Ky., high in childhood obesity, fights it with better school meals, increased activity requirements and maybe help from Big Bird

By Melissa Patrick
Kentucky Health News

Kentucky children are some of the nation's fattest.

In 2011, the last year for which data are complete, Kentucky ranked sixth in the U.S. in the percentage of obese 2-to 4-year-olds from low-income families (15.5%), eighth for percentage of obese 10-17 year-olds (19.7%), and third in percentage of obese students in high school (16.5%), according to a project of the Trust for America's Health and the Robert Wood Johnson Foundation. (Read more

Kentucky has several programs in place to fight childhood obesity, such as improving food choices in schools with farm-to-school mini-grants and improved school nutritional guidelines. Efforts are also being made to increase the standard expectations of physical activity, according to the federal 

Centers for Disease Control and Prevention website.  

Laws that require Kentucky school districts to develop local wellness policies for grades K-5 that includes moderate to vigorous physical activity each day and encourages healthy choices among students are a step in the right direction toward decreasing childhood obesity. This legislation also requires assessment tools to measure each child's level of physical activity on an annual level, according to the National Association of State Boards of Education website. There is also a push to increase the activity requirements in child care facilities, according to the CDC website.

The frequency at which children eat fast food, and its nutritional value, are also challenges in decreasing childhood obesity. Kids and teens consume up to 300 calories more per trip to a fast-food or full service restaurant compared to days they eat at home, Ryan Jaslow reports for CBS News. (Read more)

Although fast-food restaurants have made some improvements with healthier sides and beverage choices in most children's meals, "there is room for improvement," researchers say in the "Fast Food Facts 2013" report, issued by Yale University's Rudd Center for Food Policy & Obesity.

The report examines how 18 major restaurant chains market their foods and beverages to children and teens, and analyzes the nutritional quality of the chains' food. Significant findings included: Less than 1 percent of all children's meal combinations at such restaurants met recommended nutrition standards; McDonald's spent 2.7 times as much to advertise its products as all fruit, vegetable, bottled water and milk advertisers combined; the total amount spent on all advertising by fast-food restaurants in 2012 was $4.6 billion; preschoolers viewed 2.8 fast-food ads per day in 2012; children 6 to 11 saw 3.2 such ads per day; and teens viewed 4.8. The researchers also found that fast-food restaurants continued to target black and Hispanic youth, populations at high risk for obesity and related diseases.

Researchers called for fast-food restaurants to stop marketing unhealthy foods to children and teens, saying "Research shows that exposure to food marketing messages increases children’s obesity risk." (Read more

On the marketing front, "Sesame Street" characters have joined the Produce Marketing Association to help market fresh fruits and vegetables to children, according to a press release from the Robert Wood Johnson Foundation.

"Marketing healthy products with the same skill and vigor typically used for less healthy options could make a major difference in shaping children's food preferences," Dr. Risa Lavizzo-Mourey, the foundation's president and CEO. "I have a vision of children pestering their parents for pears and begging for broccoli."

Hard-hitting TV ads against smoking do motivate smokers, like one mother from Elizabethtown, to quit

Hancock with CDC Director Tom Frieden

A 38-year-old Elizabethtown mother's response to a federally funded anti-smoking advertising campaign has been featured in national news this week, showing that these graphic ads can motivate smokers to quit.

Lisha Hancock's decision to stop her two-decade smoking habit was sparked by her viewing of a Centers for Disease Control and Prevention’s “Tips from Former Smokers” campaign commercial, reports Sarah Bennett of The News-Enterprise in Elizabethtown.

Hancock's husband often urged her to quit, and several of her relatives died from smoking, but she still didn't quit. She continuously had a sore throat and clogged sinuses, but she still didn't quit. Then, she saw the commercial.

The advertisement featured raw images of Terrie Hall, a North Carolina woman who was diagnosed with throat and oral cancers at age 40, getting ready in the morning by putting on a wig, artificial teeth an an artificial voice box inside a small hole in her neck, since throat cancer forced her to have her larynx removed.

