Christian County Public Schools ban brought-in fast food as part of an effort to battle childhood obesity, a big problem in Ky.

Fast food is no longer a lunch option for students in Christian County Public Schools, Margarita Cambest reports for Kentucky New Era after the Board of Education voted to ban "commercially prepared, restaurant meals" Tuesday. Parents have been bringing fast-food meals to schools, even though 14 schools offer free meals under a federal program.

"Prepared foods must now be put in a non-identifiable container to pass the cafeteria doors—essentially meaning no logos," Cambest reports. "Takeout containers and bags must be discarded, and the food placed in a lunch box or brown bag if brought from home. Soda is out as well. The consumption of bottled or canned carbonated beverages during meal times is also forbidden."

Sandra McIntosh, the system's food-service director, "said the decision allows her to enforce a federal mandate that has been questioned by some local principals," Cambest reports. But then she notes that the federal school-lunch program "leaves the authority to control the sale of foods in direct competition with the national program with state and local agencies, according to the United States Department of Agriculture," which runs the program.

Changes in the program, which McIntosh said have made meals "more nutritional" by having "lower fat, more whole-grain and more dark green and red vegetables, have been unpopular with many students and parents.

A study by USDA's Economic Research Service in 2005 showed that "Students in schools that offered greater quantities of fruits and vegetables consumed more of these foods by most measures." And fast food has more calories. Research at the Yale Rudd Center for Food Policy and Obesity says on days that children eat fast food, they consume 126 additional calories and teens consume 310 more calories. The center says 33 percent of children and 41 percent of teens consume fast food daily.

Kentucky children rank third worst among the states for in obesity, with 37.1 percent of them considered either overweight or obese, according to the Child Policy Research Center.

Health reform should make Medicaid and Medicare more interested in preventing chronic diseases in young, expert says

Dr. Wayne Myers

While some rural areas may not have enough doctors (or those who accept Medicaid patients) to treat new patients generated by federal health reform, the key to healthy living is more education, not more physicians, rural medical expert Dr. Wayne Myers opines in The Rural Monitor. As an example, Myers points to Hazard and Perry County, where he once worked. The Appalachian county leads the nation in shortest average life span for women (72.65 years) and is third shortest for men (66.52 years) despite having an abundance of doctors and health facilities. The reason, Myers says, is bad habits that lead to unhealthy lives, something no amount of medical attention can cure.

"In Perry County, as in much of America, medical care is losing to unhealthy behavior," Myers writes. "Clinicians aren’t trained, nor is our clinical system structured, to accomplish changes in long-term cultural behavior, or to respond to the needs of groups of people. Certainly the 15-to-20-minute acute-care visit is a poor situation to try to work with a person on diet, level of activity, his/her addictions. We can’t modify family and social patterns with tools developed to treat strep throat, sprained ankles or breast cancer."

Myers, who headed the federal and Kentucky rural-health offices, said the solution is education at the local level, with "a lot more health educators, community health nurses and nutrition educators" that are trained within the community. Areas with community colleges can build partnerships with schools to receive training, he suggests. His hope is that the Patient Protection and Affordable Care Act will provide the resources and motivation necessary to bring about changes.

As the law generates enrollees, the Center for Medicare and Medicaid Services’ "book of business will shift from old people on Medicare toward younger people on Medicaid," he writes. "When the main business of CMS was Medicare, the rational business strategy was to seek the most economical quality care for those with only a few years to live. As the business shifts toward Medicaid and subsidized private insurance customers, the rational business strategy for CMS shifts toward preventing chronic disease. From an insurer’s point of view, a 70-year-old obese hypertensive diabetic is a self-limited problem. She’ll die soon. A 30-year-old with the same diagnoses will be a very long-term financial drain.  It will be good business for CMS to keep their 'covered lives' healthy."

This, he said, is kind of forward thinking we need to ensure young Americans get healthy. "We need new approaches to keeping people healthy, instead of trying to heal them after they get sick," Myers writes. "Clinicians can’t change the way people live and raise their kids, even if some of the choices the parents make turn out to be pretty dangerous for the kids. These are sensitive life and death issues. We need to tackle them." (Read more)

UK gets biggest-ever grant from National Institutes of Health to probe links between obesity and cardiovascular disease

The University of Kentucky has received its largest-ever National Institutes of Health grant to explore connections between two of the state's biggest health problems, obesity and cardiovascular disease.

