obesity

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Boston Moms: Let’s Spend Olympics Savings On Gym And Recess For Kids

(Steven Depolo/Flickr)

(Steven Depolo/Flickr)

By Kate Lowenstein
 and Ramika Smith
Guest contributors

We have a suggestion for how to spend some of the billions of dollars that Boston will likely save by not hosting the Olympics: How about we invest even 1 percent of that into the bodies and brains of our children by ensuring they get ample physical education and recess time?

Instead of spending billions to have elite adult athletes playing sports in our city, we can at least give our own Boston Public Schools kids the chance to run and play here.

Most parents of kids in the city’s public schools assume their children get recess every day, as we did when we were kids, but the reality turns out to be quite different. While the CDC recommends that all children get at least 60 minutes of vigorous exercise every day, and at least 30 minutes of school-time physical activity, many of our schools allow for as little as 20 minutes, if that.

Over the past two decades, accelerated by No Child Left Behind’s focus on testing, the tendency has been to reduce or eliminate physical education and recess. And our school administrators and legislators look the other way without recognizing the overwhelming amount of evidence that shows the significant academic and mental health benefits of these physical activity breaks.

Recess and physical education are as integral to a long school day as are Math, Science, and English.

In January of 2009, the journal Pediatrics published a groundbreaking study of 11,000 third-graders, comparing those who had little or no daily recess with those that had more than 15 minutes of recess per day. The findings show that children who have more recess time behave better in the classroom and are likelier to learn more.

In January of this year, The Boston Foundation released a report: “Active Bodies, Active Minds: A Case Study on Physical Activity and Academic Success in Lawrence, Massachusetts.” The report found that only 15 to 20 percent of Massachusetts children are meeting the 60-minute daily recommendation for physical activity and only 10.2 percent were meeting the school-time recommendation of 30 minutes.

It also underscored what we already know from many other studies; that children in schools that provide an adequate amount of time and opportunity (and encouragement) for daily physical activity, in the form of recess, gym classes and movement breaks, have higher MCAS scores in both math and ELA. Continue reading

Roxbury Center Targets Health Disparities In Boston’s Poorest Neighborhoods

Whittier Street Health Center opened its community vegetable garden on June 24. (Courtesy of Chris Aduama)

Whittier Street Health Center opened its community vegetable garden on June 24. (Courtesy of Chris Aduama)

By Marina Renton
CommonHealth Intern

When it comes to health in Boston, it’s hard to deny there’s a great divide across neighborhoods.

Need proof? A 2013 Boston Public Health Commission report found that, from 2000 to 2009, the average life expectancy for Boston residents was 77.9 years. But in the Back Bay, it was higher — 83.7 years — compared to Roxbury, where the average life expectancy was 74.

If you want to get even more local, you can analyze the same data by census tract, where life expectancy varies by as many as 33 years: 91.9 years in the Back Bay area between Massachusetts Avenue and Arlington Street, and 58.9 years in Roxbury, between Mass. Ave. and Dudley Street and Shawmut Avenue and Albany Street. That’s according to a 2012 report from the Center on Human Needs at Virginia Commonwealth University in Richmond.

The Whittier Street Health Center in Roxbury is trying to tackle the disparities in a very concrete way. With the launch of a new fitness club and community garden, the center is trying to make healthy food and exercise opportunities available and affordable to all, despite geography.

“What we’re trying to do is to remove those social determinants and barriers that are causing these [health] disparities,” said Frederica Williams, president and CEO of the health center.

‘If I Sweat, I’m Doing Something Right’

The fitness club and garden initiatives just launched June 27, but the Whittier Health and Wellness Institute is already drawing in community members.

Eight months ago, Wanda Elliott weighed 256 pounds. On a visit to her Whittier Street physician, she learned her blood pressure was high — high enough that she had to start taking medication. That was the wake-up call that motivated her to change her diet and start exercising.

“I was dragging,” she said.

Elliott began exercising at a local Y but joined the Whittier Street fitness club when it opened. In eight months, she has lost 52 pounds, leaving her 4 pounds shy of her 200 pound goal weight.

“I have two knee replacements, so I have to keep active every day,” she said. Trainers at the center helped her learn to use the exercise machines, and now it feels like a routine, she said.

“I feel addicted to working out. I feel like if I sweat, I’m doing something right,” she said. “From 256 to 204, I feel like a model. I can walk the runway; that’s how energized I feel now.”

