):297-308. Epub 2010 Jul 27. PubMed PMID: 20801725. http://www.ncbi.nlm.nih.gov/pubmed/20801725

2.4.    Physical activity and Nutrition
2.4.1.    Regular Multicomponent Exercise Increases Physical Fitness and Muscle Protein Anabolism in Frail, Obese, Older Adults. Dennis T. Villareal, Gordon I. Smith, David R. Sinacore, Krupa Shah and Bettina Mittendorfer. Obesity 2011 19: 312-318; advance online publication, May 20, 2010; 10.1038/oby.2010.110. Abstract | Full Text
2.4.2.    Chefs' Opinions About Reducing the Calorie Content of Menu Items in Restaurants. Julie E. Obbagy, Margaret D. Condrasky, Liane S. Roe, Julia L. Sharp and Barbara J. Rolls. Obesity 2011 19: 332-337; advance online publication, September 2, 2010; 10.1038/oby.2010.188. Abstract | Full Text
2.4.3.    Blanck HM, Thompson OM, Nebeling L, Yaroch AL. Improving Fruit and Vegetable Consumption: Use of Farm-to-Consumer Venues Among US Adults. Prev Chronic Dis. 2011 Mar;8(2):A49. Epub 2011 Feb 15. PubMed PMID: 21324263. http://www.ncbi.nlm.nih.gov/pubmed/21324263
2.4.4.    A Mediterranean diet pattern with low consumption of liquid sweets and refined cereals is negatively associated with adiposity in adults from rural Lebanon. C Issa, N Darmon, P Salameh, M Maillot, M Batal and D Lairon. Int J Obes 2011 35: 251-258; advance online publication, July 6, 2010; 10.1038/ijo.2010.130. Abstract
2.4.5.    Mechanisms Behind the Portion Size Effect: Visibility and Bite Size. Kyle S. Burger, Jennifer O. Fisher and Susan L. Johnson. Obesity 2011 19: 546-551; advance online publication, October 14, 2010; 10.1038/oby.2010.233. Abstract | Full Text

2.5.    Intervention, Outcomes, including Cost
2.5.1.    The Effect of Electronic Self-Monitoring on Weight Loss and Dietary Intake: A Randomized Behavioral Weight Loss Trial. Lora E. Burke, Molly B. Conroy, Susan M. Sereika, Okan U. Elci, Mindi A. Styn, Sushama D. Acharya, Mary A. Sevick, Linda J. Ewing and Karen Glanz. Obesity 2011 19: 338-344; advance online publication, September 16, 2010; 10.1038/oby.2010.208. Abstract | Full Text
2.5.2.    . A motivation-focused weight loss maintenance program is an effective alternative to a skill-based approach. D S West, A A Gorin, L L Subak, G Foster, C Bragg, J Hecht, M Schembri and R R Wing for the Program to Reduce Incontinence by Diet and Exercise (PRIDE) Research Group.Int J Obes 2011 35: 259-269; advance online publication, August 3, 2010; 10.1038/ijo.2010.138. Abstract

2.6.    Measurement
2.6.1.    The Relationship of Waist Circumference and BMI to Visceral, Subcutaneous, and Total Body Fat: Sex and Race Differences. Sarah M. Camhi, George A. Bray, Claude Bouchard, Frank L. Greenway, William D. Johnson, Robert L. Newton, Eric Ravussin, Donna H. Ryan, Steven R. Smith and Peter T. Katzmarzyk. Obesity 2011 19: 402-408; advance online publication, October 14, 2010; 10.1038/oby.2010.248. Abstract | Full Text
2.6.2.    Waist Circumference, BMI, and Visceral Adipose Tissue in White Women and Women of African Descent. Anne E. Sumner, Lisa K. Micklesfield, Madia Ricks, Anita V. Tambay, Nilo A. Avila, Francine Thomas, Estelle V. Lambert, Naomi S. Levitt, Juliet Evans, Charles N. Rotimi, Marshall K. Tulloch-Reid and Julia H. Goedecke. Obesity 2011 19: 671-674; advance online publication, September 16, 2010; 10.1038/oby.2010.201. Abstract | Full Text


 
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