Dr. Lisa Cassis
directs the program.

The university's Center of Biomedical Research Excellence "supports research of promising junior faculty focused on identifying mechanisms linking the epidemic of obesity to a high prevalence of cardiovascular diseases," a UK press release said. The faculty support helps the researchers compete for new NIH grants. In the first phase of the program, 90 percent competed successfully, and they published 500 study reports.

"Research to be executed under the present grant runs the gamut from laboratory research conducted at the cellular level, to bedside translational research conducted in pediatric and adult patients," the release said. "Projects focus on mechanisms for the development of obesity, the influence of obesity on recovery of the heart following a heart attack, obesity-induced inflammation, and how this influences the cardiovascular system, and imaging of heart dynamics and function in obese children."

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."

Kentucky, in Diabetes Belt, needs to do more to keep percentage of residents with costly disease from rising, advocates say

By Dr. Gilbert Friedell and Isaac Joyner

World Diabetes Day is Nov. 14, and we urgently need to address this plague right here at home. Diabetes is a major public health problem — an epidemic — in the United States. One out of 10 people over the age of 20 now has diabetes, primarily Type 2 or “adult onset” diabetes, and the disease is rapidly increasing. This increase has been particularly striking in the several Southeastern states comprising what the federal Centers for Disease Control and Prevention calls the “Diabetes Belt.”

PERCENTAGE
OF ADULTS

In Kentucky, one of eight people now has the disease — a frightening fact. Even more frightening: one-fourth of those with diabetes do not know they have the disease! If this epidemic is not interrupted, by 2050 about one out of three people in this country will have diabetes. For minorities, that figure will be closer to one out of two.

Diabetes itself poses a significant health problem, but the real burden of the disease is its complications. The high blood-sugar levels characteristic of diabetes, plus the effects of high blood pressure and elevated cholesterol levels, damage both small and large blood vessels. Over time, those with diabetes frequently go blind, have a toe or foot amputated, lose kidney function and frequently die of a stroke or heart attack. These complications are BAD: blindness, amputations and dialysis.

The cost of diabetes is staggering. In 2025 its annual direct and indirect cost to the country is projected to exceed $500 billion. Here’s what we need to do about this epidemic.

First, we need to focus on primary prevention of the disease, and that means stressing proper nutrition and regular exercise. Early childhood is the time to begin good dietary habits, and the conscious selection of food for school snacks and lunches provides an excellent opportunity for establishing these habits.

With young people and adults, a structured program of weight loss and exercise can prevent the onset of diabetes among about half of the overweight population that has elevated but not diabetic levels of blood glucose.

At the community level, we need active engagement by local health departments and officials interacting with the population. We recommend the creation of broad-based Community Diabetes Control and Prevention Councils, with health providers, business leaders and teachers, along with diabetes patients and their advocates.

At the state level, we need mandatory screening of all adults, and mandatory reporting of all new cases of diabetes to a state diabetes registry. Strong support from the federal government must be provided for these efforts, and for local health departments.

Diabetes prevention will require a significant change in the behavior of patients, health providers, communities and government. This will not be easy, but the current fragmented way in which we deal with diabetes is not working. It is long past time for greater public recognition of the grave threat that the diabetes epidemic poses — and for a rational, coordinated response to it.

Gilbert Friedell and Isaac Joyner, of Lexington, are co-authors of The Great Diabetes Epidemic: A Manifesto for Action.

November is National Diabetes Month; here are some tips to stay healthy and keep the disease from stealing your vision

November is National Diabetes Month, and if you're one of more than 370,000 Kentuckians with the disease, in addition to watching your diet and keeping track of your blood sugar, it’s also important to have regular eye exams.

A comprehensive dilated eye exam can catch
diabetic eye disease early, before symptoms appear

Diabetic eye disease is the leading cause of vision loss among working-age Americans, says a release from the National Institutes of Health.  Diabetic retinopathy is the most common form of this disease, affects=ing more than 7 million Americans, a number that is expected to reach 11 million by the year 2030.