Elliott is now off her blood pressure medication. She is working on making changes to her diet “slowly but surely,” drinking more water, eating more salad, and cutting back on red meat. Continue reading

Study: Bottled Water Bans May Increase Consumption Of Sugary Drinks

The University of Vermont instituted a ban on the sale of bottled water in 2013. (Courtesy University of Vermont)

The University of Vermont instituted a ban on the sale of bottled water in 2013. (Courtesy University of Vermont)

By Marina Renton
CommonHealth Intern

Bans on bottled water are sweeping the nation, driven by concerns about the environment. But, according to a new study, the bans might bring some unintended consequences, including increased consumption of sugary beverages without a reduction in plastic waste.

The study, out in this month’s issue of the American Journal of Public Health, came from the University of Vermont, which instituted its own ban on the sale of bottled water in January 2013. Researchers found that more sugar-sweetened beverages were shipped to the campus following the ban — despite efforts to reduce the presence of unhealthy drinks — while the number of bottles shipped per person actually increased.

In 2008, the average American consumed 30 gallons of bottled water a year, or over 200 single-serve bottles. While no one can fault a preference for water over less healthy beverages, the plastic bottles are not environmentally friendly — about 2 million tons of polyethylene terephthalate (PET), the plastic commonly used in beverage containers, entered the waste stream in 2013, while far less, about 899 thousand tons, were recycled.

Recently, bottled water bans have been proposed in towns and on university campuses as a way of reducing plastic waste. In 2013, Concord became the first town in the country to ban the sale of plastic water bottles under 1 liter, and others have since followed suit. Colleges and universities around the country — including Brandeis, Emerson and Harvard — also have bans in place.

Before its ban was implemented, University of Vermont made an effort to increase the presence of healthy beverages on campus by enacting a 30 percent healthy beverage requirement, meaning that at least 30 percent of the drinks for sale on campus needed to fit certain criteria, said Dr. Rachel Johnson, a UVM professor of nutrition and co-author of the new study. Continue reading

50 Years Of American Health Choices: Smoking Gains Offset By Getting Fatter

(Lucia Sofo via Wikimedia Commons)

(Lucia Sofo via Wikimedia Commons)

Feeling optimistic? Then you may see the moral of this story as, “Yay, public health efforts! They can wield amazing power and save many lives.”

In more of a glass-half-empty mood? Then your takeaway may be, “If it’s not one thing, it’s another.” Or perhaps, that public health must play an eternal game of Whack-a-Mole.

The story itself: The National Bureau of Economic Research just sent over word of a new working paper that looks at American health behaviors and their effects over 50 years, from 1960 to 2010. It examined six behaviors: obesity, smoking, heavy drinking, unsafe driving, firearms, and poison or overdoses. What most struck me: Though we’re generally living longer, our health gains from shunning cigarettes and safer driving are all but erased by the rise in obesity and drug overdoses. Sigh. From the summary:

(Source: NBER working paper 20631, “The Contribution of Behavior Change and Public Health to Improved U.S. Population Health”)

(Source: NBER working paper 20631, “The Contribution of Behavior Change and Public Health to Improved U.S. Population Health”)

…The authors find that the gains associated with declines in smoking, motor vehicle fatalities, and heavy drinking are essentially offset by the losses arising from rising obesity and misuse of firearms and poisonous substances. Valued in dollar terms, there is a near zero net gain in health from public health and behavioral changes over the past fifty years. However, the analysis includes a mix of some risk factors that have been aggressively addressed through public health and behavioral changes over a long period (smoking, unsafe driving), and others that are in the earlier stages of being addressed and have proven challenging (obesity, prescription drug addiction).

The authors conclude “our study demonstrates the enormous benefits of public health and behavioral change in improving population health, underscoring the importance of continued advances in these areas of research and practice.”

I asked Harvard health economist David Cutler, who co-authored the report, what he’d want the public’s takeaway to be (and included a plea to help me beat down my own cynicism.) His e-mailed response:

There are some who see this as ‘glass mostly empty’ – i.e., if it’s not one thing, it’s another. But remember how hard these changes are. Quitting smoking is very difficult, and yet millions of people have done it. Reducing caloric intake is very difficult, though weights finally seem to be stabilizing. The difficulty of these interventions makes the successes particularly notable.

Readers, your own thoughts? Read the full paper here and the summary here.

The Buffet Phenomenon: Researchers Find More Food Choices Linked To Fatter Mice

(Alpha/Flickr)

(Alpha/Flickr)

This is why I hate buffets: Too many food choices make my head spin. For weight control, I prefer the out-of-sight, out-of-mind approach — keep the oversized muffins and pepperoni pizzas out of the house altogether. Call me rigid, but it seems to work.

Apparently, mice have similar issues, according to a study published in the journal Endocrinology.

