Greetings!
As February is American Heart Month, you have probably been reminded recently that heart disease is the leading cause of death for most Americans. Keep in mind that our shared efforts address three important risk factors for heart disease: eating well, staying active, and maintaining a healthy weight. Ideally eating well for children starts during pregnancy as women need iron, folate, and iodine for healthy fetal growth and development. Last year we updated our website’s pages on infant and toddler nutrition. Topics include breastfeeding, formula feeding, feeding from a bottle, mealtime tips, essential vitamins and minerals, and food and drinks for children younger than 2 years of age. Please feel free to share these pages with your partners and constituents to help give children a healthy start. Lack of physical activity is another risk factor for heart disease. In January we launched Active People, Healthy Nation to help 27 million Americans become more active by 2027. I have joined the movement – have you? Overweight and obesity are additional risk factors for heart disease. In November we reported modest declines in obesity among young children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Despite this progress, obesity affects about 13.7 million US children and adolescents. This calls for continued commitment to interventions and prevention. Read about our pediatric weight management work in this newsletter. In collaboration with our national, state, and local partners, I look forward to future progress reports on improving nutrition, increasing physical activity, and maintaining healthy weight. Ultimately this will reduce the incidence of heart disease and other chronic diseases including obesity, type 2 diabetes and 13 types of cancer. It will take all of us working together to make this happen. Thank you for all that you do. Dr. Ruth Petersen, Director, DNPAO |
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Among the partners attending the Active People, Healthy Nation launch in January were, from left, Ruth Petersen - DNPAO; Holly M. O’Malley, Ayanna McKnight, Laurie Whitsel, and Emily Holubowich - American Heart Association; Janelle Gunn, Ken Rose, and Janet Fulton - DNPAO; Katrina Piercy - U.S. Department of Health and Human Services; and Rick Troiano - National Cancer Institute. Photo @Melissa Talbot.
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In The Spotlight
Added Sugars Intake Among US Infants and Toddlers
National estimates of added sugars intake show that between 2011 and 2016, 84.4% of US infants and toddlers consumed added sugars on a given day. A greater proportion of toddlers (98.3%) consumed added sugars than infants (60.6%). Non-Hispanic black toddlers consumed more added sugars than non-Hispanic Asian, non-Hispanic white, and Hispanic toddlers.
For infants, top sources of added sugars were yogurt, baby food snacks/sweets, and sweet bakery products; top sources among toddlers were fruit drinks, sugars/sweets, and sweet bakery products. The mean amount of added sugars decreased from 2005-6 through 2015-16 for both age groups; however, percent energy from added sugars only decreased among infants.
The authors noted that eating patterns established early in life shape later eating patterns. They concluded that “the findings of this paper may inform efforts to reduce added sugars intake and establish healthy dietary practices in early childhood.”
Fortified Wheat Flour Associated with Lower Levels of Anemia in Colombia Pre-school Children
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This article examined the association between consumption of fortified wheat flour in Colombia and two outcomes among women and children: low serum ferritin (blood iron level) and anemia prevalence. Results showed that consumption of foods containing fortified wheat flour is associated with lower levels of anemia in pre-school aged children.
The World Health Organization notes that young children have increased iron requirements during periods of rapid growth. Anemia from iron deficiency in childhood is linked to increased illnesses and impaired cognitive development and school performance.
Feature Of The Month
Obesity Declines Among WIC-Enrolled Young Children;
CDC Addresses Pediatric Weight Management
In a study published in November, 41 states and territories showed modest declines in obesity in WIC-enrolled children ages 2-4 years old. WIC is the Special Supplemental Nutrition Program for Women, Infants and Children. Also see a press release and a table with state data.
Ideally, all children and adolescents would be screened for obesity, and more children 6 years and older with obesity would be referred to family-centered pediatric weight management interventions. DNPAO is leading the following three projects to address pediatric weight management:
- The Childhood Obesity Research Demonstration (CORD) project is in its third phase. Building on prior CORD projects, CORD 3.0 focuses on increasing the availability and number of effective programs to address childhood obesity. See the background, implementation, and selected findings from CORD 1.0.
- COMMIT! aims to increase implementation of an evidence-based childhood weight management program called Mind, Exercise, Nutrition, Do It! or MEND®. MEND is a family-based direct education intervention. The COMMIT! acronym stands for Childhood Obesity Management with MEND® Implementation Teams.
