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These 5 Preventable Conditions Shorten Lives

More bad news for plus-sized Americans: Obesity is the leading cause of preventable life-years lost in the nation, a new study finds.

Obesity steals more years than diabetes, tobacco, high blood pressure and high cholesterol – the other top preventable health problems that cut Americans’ lives short, according to researchers who analyzed 2014 data.

“Modifiable behavioral risk factors pose a substantial mortality burden in the U.S.,” said study lead author Glen Taksler, an internal medicine researcher at the Cleveland Clinic.

“These preliminary results continue to highlight the importance of weight loss, diabetes management and healthy eating in the U.S. population,” Taksler said in a clinic news release.

Obesity was linked with as much as 47 percent more life-years lost than tobacco, his team said.

Tobacco, meanwhile, had the same effect on life span as high blood pressure, the researchers found.

The researchers noted that three of the top five causes of life-years lost – diabetes, high blood pressure and high cholesterol – can be treated. And helping patients understand treatment methods, options and approaches can have a significant effect, the study authors said.

The findings also emphasize the importance of preventive care, and why it should be a priority for physicians, Taksler’s team said.

However, the researchers acknowledged that some people’s situations may be different than those of the general population. For example, for someone with obesity and alcoholism, drinking may be a more important risk factor than obesity, even though obesity is more significant in the general population.

“The reality is, while we may know the proximate cause of a patient’s death – for example, breast cancer or heart attack – we don’t always know the contributing factor(s), such as tobacco use, obesity, alcohol and family history,” Taksler said. “For each major cause of death, we identified a root cause to understand whether there was a way a person could have lived longer.”

The findings were scheduled for presentation Saturday at the annual meeting of the Society of General Internal Medicine, in Washington, D.C. Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

Obesity steals the most years of all, researchers say

By Robert Preidt     HealthDay Reporter     MONDAY, April 24, 2017
Sources: Cleveland Clinic, news release, April 22, 2017     WebMD News from HealthDay

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Nafta Is Making Canadians Fat, New Study Suggests

Obesity is a major problem in Canada. And though it’s not as pronounced as in the U.S., among advanced economies, the Great White North ranks with the fattest countries.

A new study suggests that may have something to do with NAFTA.

The research, published in the Canadian Medical Association Journal (CMAJ), found that lower import tariffs on high-fructose corn syrup (HFCS) implemented under the free trade agreement resulted in a larger supply and likely consumption of added sweeteners in Canada.

HFCS, a common sweetener in sodas, fruit drinks and many solid foods, has been linked to obesity.

As use of HFCS went up, so did the incidence of obesity and other health problems such as diabetes, according to the Mayo Clinic, a U.S.-based medical research centre.

Scientists disagree about whether the human body assimilated HFCS differently than other types of sugars but agree that excessive consumption of sugars of any kind is linked to weight gain, type 2 diabetes and a higher risk of heart disease, among other health issues.

The CMAJ study, which looked at the period from 1985 to 2000, found that lower tariffs on HFCS likely resulted in an increase of 41.6 kilocalories in the daily supply of caloric sweeteners (which include HFCS, fructose and maltose, maple sugar and syrup, glucose, dextrose, lactose and molasses).

Soaring Canadian imports of HFCS were correlated with a sharp rise in obesity rates, from 5.6 per cent in 1985 to 14.8 per cent in 1998, the authors noted.

Lower tariffs on high-fructose corn syrup through NAFTA
seemed to have caused a pause
in Canada’s long-term trend toward lower sugar consumption.

The period after the implementation of NAFTA (in 1994) also saw diabetes rates balloon, from 3.3 per cent to 5.6 per cent, between 1998-99 and 2008-09.

With NAFTA in place, tariffs on food and drinks containing HFCS were gradually removed between 1994 and 1998. However, tariffs on cane and beet sugar remained due to a long-standing trade dispute between Canada and the U.S.

The researchers found that Canada’s supply of caloric sweeteners kept rising with every gradual lowering of the tariffs on HFCS and held steady after the final reduction in 1998.

The country’s overall supply of sugars and sweeteners also stopped declining, as it had been for some time before the introduction of NAFTA, they noted.

Countries that are not parties to NAFTA, including Australia and the U.K., didn’t see a similar increase over the same time period, the authors said.

NAFTA also coincided with HFCS gaining a larger share of the Canadian market for sugar and sweeteners.

Caloric sweeteners including HFCS accounted for only 4.8 per cent of total sweetener use in Canada before NAFTA, but a whopping 13.5 per cent after the implementation of the free trade agreement.

The findings raise concerns about the public health implications of free trade deals with the U.S. that would use NAFTA as a blueprint, according to the authors.

These include a potential new deal between the U.S. and the U.K. after the latter decided to leave the European Union, and the Trans-Pacific Partnership, which would create a free-trade zone among the U.S., Canada, Mexico and nine other Pacific Rim countries.

Such “new trade deals could harm population health should lower tariffs lead to increased supply and potential consumption of unhealthy food items, particularly those containing HFCS,” the study concluded.

By Erica Alini  National Online Journalist, Money/Consumer  Global News      July 5, 2017
source: globalnews.ca

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More Evidence Linking Stress to Obesity

Using hair to measure long-term levels of the stress hormone cortisol, UK researchers confirm the link between chronic stress and packing on pounds, as well as difficulty shedding excess weight.

Previous research has tied high levels of the stress hormone cortisol in the blood, urine or saliva to obesity, but these measurements can vary based on factors like the time of day and don’t capture long-term stress levels, the study team notes in the journal Obesity.

“When people are facing a stressful situation, a chain reaction is set off in the body that results in the release of cortisol, leading to higher levels of this hormone in the body,” said lead study author Sarah Jackson of University College London.
“Cortisol is involved in a broad range of biological processes, including metabolism, body composition and the accumulation of body fat,” Jackson said by email. “When we’re stressed out we may also find it more difficult to find the motivation to go for a run or resist unhealthy foods.”

Stress sets off alarms in the brain that trigger the nervous system to release hormones to sharpen the senses, tense the muscles, speed up the pulse and deepen breathing. Commonly called a flight or flight response, this biological reaction helps us defend ourselves in threatening situations.