The study tried to tease out the relative importance of genetics vs. environment when it comes to obesity risk. So, baby mice born to mothers with a defined high-fat or low-fat diet were randomly assigned to one of three diet groups: either a high-fat diet, a low-fat diet or to an “eat what you want” diet in which they got to pick and choose among the various options.

Researchers from Virginia Tech College of Agriculture and Life Sciences and the Edward Via College of Osteopathic Medicine report that:  “Offspring displayed negative outcomes of increased body weight, body fat, serum leptin, and blood glucose levels when given the choice diet compared with offspring on the [low-fat diet].”

This begs the question whether a child’s environment can indeed trump genetics when it comes to obesity.

The Virginia Tech news release quotes one of the study authors who wraps up the findings simply:

“We like variety,” said Deborah Good, an associate professor of human nutrition, foods, and exercise at Virginia Tech. “But when there is a choice, we eat more than when there is not any variety.”

Though the study was done using mice, it can help inform researchers of how human’s natural environment can affect food choices and ultimately a person’s weight. In a country where one-third of adults and 17 percent of children are obese, understanding the root causes of the problem is imperative.

One apparent upside found among mice in the choice group, according to the report: they had “improved energy expenditure” compared to the low-or high-fat diet groups. “Essentially,” the news release says, “the mice burned more energy as they wandered around and evaluated which food they were going to eat.”

This recalls the food and environment research of Brian Wansink, a professor of consumer behavior at Cornell University in Ithaca, New York. A recent Psychology Today article on how we eat (and overeat) called, “Why Out of Sight is Really Out Of Mind,” discusses how we can slip into mindless eating in a world where food is everywhere. But there are ways to eat smarter, if you think about what you’re doing:

Wansink found that slim people approach an “all you can eat” buffet by “scouting out” what is available — “getting the lay of the land,” as it were — before they grab their plates and pile on food. They are also more likely to sit facing away from, and to choose a table farther away from a buffet; more likely to choose small plates; and, if eating Chinese food, eat with chopsticks.

Jean Fain, a Harvard Medical School-affiliated psychotherapist who runs “mindful eating” training sessions, has offered some tips on how to curb excessive eating, particularly during the holidays, when tables are brimming with tempting sweets and heavy dishes loaded with nostalgia. In a December post, she wrote:

If you find yourself automatically reaching for another piece of pumpkin cheesecake, step back from the dessert table and ask yourself: “How do I feel? What do I need? Do I really want another piece of cheesecake?” If you do, by all means, enjoy. But if you feel full, better to interrupt the automatic urge for more. It’ll taste better when you’re hungry. What’s more, a short interruption can give you back control.

Nutrition Panel: Cut Down On Sugar To Combat Obesity, Chronic Disease

(Mel B via Compfight)

(Mel B via Compfight)

A U.S. advisory panel on nutrition has issued a sweeping report on the American diet that many of us won’t find earth shattering. One key conclusion: we should eat less sugar.

The 2015 Dietary Guidelines Advisory Committee offered its recommendations to the U.S. Department of Health and Human Services and the Department of Agriculture today as part of a process to develop new national dietary guidelines, which are updated every five years. Public comments are currently being accepted.

As far as sugar goes, the report states that: “Higher consumption of sugar-sweetened foods and beverages as well as refined grains was identified as detrimental in almost all conclusion statements with moderate to strong evidence.”

The report’s authors said they were guided by “two fundamental realities”:

“First, about half of all American adults — 117 million individuals — have one or more preventable, chronic diseases, and about two-thirds of U.S. adults — nearly 155 million individuals — are overweight or obese. These conditions have been highly prevalent for more than two decades. Poor dietary patterns, overconsumption of calories, and physical inactivity directly contribute to these disorders. Second, individual nutrition and physical activity behaviors and other health-related lifestyle behaviors are strongly influenced by personal, social, organizational, and environmental contexts and systems. Positive changes in individual diet and physical activity behaviors, and in the environmental contexts and systems that affect them, could substantially improve health outcomes.

Here’s more about the dietary recommendations:

The overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low-or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat;i and low in sugar-sweetened foods and drinks and refined grains. Vegetables and fruit are the only characteristics of the diet that were consistently identified in every conclusion statement across the health outcomes. Whole grains were identified slightly less consistently compared to vegetables and fruits, but were identified in every conclusion with moderate to strong evidence. For studies with limited evidence, grains were not as consistently defined and/or they were not identified as a key characteristic. Low- or non-fat dairy, seafood, legumes, nuts, and alcohol were identified as beneficial characteristics of the diet for some, but not all, outcomes. For conclusions with moderate to strong evidence, higher intake of red and processed meats was identified as detrimental compared to lower intake….

