Recent News Archive


Coming Soon — A New Drug to Treat Obesity

For the first time in more than three years, the Food and Drug Administration (FDA) approved a new drug for the long-term treatment of adult obesity. Contrave® is a combination of two drugs that were already on the market for other purposes: naltrexone SR (sustained release), used for the treatment of drug and alcohol dependence, and bupropion SR, an antidepressant that is also used to promote smoking cessation. Although Contrave was developed by Orexigen Therapeutics, it will be marketed by Takeda Pharmaceutical Company Limited as early as this fall. Contrave is taken orally and appears to act on the brain to suppress appetite and cause weight loss. One key factor that delayed FDA approval was the possibility that cardiovascular problems might develop that would outweigh the weight loss benefits of Contrave. Consequently, a study was conducted by Orexigen to focus on cardiovascular outcomes. The results suggested Contrave is safe for long-term use, a finding that undoubtedly helped Contrave win FDA approval. It is important to keep in mind that this drug was tested and found effective in combination with lifestyle changes. No drug currently on the market can substitute for healthy food choices, portion control and increased physical activity, which together comprise the foundation of successful weight loss interventions.


National Report Card on Physical Activity in Youth Shows Much Room for Improvement

The first-ever United States Report Card on Physical Activity for Children and Youth gave kids ages 6 to 15 a D-minus on overall physical activity, with only about one-quarter of these children meeting the recommended 60 or more minutes of moderate-to-vigorous physical activity a day.

The Report Card, released by the National Physical Activity Plan Alliance and the American College of Sports Medicine, measured 10 indicators related to kid’s physical activity levels, including active transportation, sedentary behaviors, participation in organized sports, school physical education courses, and community parks and playgrounds. Grades were given based on data from multiple nationally representative surveys.

The highest grade, a B-minus, went to community efforts, with 85% of kids living in neighborhoods with at least one park or playground. But an F grade went to active transportation, with only 13% of kids walking or biking to school.

Sedentary behaviors were high, resulting in a D grade, with only 54% of youth spending no more than two hours of screen time a day, including watching TV and playing on the computer or with video games. A C-minus was given for both organized sport participation and physical education (PE) class attendance in high school. Only 58% of students participated in organized sports or were on a sports team. Just 52% went to one PE class a week on average, with attendance dropping from 68% in 9th grade to 38.5% in 12th grade.

Here is a table summarizing the Report Card indicators and grades. The Report Card supports the need to promote physical fitness among American youth. Improving physical activity opportunities can improve health, help prevent obesity and enhance children’s quality of life.


Small Changes to Fast-food Kids’ Meals Can Help Cut Calories

In 2012, McDonald’s introduced a healthier Happy Meal® for kids that changed the side options and lowered the total calories in the meal combo. Curious researchers wanted to know if cutting the calories on the sides would cause kids to choose a higher-calorie entree or beverage to compensate for the reduced calories in the side items.

Before 2012, a Happy Meal was served with a choice of chicken nuggets, cheeseburger or hamburger; a side choice of small-size French fries or a package of apple slices with low-fat caramel dip; and a beverage option of a soft drink, 1% white milk, 1% chocolate milk or apple juice. By April 2012, all restaurants in the chain served an even smaller kid-sized French fries and a packet of apple slices without the dipping sauce with every meal. Advertising featured 1% white milk or fat-free chocolate milk, although other beverage options were available. The side items served in the healthier 2012 Happy Meal had 98 fewer calories than previous offerings.

Cornell University researchers Dr. Brian Wansink and Dr. Andrew Hanks analyzed sales data from 30 McDonald’s restaurants around the U.S. to find out what kids ate when served lower-calorie side items with their Happy Meals. The researchers found that 99% of the kids ordered the same entrée, with chicken nuggets making up 62% of orders. About 11% fewer children ordered sugary soda and 22% more chose white or chocolate milk. With the smaller-sized fries and apple slices as side items and the kids’ choice of beverage, the total calories for the meal dropped by 104 calories.

The researchers concluded that small changes in the foods automatically offered or promoted in children’s meals can reduce calories and improve overall nutrition from selected foods as long as an indulgence is included. Balancing a meal with smaller portions of favored foods might avoid a child’s resistance to not having any indulgence and overeating. For example, at home, giving a child a piece of fruit and a smaller amount of potato chips with a sandwich may be healthier than providing no indulgence at all.


Hunger is linked to obesity in children

It may not seem possible that a hungry child can be overweight. But when families need to stretch their food dollars, the tendency is to buy less expensive, calorie-dense foods instead of more costly, nutrient-rich foods. Limited access to healthy foods and uncertainty of having enough food to eat may lead to nutrient deficiencies and obesity.

According to the Academy of Nutrition and Dietetics, one in five children live in a food insecure home, meaning their families’ income does not allow for consistent access to food. Food insecurity can lead to increased weight or obesity in several ways:

  • When food is not available, children may eat just a little at meals or skip some meals. When food is available, they may eat a healthier diet, but some children may overeat because of fear of not having food in the future.
  • High family stress levels due to finances, housing, healthcare or other stressors may lead to unhealthy eating, or choosing to pay bills, for example, over buying healthy food for the family.
  • Limited access to grocery stores that offer a variety of healthy foods, such as fruits and vegetables, may mean more purchases at convenience stores or fast food restaurants. Many of these foods can satisfy hunger but may fall short on important nutrients needed for growth and development.

Food insecurity can also affect children’s health; if it causes obesity, this may lead to other health issues such as high blood pressure and diabetes. Children who are food insecure may have lower test scores and difficulty concentrating and may be more likely to have behavioral problems at school.

Some programs that can help reduce hunger and food insecurity include school breakfast and lunch programs, school and community gardens, SNAP (Supplemental Nutrition Assistance Program) and WIC (Women, Infants, and Children).

This Nourish to Flourish infographic by the Academy of Nutrition and Dietetics summarizes the link between hunger and obesity and what can be done to prevent food insecurity and help keep kids nourished and healthy.


Child and adult obesity rates remain high, but decline in 2- to 5-year-olds

Overall obesity rates in the U.S. have hardly budged in the past decade, but obesity in 2- to 5- year-old children dropped 43 percent, cccc according to a new report from the Centers for Disease Control and Prevention (CDC).

Obesity in these young children fell from nearly 14 percent in 2003-2004 to just over 8 percent in 2011-2012, a welcome sign compared to other age groups. In 2011-2012, about 17 percent of youth ages 2 to 19 and nearly 35 percent of adults were obese, similar to the rates in the previous eight years. However, obesity among women over age 60 increased from 31.5 percent to about 38 percent over the same eight-year period.

The CDC study did not identify the reasons for the decline in obesity among the very young, but CDC research suggests two possible reasons: children are consuming fewer sugar-sweetened drinks and more women are breastfeeding, which helps prevent obesity in breastfed children. Another possibility is that many child care centers are starting to improve nutrition and physical activity standards.

The drop in obesity among 2- to 5-year-olds is encouraging. Efforts to encourage healthy habits need to continue to help bring obesity rates down among Americans of all ages.


Americans are eating healthier and cutting down on calories

American adults are improving their diets, eating less at meals and eating away from home less often, according to a new report from the U.S. Department of Agriculture.

Researchers analyzed data from the National Health and Nutrition Examination Survey (NHANES) on over 9,800 working-age adults born between 1946 and 1985. They found that adults consumed an average of 78 fewer calories a day between 2005 and 2010. Americans also consumed less fat, saturated fat and cholesterol, had more fiber, and ate more family meals at home. More specifically, the report found that:

  • Adults consumed 127 fewer calories a day from food away from home, which included restaurant food, fast food and pizza places. Food not prepared at home made up about 35% of total calories in 2005 and 30% in 2010.
  • Adults ate about three fewer meals and 1.5 fewer snacks per month away from home.
  • Saturated fat dropped from about 11.3% to 10.6% of daily calories and fiber increased 1.2 grams per day from 16.1 grams to 17.3 grams.

Eating less food away from home accounted for just 20% of the improvements in diet quality. Since more adults used nutrition information on food products in 2010 than in 2007, this may have helped improve their diets. In addition, in 2010, adults were less likely to believe they were born to be thin or fat and more likely to believe they can control their weight. Researchers suggest that when people believe their actions affect their body weight, they may be more inclined to make healthier food choices.

The researchers also found that between 2007 and 2010, families with children under age 17 increased the number of meals they ate together at home from 5.8 meals to 6.29 meals per week. Besides providing more time together, eating meals at home can help families eat healthier and control how much they eat.


If They Eat It, So Will I: How Social Groups Affect Eating Behavior

If you know what other people are eating, will that influence what you eat? A recent study in the Journal of the Academy of Nutrition and Dietetics suggests that it does.

Researchers in the United Kingdom reviewed 15 studies that examined whether providing information on other people’s food choices or quantity of food consumed affected what study participants ate. The researchers found consistent evidence that social norms influenced the type and amount of food eaten.

If participants, nearly all of whom were university students, were given information that others were making low-calorie or high-calorie food choices, it significantly increased the likelihood that the participants made similar choices. In addition, if participants found out that others ate large portions, they increased how much they ate. If they learned that others ate small portions, the participants decreased how much they ate. Eating norms influenced their intake of snack foods, fruit and vegetables, and main meals.

The researchers found a strong link between eating and social identity. One way that social norms influence food choice is by reinforcing identity to a desirable social group. In simple terms that means, if they eat it, so will I.

The researchers found that the evidence reviewed supports the idea that eating behaviors can be transmitted socially. They suggest that the findings from the review could be used as the basis for developing public health campaigns that promote healthy eating. The researchers state, “Policies or messages that normalize healthy eating habits or reduce the prevalence of beliefs that lots of people eat unhealthily may have beneficial effects on public health.”


New guidelines urge doctors to treat obesity more aggressively

New obesity treatment guidelines recommend that doctors take a more active role in identifying patients who are overweight or obese and direct them toward a treatment plan that will help them achieve a healthier weight. Simply telling a patient to lose weight is not enough; doctors need to treat obesity as aggressively as they would treat other chronic diseases such as high blood pressure.

The guidelines were developed by the American Heart Association, the American College of Cardiology and The Obesity Society. The main purpose is to guide doctors in assessing their patients' weight status and risk for obesity-related health issues, and to make weight- management decisions based on the assessment.

The report advises healthcare providers to calculate body mass index (BMI), at annual visits or more often to identify adults who may be at increased risk of heart disease or stroke because of excess weight. Evidence shows that the higher the BMI, the greater the risk of heart disease, stroke, type 2 diabetes, and death from any cause.

The guidelines advise that obese adults (BMI of 30 or over) and overweight adults (BMI of 25 to 29.9) who have any risk factors for heart disease, including elevated waist circumference, should lose weight. Sustained weight loss of 3 to 5 percent can produce some health benefits, but the guidelines recommend losing at least 5 to 10 percent of initial weight within 6 months for greater benefits. These include lower blood pressure, blood glucose and triglycerides, and improved cholesterol levels.

Different paths lead to weight loss

The guidelines support a comprehensive weight-loss plan that includes three lifestyle components: a reduced-calorie diet, increased physical activity, and behavior-change strategies to help achieve and maintain a healthy weight.

The expert committee reviewed 17 types of diets and found there is no one diet that stands out among the rest. Whichever diet is chosen — lower fat, higher protein, Mediterranean-style or others — it should reduce calories by at least 500 calories a day, and fit the person's food preferences and health status. For example, a person with high blood cholesterol may benefit from a diet lower in calories and saturated fat; someone with high blood pressure should consider a lower-calorie, lower-sodium diet such as the DASH diet for weight loss.