Since diabetic retinopathy has no symptoms until it reaches an advanced stage, it is important to get regular dilated eye exams so it can be detected early, says the release. Fortunately with early detection and timely treatment, the risk of severe vision loss from the diabetic retinopathy can be reduced by 95 percent.

If you have diabetes, controlling the disease will reduce your risk of developing diabetic eye disease. It’s now a good time to remember these health tips too:

• Get a comprehensive dilated eye exam at least once a year. 
• Tell your doctor if you're feeling down or if your eyesight changes.
• Control your blood sugar, blood pressure and cholesterol levels.  
• Take your medicine even when you feel Ok.
• Be active for 30 to 60 minutes on most days of the week.
  
• Eat healthy foods like:
• fruits, vegetables, fish, lean meats and poultry, dried peas or beans, lentils, and low-fat or skim milk and cheese
• whole grain foods such as whole wheat bread and crackers, oatmeal, brown rice, and cereals
• food prepared with little added fat, oil, salt, or sugar
• smaller servings of meat, fish, and poultry
• larger servings of fruits and vegetables. 

Click here to learn more about diabetic eye disease from the National Eye Institute. Click here to learn more about preventing and managing diabetes from the National Diabetes Education Program or here for additional tips on staying healthy with diabetes.

Free-for-all food program increases student participation, raises Ky. breakfast count by 25% with only 39% of districts participating

Kentucky schools participating in a program that provides free breakfast and lunch to all students in high-poverty schools have significantly increased student participation in school lunch and breakfast programs, Charles Edwards reports for Education Week.

Schools participating in the "community eligibility option" have increased student participation by 13 percent in the lunch program and 25 percent in the breakfast program during the first two years of its availability and eliminated significant administrative costs, according to the Washington-based Food Research Action Center and the Center on Budget and Policy Priorities.

Collectively, Illinois, Kentucky and Michigan achieved a 25 percent increase in breakfast participation over the first two years, Education Week reports.

Of the 174 school districts in Kentucky, 68 participate in the community eligibility option, Nancy Rodriguez of the Kentucky Department of Education told Kentucky Health News. That is 39 percent of the public school districts. One private school also participates.

The program allows high-poverty schools to serve all students free breakfasts and lunches without individually identifying children as eligible. Schools get about the same amount of reimbursement from the Department of Agriculture that they did under the existing system—but without the paperwork. The reimbursement is based on the total number of meals served.

The school nutrition director at Ballard County, a participant in the "community eligibility option," told Whitney Jones of WKMS-FM, Murray State's NPR station, that the district saves $500 per year per student eating both breakfast and lunch at school.

The traditional way to determine eligibility for free or reduced breakfast and lunch required families to fill out a parent-income survey, which discouraged some from enrolling. The new eligibility option has been rolled out incrementally since it was authorized by Congress in 2010, and all eligible schools in the country may participate beginning in the 2014-15 school year.

Now, the percentage of a school's children who are already enrolled in other federal need-based program or are homeless, migrant, in Head Start or in foster care, determines the eligibility of the school, reports Edward. If a school has an enrollment of at least 40 percent of such directly certified children, it is eligible. Some districts combine all their schools to include those that are below 40 percent.

Participation in the program has exceeded the original expectations, with more than 2,200 schools signed up in the first seven states allowed to participate. The original projection estimated 300 schools would participate over 10 years, Education Week reports.

Schools and students are still getting used to lunches that are healthier but not as suited to their tastes

School lunches look and taste different than they did before new federal nutrition standards kicked in, and that has caused more food to end up in garbage cans and more students to bring a lunch from home, according to an article from the October issue of Kentucky School Advocate, a magazine published by the Kentucky School Boards Association.

"We're serving more and it's going in the garbage," Estill County school food service director Belinda Puckett told KSBA reporter Madelynn Coldiron. "The (students) have to take a fruit or a vegetable and it's going in the garbage."

Others think that with time, students will adapt to the new menu, which has more whole grains, fruits and vegetables, and fewer calories and sweets.

