Category Archives: Nutrition
A recently published research brief finds that six months after updated U.S. Department of Agriculture standards for healthier meals were implemented in public schools, elementary and high school students are buying—and eating—the healthier meals.
The brief published by Bridging the Gap, a national research program of the Robert Wood Johnson Foundation (RWJF), shows that 70 percent of elementary school principals and school food directors said that students generally liked the healthier school lunches that began being served in the fall of 2012. Similarly, 70 percent of middle school students and 63 percent of high school students also like the meals. These are the first national studies to examine students’ reactions to the healthier meals.
“The updated meals standards are resulting in healthier meals for tens of millions of kids,” said Lindsey Turner, lead author of the elementary school study, and a co-investigator for Bridging the Gap. “Our studies show that kids are OK with these changes, and that there have not been widespread challenges with kids not buying or eating the meals.”
The survey responders were asked about students’ initial reaction to the meals in fall 2012, and how things were progressing a few months afterwards. Findings included:
- About half of the responders from elementary schools (56 percent) reported that students complained at first, but by spring 2013 64 percent of responders said few students were complaining.
- In middle schools, the percentage of students complaining dropped from 44 percent in fall 2012 to 11 percent in spring 2013. High schools saw similar declines, from 53 percent to 18 percent.
- Eighty-four percent of elementary school responders said approximately the same number of students (or more) were purchasing lunch this school year as did the previous year.
- Seventy percent of responders said middle-school students generally liked the new lunches, as did 63 percent of responders from high schools.
“The updated meal standards are a landmark achievement—they make schools healthier places for our nation’s children and are a critical step toward reversing the childhood obesity epidemic and building a Culture of Health nationwide,” said Tina Kauh, program officer at RWJF. “Policymakers at all levels should be encouraged by these findings and should continue to support schools’ efforts to provide students with healthy meals and snacks.”
NewPublicHealth recently spoke with Lindsey Turner about the study findings.
NewPublicHealth: News reports from about a year back seemed to indicate some kids were not happy with the healthier lunches. But your studies show that for the most part school lunches are being well-received.
Lindsey Turner: Many of those news stories were early on soon after the lunches had been changed. They’re also based on fairly small numbers of schools or case reports, and so one challenge with that is that it may not necessarily be representative of schools in general across the country. One of the strengths of our study is that we were able to get data from a fairly large number of schools from all across the country, which presents a little bit more of a balanced picture of what’s actually going on.
Sixteen major food and beverage companies acting together as part of the Healthy Weight Commitment Foundation (HWCF) sold 6.4 trillion fewer calories in the United States in 2012 than they did in 2007, according to a study published last week in the American Journal of Preventive Medicine. The companies collectively pledged to remove 1 trillion calories from the marketplace by 2012, and 1.5 trillion by 2015.
An independent evaluation funded by the Robert Wood Johnson Foundation (RWJF) found that the companies have already exceeded their 2015 pledge by more than 400 percent.
Today, at 2 p.m. ET, Risa Lavizzo-Mourey, MD, president and CEO of RWJF, and Indra Nooyi, Chairman and CEO of PepsiCo and chair of the HWCF, will discuss the findings and efforts in an online event. PBS NewsHour’s Judy Woodruff will moderate.
UPDATE: Sierra Leone Ends Three-Day Lockdown, Reports 130 New Cases
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Officials in Sierra Leone have ended a three-day curfew designed to help contain the continuing spread of the Ebola virus, calling the effort a success. Authorities reported 130 new cases during the lockdown and are waiting for tests on 39 more people. The West African country has been one of the hardest hit by the outbreak—more than 550 of the nearly 2,800 total deaths have been in Sierra Leone. In addition more than 100 tons of health-related supplies are being flown to Sierra Leone and Liberia. They include gloves, masks, gowns, goggles, saline, antibiotics, oral rehydration solution and painkillers. "We must do all we can to reduce further the human tragedy caused by this deadly outbreak and help communities avoid an even deeper setback than has occurred already," said Chief Executive Thomas Tighe of Direct Relief, according to USA Today. Read more on Ebola.
