A Periodical Review of Research and Action
Issue 2 | October 2010
New from FRAC - Analysis of data on complicated relationship between obesity and poverty
Issue Briefs for Child Nutrition Reauthorization: Competitive Foods
- Federal Nutrition Programs and Obesity
- School Wellness
- Food Insecurity and Obesity
- Barriers to Healthy Eating
- Obesity in Early Childhood
- Environmental Influences and Disparities
New Reports and Resources
New from FRAC - Analysis of data on complicated relationship between obesity and poverty
While all segments of the U.S. population are affected by obesity, one of the common myths that exists is that all or virtually all low-income people are far more likely to be obese. In this generalization, two facts commonly are overlooked: (1) the relationship between income and weight can vary by gender, race-ethnicity, or age and (2) disparities by income seem to be weakening with time. In a new analysis, Do the Data Show A Relationship between Obesity and Poverty? (pdf), FRAC seeks to "unpack" the data and elucidate where low-income groups are more likely to be obese, and where they are not. Overall, the research for a greater risk of obesity is more consistent for women and children (especially White women and children) of low-income or low-socioeconomic-status than for men. In addition, there is evidence that where there are gaps between high- and low-income groups, they have been closing with time as those with higher incomes become more obese.
Issue Briefs for Child Nutrition Reauthorization (No. 5): How Competitive Foods in Schools Impact Student Health, School Meal Programs, and Students from Low-Income Families
Competitive foods - those foods available in vending machines, cafeteria à la carte lines, and elsewhere in schools that are not part of the official school meal programs - not only have a negative impact on the health and well-being of students but also contribute to fewer students participating in the school meal programs. A June analysis by FRAC, How Competitive Foods in Schools Impact Student Health, School Meal Programs, and Students from Low-Income Families (pdf), examines the role of competitive foods in schools and outlines strategies to improve the school food environment.
Competitive foods are widely available in U.S. public schools and are largely exempt from federal nutrition standards and regulation. They often are energy-dense, nutrient-poor items, and their availability at school can send contradictory messages to students about the importance of nutrition and health. They also can undermine the efficacy of the school meal programs. Sales of competitive foods lead to decreases in school meal participation, and the sales of such items often are subsidized by school meal reimbursements. In addition, the presence of competitive foods is especially harmful to children from low-income families, creating peer pressure and stigma that can drive students away from the regular meals program and to spend scarce dollars on less healthy food.
To improve the school food environment, especially with regards to competitive foods, FRAC recommends the following for Child Nutrition Reauthorization:
Research Highlights - Federal Nutrition Programs and Obesity
Impact of the federal nutrition programs on childhood obesity.
Findings from a new study underscore the importance of the child nutrition programs in childhood obesity prevention, as well as the need to consider local food prices in the context of obesity risk. Among a sample of 681 young (3 and 5 years of age), low-income children from 20 large U.S. cities, participation in federally-funded child care nutrition programs or school meals provided in child care, preschool, school, or summer settings was associated with a significantly lower body mass index (BMI). This finding led the study's authors to conclude that "subsidized meals at school or day care are beneficial for children's weight status, and we argue that expanding access to subsidized meals may be the most effective tool to use in combating obesity in poor children." In addition, with one exception, WIC participation and SNAP participation were not significantly associated with BMI in a variety of analyses examining direct and context-dependent effects (i.e., low or high food costs). The one exception: BMI was significantly higher among children receiving SNAP in cities with high food prices, which suggests that SNAP's impact on childhood obesity may depend on the purchasing power of program benefits (i.e., people with less purchasing power due to higher local food costs are less able to purchase a healthful diet).
Source: Kimbro, R. T. & Rigby, E. (2010). Federal food policy and childhood obesity: a solution or part of the problem? Health Affairs, 29(3), 411-418.
Cost of the Thrifty Food Plan when accounting for food preparation time.
