Many Ky. parents don't realize children are overweight, or won't acknowledge it, but many report kids' poor health behavior

By Al Cross
Kentucky Health News

Many Kentucky parents don't realize that their children are obese or overweight, or at least aren't willing to acknowledge it. That is the obvious conclusion to draw from the latest results of the Kentucky Parent Survey, released Tuesday by the Foundation for a Healthy Kentucky.

The poll found that only 14 percent of Kentucky parents say their child weighs too much, but the National Survey of Children's Health found that 37 percent of Kentucky children are overweight or obese. Conversely, 76 percent of parents in the poll think their child's weight is about right, but the national survey found that only 58 percent of Kentucky kids have healthy weight.

The Kentucky Parent survey, taken by land-line and cell telephone from July 19 to Aug. 22 by the Center for Survey Research at the University of Virginia, interviewed 1,006 Kentucky parents, step-parents, grandparents, foster parents or other legal guardians of children in Kentucky selected at random. The statistical margin of error for that sample size is plus or minus 3 percentage points.

The poll also found that 56 percent of Kentucky children are watching more than the maximum daily recommended amount of “screen time” – watching television, playing video games or using the Internet – and that 59 percent drink sugar-sweetened beverages every day. Both are major factors in childhood obesity, research has found, and experts recommend no more than two hours of screen time a day and no sugar-sweetened drinks at all.

“Parents can help reduce this risk by encouraging healthy behaviors for their children,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky.“Our children’s habits and behaviors impact their health today and shape their quality of life as they grow. When kids eat poorly and don’t get enough physical activity, it increases their risk for obesity, diabetes, heart disease and other chronic diseases. This poll data helps us understand what parents think about the behaviors that are so critical to health.”

The Kentucky Parent Survey also found that only 56 percent of Kentucky parents said their child got "enough" fruits and vegetables every day during the preceding week, and 66 percent of parents reported their child got "enough" physical activity every day during the preceding week. It also found that elementary and high-school students often get less than the recommended amount of sleep per day (chart).

The survey did not define "enough." The foundation noted that one strategy to reduce childhood obesity in Kentucky is "5-2-1-0," reflecting experts' recommendations that each day, children should eat at least five servings of fruits and vegetables, have no more than two hours of screen time, engage in one hour of physical activity, and drink zero sugar-sweetened beverages. For the foundation's press release, click here.

One S.C. county serves as incubator for state's efforts to battle weight problems, with some good results

PE teacher Sharon Williams, right,
leads morning exercises before
classes start at Bells Elementary.
(The State photo by Tim Dominick)

With nearly two-thirds of South Carolina deemed overweight or worse, lucky Colleton County got picked to be a test case for doing better. That is, for improving its chances to beat the state's already overwhelming rates of diabetes, heart disease and stroke and for helping to lower the state's $1.2 billion dollar medical bill. Lucky, because in 2010, the county was awarded almost a half million Eat Smart Move More grant by the BlueCross BlueShield of South Carolina Foundation to see if it could promote health eating and more physical exercise countywide. Joey Hollerman of The State newspaper in Columbia, S.C., reports that "the results have been striking," though he notes that changing obesity numbers is "like turning an aircraft carrier, it's a slow process." Mostly, he's talking about attitude and perseverance.

How does the county-wide program work on a daily basis? First, of course, you have to have buy-in, which this county did. Hollerman explains that now when children arrive at Bells Elementary School in the county seat of Walterboro, "they go straight to the gym and walk laps before heading to classrooms. Worshipers at Power of Faith Delivery Ministry harvest collards as well as souls, and fried chicken is discouraged at church dinners. The local farmers market has a sparkling new home and a system set up to accept cards from the Supplemental Nutrition Assistance Program." The Let’s Go, Eat Smart program and exercise programs are posted in schools, workplaces, grocery stores and churches.

So how, if the numbers aren't clear yet, how to measure if it's working? Well, only one fried chicken basket showed up at a recent church supper and the member who brought it ended up apologizing for her breach. On the day the reporter visited only the elementary school only one child in the entire first grade tried to slip through without selecting a fruit or vegetable. He was sent back and grabbed a plastic container of grapes from the Go (instead of the Slow or Whoa) food options, Hollerman reports. There are also anecdotes galore, including those of children, once on insulin, who are now fine without it.