"It really is the same food, just a little different presentation," said the state Department of Education's Valerie Crouch, who provides technical assistance and training to food service directors, told Coldiron.

The biggest challenge, Marshall County school food service director Beth Cunningham said, "is the speed at which we have had to adopt this. . . . Kids don't like change."

The timetable for transition to the new menus was short, so kids had to adjust quickly, Sabrina Jewell of Henderson, president of the Kentucky School Nutrition Association. She said food suppliers hadn't perfected offerings that would meet the guidelines, but the products have since improved, Coldiron reports.

Many schools have seen a decline in the number of students eating school meals, with some districts dropping as much as 10 percent to 20 percent, according to Jewell.  This translates into a loss of federal reimbursement dollars for those meals not purchased, Coldiron notes.

Smaller districts are affected more deeply by fewer lunches being purchased, because any small change makes a big difference in a small budget.

The state surveyed food service directors to determine the reason for the drop in participation, but the survey had too many variables to pinpoint a single factor, Crouch told Coldiron. Two variables were an increase in the cost of lunch in some districts, and an increase in the number of schools joining a federal program that provides free meals to all students regardless of income.

Budget challenges add yet another dimension to the new federal nutrition guidelines, Coldiron reports. "Fresh produce costs more than canned or frozen," said Jewell, whose Henderson County bill for produce doubled last year.

Another concern is that the students are still going home hungry.

"We have a 68 percent free and reduced lunch rate," said Puckett, of Estill County. She told Coldiron that parents are complaining about children coming home hungry. "I think they need to come look at these kids who aren't eating and they're not getting enough to eat like what they used to."

Plans are in place this year to make new recipes and food displays to encourage kids to eat, Jewell said.  Students who reject school meals are either bringing their lunch from home or not eating at all, and neither is a good outcome, Jewell told Coldiron.

"We don't get to police their lunchboxes," she said. "It's whatever is sitting on the shelf: high carbs, high fat, low nutritional value." (Read more)

Using food labels and other guidance helps you control weight and reduce risk of cardiovascular disease, FDA study finds

Food labels and dietary guidance help consumers make healthier choices and lose weight, according to a study for the U.S. Food and Drug Administration.

The FDA's Joanna Parks used data from the National Health and Nutrition Examination Survey to estimate the effect of labels and guidance on the intake of 18 nutrients. She found that people who used the Nutrition Facts panel on food labels consumed about 120 fewer calories per day, enough to explain at least an 11-pound difference in body weight between them and those who didn't use the information.

Parks also found that using health claims, ingredient lists and serving-size information appears to reduce risk of cardiovascular disease, including high blood pressure, and help weight-control efforts; and using the MyPyramid meal panel decreases the average daily intake of cholesterol.

"Unfortunately," Parks writes, "it appears that many individuals only use these tools and information once they have developed diet-related diseases that necessitate changes in diet and lifestyle." A PDF of her paper can be downloaded here.

Kentucky has nation's first statewide, comprehensive plan for diabetes prevention; 10 percent of us have the disease

Kentucky leads the way in the fight against diabetes and towards improving health for future generations of Kentuckians by becoming the first state to legislatively require a statewide, comprehensive action plan for addressing this disease epidemic.

Over 500,000 Kentuckians, 10 percent of the state’s population, are living with diabetes, costing the state about $4.8 billion a year in direct and indirect medical costs, write R. Stewart Perry and Larry Smith, co-chairs of the American Diabetes Association's national board of directors, in an op-ed piece in The Courier-Journal. While it hasn't been widely reported, state policymakers recently tackled the issue.

In 2011, the General Assembly passed a law (KRS 211.752), sponsored by Sen. Tom Buford, R-Nicholasville, and Rep. Ruth Ann Palumbo, D-Lexington, directing the Cabinet for Health and Family Services to report every two years on the impact of diabetes on the commonwealth.  The report must include the scope of the disease, its costs and what state government is doing about it.

The law requires the Department for Medicaid Services, the Department for Public Health, the Office of Health Policy and the Personnel Cabinet to “collaborate to identify goals and benchmarks while also developing individual entity plans to reduce the incidence of diabetes in Kentucky, improve diabetes care, and control complications associated with diabetes,” Perry and Smith note.

