- Research Conference: New Thoughts About Causes, Prevention & Treatment of Childhood Obesity
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Dr. Jesse Roth
The presentation begins with a survey of widely accepted current concepts related to obesity in adults and youngsters, followed by a broad overview of energy sensing and energy balance, with a focus on human evolution and disease. Four key elements of human biology will be analyzed: 1) commitment to a steady elevated body temperature; 2) complex prolonged reproductive pathways; 3) emergence of four distinct types of fat depots, each with its own functional role; and 4) an immune system that is often up-regulated by nutrition-related signals, independent of the actual presence of a pathogen.
Dr. David B. Allison
This presentation will address commonly held beliefs about the causes and potential alleviators of the obesity epidemic. It will show that some common beliefs are unsupported and will discuss why they are held despite a lack of supporting evidence. This will be followed by discussion of some less commonly considered contributors to obesity. Finally, the conclusion will outline recommendations for enhancing the evidence base in this domain.
Dr. Susan Terwilliger
Childhood weight issues are complex and multiple contexts interact with one another to place a child at risk, supporting the need for an ecological view. The principles of the ecological systems model as applied to health related practices will be reviewed. Predictors for issues with overweight will be placed within the model. A qualitative study of children in an after-school physical activity program will be described and the findings will be summarized. Recommendations for the use of this ecological perspective in framing future research efforts in weight issues in childhood will be suggested.
Dr. Janine Jurkowski
This presentation will be focused on social determinants of childhood obesity risk factors among low-income families in Rensselaer County, NY. The findings are from Communities for Healthy Living, a community-based participatory research project that Dr. Jurkowski is leading with her colleague, Dr. Kirsten Davison, now at Harvard School of Public Health. The research on determinants is based on a nine method, mixed method community assessment conducted in spring of 2010, which was guided by the Family Ecological Model and Empowerment Theory.
Dr. Kathleen Hallinan
This presentation will summarize the three year effort of a well-integrated community approach to impact the dietary and exercise habits of children in a school district. The following will be discussed: implementation of PE4life, obtaining of funding for Cool 2 B Fit, and promotion of the 5-2-1-0 Messaging Campaign that was begun in Maine. The goal is to create a change of attitude among young people that will approximate the "quit smoking" campaign, where children will go home and share good habits with their parents and guardians.
Facilitated group discussion format for exploring diverse topics related to childhood obesity and for engaging participants in dialogue that challenges them to think critically about conference presentations and their implications for the health and well-being of children.
The purpose of this session is to explore approaches for addressing childhood obesity comparing traditional individual risk factor modification for disease prevention to comprehensive structural approaches that make healthy behaviors the normative choice. This session will consider the appropriateness and effectiveness of interventions across the continuum of prevention—health promotion, diagnosis and treatment, and reduction of long-term consequences. Participants will weigh broad versus targeted strategic approaches to childhood obesity in relation to their health and social consequences, both beneficial and detrimental.
The purpose of this session is to examine the pedagogy of obesity. This session will consider broadly the topic of what and how children learn about body size and its relationship to all aspects of health, and how we transmit knowledge and values about weight across social settings and institutional sites. Participants will analyze the proverbial who, what, when, where, why, and how of teaching children about obesity.
This session focuses on the notions of personal responsibility and social accountability for health in the context of a free-market society. The session will explore industry behavior, consumer marketing, and the politics of capitalism in relation to how they contribute to childhood obesity as well as strategies to control or limit their impact on children. Participants will consider the effects of advertising, the influence of business profits, and the function of government regulation in determining what is in the best interest of children.
This session is the first in a series of three sessions specifically designed to provide a forum for practical discussion of community approaches to the issue of childhood obesity. The purpose of this session is to discuss how communities set priorities and create goals to improve the health of its youngest members. Participants will work collaboratively toward defining health-related goals in their community.
This session will feature a panel of local service providers and their work in the area of childhood obesity. Panelists will briefly describe their program, review the evidence supporting their program, describe the unique nature of their program, and provide insights for new directions. These projects have had the collaborative support of the Strategic Alliance for Health.
Nancy Coddington, Community Outreach Coordinator, WSKG Public Broadcasting
Jackie Stapleton, Director of Education and Outreach, WSKG Public Broadcasting
Working on Wellness is a childhood obesity project funded by the Corporation for Public Broadcasting and the Virginia & Conrad Klee Foundation. WOW leverages media capacity to enhance and expand programs with local schools. Through the Working on Wellness initiative, WSKG has connected our community with experts in childhood obesity, offered engaging educational resources and programs and provided our community with tools to make change. Programming included Art for the Heart billboard contest, After School Fuel recipe contest, Stride with Pride pedometer program, Songwriting Contest, family health education forums, radio community conversations and our award winning children's show Move It!