Isolated or temporary stressful situations may not be harmful, but routine exposure to stress can lead to immune system problems, heart disease, nervous system complications and mental health disorders in addition to obesity.

For the study researchers examined data collected from men and women aged 54 and older taking part in the English Longitudinal Study of Ageing. Participants underwent tests every two years starting in 2002, and during the sixth wave of the study they provided a hair clipping.

The study team tested cortisol levels that accumulated in the hair over time in 2,527 men and women and found that participants with more cortisol in their hair were also more likely to be obese or have lots of excess fat around their midsection.

Researchers looked at cortisol levels in the two centimeters of hair closest to the scalp, which typically represents about two months’ growth. They also looked at weight, waist circumference and body mass index (BMI), a measure of weight relative to height.

Participants who were classified as obese based on their BMI or waist circumference had particularly high levels of hair cortisol, the study found. Analyzing weight and body fat data from assessments in the four years prior to when the hair clipping was taken, researchers also found that obesity tended to persist over time for the people with the highest cortisol levels.

The study wasn’t a controlled experiment designed to prove how stress directly impacts cortisol levels or weight gain.

Other limitations include the primarily white, older adult study population, which means results may be different with younger people or other racial or ethnic groups, the authors note.

Even so, the findings add to growing evidence linking stress to obesity, said Dr. Susan Fried, of the Icahn School of Medicine at Mount Sinai in New York.

Cortisol is released in response to many stresses, Fried, who wasn’t involved in the study, said by email. Chronically high cortisol is thought to promote fat accumulation around the waist and increase the ability of fat cells to store fat.

The fix for stressed out people looking to shed excess pounds isn’t clear from the study results, however.

“I don’t think there is strong evidence or consistent studies showing stress reduction itself causes weight loss,” Fried said. “There is accumulating evidence that sleep is very important; people overeat when under-rested.”

The findings do suggest that people may need to take a holistic approach to weight loss that goes beyond diet and exercise to consider factors like stress, said Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Connecticut.

“You might think you need to improve your diet, or exercise more, and that’s true,” Katz, who wasn’t involved in the study, said by email. “But for you, the first priority might be to manage stress better so you are more capable of doing those things, and reduce a hormonal barrier to weight control into the bargain.”

By Lisa Rapaport   Reuters Health
SOURCE: bit.ly/2kX4fQk Obesity, online February 23, 201.     www.reuters.com

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Outsmart The Food Companies To Become A Healthier, Savvier Eater

Like many people, I crave something sweet after every meal, no matter how full I am, to the point where it feels like an addiction. A colleague told me it wasn’t an addiction, but a habit.

Still, the thought lingered: Do we experience true food cravings, perhaps as a result of an “addiction,” or is it simply out of habit? And who’s driving that habit — me or the food companies?

It’s actually both: It’s human nature for consumers to develop habits and seek out foods that satisfy our intense cravings. And so companies create products that meet people’s sensory needs.

“Food companies are interested in selling products that people want,” said Gail Civille, founder and president of Sensory Spectrum, a consulting firm that helps companies learn how sensory cues drive consumer perceptions of products.

“They run tests with consumers and ask them, ‘How much do you like this one? Or that one?’ The companies are trying to figure out what consumers want, and then they do testing to make sure the product has those elements in it – and people like salt, fat and sugar.”
It’s no surprise that food companies would aim to give consumers what they want in an effort to optimize sales. But the process behind product development is quite sophisticated. For companies, the key is finding a food’s “bliss point.”

Discovering the ‘bliss point’

The key for companies is finding the “bliss point” of a food, or the product formulation you like most, according to Howard Moskowitz, an experimental psychologist who did pioneering work on bliss points and their role in product development when he was optimizing menus for soldiers in 1971. He’s since helped major food and beverage companies such as Dr Pepper and Prego find bliss points for their products.

Starbucks’ menu, as selected by a nutritionist

He offered this example: “Let’s just look at coffee with milk. Make some coffee, and pour it into seven cups. Start with no milk, and add a certain amount,” such as you’d find in the tiny plastic containers at a diner.
“Do this so you have zero, one, two, three, four, five and six added containers. The one at the left has no milk; the ones to the right have six different but increasing levels of milk. One of these is the ‘tastiest’ for you.” This is your bliss point.

How does bliss point play out behind the scenes, when it comes to product design and development? For new products, like pickles or pasta sauce, the company may systematically vary the ingredients and test these variations. It’s not just one ingredient alone, but a set of them. Some ingredients appear at different levels. Others appear in different types (such as flavoring A or flavoring B).

“The careful product developer makes the combinations, tests them and builds a mathematical model showing how the ingredients interact to drive liking,” Moskowitz said. “The bliss point — that’s at the top. Sometimes, there are different bliss points, or ‘optima,’ say for people who like strong ‘dark roast (coffee) brews’ and those who like the regular or weaker ‘lighter brews.’ “

Bliss points have been discovered for many foods – even hummus and orange juice – in order to appeal to consumers’ sensory preferences. And this can help explain why, over time, foods evolve to have more sweetness.

The mindful way to distract you from your cravings

“Each generation of food marketers wants to increase acceptance, and the easiest way to do this for many foods is to add sugar,” Moskowitz said. But it’s a slippery slope.
“You add just a little bit each time, so over the course of a decade, there’s a bigger change.” Thus, foods like condiments, tomato sauce and bread – foods that we might not necessarily think of as sweet – often contain added sugars.

Tomato sauce can have 12 grams, about 3 teaspoons, of sugar per half-cup. That’s more than you would find in a chocolate mini doughnut. Barbecue sauce can have 16 grams of sugar – or 4 teaspoons in a 2-tablespoon serving – more sugar than the amount in four chocolate chip cookies or eight sugar wafers. It’s no wonder our palates have evolved to the point where we don’t necessarily know what natural sweetness is anymore: Our taste buds have been, to some degree, externally manipulated over the years.