Here are some more recommendations from the guidelines:

  • For patients that prefer calorie counting, doctors should prescribe 1,200-1,500 calories a day for women and 1,500-1,800 calories a day for men.
  • The most effective plan is a high-intensity, comprehensive lifestyle program (diet, exercise, behavior) that offers in-person individual or group sessions delivered by a trained interventionist, such as a registered dietitian, psychologist, exercise specialist or health counselor. Patients should meet for at least 14 sessions within the first six months.
  • If frequent in-person meetings are not doable, then other treatment options that generally provide smaller weight-loss results may be used. These include web-based, phone, or commercial weight-loss programs.
  • Physical activity should be part of the plan. The goal is at least 150 minutes a week of moderate-intensity physical activity, such as brisk walking. Behavioral strategies, such as recording food intake and activity, and counseling to help patients follow diet and activity recommendations are important.
  • If lifestyle treatment is not working for patients with a BMI of 40 or higher or a BMI of 35 or higher with obesity-related risk factors such as diabetes, then doctors should consider bariatric surgery.

Keeping the weight off

To help patients who lost weight keep it off, the guidelines recommend that doctors continue to offer support to their patients and address small weight gains before they become larger. Research shows that for people who make lifestyle changes to lose weight, maximum weight loss tends to occur at six months, followed by a plateau and gradual regain over time.

To help keep the weight off, doctors should advise patients to participate in a weight-loss maintenance program for at least one year. This includes monthly, or more frequent, in-person or phone contact with a trained interventionist who can encourage them to increase their physical activity to 200 or more minutes a week, monitor their body weight at least weekly, and consume a reduced-calorie diet. These practices can help people maintain a lower body weight over time.


Family dinnertime habits may help fight obesity

It’s not just what your family eats, but where you eat, and how long you eat together and socialize that may influence your family’s weight.

Researchers Brian Wansink and Ellen van Kleef looked at the relationship between family dinner rituals and body mass index (BMI) of 190 parents and 148 children. BMI is a measurement of body fat based on height and weight.

In the study, parents completed a survey on their family’s mealtime habits. The researchers found that families who ate dinner together at the kitchen or dining room table had lower BMIs than those who ate anywhere else. Parents with higher BMIs were more likely to eat in front of the TV.

The researchers also found that girls who helped make dinner were more likely to have higher BMIs. But it was not known if cooking led girls to become heavier or if heavier girls were more interested in learning to cook and helping to make the meal. Boys who stayed at the table until everyone was finished eating tended to have lower BMIs, and families who talked meaningfully about their children’s day had parents with lower BMIs than families who did not. The researchers suggested that having positive, social interactions with others at dinner may override the desire to overeat.

The researchers pointed out that the link between dinnertime habits and BMI does not necessarily mean that one causes the other. However, the findings highlight the importance of sharing a family meal and conversation at the table.

To connect with your family and possibly help everyone to stay at a healthy weight, try to eat together at the kitchen or dining room table with the TV off and encourage your children to talk about their day.


Using Low-Calorie Sweeteners May Help with Weight Control

A new study recently presented at the International Congress of Nutrition in Granada, Spain, suggests that low calorie sweeteners (LCS) can be an effective tool in weight management. The presentation by Adam Drewnowski, PhD, an obesity researcher from the University of Washington, showed that consumers who use LCS in foods, beverages or as tabletop sweeteners are more likely trying to manage their weight than are nonusers of LCS. That’s an important point since other reports have linked LCS use with overweight or weight gain. Drewnowski’s research found that LCS use increases with age, income and education level, and that most LCS users are women over age 40. Further, people who use LCS are more likely to be physically active and have healthier diets and less likely to smoke than those who don’t use LCS. The conclusion was that “when combined with a healthy diet, being physically active, and adopting other healthy behaviors, using low-calorie sweeteners to reduce calories is a winning strategy for improved weight management and better health. The findings presented at the congress are summarized in this infographic.


A report card on America's diet: how are we doing?

Americans are eating more chicken and yogurt and cutting down — slowly — on sugars, shortening, beef, whole milk, and white flour. That’s the good news. But we’re consuming 450 calories more a day than in 1970, getting our fill of grains, using more fats and oils, loving cheese way more than we used to, and not making much progress in eating more fruits and vegetables. That means, according to a new diet report card issued by the Center for Science in the Public Interest, that Americans have some work to do to improve their grades. Americans ate about 2,075 calories a day in 1970, jumped to 2,600 calories in 2007 and then shifted down a bit to 2,535 calories a day in 2010. That’s still far above where we were 40 years ago. Here are the grades, from best to worst, on America’s report card, based on data from the U.S. Department of Agriculture:

Fats & Oils: B+

Total fats and oils continue to rise, but the types of fats being used more often are changing for the better. Salad and cooking oils have replaced some of the shortening, which has more saturated fat, and margarine now has less unhealthy trans-fat.

Meat, Poultry & Seafood: B

We’re eating less beef than we ate in the 1970s, but red meat (mostly beef and pork) still surpasses white meat (poultry and seafood) at 74 pounds per person per year compared to 65 pounds.

Milk: B

We drink much less whole milk than in 1970, down from 18 gallons per person to 4 gallons. Some milk is being replaced by lower-fat and fat-free milk, but we still get dairy fat from eating lots of cheese.

Fruits & Vegetables: B–

We started to eat more vegetables in the 1980s, but it has leveled off. Fruit, not including juice, is about the same as it was in 1970.

Grains: C

We’re eating more grain foods, such as breads, cereal, pasta, pizza, and cookies, than in 1970. Flour consumption peaked at 116 pounds per person in 2000 and has dropped slightly to 109 pounds.

Dairy: C–

Since 1970, cheese has jumped from 8 pounds per person to 23 pounds. Think pizza, cheeseburgers, quesadillas and cheese in salads, soups and sandwiches. On the other hand, we’re eating more mostly low-fat yogurt, which is up to 9 pounds per person.

Sweeteners: D+

We’ve made some progress with sweeteners, but still have a way to go. We went from a high of 89 pounds of sugar per person in 1999 to 78 pounds of mostly sugar and high- fructose corn syrup. Much of the added sugar comes from sugary drinks.

What can Americans do to get a better report card next time? The report recommends we go for less — less red meat, cheese, starches, sweets and shortening.

To get all A's and the benefit of good health, eat more fruits and vegetables; choose low-fat or fat-free milk, dairy, and cheese instead of full-fat; replace white flour with whole wheat flour and whole grains; include foods with unsaturated, healthy fats such as nuts and seeds; and eat less fatty meats, sweets and sugary drinks.


Obesity rates in adults holding steady but still high overall

After rising for three decades, adult obesity rates leveled off in every state except one in the past year, according to F as in Fat: How Obesity Threatens America’s Future 2013, a report from the Trust for America’s Health and the Robert Wood Johnson Foundation.

While that is good news, obesity in the US remains high. In fact, say the authors of the report, 30 years ago the highest adult obesity rate for any state was still lower than the lowest obesity rate today. The 2013 report found that 13 states now have an adult obesity rate over 30 percent, 41 states have rates above 25 percent, and every state is above 20 percent. In 1980, no state was above 15 percent. Currently, Louisiana has the highest rate of obesity at 34.7 percent, Mississippi follows at 34.6 percent, and Colorado has the lowest rate at 20.5 percent. Check this map to see how your state rates.

Although the report found that obesity rates overall held steady across the US, except for an increase in Arkansas, extreme obesity continues to rise among adults and children. The rate of adults considered extremely obese — at least 100 pounds overweight or with a body mass index (BMI) of 40 or greater—increased 350 percent in the past 30 years, from nearly 1.5 percent in 1976–1980 to over 6 percent in 2009–2010. About 5 percent of children and teens ages 2–19 are now severely obese. Rates of extreme obesity are twice as high for women than men and are high among Hispanic boys (9 percent) and black girls (12.6 percent).

Some other key findings from the 2013 report:

  • 19 of the 20 states with the highest obesity rates were in the South or Midwest; the other state in the top 20 was Pennsylvania.
  • Obesity among Baby Boomers, meaning those ages 45–64, is a concern since obesity rates reached 30 percent or higher in 41 states; in Alabama and Louisiana, it reached 40 percent.
  • Ten years ago, there were about 10 percent more women considered obese than men; now it’s about even at 36 percent.
  • Adults who did not graduate high school are more likely to be obese than those who graduated college.
  • Adults who earn less than $25,000 per year are more likely to be obese than those who earn at least $50,000 per year.

In addition to the leveling off of adult obesity, a recent report showed a decrease in obesity rates among preschool children from low-income families. It appears that the country’s efforts to curb obesity may be starting to show some positive results. The report highlights some policies that may have contributed to this and suggests strategies to improve health and prevent obesity. These include providing only healthy food in schools, offering more opportunities to be physically active, posting calorie information on restaurant menus, having food and beverage companies market their healthiest products to children, encouraging walking and biking in the nation’s transportation plans, and making it possible for everyone to buy healthy, affordable food close to home.


Growth spurt may help some kids outgrow obesity without losing weight

A new mathematical model on childhood energy balance quantifies the excess calories that lead to childhood obesity and predicts how best to intervene to manage body weight.

It is the first model to differentiate between healthy weight gain that is expected in children and excess weight gain that could lead to obesity. It also takes into account changes in body weight from calories consumed and energy burned during activity, distinguishes between the energy needs of muscle mass and fat mass, and considers the differences in metabolism and growth between boys and girls. The model was developed by lead researcher Kevin Hall, PhD, of the National Institutes of Health and colleagues, and was recently published in The Lancet Diabetes & Endocrinology.

Researchers accounted for normal growth in children and teens between ages 5 and 18 and predicted gradual increases in energy intake of about 1200 calories a day in boys and 900 calories a day in girls. They also predicted calorie differences between 5- to 11-year-old obese and healthy weight children. Using the model, they found that on average obese boys consumed 750 calories a day more and obese girls consumed 850 calories a day more than healthy weight boys and girls. By the end of the 6-year period, obese boys and girls consumed about 1100 and 1300 calories a day more, respectively, than healthy weight children.

Researchers found that overweight kids consume more calories than previously thought. For example, current models used by health care providers predict that a 10-year-old girl who is 10 kilograms (about 22 pounds) overweight but was at a healthy weight at age 5 consumes about 40 excess calories a day. The new model, which takes into account children’s increased energy needs as they gain weight, calculates that the same 10-year-old girl is eating 400 more calories a day than a girl who remains at a healthy weight during those years.

The good news is that during periods of rapid growth, some children, especially boys, may be able to outgrow their obesity without losing weight. This window of opportunity takes advantage of their growth spurt and increase in muscle mass to help get weight and body composition back on track. Researchers showed that from ages 11 to 16, boys grew taller and added more muscle mass while losing body fat, yet their weight remained the same. However by age 11, girls had already gained much more body fat than boys and did not gain as much muscle mass, so to normalize their body composition they would need to lose body weight. This suggests that the best time to intervene for weight change and body fat loss is before puberty, especially in girls.

The model also found that it takes more calories for children to become obese than it does for adults. Obese children under age 10 were predicted to need over twice the calories per pound of extra body weight than older and more sedentary adults would need to gain a pound.

The researchers tested their model against outcomes from existing data and weight loss intervention studies on children. They showed that that their model provides the most accurate tool to date that can predict how a child’s calorie intake affects the odds of becoming overweight or obese and the extent of intervention needed to achieve a desired change in body weight. They conclude, “policy makers and clinicians now have a quantitative technique for understanding the childhood obesity epidemic and planning interventions to control it.”


High blood pressure risk rising in children and teens — obesity and excess salt linked to increased risk

The risk of elevated blood pressure among 8- to 17-year-olds increased 27 percent in 13 years, according to new research published in the journal Hypertension. Higher body mass index (BMI), larger waist size and diets high in sodium were linked to elevated blood pressure. This is a concern since high blood pressure is a risk factor for heart disease, stroke, and kidney failure.