Such reporting will encourage the development of prevention strategies that are more effective and efficient, representing an unprecedented, coordinated effort against diabetes, they write. Many other states are using Kentucky’s plan as a model for legislation. "We call on every Kentuckian to enlist in the effort to step up the fight against diabetes," they urge.

Statewide forum on community efforts to promote children's health will be held in Northern Kentucky Monday, Sept. 16

"The goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort," veteran Kentucky broadcaster Greg Stotelmyer reports for Public News Service.

Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, main sponsor of the forum, told Stotlemyer that its title, "Communities Connecting for Healthier Kids," sends the message that everyone has a role to play in improving health, “whether it's fast food outlets that are offering healthy alternatives, whether it's state parks that are offering healthy kid friendly meals made with local produce, whether it's employers who gently encourage employees to use the steps.”

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., who will be a headline speaker at the forum, told Stotlemyer it takes leadership and vision to grow community health. “The faith community, the schools, the neighborhoods you know, all have something at stake here,” he said. “And by working together for community health, everyone benefits.” Cohen said a study in which his organization was involved found that for every $1 spent on community prevention of health problems, $6 could be saved. (Read more or listen)

Other speakers include David Jones Jr., member of the Jefferson County school board and former chairman of the Humana Inc. board of directors; and Daniel Hatcher, healthy out-of-school time adviser at the Alliance for a Healthier Generation. The conference is the latest of the foundation's annual Howard L. Bost Memorial Health Policy Forums, and is free to the public. For more information, click here. For a conference agenda, go here. To register, here.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpuf

Some parents complain about healthier school lunches, but USDA says it's on course to improve public health

A few school districts in other states are opting out of a federal-funded school lunch program that was touted by first lady Michelle Obama to provide healthier options to students, and some parents in Harlan County are complaining about the new menus. But the U.S. Department of Agriculture, which runs the National School Lunch Program, says the naysayers are in a small minority and the healthier fare will become more popular and improve public health.

That is backed up in a study forUSDA's Economic Research Service of 2005, showing that "Students in schools that offered greater quantities of fruits and vegetables consumed more of these foods by most measures." During the 2012-13 school year the lunch program increased servings of fruits, vegetables, whole grains and fat-free or low-fat milk, while setting standards for calorie content and reducing intakes of sodium and trans fat. Students are allowed to eat as much fruit and vegetables as they want. The full report can be read here. (USDA graphic)

Districts from Kentucky to Illinois to New York have complained that students aren't interested in the healthier foods, leading students to buy fewer school meals, which costs the school districts who rely on federal reimbursements. But the number of districts opting out could be minimal. The School Nutrition Association "found that 1 percent of 521 district nutrition directors surveyed over the summer planned to drop out of the program in the 2013-14 school year and about 3 percent were considering the move," Carolyn Thompson reports for The Associated Press. There were 31 million students in the program in 2011.

So many students and parents have complained in Harlan County that the school board held a special meeting to address the issues, Mark Bell reports for the Harlan Daily Enterprise. "Complaints ranged from not being fed enough to food received not being good enough. While fruits and vegetables are offered freely and students can take their fill of those, meats and carbohydrates will continue to be served in limited portions only, so students complain of not getting enough food."

In Spencer County, there were no complaints about the food, just a price increase of 10 cents for lunches, to $2.30 ($2.45 at the high school) that school officials attributed to the 2010 federal law. District Director of Operations and Transportation Brett Beaverson wrote in a school-board agenda item, "The logic behind the mandated increase is to eventually equal the difference between the reimbursement rate ($2.86) and the full-pay lunch price." Malloy Bilger reports for the Magnet, "Beaverson said failing to pass the increase would make it appear that the federal government was subsidizing full-pay lunches." (Read more)

Overall, schools are getting healthier, according to a report released Monday by the Centers for Disease Control and Prevention. Since 2006, "the percentage of districts that required schools to prohibit offering junk food in vending machines increased from 29.8 percent to 43.4 percent . . . and the percentage of districts with food procurement contracts that addressed nutritional standards for foods that can be purchased separately from the school breakfast or lunch increased from 55.1 percent to 73.5 percent." states the CDC. "Between 2000 and 2012, the percentage of districts that made information available to families on the nutrition and caloric content of foods available to students increased from 35.3 percent to 52.7 percent." (Read more)

Community-based solutions to childhood obesity show signs of progress elsewhere; will Kentucky pick up on them?