Study: Medicare Patients Less Likely to Receive Post-Stroke Surgery
Despite the fact that it can significantly help recovery and reduce the risk of long-term disability or even death, a common post-stroke surgical treatment is far less likely to be referred by physicians of patients with Medicare, according to a new study in the journal PLOS One. Researchers at the University of Florida (UF) analyzed data on more than 21,000 adult patients discharged from 2003 to 2008 with a diagnosis of subarachnoid hemorrhage, finding that—when compared to patients with private insurance—Medicare patients were almost 45 percent less likely to receive surgery and were more than twice as likely to die in the hospital. Azra Bihorac, MD, the study’s senior author and an associate professor of anesthesiology, medicine and surgery at the UF College of Medicine, said the results could indicate a conscious or unconscious bias. “Not every hospital has skilled neurosurgeons who specialize in subarachnoid hemorrhage,” he said in a release. “If these hospitals don’t have the necessary expertise, then they may actually overestimate the risk of a bad prognosis. They may assume that the patient won’t do well anyway, so they won’t proceed with surgery.” Read more on access to care.
Study: Weekly Text Reminders about Calories Help People Make Healthier Choices
Something as simple as a weekly text reminder may help U.S. adults develop a better understanding of basic nutrition and make healthier food choices, according to a new study in Health Promotion Practice. Researchers from the Johns Hopkins Bloomberg School of Public Health sent either a weekly text message reminder, a weekly email reminder, or no weekly reminder about the U.S. Food and Drug Administration’s recommendation of a reasonable daily caloric intake—2,000 calories—to 246 participants dining in the Johns Hopkins Hospital cafeteria. They found that at the beginning of the study approximately 58 percent knew the recommended benchmark, but after four weeks the participants who received texts were twice as likely to know the benchmark. “While daily energy needs vary, the 2,000-calorie value provides a general frame of reference that can make menu and product nutrition labels more meaningful,” said study leader Lawrence J. Cheskin, MD, director of the Johns Hopkins Weight Management Center, in a release. “When people know their calorie ‘budget’ for the day, they have context for making healthier meal and snack choices.” Read more on nutrition.
EBOLA UPDATE: Death Toll Now to at Least 2,296
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The death toll from the ongoing Ebola outbreak in West Africa is now at least 2,296, according to the World Health Organization. However, the global health agency does not have the latest figures from Liberia—the country that has been hit hardest by the disease—making the true toll likely much higher. "It remains a very grave situation," said Liberian President Ellen Johnson Sirleaf on Tuesday, according to Reuters. "It is taking a long time to respond effectively .... We expect it to accelerate for at least another two or three weeks before we can look forward to a decline." As of Sept. 6 there were 4,293 recorded cases in five countries. Read more on Ebola.
Johns Hopkins Bloomberg School of Public Health, Clinton Foundation Announce Consensus Statement on Treating Prescription Drug Abuse and Misuse
The Johns Hopkins Bloomberg School of Public Health and the Clinton Foundation have released a consensus statement calling for a public health frame to analyze and disseminate proven, evidence-based intervention to combat prescription drug abuse and misuse. The statement is in response to President Clinton’s call-to-action on the subject in May of this year. “Prescription drug abuse and misuse, as well as widespread addiction and diversion of these products to the illicit market, represents one of the greatest challenges to our country’s public health in recent memory,” said Michael J. Klag, MD, MPH, dean of the Johns Hopkins Bloomberg School of Public Health, in a release. “This consensus statement marks a continuation of our school’s commitment, as well as that of the Clinton Foundation, to address epidemic rates of poisonings and deaths that are occurring due to prescription opioids and other prescription drugs that are highly prone to abuse and misuse.” According to the U.S. Centers for Disease Control and Prevention, drug overdoses killed 41,430 people in 2011, making it the leading cause of injury deaths. Read more on substance abuse.
CDC: 90% of Youth Ages 6-18 Consume Too Much Sodium
Approximately 9 in 10 U.S. children ages 6-18 consume more than the recommended amount of sodium, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). The report also found that approximately 43 percent of the sodium comes from the ten foods they eat the most often: pizza; bread and rolls; cold cuts/cured meats; savory snacks; sandwiches; cheese; chicken patties/nuggets/tenders; pasta mixed dishes; Mexican mixed dishes; and soups. “Too many children are consuming way too much sodium, and the result will be risks of high blood pressure and heart disease in the future,” said CDC Director Tom Frieden, MD, MPH, in a release. “Most sodium is from processed and restaurant food, not the salt shaker. Reducing sodium intake will help our children avoid tragic and expensive health problems.” Read more on nutrition.