- The Childhood Obesity Data Initiative (CODI) plans to leverage existing information technology tools in innovative ways to increase access to data across health systems and sectors. A pilot project in Colorado is expected to go live in mid-2020. CODI will allow scientists and researchers to query information from multiple data sources to create a more comprehensive record about children. The April 21 Public Health Grand Rounds about Predictive Analytics and Public Health will include novel technology from CODI. The free webcast, which is open to the public, will begin at 1 p.m. Eastern Time.
While addressing existing childhood obesity, we are also involved in prevention. Infants who are breastfed have reduced risk of obesity and many other illnesses and conditions. Consequently, making breastfeeding easier for mothers to initiate and sustain is another obesity-prevention strategy.
Starting good nutrition practices early can help children develop healthy dietary patterns. Obesity prevention is one more reason we urge you to share the information on our infant and toddler nutrition pages
Another prevention step is promoting good nutrition and physical activity in early care and education settings. Most young children spend time in care outside their home, including child care centers and pre-kindergarten programs. These programs can influence what children eat and drink, encourage physical activity, and promote healthy living.
For national and state data, see Data, Trends, and Maps. The “Obesity/Weight Status” category has indicators for adults and adolescents with obesity as well as adults and adolescents with an overweight classification. Data, Trends, and Maps includes the following data for WIC-enrolled children: 2-4 year-olds who have an overweight classification, 2-4 year-olds who have obesity, and 3-23 month-olds who have high weight-for-length.
Maps of changes in obesity prevalence between 2010 and 2016 among WIC-enrolled children ages 2-4 years old are available, as well as tables with state data.
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News You Can Use
Join the Active People, Healthy Nation℠ Initiative
You are invited to join the Active People, Healthy Nation initiative to help 27 million Americans become more active by 2027. Get involved by signing up as an individual, organization, or community champion.
Also, share these design elements in your social media, website, blogs, and printed material. Increased physical activity can improve health and quality of life and reduce healthcare expenses. By leveraging our collective strengths, we can achieve the goal of creating an active America, together. |
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Sugary Drink Material Available
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Five new pieces are available to improve parents’ knowledge about what drinks contain added sugar. The products are part of Alaska’s “Play Every Day” campaign.
The videos and print material are free, and some of it can be rebranded for a small fee. To review the content on the State and Community Health Center, choose free in the search filter for cost range. In the “Produced For” section, choose Alaska Department of Health and Social Services. For more information, email schmc@cdc.gov. |
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Wins from the Field: Ideas from CDC-Funded Grantees
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Be Wild, Be Wonderful, Be Healthy
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West Virginia’s High Obesity Program documented its first year of progress in a video shared on Facebook. The community-based project includes 18 organizations from Clay and McDowell counties.Together they are addressing health challenges by increasing access to physical activity and healthy foods. After one year, leaders report that they have reached 8,000 residents, established a deeper connection with the communities, and created sustainable change.
Pilot Program Increases Access to Healthier Food Choices in Shasta Lake, California
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To encourage retail markets to provide more healthy choices, Shasta County (California) Health and Human Services formed the Shop Healthy Shasta Lake community collaborative. A 2018 survey showed promoting fresh produce at three markets had a positive effect on consumer purchases of fruits and vegetables; 48% of respondents said the changes made them more likely to eat healthier. These efforts reached more than 7,000 residents. Two store owners reported improved sales of healthy items.Read more.
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Upcoming Happenings - health observances with related social media suggestions
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March
National Nutrition Month
National Walking Day, April 1
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Behind The Scenes
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Chris Kochtitzky, Senior Advisor, DNPAO Physical Activity Translation and Evaluation Team
As a trained community planner, I serve as a content expert in community design and transportation infrastructure that can facilitate or hinder physically active lifestyles. I also serve as a bridge to leaders in those sectors – such as other planners, transportation engineers, architects, and neighborhood developers. These almost 500,000 professionals are primarily responsible for related local and state activities. They are crucial to the success of things like Active People, Healthy Nation and the Physical Activity Guidelines for Americans, 2nd Edition, as demonstrated by their Joint Call to Promote Healthy Communities and the Institute of Transportation Engineers’ Transportation and Health Initiative. I consider these colleagues a new “public health” workforce.