Researchers looked at national survey data on over 3,200 children in the National Health and Nutrition Examination Survey (NHANES) III, covering 1988 to 1994, and compared it to over 8,300 children in NHANES from 1999 to 2008. They focused on elevated blood pressure, defined as blood pressure that is either >90th percentile, meaning higher than what 90 percent of kids of the same age, gender and height would have, or that has reached 120/80 mm Hg or higher. In this study, children with elevated blood pressure could not be classified as having high blood pressure since blood pressure readings must be high three times in a row to make that diagnosis.

In comparing NHANES III to the later NHANES, researchers found that:

  • Boys had higher blood pressure than girls but the rate increased more in girls from the earlier survey to the later years.
  • More children were overweight and had a larger waist circumference over time, with girls having greater increases in waist size than boys.
  • Children with the largest waist circumference were about twice as likely to have elevated blood pressure compared to those with the smallest waists.
  • Black children had a 28 percent higher risk of elevated blood pressure than white children.
  • Children who consumed the most sodium per day (over 3,450 milligrams [mg]) were 36 percent more likely to have elevated blood pressure than those who consumed the least amount of sodium (less than 2,300 mg).

Over 80 percent of children in both surveys had over 2,300 mg sodium a day, an amount considered by the Institute of Medicine as the upper daily limit that is not likely to pose adverse health effects in Americans. Although dietary sodium intake has increased in children and adults, fewer children consumed more than 3,450 mg sodium in the later NHANES study — a small step in the right direction.

The trend toward increasing blood pressure gives good reason for children, as well as adults, to eat healthfully (focus on veggies, fruits, whole grains, lean protein and low-fat dairy), limit fast foods and high-sodium processed foods and snacks, reach a healthy weight, and exercise daily.


Poll says schools should lead the way in preventing obesity

Nearly all Americans view obesity as a problem for adults, children and teens, but it’s not something they want to deal with alone. A recent survey from Kaiser Permanente found that most Americans want community support in fighting obesity and believe that local K–12 schools should have the biggest role.

Among the findings from the nationwide survey:

  • 78 percent of adults believe that eating healthier food in school will increase academic performance and a similar percentage think that getting more physical activity during school will also boost academic achievement.
  • Over 80 percent support new federal school nutrition standards for student meals that include more fruits, vegetables and whole grains, less sodium, saturated fat and trans fat, and low-fat or nonfat milk instead of whole milk.
  • About 70 percent support extending the nutrition standards to food children can buy at school outside of mealtimes.

When asked the importance of actions schools could take to encourage kids to eat healthier:

  • 90 percent of adults polled said it is highly important to have fresh drinking water freely available at school.
  • Over 80 percent said it was highly important to expand nutrition education to teach kids about the benefits of healthy eating and help them identify which foods are healthy and which are not.
  • Over half said it was highly important to stop selling junk foods and candy at school fundraisers.

When asked the importance of actions schools could take to encourage kids to be more physically active:

  • 80 percent of adults said it was highly important to give kids more opportunities to be physically active.
  • 80 percent said it was highly important to require daily physical education classes for all grades.
  • A large majority of adults also want more sidewalks, paths, trails, and bike lanes to allow kids to walk or bike to school.

This nationwide survey of over 2100 adults was conducted by Field Research Corp. for Kaiser Permanente, a leading healthcare provider in the U.S.


Studies find Americans cutting back on sugary drinks and sweets

Here’s some good news. Americans are getting the message that too much sugar is not good for our waistlines or our health, and we’re starting to do something about it. New national data show that from 1999 to 2010, youth and adults consumed fewer calories from sugary drinks. In 2009-2010, children and teens consumed 155 calories of sugary drinks a day, which is 68 fewer calories than in 1999-2000. Adults had about 151 calories a day, or 45 fewer sugary-drink calories than 12 years prior. Yet, despite the decreasing trend, the calories consumed from these drinks in 2010 equates to about one 12-ounce can of soda a day.

The data was from the Centers for Disease Control and Prevention’s (CDC’s) National Health and Nutrition Examination Survey (NHANES). It was based on consumption of sugar-sweetened beverages (SSBs) in a 24-hour period in over 22,300 youth, ages 2-19, and over 29,000 adults. In the survey, SSBs included soda, fruit drinks, sports and energy drinks, sweetened coffee and tea, and other sweetened beverages. Researchers found decreases in SSBs in home and away from home and at meals and snacks. The largest declines in sugary drinks were from soda.

Americans are cutting down on sweets too. In data analyzed for USA Today by the NPD Group, children are eating fewer sugary sweets than they did 15 years ago. That includes drinking carbonated soft drinks 62 fewer times and eating pre-sweetened cereal 22 fewer times than they did in 1998. Children still consume about 14% more sweets than adults a year, but they are cutting down on sweets at a faster rate than adults. NPD researchers attribute that to parents taking charge of the amount of sweets their kids are eating and offering them less frequently.

In New York City, the Health Department wants New Yorkers to know that drinks that seem good for you can actually be packed with added sugars and health risks. During June, as part of the city’s Pouring on the Pounds campaign, ads on buses and TV will explain that non-carbonated sugary drinks such as sports drinks may “sound” healthy, but the added sugars in most of them can bring on obesity and diabetes. The TV ads encourage New Yorkers to replace sugary sports drinks, energy drinks, fruit-flavored drinks and sweet teas with healthier options such as water, seltzer, fat-free milk and fresh fruit.


Obesity ranked by job: transportation workers take top spot, doctors least obese

Workers in transportation, manufacturing, and installation and repair are the most likely to be obese, while doctors, business owners, and teachers are the least likely, according to a 2012 survey for the Gallup-Healthway Well-Being Index. The survey measured obesity rates among 14 occupation groups, based on interviews with 139,000 U.S. workers. Analysts found that transportation workers had the highest rate of obesity at 36%, while physicians had the lowest rate at 14%.

The Gallup survey also looked at 27 behavioral factors and how they relate to obesity. Analysts found that obese workers were more likely to exercise fewer than three days a week, not eat healthy, struggle to afford food, have difficulty finding a safe place to exercise, have a history of depression, and skip their annual dental checkup.

When broken down by occupation:

  • Service workers were most likely to have difficulties affording food and to have been diagnosed with depression. They tied with farmers as least likely to have a safe place to exercise.
  • Office workers were the least likely to exercise 30 minutes three or more days a week.
  • Sales workers were the least likely to eat healthy.
  • Construction workers were the least likely to visit a dentist
  • Farming, fishing and forestry workers were the most likely to eat healthy and exercise often.

What can employers do?

The Gallup analysts recommend that employers use this information to cut healthcare costs and improve on behaviors their occupation group struggles with the most. Since not getting enough exercise is the behavior most closely linked to obesity, they suggest that employers provide a safe place for employers to work out, or offer discounts or incentives to join a gym. They could also offer food programs that make healthy food affordable to employees. In addition, employers should create an office environment where employees are involved in and enthusiastic about their work. Previous Gallup research found that employees who are engaged at work exercise more frequently and eat healthier than those who are not involved or connected with their work.


Study offers strategies for handling all-you-can-eat buffets

All-you-can-eat buffets can throw those trying to control their weight off course. Large portions and high-calorie foods have been linked to obesity, and all-you-can-eat buffets offer all that plus the freedom to keep filling up your plate for more — all for one set price. But not everyone who goes to buffets overeats or is overweight.

Researchers Brain Wansink and Mitsura Shimizu of Cornell University wanted to know what diners do that predicts how many trips to the buffet they make, which may be linked to how much they eat. Their findings were published in a research letter in the April issue of the American Journal of Preventive Medicine.

They had 30 trained observers inconspicuously gather information on over 300 diners in 22 all-you-can-eat Chinese restaurants in six states. The observers recorded if the diners served themselves immediately when reaching the buffet or surveyed the food choices first, used larger plates or smaller plates, sat facing the buffet or away from it, sat at a table or booth, used a fork or chopsticks, and put their napkin on the table or their lap. They also estimated each diner's body mass index (BMI) by sight, using a method taught prior to the observations.

The study found that diners who served themselves immediately and used larger plates made more trips to the buffet table. The researchers noted that this behavior may lead to more eating and could eventually influence BMI. They wrote, “Consistent with the idea that small changes might lessen one's tendency to overeat, deliberate thought about what to serve oneself [scouting out the food options first] and using a smaller plate may reduce overeating in buffets.”

A previous study by Wansink and Cornell colleagues found that buffet diners with higher BMIs were more likely to serve themselves immediately, use larger plates, sit facing the buffet, use forks instead of chopsticks, and put their napkin on the table.

Bottom line: To stop temptation from getting the best of you at an all-you-can-eat buffet:

  • Walk around the buffet table to check out your options before choosing what to eat.
  • Use a smaller plate instead of larger one.


Kids need recess at school — here's why

Pressure for schools to focus more on academics and improving test scores is squeezing out time for recess. Yet, there are many reasons for recess to stay a part of a child’s school day. The American Academy of Pediatrics (AAP) believes that recess is crucial for a child’s development and should not be withheld as punishment or for academic reasons.

In a recent policy statement on the role of recess in schools, the AAP looked at the benefits of safe and well-supervised recess on a child’s cognitive, social, emotional and physical development. They found that:

  • Recess, especially unstructured play, helps a child learn better. Studies show that taking a break after a period of concentrated instruction helps children process what they just learned and makes them more attentive and productive in the classroom. Regular breaks from classwork are beneficial for younger children and adolescents.
  • Play at recess helps children learn communication and coping skills. They learn how to negotiate, cooperate, share and problem solve, and they get practice in persevering and self-control. Play also gives children a social way to manage stress.
  • Recess allows children to be active and practice movement and motor skills. Active play helps children meet the recommended 60 minutes of moderate to vigorous activity a day, which can help lower the risk of obesity.

The policy statement discusses the pros and cons of structured play (recess based on games and physical activities led by trained adults), and unstructured play (free play time in which children choose what they want to do). Whether recess is structured or unstructured, it should be well-supervised and safe, with safe spaces and equipment, enough trained adults able to manage safety concerns should they arise, and a school policy in place to prevent bullying or aggressive behavior.

The length of time for recess and when it should be scheduled does not follow a set rule. However, some studies found that when recess was before lunch, students wasted less food and behaved better at mealtime and in afternoon classes.

AAP recommends that recess complement, but not replace, physical education. Although both have the potential to promote activity and a healthy lifestyle, only recess—especially unstructured recess—provides the creative, social and emotional benefits of play. The lifelong skills learned during recess are an important part of the school experience.

Bottom line: Kids need recess. It is important for their development and academic performance and should not be cut down or eliminated from the school day.


Social media may help beat childhood obesity

Texting, tweeting and using Facebook and other forms of social media may help kids and teens manage excess weight, according to a recently released statement by the American Heart Association (AHA). About 95% of teens ages 12 to 17 have access to the Internet and most use online social media to connect with friends and family. Since social networking is an increasingly important part of their daily lives, the authors recommend that healthcare professionals consider using social media as a tool to promote weight-related behavior change.

The AHA expert committee looked at the limited research on Internet-based interventions that promoted weight loss, physical activity and healthy eating. Results were mixed in the several studies reviewed. In one online program with overweight kids and teens, success was linked to greater involvement by parents and more online interaction with counselors and peers. In the studies, the frequency with which the kids and teens logged on to the programs also influenced their success.

The report noted that texting may be useful for self monitoring healthful behaviors because it offers support and immediate feedback based on a person’s goals. More research is needed on the use of texting to improve health.

The AHA statement supports the potential value of social media in weight management programs. It also warns of the risks of social media including cyberbullying, privacy concerns and lack of sleep from spending too much time on the Internet. The authors call for more research that evaluates the effectiveness of incorporating social media and electronic technologies, such as active video games, into weight-management programs for children and teens. This includes developing ways to use social media to encourage healthful behaviors such as self-monitoring, goal setting and rewards, and making the intervention appealing to kids so that it helps them reach a healthy weight.