Heading off food burnout

Although bliss point may be used to find how much pulp an orange juice should contain or the optimal amount of fat for the tastiest ice cream, it has other applications, too. Bliss point has also been used to figure out at which point during a consumption period a person is most sated. But the two applications don’t necessarily work together, because the same sensory characteristics that make your taste buds most excited can run the risk of burnout with each additional bite.

The concept, known as sensory specific satiety, refers to a temporary decline in pleasure derived from consuming a certain food. The result, according to a study in the journal Appetite, is a decrease in a person’s liking and desire for a specific food after eating it.

“The more powerful your experience with the first couple of bites, the less satisfying each additional bite is,” said Brian Wansink, director of Cornell University’s Food and Brand Lab and author of “Slim by Design.” The result: You get bored of eating relatively quickly. “When you eat salted caramel ice cream, the first two bites are incredible. But then there’s a big jump by the time you get to bites six and seven. … By then, you may be saying, ‘Eh, this wasn’t as good as it was initially.’ ”
Interestingly, sensory specific satiety can be thought of as a human protection element – and a way the body adapts in order to avoid sensory overload, according to Civille, of Sensory Spectrum. Imagine stepping slowly and carefully into a very hot bathtub. “At first, you feel HOT, HOT, HOT! But then your body adapts to the hot temperature in order to protect itself from having too much stimulation, as the brain cannot process all of the messages at once,” Civille said. “In the case of food, adaptation results in fullness.”

Despite this scientific reality, the notion of sensory specific satiety doesn’t stop companies from prioritizing taste experience, with the hope that you won’t be able to stop after just one bite.

“Companies are developing products for that initial ‘Oh, my goodness!’ with the first couple of bites,” Wansink said. And even if the level of sensory satisfaction drops, if you start high enough, it won’t necessarily matter.
“The seventh and eighth bite of the salted caramel ice cream will still be pretty good,” he said. “You’re still far ahead of the grapefruit.”



How the sugar industry sweetened research in its favor

In order to extend the amount of time it will take before you get bored of eating a food, its maker may include ingredient variety – for example, making a raisin bran with yogurt puffs or oatmeal clusters. Wansink explains how: “If you mix popcorn with M&Ms, you can eat a lot more than you would if you ate either food alone, because the M&Ms counter the salty flavor of the popcorn, and the buttery popcorn counters the sweetness of the M&Ms.”

Civille agrees. “Without texture and flavor variety, you become full or burnt out. Any new input is not interesting.” This phenomenon helps explain why kids – and adults – can say “I’m so full” after a meal but still have room for dessert. “Dessert is sweet and interesting.”

No wonder I need my sugar fix, even when I’m stuffed from a larger-than-usual meal. Perhaps I’m not truly addicted to sugar, but rather, my body has succumbed to the science of sensory specific satiety.

Becoming an empowered eater

The psychology that goes into finding a “bliss point” and coping with sensory specific satiety is significantly helpful for companies’ bottom lines, but the practical takeaway can have implications for consumers’ health, particularly when foods and beverages are consumed in excess.

Changing kids’ palates – which already prefer sweet tastes – toward sweetness can lead to weight gain, obesity and other health problems. In a world of such abundance, how can consumers become more educated and make the right choices? Here are some tips and tricks to help become savvier,

1. Find a food mantra. “What if we could find the messages to repeat to ourselves, almost like self-advertising, to get us to eat healthily?” asked Moskowitz. In fact, that’s what the bliss point pioneer is working on now: messages that work for consumers. “The science is of words, but it’s still looking for the bliss point. But now the bliss point is the combination of messages that a person will find compelling.” You might ask yourself, “Am I really hungry? Do I really want this food? Or am I bored or stressed?” External motivation works too, he says. “Many people will remind themselves of goals, like, ‘I want to look good in a dress for my daughter’s wedding.’ ”

2. Have a decent breakfast. It will help you avoid cravings, especially sugar cravings. “If your blood sugar is low (from skipping breakfast), you’re going to start eating anything and everything,” Civille said. But a bagel with nothing on it? You’ll be hungry again by 10:30. “The key is to manipulate your own body’s cravings by giving it the right kinds of foods to start with,” she said. And different foods may work better for different people. “If I eat a bowl of oatmeal at 6:30, I’m not hungry until lunch.”

3. Wean your palate. You can change your palate to crave less sweet, salty, fatty foods. “Once people learn to like skim milk, whole milk is too much for them,” Wansink said. One of the ways you can make it happen, he says, is to make sure you pair the product that contains less sugar, salt, fat, whatever – with something that you do like.

“Let’s say you drink way too much Coke. You tell yourself you’re going to drink Diet Coke instead, but you hate the taste of diet soda. So you pair it with something you do enjoy, like taking a walk.” By doing this, he says, you don’t experience the switch to diet soda as such a sacrifice, and eventually you will like it more. Or try making the switch from a sugary cereal to a more protein-rich breakfast. Something as simple as pairing cheese or ketchup with eggs can make a protein-rich breakfast more appealing, and eventually, you won’t even crave the sugar.

4. Add fat. “You should have some fat in your diet, because fat is interesting and satiating. It holds flavor and releases the flavor in a different way than a water-based system,” Civille said. Consider the difference between a teaspoon of vanilla extract in heavy cream (that’s so good!) versus skim milk (awful). The satiety and satisfaction that the fat offers will ultimately allow you to eat less. Spread peanut butter on apple slices or top a mixed green salad with a vinaigrette dressing.

5. Choose portion-controlled snacks. Here’s a case where package design (think 100-calorie packs) may be more costly, but they help you eat less, because they slow the pace of eating. “Having to open up three 100-calorie packs to get 300 calories of chocolate takes a longer time to eat and makes you less sated than if all 300 chocolate calories were in front of you,” Wansink said. The result: People usually give up — and consume fewer calories overall. To save money, buy snacks in bulk and make your own portion-controlled snacks at home using small plastic bags.

6. Drink a glass of water. “Having a glass of water with you all the time is one way of dealing with sensory specific satiety,” Civille said. “The sense of fullness reduces hunger and keeps us hydrated. Often, we eat when we, in fact, are thirsty or dehydrated.”

7. Choose cheese over chips at a party. “People immediately go to the bowl of chips, but you should be looking for the more protein-rich appetizer, which will give you more satiety,” Civille said. A cube of cheese, shrimp or even a slider is a good choice.