South Carolin's BlueCross BlueShield recently awarded another grant to Eat Smart Move More, in part to continue the work in Colleton County but also to for expand it to other communities. (Read more)

Health coalition asks Nickelodeon to stop marketing sugary and fatty snacks to children

A coalition of health groups thinks maybe it's time to enlist SpongeBob in the childhood obesity fight. Earlier this week, the groups asked the Nickelodeon Channel to stop airing commercials that promote unhealthy foods with the help of the doofy adorable sponge, among other lovable characters the children's channel employs. The letter the groups signed asked that Nickelodeon's parent company, Viacom, put in place strong nutrition standards for the foods marketed by it and by its characters. Their sentiment was strongly backed by the American Academy of Pediatrics.

Elise Viebeck of The Hill's Healthwatch blog quotes the letter: "Research shows that food marketing is an important factor contributing to children's poor diets and obesity. The majority of foods marketed to children remain of poor nutritional quality. The [federal Institute of Medicine] concluded that marketing puts children's health at risk." The letter went on to shake its finger at Nickelodeon for being behind Disney and other prominent child marketers on this front. (Read more)

This comes on the same day that the University of Missouri-Kansas City and the University of Kansas Medical Center release study results that found obese children may be more susceptible to food advertising than healthy-weight children, suggesting at least one reason the nation's childhood obesity rate could continue to climb as feared. (Read more)

Japan approves a high-fiber version of Pepsi as a fat blocker

Let's start here: Way too much of Kentucky is way too fat. And, let's add this, we drink lotsa sugary beverages. Why, our intake of Mountain Dew alone is legendary. So, here comes some news out of Japan which may have particular interest to Kentuckians: This week, Pepsi will start marketing a new product called Pepsi Special that is special indeed, since it has the blessing of that country's National Institute of Health and Nutrition as a "food for specified health use." That use, you ask? Fat blocking. Let me at it, you say? Hold up, we caution. Pepsi Special is, in a nutshell, Benefiber Pepsi.

According to reporters at the The Atlantic magazine, wheat dextrin is the same additive in Pepsi Special as the one that's sold as Benefiber in the U.S. It's a soluble fiber that "absorbs water as it moves through our intestines and promotes movement of food through the bowel, and contraction of the bowel wall itself." In a 2006 Japanese study, rats that ate wheat dextrin absorbed less fat from their food because, notes the magazine, "It essentially moved right through them."

So, is any of this actually good for you? Dextrin "may increase micronutrient absorption, stabilize blood glucose, lower serum lipids, may prevent several gastrointestinal disorders, and have an accepted role in prevention of cardiovascular disease," experts say. But you still have to restrict your soda intake for any of this to matter. (Read more)

Study finds kids get more fat and calories when they eat out

Nobody's surprised to hear what researchers have now quantified: When children eat out, they take in more calories and fat than they would have at home. It doesn't matter if they're sitting down or driving through, at a fancy restaurant or at a McDonald's, we're not doing them any nutritional favors when we get in the car to go eat.

Jon Bardin of the Los Angeles Times reports that a study, published Monday in the medical journal Archives of Pediatrics & Adolescent Medicine, found that 2- to 11-year olds average an extra 126 calories when they eat a fast-food meal and 12- to 19-year-olds add an average of 309 calories. Full-service restaurants could added an average of 160 and 267 for the two age groups, respectively. And a lot of those calories were of the empty-nutrition kind that come from sugary drinks; kids in the study drank significantly more of those while dining out than when eating at home. (Getty Images photo)

In their report, writes Bardin, the authors argue that government intervention likely will be required to see any improvement: “Public policies that aim to reduce restaurant consumption -- such as increasing the relative costs of these purchases; limiting access through zoning, particularly around schools; limiting portion sizes; and limiting exposure to marketing -- deserve serious consideration.” (Read more)

Calorie counts on your Coke and Pepsi machines coming in 2013

Coca-Cola, PepsiCo and the Dr Pepper Snapple Group, for starters, will start displaying calorie counts on vending machines in an effort to encourage consumers to make lower-calorie choices, starting in 2013. The plan, explains Time magazine, falls in line with the Patient Protection and Affordable Care Act’s requirement that vending machines and restaurant chains with more than 20 locations display calorie information. The labels will be marked "Check Then Choose" or "Try A Low-Calorie Beverage." The industry initiative, called the Calories Count Vending program, will begin its launch in city buildings in Chicago and San Antonio, where government employees are participating in a “wellness challenge.” The nationwide rollout will begin next year.