Julie Tucker, RD, CDN, Registered Dietician, Broome-Tioga BOCES
Ray Denniston, Special Projects Coordinator, Broome-Tioga BOCES
Rock on Café is a collaborative community effort lead by Broome-Tioga BOCES (Board of Cooperative Educational Services) and the regional school district food service directors in partnership with the Broome County Health Department Steps to a Healthier NY Program/Strategic Alliance for Health Program among many others. This community coalition was the catalyst that created a standard regional lunch menu system. This system is mutually beneficial for districts because it enables them to leverage their purchasing power allowing increased fresh fruits and vegetables to be purchased at a lower cost.
Broome-Tioga BOCES established the Patriot Breakfast Program as an evidence-based strategy for serving universal breakfast in the classroom. The setting for this project was the Woodrow Wilson Elementary School in the Binghamton City School District where close to 60% of students are eligible for free or reduced-price lunch. Research suggests that skipping breakfast has a negative impact on health as well as academic performance. Universal school breakfast programs provide all students with a healthy meal to start their day and breakfast in the classroom programs have demonstrated success in increasing participation rates in the School Breakfast Program for low-income students.
Patricia Fell, RN, MS, ANP, Director, Community Health Services
Jenny English, RN, AE-C, Project Coordinator, Stay Healthy Center
Stay Healthy Kids is a collaborative effort of United Health Services Hospitals and the Broome County Health Department, Strategic Alliance for Health. Stay Healthy Kids is designed to address overweight in children by using existing health systems to identify children who are overweight or at risk for overweight and create a referral system to an innovative parent-child education program that uses science-based strategies to encourage healthy lifestyles for families. The project involved adoption of the U.S. Preventive Services Task Force Childhood Obesity Screening Guidelines in pediatric and primary care clinics in Broome County. The Stay Healthy Kids club uses CATCH for children and We Can! for parents to deliver a 12-week healthy lifestyle education program.
Dave Garbarino, Director of Health, Physical Education & Athletics, City of Binghamton School District
Learning in Motion is a program that infuses physical activity into the classroom to assist Binghamton City elementary schools in meeting the NYSED physical education requirement of 150 minutes of physical education per week. Based on research that suggests physical activity enhances learning ability, the project enabled teachers to receive training in an evidence-based curriculum called Learning in Motion. Using a train the trainer approach, physical education teachers were trained and subsequently trained classroom teachers in 7 elementary schools. Thirty sets of curriculum for grades K-5 have been created and allow children to meet NYSED mandates and achieve the recommended 60 minutes of physical activity per day.
Tarik Abdelazim, Former Director of Planning Housing, Community Development, City of Binghamton
Mark Bowers, Associate Capital Program Analyst, NYS Department of Transportation
Caroline Quidort, Chief Planner, Acting Director of Planning, Housing, Community Development, City of Binghamton
Scott Reigle, Senior Transportation Planner, Binghamton Metropolitan Transportation Study
The Livable Communities Alliance is working to develop infrastructure that supports walking and biking. The CDC suggests improvements to the built environment are associated with increased physical activity in adults and children. The City of Binghamton passed a complete streets policy that creates street-scale urban design and land use to support physical activity. This policy change provides infrastructure to increase the safety of street crossings, use of traffic calming approaches, and enhancing street landscaping. In addition, the Livable Communities Alliance has sought to establish Smart Growth and Livable Community policies that preserve open space, protect water and air quality, and reuse already-developed land. A growing body of research suggests that by designing neighborhoods that have shops, offices, schools, churches, parks, and other amenities near homes, communities are giving their residents and visitors the option of walking, bicycling, or taking public transportation as they go about their business.
Lisa Vroman, BSN, RNC-MNN, ICCE, DePaul Pediatrics, Our Lady of Lourdes Hospital
Robin Mosher, RN, BC, Nurse Manager, Lourdes Primary Care Network
This project uses a systematic approach to implement ACP guidelines for diagnosis and treatment of childhood obesity within a pediatric physician office which serves a predominately lower income population. The project incorporates an on-site nutrition specialist for access to specific nutritional guidance. Additionally, collaborations were formed with community agencies such as the Broome County Health Department and the YMCA. The YMCA offered classes and memberships at reduced cost or free, for those who qualified for financial assistance. The project also utilizes an on-site social worker for addressing psycho-social barriers. Currently, a treatment program is being created for families and the practice site will be transitioning to an electronic health record to help identify and manage patients who are currently obese or at risk for developing obesity.