Health effects of childhood obesity don’t wait until adulthood

Experts have been warning Americans for years about the long-term effects of childhood obesity, including higher risk of heart disease and diabetes in adulthood. New research has found that obese children are already feeling the impact on their physical and mental health and development.

A UCLA study, published in Academic Pediatrics, looked at parent-reported data on nearly 43,300 boys and girls aged 10 to 17 from the 2007 National Survey of Children’s Health. Fifteen percent were overweight and 16 percent were obese. Compared to normal weight children, obese children:

  • were more than twice as likely to have their health considered poor, fair or good instead of very good or excellent
  • were more likely to have restrictions on their activity, and to internalize problems, have behavior and school problems, repeat grades and miss school more
  • had more attention-deficit/hyperactivity disorder (ADHD) and conduct disorder, depression, learning disabilities, developmental delays, bone, joint and muscle problems, asthma, allergies, headaches and ear infections

Overall, obese children had almost double the risk of having three or more physical health, mental health or developmental problems than normal weight children (18% vs 10% of children). Overweight children had a 1.3 times higher risk (13% vs 10%).

Although the study linked obesity to these conditions, it is not clear which came first—did obesity cause these conditions or vice versa, or are these problems related to some other factor. For example, depression could lead to less healthy eating and activity habits, resulting in weight gain. Or weight gain could lead to depression. The relationship between obesity, health, biology, environment and behavior is complex and requires further investigation.

The researchers suggest that doctors, parents and teachers should be informed of the specific health and mental health issues linked with childhood obesity so appropriate actions can be taken early on to improve children’s health and well-being.

How can parents help their children now?

Shape Up America! advises parents to begin with small steps at home, such as eating healthy meals together as a family and being a good role model for their children. All family members should be encouraged to have a fruit and/or vegetable at each meal and to limit high-fat and high-sugar snacks. Shape Up Secrets has some more ideas to help families get started.


Study finds a little excess weight may not increase risk of early death

A new government study found that people who are overweight or obese by up to about 30 pounds do not have a greater risk of dying early than people who are normal weight. But those who are substantially obese, meaning about 60 pounds or more above a normal weight, have a greater risk of early death than people at a normal weight.

Researchers from the Centers for Disease Control and Prevention reviewed 97 studies from around the world involving nearly 3 million people and 270,000 deaths. They looked at body mass index (BMI), which is a measure of body fat based on height and weight, and deaths from all causes. BMI is categorized as:

BMI Weight status
Less than 18.5Underweight
18.5 to less than 25Normal
25 to less than 30Overweight
30 and aboveObese—subdivided into grades
30 to less than 35Grade 1 obesity
35 to less than 40Grade 2 obesity
40 and aboveGrade 3 obesity

The researchers found that compared to people who were normal weight, the risk of dying early was:

  • 6% lower in people who were overweight
  • 18% greater in people who were obese (all subgroups)
  • 29% greater in people with grades 2 and 3 obesity

Grade 1 obesity did not show a greater risk of dying and underweight was not studied. More than half of American adults who are obese are in the grade 1 category, with a BMI of 30–35.

Possible reasons for the lower risk of death in those who are overweight or moderately obese are that heavier people may get screened and treated for weight-related risk factors, such as diabetes or heart disease, earlier than those at a normal weight. Also, increased body fat may help people with certain injuries and may provide needed energy reserves when they are ill and unable to consume enough food.

Green light to overeat?

Do the findings from this study make it OK to be overweight? Not necessarily. “Overweight should be avoided not because it raises your risk of dying prematurely, but because it raises your risk of becoming less active and gaining more weight,” says Barbara Moore, PhD, President and CEO of Shape Up America! “Overweight is harmful to joints and leads to osteoarthritis; excess fat compromises immune function and raises your risk of type 2 diabetes, high blood pressure and other chronic diseases, including certain cancers. Medical science has advanced so that we can keep people alive despite their obesity, but the risk of illness increases and quality of life decreases markedly, and medical costs go up as well,” adds Moore.

Although the JAMA study focused on BMI and its risk of early death, the impact of extra pounds on health should not be overlooked. The connection between weight, health and risk of death is complicated. BMI is just one measure of health risk and it is not perfect. As researchers work toward establishing the ideal weight for good health as well as long life, it is best that adults aim for a weight in the normal, healthy weight range.

Making healthier food choices, limiting portion sizes, and increasing physical activity can help you reach and maintain a healthy weight.


When counting daily calories, keep tabs on alcohol

The average American consumes about 100 calories a day from alcoholic beverages. About one-third of men and 18% of women drink alcohol daily. Men get more of their daily calories from alcohol than women, and younger adults take in more calories from alcohol than older adults. On average, people who drink get 16% of their daily calories from alcoholic beverages.

A recent report from the National Center for Health Statistics examined data on adults from the National Health and Nutrition Examination Survey, 2007–2010. Based on 24-hour dietary recall interviews, researchers found that men consume about 150 calories a day from alcohol compared to slightly over 50 calories a day by women. Younger men, ages 20–39, take in 175 alcohol calories a day vs 96 calories by men ages 60 and over. Women under age 60 consume about 60 calories a day from alcohol compared to about half that amount, or 33 calories, by older women.

Men consume more beer than other types of alcohol: 103 calories a day from beer vs 34 calories from liquor and 12 calories from wine. More women drink wine in a day than men, but women’s average calories from beer, liquor and wine are about the same (17–18 calories). In both men and women, beer drinking goes down with age. Younger men, ages 20–39, consume an average of 128 calories a day from beer, and older men, ages 60 and older, take in 48 calories. Younger women consume 24 calories a day from beer compared to 6 calories in older women.

The Dietary Guidelines for Americans 2010 recommend that adults who choose to drink should do so in moderation—up to one drink a day for women and up to two drinks a day for men. A standard drink is 12 oz regular beer (about 150 calories), 5 oz wine (about 120 calories), or 1.5 oz hard liquor or distilled spirits (about 100 calories). While most Americans fall within these guidelines, the research found that 19% of men consume more than 300 calories a day from alcoholic beverages, which is over two drinks. Among women, 12% consume more than 150 alcoholic beverage calories a day, or over one drink.

SUA supports standardized “Alcohol Facts” labeling on beer, wine and distilled spirits and has been active in advocating for alcohol labeling as a way to encourage weight management, reduce the health risks associated with alcohol, and help consumers drink responsibly. Before you reach for a drink to celebrate the holiday season, find out more about what you’re drinking. Alcohol Facts, developed by the Consumer Federation of America, provides information on alcohol content and calories in some top-selling brands of beer, spirits and wine.

Shape Up America! wishes you a joyous holiday season and a healthy and happy new year!


Diabetes rates rise dramatically across the U.S.

November is National Diabetes Month, an opportune time for people who have diabetes or are at risk of diabetes to make important lifestyle changes to improve their health. In 2010, nearly 26 million Americans had diabetes; 18.8 million of these had diagnosed diabetes and the other 7 million did not know they had it. According to a new report from the Centers for Disease Control and Prevention (CDC), the prevalence, or total number of new and existing cases, of diagnosed diabetes jumped dramatically between 1995 and 2010.

Over the 16-year period, diagnosed diabetes increased by 50 percent or more in 42 states and by 100 percent or more in 18 states. States with the largest increase were Oklahoma (up 226 percent), Kentucky (158 percent), Georgia (145 percent), Alabama (140 percent), and Washington (135 percent).

The study used data from the Behavioral Risk Factor Surveillance System, which is a yearly telephone survey of health conditions and risk behaviors of US adults aged 18 years and older. The researchers found that in 1995 the prevalence of diagnosed diabetes was 6 percent or more in only three states, plus the District of Columbia (DC) and Puerto Rico. By 2010, it was 6 percent or more in all 50 states, DC and Puerto Rico. In six states and Puerto Rico, at least 10 percent of the people had diabetes.

Policies and programs are needed to stop the rates of diabetes from increasing further. One such program, the National Diabetes Education Program (NDEP) helps people with diabetes improve their health and assists those at risk to make lifestyle changes to prevent or delay the onset of type 2 diabetes. About 90– 95% of all cases of diabetes are type 2 diabetes, in which the body does not make enough insulin or doesn’t use it well. Healthy eating and regular physical activity, plus medication when prescribed, can help people manage their diabetes and live healthier lives.

The NDEP Just One Step helps people identify one small step they can take toward better health and preventing or managing type 2 diabetes. Make a plan helps make these changes part of their daily routine, starting with choosing a goal and taking steps to reach the goal.

For additional information on diabetes, NDEP has resources for consumers and health professionals. CDC leads the National Diabetes Prevention Program, a public-private partnership that provides evidence-based, community, lifestyle programs that promote modest weight loss, healthy eating and increased physical activity for people at high risk of developing type 2 diabetes.


Leisure-time physical activity extends life

Adults who are physically active live longer than those who are not active, even if they are overweight. A team of international researchers led by the National Cancer Institute looked at data from six population-based studies that included close to 650,000 people who were age 40 and over. Adults who participated in regular leisure- time physical activity lived up to 4.5 years longer than those who were inactive. Leisure- time physical activities are activities that are not essential for daily living and include sports, recreational walking and exercising.

Both the 2008 Physical Activity Guidelines for Americans and the 2010 World Health Organization’s Global Recommendations on Physical Activity for Health advise adults to do at least 150 minutes per week of moderate- intensity activity such as brisk walking, or 75 minutes per week of vigorous-intensity activity, for health benefits. Researchers found that people who reported getting the recommended level of physical activity added 3.4 years to their life compared to those who did not exercise. Those who did twice the recommended amount of activity lived 4.2 years longer. Even adults who did half the government-recommended level of daily activity, or 75 minutes per week of moderate- intensity physical activity, gained 1.8 years of life.

The researchers also looked at how obesity and activity affect life expectancy. Obesity is linked to a shorter life expectancy, but being active helped lessen the impact. Adults who were obese and inactive had a shorter life expectancy of 5 to 7 years, depending on their level of obesity, compared to those who were at a normal, or healthy, body weight ( body mass index or BMI of 18.5–24.9) and were moderately active (150 minutes of moderate-intensity activity per week). However, people who were normal weight but inactive had 3.1 fewer years of life than those who were obese with a BMI range of 30–34.9 and active.

Bottom line: Inactivity and obesity lessen life expectancy; doing more physical activity at any weight may extend life. Aim for the recommended 150 minutes or more of moderate-intensity physical activity per week; doing even low levels of activity, such as 75 minutes of brisk walking per week, may lead to a longer life.


More studies link sugary drinks and weight gain

Three recent studies published in the New England Journal of Medicine (NEJM) support a link between sugar-sweetened beverages, genes and obesity.

In one of the studies, scientists examined the relationship between sugar-sweetened beverages and the genetic risk of obesity. They analyzed data from three large cohort studies with a combined total of over 33,000 people. The researchers found that the genetic effects on body mass index (BMI) and risk of obesity among people drinking one or more servings of sugar-sweetened beverages per day were about twice as large as those drinking less than one serving per month.

According to the researchers, the data suggests that people who drink greater amounts of sugary beverages may be more susceptible to the genetic effects on obesity. Put another way, people with a greater genetic predisposition to obesity may be more susceptible to the adverse effects of sugary drinks on BMI.

While the study does not prove that drinking large amounts of sugary drinks causes obesity, it supports the need to test interventions that reduce consumption of sugar-sweetened drinks as a way to lower the risk of obesity and that show whether drinking fewer sugary beverages would be more effective in people with a genetic propensity to obesity.

The two other studies published in NEJM looked at the effects of reducing sugary drinks on weight gain in children and teens. In a study from the Netherlands, mostly normal-weight children, who regularly drank sugary beverages, were randomly assigned to receive one can of a zero-calorie, artificially-sweetened drink or one can of a sugar-containing drink with 104 calories every day for 18 months. The drinks were developed to look and taste the same so the children did not know the difference.

