Sept. 25, 2007

Studies: Children obese due to a host of unhealthy pressures

ANN ARBOR, Mich.-Unhealthy options and pressures influence nearly
every part of children's daily lives, according to studies released
this week in a special supplement of the American Journal of
Preventative Medicine.

The national studies, which include work conducted at the University
of Michigan, reveal that, in most middle and high schools across the
nation, contracts with soft drink bottling companies give students
easy access to sugary beverages.

Low- versus high-income neighborhoods have a higher proportion of
their restaurants serving fast foods and have fewer supermarkets and
more convenience stores at which to buy their groceries. In the media,
television advertisements steer kids to spend their money on junk
food, and minority students get considerably more such exposure, the
studies showed.

For the special supplement, Bridging the Gap, a national research
program funded by the Robert Wood Johnson Foundation and based at U-M
and the University of Illinois at Chicago, produced a groundbreaking
collection of evidence on factors that contribute to the escalating
rates of childhood obesity.

The studies offer new insight about how current school policies,
neighborhood characteristics and advertising collectively impact the
childhood obesity epidemic-and together create an overwhelmingly
unhealthy environment for young people.

A study by U-M Distinguished Research Scientist Lloyd Johnston and
colleagues finds that the vast majority of middle schools (67 percent)
and high schools (83 percent) have contracts with a soft drink
bottling company, which in many cases gives students access to soft
drinks all day long.

Estimates of the median annual revenue for soft drink contracts in
high schools turn out to be $6,000 ($6.48 per student), while for
middle schools the annual revenue is about $500 (70 cents per
student).

"The financial benefits of school contracts are modest in relation to
the health threat that soft drink promotions entail, and clearly the
problem is most serious at the high school level," Johnston said.

Other studies by the U-M team found that physical education is lacking
among older students. The average number of minutes students spend in
PE each week drops from 172 minutes in 8th grade to 89 minutes in 12th
grade, by which time only a third of students are even taking a gym
class at some time during the school year.

Minority students from lower socioeconomic levels attend schools in
which fewer students are involved in varsity sports, quite possibly
because such schools have fewer resources available to offer a full
range of sports and the exercise that goes with them.

The U-M studies also show evidence of unhealthy school nutrition
policies and serious disparities across racial/ethnic lines and across
different socioeconomic levels:

--An article by Jorge Delva, U-M associate professor of social work,
and colleagues documents the great extent to which children in school
have access to high-fat, high- sugar and salty foods through vending
machines and snack carts in schools

--Racial and ethnic minorities have less access to healthier foods,
such as low-fat snacks.

--Students of low socioeconomic status have less access to healthy
snacks at school than do students with higher socioeconomic status.

--On average, Hispanic high school students are exposed to brand-name
fast-food items at lunchtime twice as often as African-American and
white students.

U-M's Patrick O'Malley and colleagues found that in the 10 percent of
schools that have the least overweight students, one in 10 students
are overweight, on average, whereas in the 10 percent of all schools
with the greatest problem, fully 44 percent of their students are
overweight, on average.

"Research is showing us that we have in our schools and communities a
perfect storm that will continue to feed the childhood obesity
epidemic until we adopt policies that improve the health of our
communities and our kids," said Frank Chaloupka, head of the
University of Illinois at Chicago research team.

The UIC researchers found that, outside of school, it does not get
much easier for kids to consume a healthy diet. Too many kids live in
neighborhoods where fast-food restaurants and convenience stores far
outnumber supermarkets. This is especially true in lower-income
communities.

UIC economist Lisa Powell found a statistically significant
association between the availability of supermarkets and lower
adolescent and overweight status. In addition, Powell found a
statistically significant association between the availability of
convenience stores and higher overweight status.

"In communities where convenience stores outnumber supermarkets and
fast-food restaurants are particularly prevalent, we're making it
extremely difficult for parents and kids to eat balanced, healthy
diets," Powell said. "These families simply don't have easy access to
affordable fresh foods."

Powell and her colleagues also found that high-income neighborhoods
have a significantly lower proportion of fast-food restaurants than do
lower-income neighborhoods. There are also racial disparities:
predominantly African-American urban neighborhoods have a
significantly higher proportion of fast-food restaurants out of total
restaurants compared with predominantly white urban neighborhoods.

"I think that the role of the environment in bringing about the
epidemic of overweight among our children is still not fully
appreciated," Johnston said. "There are many influences in our
schools, communities and the media that contribute significantly to
the problem and that can be changed for the better. If we don't make
those changes, the consequences in terms of the health, longevity and
the health care costs of our newest generations are going to be
staggering."

About Bridging the Gap Bridging the Gap, which is funded by the Robert
Wood Johnson Foundation, is a joint project of the University of
Illinois at Chicago's Institute for Health Research and Policy and the
University of Michigan's Institute for Social Research. It is intended
to improve our understanding of the role of policy and environmental
factors in youth alcohol consumption, illicit drug and tobacco use, as
well as diet and physical activity. Bridging the Gap also evaluates
the effectiveness of policies and changes in environmental conditions
in reducing substance use and obesity among youth. For more
information, visit www.impact0een.org and www.yesresearch.org.