The Thrifty Food Plan (TFP) - the basis for determining SNAP benefit allotments - underestimates the real costs associated with the plan because it does not account for the time needed to prepare food. This was the conclusion of researchers who developed economic models to compare the total TFP cost (including food preparation time) with the TFP allotment (excluding food preparation time) among 6,331 single-headed households with profiles comparable to current SNAP participants. The average total TFP cost was approximately $20 and $100 a week more than the average TFP allotment (estimated at $153.81 a week for the sample) if the labor requirement to prepare food was 8 and 16 hours a week, respectively. According to the authors, one reason why SNAP families may fall short in meeting TFP nutrition guidelines could be because "the TFP is not very thrifty once labor cost is included" or, viewed in terms of adequacy given the context, the allotment is not adequate to purchase a diet unless extra time - often unavailable time - is devoted to food preparation.
Source: Davis, G. C. & You, W. (2010). The Thrifty Food Plan is not thrifty when labor cost is considered. Journal of Nutrition, 140(4), 854-857.
Availability, affordability, and accessibility of the Thrifty Food Plan.
Brown University researchers created a theoretical market basket of foods that would fulfill the Supplemental Nutrition Assistance Program (SNAP, or food stamps) Thrifty Food Plan (TFP) guidelines and found that meeting TFP guidelines is challenging for residents of Central Falls, Rhode Island - a predominantly Hispanic, low-income city - due to the limited availability of stores offering foods to fill the market basket and high food costs. (The researchers did exclude those foods from their theoretical market basket that were generally unavailable based on a prior assessment of the retail stores in the area.) The findings are based on 22 retail stores that were evaluated on the variety and weekly cost of the theoretical TFP market baskets as well as proximity to public transportation. The most frequently sold TFP items in the stores were white bread, white rice, white pasta, tomatoes, milk, juice, eggs, and fish; less readily available items included brown rice, broccoli, lettuce, and fresh meats. Of the 22 retail stores, only two in the city (one small grocery store and one convenience store) and one discount supermarket in an adjacent city offered enough food variety to fill the TFP baskets. Compared to the national average, the TFP market basket costs were up to 30 percent higher at the small grocery store, 41 percent higher at the convenience store, and 18 percent cheaper at the discount store. Most of the 22 stores were accessible by public transportation.
Source: Sheldon, M., Gans, K. M., Tai, R., George, T., Lawson, E., & Pearlman, D. N. (2010). Availability, affordability, and accessibility of a healthful diet in a low-income community, Central Falls, Rhode Island, 2007-2008. Preventing Chronic Disease, 7(2), A43. (pdf)
Research Highlights - School Wellness
Impact of a state-wide school nutrition policy on student dietary energy density at lunch
Student dietary energy density at lunch significantly decreased after implementation of the Texas Public School Nutrition Policy in a study of three middle schools in Southeast Texas, possibly a result of increased consumption of foods offered through the National School Lunch Program (NSLP). The Texas Public School Nutrition Policy went into effect beginning in the fall of 2004 to promote a healthy school environment through restrictions on the fat content of all foods, sales of sweetened beverages, and portion sizes of snacks and high-fat foods. Compared to consumption prior to policy implementation, the energy density (kilocalories per gram, kcal/g) of foods at lunch decreased from 2.80 kcal/g to 2.17 kcal/g, though the greatest effects were observed at schools with higher socioeconomic status (SES). The energy density of foods and beverages at lunch decreased from 1.38 kcal/g to 1.29 kcal/g, but the reductions were only significant for lower SES schools. The overall positive improvements in energy density after policy implementation were associated with increased consumption of the NSLP entrée, NSLP dessert, vegetables, and fruit, and with decreased consumption of snack chips, fat/oil, and candy.
Source: Mendoza, J. A., Watson, K., & Cullen, K. W. (2010). Change in dietary energy density after implementation of the Texas Public School Nutrition Policy. Journal of the American Dietetic Association, 110(3), 434-440.