8. Don’t go food shopping on an empty stomach. “When you go to the supermarket hungry, you buy things that you crave … and those are typically not good choices, like ice cream, doughnuts and cookies, as opposed to buying more vegetables,” Civille said. Wasnick agrees. “You buy more of the ready-to-eat convenience food, the stuff you can eat in the parking lot,” he said.

Here’s food for thought: Simply eating a piece of fruit 30 minutes before going into a grocery store can significantly change your purchasing habits for the better. “Even just a piece of an apple before you leave – or even a sample of one – dramatically increases how much fruit you buy and decreases the amount of junk food,” Wansink said.

9. Divide your cart in half. “An easy thing that we’ve discovered is the half-cart rule,” Wansink said. “Divide your cart in half with a coat, purse or briefcase. The front half of the cart is reserved for fruits and vegetables. The back half of the cart is for whatever else I want. Simply doing this increases the amount of fruit and vegetables people buy by 25%-30%.”

10. Distract yourself. “There’s a really neat study we did: We had people only eat a quarter as much of a snack as they usually eat in the afternoon,” Wansink said. “So let’s say you usually eat eight Hershey’s Kisses, and we gave you two. We found that 15 minutes later, people rated themselves as equally full, satisfied and happy – and less guilty!” But here’s the important part: “After they had their first two bites, they had to put the food away – they couldn’t stare at it – and they had to do something (active) for those 15 minutes to distract themselves, like cleaning the office or returning phone calls. They could not sit at the computer.”

The results were encouraging. “All they could remember is that they still tasted that chocolate, apple pie or potato chips — and they realized they didn’t deny themselves anything.” But getting their minds off of the food was key. “They realized they can have what they enjoy — as long as they can distract themselves enough to not think about it.”

By Lisa Drayer, CNN           Mon November 21, 2016

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Excess Weight Tied to 8 New Cancer Types: Review

A review of more than 1,000 studies has found a link between excess weight and eight new types of cancer.

Scientists have eight more reasons for you to watch what you eat.

A review of more than 1,000 studies has found a link between excess weight and eight new types of cancer.

They include cancers of the stomach, liver, gall bladder, pancreas, ovary, thyroid, meningioma brain tumors and multiple myeloma.

The studies were analyzed by the World Health Organization’s International Agency for Research on Cancer and the group’s findings will be published in the New England Journal of Medicine Thursday.

“The burden of cancer due to being overweight or obese is more extensive than what has been assumed,” said Graham Colditz, a cancer prevention expert and the chair of the IARC research group.

He added, “many of the newly identified cancers linked to excess weight haven’t been on people’s radar screens as having a weight component.”

For most of the cancers on the new list, researchers found a correlation between body-mass index and the disease. The higher the BMI, the greater the likelihood a person had of developing cancer.

The group says the reason for the link is because excess fat can lead to more estrogen, testosterone, insulin and inflammation. These things can all promote cancer growth.


Researchers also found the risk of developing cancer was similar for men and women and consistent around the world where data was available.

That’s why the group says it’s important people maintain a healthy diet and exercise to reduce their cancer risk.

“Public health efforts to combat cancer should focus on these things that people have some control over,” said Colditz.

Still Colditz acknowledged losing weight can be difficult for some, so he suggested people instead focus on being healthy.

“Rather than getting discouraged and giving up, those struggling to take off weight could instead focus on avoiding more weight gain,” he said.

In the past, IARC researchers have also linked excess weight to other cancers, including those of the colon, esophagus, kidney, breast and uterus.

In Canada, there are approximately 14 million obese or overweight adults and nearly 500,000 youth, according to self-reported data.

CTVNews.ca Staff     Published Wednesday, August 24, 2016

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TV Ads May Spur Snacking in Kids as Young as Two

Mindless snacking in front of the television set may start long before children know how to work the remote control, a U.S. study suggests.

In an experiment with 60 kids aged 2 to 5 years, researchers focused on how advertising influences what’s known as eating in the absence of hunger.

They gave all the children a healthy snack to make sure they had a full belly, and then sat the kids down to watch a TV program with ads for Bugles corn chips or for a department store.

All of the kids had Bugles corn chips and one other snack in front of them while they watched the show. Children who saw ads for the corn chips ate 127 calories on average, compared to just 97 calories for kids who didn’t see Bugles on the screen, researchers report in Pediatrics.

“This is the first study to show that exposure to food ads cues immediate eating among younger children – even after they had a filling snack,” said lead study author Jennifer Emond of Geisel School of Medicine at Dartmouth College in Hanover, New Hampshire.

“Young children average up to three hours of TV viewing a day,” Emond added by email. “If kids are exposed to food ads during that time, they may unconsciously over consume snacks which can lead to extra weight gain.”

More than one third of U.S. children are overweight or obese, according to the Centers for Disease Control and Prevention.

The American Academy of Pediatrics (AAP) recommends against any screen time for children younger than 18 months and suggests no more than an hour a day for kids aged 2 to 5 in part to encourage language development, support healthy sleep habits and limit sedentary activity that can set preschoolers on a path toward obesity.

The type of TV program matters too. The AAP encourages educational programming like “Sesame Street” that can support language learning.

For the experiment, researchers sat kids down to watch a 14-minute segment of “Elmo’s World” that included three minutes of advertising.


Before the show started, all of the kids could snack as much as they liked on banana, sliced cheese and crackers. They also got water to drink.

Children were randomly assigned to view ads for national department stores or to watch Bugles spots that showed kids playing and eating the corn chips.

While the shows played, kids were given bowls of Nabisco Teddy Grahams and Bugles corn snacks.

There wasn’t a meaningful association between how much kids ate during the program and their age, weight or the way their parents typically supervised mealtime at home.

In particular, researchers looked at whether parental feeding restrictions – which can include things like pressuring kids to eat or prohibiting certain foods – and didn’t find any association between these practices and the amount of snacks kids consumed in the experiment.

One limitation of the experiment is that it included mostly white, affluent rural kids, which may make the results less relevant to the broader population of U.S. children, the authors note.

