Posts Tagged obesity

Obesity, diabetes, more prevalent among poor and less educated Californians

Published: September 1, 2010 | No Comments

By Daniel Weintraub

The latest look at obesity and diabetes trends in California from the UCLA Center on Health Policy Research shows how closely the twin maladies are tied to income and education levels.

The report notes that more than a quarter (27.7 percent) of adults living below the poverty line are obese, compared to 19.6 percent of higher-income adults. Diabetes was also more prevalent among adults whose incomes are less than 200 percent of the federal poverty level.

The numbers for education levels are even more dramatic.

Adults with no more than an 8th grade education are twice as likely to be obese as those who graduated from college (30.3 percent versus 14.9 percent). And diabetes is three times as common among adults with no high school education (14.8 percent) as among those who graduated from college (5.1 percent).

The report suggests that the concentration of fast-food restaurants and relative scarcity of markets that sell fresh food are likely factors in leading to the disparities in the prevalence of obesity and diabetes among the poor and lesser educated. Another factor: a lack of parks and open space.

See the full report here.

 

Obesity rates levelling off among some children

Published: August 17, 2010 | No Comments

By Daniel Weintraub

Childhood obesity rates in California are showing signs of leveling off or even declining among some adolescents, a new study led by UC San Francisco researchers has found.

But the rates continue to climb for some ethnic groups, and the worst cases are as numerous, and as serious, as ever.

The study, published online today in the journal Pediatrics, was the first to find differences in obesity trends over time by race and ethnicity, according to the authors.

Kristine Madsen, MD, MPH, an assistant professor of pediatrics at UCSF, and colleagues examined the body mass index (BMI) among adolescents in California from 2001 through 2008. The data for 8 million 5th, 7th and 9th graders were available from records kept as part of school fitness exams.

The study found that obesity rates among white and Asian girls and boys peaked in 2005, then dropped through 2008. Rates for Hispanic children also peaked that year and then leveled off, even as obesity rates for Hispanic boys declined. Rates among black boys were stable through the entire period.

Obesity rates for black and American Indian girls climbed throughout the period. And these groups were more than three times as likely as white girls to be severely obese.

And when comparing groups at the 99th percentile of body mass index — severely obese — only Asian youth and white boys showed any signs of decline after 2005. All other groups – including Hispanic boys and girls, white girls, black boys and girls, and American Indian boys and girls – peaked in 2005 and then remained at a plateau through 2008.

“When you look at the very heaviest end of the spectrum, the picture is pretty bleak, and we do not yet know if severe obesity rates for these groups will remain at a plateau or continue to increase,” Madsen added.

While the results suggest that anti-obesity campaigns are having an effect, Madsen said more change is needed at home, at school and in after-school gathering places to encourage healthier eating habits and reduce food consumption.

“While the decline and stabilization of obesity among certain groups is encouraging, we are seeing an increase in disparities that is troubling, especially among the most severely obese youth,” Madsen said. “As our country becomes increasingly diverse, it is critical that we act quickly to address these disparities.”

 

Obesity rates keep climbing in US

Published: August 3, 2010 | No Comments

By Daniel Weintraub

A record number of US adults are now obese, with 2 million more people crossing that unhealthy weight threshold between 2007 and 2009, according to new numbers released by the US Centers for Disease Control and Prevention.

More than 72 million adults are now classified as obese, which is defined as a body-mass index of 30 or more, a calculation based on the relationship between a person’s weight and height.

No US state has a population with an obesity rate of less than 15 percent, which is the official US government goal for the country. In nine states, the rate is greater than 30 percent. Just 10 years ago, no state had an obesity rate of greater than 30 percent.

California’s obesity rate is 24.8 percent. Sixteen states have lower rates.

Non-Hispanic black women (41.9 percent) and Hispanics (30.7 percent) have the highest rates of obesity.