At the end of the study, the children in the sugar-free group gained 2.2 pounds less weight and had smaller gains in body fat and BMI. When 18-month measurements on most of the one-quarter of children who dropped out of the study were combined with the other children, changes in BMI were no longer statistically significant. Researchers noted this was likely because those who didn’t complete the study went back to drinking sugary beverages. They also suggested that since children in the US get almost three times as many calories from sugary beverages as the amount given in this study, drinking less of these beverages may help reduce the prevalence of overweight in these children.

In a study done in Boston, overweight or obese teens who drank at least 12 ounces of sugar-sweetened beverages or 100% fruit juice every day were randomly assigned to an

experimental group or control group. The experimental group received home delivery of bottled water and zero-calorie “diet” beverages every two weeks, plus monthly phone calls with parents, three check-in visits with participants and written messages to not drink sugary beverages for one year, and they were followed for two years. The control group received two supermarket gift cards with no instructions.

At two years, the change in BMI was not significantly different between the two groups. Researchers suggested this could reflect an increase in calories and sugary drinks by the experimental group once the one-year delivery of sugar-free drinks ended or it could be from the control group not drinking as much sugary beverages due to efforts to eliminate these drinks at schools.

However, at one year there were significant differences in BMI. For all participants, the group that received sugar-free beverages gained 4 pounds less on average than the group that continued to drink sugary beverages. Among Hispanics, the sugar-free group gained 14 fewer pounds at one year and about 20 fewer pounds at two years. Since the Hispanic group was very small, firm conclusions about possible ethnic differences could not be made.

Although sugar-sweetened drinks are the largest source of added sugars in the diet, there are many factors that lead to obesity, including eating too much food and being inactive. Cutting down on sugary drinks alone will not solve the obesity problem. However, Barbara Moore, PhD, president and CEO of Shape Up America!, stated in MedPage Today,

These findings and other relevant data suggest that cutting back on sugar-sweetened beverages is likely to be a useful weight management strategy because it is easy, and there is no downside risk because such beverages are not nutritionally valuable.


Adult obesity projections for 2030: soaring rates threaten America’s health

If obesity rates continue on their current path, close to half of American adults could be obese by 2030. But if adults are able to reduce their body mass index (BMI) by 5% on average, millions of Americans could be spared from obesity-related diseases and states could save billions in healthcare costs.

According to projections in F as in Fat, a report recently released by the Trust for America’s Health and the Robert Wood Johnson Foundation, more that 44% of adults will be obese in all 50 states by 2030, with the number increasing to over 60% obese in 13 states. The Centers for Disease Control and Prevention (CDC) has reported that more than 35% of U.S. adults were obese in 2009-2010.

According to F as in Fat, if the average BMI in each state were reduced by 5%, which would lower the states’ obesity rates by 9-14% by 2030, obesity would still rise, but not as much. No state would have obesity rates over 60% and two states, Colorado and Alaska, would have rates under 40%. For an adult of average weight, reducing BMI by 1% is equivalent to losing about 2.2 pounds. A six-foot-tall person weighing 200 pounds could reduce BMI by 5% by losing about 10 pounds.

The report projects that if obesity rates continue on their current track, the number of new cases of type 2 diabetes, heart disease and stroke, high blood pressure, and arthritis could increase 10 times between 2010 and 2020 and then double that by 2030. That’s about 6 million new cases of diabetes and 5 million new cases of heart disease and stroke by 2030. Obesity-related medical costs would increase up to $66 billion per year by 2030; current medical costs of adult obesity costs are estimated at $147 billion to $210 billion per year.

The F as in Fat report has suggested several policy recommendations to help prevent obesity. Some of these include:

  • Fully implement the Healthy, Hunger-Free Kids Act with the new school meal standards and by updating nutrition standards for snack foods and beverages in schools
  • Increase opportunities to promote physical education and physical activity in schools and make it a priority in the reauthorization of the Elementary and Secondary Education Act
  • Finalize the Interagency Working Group voluntary guidelines on food marketing to children
  • Fully support healthy nutrition in federal food programs.


Key strategies to maintain weight loss after menopause

For overweight women who have reached menopause, it often seems like losing weight and keeping it off are a constant struggle. With increasing age, a slow-down in the rate at which the body burn calories and a lifestyle that is less physically active add to the challenge of maintaining a healthy weight. But weight gain is not inevitable.

Researchers at the University of Pittsburgh examined changes in eating behaviors that were linked to postmenopausal weight loss at six months and four years. In this study of 481 overweight and obese women in their 50s to early 60s, researchers found that certain strategies that worked in the short term were not effective or sustainable in the long term.

At six months, eating behaviors associated with weight loss were:

  • eating fewer desserts
  • eating fewer fried foods
  • drinking fewer sugar-sweetened beverages
  • eating more fish
  • eating less often in restaurants

At four years, weight loss was linked to:

  • eating fewer desserts
  • drinking fewer sugar-sweetened beverages
  • eating more fruits and vegetables
  • eating less meat and cheese

Restaurant eating decreased whether study participants lost weight or not, so it was not specifically related to weight outcomes. Lead researcher Bethany Barone Gibbs, PhD, suggested that strategies that led to short-term weight loss, such as eating fewer fried foods, may not be sustainable in the long term. But small changes, like eating more fruits and vegetables can lead to better long-term results because they’re easier to do than never eating French fries.

Eating more fruits and vegetables, along with making other realistic changes, such as having less meat and cheese and fewer desserts and sugary drinks, may help women achieve long- lasting success. Future research is needed to confirm that targeting these eating behaviors could help with weight control.


More Americans are walking

Adults who said they walked for 10 minutes or more at least once a week increased from 56% in 2005 to 62% in 2010, according to a new report from the Centers for Disease Control and Prevention (CDC). That’s 15 million more Americans walking in 2010 compared to 2005, bringing the total to more than 145 million adults who walk to relax, exercise, walk the dog or get somewhere.

Regular physical activity, such as walking, helps control weight and also improves health by lowering the risk of heart disease, stroke, type 2 diabetes, depression and some cancers, and it helps people to live longer. The 2008 Physical Activity Guidelines for Americans recommend that adults get at least 150 minutes (2½ hours) of moderate-intensity aerobic activity, such as brisk walking, each week. Only about 48% of adults said they got 2½ hours of activity a week, but the CDC’s 2010 National Health Interview Survey found that walkers were three times more likely to meet this guideline than nonwalkers.

According to the survey, walking is most common in the West, where over two-thirds of people walk, but the South showed the largest increase, up 8% to about 57% in 2010.

Walking is a physical activity that most people can do. It doesn’t require special skills or equipment, can be done alone or in groups, indoors or outdoors, and is free. Communities can encourage people to be more active by creating spaces for physical activity and providing safe, convenient places to walk.

If you’re looking for somewhere to walk, search for an American Heart Association Walking Path near you. To track your walking steps and mileage and support Shape Up America!, try MOVband, a colorful activity monitor that is worn on your wrist, and which you can purchase through SUA.


From Mississippi to Colorado, US obesity rates remain high

In 2011, Mississippi ranked #1 with the most obese adults in the nation. While 34.9% of its adult population was obese, 11 other states were not far behind, with obesity rates over 30%. The trimmest state was Colorado, with 20.7% obese, which means that in every state in the US at least 1 in 5 adults are obese.

This data comes from the Centers for Disease Control and Prevention’s (CDC) annual telephone health survey called the Behavioral Risk Factor Surveillance System or BRFSS, in which adults from every state are interviewed about health risks, behaviors and practices mostly related to chronic disease.

In the 2011 BRFSS survey, the 12 states with more than 30% obese adults, in order with the highest number first, were Mississippi, Louisiana, West Virginia, Alabama, Michigan, Oklahoma, Arkansas, Indiana, South Carolina, Kentucky, Texas and Missouri. Adult obesity was greatest in the South.

Whether more Americans were obese in 2011 compared to previous years is not certain since changes in how Americans were reached — people who only had cell phones were included in the 2011 survey — and how data were analyzed meant that the findings could not be accurately compared to prior survey results.

The CDC has created a map showing the percent of adults who are obese and a state-by-state ranking of obesity rates based on the BRFSS data.

A body mass index (BMI) of 30 or higher is considered obese. You can find out your BMI here.


Nutrition and health organizations take a stand on sweeteners

We are born with a preference for sweets, and using sweeteners makes food taste good. But eating a lot of sugary foods and drinks adds calories, which increases the risk of obesity, diabetes and heart disease. So, does that mean all sweeteners are off limits? Not necessarily. In a recent position statement by the Academy of Nutrition and Dietetic, consumers can safely enjoy a variety of calorie-containing and no-calorie sweeteners as part of an eating plan that is guided by current federal nutrition recommendations, such as the Dietary Guidelines for Americans, as well as by individual health goals.

What about nonnutritive sweeteners that provide little or no calories, such as aspartame, acesulfame potassium, sucralose, saccharin and stevia? Are they better than nutritive or caloric sweeteners, such as sucrose, corn syrup and fruit juice concentrates, to help reduce calories and lose weight? Maybe.

According to a recent scientific statement by the American Heart Association and the American Diabetes Association, substituting nonnutritive sweeteners for sugars added to foods and drinks may help people reach and maintain a healthy body weight, as long as they don’t compensate for the calorie cuts by eating more high-calorie foods later on. For example, there is no benefit to drinking a no-calorie diet soda instead of a 150-calorie can of regular soda, if the reward for choosing the diet soda is to have a 300-calorie slice of cake later in the day.

Since nonnutritive sweeteners do not increase blood glucose levels and foods that contain them tend to have fewer carbohydrates than high-sugar foods, these sweeteners may benefit people with diabetes. Whether nonnutritive sweeteners are used to cut calories or carbohydrates for weight loss or diabetes control, their impact needs to be considered in the context of the overall diet. Strategies to reduce calories and sugar also involve choosing foods that don’t have either added sugars or nonnutritive sweeteners, such as vegetables, fruits, whole grains and non- or low-fat dairy.

The Academy of Nutrition and Dietetics offers these tips for healthfully consuming nutritive and nonnutritive sweeteners:

  • Cut back on calorie-containing sweeteners by drinking fewer sugar-sweetened beverages, sports or fruit drinks.
  • Decrease consumption of foods that are high in added sugars, such as sugar-sweetened beverages or grain-based desserts, including cakes, cookies and pastries.
  • Enjoy the sweet taste of foods and beverages but keep your calorie count lower by choosing from the variety of no-calorie sweeteners approved for use by the Food and Drug Administration.

As part of a healthful eating plan as outlined in the 2010 Dietary Guidelines for Americans, safely enjoy the range of calorie-containing and no-calorie sweeteners in foods and beverages.


Study finds three key strategies can boost your weight-loss success

If you’re trying to lose, keep a food diary, don’t skip meals and steer clear of restaurants, especially at lunch.

That’s what researchers from Fred Hutchinson Cancer Research Center found when they tracked the eating habits and behaviors of 123 overweight or obese postmenopausal women who followed a weight-loss program for one year. Women who wrote down what they ate daily, ate at regular intervals and went to restaurants less often lost more weight than those who did not follow these practices.

At the end of the year, women lost about 11% of their weight, on average.

  • Women who consistently kept a food diary lost about 6 pounds more than those who didn’t.
  • Women who skipped meals lost about 8 pounds less than those who didn’t skip meals.
  • Women who ate out more often lost less weight. Those who ate lunch out once or more times a week lost about 5 pounds less than those who ate out less frequently.

If you’re looking to lose weight, the top strategy to help you reach your goal is to keep a food diary. Journaling makes you aware of what and how much you’re eating. It doesn’t matter where you record it, on a piece of paper, using a smartphone app, or on your computer. The idea is to be honest about what you eat, making sure to include details like sauces, snacks and nibbles; be accurate with how much you eat, by measuring portions and reading labels; and do it consistently, reviewing it all at the end of the day to see how you did. You may find that what you thought you ate is not exactly the same as what you actually ate.

