Posts Tagged: Nutrition Policy Institute
So today seems the perfect time to revisit a 2015 conversation with Rose Hayden-Smith, UC's Food Observer, and Crawford, now the Senior Director of Research at UC ANR's Nutrition Policy Institute. As Pat stated in her interview—
“Not changing is risky. The United States – along with Mexico – has the highest obesity rates in the industrialized world. With these extraordinarily high obesity rates, we are on a path toward ever-rising chronic disease rates including not just diabetes, but also heart disease and some cancers, increasing health care costs and reducing productivity.
Even more alarming, is a little known fact that 23 percent of the adolescents in this country currently have pre-diabetes or diabetes as measured by actual blood tests in our largest national study of health (NHANES). Something is seriously wrong in a society such as ours where so many children are growing up with such a high risk of preventable disease.”
You can read the complete interview at the UC Food Observer. You'll also find a recent story about the 45 youth advocates from organizations around California joining this year's conference to bring the voices of youth to this vital conversation.
One in five Mexican-American children is obese, according to national statistics. While scientists agree that diet and exercise play a role in obesity, studies also suggest that children who don't get enough sleep may also be at increased risk for obesity. Does this mean that children who don't get enough sleep are more likely to become obese due to poor eating habits and being less physically active?
The National Institutes of Health has awarded $895,620 to Suzanna Martinez, Ph.D., assistant researcher for UC Nutrition Policy Institute (NPI) in the UC Division of Agriculture and Natural Resources, to try to answer that question. This will be the first pediatric study to examine health behaviors that link sleep to obesity in Mexican-American children.
Studies have shown that adults who are short on sleep may experience a change in metabolism and hormones, causing the person to eat more and to be more sedentary the following day.
To explore how sleep affects child obesity, Martinez will examine social and cultural factors that may impact Mexican-American children's sleep and, in turn, how sleep affects their diet and physical activity.
“Some researchers just focus on diet, some researchers just focus on physical activity, while other researchers say it's all about the environment so we have to improve the environment in terms of food environment and opportunities to be active,” Martinez said. “There's very little research that tries to target all three aspects of health behavior – sleep, diet and physical activity – because there are so many factors to consider. We have to know which will make the biggest impact on obesity prevention. Is it sleep, diet or physical activity or a combination of all three?” Currently, programs are heavily focused on diet and/or physical activity.
Social and cultural factors may affect sleep
Martinez is essentially combining three different studies into one to evaluate the context of sleep and how it impacts obesity. The five-year study will occur in two phases.
She'll begin by looking at the culture, environment and socioeconomic status of the Mexican American families to see which factors may relate to sleep duration.
For example, Martinez said, “If less acculturated Mexican-American parents have stricter or earlier bedtimes for their children, is that protective for getting optimal sleep, less protective or does it even matter?”
Living in crowded housing or in neighborhoods with high crime, homelessness and drugs can impact sleep for urban Latino families, Martinez learned from interviews with Latino parents for a study she published in 2015.
Sleep and physical activity and diet
The second phase of the study will involve evaluating the sleep duration of 40 Mexican American kids, ages 8 to 10, in the San Francisco Bay Area over two summers.
To record their sleep and physical activity, the participating kids will wear accelerometers during the day and while they sleep. The small, pedometer-like devices are worn on a belt around the hip.
For the first week of the three-week study, the children will be asked to get their normal sleep. During the second week, half of the children will be asked to sleep for less than 8 hours and the other half will be asked to sleep at least 10 hours. The third week, the two groups will switch over to the other sleep schedule.
Their diets will be measured using 24-hour dietary recalls. On Friday and Saturday, children will be asked what he or she ate the day before (Thursday and Friday). Starting with breakfast, the children will report what they ate and drank for meals and any snacks.
Martinez will evaluate whether healthy sleep or restricted sleep the previous night impacts the children's diet and physical activity the next day.
“With the crossover study, we will be able to see how kids compare when they get their usual sleep, healthy sleep or not enough sleep and how that impacts how much they eat and how much they move the next day,” she said.