Continue reading

Biggest Gene Study Finds New Clues To Obesity, Apple Vs. Pear Shapes

(Wikimedia Commons)

(Wikimedia Commons)

You might think the link between genes and weight is simple: Fat tends to run in families, right? But as researchers tease apart the underlying genetics of body weight, it becomes ever clearer that it is a complex trait. Very complex, with ultimately perhaps hundreds of genes involved in what you see when you step on the scale.

Today, the biggest-ever study of the genetics of obesity, involving genetic samples from nearly 350,000 people, reveals dozens of new spots on the human genome that are involved with body weight and body shape, according to two papers (here and here) published in the journal Nature.

My dominant impression: The data tend to implicate the brain as a powerful influence on overall body weight, but point more towards hormones and the fat cells themselves as strong determinants of whether we’re shaped like “apples” — with more upper body fat — or “pears,” with more fat concentrated below the waist.

Dr. Joel Hirschhorn, of Boston Children’s Hospital, the Broad Institute and Harvard Medical School, leads the Genetic Investigation of Anthropometric Traits consortium, or GIANT, the friendly collaborative of hundreds of researchers around the world who contributed to the studies. Our conversation, lightly edited:

How would you sum up the findings that come out in “Nature” today?

We did a very large genetic study looking at two different kinds of obesity: Overall obesity measured by body mass index and central obesity — fat around the belly — measured by waist circumference and hip circumference. And what we found was that there are a lot of genes that influence both types of obesity, but, really interestingly, the types of genes that influence overall obesity are actually quite different than the types of genes that influence where the fat goes on the body.

Interesting. So what does that tell us?

That tells us that even though both types of obesity are bad for your health, that it may be very important to understand what kind of obesity you have, because if the biology is different, that means the way we can treat that obesity, or prevent it effectively, is probably going to be different for the two kinds of obesity.

So it may matter even more than we thought whether you’re shaped like an ‘apple or a ‘pear’?

That’s right. It matters both whether you’re an apple or a pear and it matters just how big you are in general. But the way you get to be big in general is probably different than the way you get to be an apple or a pear.

So it’s different pathways? Perhaps whole different mechanisms at work?

That’s right. The overall obesity seems to have more to do with what’s going on in the brain, maybe controlling appetite or whether you get full or how quickly you get full. And the apple vs. pear seems to have more to do with your fat cells and hormones that your body makes, things like insulin.

So does all this translate into any action points for the general public? Continue reading

Sugar On The Brain Circuit: Mice Seeking Sweets May Hold Key To Compulsive Overeating

You know the feeling: you’re tired, cranky, low or just have a serious, relentless desire for something sweet. Part of your brain cries out, “No, don’t do it, this will end badly.” But another (louder) part wants what it wants and won’t let up until that pint of Cherry Garcia, or red velvet cupcake or Caramel Macchiato is in plain sight. It’s an itch that must be scratched.

Now, brain scientists at MIT say they’ve identified a specific neural circuit in mice that can increase that compulsive overeating of sweets, but doesn’t interfere with normal eating patterns necessary for survival. More specifically, turning on this set of neurons drove mice to seek the reward of a sugary drink even in the face of punishment (a shock to the foot); and compelled them to eat voraciously even when full.  When the researchers shut down this pathway, however, the compulsive sucrose-seeking decreased.

Why does this matter? The new research, published in the journal Cell, may ultimately provide a target for the treatment of compulsive overeating and sugar addiction in humans, without undermining the clearly critical drive of eating to live, the scientists say.

“Imagine if I told you that in the future, we could change the way our neural circuits communicate in a way that I did not want to binge on sweets, but still allowed me to eat healthy foods when I’m hungry?” says Kay Tye, the study’s senior author and an assistant professor in the Department of Brain & Cognitive Sciences at MIT. “Obviously there is a ton of work that needs to be done to make this vision a reality, but our study suggests that it is possible.”

A Binge-Free Future?

As obesity rates have spiked in recent decades, experts say that overeating in general and consuming too much sugar in particular are major threats to human health.

But Tye says “the real underlying problems are the cravings that lead to compulsive eating, and the behavior of compulsive overeating itself.”

To tease out what might be driving that compulsion, Tye looked to a particular set of neurons in the mouse brain.

She and her colleagues showed that when mice perform reward-seeking actions enough that they become habits, that activates neurons connecting two key areas: a brain region called the lateral hypothalamus (an area important for hunger, feeding and homeostasis) and the ventral tegmental area (a brain region important for motivation and reward).