Young children can also be unreliable when they tell adults whether they are full, so it’s possible some children who claimed they had enough to eat before watching TV were actually hungry, the researchers also point out.

Even so, the findings should give parents another reason to limit children’s exposure to media that comes with advertising, said Dr. Julie Lumeng, a researcher at the University of Michigan’s C.S. Mott Children’s Hospital who wasn’t involved in the study.

“Many children’s programs are now instead using product placement to advertise,” Lumeng added by email. “Parents should also pay attention to how product placement occurs in the television programs or other media their young children may be watching.”

Age 2 may be too young to understand how ads can influence behavior, Lumeng noted.

“But parents can consider gradually introducing the power of advertising to young children as a strategy for helping their children resist the effects of these ads,” Lumeng said. “Ultimately limiting the child’s exposure to the ads is the key strategy.”

 By Lisa Rapaport    Reuters Health

 SOURCE: bit.ly/2fCqsMF Pediatrics, online November 21, 2016.

 source: http://www.reuters.com


Soda tax ‘more powerful than anything I’ve ever seen’

Study offers ‘substantial evidence that soda taxes work,’ nutrition professor says

As voters consider soda taxes in four U.S. cities, a new study finds that low-income Berkeley neighbourhoods slashed sugar-sweetened beverage consumption by more than one-fifth after the Northern California city enacted the first soda tax in the U.S.

Berkeley voters in 2014 levied a penny-per-ounce tax on soda and other sugary drinks to try to curb consumption and stem the rising tide of diabetes and obesity. After the tax took effect in March 2015, residents of two low-income neighbourhoods reported drinking 21 per cent less of all sugar-sweetened beverages and 26 per cent less soda than they had the year before, according to the report in the October American Journal of Public Health.

From a public health perspective, that is a huge impact.

That is an intervention that’s more powerful than anything I’ve ever seen aimed at changing someone’s dietary behaviour,” senior author Dr. Kristine Madsen said in a telephone interview.
Madsen, a professor of public health at the University of California at Berkeley, said the drop in sugary drink consumption surpassed her expectations, though it was consistent with consumption declines in low-income neighbourhoods in Mexico after it imposed a nationwide tax on sugar-sweetened beverages.

Just like tobacco, these are commodities we can live without that are killing us– Malia Cohen

The Berkeley results also pleasantly surprised Marion Nestle, a professor of nutrition, food studies and public health at New York University.

“I hadn’t expected the effects to be so dramatic,” she said in an email. “This is substantial evidence that soda taxes work.”

Public health experts believe soda
helped drive American obesity rates
to among the highest in the world.

The soda industry has spent millions of dollars defeating taxes on sugary drinks in dozens of U.S. cities. But the tax passed easily —  with 76 per cent of the vote — in Berkeley. In addition to soda, the measure covers sweetened fruit-flavoured drinks, energy drinks like Red Bull and caffeinated drinks like Frappuccino iced coffee. Diet beverages are exempt.

Weans residents off sweetened drinks

In June, the Philadelphia City Council enacted its own tax on sugar-sweetened beverages. The 1.5-cent-per-ounce tax is set to take effect in January, although soda trade groups have sued to try to block the measure.

Meanwhile, voters in Boulder, Colorado and the Bay Area cities of San Francisco, Oakland and Albany will vote on whether to tax their sugary beverages on November 8.

San Francisco voters also considered a soda tax in 2014, but it failed to garner a two-thirds majority needed for approval.

Public health officials and politicians point to the Berkeley study as proof of the power of an excise tax to wean residents of low-income neighbourhoods off sweetened drinks.

“The study is another tool highlighting how effective a tax on sugary beverages will be on changing the consumption rate,” San Francisco Supervisor Malia Cohen told Reuters Health.

“Just like tobacco, these are commodities we can live without that are killing us,” she said. Cohen wrote the San Francisco ballot measure.

Researchers surveyed 873 adults in low-income commercial neighbourhoods in Berkeley and 1,806 adults in similar neighbourhoods in nearby San Francisco and Oakland before and a few months after imposition of the soda tax.

Sweetened beverage consumption increased slightly in San Francisco and Oakland at the same time it dropped in Berkeley, the study showed. In Berkeley, water consumption spiked 63 per cent, compared to 19 per cent in San Francisco and Oakland, after the tax took effect.

The researchers attributed the surge in water consumption to a heat wave. But the American Beverage Association saw it as example of the study’s flaws.

In a statement, Brad Williams, an economist working for the trade group, criticized the research for using “unreliable and imprecise methodology” and producing “implausible” results.

The association’s criticism may hold grains of truth, Nestle said. But she largely dismissed it. “Obviously, the ABA is going to attack the results. That’s rule number one in the playbook: cast doubt on the science,” she said.

Public health experts believe soda helped drive American obesity rates to among the highest in the world. The U.S. spent an estimated $190 billion US treating obesity-related conditions in 2012.
Diabetes rates have almost tripled over the past three decades, while sugary beverage consumption doubled.

source: www.cbc.ca      Thomson Reuters     Posted: Oct 28, 2016

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Childhood Obesity: Sizing Up Our Kids

A new Senate committee report on the obesity crisis in Canada was released this week. It includes 21 recommendations to combat the high rate of obesity, including a ban on food and drink advertising aimed at children, a tax on sugary drinks and creating government subsidies for healthy food.

Feeding a child can be simple—in the beginning, at least. Weight gain is celebrated: We smother plump bellies with raspberry kisses, gush over dimpled knees and happily dole out extra helpings. After all, food is love; it’s warmth; it’s family. Until suddenly it’s not. Baby fat blossoms into a fleshy frame. Bullies take their toll. Maybe food becomes a solace, consumed mindlessly while staring into screens, turning flesh into flab. As a parent, do you even see it?

Many of us don’t. Parental bias can stack its own mental blocks. In the past year, three major studies have concluded most parents fail to recognize when their child is overweight. One study from New York University, involving nearly 7,000 kids, found the vast majority of parents felt that even their obese children were “just about the right weight.”