Time reporter Olivia B. Waxman asked whether this move will make a difference in calorie consumption. Early research didn't hold much hold, but later studies were more promising, she reports: "Studies have found that calorie information, when presented clearly — and at the point of sale — does tend to sway people’s eating and drinking behaviors. In a December study published in the American Journal of Public Health, for example, researchers at Johns Hopkins went to corner stores in predominantly black neighborhoods and posted signs with calorie information about sugary drinks (sodas, fruit drinks, energy drinks and the like) on refrigerated beverage cases. Overall, the study found, black teens — a population that is more likely to consume sugary drinks and is at higher risk of obesity than other groups — were 40 percent less likely to buy soft drinks when they saw the calorie signs. They were even less likely to buy them when the calorie labels put information in context: for instance, by noting that it would take 50 minutes of running to burn off the calories in one sugary drink. Those signs reduced soda consumption by 50 percent." (Read more)

Is there a correlation between food-stamp use and obesity? Some say yes, and that corporations are getting fat in the process

"Who's getting fat off food stamps?" asks ABC News' Alan Farnham, reporting that a record number of Americans -- 46.7 million, or nearly 1 in 7 -- now uses the benefit, known as the Supplemental Nutrition Assistance Program. It cost $72 billion last year, up from $30 billion four years earlier. Budget hawks have targeted the program's swollen size and cost, helping prevent passage of a new Farm Bill. Now Farnham reports, "There are those who say SNAP is making two different constituencies fat -- big corporations and the poor -- the first, figuratively; the second, literally."

In Kentucky -- with its extraordinarily high rate of obesity and, as of June 2012, its 406,689 households on food stamps -- the correlation between those two bears close scrutiny.  Many health advocates who are concerned about Americans' increasing obesity argue that "food stamp purchases should be disallowed for items high in salt or fat or sugar," Farnham notes. Consumer watchdog groups such as Eat Drink Politics similarly argue that food and beverage makers are making a mint from SNAP, and are spending equal portions to oppose legislation antithetical to their interests.

Hard numbers about what the program buys are hard to come by, says the report, in part because the U. S. Department of Agriculture either doesn't have or does not release certain crucial data: "It lacks the legal authority, for example, to require retailers to report what products SNAP participants are purchasing. It knows the dollar value of transactions, but not whether the customer bought Cheesy Puffs or broccoli."

As for the increasing obesity of the poor, data on that problem are readily available, but food stamps' complicity in it is the subject of much debate. Julian Alston, professor of agricultural and resource economics at the University of California, Davis, has studied the question in depth. Alston and his co-authors conclude that food stamp participants are more likely than non-participants to be overweight or obese. Farnham writes that "they don't say food stamps are making them fat. The authors then go on to analyze whether the exclusion of certain food items from program eligibility might make participants healthier." (Read more)

Sodas losing fizz in schools, but exclusive deals remain

New research from the Robert Wood Johnson Foundation shows more than half of middle and high schools have purged the pop since the 2006-2007 school year. That year, 53.6 percent of high schools and 27.4 percent of middle schools gave students access to soda. In the 2010-2011 those numbers dropped to 25.3 in high schools and 12.5 percent in middle schools, reports Sarah Kliff for The Washington Post.

"You have policymakers at the state level, and also more local, moving policies into this directions," said researcher Yvonne Terry-McElrath. "You have policymakers at the state level, and also more local, moving policies into this direction. I also think you're seeing movement from parents and individuals who are becoming more aware of what is and isn't healthy."

That is the case in Kentucky. Under a state law passed a few years ago, students can only buy school-day-approved beverages — 100 percent fruit juice, lowfat milk and any beverage that contains no more than 10 grams of sugar per serving — during the school day. It may benefit reporters to ask school administrators though if there are vending machines at school that sell soda after the school day is finished, however. 

Though schools are getting rid of soda in high numbers across the country, a lot of them still have relationships with Coke or Pepsi, something reporters can find out by simply asking administrators.

Photo by Paul Robert Lloyd, via Flickr

A 2005 survey found nearly half of elementary schools and about 80 percent of public high schools nationwide had pouring rights contracts with one or the other of the soda companies, which gives them exclusive rights to supply all the beverages in school snack bars, vending machines, school stores and at sports events.