TV spokeswoman Terrie Hall with grandson's picture

"The only voice my grandson’s ever heard is this one,” Hall says in a robot-like voice, displaying his picture. UPDATE: Hall died Sept. 16.

The ad made a lasting impression on Hancock, who told Bennett she decided to quit smoking after watching the ad with her son: “One time my son asked me, ‘Mom, why does her voice sound like that?’ I said, ‘Because she smoked.’ Then he asked, ‘So you’ll sound like that?’”

Hancock said she had tried to quit before, but "There's nothing that touched me like Terrie's ad. It definitely impacted my life and, in return, impacted my family's life. We all live happier and healthier now."

Hancock started to quit eight months ago. Using nicotine lozenges and a combination of exercise and healthful eating, she's been able to go without even one cigarette, reports Anahad O'Conner of The New York Times.

Others have also been struck by this hard-hitting campaign, which may have prompted more than 100,000 Americans to quit smoking permanently, says a new CDC study published in The Lancet, the leading British medical journal. The CDC says an estimated 1.6 million U.S. smokers attempted to quit this past year after viewing campaign materials funded by the Affordable Care Act.

"Hard-hitting ads work," said CDC Director Dr. Tom Frieden. The agency paid approximately $50 million to produce and place the spots, the first time the federal government funded a nationwide tobacco-education ad campaign, reports Jonathan Serrie of Fox News.

"The impact is huge because a smoker costs about $2,000 more [per year] than a non-smoker, and about $1,000 more than an ex-smoker, to care for," Frieden said. "And if you do the math, this program pays for itself in a year or two in reduced health-care and societal expenditures."

The campaign also saved an estimated 300,000 years of life that smoking-related diseases would have taken, reports Brady Dennis of The Washington Post. Smoking remains the leading cause of preventable death in the United States, killing more than 1,200 Americans each day, says the CDC.

Click here for the CDC ads and other smoking-cessation resources.

Bill to shield nursing homes from lawsuits clears Senate along party lines; not looking healthy in House despite TV, radio ads

Last week the state Senate approved on party lines a bill that would make lawsuits against nursing homes go through a review panel first. Republicans supported the bill and Democrats voted against it in a 23-12 vote that marked the clearest partisan split in the Senate in this year's legislative session.

Senate Bill 9 would create medical review panels of three physicians and an attorney moderator to hear complaints against long-term care facilities and vote on whether the suit had enough merit to go to court.  The bill's sponsor, Senate Health and Welfare Chairwoman Julie Denton, R-Louisville, declind to answer an opposign senator's questions about the bill. She said in introducing it that the panel would be advisory but its opinion would be admissible in court and would curb such lawsuits, reports Jack Brammer of the Lexington Herald-Leader.

Bills like this have failed in years past and could have diverse implications for Kentucky communities and nursing homes. At least one Kentucky newspaper looked around and found that lawsuits are one reason Extendicare Health Services Inc. shed management responsibilities last year for all 21 of its facilities in Kentucky, reports Nick Tabor of the Kentucky New Era in Hopkinsville.

Without Extendicare management in Western Kentucky, the volume of nursing-home lawsuits in the region appears to be shrinking, Tabor reports. In recent years, nearly all the Christian County cases that have been closed were dismissed through settlements, not by judges declaring them unfounded. This suggests the bill would minimally affect the county, writes Tabor. Other Kentucky communities may be affected differently; judges differ from circuit to circuit.

Although the bill passed the Senate, it appears to be on its deathbed in the House. Rep. Tom Burch, D-Louisville, who chairs the House Health and Welfare Committee, joked about its prospects to Tabor: “I can’t make any predictions about the bill this time, but I’ve called in three priests to have the last rites ready.” If nursing homes received this new layer of protection, he said, hospitals and day-care centers would want it too.

A similar bill died in Burch's committee last year; this version is being supported by television and radio commercials urging viewers and listeners to call their legislators in support. When Extendicare announced last spring it was transferring management of all its Kentucky facilities to a Texas company, it cited Kentucky’s “worsening litigation environment” and said tort reform seemed unlikely here.