Dr. Christine Olson
This presentation begins with a brief overview of what is known about the fetal origins of obesity. Results from studies in Upstate New York on the relationship of maternal factors to offspring risk of overweight and obesity during the preschool years will be presented. Implications for action and intervention to prevent childhood obesity will be discussed.
Dr. Kathleen Rasmussen
Studies in both animal models and women provide clear evidence that obesity before, during and after pregnancy is associated with shortened duration of breastfeeding. The mechanisms for this association will be explored in this presentation. In addition, the role of the baby in modulating the duration of breastfeeding and the role of breastfeeding in modulating the growth of the child will be explored.
Dr. Lauren Hale
The sleep research community has made considerable progress toward understanding the association between chronic short sleep duration and obesity. Despite varied study samples, measurement techniques, and methods of statistical adjustment, nearly all existing studies of sleep duration and weight gain in children have reached the same conclusion – short sleep is associated with subsequent weight gain. The consistency of results across epidemiologic studies is further undergirded by evidence from laboratory studies indicating that sleep deprivation has adverse effects on glucose and appetite regulation. As such, the Institute of Medicine (IOM) recently codified the promotion of age-appropriate sleep durations as a primary goal in the prevention of childhood obesity. In this brief talk, Dr. Hale will review epidemiological studies that examine the relationship between sleep duration and subsequent weight gain in observational longitudinal human studies in children and adolescents. Further, she will recommend translating this recent research into large-scale prevention efforts that incorporate sleep hygiene education, especially among vulnerable populations who are already at risk for adverse developmental outcomes.
Dr. John G. Kral
Maternal obesity compromises pregnancy outcomes including offspring health carried into adulthood. Results of conventional treatment of obesity are disappointing. Surgical treatment of maternal obesity prior to pregnancy improves pregnancies and offspring health. With weight loss after gastrointestinal bypass surgery improvements in maternal cardiometabolic risk factors are transmitted to subsequent offspring and are maintained into adulthood in our studies comparing siblings born before to those born after maternal surgery. Laparoscopic obesity surgery in an experienced hospital is safe for young women and any future pregnancies. It durably improves health and quality of life of the offspring into adulthood.
Facilitated group discussion format for exploring diverse topics related to childhood obesity and for engaging participants in dialogue that challenges them to think critically about conference presentations and their implications for the health and well-being of children.
The focus of this session will be on evaluation methods and design, and will consider how to achieve optimal process and outcome assessment for intervention programs and policies that address childhood obesity. The session will explore collaborative approaches for systematically collecting and analyzing information about the effectiveness and efficacy of interventions to inform planning in real-time as well as determine long-term beneficial or harmful effects. Participants will examine evaluation metrics and discuss surveillance and monitoring in the context of public access to and accountability for data-driven outcomes.
This session will discuss the effects of pre-pregnancy weight and gestational weight gain on fetal growth, birth outcomes, and childhood obesity. The focus of this session will be on the social and environmental factors that contribute to gestational weight gain and educational interventions to minimize its short- and long-term consequences for both mother and child. Participants will be asked to consider strategies that increase awareness, activate the community, and educate women about the issue of gestational weight gain.
The purpose of this session is to consider how land use, zoning restrictions, public transportation, neighborhood safety, and agricultural policies can promote active travel, provide access to healthy foods, and create a community designed for active living. Participants will examine contextual factors along the rural-urban continuum that contribute to childhood obesity and explore ways in which the physical and social elements that make up the structure of a community can be modified or enhanced to promote health.
This session is the second in a series of three sessions specifically designed to provide a forum for practical discussion of community approaches to the issue of childhood obesity. This session focuses on identification of barriers to community-level change and pragmatic solutions to overcome these obstacles. Participants will actively engage in analysis of social, institutional, and organizational barriers to community-level change and collaboratively explore innovative ways to effectively engage and leverage community assets and resources to embed sustainable change.
Dr. Mandana Arabi
This presentation will provide the latest global data and trends on overweight and obesity, and factors associated with them. The current global framework and policy guidelines developed by the World Health Organization and other key agencies to address the obesity epidemic will be reviewed, and gaps and future actions needed to deal with the double burden of malnutrition through a supportive policy framework and local and regional action will be discussed.