“If we want to understand how the brain gives rise to these feelings, thoughts and actions, we need to know more than what they are saying, we need to know who they are talking to,” Tye said. The team used so-called “optogenetic projection-defined phototagging” [essentially using laser light to activate or silence neurons] to see “which neurons…were saying what…and who they were talking to…”

These neural communications are quite distinct, Tye said; for instance, it’s important to distinguish between two types of reward-seeking behavior: binge-eating and drug addiction: “You don’t need cocaine to survive, you need food to survive,” she said.

The “Wanting” Neurons

Tye says that one of the biggest challenges with treating the obesity that comes from compulsive overeating disorders is that “most treatments are just a band-aid — treating the symptoms instead of the core problems.  Gastric bypass for example, is something that just makes it harder to eat, it doesn’t always change a person’s habits and eventually many people relapse and regain the weight.” Again, she theorizes that it’s the craving embedded in the brain that drives the compulsive behavior. She says there may be a distinctive set of  “wanting neurons” as opposed to “liking neurons.” Continue reading

That Extra Slice: Study Finds When Kids Eat Pizza, They Eat More Calories

Pizza birthday party (Flickr Creative Commons)

Pizza birthday party (Flickr Creative Commons)

By Alvin Tran
Guest contributor

Parents, if you want to prevent your kids from eating too many extra calories, you might want to think twice about letting them have that “just one more” slice of chewy dough, tangy tomato sauce and glistening melted cheese.

In a new study, published Monday in the journal Pediatrics, researchers found that pizza contributed to children and adolescents consuming more calories, saturated fat, and sodium in their usual diet.

“They’re taking in substantially more nutrients we really want to be thinking about limiting,” said Lisa Powell, PhD, a University of Illinois at Chicago professor of health policy and administration and the study’s lead author.

Powell’s study, which analyzed 24-hour dietary recalls of more than 12,000 kids over a 7-year period, found that children between the ages of 2 and 11 consumed an extra 84 calories on the days they ate pizza, while adolescents consumed an extra 230 calories.

It’s not a good idea to eat pizza as a snack.

– Lisa Powell, PhD

They also consumed significantly more sodium and saturated fat, which nutrition and health experts often dub the “bad fat.”

There is a silver lining, however. Children’s overall caloric intake from pizza declined by 25 percent over the course of the study. The study’s adolescent population, which ranged from ages 12 and 19, also demonstrated similar trends: its caloric intake from pizza fell by 22 percent.

But while the number of calories that adolescents consumed dropped, their overall consumption, on average, did not significantly change over the course of the study. According to Powell and her co-authors, this may be due to a slight increase in pizza consumption.

“The average adolescent takes in 620 calories of pizza. By showing that they consume this extra 230 calories, that means that on days they consume pizza, they’re not adequately adjusting the caloric intake and other things they take in that day,” Powell said. “They may be eating pizza but they’re having this additional 230 calories that they’re taking in.”


Overall, pizza consumption remained highly prevalent across both groups. In 2009 to 2010, 20 percent of children and 23 percent of adolescents consumed pizza on a given day.

Powell and her colleagues also found that consuming pizza as a snack or from fast-food restaurants were the two greatest culprits influencing both children and adolescents’ overall daily calorie intake.

“It’s not a good idea to eat pizza as a snack. That’s one thing that teens and parents should keep in mind,” Powell said. Continue reading

Why To Exercise Today (Even A Short Walk): Avoiding A Premature Death

I’ve been having such a hard time dragging myself out in the frigid, icy cold to run or get to a gym lately: there are so many excellent reasons not to do it. But here’s the best I could come up with today for why I shouldn’t listen to that “stay-warm-and-slip-into-bed-with-a-laptop little voice in my head: exercise is truly the “best way to avoid an early death,” according to U.K researchers, who report that even small chunks of exercise — a brisk 20-minute walk, for instance — can provide benefits.

Steve Koukoulas/flickr

Steve Koukoulas/flickr

The U.K. Telegraph headline sums up the new study tidily: “Lack of exercise is twice as deadly as obesity, Cambridge University finds.”

Indeed, this cohort study of 334,161 European men and women over 12 years, published in the American Journal of Clinical Nutrition found that “physical inactivity may theoretically be responsible for twice as many total deaths as high BMI” and concludes: “The greatest reductions in all-cause mortality risk were observed between the inactive and the moderately inactive groups across levels of general and abdominal adiposity, which suggests that efforts to encourage even small increases in activity in inactive individuals may be of public health benefit.”

Here’s more from The Telegraph report:

Using the most recent available public data, the researchers calculated that 337,000 of the 9.2 million deaths that occurred in Europe in 2008 could be attributed to obesity.

But physical inactivity was thought to be responsible for almost double this number – 676,000 deaths. Continue reading