Shape Up America! can help you get started on tracking your food and activity for the day. You can print out our food and activity diary for your personal use.


New York City Plans to Ban Supersized Sugary Drinks

In a bold move to tackle the obesity problem in New York City, Mayor Michael Bloomberg announced a plan to limit the size of sugary beverages sold in restaurants, delis, theaters, stadiums and food carts. Sweetened drinks larger than 16 ounces would be prohibited in eating establishments regulated by the city’s health department, but consumers would still be able to get refills and buy more than one drink.

The size limit would not apply to diet soda, fruit juice, dairy drinks like latte or cappuccino and unsweetened coffee or tea. It would also not affect drinks sold in grocery or convenience stores and vending machines.

Not surprisingly, reactions to the restriction have run the gamut from criticism for creating a “nanny state” to praise for making the long-term health of New Yorkers a top priority.

Mayor Bloomberg’s plan is backed up by Reversing the Epidemic: The New York City Obesity Task Force Plan to Prevent and Control Obesity. This report states that Americans consume 200-300 more calories a day than 30 years ago, with the single largest increase in calories coming from sugary drinks. This increase was due, in part, to expanding portion sizes over the years. Between 2007 and 2010, the percentage of New Yorkers drinking more than one sugary beverage a day did go down, but neighborhoods with the highest obesity rates have a greater percentage of people who drink more than one sugary beverage a day.

While some people say that limiting soda size takes away from their freedom of choice, from a public health perspective, obesity is a huge concern that needs to be addressed. In New York City, 58% of adults, or over 3.4 million people, are overweight or obese. Obesity and obesity-related diseases hit lower-income and minority areas hardest, with overweight and obesity rates reaching 70% in some neighborhoods. About 40% of the city’s elementary school children are overweight or obese. Obese children and teens are more likely to become obese adults. Even when young, they have a greater chance of developing obesity-related conditions such as high cholesterol, high blood pressure and type 2 diabetes.

Obesity is a complex issue with multiple approaches needed for its prevention or control. Limiting soda size will not, on its own, solve the public health problem of obesity. But it is a bold and important step in the right direction.

The mayor’s proposal needs the approval of the Board of Health, which is likely, and is expected to be in effect by early next year.


HBO documentary The Weight of the Nation tackles America’s obesity epidemic

The Weight of the Nation is a wake-up call about obesity, one of the most pressing health issues facing Americans today. This four- part documentary series features case studies and interviews with leading experts and people struggling with obesity. It explores how obesity affects the nation’s health and health care system — and what individuals and communities can do.

  • The first film, Consequences, examines the scope and health consequences of being overweight or obese.
  • The second film, Choices, reveals the science and struggles with weight loss and weight gain and what to do to live healthier and maintain a healthy weight.
  • The third film, Children in Crisis, explores the risks children face from carrying too much weight. It highlights the challenges to a healthy lifestyle, including the state of school lunch, decline of physical education and school recess, and the marketing of unhealthy food to children.
  • The fourth film, Challenges, examines the major forces driving the obesity epidemic, including economics and subsidized food commodities, socioeconomic disparities, physical inactivity, food culture and accessibility, and the influence of the food and beverage industry.

The HBO documentary airs consecutively, with the first two films on May 14 and the last two on May 15, beginning at 8:00pm ET/PT. It is also available online

In addition, a community meeting toolkit gives leaders resources and guidance to organize a screening of one or more of the films, followed by a discussion about obesity in their community.

A companion book, based on the research behind the film series, explores why people get fat and gives practical advice on how to achieve a healthy weight and lifestyle.

The Weight of the Nation was developed by HBO and the Institute of Medicine (IOM), in association with the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), with support from the Michael & Susan Dell Foundation and Kaiser Permanente.


Weight control is not as simple as energy in = energy out

Weight management is a balancing act. When energy in (calories consumed) is equal to energy out (calories burned through physical activity), you maintain your weight; when energy in is greater than energy out, you gain weight; and when energy in is less than energy out, you lose weight.

You may ask, so why is it that when you seem to be doing everything right to tilt the balance toward weight loss, the pounds don’t come off as easily as you’d expect? Experts tell us that finding the right energy balance is not as straightforward as it may seem.

In a new consensus statement put together by the American Society of Nutrition and the International Life Sciences Institute, experts reviewed the complexities of energy balance and its regulation and dispelled some popular myths about weight management. Here are some of their findings:

  • All components of energy balance — energy in and energy out — interact with each other to impact body weight. The impact of exercise on body weight varies greatly, with some people losing weight and others compensating for their exercise by eating more and gaining weight.
  • Energy balance depends on the time over which it is considered. We are never really in energy balance but the imbalance is greater in the short term than in the long term, when energy intake and expenditure don’t vary as much. So, short-term weight loss is a temporary energy imbalance that moves toward energy balance over time.
  • The plateau that occurs when a person is trying to lose weight is not caused by a slowed metabolism, but rather to not following the diet as strictly. This may be due to biological and psychological drives to eat.
  • Weight loss slows over time. The notion that reducing energy intake by 3500 calories will lead to one pound of weight loss is false and should not be used to determine how long it will take to lose weight. For example, the experts predict that burning 100 calories by walking about one mile a day results in a 10-pound weight loss over five years, not 50 pounds as is estimated using the 3500 calorie per pound rule. For this reason, it is important to not have unrealistic expectations about how small lifestyle changes can impact weight loss. A 10-pound weight lose can result in major health benefits, but it may take longer than expected.

Know that people vary greatly in how they respond to changes in energy balance. More research is needed on how and why this is so, to help identify those who will respond best to diet and exercise interventions for weight loss.


SUA Supports Farm Bill Nutrition Priorities

Shape Up America! has signed on to an important statement regarding nutrition priorities for the 2012 Farm Bill. The statement was prepared by the Public Health Institute and is available here:

2012 Farm Bill Nurition Priorities (PDF)


CDC’s WHO growth chart training is online

CDC has released an online training module, Using the World Health Organization (WHO) Growth Charts to Assess Growth with Children less than 2 Years of Age in the U.S. , for health care providers and public health professionals who measure and assess growth of infants and young children. The purpose of the training is to provide professionals with expertise on using and interpreting the WHO growth charts. The training takes 45 minutes to complete and has seven sections that include Recommendations and Rationale, Breastfeeding as the Norm for Infant Feeding and Using the WHO Growth Standard Charts. Self-assessment questions are included for each section and case examples illustrate various scenarios to guide interpretation of the growth charts. For more information, contact Barbara Polhamus or Daurice Grossniklaus.


Online games sway kids’ snack preferences

Kid-friendly games on food company websites draw children in and influence what they choose to eat. Recent research from the Rudd Center for Food Policy and Obesity at Yale University showed that 1.2 million children visit food company websites with product-promoting “advergames” each month and spend up to one hour a month on these sites.

The researchers found that children visited 77% more web pages and spent 88% more time per visit on food company websites with advergames than on sites without advergames. Most food company sites with advergames promote candy, high-sugar cereals and fast food.

The researchers then examined how playing advergames affected the children’s snacking. They chose two advergames with unhealthy foods, two with healthy foods and two control games that didn’t promote any food. They asked 152 children to play two randomly assigned games, with a snack break in between. Children picked their own snacks from a choice of grapes, carrots, fruits snacks, crackers, potato chips and cookies.

Children who played advergames that promoted healthy food ate 50% more healthy snacks than those who played advergames promoting unhealthy food. Children who played the unhealthy food advergames ate 56% more unhealthy snacks, or 77 more calories, than those playing the healthy food games; they ate 16% more unhealthy snacks, or 25 more calories, than children playing the control games. The unhealthy advergame players also ate one-third fewer grapes and carrots than the other children.

These results show that food-branded advergames may encourage unhealthy, high-calorie snacking in children. However, if marketers create more advergames that promote healthy foods like fruits and vegetables, it could help in the fight against childhood obesity and influence children’s snack choices for the better.


Kids get more calories from added sugars in foods than drinks

Kids eat too much added sugar but more of it comes from processed and prepared foods than from beverages. New government data from NHANES (National Health and Nutrition Examination Survey 2005-2008) found that 2-19-year-old boys and girls consumed about 16% of their daily calories from added sugars, with boys averaging 362 calories a day from them, and girls, 282 calories a day. That’s more than the daily recommendation of 5-15% of calories from both added sugars and solid fats.

The survey found that 59% of added-sugar calories came from foods compared to 41% from drinks. It also found that more of the added sugars were from foods and drinks eaten at home than away from home.

Added sugars are ingredients found in processed and prepared foods like cake, cookies, jam, soft drinks, chocolate and ice cream, or that are added to foods at the table. You can spot added sugars by reading the ingredient list on packaged foods. Added sugars have many different names such as white sugar, brown sugar, corn syrup, high fructose corn syrup, maple syrup, honey and molasses. They do not include natural sugars found in fruit and 100% fruit juice and in milk products.

Although the NHANES data showed that more calories came from added sugars in foods than from drinks, earlier research showed that the single leading source of added sugars is soda. For Americans of all ages, cutting down on foods and beverages high in added sugars can benefit health and weight-control efforts, without compromising on good nutrition.


Contrasting colors help reduce serving size

It’s not just size but color that affects how much you put on your plate. People tend to serve themselves more from a larger plate than a smaller one. But what happens if the color of the plate or the tablecloth were changed?

In a recent study in the Journal of Consumer Research, 60 college students were asked to serve themselves pasta mixed with white Alfredo sauce or with red tomato sauce on either a white plate or a red plate. People served themselves more when given the same color plate as the pasta sauce, such as pasta with white sauce on a white plate, than when given a contrasting color plate, such as pasta with white sauce on a red plate.

Changing the color of the plate to a high contrast from the food reduced how much they served themselves by 21 percent. Interestingly, changing the color of the tablecloth so it was the same color as the plate, such as a putting a white plate on a white tablecloth instead of a black tablecloth reduced how much the students served themselves by 10 percent.

The authors suggest that the Delboeuf illusion may explain how the size of plates influences serving behavior, leading people to overeat on larger plates and under-eat on smaller plates. According to the Delboeuf illusion, people perceive the size of a circle to be much smaller when surrounded by a large circle than by a small circle. So, when using a large plate, the serving size looks smaller than it is, leading people to serve themselves more. Likewise, when using a small plate, the serving size looks larger than it actually is, leading people to serve themselves less. In addition, changing the color of the plate or tablecloth can help reduce the effect of the Delbouef illusion on plate size and how much people serve themselves.

To serve yourself less and help prevent overeating, replace larger bowls and plates with smaller ones. Or use bowls and plates that contrast with the color of the food being served.


Parents’ Role in Helping Obese Children Lose Weight

A new report by the American Heart Association (AHA) suggests that parents should be involved in treatment programs for obese children. The report explains how parents and adult caregivers can be “agents of change” for their children. To do this, they may need to change their own behaviors and lead by example.

Behavior change strategies for helping obese children lose weight suggest that families:

  • identify specific behaviors that need to be changed and do them together as a family
  • set small, achievable goals that are age appropriate and clearly defined. For example, make a goal to limit TV and computer screen time to no more than two hours a day instead of setting a goal to watch less TV
  • keep track of progress (for example, with a diary, internet tracking or smartphone app) and review food and physical activity behaviors daily or weekly
  • make healthier foods and activities that encourage movement more accessible at home
  • offer praise or nonfood rewards for the child’s progress instead of punishment for failure

The AHA review found mixed results when evaluating studies focused on parental involvement. About 17% of the studies reviewed found that children lost more weight when parents were involved in treatment. In some studies, parents that adhered to core behavior change strategies, such as being good role models for healthy behaviors or including children in meal planning or preparation, helped children keep weight off for longer after a few years. In other studies, having parents more involved in treatment did not impact the child’s weight loss overall. The review stated that future studies are needed to identify the conditions in which greater parent involvement can lead to better weight loss in children.