EBOLA UPDATE: 55 CDC Workers Now on the Ground in West Africa
(NewPublicHealth is monitoring the public health crisis in West Africa.)
There are now 55 disease detectives and other experts from the U.S. Centers for Disease Control and Prevention (CDC) on the ground in West Africa in response to the ongoing Ebola outbreak. All told, more than 350 CDC U.S. staff are working around the clock on logistics, communications, analytics, management and other support functions. “We are fulfilling our promise to the people of West Africa, Americans, and the world, that CDC would quickly ramp up its efforts to help bring the worst Ebola outbreak in history under control,” said CDC Director Tom Frieden, MD, MPH. “We know how to stop Ebola. It won’t be easy or fast, but working together with our U.S. and international partners and country leadership, together we are doing it.” Read more on Ebola.
Three Studies Offer Differing Takes on Extremely-Low Salt Diets
Two new studies in the New England Journal of Medicine are calling into question the conventional wisdom that as little sodium as possible is always the ideal. The first study found that extremely low-salt diets may not be as beneficial as believed—and may even be dangerous—and the second found that people with moderate salt intake don’t benefit from reductions as much as people who consume higher amounts of salt. "Previously it was believed that the lower you go the better. What these studies show collectively is that there is an optimal level, and lower is not necessarily better," Andrew Mente, MD, of McMaster University in Hamilton, Ontario, chief author of the blood pressure study, according to Reuters. However, a third study also published in the journal found a direct link between less salt and better health, and no evidence to indicate that extremely-low sodium levels were dangerous. Read more on nutrition.
SAMHSA: States Meeting Goals for Reducing Tobacco Sales to Minors
All states and the District of Columbia continue to meet their goals of preventing tobacco sales to people under the age of 18, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). The report found that only 9.6 percent of inspected retail outlets illegally sold tobacco products to minors in 2013, below the goal of 20 percent set by the Synar Amendment program. The rate was as high as 72.7 percent only 16 years ago. “Tobacco use is still the nation’s leading cause of preventable death. We must do everything we can to deter minors from buying tobacco products,” said Frances Harding, director of SAMHSA’s Center for Substance Abuse Prevention. “For the past 17 years, the Synar program has made a real difference in lowering the levels of illegal tobacco sales to minors across the nation. However, everyone in the community must continue to work together in eliminating these illegal sales.” Read more on tobacco.
Crowdsourcing Apps as Effective at Experts in Providing Healthy Food Information
Crowdsourcing healthy food information and feedback via smartphone apps can be as effective as working with trained experts, according to a new study in the Journal of the American Medical Informatics Association. Researchers used 450 photos of food/drink uploaded onto the Eatery app by 333 unique users in Europe and the United States, comparing the “healthiness” ratings from the app’s users to those from three public health students training in dietary assessment. The results were similar and both were in line with national dietary guidance. "Crowdsourcing has potential as a way to improve adherence to dietary self-monitoring over a longer period of time," wrote the researchers. "The results of this study found that when basic feedback on diet quality by peer raters is crowdsourced, it is comparable to feedback from expert raters, and that peers can rate both healthy and unhealthy foods in the expected direction.” Read more on nutrition.
HUD: $106M to Improve Home Visiting Programs for Pregnant Women, Parents of Young Children
The U.S. Department of Health and Human Services (HHS) has awarded nearly $106 million to expand voluntary, evidence-based home visiting services for pregnant women and the parents of young children. Forty-six states, the District of Columbia and five jurisdictions will share the funding from the Maternal, Infant, and Early Childhood Home Visiting Program; home visits have been shown to prevent child abuse and neglect, while promoting childhood health and development. “These awards allow states to reach more parents and families in an effort to improve children’s health while at the same time building essential supports within their communities,” said Mary Wakefield, PhD, RN, administrator of the Health Resources and Services Administration, in a release. Read more on maternal and infant health.
Study: Hepatitis C Could Be ‘Rare’ In the U.S. By 2036
A new computer model indicates that improved medicine and screening regimens could make hepatitis C a “rare” disease in the United States within the next two decades, according to a new study in the Annals of Internal Medicine. Currently approximately one in every 100 people in the United States are infected with the virus, which is a liver infection that can cause fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain and other symptoms, according to the U.S. Centers for Disease Control and Prevention. The researchers determined that this incidence rate could drop to approximately one in every 1,500 people by 2036 based on current and continuing improvements in treatment, and recommend a greater emphasis on identifying at-risk and infected patients. Read more on infectious disease.