Dr. Omry Koren
During pregnancy, several of the immune and metabolic changes are similar to aspects of metabolic syndrome that can be triggered by gut microbiota, but their role in pregnancy is unexplored. We used a metagenomic approach to characterize the gut microbiota of pregnant women and infants. The gut microbiome changed substantially from normal in the first trimester to highly variable and less diverse in the third trimester. Transfer of human pregnancy-associated gut microbiota from first and third trimesters to germ-free mice led to greater adiposity gain and inflammation and lower insulin sensitivity for the recipients of third trimester compared to first trimester stool. These findings provide an evolutionary perspective on the gut microbiota's impact on metabolism, which can be beneficial in pregnancy but detrimental to health in the non-pregnant host.
Dr. John Jakicic
Body weight regulation is influenced by the balance between energy intake and energy expenditure. Clinical guidelines recommend modifying one or both of these components of energy balance to influence body weight. This presentation will focus on the importance of including physical activity as a key component of weight loss and weight loss maintenance intervention. Moreover, this presentation will focus on the effects of physical activity on other physiological factors that may influence body weight, along with considerations for the promotion of physical activity.
Dr. Diane Craft
This presentation offers strategies for overcoming commonly perceived barriers to getting young children up and active. View videos of 18-month to 5-year-olds engaged in fun, inclusive, developmentally appropriate physical activities. These activities require only inexpensive equipment and small spaces. They work well in a variety of child care settings and homes.
Dr. David Levitsky
Frequent (daily) body weight weighing traditionally has been viewed negatively as an adjunct to weight control, especially for weight loss. However, a number of recent studies have demonstrated that (a) successful dieters do weigh themselves frequently and (b) there is no evidence that frequent weighing can cause eating disorders. We have recently demonstrated that daily weighing can produce a significant weight loss among people who want to lose weight and can successfully help people maintain their weight after they have lost it. We are currently planning to evaluate the use of daily weighing to reduce adolescent obesity in a group of pre-adolescent obese children. In addition to using a digital scale that instantly sends weight to our website, we will be examining the use of monetary incentives to maintain daily weighing in this population of impoverished children, with the idea that it will be less expensive to pay children to weigh themselves than to pay the medical costs of doing nothing.
Facilitated group discussion format for exploring diverse topics related to childhood obesity and for engaging participants in dialogue that challenges them to think critically about conference presentations and their implications for the health and well-being of children.
The purpose of this session is to examine the state of the science in relation to childhood obesity and identify research priorities to address knowledge gaps. The session will also focus on the challenges of conducting research in community settings especially in relation to long-term surveillance despite short-term funding, ethical considerations and rights of children, values of community engagement and participation, ensuring health equity and reduction of health disparities, developing metrics that cross socio-ecologic frames, and use of triangulation and mixed methods research to inform outcomes. Participants will judge the evidence on childhood obesity interventions, consider new directions for research, and generate a prioritized research agenda.
This session will examine the emerging role of social media on health--both the manner in which social media may be contributing to childhood obesity as well as the opportunities that social media hold for positively influencing normative behavior and public policy. This session will move beyond the use of social media for public health education purposes. Participants will be asked to consider how social media can create consumer demand for healthier diet and physical activity options, promote the participation of children in democratic decision-making and shaping policy debates, and engage children in creating their own future.
The purpose of this session is to examine the economic aspects of childhood obesity, especially in relation to limited funding and tight fiscal budgets. This session will consider unfunded mandates, healthcare expenditures for obesity-related conditions, insurance coverage and reimbursement, "seed money" or incentives to drive change, and competition for federal funding and foundation dollars. Participants will discuss strategies to maximize resources through cost-benefit analysis, foster community-academic partnerships for collaborative research, and capitalize on grant funding opportunities that require interdisciplinary collaboration and community partnering.
This session is the third in a series of three sessions specifically designed to provide a forum for practical discussion of community approaches to the issue of childhood obesity. This session focuses on identifying past and current efforts, sharing lessons learned, ascertaining common issues or concerns, and discovering opportunities for coordinating services and forming new community partnerships. Participants from across sectors will engage in collaborative discussions to create a program/policy inventory, note linkages among them, and identify new avenues for generating synergy of effort across sectors including schools and child care settings, healthcare systems and insurance companies, businesses and non-profit organizations, universities and research organizations, local and regional government, as well as faith communities and the media.