Bernie Vonderheide, director of Kentuckians for Nursing Home Reform, said most so-called “frivolous” lawsuits would cease if the state imposed minimum staffing requirements on nursing homes, his group's main legislative goal. (Read more)

Coalition of health groups launches two-week ad campaign to drum up support for a statewide smoking ban

A geographically targeted newspaper and online advertising campaign calling for "a comprehensive, statewide smoke-free law" is hitting Kentucky media outlets this week, as the legislature convenes, and next week. The campaign was launched by Smoke-Free Kentucky Coalition, the Campaign for Tobacco-Free Kids and the Robert Wood Johnson Foundation. The newspaper ad can viewed here.

Twenty-nine percent of Kentucky adults are smokers, giving the state the highest smoking rate in the U.S., and ranks very high in youth smoking, according to the Centers for Disease Control. Kentucky also has the nation's highest lung cancer death rates, 87 percent of which are caused by smoking, according to the National Cancer Institute. The state also "lags behind other states in enacting a comprehensive, statewide smoke-free law that covers all indoor workplaces, including bars and restaurants," a press release about the ad campaign says. Twenty-four states have smoking bans. A fall poll for the Foundation for a Healthy Kentucky showed that 59 percent of Kentucky adults support a smoking ban in workplaces, restaurants and bars. For a story on the poll, click here.

Tobacco-Free Kids communications manager Catherine Butsch said the ad is running in the Lexington Herald-Leader, the Messenger-Inquirer of Owensboro, the Daily Independent of Ashland, the Commonwealth Journal of Somerset, the Kentucky New Era of Hopkinsville, the Glasgow Daily Times, the Paducah Sun, the Paducah-based West Kentucky News, the Sentinel-Echo of London, the Lebanon Enterprise, the Jessamine Journal, the Tompkinsville News, the Carlisle Weekly of Bardwell, the Fulton Leader, the Marshall County Tribune Courier, and the Kentucky Gazette, a government-oriented twice-monthly in Frankfort. The online ad will run on websites of the Herald-Leader, Business Lexington, The Lane Report and CN2, a cable news service. The campaign will cost $93,000, Butsch said.

Obesity is a dirty word: Study looks at what works in anti-obesity campaigns, and it's not telling people they're fat

What about those anti-obesity ads? Is anyone listening? If so, is anyone motivated to do better? Might they be offensive to some? Educational? Helpful? Are they working at all? More importantly, why and why not?

Researchers at Yale University's Rudd Center for Food Policy and Obesity have stepped into the breach to measure Americans' attitudes about ads meant to encourage less girth and better nutrition. According to The Atlantic's Lindsay Abrams, the researchers took a nationally representative sample of Americans and asked them to look hard at these highly visible campaigns and their somewhat showy slogans. Abrams writes: "The researchers were interested in knowing what the respondents thought about how informative, motivating, or credible the slogans seemed. They were also curious as to which ads came off as confusing, stigmatizing, or inappropriate. Finally, they asked the respondents whether they intended to follow the messages' advice."

The result? Not surprising, really. We want positive reinforcement and reject stigmatizing or otherwise negative messages. Our favorite message of the ones examined? The simple one from First Lady Michelle Obama's "Let's Move" campaign, "Move Every Day."  The most positively rated campaigns? "Those focused on encouraging specific health behaviors or actions, like eating fruits and vegetables every day or engaging in physical activity," said the study's lead author Rebecca Puhl, "And the most motivating were the ones that made no mention of obesity or weight at all."

Nobody, researchers found, likes being told that their child's obesity is their fault or that it is child abuse. Neither do we like being told we're fat but not told clearly what to do about it. 'Obesity' itself is a bad word. "Certainly what we find is when more neutral words are used, like 'unhealthy weight' or 'high BMI' those are preferred and viewed to be more motivating," said Puhl. The trick, Abrams writes, is going to be in "figuring out how to be anti-obesity without being anti-obese people" -- and boiling these issues down to a slogan is difficult to do. (Read more)

You might also be interested in a related Atlantic story about how a Minnesota "anti-obesity" campaign lies in that gray area between educating and shaming. To read the story and view the videos of the ads, go here.