Study: Families With Preschoolers Purchasing Fewer High-Calorie Drinks
Recent progress in stalling and perhaps even reversing the childhood obesity epidemic may be linked to fewer families with preschool-aged children purchasing high-calorie drinks, according to a new study in the American Journal of Preventive Medicine. Researchers used Nielsen Homescan data from approximately 43,000 U.S. households with young children from 2000 to 2011, identifying the top 20 foods and beverages purchased. “Decreases in purchases of fluid milks, soft drinks, juice and juice drinks, and grain-based desserts were the primary drivers of this change,” said lead author Christopher Ford, MPH, doctoral candidate in nutrition at the University of North Carolina’s Gillings School of Global Public Health. “These data suggest that these households may have purchased fewer calories from solid fats and added sugars.” Previous research shows that approximately 70 to 80 percent of a preschooler’s diet comes from food purchased at stores. Read more on nutrition.
Peace Corps Withdraws from Three West African Countries Due to Ebola Crisis
The Peace Corps announced yesterday that it was removing all 340 of its volunteers from Liberia, Sierra Leone and Guinea in reaction to the increasing spread of the Ebola virus in West Africa. The organization said it has been working closely with experts from the U.S. Centers for Disease Control and Prevention and the U.S. Department of State to monitor the health crisis and determine how it should respond. “The Peace Corps has enjoyed long partnerships with the government and people of Liberia, Sierra Leone and Guinea and is committed to continuing volunteers’ work there,” according to a Peace Corps release. “A determination on when volunteers can return will be made at a later date.” Read more on global health.
Study: Women Who Live Near Green Spaces Give Birth to Healthier Babies
Pregnant women who live near green spaces—such as parks, community gardens and even cemeteries—give birth to healthier babies with significantly higher birth weights, according to a new study in the journal Occupational and Environmental Medicine. Researchers analyzed data on approximately 40,000 single live births in Tel Aviv, Israel. "We found that overall, an increase of surrounding greenery near the home was associated with a significant increase of birth weight and decreased risk for low birth weight," said Michael Friger, PhD, of Ben-Gurion University of the Negev's Department of Public Health. "This was the first study outside of the United States and Europe demonstrating associations between greenery and birth weight, as well as the first to report the association with low birth weight." Read more on maternal and infant health.
Late last month, the Bipartisan Policy Center, a think tank based in Washington, D.C., released a new white paper, Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention-Oriented Care, that strongly recommends providing greater training in nutrition and physical activity for medical students and physicians in order to help reduce U.S. obesity rates. The report was jointly published with the American College of Sports Medicine and the Alliance for a Healthier Generation, a nonprofit founded by the American Heart Association and the Clinton Foundation as a response to the growing rate of childhood obesity. The report found that current training for medical professionals and students in nutrition and exercise is inadequate to cope with the nation’s obesity epidemic.
A survey conducted for the new report found that more than 75 percent of physicians felt they had received inadequate training to be able to counsel their patients on changing diet and increasing activity levels. It also found that while some schools have stepped up their performance, fewer than 30 percent of medical schools meet the minimum number of hours of education in nutrition and exercise science recommended by the National Academy of Sciences.
“The health care marketplace needs to place greater value on preventive care,” said Jim Whitehead, Chief Executive Officer and Executive Vice President of the American College of Sports Medicine. “Doing so will provide medical schools with the incentive to train their students accordingly. And it will give medical professionals the leverage they need to address healthy lifestyles with their patients.”
NewPublicHealth recently spoke with Lisel Loy, director of the Nutrition and Physical Activity Initiative at the Bipartisan Policy Center, about the report and about how to improve training for medical professionals on nutrition and exercise.
NPH: What was the idea that propelled you to look into making changing to medical school education?
Loy: Well, the technical launching pad was our June 2012 policy report called Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future. And in that, my four co-chairs recommended a suite of policy changes that would improve health outcomes and lower costs for families, communities, schools and work sites. Within that community context they called out the need to improve training for health professionals—not just physicians but health professionals much more broadly defined than that—in pursuit of the goal of reducing obesity and chronic disease and cutting costs.