The review also suggested that more research is needed in such areas as parents’ perceptions of their children’s weight status, the influence of parent-child relationships, culture, parenting styles and grandparents in changing lifestyle behaviors, and the effectiveness of new technology in treating childhood obesity.


American Cancer Society releases updated nutrition and physical activity guidelines

According to the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention, the environment where we live, work, learn and play impacts our ability to choose healthy behaviors that reduce cancer risk. In their recently updated guidelines, ACS experts make recommendations not only for individuals to lower cancer risk, but also for communities to help make healthy eating and activity behaviors easier for Americans to achieve.

The report makes four main recommendations, along with supporting recommendations for each. The four key actions for individuals are:

  • Achieve and maintain a healthy weight throughout life
  • Adopt a physically active lifestyle
  • Consume a healthy diet, with an emphasis on plant foods
  • If you drink alcoholic beverages, limit consumption

What makes these recommendations so important? One-third of cancer deaths is due to diet and physical activity habits, including overweight and obesity, and another one-third is from tobacco. Overweight and obesity are linked to increased risk of many cancers, including cancers of the breast in postmenopausal women, colon and rectum, endometrium, esophagus, kidney and pancreas. People who avoid tobacco, maintain a healthy weight, stay active and eat a healthy diet can substantially reduce their risk of developing or dying from cancer. These are also linked to a lower risk of heart disease and diabetes.

The ACS Guidelines stress that public policy and environmental changes are needed to help individuals choose healthy behaviors. It recommends:

  • Increased access to affordable, healthy foods in communities, worksites and schools, and decreased access to foods and drinks of low nutritional value and marketing of these foods, particularly to youth.
  • Safe, enjoyable and accessible environments for physical activity in schools and worksites, and providing for transportation and recreation in communities.

The full report also reviews the evidence on diet and physical activity factors that affect the risk of specific cancers and provides answers to commonly asked questions on diet, physical activity and cancer.


Effective ways to lose weight — what does the evidence say?

January is the most popular month for ads on weight loss products and services. With so many enticing options for slimming down, choosing the one that will work the best can be daunting. Researchers at the University of Arizona reviewed evidence-based strategies for treating adult obesity to find the options with the most promise for success.

Read the full article


If your New Year’s resolution is to live healthier — eat less, move more or maintain a healthy weight — USDA’s new SuperTracker can help you reach your goals.

The SuperTracker helps you plan, analyze and track your diet and physical activity. You can create a personal profile and get a plan tailored just for you. The SuperTracker allows you to:

  • Find nutrition info on 8,000+ foods and get a side-by-side comparison of foods that you choose.
  • Track the foods you eat in a day and compare them to your food group targets and daily limits.
  • Track your physical activities and see how they match up to your weekly targets.
  • Chart your weight history to monitor progress and decide if you need to adjust your eating or physical activity to move toward your weight goal.
  • Set personal goals in up to 5 areas: weight management, physical activity, calories, food groups, and nutrients. Then sign up to receive virtual daily, weekly or monthly coaching tips related to your goals.
  • Print out reports to see how you’re doing in meeting your goals. View food groups and calories, nutrients, or a meal summary for a chosen time period; check your weekly physical activities; view charts that show your weight, activity or food and nutrition trends over time.
  • Keep a journal of your progress. You can record food and activities, mood, location and any notes on daily events to help identify triggers that may be linked to your health behaviors and weight.

Go to SuperTracker and start the New Year in a healthy way.


Holiday Spirits Flag as Foot Dragging Continues on Nutrition Facts Labeling for Alcohol-Containing Beverages

“For consumers planning on drinking or serving alcoholic beverages this holiday season, one gift they won’t be getting is the gift of information. That’s because the federal government continues to delay a proposal to provide consumers with basic nutrition and alcohol facts on containers of beer, wine and spirits.” This sad fact was reported by the Consumer Federation of America (CFA) in their recent press release. The federal agency responsible for such labeling is the Alcohol and Tobacco Tax and Trade Bureau (TTB) and so far, the TTB has not met their responsibility to American consumers who need to know the alcohol and calorie content of their alcohol-containing beverages. If you want to let the TTB know what you think about this issue, you can contact them through their website at In the meantime, CFA has made helpful information about popular alcoholic drinks available on a poster.


As the Department of Health and Human Services (HHS) considers what health benefits must be covered by new state insurance plans operating under the Affordable Care Act, one of the nation’s leading groups on healthy weight for life is encouraging HHS to follow the lead of its agency, the Centers for Medicare and Medicaid Services (CMS), by extending Medicare coverage for obesity screenings and physician-based counseling to the rest of the obese population.

press release: Dec. 14, 2011 (pdf)


There are various ways to lose weight safely and effectively, but using homeopathic HCG products isn’t one of them.

The Food and Drug Administration (FDA) and Federal Trade Commission (FTC) have sent warning letters to seven companies selling homeopathic HCG weight-loss products. These drugs are illegal since they have not been approved by the FDA for this purpose and make unsupported claims about weight loss.

Homeopathic human chorionic gonadotropin (HCG) weight-loss products are sold over-the-counter as oral drops, pellets and sprays and can be found online or in some retail stores. These products are marketed with a very low calorie diet that usually restricts calories to 500 a day. According to review by the FDA, many of these products claim to “reset your metabolism,” change “abnormal eating patterns” and lead to a 20-30 pound weight loss in 30-40 days.

HCG is a hormone produced by the human placenta during pregnancy. It is approved as a prescription drug for treatment of female infertility and for hormonal treatment in males. But there is no substantial evidence that HCG increases weight loss beyond what would occur from severe calorie restriction, that it causes a more attractive redistribution of fat, or that it decreases hunger.

What to do? FDA advises consumers who are using homeopathic HCG for weight loss to stop using it, stop following its diet instructions, and throw the product out. Anyone who believes the product may be harming them should contact a licensed health care professional immediately. FDA encourages those who are experiencing harmful effects to report it at the MedWatch reporting form.

For more information, visit the FDA Medication Health Fraud section


Here’s some good news for overweight kids. Being heavy doesn’t put kids at risk for heart disease later in life IF they lose weight by the time they’re adults.

In a recent study published in the New England Journal of Medicine, researchers looked at data from four large studies that measured childhood and adult body mass index (BMI). In the studies, over 6300 people were followed for an average of 23 years. There was no difference in risk of heart disease in people who were normal weight all their lives compared to those who were overweight or obese as kids but not as adults. Children who lost weight lowered their chances of getting type 2 diabetes, high blood pressure and abnormal blood lipid levels, which are linked to cardiovascular disease risk.

But overweight or obese children who were obese as adults had a greater risk of type 2 diabetes, high blood pressure, high LDL (bad) cholesterol, reduced HDL (good) cholesterol, high triglycerides and atherosclerosis (plaque buildup on the artery walls).

It’s all the more reason for children to lose weight or maintain a healthy weight into adulthood. Check out the Shape Up America! Children’s Center for more information on childhood obesity, plus Beyonce’s Move Your Body video and tips for family fitness fun.


Expert panel report on cardiovascular health and risk reduction in children and adolescents

All children between 9 and 11 years old should be tested for high blood cholesterol so steps can be taken, if needed, to prevent heart disease when they’re older. Children should also have their fasting blood glucose levels checked every two years, beginning at age 10, if they are overweight and have other risk factors for type 2 diabetes, such as a family history.

These recommendations are from new guidelines on cardiovascular health and risk reduction in children and adolescents. An expert panel appointed by the National Heart, Lung, and Blood Institute (NHLBI) developed the guidelines to assist pediatric health care providers in promoting heart health and managing risk factors to prevent future heart disease.

Risk factors that quicken the development of atherosclerosis, the buildup of fat, or plaque, in artery walls begin in childhood. Reducing the risks may delay progression to cardiovascular disease later on, including heart attack and stroke. Risk factors include overweight and obesity, high blood cholesterol, high blood pressure, diabetes and family history of heart disease.

Obesity in childhood is linked to heart disease in adult life. According to the report:

  • A combination of reducing calories, limiting sedentary behavior and increasing physical activity is more effective than diet alone.
  • For children ages 6 to 12, family-based programs are recommended. The greatest weight loss is achieved when parents are the focus of the intervention.
  • For adolescents, the greatest weight change occurs when teens are the main focus of the intervention and they are making behavior changes with the support of their peers.

Parents should speak with their child’s doctor about their child’s weight status and screening for blood cholesterol and other health indicators, as needed.

Summary report on the Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents


Is Walking a “Vaccine” Against Cancer?

Some people think so. At a 2011 American Institute for Cancer Research conference in Washington, DC, experts presented preliminary data suggesting that a brisk daily walk helps to reduce several key biological indicators of cancer risk, including sex hormone levels, insulin resistance, inflammation and body fatness.

The big surprise is that sitting for long periods of time can increase some of those same indicators of cancer risk, even among people who exercise daily. People are being urged to break up every hour of sitting with a few minutes of activity. These breaks can be as simple as walking to a colleague’s office instead of sending an email or going to the kitchen to get a glass of water.

Senior Research Epidemiologist Christine Friedenreich, PhD, of Alberta Health Services-Cancer Care in Canada, presented just-published findings from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial. The latest results from this trial involve C-reactive protein, a marker of inflammation, which is linked to cancer risk. In a study appearing in the October issue of the journal Cancer Prevention Research, moderate to vigorous daily activity reduced C-reactive protein levels among post-menopausal women.

Dr. Friedenreich’s research demonstrates that even in previously sedentary postmenopausal women, a moderate- to vigorous-intensity exercise program results in changes in several biomarker levels that are consistent with a lower risk for postmenopausal breast cancer.

In breast and colon cancers we're seeing overall risk reductions of about 25 to 30 percent associated with higher levels of physical activity. With prostate cancer the evidence isn't as strong but it's still there — about 10 to 20 percent lower risk. For endometrial cancer, we are finding about 30 to 35 percent risk reduction with more physical activity.

Neville Owen, PhD, Head of Behavioral Epidemiology at Australia’s Baker IDI Heart and Diabetes Institute suggests sitting for long periods of time is associated with health risks — even for people who are regularly physically active. Sitting time is emerging as a strong candidate for being a cancer risk factor in its own right. It seems highly likely that the longer you sit, the higher your risk.

Sedentary time may also be an important factor for cancer survivors. For survivors, diabetes and cardiovascular disease are particular concerns and overweight and obesity increases the risk for both conditions. Television viewing time, a sign of sedentary behavior, appears to increase subsequent risk of weight gain in cancer survivors.

How sedentary are we? The majority of adults’ days are spent sedentary. One accelerometer study found that 60 percent (9.3 hours) of subjects’ waking day was spent sedentary, including meals, commutes and computer/television time, while another 35 percent (6.5 hours) was spent engaged in light activity such as walking to a meeting. Office workers can spend over 75 percent of their working hours sitting, with bouts of 30 minutes or more of unbroken sedentary time common.

“Make Time” + “Break Time” = Cancer Protection AND WEIGHT CONTROL

For good health — make time for 30 minutes of daily exercise. For weight control — make time for 60 minutes of daily exercise. Whichever you choose as your goal, combine that with “Break Time” — which means take a break of several minutes of activity for every hour of sitting time.

Break time tips:

  • Set the timer on your computer to remind you every 60 minutes that it’s time to step away from your desk and take a short walk down the hall.
  • “Walk with me.” Got a quick thing to discuss with a co-worker? Instead of sending an email, ask him or her to join you for a walk to hash it out on the go. The “pede-conference”: It’s not just for TV characters anymore
  • Keep light hand weights in your office to use while reading email or talking on the phone
  • During all phone calls and phone meetings, stand up and walk around
  • Your office or cubicle wall is all you need for simple activities like stretches, vertical push-ups and leg lifts
  • For a more vigorous activity break, ask your employer to put a punching bag or chin-up bar in your break room


Did you know that drinking just one 20-ounce soda a day for a year equals 50 pounds of sugar a year? Or that you’d have to walk about 3 miles to burn off the calories from that one sugary soda? The New York City Health Department wants New Yorkers to know how sugary drinks can impact their health. They recently launched a 30-second TV spot, along with bilingual subway posters to educate New Yorkers about the health consequences linked to sugary drinks and what healthier beverages to drink instead.