Government agencies and non-profit groups across the country and in California are placing intense focus on the obesity issue, in part because the condition contributes to so many other health problems. The direct and indirect costs of obesity were estimated at $147 billion in 2008 dollars.

One example of a group fighting the epidemic is the Health Education Council. The council has launched a variety of initiatives to educate people about obesity and try to change their behavior. Many are aimed at children because so many children are overweight and destined for obesity and other health problems if they continue on their present course.

The council’s Rethink Your Drink” initiative works with medical professionals, agencies targeting children five years old and younger, schools, employers and local officials to provide training and education to get consumers to reduce or eliminate the consumption of sweetened beverages, which are associated with obesity, and Type 2 diabetes.

The council is also working with local farms to bring boxes of fresh produce to worksites, schools and community-based organizations, and working with employers to provide healthier food at meetings.

The council’s In the Grow program offers parent education and teacher training about healthy food choices and physical activity as well as how to start a school or community garden. And the council is working more broadly to ensure that all Californians have access to healthy and affordable foods and beverages, especially fresh fruits and vegetables.

To see the full CDC report, go here.

 

Putting walkability to the test

Published: June 2, 2010 | No Comments

ashby wolfe

Ashby Wolfe MD, MPP, MPH

By Ashby Wolfe

I recently returned from a very interesting few months working in the hospital and traveling to various conferences around the country. The topic at many of these meetings was, of course, health reform. It is no secret that I am a big fan of much of what is in the legislation, especially the emphasis on preventive health care, and funding for primary care to assist patient in the treatment of chronic disease.

Part of the reason I am so excited about the national push for prevention is because our country continues to move slowly towards becoming the most overweight nation in the world. Our rates of heart disease and diabetes are sky rocketing. It is my hope that funding for preventive care can help get our health back on track.

However, it is going to take more than national legislation to reduce our collective body mass index. This was never so apparent to me as when I recently attended a two-day conference in Washington DC. I began my trip reading more about the Let’s Move Campaign, an ambitious federal program aimed to reduce childhood obesity by promoting physical activity and healthful eating in schools. Motivated by the opportunity to meet some of the people behind the creation of the program, I eagerly reviewed the action plan. Seeing the words “food desert” and “complete street” in a national policy brief was exciting – especially since many dedicated community members, academic researchers and patient advocates have been using this terminology for decades without much national attention.

I was properly motivated as I deplaned in DC, and being a fan of public transportation, I decided to do as much walking as possible in our nation’s capital and really embrace the spirit of Let’s Move. I decided to keep track of my efforts and see just how easy it was to stay physically active while on a highly scheduled two-day business trip.

I had no trouble walking through National Airport, and made it to the METRO train (conveniently located across the street from the airport) without incident. One fifteen minute ride later and I had arrived in Alexandria, Virginia. I had just a short 10 minute walk to the place I would be staying, but this walk proved rather difficult in a business suit and suitcase. A sidewalk was available for the first three minutes of my walk, but then ended abruptly at the busiest intersection in town, without a cross walk in sight. Undeterred, I continued along the safest side of the street, half in grass and half in dirt. I eventually made it to another section of sidewalk, which then took me to the driveway of my destination.

The remainder of my trip was spent mostly in the downtown areas of DC near the Capitol, where the METRO stops regularly and sidewalks are plentiful. However, my return to the airport again involved a walk along a rather dismal stretch of road that only the bravest of souls would consider traveling with a suitcase. Needless to say, a street complete with sidewalk and bike lane is always welcome.

As the country continues to focus on prevention as a key part of our improved health, many local groups are starting to discuss complete streets, and smarter growth development policies, to make communities safe for outside activity that is not dependent on the automobile.

For health professionals like me, who tend to recommend walking as a key activity to promote weight loss and healthy lifestyles, the importance of campaigns like Let’s Move and community coalitions supporting smart growth cannot be overstated.

