Friday, August 24, 2012

Guest post: stronger laws may mean less childhood obesity

A New York Times piece earlier this month reported on a study that found Body Mass Index (BMI) increases were smaller for students from the 5th to the 8th grade in states where strong laws govern what foods can be sold at schools outside of the federal meal program. These “competitive foods” include products sold in vending machines, at cafeteria ala carte lines and in school stores.  

The study, published on Aug. 13 in the journal Pediatrics, was titled “Weight Status among Adolescent in States that Govern Food Nutrition Content.”  Its findings establish an interesting correlation for public health advocates like me who have been looking for evidence to support a more global approach to our fight against the childhood obesity epidemic. The Times piece links to the Centers for Disease Control, which reports that about one fifth of American children are obese.

Among the strengths of the study is that it objectively rates 40 states on how strong and specific their laws are concerning the types of foods sold in schools. The research team also used data gathered on the actual, competing foods obtained rather than relying on self- reports from parents or children. The study also appropriately stopped short of stating that stricter states laws were the cause of the lower BMI increase because this type of study could not answer that question. But the correlation seen in their data does raise the possibility that stronger state laws could help.

BMI overall increased from 5th to 8th grade for the 6,000 students in this study, but for the kids in the states that had stronger laws, the BMI gain was not as great. This is hard to interpret for individual children because I have taken care of some adolescents who have medical conditions, or are underweight and need to gain. From a population perspective in a country with an epidemic underway, however, any change that can slow weight gain is a plus. For many children, especially in Alabama, laws that promote the slowing of BMI increases should be welcomed.

Speaking of Alabama, I am left to wonder how we did in this study. The authors did not disclose how each state ranked in terms of their scale of strong to weak. There were data license restrictions and they could not report this. They did mention that, at the start of the study in 2003, 70 percent of the students in states with strong laws lived in the South.

Alabama was given a “B+” grade in 2006 by the Center for Science in the Public Interest in regards to policies for competitive foods in school.  In 2009 the “F as in Fat Reports” funded by the Robert Wood Johnson Foundation reported that Alabama has a nutrition standard for school meals and snacks that exceeds government standards, nutritional standards for competitive foods and limited access to such competitive foods. That said, Alabama, along with several Southern states, continues to rank among the highest in terms of childhood obesity levels. The research presented in Pediatrics does suggest that stronger laws could help slow the obesity epidemic facing our children.

Guest Blogger: Stephanie Wallace, M.D., is an assistant professor in the UAB Department of Pediatrics who is active in UAB's Pediatric Weight Management Program.

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