Research Highlights - Food Insecurity and Obesity
Household food insecurity and pregnancy-related weight.
Living in a food insecure household was associated with being severely obese before pregnancy and with experiencing greater weight gain during pregnancy in a study of 810 pregnant women in North Carolina with incomes less than or equal to 400 percent of the federal poverty line. Compared to women from food secure households, those from food insecure households were three times as likely to be severely obese before pregnancy (body mass index greater than or equal to 35) after controlling for age, race, education, marital status, number of children, and income. When adjusting for the latter factors as well as smoking, physical activity, gestational age, and pre-pregnancy body mass index, women reporting household food insecurity gained an average of 1.87 kilograms (approximately 4 pounds) more during pregnancy than women reporting household food security. This study is one of the few to examine household food insecurity and pregnancy-related weight, but the findings are consistent with research on food insecurity and weight status among nonpregnant women.
Source: Laraia, B. A., Siega-Riz, A. M., & Gundersen, C. (2010). Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications. Journal of the American Dietetic Association, 110(5), 692-701.
Food insecurity-obesity paradox in older adults.
In one of the few studies on obesity and food insecurity among seniors, obesity and weight-related physical disability were both associated with food insecurity among a sample of 621 older adults (median age of 76 years). Participants were recruited from 40 senior centers in Georgia and most received congregate meals at the centers. Rates of obesity (32.2 percent) and food insecurity (18.7 percent) were higher among this primarily White, female sample compared to the national average for older adults. Obesity (as assessed by waist circumference) was strongly associated with food insecurity in models that controlled for demographic characteristics, physical limitations, and/or overall health. Findings were less consistent for obesity classifications based on body mass index. Furthermore, weight-related disability was consistently and significantly associated with food insecurity in a number of statistical models, suggesting that physical limitations, obesity, and food insecurity may often co-exist among older adults.
Source: Brewer, D. P., Catlett, C. S., Porter, K. N., Lee, J. S., Hausman, D. B., Reddy, S., & Johnson, M. A. (2010). Physical limitations contribute to food insecurity and the food insecurity-obesity paradox in older adults at senior centers in Georgia. Journal of Nutrition for the Elderly, 29(2), 150-169.
Research Highlights - Barriers to Healthy Eating
Farmers' market use and related barriers among African-American WIC clients.
A pilot study examining farmers' market use by pregnant, African-American WIC clients in two U.S. cities suggests that the WIC Farmers' Market Nutrition Program (FMNP) can have an impact on farmers' market use both during and after participation in the program. WIC clients with previous FMNP participation reported higher farmers' market use rates than clients without previous FMNP participation (about two-thirds versus one-third). Previous redemption of FMNP vouchers and higher fruit and vegetable intake were all significantly associated with farmers' market use in models that adjusted for city of residence. A number of barriers to purchasing fruits and vegetables at farmers' markets were reported by the WIC clients, including lack of awareness of markets, lack of markets close to their home, lack of transportation to markets, and preference for grocery stores. More research, preferably with a larger sample, is needed to better understand farmers' market use among WIC clients as well as the potential impacts of the FMNP.
Source: Racine, E. F., Smith Vaughn, A., & Laditka, S. B. (2010). Farmers' market use among African-American women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. Journal of the American Dietetic Association, 110(3), 441-446.
Research Highlights - Obesity in Early Childhood
Child and maternal determinants of obesity among children enrolled in WIC.
A variety of child and maternal factors were associated with child obesity in a study of 22,837 preschoolers 2 to 4 years of age enrolled in the Texas WIC program. These findings highlight the need for effective interventions targeting young children as well as pregnant women and mothers who are overweight or obese. More specifically: living in a nonborder urban area, Hispanic race-ethnicity, maternal overweight, high maternal weight gain during the pregnancy with the child, and gestational diabetes during the pregnancy with the child were significantly associated with greater odds of child obesity when adjusting for demographic variables, mother's WIC certification status, and the number of times the mother was WIC-certified. It is important to note that the majority of the sample (84 percent) was Hispanic, a larger proportion than other studies on the topic, and obesity rates were higher than national estimates.