Yet it’s also true that overweight kids don’t stand out as they once did. Children all over the world are heavier than they ever have been. As the World Health Organization reported in January, 41 million children under age five are now overweight or obese—in 1990, the number was 31 million—a spike blamed largely on the consumption of processed foods and not enough physical activity. In Canada, the rate has tripled over the past 30 years; almost a third of children between ages five and 17 are overweight or obese.

“It’s quite natural that parents don’t recognize it, because we assess ourselves by comparison and look at everyone else,” says Tom Warshawski, a paediatrician and chair of the Childhood Obesity Foundation in Kelowna, BC. But experts agree this is a worrisome gap in perception, as parents who don’t see a weight problem are unlikely to help a child overcome it, and there’s no sugar-coating the end result: Most children will not grow out of it. “If you are obese at 16,” says Warshawski, “there’s an 80 percent chance you will be obese as an adult.”

With obesity comes a long list of life-threatening ailments: hypertension, Type 2 diabetes, heart disease, cancer, respiratory problems, bone conditions and many more. Some scientists predict that with the record-high rates of childhood obesity, today’s kids will be the first generation to live shorter lives than their parents. Last November, the American Heart Association reported that obese kids as young as eight are showing signs of heart disease. Says Warshawski: “We are setting our children up for a life of ill health.”

Of course, it’s a prognosis no parent wants to hear. Yet even if you recognize that your child is overweight, figuring out what to do next can be daunting. There’s no magic potion to make pounds disappear, and most obesity research has focused on adults. In fact, helping a child reach or maintain a healthy weight may be one of the thorniest challenges of modern parenting.

It’s hard enough for adults to lose weight, and we presumably have more patience, reason and willpower. No one wants to police the pantry or make a kid count calories. In most families, fat is the other F-word. So how—in a conflicted world that’s thin-obsessed but awash in junk food—do you manage a child’s weight without creating lifelong anxieties around eating and body image?

Very carefully, says Laurie Clark, an Ottawa psychologist at the Centre for Healthy Active Living (CHAL) at the Children’s Hospital of Eastern Ontario. At CHAL, there’s a team of specialists who help children with severe obesity and their families improve their health through behavioural and lifestyle changes. But none of it is set in the context of losing weight or slimming down—rather, it’s all about getting fit and healthy.

When kids are just starting to develop their relationship with food and themselves, Clark says it’s important they hear that healthy bodies come in different shapes and sizes, and that the goal of making healthier lifestyle choices is “to be active and happy in our bodies.” So instead of talking about calories or diets, which “sets kids up to be preoccupied with that,” she says, discuss choices in terms of good health and overall happiness. “If a child is functioning well and has no other health issues, a parent needs to step back and say, How are we running our household?”

The most critical step in managing a child’s weight, experts say, is to recognize that the issue is not about the child—it’s about the family. When lifestyle changes are the best (and usually the only) available treatment for a kid carrying excess weight, those changes have to be adopted by everyone.

“You may see the problem with one child, but weight is a reflection of genetics and environment,” Warshawski says. “So it’s actually a problem with the whole family that’s just showing up in this one kid.”

About 16 different genes impact an individual’s propensity to gain weight, Warshawski says, and you can see the effect even in infancy. One baby will be content after four ounces of milk, while another needs three more to feel full. “That will continue into childhood, but now the food you’re filling him with is rich in fats and sugars. So one child can eat whatever she wants and never gain, while others just see food and pack on the pounds. That’s the way genetics interplays with the environment.”

But unlike genes, the environment is something parents can generally control, especially in the younger years, when we hold more sway than peers and when the chances are highest of forming healthy lifelong habits. Yet studies suggest that many families have a long way to go: Most kids—seven out of 10 of those between ages four and nine—do not eat the recommended five-serving minimum of fruits and vegetables each day, and only seven percent of five- to 11-year-old kids get the daily recommended minimum of 60 minutes of physical activity.

Which is why, in 2013, Warshawski’s foundation helped launch a family-based program in BC called MEND, short for Mind, Exercise, Nutrition, Do It! Started in the UK in 2004, the program takes a hands-on approach to helping parents and kids with weight issues become fitter, healthier and happier by teaching them how to make healthy food choices and live more active lives. Run out of local recreation centres, the free 10-week program involves at least 20 visits with a team of specialists. It also includes a three-month membership to the community rec centre and a tour of a grocery store to learn how to shop healthily.

Obesity & Children
Ed.’s Note: A new Senate committee report
on the obesity crisis in Canada was released this week.
It includes 21 recommendations to combat the high rate of obesity,
including a ban on food and drink advertising aimed at children,
a tax on sugary drinks and creating government subsidies for healthy food.

It’s a big commitment, says Warshawski, but studies suggest it can make a difference in reducing weight and body mass index. However, he cautions, it may not work for everyone: “I saw a family yesterday, and they are all still gaining weight; another is doing really well. It’s not one-size-fits-all.” What is key, he says, is that “the whole family has to buy into the lifestyle solutions for this to work—if you get the habits right, you’ll get the body that’s right for you.”

At the CHAL program in Ottawa, dietitian Anna Aylett says that any attempts to change the lifestyle of just one child are likely to backfire. “I often see families where they have started to restrict the overweight children by not giving them dessert or treats, but it can lead to food sneaking,” she says. There may be genetic differences in a family that make one child prone to gaining weight, but the food available has to be the same for everyone in the household, Aylett says. “You have to have the same rules for everyone.”

Doing otherwise can make your kid feel unfairly singled out and cause her to associate feelings of guilt and shame with eating. Instead, experts say, it’s up to parents to create a healthy food environment for everyone and then practise a clear division of responsibility on food matters—parents decide what, when and where the family eats; children choose how much they want to eat.

If a child, however, seems to suddenly gain weight, there could be underlying forces at work. Stasia Hadjiyannakis, a paediatric endocrinologist and director of the CHAL program, says parents should find out if there are genetic factors that could be influencing weight or whether kids are eating in private, skipping meals or not getting enough sleep. Screens, especially in the bedroom, she notes, can interfere with sleep and lead to hormonal changes “that can impact your appetite and increase the risk for obesity.”