If you are curious, you can test the “walkability” of your city or town and find handy routes to exercise or explore. Consider supporting local community efforts; many cities are developing tools for smart growth advocacy to support such change. You can also visit the Let’s Move website (see link above) to see how you and your community can get involved.

Or, do your own walkability test and see for yourself!

Ashby Wolfe is a resident physician in the Department of Family and Community Medicine at the UC Davis Medical Center in Sacramento. She holds an MD as well as masters degrees in public policy and public health. She blogs at www.ashbywolfe.com and is a guest blogger for HealthyCal.org on issues of family medicine and community health. Her opinions are her own and do not necessarily represent the views of UC Davis or HealthyCal.org

 

State Senate bans sport drinks in high schools

Published: May 27, 2010 | No Comments

The state Senate has approved a bill to ban the sale of sugar-sweetened sport drinks in the public schools during school hours.

The bill, SB 1255, would tighten a restriction that already forbids the sale of soft drinks but did not include electrolyte replacement beverages in the ban.

The author of the bill, Sen. Alex Padilla, called it a “common sense step” in the effort to address obesity in California. Gov. Arnold Schwarzenegger also supports the bill, which now moves to the Assembly.

Childhood obesity is the primary cause of type-2 diabetes and other long-term health problems. Studies have found that greater consumption of sweetened beverages is associated with weight problems and obesity among children and adults.

Padilla said California Department of Public Health studies show that electrolyte replacement beverages are replacing sodas as the beverage of choice for school-age children. Instead of replacing soda with water and other healthier beverages, Padilla said, students are buying sport drinks. Eight of the top 10 beverages sold a la carte in California public high schools are electrolyte replacement beverages, he said.

 

Hospitals pressured to back more breastfeeding

Published: May 5, 2010 | Comments (2)

By Daniel Weintraub

California advocates for women and children are making a major push for breastfeeding and laying the groundwork for proposals in the Legislature that could require hospitals that deliver babies to reduce the number of newborns fed with bottled formula.

The campaign is coming from an association that represents the Women, Infants and Children program (WIC), which provides nutrition for low-income families and is the largest purchaser of baby formula in the state.

Registered Nurse Barb Hanson meets with new mother Phana Yon, 28, in the drop-in Lactation Center at Kaiser Permanente South Sacramento Medical Center. Yon, who gave birth to her son three days ago, walked into the clinic to ask questions about breastfeeding. Photo from Kaiser Permanente.

Studies have shown that breastfeeding helps prevent a number of diseases and conditions, including childhood obesity. The Centers for Disease Control estimates that 15
percent to 20 percent of obesity could be prevented through breastfeeding.

“It can’t cure everything, but it can help prevent a lot of acute and chronic disease,” said Karen Farley, a program manager for the association.

Bottle feeding is thought to contribute to obesity for several reasons.

Breastfeeding and formula are believed to have different effects on metabolism and hormones, including insulin, which helps regulate how much fat the body stores.

Breastfed babies also may be better at regulating their food intake. Mothers who cannot see how much milk their babies are getting are more likely to rely on the infant to signal when he or she is full, rather than feeding them a bottle until all the formula is gone.

“It’s kind of like cleaning your plate when you are already full,” Farley said. “Breastfed babies stop when they are no longer hungry.”

Citing data that show a wide disparity among hospitals in the number of women who feed their infants exclusively breast milk before taking their children home, the association asserts that much of that difference is due to practices that could be and should be changed.

The WIC program is trying to lead the way by giving new mothers incentives to breast feed, including extra food in a breastfeeding mom’s food package and breast pumps so that mothers who return to work can still feed their babies.