Source: Lewis, K. L., Castrucci, B. C., Gossman, G., Mirchandani, G., Sayegh, M. A., Moehlman, C., Van Eck, M., & Petrilli, K. (2010). Overweight among low-income Texas preschoolers aged 2 to 4 years. Journal of Nutrition Education and Behavior, 42(3), 178-184.
Research Highlights - Environmental Influences and Disparities
Immigrant and socioeconomic disparities in adult obesity prevalence.
Socioeconomic disparities in obesity prevalence are decreasing over time, and immigrant obesity risk increased with longer duration in the U.S. These are just a few highlights from a recent study of obesity and body mass index trends and disparities among immigrant and socioeconomic groups. In this large, nationally representative sample of adults, U.S. obesity rates tripled from 8.7 percent in 1976 to 27.4 percent in 2008. Obesity prevalence was higher in lower income and education groups, but the rate of increase in obesity over two decades was faster for higher income and education groups. For instance, in a 2003-2008 survey, the obesity rate was 28.4 percent for adults with family incomes under $10,000 and 22.1 percent for those with family incomes at or above $65,000. But between 1992 and 2008, obesity prevalence increased by only 42.3 percent for this lower income group compared to 88.5 percent for the higher income group. In addition, immigrants had lower obesity rates than those born in the U.S. for all 10 racial-ethnic groups under examination in the study, but the odds of being obese increased with increasing duration of U.S. residency in statistical models that controlled for sociodemographic factors.
Source: Singh, G. K., Siahpush, M., Hiatt, R. A., & Timsina, L. R. (2010). Dramatic increases in obesity and overweight prevalence and body mass index among ethnic-immigrant and social class groups in the United States, 1976-2008. Journal of Community Health, Epub ahead of print (June 12, 2010) (pdf).
Relationship between adult obesity and individual and neighborhood-level characteristics, including neighborhood income.
Neighborhood poverty, lesser availability of food and fitness amenities, and certain individual characteristics were associated with higher risk of obesity among a diverse sample of 9916 adults from across New York City. These were the key findings from one of the only studies to examine the joint effects of protective and "obesogenic" (i.e., obesity-promoting) neighborhood determinants of physical activity and nutrition while accounting for individual factors. With regard to individual-level characteristics, obesity rates were significantly higher for adults who were low-income (family income less than 100 percent of the federal poverty level), 45-64 years of age, Black or Hispanic/Latino, and born in the U.S. Neighborhood-level income was one of the neighborhood variables most strongly associated with obesity even when controlling for individual demographics, socioeconomic status (SES), and smoking - a $10,000 increase in a neighborhood's average annual income was associated with an approximate 10 percent reduction in a resident's risk of obesity. After controlling for neighborhood-level income and individual-level factors (e.g., demographics, SES, smoking), several other neighborhood-level characteristics were associated with lower risk of obesity, including greater availability of restaurants, fast food outlets, and beverage/snack food stores, as well as greater availability of large supermarkets and fitness facilities.
Source: Black, J. L., Macinko, J., Dixon, L. B., & Fryer, G. E., Jr. (2010). Neighborhoods and obesity in New York City. Health and Place, 16(3), 489-499.
Influence of food avoidance and modification on dietary quality among rural older adults.
Food avoidance and modification as a result of oral health problems have a significant impact on the dietary quality of older adults, based on a study of 635 ethnically-diverse adults 60 years of age or older residing in two rural North Carolina counties. Ethnicity, income, education, and tooth loss were significantly related to food avoidance and modification. For instance, 75 percent of those with incomes below the federal poverty line avoided at least one food, compared to 55 percent of those with incomes above the federal poverty line. Scores for dietary quality were significantly lower for older adults avoiding more foods but - because they were able to maintain more foods in the diet - dietary quality scores were significantly higher for older adults modifying more foods in models that adjusted for age, sex, ethnicity, poverty status, education, and tooth loss severity. Also in these models, older adults avoiding the most foods or modifying the fewest foods consumed more energy from solid fats and added sugars.