Emotions can also figure powerfully into food relationships. After all, the idea that people eat their feelings has been around longer than ice cream binges have been associated with breakups. Alex Jadad, for instance, a renowned University of Toronto physician and founder of the Centre for Global eHealth Innovation, learned the hard way that unhappiness was at the root of his 10-year-old daughter’s overeating.

Jadad and his wife hadn’t even realized their daughter Alia had gone from chubby to obese. “I think sometimes familiarity breeds blindness,” says Jadad. But then she told them that she was being bullied at school because of her weight. “They called her ‘Blue Marshmallow,’ because of her blue jacket…. They taunted her with chocolate,” he says. “That’s how we found out [she was obese]—we didn’t realize it ourselves. You know your child, you see her all the time, and she’s perfect—and she was perfect.”

Only when they took Alia to the doctor did they discover that school bullies were not the true source of her sadness—as Alia diagnosed herself: “She said, ‘I’m jealous.’” Jadad explained that his wife’s niece had recently come to live with them, and Alia felt displaced. “She was overeating to compensate. Weight was the issue, but it was a manifestation of other things.”

Alia’s revelation marked the beginning of a long journey—one the Jadad family took together. They bought bicycles, educated themselves about nutrition and eliminated most sugar from their diet. They even grocery shopped together, making a game of it to find packaged products that did not carry one of the 50 sugar synonyms on their labels. (It was almost impossible, he says.)

Alia, now a grown woman, did eventually lose weight, but more important, says Jadad, is that his daughter and the whole family created a new and healthier—and happier—lifestyle for themselves. Alia also switched to a new school, where she thrived and regained her self-confidence.

The point, he says, is that “it’s not an individual’s responsibility to solve—it’s not ‘Oh, there’s something wrong with you.’ It wasn’t her fault, and it cannot be a case of telling your child, ‘Don’t do this. Don’t eat that. Don’t eat this.’” It’s about getting the family back to fundamentals, says Jadad, who is a founding member of the Canadian Obesity Network.

Blaming individuals for being overweight only contributes to the discrimination and isolation they already face. “What makes this problem so monumental,” Jadad says, “is that it’s one of those rare cases where the stigma alone can become a public health problem because of the toll it takes on mental health.” In fact, Warshawski notes, kids who are obese rate the quality of their lives lower than children undergoing cancer therapy.

What’s important is that children feel good about themselves by making healthy choices. “We know a lot comes down to the way our body was designed, and there’s a strong biologic response to weight loss —that’s why it’s often regained. Ideally, prevention happens early on,” says Hadjiyannakis. For example, encouraging kids to move, play and be physically active is a huge step in the right direction.

“I think it’s about shifting the outcome we’re celebrating,” she says. “So we might not see a big change in body weight, but if we have patients that find a new physical activity they love—that’s a success, and that’s something people can control, more than a number on a scale.”

By the numbers

The MEND program encourages families to follow the daily 5-2-1-0 formula: five servings of fruits and veggies; no more than two hours of screen time; at least one hour of activity and zero sugary drinks.

Taking measure

The body mass index isn’t a fail-proof way to diagnose childhood obesity—if your kid is muscular, for instance, the results might be skewed. That said, tracking BMI is a good starting point to help you and your paediatrician monitor your kid’s growth.

Today’s Parent    Carolyn Abraham    2016-03-02
source: www.msn.com

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8 Countries Taking Action Against Junk Food Marketing

Some countries are responding to the high levels of junk-food advertising by restricting broadcast advertising and other child-targeted marketing techniques.

Children from the United States view an average of one food commercial for every five minutes of television watched, according to a study from the University of Minnesota. Unfortunately, these youth-targeted advertisements focus predominately on foods high in sugar and fat, such as fast food, high-sugar cereals, sugary drinks, and candy, making it no surprise that many children are not consuming healthy diets. In response to the high levels of junk-food advertising, some countries are taking the issue into their own hands by restricting broadcast advertising and other child-targeted marketing techniques.

According to the World Health Organization, advertisements can significantly influence food preferences and consumption. The impact is especially acute for young children under 10 years old, who tend to view ads as unbiased sources of information, making it more difficult for them to respond judiciously to marketing, found researchers from the University of Minnesota.

Furthermore, food marketers have expanded and intensified marketing efforts through a variety of channels in recent decades. “Parents’ efforts to help their children eat healthily are being undermined by sophisticated promotion of junk food to children: on TV, online, at the cinema, in magazines, in supermarkets, on food packaging, and for some even at school,” says Malcolm Clark, coordinator of the Children’s Food Campaign, a United Kingdom-based organization that aims to protect children from junk-food marketing.

Anne Lappé, founder of Food MythBusters, a food-focused media initiative, accuses food companies of pushing cheap, addictive foods on children and teens in the name of profit. “Food corporations spend roughly two billion a year on ads specifically targeting children and teens,” says Lappé in a Food MythBusters video. “No wonder pediatricians are seeing diet-related illnesses of young people alarmingly on the rise.”

Some countries have pursued voluntary, industry-led pledges restricting advertising. The Children’s Food and Beverage Advertising Initiative, EU Pledge, and Children’s Advertising Initiative in the United States, European Union member states, and Canada, respectively, are composed of candy, fast-food, and soft drink companies who pledge to shift their marketing to healthier foods for children under 12. Critics say that these policies are ineffective since industries set the bar too low given the highly competitive marketplace. However, EU Pledge participants claim that children’s exposure to television marketing has fallen 48 percent and that U.S. industry spending on child food marketing has dropped by 19.5 percent since the pledges were enacted.

But governments can play a greater role in limiting the harmful public health impacts of food advertising by implementing legislation that restricts broadcasting, bans the use of cartoons and toys, or requires health warnings on commercials. This week, Food Tank highlights eight countries that have taken steps to limit the harmful impact of junk-food marketing.

1. Canada.

Quebec’s law passed in 1980 restricting junk-food marketing to kids was the first of its kind, banning fast food marketing aimed at children under 13 in print and electronic media. Fast-food expenditures subsequently decreased 13 percent. While the rest of Canada has seen a drastic increase in obesity among children, Quebec maintains the lowest child obesity rate.

obesity in kids

2. Chile.

Chilean law restricts advertising which targets children under the age of 14 for foods considered high in calories, saturated fat, sugar, and sodium. The regulation applies to television programs, websites, radios, and magazines directed at children or those where the audience is composed of 20 percent children or more. Likewise, these select food items may not be marketed in schools. Promotional strategies including the use of cartoons and toys are also prohibited.