No U.S. sleep guidelines
To maintain a healthy weight, U.S. Office of Disease Prevention and Health Promotion recommends that children get at least 30 minutes of physical activity daily and the Dietary Guidelines for America recommend that children eat a nutrient-dense and calorically balanced diet. The government office currently has no national sleep guidelines for Americans.
In a 2014 study, Martinez found that 82 percent of Mexican-American children ages 8 to 10 obtained less than the 10 to 11 hours of sleep the National Sleep Foundation recommended before 2015. Under the network of sleep researchers' new sleep recommendation of 9 to 11 hours for this age group, 20 percent of children received less than adequate sleep.
“There needs to be more research on sleep duration before we can say, ‘Sleeping this amount of time will help prevent obesity,'” Martinez said.
If her hunch is correct, promoting optimal sleep (at least 10 hours for school-age children) may be an effective way to reduce childhood obesity, and understanding the role of culture in obesity among Mexican-American children who have some of the highest rates obesity will be a key to designing effective solutions.
Research has shown that obesity contributes to numerous lifelong health problems, including heart disease, stroke, diabetes and high blood pressure. One in four overweight children become obese as an adult, and diseases like diabetes are presenting earlier than adulthood. National data show that 14 percent of white children are classified as obese, while 21 percent of Latino children are obese. With Latino children at increased risk, Martinez is committed to finding the causes of this disparity and to develop effective ways to reduce obesity among Mexican-American children.
This child obesity study is funded by a K01 Career Development Award from the National Institutes of Health National Heart, Lung and Blood Institute. Martinez has also been accepted into the K Scholars Program at UC San Francisco, which will provide her with peer support and mentorship to conduct the study.
With an eye on reducing childhood obesity and improving overall health for children, the U.S. Department of Agriculture announced the final rule for snacks at schools. The rule made final on July 21 includes requiring snacks served at school to meet nutritional standards similar to those required of school meals.
Lorrene Ritchie, director of UC ANR's Nutrition Policy Institute applauds the USDA for their recently final Smart Snacks in School rule, which complements the nutritional improvements made to school lunches and breakfasts through the Healthy, Hunger-Free Kids Act.
Creating school environments that offer more healthful foods such as fresh fruits, vegetables and whole grains can also influence the way children eat at home and away from school.
“No single setting has the potential to influence the nutrition of more children than schools,” said Ritchie.
“Research – conducted by our Nutrition Policy Institute and others – has demonstrated that the healthy school foods and beverages consumed by children have a positive impact on their overall diet quality,” she said.
USDA also now requires any food or beverage that is marketed on school campuses during the school day to meet the Smart Snacks standards. Children are a target market for many foods and beverages that contain low nutritional quality and high calories that contribute to excess weight. To be advertised on a school campus, foods and beverages must meet the same Smart Snack standards for items sold or served by a school, according to the new Local School Wellness Policy rule.
“We are starting to see a leveling of child obesity rates in some places and changes to the school food environment are essential to furthering this progress,” said Ritchie.
Providing a consistent source of nutritious food at school will help the approximately 6.2 million California K-12 students develop healthy eating habits for life.
To read more about the federal changes to school food requirements, read the USDA news release at http://www.usda.gov/wps/portal/usda/usdahome?contentid=2016/07/0172.xml&contentidonly=true.
"Years of federal neglect have resulted in many poorly equipped school kitchens, making it impossible to serve the nutritious meals that students need, particularly in light of the obesity epidemic that has affected so many youngster," said Kenneth Hecht, NPI coordinator.
During the past six years, Congress provided nearly $200 million to help schools purchase new equipment. Pew Charitable Trusts engaged NPI to see whether the grants enabled schools to make more meals from scratch with locally grown food and lead children to make healthy food choices.
NPI researchers visited 19 schools across the country to see new equipment in action and interview food service professionals, administrators and students. Their report was issued this month by Pew Charitable Trusts.
“Just one new appliance or serving station can have surprising impact on meal programs and students,” Hecht said. “Because of the USDA's School Kitchen Grants, more students are choosing school meals and they are eating more fruits, vegetables and other healthy options.”