Source: Savoca, M. R., Arcury, T. A., Leng, X., Chen, H., Bell, R. A., Anderson, A. M., Kohrman, T., Gilbert, G. H., & Quandt, S. A. (2010). Association between dietary quality of rural older adults and self-reported food avoidance and food modification due to oral health problems. Journal of the American Geriatrics Society, 58(7), 1225-1232.
Relationship between childhood obesity and less favorable social and built environments.
Unfavorable neighborhood social conditions and built environments increased the odds of obesity and overweight among 10- to 17-year-old children in a nationally representative sample of more than 40,000 participants. After adjusting for age and gender, the odds of being obese were 61, 44, and 31 percent higher for children living in neighborhoods that were unsafe, had garbage and litter, and had poor housing conditions, respectively. However, these excess risks dropped to 5, 10, and 4 percent, respectively, when adjusted for individual-level sociodemographic and behavioral risk factors (e.g., race-ethnicity, household poverty or education levels, television viewing time, physical activity, etc.). But children also had about 20 percent higher odds of obesity if they lived in neighborhoods without access to sidewalks or walking paths, parks or playgrounds, and recreation or community centers, compared to children with access to such neighborhood amenities. In these cases, excess risk persisted, and even increased for some variables, after controlling for individual-level sociodemographic characteristics and behaviors. Furthermore, the built environment effects were strongest for girls and children 10 to 11 years of age. In fact, an unfavorable built environment had the most powerful influence on girls in this age category; they were two to four times more likely to be overweight or obese if they lived in neighborhoods with the fewest health-promoting amenities, compared to their counterparts with more amenities.
Source: Singh, G. K., Siahpush, M., & Kogan, M. D. (2010). Neighborhood socioeconomic conditions, built environments, and childhood obesity. Health Affairs, 29(3), 503-512.
Socioeconomic and racial/ethnic disparities in childhood obesity.
A separate analysis of that same national study of more than 40,000 children aged 10 to 17 years revealed that socioeconomic and racial-ethnic disparities in childhood obesity rates persist and, in some instances, have increased in magnitude over time. Obesity rates significantly increased, by 10 percent, for all U.S. children between 2003 and 2007, but by 23, 24, and 33 percent during the same time period for low-income children (below 100 percent of poverty), Hispanic children, and children with parents with less than 12 years of education, respectively. In 2007, children from households with lower socioeconomic status (SES) had more than two times higher odds of obesity or overweight than children from higher SES households, after adjusting for a number of demographic characteristics (e.g., age, race, gender) and behaviors (e.g., television viewing); the odds were less than two in 2003. In comparable analyses, Hispanic, non-Hispanic Black, and American Indian children had approximately three times higher odds of obesity or overweight than Asian children.
Source: Singh, G. K., Siahpush, M., & Kogan, M. D. (2010). Rising social inequalities in US childhood obesity, 2003-2007. Annals of Epidemiology, 20(1), 40-52.
Influence of economic factors on adolescent dietary intake and obesity.
Subsidies for fruits and vegetables, price increases on fast food and other energy-dense foods, and improvements in supermarket access could positively influence adolescent food consumption and weight outcomes. These are the policy implications proposed by researchers from the University of Illinois in a review of their extensive work examining the impact of economic contextual factors on adolescent dietary intake and obesity. Over time, they found that healthful foods like fruits and vegetables have increasingly cost more relative to unhealthful foods like fast food and soft drinks, and African-American and low-income neighborhoods have experienced the greatest reductions in grocery store availability. Based on national adolescent data, lower body mass index (BMI) was associated with higher fast food prices, lower fruit and vegetable prices, and greater supermarket access in a number of their studies, especially among low-income youth. Their research and other recent studies also suggest that it is the low cost of fast food rather than the widespread availability of fast food that influences adolescent diet and weight, particularly for overweight youth and low-income youth.