3. France.

Rather than setting restrictions on the amount of junk-food advertising, French authorities require that advertisements for products containing added fats, sweeteners, or sodium be accompanied by a message explaining dietary principles. One example is “for your health, eat at least five fruits and vegetables a day.”

4. Ireland.

Foods high in fats, sugar, and sodium are banned from advertising, sponsorship, teleshopping, and product placement in children’s TV and radio programs where over 50 percent of the audience is under 18 years old. Any advertising targeting children under 18 cannot include celebrities, and those directed to children under 13 cannot include health claims or use licensed characters. Overall, advertisements for unhealthy foods may compose up to only 25 percent of all paid advertising on all channels.

5. Mexico.

The Mexican government commission reports that their children see more junk-food advertisements than any other country, totaling 12,000 a year. The Ministry of Health has taken a series of steps to limit child exposure to unhealthy food marketing, beginning with restricting advertising of certain foods and sweetened beverages, determined by their compliance to a nutrient profile model. Restrictions apply to television programs with more than 35 percent of the audience under 13 years old, between 2:30 pm and 7:30 pm on weekdays and 7:00 am and 7:30 pm on weekends. In July 2014, the government extended the restriction to films.


6. Norway.

The Norwegian government restricts all broadcast advertising directed specifically to children through the Broadcasting Act of 1992. In 2013, industry and government took a step further: companies agreed to a self-regulated ban on all marketing of unhealthy foods and drinks to children under the age of 16. Norway also leads a World Health Organization network of 28 countries focused on reducing marketing pressures on children.

7. Taiwan.

In January 2016, Taiwan implemented unhealthy food advertising limits for kids under 12 years old. Dedicated television channels for children cannot broadcast advertisements of foods exceeding set fat, sodium, and sugar content limits from 5 pm to 9 pm. Like their Chilean counterparts, food marketers cannot promote their products with free toys at restaurants, a common practice among fast food chains.

8. United Kingdom.

A decade ago, the government passed a statutory ban on television advertising to children under 16 of foods high in fats, sugar, and salt. According to the UK Department of Health, children are now exposed to 37 percent fewer commercials and annual expenditures towards child-targeted advertisements have decreased 41 percent.

By Marisa Tsai / Food Tank June 27, 2016

Marisa Tsai is a Masters candidate of the Food Policy and Applied Nutrition program at Tufts University. In addition to her academics and work with Food Tank, she is involved with the Long Beach Health Department’s healthy retail program and nutrition education efforts. Marisa is passionate about food justice, nutrition, and sustainable food policy. Find her on social media: @marzipantsai.

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Bigger Baby Bottles Linked to Weight Gain

BY LISA RAPAPORT   Tue Jun 7, 2016 

(Reuters Health) – Babies who drink from large bottles early in life may be experience more weight gain by six months of age than infants who drink from smaller bottles, a study suggests.

Starting when the babies were two months old, researchers tracked their weight based on the size of their bottles, which ranged from 2 ounces to 10 ounces. About 45 percent were being fed from bottles that held at least six ounces of baby formula.

Compared with babies fed from smaller bottles, infants with at least six-ounce bottles had about a half-pound (0.21 kilograms) more weight gain by six months, the study found.

“Every baby is different, but we know that a two-month-old infant will generally take four ounces per feed,” said lead study author Dr. Charles Wood, a pediatrics researcher at the University of North Carolina at Chapel Hill.

“Larger bottles may mean parents are more likely to overfeed their infants, contributing to more weight gain,” Wood added by email.

To assess how bottle size influences infant weight gain, Wood and colleagues focused on 386 babies whose parents fed them only formula.

About 41 percent were black, 35 percent were Hispanic, and 23 percent were white.

Almost two-thirds were from households earning less than $20,000 a year, with parents with no more than a high school education.

Only 298 infants had complete information on weight and length at their six-month checkup, and these infants were included in the analysis.

On average, babies weighed about 7.1 pounds (3.2 kg) at birth, 11.7 pounds (5.3 kg) at two months, and 17.6 pounds (8 kg) at six months, researchers report in the journal Pediatrics.

baby bottle

But babies who used smaller bottles weighed less at two and at six months, 11.2 pounds (5.1 kg) and 17.2 pounds (7.8 kg), respectively.

That compares 11.9 pounds (5.4 kg) at two months and 18.1 pounds (8.2 kg) at six months for infants who had larger bottles.

One limitation of the study is that researchers didn’t directly measure how much babies drank, the authors note.

They also didn’t look at how bottle size changed over time or the range of bottle sizes parents used during the study period. It’s possible that families used different sizes of bottles or used smaller bottles but gave babies multiple bottles at each feeding, the authors point out.

One challenge for bottle-fed babies is that they may have a harder time than breast-fed infants learning to sense when they’re full, said Karen Bonuck, a pediatrics researcher at Albert Einstein College of Medicine and Montefiore Medical Center in New York who wasn’t involved in the study.

With bottle feeding, parents may take a “clean your plate approach because they can visualize any remaining milk in a bottle in a way that they cannot when an infant is being fed at the breast,” Bonuck said by email.

“Parents who purchase larger bottles may be doing so out of a desire to express nurturance through feeding,” Bonuck added.

The problem with this parental impulse is that those first few months are a crucial time for babies to figure out when they’re full, said Dr. Wendy Sue Swanson, a pediatrician at Seattle Children’s Hospital who wasn’t involved in the study.

“It’s known that rapid weight gain is a risk for obesity and it’s also thought that the first few months of life help develop our satiety responsiveness – how our cravings and sense of fullness while eating feel – and therefore if fed excess amounts during that time we may set children up for a bigger challenge with overweight later in life,” Swanson said by email.

SOURCE: bit.ly/1TTzRwa      www.reuters.com    Pediatrics, online June 7, 2016.