Why all the fuss? Sugar-sweetened drinks are the main source of added sugar in the American diet. They provide extra calories that can lead to obesity and other health problems, such as diabetes and heart disease. With ⅔ of American adults and ⅓ of children either overweight or obese, finding ways to stem the tide of obesity is a national concern.

Here are some other ways that states and schoolchildren are trying to get people to cut down on soda.

The Tennessee Obesity Task Force wants lawmakers to tax sugar-sweetened soft drinks. The soda tax bill would place a 1-cent-per-ounce tax on bottled, sugar-sweetened drinks bought at convenience and grocery stores, while also reducing the state food tax by 1 percent.

In Columbia, Maryland, nearly 100 fourth- and fifth-graders and their teachers signed a pledge to not drink soda for one month. If Talbott Springs elementary school can do it, county health officials hope to take the pledge idea to other schools throughout Howard County.

The New York City Health Department offers these healthy alternatives to sugary drinks:

  • Water: add slices of lemons, limes, oranges, watermelon, cucumber or mint
  • Unsweetened teas: if desired, just add a few drops of honey
  • Seltzer or club soda with a splash of 100% juice: Mix one part juice (cranberry, orange or grape) with 3 parts seltzer
  • Coffee: skip the fancy sweetened ones
  • Low-fat (1%) or fat-free (skim) milk: always a good, healthy choice

For more info, go to the New York City Health Department site


Beverage companies are marketing sugary drinks to young people, especially black and Hispanic youth. Despite their pledge to market fewer unhealthy drinks to children, youths are seeing more advertising overall for sugary drinks, according to a new study from the Yale Rudd Center for Food Policy & Obesity.

Researchers analyzed the marketing practices of 14 beverage companies and the nutritional quality of close to 600 products including regular soda, energy drinks, fruit drinks and diet drinks. They found that from 2008 to 2010, children's and teens' exposure to TV ads for sugary soda doubled and energy drink ads marketed to teens rose by 20 percent. Marketers are engaging youth in new ways, such as giving rewards for buying sugary drinks, sponsoring events or sports teams, and using social media (Facebook, Twitter and YouTube).

While the American Beverage Association points to recent declines in sugary drink consumption and sales, the researchers feel that beverage companies need to do more to change their marketing practices toward youth.

What can parents do?

  • Serve water and low-fat milk.
  • Keep juice portions small (8–12 oz/day for children over age 6).
  • Read the ingredients list (fruit drinks have added sugar).
  • Contact the beverage companies with any questions or concerns.

For the full report


Do you fear a healthy Halloween will be a frightening experience for your child? By shifting the focus from candy to costumes, no-candy treats and creative play, you can keep your kids from sugar overload without missing out on this super-fun day.

Experts at offer up these tops tips for a healthy and happy Halloween:

Focus on the FUN: Shift the attention away from the candy and onto the costume. Hold a costume contest for the neighborhood. From “Scariest”, to “Cutest”, to “Funniest”, each kid can win a title. Make the grand prize a fun activity like jumping rope, kickball, chalk and other outdoor activities.

Push Play! Instead of consuming the calories, encourage kids to expend them with activity coupons. Giving away coupons to your local bowling alley, ice skating rink, batting cage or other indoor play centers is a fun way to encourage families to get up and be active together!

Top 10 Steps Towards a Healthier Halloween


What is Obesity?

Obesity refers to excess body fat — enough to place your health at risk. In the clinic, measuring body fat is typically not done, and weight for height or BMI (body mass index) is used instead. For the average person, obesity (a BMI of 30 or above) is roughly 30 pounds or more of excess weight in the form of fat.

The reason that the health care professionals are concerned about obesity is that the risk of diabetes, hypertension, cardiovascular disease, osteoarthritis, and certain cancers increases markedly in obese people. If obesity is prolonged, irreversible metabolic and physiological changes occur that lead to insulin resistance, high blood glucose levels, joint pain, loss of breath and more. One negative consequence is that weight reduction becomes harder and harder to achieve. So obesity is not a cosmetic issue, it is a health issue.

A recent random survey conducted by Dr. Matthew Ryan of the University of Florida, Gainesville of folks in a hospital Emergency Department found:

  • Only 30% of people told by their health care provider that they were overweight agreed with that assessment.
  • Only 1 in 5 people with a weight problem said they had ever discussed it with a health care provider

These findings are a concern because taking action is unlikely to occur in folks who do not see the health consequences of excess weight. Learn your BMI today and if your BMI falls between 25.0 – 29.9 you are overweight; a BMI of 30 or above is considered obese.

SOURCES: Matthew Ryan, M.D., Ph.D., assistant professor, emergency medicine, University of Florida, Gainesville; Keri Gans, R.D., spokesperson, American Dietetic Association; Oct. 15, 2011, presentations, American College of Emergency Physicians annual meeting, San Francisco


On October 24, 2011, thousands of events will inspire Americans to improve their diets and fix our food system. Go to to attend an event near you, or volunteer to organize an event for your school, church or community.

Thanks to folks at the Cooking Channel, you can view a 60-second promotional spot about Food Day featuring Morgan Spurlock (famous for the movie Super Size Me).

Feel free to share it with your friends on Twitter, Facebook, or Google+!


The Obesity Society (TOS) is meeting this week in Orlando, Florida so the media are picking up on presentations about obesity and weight management that are considered provocative. Bear in mind that these are preliminary findings, presented by researchers, and not full-length studies published in peer-reviewed publications. Peer review usually means that two separate persons with expertise in the subject area of the study have reviewed the publication. It is not unusual for authors of studies to revise their manuscripts in response to the review process. It is also not unusual for journals to reject manuscripts altogether. So as you read stories in the media about studies presented at the TOS meeting, keep in mind that the findings may not stand up to closer scrutiny via the peer-review process.

The Obesity Society 2011 Annual Meeting


September is National Childhood Obesity Awareness Month. 12.5 million US children are obese, but we can make changes to ensure our children live active, healthy lives. Childhood obesity is a major public health problem. In the US, 17% of children are obese, and certain groups of children are even more severely affected by this problem. Nearly 27% of Mexican-American boys are obese, and nearly 30% of non-Hispanic black girls are obese. There is no single or simple solution to childhood obesity. It is influenced by many different factors, including a lack of access to healthy food and drinks as well as limited opportunities for physical activity in the places where children live, play and learn. Working together, states, communities, and parents can help make the healthy choice the easy choice for children and adolescents.

Presidential Proclamation — National Childhood Obesity Awareness Month


New Yorkers may remember former mayor Ed Koch who served three terms from 1978 to 1989, but few know that he was a chubby child, according to an August 10 article in the New York Times. Mayor Koch teamed up with his sister, Pat Koch Thaler, to write a children's book entitled “Eddie Shapes Up.” The book draws upon Koch's experiences as an overweight young boy and serves as a cautionary tale about the importance of adopting a healthy diet and active lifestyle at an early age.

To underscore the importance of weight control during young adulthood, June Stevens and her colleagues at UNC Chapel Hill published a compelling study of nearly 14,000 people in the Journal of Adolescent Health. These workers showed that in both African-American and white people, excess weight in young adulthood (approximately age 25) contributes to significantly higher death rates over the next 20-30 years.

A body mass index (or BMI) that falls between 18.5 and 24.9 is associated with lowest mortality. To learn about your own BMI and more about the effects of excess body fat, go to:
BMI calculator
Body Fat Lab


Many people would like to quit smoking but hesitate to try because they fear gaining weight. Weight gain following smoking cessation is commonly reported, but does not have to be inevitable. A new study published in the August 2011 issue of Nicotine & Tobacco Research offers a promising solution. Researchers in this study counseled subjects for only 15 to 20 minutes about smoking cessation and provided them with an 8-week supply of the nicotine patch. Those who completed 2 one-hour full-body weight lifting (also known as resistance training) sessions each week for 12 weeks were more likely to kick the smoking habit and they lost weight as an added bonus. The control subjects who did not exercise were less successful at quitting and they gained weight and body fat during the 12-week period. Months later, quitters in the exercise group were more likely to continue to kick the habit than those in the non-exercise group.


On July 6, 2011 Shape Up America! President, Barbara J. Moore, participated in a delegation led by Senator George McGovern to the Secretary's Office at the Department of the Treasury to brief the Secretary's Chief of Staff, Mark Patterson, on our efforts to achieve labeling of alcohol-containing beverages. Sadly, Senator McGovern lost a beloved daughter to the ravages of alcoholism and was willing to share his story to open the meeting.

Meeting attendees included representatives from the National Consumers League and the Consumer Federation of America who have partnered with Shape Up America! in the past to conduct consumer research on alcohol labeling. Those findings were published in Nutrition Today in 2010 and suggest that the majority (90%) of consumers support labeling of alcohol-containing products with an “Alcohol Facts” label. When presented with three different labeling formats, they preferred the most complete label that provides information about alcohol (by volume and fluid ounces), calories, protein, fat, carbohydrate and the definition of a standard drink in terms of fluid ounces of alcohol.

On July 12, 2011 Shape Up America! sent a copy of Moore's Nutrition Today article to Mr. Patterson thanking him for meeting with us and expressing the hope that 2011 will mark the inauguration of the long awaited “Alcohol Facts” label that will give consumers the information they need to make the right choice, the easy choice.


Over the years, Shape Up America! has received many questions about healthy eating and it always seemed easiest to explain what constitutes a healthy balanced diet in terms of a plate since that is something everyone can relate to. A search on our website — — using the word “plate” as the search term will illustrate my point. Finally the U.S. government has decided to make it official — the plate icon is replacing the Food Pyramid and has launched a website — — to help consumers learn more about healthy eating. We welcome this new icon as a teaching tool, and hope that it encourages more people to cover the majority of their plate with plant-based foods (veggies, fruits and products made from whole grains) at mealtimes.

Although there is evidence that protein is helpful for weight management, the new plate icon shows that the protein source should not cover more than ¼ of the plate. To that we would add that fish, skinless poultry, and lean cuts of meat are preferred. One thing the icon does not make clear is the role of fat and added sugars. For weight management, suffice it to say that minimal amounts of both are preferred. Note that dessert is not a part of the icon, which is an important message for those of us watching our weight.


Shape Up America! is honored to be selected as one of the 10 best obesity sites on the web by TopSite!

TopSite: 10 best obesity sites


Shape Up America! remembers Jack LaLanne, as the first TV fitness and nutrition personality who not only talked the talk but also walked the walk. May he rest in peace.


In addition to this startling statistic on the costs of obesity, the CDC Vital signs (August 2010) highlights a few other startling statistics. They are:

  1. More than 72 million U.S. adults are obese (12.5 million children are obese per W. Dietz testimony of 2010 to Congress)
  2. Persons who are obese have medical costs that are $1429 higher (per year) than those of normal weight
  3. No state has an obesity rate less than 15%—the national goal.

Society of Actuaries obesity report (pdf)


The new Dietary Guidelines for Americans, 2010 emphasize the widespread increase in obesity among Americans. For the first time, the Guidelines address the fact that over 70 percent of American women and over 60 percent of men are overweight or obese. According to Dr. Linda Van Horn, chair of the Dietary Guidelines Committee, for the first time the Guidelines are “completely evidence-based,” meaning that sound scientific research provided the basis for the committee's conclusions and recommendations.

Article: Dietary Guidelines do improve nutrition, says committee chair

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