Source: Powell, L. M., Han, E., & Chaloupka, F. J. (2010). Economic contextual factors, food consumption, and obesity among U.S. adolescents. Journal of Nutrition, 140(6), 1175-1180.
Depression, income, and diet quality.
Diet quality was inversely related to depressive symptoms in a study of more than 1,100 African-American and white adults in Baltimore, Maryland - that is, those consuming lower quality diets reported more depressive symptoms. This relationship between diet quality and depressive symptoms was weaker but still significant after adjusting for education, income, sex, and race. While race was not a significant predictor of depressive symptoms in the latter statistical model, female gender, low education levels, and lower incomes also were each associated with increased depressive symptoms. In fact, income was a stronger predictor of depressive symptoms than diet quality, education, or sex. Age and food-assistance program participation were not significant predictors in any of the statistical models and, therefore, were dropped from all final analyses.
Source: Kuczmarski, M. F., Cremer Sees, A., Hotchkiss, L., Cotugna, N., Evans, M. K., & Zonderman, A. B. (2010). Higher Healthy Eating Index-2005 scores associated with reduced symptoms of depression in an urban population: findings from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study. Journal of the American Dietetic Association, 110(3), 383-389.
New Reports and Resources
White House Task Force on Childhood Obesity's Report to the President: Solving the Problem of Childhood Obesity within a Generation
The White House Task Force on Childhood Obesity released an action plan designed to solve the problem of childhood obesity in a generation. It includes a number of recommendations focused on increasing access to the federal nutrition programs, increasing access to healthy and affordable foods in communities, and improving the quality of school foods. The 70 recommendations in the action plan target five priority areas, including the four pillars of the "Let's Move!" campaign (empowering parents and caregivers, providing healthy food in schools, improving access to healthy and affordable foods, increasing physical activity opportunities), plus early childhood. Specific recommendations include the following:
Read FRAC's analysis of the report.
Source: White House Task Force on Childhood Obesity. (2010). Solving the Problem of Childhood Obesity within a Generation. Accessed on September 17, 2010.
Convergence Partnership Report: Recipes for Change - Healthy Food in Every Community
The Prevention Institute authored a Convergence Partnership report outlining organizational practices and public policies to improve access to healthy foods, particularly in low-income communities and communities of color. Based on key informant interviews and a scan of policy and research reports, the report details strategies in four categories: retail food environments (e.g., invest in fresh food financing initiatives, ensure that grocery stores and small stores are equipped to accept SNAP and WIC benefits); institutional environments (e.g., set nutrition standards for competitive foods in schools); federal nutrition assistance programs (e.g., improve SNAP benefits, expand access to federal child nutrition programs); and regional food systems (e.g., establish incentives and resources for growers to produce healthy products). The guide is a useful resource for community leaders, funders, practitioners, and advocates interested in promoting healthy eating and active living in communities.
Source: Convergence Partnership. (2010). Recipes for Change: Healthy Food in Every Community (pdf). Accessed on September 17, 2010.
Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute Data Release: County Health Rankings
The Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute released the first set of reports to rank the overall health of every county in all 50 states and found that poorly ranked counties tend to have less access to healthy foods and higher rates of premature death, smoking, obesity, poverty, and unemployment. Using the latest available data, each county was ranked within its state on how healthy people are and how long they live. Counties also were ranked on key factors that influence health, including obesity, access to primary care providers, rates of high school graduation, access to healthy foods, income inequality, unemployment rates, and the number of children living in poverty. View the county rankings and online tool with state summary reports, color-coded maps and tables, and resources for taking action.