Baby Friendly Policies
Hospitals must follow these ten policies in order to be certified as “Baby Friendly.”
1. Maintain a written breastfeeding policy that is routinely
communicated to all health care staff.
2. Train all health care staff in skills necessary to implement
this policy.
3. Inform all pregnant women about the benefits and
management of breastfeeding.
4. Help mothers initiate breastfeeding within one hour of birth.
5. Show mothers how to breastfeed and how to maintain
lactation, even if they are separated from their infants.
6. Give infants no food or drink other than breast milk, unless
medically indicated.
7. Practice “rooming in” – allow mothers and infants to
remain together 24 hours a day.
8. Encourage unrestricted breastfeeding.
9. Give no pacifiers or artificial nipples to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and
refer mothers to them on discharge from the hospital or clinic.

The group is also pushing hospitals to adopt a collection of “Baby Friendly” guidelines developed by the World Health Organization. The policies require more training of hospital staff, education of pregnant women about the benefits of breastfeeding, helping mothers initiate feeding within an hour of birth, and giving infants no food or drink other than breast milk unless medically indicated.

Hospitals must also agree not to accept free or discounted formula from the manufacturers – a perk that advocates of breastfeeding believe makes hospitals more likely to use formula.

Sheree Kruckenberg, vice president of the California Hospital Association, said her members support breastfeeding but do not necessarily want to follow the “Baby Friendly” guidelines. Instead, she said, the association backs a separate set of model policies already recommended by the state.

“In order to qualify for the Baby Friendly status, there’s a lot of things that a hospital would have to do,” she said. “For some hospitals, they don’t do enough births to justify the expenditure.”

The bigger issue, Kruckenberg said, is that new mothers are usually in the hospital for less than 24 hours.

“The ability for a hospital to influence a mother’s decision is very short-lived,” she said. “Most mothers that come to us have predetermined whether they ae going to breast feed or not.”

That decision can be affected by cultural norms, socio-economic levels, a family’s support and whether or not a woman is going to return quickly to work.

“There are so many factors a mom takes into consideration,” she said. “We’re not able to influence their decisions.”

But many hospitals are trying. One is Kaiser Hospital in South Sacramento. Barb Hansen, a registered nurse there and assistant manager of health education, said the hospital started by adopting the model guidelines the state recommends and then found it easy to move on to the more involved Baby Friendly system.

That step required nurses to get 18 hours of training in how to help new mothers breast feed, and all staff, including doctors, had to have at least some training.

The hospital, which delivers about 200 babies a month, has large birthing rooms where mothers can keep their babies with them, and even mothers who have Caesarian sections typically have their babies with them within an hour. The hospital also discourages mothers from supplementing their milk with formula, which can distract a baby from nursing.

“The concept is that babies are born healthy and are wired to breast feed,” Hansen said. “They don’t need to be supplemented unless there is a medical indication.”

Hansen said some hospitals balk at giving up free formula from the manufacturers, but she believes it is wise to do so.

“You don’t have the formula reps coming into your hospital and offering education, free trips, free formula if the nurses have babies,” she said. “You remove that conflict of interest and that’s a huge hurdle if hospitals have to pay for that.”

Although Kruckenberg of the hospital association said cultural traditions often lead Hispanic women to prefer bottle-feeding, Hansen said those habits can be overcome with supportive hospital staff.

“Most Hispanic moms do breastfeed,” she said. “Understanding their beliefs and being supportive of their cultural beliefs helps.”

Statewide, records on the behavior of new mothers while still in the hospital show that 87 percent do some breastfeeding but only 43 percent breast feed exclusively. Among major counties, the rates for exclusive breast feeding range from a high of 76 percent in San Francisco to a low of 24 percent in Los Angeles County. At Kaiser in South Sacramento, the most recent numbers from the state, from 2007, show that 90 percent of new mothers breastfeed and 71 percent do so exclusively. Those numbers are likely higher today.

Laurie True, executive director of the WIC Association, said the group will probably push soon for legislation requiring any hospital that is reimbursed by Medi-Cal for delivering babies to follow the Baby Friendly guidelines.

“Breast feeding is a learned skill,” she said. “It’s not easy. It needs a lot of support. It needs to be built into the health care system.”

