In the past, food insecurity and obesity were viewed as separate public health problems, yet research now shows that people with unreliable access to food are also more likely to be obese. A new brief, Making the Connection: Linking Policies that Prevent Hunger and Childhood Obesity released by Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation, suggests that policymakers seeking to address hunger in their communities can find solutions that will also contribute significantly to reversing the childhood obesity epidemic. Some of the policy strategies outlined in the brief include:

·      Establishing healthy food financing initiatives to increase access to nutritious foods

·      Supporting farm-to-institution, farm-to-school and school garden programs

·      Increasing free and reduced-price school meals

·      Partnering with the private sector to increase the value of federal nutrition assistance benefits for healthful foods through double-coupon initiatives.

Filename: lhc_hunger_obesity_02.14.12.pdf


In the past, food insecurity and obesity were viewed as separate public health problems, but there is growing concern that the issues are related. While researchers have yet to definitively answer why people with unreliable access to food are more likely to be obese, it does appear that lack of access to healthy affordable food and exposure to high levels of stress may be contributing factors.10 Individuals in food-insecure households tend to choose foods high in fat. Although those types of foods may satisfy hunger more easily, they typically do not provide sufficient nutrients.11,12

Additionally, food-insecure families may tend to overeat when they do have access to food.13

Policymakers seeking to address hunger in their communities will find that many of the interventions they consider also can contribute significantly to reversing the childhood

obesity epidemic.

Making the Connection

The United States is experiencing an obesity crisis: two-thirds of adults and nearly one-third of children and adolescents are overweight or obese.14,15,16,17 While obesity is prevalent at all income levels, lower-income households are disproportionately affected. 18,19 The poorest families and some racial and ethnic groups also are at greatest risk for obesity and food insecurity.20 This is particularly evident among Hispanic and Black households.21

As neighborhoods across the country continue to confront these two challenges, policymakers can use the approaches discussed below to help support the needs of residents at risk for food insecurity and obesity.




Is Advertising Contributing To An Obesity Epidemic?



by Tikeyah Whittle | Nov 20, 2012 7:22am

A pediatrician from the Children’s Health Center at St. Mary’s Hospital in Waterbury thinks so.

“Commercialism is driving change in how we feed our infants,” Dr. M. Alex Geertsma told a group of advocates Monday at a Capitol forum on childhood obesity.

Geertsma said infants go from nursing or breastfeeding, which has proven to prevent childhood obesity, to eating additive-free, pureed mixed of foods.

“This is where the good news stops,” Geertsma said.

Problems arise at a greater rate when infants begin to give social cues that they are ready to consume more than liquids and purees. After being on a liquid diet for the first six months of life, they begin to taste discriminate, or recognize certain foods as tasty or disgusting. They begin to want something “novel” whether it is extremely sweet or really salty.

“This suggests to me that we’re meant to continue to get a variety of different foods as we got a little bit older,” Geertsma said.

This is when the foods that appear on grocery store shelves begin to be detrimental to children’s health. The change in palate prompts the food industry to make mixed dinners with huge amounts of added starch and finger foods like “heavily spiced” Gerber Lil’ Graduates Meat Sticks, Geertsma said.

These meat sticks contain 300 mg of sodium.

Starting at age nine, children start eating cookies and fruit snacks, Geertsma said. This provides kids with huge amounts of added sugar and “clearly primes the pump for them to prefer certain foods.” Think Oreos and gummy bears.

“I try to explain these things to parents and there’s an initial resistance,” Geertsma said “But as they talk about it in terms of normal developmental processes they re-think why they respond to their children’s demands for eating things and they start to see this as a manipulation.”

At the forum, Geertsma discussed the normal growth process in which there is an increase body fat that occurs after the percentage of body fat reaches its lowest point.

“Infants will grow most rapidly in particularly weight versus height during the first six months of life,” Geertsma said. “They then slow somewhat, but then really slow down in the period from one to approximately seven or eight years of life.”

So most children look fairly lean during that period of time, he added.

But it has been recently confirmed in Connecticut that an increase in body fat has been occurring much earlier than seven to eight years of age in children who eventually become long-term obese. This pattern is worse in African-American and Latino children, Geertsma said.

“I would not try to impugn the food industry in doing this overtly or even covertly. They may simply be following what consumers want,” he added.

Obesity is the second-leading cause of preventable death in the United States, after smoking, according to the Connecticut Public Health Department.

“In just over one generation, U.S. rates of obesity have approximately tripled among preschoolers and adolescents, and quadruples among children aged six to 11 years old,” according to the Connecticut Public Health Department.

If a child is overweight before age 8, obesity in adulthood is likely to be more severe, statistics by the American Academy of Pediatrics revealed.