Source: Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute. (2010). County Health Rankings. Accessed on September 17, 2010.
USDA Data Release: Food Environment Atlas
The USDA Economic Research Service released an interactive Food Environment Atlas to provide a spatial overview of a community's ability to access healthy food and its success in doing so. Users can assemble local-level statistics on food choices (e.g., access and proximity to a grocery store), health and well-being (e.g., diabetes and obesity rates), and community characteristics (e.g., poverty rates). This online tool was unveiled at a briefing to launch the "Let's Move!" childhood obesity campaign during which First Lady Michelle Obama announced the Administration's goal to eliminate food deserts within seven years so that all Americans have access to healthy, affordable foods.
Source: U.S. Department of Agriculture, Economic Research Service. (2010). Food Environment Atlas. Accessed on September 17, 2010.
CDC Data Release: Youth Risk Behavior Surveillance - United States, 2009
The CDC released the most recent prevalence rates of overweight and obesity among high school students for the nation, 42 states, and 20 local communities. Based on the 2009 Youth Risk Behavior Surveillance System (YRBSS), the national rates of overweight and obesity among high school students are 15.8 percent and 12.0 percent, respectively. Across states, rates of overweight range from 10.5 percent (Utah) to 18.0 percent (Louisiana), and rates of obesity range from 6.4 percent (Utah) to 18.3 percent (Mississippi). In conjunction with this release, the CDC updated the Youth Online resource for creating custom graphics and performing statistical tests on the YRBSS data. Follow this link to learn more about the YRBSS, which includes a variety of measures on health behaviors, and to access Youth Online.
Source: Eaton, D. K., Kann, L., Kinchen, S., Shanklin, S., Ross, J., Hawkins, J., Harris, W. A., Lowry, R., McManus, T., Chyen, D., Lim, C., Whittle, L., Brener, N. D., & Wechsler, H. (2010). Youth Risk Behavior Surveillance - United States, 2009. Morbidity and Mortality Weekly Report, 59(5), 1-142.
Institute of Medicine Report: Bridging the Evidence Gap in Obesity Prevention
Given the need for useful, relevant, and evidence-based prevention strategies to address the U.S. obesity problem, an Institute of Medicine committee developed the L.E.A.D. framework process (short for Locate evidence, Evaluate it, Assemble it, and inform Decisions) in their April report, Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making. The action-oriented L.E.A.D. framework was designed to guide the use of evidence in decision-making about obesity prevention policies and programs and to guide the generation of new and relevant evidence.
Source: Institute of Medicine. (2010). Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making. Washington, DC: The National Academies Press.
F as in Fat: How Obesity Threatens America's Future 2010
A new report from the Trust for America's Health (TFAH) and Robert Wood Johnson Foundation (RWJF) examined obesity trends and assessed policies addressing it. Among the many findings, adult obesity rates have increased in 28 states in the past year and only declined in the District of Columbia. Thirty-eight states have adult obesity rates that exceed 25 percent, with the highest rates in Mississippi, Alabama, Tennessee, West Virginia, and Louisiana. State rates of child obesity (among 10- to 17-year olds) ranged from 9.6 percent to 21.9 percent, with the highest rates in Mississippi, Georgia, Kentucky, Illinois, and Louisiana. Some states with the highest obesity rates also have the highest poverty rates. There has been a substantial increase in state anti-obesity legislation in the past few years, including more states with legislation setting nutritional standards for competitive foods sold in schools and requiring stricter standards than the USDA for school meals and snacks. According to TFAH and RWJF survey findings presented in the report, 81 percent of American voters believe childhood obesity is a serious problem and 73 percent believe childhood obesity prevention is an important priority for the government to focus on.
Source: Levi, J., Vinter, S., St. Laurent, R., & Segal, L. M. (2010). F as in Fat: How Obesity Threatens America's Future 2010 (pdf). Accessed on September 17, 2010.