So that’s sort of the technical answer to your question. The more philosophical answer is as we as a country shift toward more preventive care, they really saw a gap in the education and training of health professionals in terms of being able to best support improved health outcomes. So that’s how they determined that that belonged in our report as a policy recommendation, and since we put out that report we prioritized a handful of recommendations, one of which had to do with health professional training.
Proposed Tobacco Merger Could Boost Smoking Rates
The proposed merger of the Reynolds American and Lorillard tobacco companies announced earlier this week could result in increased smoking rates, according to the Campaign for Tobacco-Free Kids. “This proposed merger is clearly driven by steep smoking declines in the U.S.,” said Matthew L. Myers, president of Tobacco-Free Kids. Myers said cigarette sales fell by 37.1 percent from 2000 to 2013, with the largest decline in 2009, when a 62 cent per-pack increase in the federal cigarette tax was implemented. “Reynolds and Lorillard no doubt hope the economic and political power of a merged company will help them slow or reverse these trends. Elected officials and regulators must be equally aggressive in working to accelerate progress in reducing smoking and other tobacco use.” Read more on tobacco.
Health Education Program Also Reduces Youth Dating Violence
A health education program designed to delay sexual behavior and promote healthy data relationships also significantly reduces dating violence behaviors among minority youth, according to a new study in the American Journal of Public Health. Researchers at the University of Texas Health Science Center at Houston (UTHealth) analyzed 766 students in 10 middle schools in a large, urban school district in southeast Texas, where 44 percent were African American and 42 percent were Hispanic. They looked at four areas—physical victimization, emotional victimization, physical perpetration and emotional perpetration—finding that the It’s Your Game...Keep it Real program reduced all but physical dating violence, which comprised the smallest portion of the program; a revised program with a heavier emphasis on this area is currently being tested in schools. The U.S. Centers for Disease Control and Prevention estimates that 10 percent of high school youth are victims of physical dating violence (with ethnic-minority students at increased risk), with other studies indicating that as many as 20 percent are victims of emotional dating violence. Read more on violence.
CDC Report Finds High Rates of Youth Fruit, Vegetable Consumption
Approximately 77.1 percent of U.S. youth ages 2-19 years consume fruit on any given day and 92 percent consume vegetables, according to a recent NCHS Data Brief from the U.S. Centers for Disease Control and Prevention. However, the rate drops as youth age, while at the same time the amount of fruits and vegetables they eat should be increasing. The report used data from the National Health and Nutrition Examination Survey, 2009–2010. The focused report looked only at whether the foods were consumed, and now how much was consumed. Read more on nutrition.
CDC: 60 Percent of Diners Will Use Menu Calorie Counts When Available
Approximately 6 in 10 U.S. adults will choose their restaurant meals in part because of menu label information when it’s available, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Report. Researchers analyzed the self-reported usage of 118,013 adults in 17 states in 2012 to determine that about 57 percent will look to the provided calorie information. New York had the highest rate, with 61.3 percent, while Montana had the lowest, at 48.7 percent. Federal law requires calorie information be provided by any restaurant with 20 or more locations; while the regulations are not yet final, many establishments already voluntarily provide menu labeling, according to the CDC. Read more on nutrition.
Depression, Stress, Hostility Tied to Higher Stroke Risk
Depression, stress and hostility may be linked to a higher risk for stroke, according to a new study in the journal Stroke. Using information provided by approximately 7,000 adults who did not have heart disease or a history of stroke at the beginning of the study, researchers followed up nearly nine years later and determined that depression was associated with an 86 percent increased chance of a stroke or a transient ischemic attack, stress was associated with a 59 percent increase and hostility doubled the risk. “[C]hronic stress and negative emotions are important psychological factors that affect one's health, and findings from this study link these factors to brain health in particular," said the study's lead author, Susan Everson-Rose, an associate professor of medicine at the University of Minnesota, according to HealthDay. "Patients and their health care providers should be aware that experiences of chronic stress and negative emotional states can increase risk for stroke.” Read more on heart health.
Washington State Sees Most Measles Cases Since 1996
A slight decline in Washington State’s mumps and rubella vaccination rate has coincided with the state’s highest number of measles case in 18 years, according to officials. Washington has reported 27 cases so far this year and is currently in the midst of its third outbreak. While homegrown measles was declared officially eliminated from the United States in 2000, infections from people who have travelled overseas remain a threat. There were 554 total cases of measles and 17 outbreaks reported in the United States between Jan. 1 and July 3 of this year. Read more on infectious diseases.