Meds-for-meth bill drew record lobbying expenses, not even including radio and newspaper ad campaigns

Makers of over-the-counter drugs spent more than any lobbying interest ever had during a single Kentucky legislative session in their effort to defeat a bill requiring prescriptions for the key ingredient in methamphetamine, Bill Estep reports for the Lexington Herald-Leader.

"The Consumer Healthcare Products Association spent $457,053 on lobbying activities in the first three months of this year's legislative session, according to reports filed with the state Legislative Ethics Commission," Estep writes. "The group's lobbying effort was so dominant that it spent more than the next five groups combined in that period, January through March, according to spending reports."

And the figure doesn't even included hundreds of thousands of dollars that the trade group spent on radio and newspaper campaigns, because the lobby-reporting requirements do not apply to messages aimed only at the general public. The group did report spending on "a phone-bank operation to put people in contact with legislators to voice concerns about legislation to require a prescription for medicine containing pseudoephedrine, which is now available over the counter," Estep writes.

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

The efforts, dating back to 2010, were partly successful. The legislature passed a bill "that will require a doctor's prescription for pseudoephedrine, but only after someone has bought 24 grams of the medicine a year," Estep notes. "A 48-count box of the generic medicine with 30-milligram pills contains 1.44 grams of pseudoephedrine. The bill excludes limits on gel caps and liquid pseudoephedrine." (Read more)

The lobbying effort wasn't only about Kentucky. The makers of Sudafed and other pseudoephedrine preparations are trying to stave off similar efforts in other states, and viewed Kentucky as a sort of firewall after seeing prescription-only laws pass in Oregon and Mississippi.

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

Makers of Sudafed, similar cold medicines again lead in legislative lobbying expenses, and that doesn't count their radio ad campaign

The Consumer Healthcare Products Association, which is fighting legislation that would limit the amount of pseudoephedrine that could be bought without a prescription, remained the leading spender among lobbying interests at the General Assembly in February, the state Legislative Ethics Commission said in its monthly newsletter.

CHPA, which represents manufacturers and distributors of over-the-counter medicines, spent $192,985 on lobbying in February, and a total of $388,000 for the first two months of the session. Those amounts do not include an extensive radio advertising campaign, which from all indications has cost more than the spending that had to be reported.

Other health-care interests were among the top spenders in February. Ranking second through 11th were the Kentucky Hospital Association ($38,422, for a two-month total of $74,543); the Kentucky Chamber of Commerce ($30,056, two-month total $63,404); Altria (Philip Morris) Client Services ($28,129, two-month $50,434); the Kentucky Farm Bureau Federation ($24,805, total $38,655); AT&T ($24,199, total $47,432); the Kentucky Medical Association ($21,958, total $42,731); the Kentucky Education Association ($21,629, total $45,249); the Kentucky Retail Federation ($21,191, total $45,452), which also opposes the meds-for-meth bill; Kentuckians for the Commonwealth ($18,317, total $34,188) and the Kentucky Optometric Association ($18,227, total unavailable).

Group fighting meds-for-meth bill says it spent nearly $200,000 in January on lobbying, and that apparently omits radio buys

The group fighting a bill that would make the key ingredient for making methamphetamine available only by prescription spent more than $194,000 last month alone to lobby lawmakers, far more than any other lobbying interest at the General Assembly.

The Consumer Healthcare Products Association "reported spending more on Frankfort lobbying for the month than the next eight largest groups combined," reports Tom Loftus of The Courier-Journal. "That's almost an obscene amount of money to be spending on one month on one issue," said Senate Majority Leader Robert Stivers, R-Manchester. Stivers is sponsoring the bill, which would require a prescription for cold and allergy medicine that contains pseudoephedrine.

The group with the second highest spending was the Kentucky Hospital Association, at $36,120.