A recent Connecticut report found that about one third of Connecticut children in kindergarten and third grade are overweight or obese and about one out of every seven are obese.

The Connecticut Coalition Against Childhood Obesity, a coalition of more than 30 health advocacy organizations across the state, hosted the forum Monday to discuss ways to overcome the obesity epidemic, which they say is contributing to the achievement gap.

According to the American Medical Association obesity kills more Americans than AIDs, cancer, and injuries combined. At this rate, the current generation of children will not live as long as their parents.




Halting the Epidemic by Making Health Easier
At A Glance 2011


Cover of Obesity At A Glance 2011


The Obesity Epidemic

More than one-third of U.S. adults (over 72 million people) and 17% of U.S. children are obese. During 1980–2008, obesity rates doubled for adults and tripled for children. During the past several decades, obesity rates for all population groups—regardless of age, sex, race, ethnicity, socioeconomic status, education level, or geographic region—have increased markedly.

Obesity and Health Disparities

Recent reports show that substantial differences exist in obesity prevalence by race/ethnicity, and these differences vary by sex and age. For example, according to 2005–2008 data from the National Health and Nutrition Examination Survey, 51% of non-Hispanic black women aged 20 years or older were obese, compared with 43% of Mexican Americans and 33% of whites. Among females aged 2–19 years, 24% of non-Hispanic blacks, 19% of Mexican Americans, and 14% of whites were obese. Efforts are being made to reduce these disparities by focusing interventions on subgroups with high prevalence of obesity.

Health Consequences of Obesity

Obesity increases the risk of many health conditions, including the following:

  • Coronary heart disease, stroke, and high blood pressure.

  • Type 2 diabetes.

  • Cancers, such as endometrial, breast, and colon cancer.

  • High total cholesterol or high levels of triglycerides.

  • Liver and gallbladder disease.

  • Sleep apnea and respiratory problems.

  • Degeneration of cartilage and underlying bone within a joint (osteoarthritis).

  • Reproductive health complications such as infertility.

  • Mental health conditions.

Obesity Is Costly

In 2008, overall medical care costs related to obesity for U.S. adults were estimated to be as high as $147 billion. People who were obese had medical costs that were $1,429 higher than the cost for people of normal body weight. Obesity also has been linked with reduced worker productivity and chronic absence from work.

Policy and Environmental Approaches Needed

The causes of obesity in the United States are complex and numerous, and they occur at social, economic, environmental, and individual levels. American society has become characterized by environments that promote physical inactivity and increased consumption of less healthy food. Public health approaches that can reach large numbers of people in multiple settings—such as in child care facilities, workplaces, schools, communities, and health care facilities—are needed to help people make healthier choices.

Policy and environmental approaches that make healthy choices available, affordable, and easy can be used to extend the reach of strategies designed to raise awareness and support people who would like to make healthy lifestyle changes.


Map showing percentage of adults who are obese by state 2009, text description available below

[A text description of this map is also available.]


CDC’s Response

CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO) is working to improve nutrition and physical activity and reduce obesity through state programs, technical assistance and training, surveillance and applied research, program implementation and evaluation, translation and dissemination, and partnership development.

Supporting State Programs

CDC's State-Based Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases (NPAO) currently funds 25 states to work with partners across multiple settings—such as child care facilities, workplaces (including hospitals), schools, and communities—to implement policy, system, and environmental strategies that have been proven to work. These strategies address the five target areas identified by CDC for preventing and reducing obesity, which are to

  • Increase consumption of fruits and vegetables.

  • Increase physical activity.

  • Increase breastfeeding initiation, duration, and exclusivity.

  • Decrease consumption of sugar drinks.

  • Decrease consumption of high-energy-dense foods, which are high in calories.

The NPAO Program emphasizes the need to reduce health disparities among different population groups, such as racial and ethnic minorities, and requires that states implement a comprehensive state plan. CDC provides technical assistance to help states develop comprehensive plans, implement interventions, and build the leadership needed to improve nutrition and physical activity environments and reduce obesity rates. State program highlights are available at http://www.cdc.gov/obesity/stateprograms/statestories.html.

CDC's Communities Putting Prevention to Work (CPPW) State and Territory Initiative is a 2-year cooperative agreement (2010–2012) that is focused on helping states promote health and prevent chronic disease through sustained policy, system, and environmental strategies. DNPAO provides program and evaluation assistance to 50 states and 8 U.S. territories to help them implement changes to the social and physical environments that make it easier for people to make healthy choices. DNPAO also provides technical assistance to the CPPW Communities Initiative, which gives direct funding support to selected communities.