 

Santa Clara to restrict linking of toys, unhealthy food

Published: April 27, 2010 | No Comments

The Santa Clara County Board of Supervisors has given tentative approval to an ordinance that would restrict the ability of restaurants to use toys or other incentives to entice children into eating meals that are high in fat, sugar, and calories. The ordinance is believed to be the first of its kind in the United States.

According to county Supervisor Ken Yeager, who sponsored the ordinance, the Federal Trade Commission estimated that in 2006, restaurants sold 1.2 billion meals accompanied by toys to children under 12. A 2008 study by the Center for Since in the Public Interest found that 10 out of 12 meals exceeding the recommended number of calories for children came with toys, according to Yeager.

“This ordinance levels the playing field,” Yeager said. “It helps parents make the choices they want for their children without toys and other freebies luring them toward food that fails to meet basic nutritional standards.”

The ordinance, which would apply only in the unincorporated areas of the county, would allow restaurants to offer toys and other incentives as long as the food they come with meets national nutritional criteria for children.

Food would be considered unhealthy if it had more than 120 calories for a beverage, 200 for a single food item or 485 for a meal) excessive sodium (480 mg for a single food item or 600 mg for a meal), excessive fat (more than 35 percent of total calories from fat), or excessive sugar (more than 10 percent of calories from added sweeteners.) The criteria are based on standards for children’s health created by the Department of Health and Human Services (DHHS) and the Department of Agriculture (USDA) and recommendations for children’s food published by the Institute of Medicine (IOM).

The ordinance will not go into effect until the board of supervisors gives it final approval, scheduled for a May 11 meeting.

 

Majority of voters back soda tax to fight obesity

Published: April 20, 2010 | No Comments

A majority of Californians would support a “small” tax on sweetened soda as a way to fight obesity, according to a Field Poll survey sponsored by a public health advocacy group.

The poll found that 56 percent would support such a tax, with 43 percent opposed. The margin of error in the survey of 503 registered voters was 4.5 percent in either direction.

The survey found support highest for a tax in Los Angeles (61 percent in favor) and the Bay Area, where support was 60 percent. In San Diego, Orange and other Southern California counties, support was at 54 percent.

The only region of the state where less than a majority supported the tax was the Central Valley, where only 43 percent said they were in favor of it. The Central Valley is also the region with the highest rates of soda consumption in California, according to earlier studies.

Although low-income people tend to drink more soda and are more at risk for obesity, 60 percent of voters in families making less than $40,000 per year said they would support it. Among Latinos, another high-risk group, support was at 66 percent.

“Californians are deeply concerned about the health of children and are ready to take concrete steps to halt the obesity crisis in our state,” Harold Goldstein, director of the California Center for Public Health Advocacy, which commissioned the poll, said in a statement. “They not only have specific ideas of what will make a difference, but are ready to support legislation to make that happen.”

The center is the sponsor of Senate Bill 1210, by Sen. Dean Florez, which would add a tax of one penny per teaspoon of added sugar or high fructose corn syrup in soda. The tax would add an estimated ten cents to the cost of a can of soda and would raise $1.5 billion for childhood obesity prevention programs.

A study last year by the UCLA Center for Health Policy Research found that 41 percent of children, 62 percent of adolescents and 24 percent of adults drink at least one soda or other sugar-sweetened beverage every day. Regardless of income or ethnicity, adults who drink one or more sodas or other sugar-sweetened beverages every day are 27 percent more likely to be overweight or obese, according to the researchers.

Still, the poll released Tuesday found that Californians, as they are on so many issues, are more supportive of increasing funding to fight obesity than they are in raising a tax to finance that spending.

The survey found that 84 percent support providing healthier food in public schools, 84 percent backed providing more active physical education programs, 82 percent support ensuring all schools have clean drinking water, and 74 percent support subsidizing health insurance for children whose families cannot afford it. Sixty-four percent support improving local parks and building more bike and walking paths.

 
Page 1 of 212»