CHPA "is a group of manufacturers and distributors of over-the-counter medicines whose members include Bayer Healthcare, GlaxoSmithKline and Johnson & Johnson," Loftus reports. In a statement Monday, the group said it is again "efforts by some legislators to deny law-abiding citizens nonprescription access to certain cold and allergy medicines they depend on."

The $194,957.76 spent on lobbying apparently does not include what the CHPA spent on broadcast advertising, which it does not have to report. As of Feb. 3, the group had spent more than $82,000 running ads on Louisville, Lexington and Somerset radio stations owned by Clear Channel Communications Inc., the nation's largest radio operator, according to public-inspection files at those stations, the only ones that have been checked by Kentucky Health News and its journalistic partner, Jonah Engle. In 2011, CHPA paid the Kentucky Association of Radio and Television more than $93,000 to run ads, according to public-inspection files from Cumulus Broadcasting, another major owner of stations in Kentucky.

As for lobbying expenses, more than $12,000 was spent on salaries for three lobbyists, plus nearly $4,000 for food, lodging, beverage and transportation expenses. More than $150,000 was spent "for professional and technical research and assistance," plus nearly $27,000 for "educational and promotional items."

"I'm not surprised they reported so much for lobbying because it's obvious they're doing a pretty good job of getting their message out ... which I believe is a misleading scare campaign," said Sen. Ray Jones, D-Pikeville, who is co-sponsoring the meds-for-meth bill. (Read more)

Pat Boone commercial about Medicare has many inaccuracies

A television commerical misleads seniors into believing the federal health-care reform law will ration and deny care and contains other inaccuracies, according to FactCheck.org, a non-partisan, non-profit service based at the University of Pennsylvania.

The ad features singer Pat Boone and is being aired repeatedly in Ohio (and presumably in Northern Kentucky) by the conservative 60 Plus Association. It claims the Patient Protection and Affordable Care Act will create the Independent Payment Advisory Board, made up of elected bureaucrats who "can ration care and deny certain Medicare treatments so Washington can fund more wasteful spending."Boone says,"Unaccountable bureaucrats should never have the power to deny you the care you deserve."

The board is neither made up of bureaucrats, nor can it ration care. "The IPAB is tasked with finding ways to reduce the growth in Medicare spending," FactCheck reports. "Its 15 voting members won't be bureaucrats, according to the health care law (see page 502); they will be doctors and medical professionals, economists and health care management experts."

The law also says proposals from the IPAB "shall not include any recommendation to ration health care, raise reveneues or Medicare beneficiary premiums ... increase Medicare beneficiary cost-sharing (including deductibles, coinsurance and copayments), or otherwise restrict benefits or modify eligibility criteria."

The ad says the law will cut $500 billion from Medicare, but fails to mention that cut is in the future growth of Medicare over 10 years and will come from the supplemental Medicare plans seniors can buy.  Moreover, though Boone suggests seniors should object to the $500 billion in cuts, they are meant to extend the funding of Medicare Part A by 12 years.

The ad also states Medicare will be bankrupt in nine years. "The truth is that Medicare Part A — the hospital insurance trust fund, one of four parts of Medicare — is expected to be insolvent by 2020, according to the projections from the Congressional Budget Office, or perhaps 2024, according to the Social Security and Medicare Boards of Trustees," FactCheck reports. "Shortfalls have been projected for Part A 'almost from inception,' says a Congressional Research Service report," but Congress has always found a way to extend the program. (Read more)

Link found between kids watching food-based TV commercials and childhood obesity

Watching TV commercials, not the sedentary act of watching TV itself, contributes to obesity in children, according to a study published by the American Journal of Public Health.

The study found that the average child sees about 4,000 television commercials advertising food each year. During Saturday morning cartoons, kids see a food ad about every five minutes. Of that food advertised, about 95 percent of it is of poor nutritional value.

In the study, Associations of Television Content Type and Obesity in Children, researchers followed children from 1997 to 2002 to observe how different types of television might affect obesity rates. They found "television advertising, rather than viewing per se, is associated with obesity." During the five-year period, children saw an increasing amount of commercials and a decreasing amount of non-commercial programming. (Read more)