Conducting Surveillance and Research

CDC tracks obesity trends among children and adults, as well as policy, environmental, and behavioral factors related to obesity and overweight. For example, in 2010, CDC's new Vital Signs program used 2009 data from the Behavioral Risk Factor Surveillance System to describe the prevalence of obesity at the state level. The data showed that no state had met the national goal of reducing the adult obesity rate to less than 15% and that, in 9 states, at least 30% of adults were obese.

CDC also publishes state-level reports on policy, environmental, and behavioral indicators associated with nutrition (e.g., fruit and vegetable consumption, breastfeeding) and physical activity. States can use these state indicator reports, which include action guides and train-the-trainer materials, to identify priority actions for state coalitions, monitor their progress over time, and celebrate successes.

CDC also identifies, evaluates, translates, and disseminates effective or promising interventions for obesity prevention and control. For example, CDC provides funding and technical support for the Nutrition and Obesity Policy Research and Evaluation Network (NOPREN), whose members include Prevention Research Centers (PRCs) across the country. Network members work to identify effective policies, the factors needed to support them, and the barriers that can prevent their adoption. They also assess whether policy changes can improve people's access to healthy foods and beverages (including water), determine if food labels give people the information they need to make healthy choices, and improve eating behaviors and health outcomes. The Harvard University PRC coordinates the network, and five additional PRCs are funded as collaborating centers.

Working with Partners

CDC is making progress in stopping the obesity epidemic through innovative partnerships such as the following:

  • The Healthy Eating Active Living Convergence Partnership fosters policy and environmental change by working with partners in fields not traditionally involved in public health. The group is currently focused on changing transportation and food systems to develop active living environments and improve access to healthy foods. Partners include the California Endowment, Kaiser Permanente, Nemours, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation.

    CDC provides technical assistance, PolicyLink (a national research and action institute) provides program direction, and the national, nonprofit Prevention Institute provides policy research, analysis, and strategic support.

  • The National Collaborative on Childhood Obesity Research (NCCOR) brings together research funders in a public-private collaboration to accelerate progress on reversing the epidemic of overweight and obesity among U.S. youth. NCCOR's focus is on identifying and evaluating effective interventions (particularly policy and environmental interventions) at individual, community, and population levels. The NCCOR Web site provides a database of diet and physical activity measures used in childhood obesity research and a catalog of relevant surveillance systems. (http://www.nccor.orgExternal Web Site Icon)

    NCCOR members build on each other's strengths through complementary and joint projects. Partners include the Robert Wood Johnson Foundation, National Institutes of Health, CDC, and U.S. Department of Agriculture.

Translating Practice-Based Evidence and Research

CDC translates practice-based evidence and research findings for use by practitioners, communities, and the public to foster environments that support healthy eating and active living. Recent efforts and products include the following:

  • The Center of Excellence for Training and Research Translation (Center TRT) works with CDC's NPAO Program to bridge the gap between research and public health practice, with a focus on nutrition, physical activity, and the prevention and control of obesity. The Center TRT Web site presents information on intervention strategies that focus on the factors that contribute to obesity and on interventions that have been used and evaluated in other communities. It also provides Web-based training modules on obesity and other chronic diseases and tools that can help practitioners implement effective interventions in their
    communities. (http://www.center-trt.orgExternal Web Site Icon)

    CDC also cosponsors an obesity prevention course on policy and environmental change strategies each year with the Center TRT at the University of North Carolina. Forty public health practitioners attended in 2010 to learn how to promote integrated strategies at state and community levels to address health equity.

  • LEAN Works! Leading Employees to Activity and Nutrition is a Web-based resource that offers interactive tools and evidence-based resources that can be used to design effective workplace programs to prevent and control obesity. (http://www.cdc.gov/leanworks)

  • The Healthy Weight Web site includes a body mass index (BMI) calculator and gives people information and tools to help them achieve and maintain a healthy weight for a lifetime. (http://www.cdc.gov/healthyweight)

  • The Body Mass Index: Considerations for Practitioners fact sheet summarizes the science behind BMI. It emphasizes that BMI is not a diagnostic tool, but a population surveillance tool and a screening tool designed to identify people who may be at risk for health problems because of their weight. (http://www.cdc.gov/obesity/downloads/BMIforPactitioners.pdf Adobe PDF file [PDF-142KB])

  • The Weight Management Research to Practice Series summarizes the science in this area and highlights the implications of research findings for public health and medical care professionals. (http://www.cdc.gov/weightr2p)


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For more information please contact the
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
4770 Buford Highway NE, Mail Stop K-26, Atlanta, GA 30341-3717
Telephone: 800-CDC-INFO (232-4636) • TTY: 888-232-6348
E-mail: cdcinfo@cdc.gov • Web: http://www.cdc.gov/nccdphp/dnpao/





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