What is your greatest professional satisfaction?
I am proud to see concrete and practical outcomes that we’ve supported come to fruition, particularly related to potentially vulnerable populations. These include resources such as the Active Communities Tool, the Built Environment Assessment Tool, the Parks, Trails, and Health Workbook, and the Transportation and Health Tool.
They also include grassroots efforts that we’ve supported through trainings such as Walkability Action Institute (WAI) and technical assistance on projects. For example, elements of the Regional Active Transportation Plan in central Texas, including the City of Austin, occurred as a direct result of a team participating in the WAI. In addition, products like the Urban Land Institutes (ULI) Building Healthy Places report “Active Transportation and Real Estate: The Next Frontier” occurred in part because of technical assistance provided by CDC staff to the ULI project. |
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How do partners help you do your work?
First and foremost, partners keep me grounded in practical reality. Almost as important, they provide the crucial conduit to reach and positively affect people in their day-to-day lives. Prior to coming to CDC, I spent more time at the grassroots level. Since all public health is local, as the saying goes, I never want to be too removed from where the rubber hits the road, and in this line of work, I mean that literally.
What would you like partners to know?
I would like partners to know that to design community plans and change other key policies and systems that encourage more physically active lifestyles, help is just down the hall or maybe down the street. If you are in public health, reach out to your colleagues in planning, transportation, or public works. If you are in these other sectors, call your colleagues in public health or your local medical society or hospital administrator.
Favorite quote:
“You see things; and you say “Why?” But I dream things that never were; and I say “Why not?” — George Bernard Shaw as quoted by President John F. Kennedy
Recently Published DNPAO Articles
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- Added Sugars Intake among US Infants and Toddlers [Herrick KA, Fryar CD, Hamner HC, Park S, Ogden CL. J Acad Nutri Diet. / November 2019]
- American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control [Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, Winters-Stone K, Gerger LH, George SM, Fulton JE, Denlinger C, Morris GS, Hue T, Schmitz KH, Matthews CE. Med Sci Sports Exerc. / November 2019]
- Breastfeeding trends by race and ethnicity among U.S. children born from 2009 to 2015 [Li R, Perrine CG, Anstey EH, Chen J, MacGowan CA, Elam-Evans LD. JAMA Pediatr. / October 2019]
- Clinical Decision Supports in Electronic Health Records (EHR) to Promote Childhood Obesity-Related Care: Results from a 2015 Survey of Healthcare Providers [Harrison MR, Lundeen EA, Belay B, Goodman AB. Clin Nutr Res. / October 2019]
- Consumption of fortified wheat flour and associations with anemia and low serum ferritin in Colombia [Fothergill A, Fonesca Centeno ZY, Ocampo Téllez PR, Pachón H. Perspect Nutr Humana / November 2019]
- Dietary quality among children from 6 months to 4 years, NHANES 2011–2016 [Hamner HC, Moore LV. Am J Clin Nutr. / October 2019]
- Digital Segmentation of Priority Populations in Public Health [Evans WD, Thomas CN, Favatas D, Smyser J, Briggs J. Health Educ Behav. / December 2019]
- Predictors of micronutrient powder (MNP) knowledge, coverage, and consumption during the scale‐up of an integrated infant and young child feeding (IYCF‐MNP) programme in Nepal [Locks LM, Dahal P, Pokharel R, Joshi N, Paudyl N, Whitehead RD, Chitekwe S, Mei Z, Lamichhane B, Garg A, Jefferds ME. Matern Child Nutr. / October 2019]
- Predictors of Micronutrient Powder (MNP) Sachet Coverage and Recent Intake among Children 12-23 Months in Eastern Uganda [Ford ND, Ruth LJ, Ngalombi S, Lubowa A, Halati S, Ahimbisibwe M, Mapango C, Whitehead RD, Jefferds ME. Matern Child Nutr. / October 2019]
- Report to Congress: Childhood Obesity Research Demonstration (CORD) Project [Centers for Disease Control and Prevention / October 2019]
- State-Specific Obesity Prevalence Among Enrollees Aged 2–4 Years in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) —United States, 2010–2016 [Pan L, Blanck HM, Park S, Galuska DA, Freedman DS, Potter A, Pettersen R. / MMWR Morb Mortal Wkly Rep. / November 2019]
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