Policies to Prevent Childhood Obesity and Weight Bias

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1 Policies to Prevent Childhood Obesity and Weight Bias Roberta R. Friedman, ScM Director of Public Policy Women in Government Conference Oklahoma City, Sept 21-22, 2013

2 Strategic science Food marketing to kids School and pre-school initiatives Sugary drinks Weight bias Legal and economic approaches Policy resources

3 Policy proposals No sugary drinks or fruit juice in preschools Eliminate marketing of junk food in schools Protect against weight-based bullying in schools Impose sugary drink taxes, earmark for child obesity prevention

4 No fruit juice, sugary drinks in pre-schools Why no sugary drinks? Juice drinks perceived as healthful, but full of sugar Empty, nutrition-less calories Clear association w. weight gain Displace nutrient-rich foods Contradicts health messages Should encourage water

5 Water, high fructose corn syrup, apple, orange and water extracted from orange juice concentrates Water, Corn syrup, Sucralose, Acesulfame Potassium, Neotame

6 No sugary drinks, 100% fruit juice in pre-schools Why no 100% juice? No fiber; whole fruit better Excessive consumption associated w. increased risk of obesity USDA: limit to 4 oz Getting plenty at home Leave to parental discretion Wojcicki et al.,ajph, 2012

7 Obesity reflects nutrition crisis Children under-consume Fruits and vegetables Fiber And over-consume Refined grains Sugar Saturated fat Sodium

8 States/Cities with pre-school sugary drink policies California New Mexico New York City Limit to special occasions North Carolina Georgia

9 Eliminate marketing of junk food in schools Why? Marketing works Higher exposure significantly associated w. higher consumption IOM, Food Marketing to Children and Youth, 2006;

10 Eliminate marketing of junk food in schools Why? Children are captive audience Affects what kids eat by increasing awareness of, desire for, intention to buy promoted products. No 1 st Amendment limits Harris et al., Crisis in Marketplace, Ann Rev Pub Hlth, 2009

11 Marketing in Schools Scoreboards Textbooks/book covers Fundraisers Boxtops for Education Vending machines Reading incentive programs Teacher resources School buses

12 Fundraising

13 Sale of branded foods Vending machines/ competitive foods Fast food in cafeterias Packaged breakfasts

14 Ads in schools

15 Eliminate marketing of junk food in schools Options: Eliminate all food/bev marketing No contracts permitting ads Market only foods allowable for sale Per USDA regs (b fast, lunch, competitive foods)

16 Maine: Act to Protect Children s Health on School Grounds (2007) Brand-specific advertising of food or beverages is prohibited in school buildings or on school grounds Exceptions: Food and beverages meeting standards for sale or distribution on school grounds; advertising in broadcast and print media; clothing with brand logos or images; advertising on product packaging

17 Weight-based bullying in schools What s the problem?

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19 National Education Association (1994) For fat students, the school experience is one of ongoing prejudice, unnoticed discrimination, and almost constant harassment From nursery school through college, fat students experience ostracism, discouragement, and sometimes violence

20 Stigma of Overweight & Obese Youth Forms: Verbal, physical, relational, cyber Sources: Peers, teachers, parents Consequences: emotional, social, physical Puhl & Latner, Psychological Bulletin, 2007.

21 National Education Association, 2011

22 Teasing and Bullying in Adolescence Adolescent reports of why peers are teased/bullied, and observed frequency Reason for teasing Primary reason Observed sometimes, students are teased often, very often % % Being overweight Gay/lesbian Ability at school Race/ethnicity Physical disability Religion Low income/status Puhl, Luedicke, & Heuer. Journal of School Health, 2011

23 Parental Perceptions of Why Youth are Bullied Puhl, Luedicke, DePierre (in press)

24 State anti-bullying laws 49 states and DC have laws BUT Only ME,NH,NY include weight or obesity DC includes personal appearance 18 states list personal characteristics of victim Definitions include physical, psychological, cyber retaliation

25 Sugary drink taxes Penny per-ounce on all types 10% increase in price = 10-12% decrease in consumption Earmark revenue for child obesity prevention

26 Which sugary drinks?

27 Why sugary drinks? Science Sugar Consumption Marketing Portions Caffeine

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29 SSB consumption promotes weight gain in children and adults. American Journal Clinical Nutrition, 2013

30 higher consumption of SSBs is associated w. development of metabolic Diabetes Care, 2010 syndrome and type

31 Diabetes and Pre-Diabetes, Age 20 and Younger 2m 215k American Diabetes Association, 2008

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33 Thank you! I can send you relevant studies, fact sheets, other resources. Roberta R. Friedman, ScM Director of Public Policy Roberta.friedman@yale.edu (203)