The Nutrition Policy Institute, a statewide program that is part of UC Agriculture and Natural Resources, contracted with Pew to take a close look at a sample of representative schools that received the USDA kitchen equipment grants. The 19 schools – in the states of Kansas, Kentucky, California, Pennsylvania, Hawaii, North Dakota and Maine – were chosen to represent a range of sizes, grade levels and community types (urban, suburban and rural).
One of the schools in the study was Ygnacio Valley Elementary School in Concord, where the worn and dimly lit serving line made meals look lackluster. With the USDA grant, the school purchased a new serving counter with heated and refrigerated serving wells to keep dishes at proper temperatures, a salad bar and under-counter lighting that draws attention to colorful produce and other healthy fare.
“Children are taking and eating more fruits and vegetables because they can actually see how beautiful the food is and get to it easily,” says Megan Webb, the school's food service manager.
Another California school involved in the research, Robertson Intermediate School in Daly City, used the grant funds to purchase a large, three-door refrigerator and a warming oven. The upgrades helped the school increase the number and appeal of its entrée options and made it possible to contract with a different meal vendor for the 2015-16 school year.
“We absolutely needed new equipment; what we had barely functioned,” said Audra Pittman, superintendent of the Bayshore Elementary School District.
“The food is really good,” said one student cafeteria helper. “It's much better than last year.”
“I applaud USDA's decisions to increase servings of fruits and vegetables, whole grains, cereals low in sugar, and healthy beverages, including breastfeeding,” said Ritchie, who has devoted her career to the development of interdisciplinary, science-based and culturally relevant solutions to child obesity.
The U.S. Department of Agriculture released new nutrition standards in April for food and beverages served to young children and others in child care settings that participate in the Child and Adult Care Food Program (CACFP). Through CACFP, more than 3.3 million children and 120,000 adults receive nutritious meals and snacks at day care, afterschool centers and emergency shelters. The final rule is intended to better align the nutritional quality of meals and snacks provided under the program with the Dietary Guidelines for Americans.
At USDA's behest, the Institute of Medicine convened a committee of eminent nutrition researchers to develop science-based recommendations for CACFP meals and snacks that meet the challenge of the Healthy, Hunger-free Kids Act of 2010: to align the CACFP standards with the latest Dietary Guidelines for Americans.
“USDA has taken the IOM's recommendations and translated them into nutrition standards that help address obesity and overweight as well as food insecurity. The new standards are straightforward for childcare sponsors and providers and impose no new, added costs,” said Ritchie, who is also a UC Cooperative Extension nutrition specialist.
This update to CACFP standards is an important step toward ensuring that young children have access to the nutrition they need and develop healthy habits that will contribute to their well-being over the long term, Kevin Concannon, USDA undersecretary, said in announcing the new standards.
“Research indicates that America's obesity problem starts young, with obesity rates in preschoolers more than doubling over the last three decades and one in eight preschoolers classified as obese,” Concannon said. “Since taste preference and eating habits develop early in life, CACFP could play a crucial role in the solution.”
Ritchie, who has conducted studies on the impact of policy on nutrition practices in child care settings, thinks USDA's process for developing the new nutrition standards is effective.
“The new meal patterns demonstrate that the process for regularly updating nutrition standards in the federal food programs, using evidence-based IOM recommendations, is working well,” she said. “The new CACFP standards should make a significant beneficial contribution to the health and development of the nation's young children.”
The NPI director, who has led a push to persuade the government to make water the drink of choice in the dietary guidelines and add an icon for water on the MyPlate food guide, also praised USDA's authorization of reimbursement for the expenses involved in providing bottled water in the rare instances when tap water is not potable.
“UC Nutrition Policy Institute has a special commitment to expanding children's consumption of drinking water,” Ritchie said.
The UC Nutrition Policy Institute's mission is to improve nutrition and reduce obesity, hunger and chronic disease risk in children and their families in diverse settings. NPI provides nutrition policy leadership built from UC Agriculture and Natural Resources' numerous research, and education activities, and works in synergy with research and outreach efforts being conducted throughout the University of California system.