The upside for the schools can include funding for field trips, gym uniforms, SMART boards and other perks, reports blogger Tom Philpott for Mother Jones. Philpott cites one study that shows students living in states with laws that limit junk food sales gained less weight — an average of about 2.25 pounds for a 5-foot child — than those that didn't. A study in California showed students consumed 158 less calories each day in schools where sodas were banned and new nutritional regulations were implemented in cafeterias.

But one study of 20,000 students found no correlation between obesity rates and access to soda at school. "The research is pretty mixed," Terry-McElrath said.

NYC deeply split on Bloomberg plan to ban supersize sodas

Bloomberg with Linda I. Gibbs, deputy mayor for health.
(New York Times photo by Chang W. Lee)

In a bold move to curb obesity, New York City Mayor Michael Bloomberg wants to ban the sale of supersize sodas and other sugary drinks by restaurants, movie theaters and street carts.

"The sale of any cup or bottle of sweetened drink larger than 16 fluid ounces — about the size of a medium coffee, and smaller than a common soda bottle — would be prohibited under the first-of-the-nation plan, which could take effect as soon as next March," reports Michael Grynbaum for The New York Times.

Exempt from the measure are diet sodas, fruit juice, dairy-based drinks and alcoholic drinks. The ban would include drinks sold in grocery or convenience stores.

"New York City is not about wringing your hands; it's about doing something," Bloomberg said. "I think that's what the public wants the mayor to do." In NYC, more than half of adults are obese or overweight.

A poll conducted Sunday showed about half of New Yorkers feel Bloomberg is going too far, while 42 percent said it would be good health policy, reports Samantha Gross for The Associated Press. The idea has been harshly criticized, with an editorial in the Times calling the plan "overreaching" and saying "Too much nannying with a ban might well cause people to tune out."

But conservative David Frum, a contributing editor for Newsweek and The Daily Beast, said "good for Bloomberg," pointing out: "Sugary drinks now provide 7 percent of the calories in the American diet, the largest single national source of calories. Teen boys average more than a quart of sugary soda per day. Even adults who say they are trying to lose weight still drink more two 12-ounces cans per day, on average."

"The campaign against obesity will have to look a lot less like the campaign against smoking (which involves just one decision, to smoke or not to smoke) and much more like the generation-long campaign against highway fatalities, which required the redesign of cars, the redesign of highways, and changes in personal behavior like seat-belt use and drunk driving," Frum argues.

Kids are still eating too much sugar, regardless of parents' income, and they're getting most of it at home

By Tara Kaprowy
Kentucky Health News

American children's sugar consumption is down, but kids are still eating too much sugar, and they are getting most of it at home.

So says a new study from the National Center for Health Statistics, which also found parent income is not playing a part in how much sugar kids are consuming. "We found that all kids are eating a lot of added sugars," said Cynthia Ogden, the study's co-author and an epidemiologist with the Centers for Disease Control and Prevention. (One study found kids in low-income families are drinking more juice than recommended, however.)

The study found sugar consumption has dropped to 17 percent of total caloric intake, from 22 percent, but 17 percent is still well higher than federal guidelines, which say total discretionary calories, including added sugar and solid fat, should account for only 5 to 15 percent of total daily caloric intake.

Sugar consumption may have declined because kids are consuming less sugar when they're not at home, thanks to bans or limits on sugary drinks at schools, said Dr. Wendy Slusser, an associate clinical professor of medicine at the Mattel Children's Hospital at the University of California. Kentucky has such a ban.

Most of the sugar is coming from food, not beverages, Linda Carroll reports for MSNBC. About 16 percent of kids' calorie intake comes from "added sugars," such those added to breads, cakes, jams, chocolate and ice cream. Those numbers do not include sugars that naturally occur in food, such as in fruit or fruit juice.

Going forward, the goal is to address how parents are feeding their children. "This is an opportunity for families," Slusser said. "There are estimates now that we could shift children's weights back to 1970s levels if we could just take 350 calories out of a kid's diet each day."

One way to do so is using water to replace sports drinks and those with 10 percent fruit juice. Giving kids Cheerios rather than Honey Nut Cheerios — or any cereal that's lower in sugar — also helps. Reading nutrition labels, avoiding processed foods and planning ahead for healthy snacks and nutritious dinners can also solve the problem. "Once there's a routine, parents can integrate healthier foods into their children's diets," Slusser said. "When you're always eating on the fly, you end up eating too many processed foods." (Read more)

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.