By Molly Burchett
Kentucky Health News

For decades, researchers reported with alarm the increasing trend of overweight children in America, with one in three kids on the way to developing Type 2 diabetes. Across the country, action has been taken to address this problematic trend, and now some preliminary, scattered results indicate that obesity rates have plateaued or dropped in some areas. Is Kentucky part of this success, and if not, will it learn from it?

The first set of positive signs came last year, with falling child obesity rates in New York City and Philadelphia, reports Lydia DePillis of The Washington Post. And, a recent Robert Wood Johnson Foundation brief shows similar progress in states with a large rural population as well:

• Mississippi posted a decrease from 43.9 percent of kids being overweight and obese in 2005 to 40.9 percent in 2011, three years after passage of the Mississippi Healthy Students Act. 
• In North Carolina, Vance and Granville counties saw significant declines after implementing healthy living programs based on the Centers for Disease Control’s community guide.
• Kids in Kearney, Neb., in grades one through five saw a 13.5 percent decline in obesity rates between 2005 and 2011.
• West Virginia fifth graders posted a 8.6 reduction in obesity rates over a six-year period.

Overall, progress was made through community-based solutions, including changes to make healthy foods available in schools while eliminating fried foods and working to integrate physical activity into people's daily lives while educating them about the importance of doing that, says the brief.

Kentucky, which suffers from one of the highest childhood obesity rates in the country, could learn from these successful programs. The state ties Mississippi for the highest percentage of youth in grades 9 to 12 that are obese (18 percent) and has the third highest percentage of children ages 10 to 17 who are obese (21 percent), compared to 16.4 percent nationally, says a report by Kentucky's Task Force on Childhood Obesity.

The Kentucky General Assembly has not enacted legislation regarding healthy eating and physical activity like many other states, notes a National Conference of State Legislatures report, but established a task force that made various recommendations to the legislature in September for strategies that address the problem of childhood obesity and that encourage better nutrition and increased physical activity among Kentucky children.

Some of the task force's recommendations include: requiring schools to improve nutritional content of school food, including promoting the use of school gardens, adopting a statewide standard for physical activity initiatives and nutrition education in schools and encouraging physical activity through a coordinated school health program. To view that report, click here.

Kentucky has no requirements for physical activity in schools. About 65 percent of Kentucky's youth did not attend physical-education classes in 2010, and 80 percent did not attend such classes five days per week, says a 2011 Center for Disease Control and Prevention survey.

However, the state does have several programs to promote physical activity or healthy eating. They includes the Farm to School program, which has been adopted by 1,243 schools and 174 school districts and is a collaborative effort between federal and state agencies to bring local agricultural products to schools and to educate students about local food production, says the report.

Using the success of other state programs and existing Kentucky programs as a guide, Kentuckians and "the members of the Task Force on Childhood Obesity are encouraged to continue their advocacy efforts to address Kentucky’s health crisis in ways that have the greatest likelihood of preventing and reversing chronic diseases associated with childhood obesity," says the report.

Kids' excessive salty snacks are linked to obesity, high blood pressure; new limits on school vending items may help

As new research shows that America's child-obesity epidemic is linked to eating too many salty snacks,  new federal regulations could ensure that vending-machine snacks in Kentucky's schools are healthier and lower in sodium.

Spurred by children eating too much salt and being too fat, "blood pressure in America's kids and teens has gone sky-high," creating a young generation at risk for serious health problems, including heart disease, stroke, reports Brian Alexander of NBC News.

“Kids eat far too much sodium,” the study's co-author, Dr. Stephen Daniels told NBC. “And they aren’t adding it at the table, and their parents aren’t putting it into food; they’re getting it through processed foods.” The research, published Monday in the journal Hypertension, links this rising blood pressure to children's increasing bod- mass index and sodium intake.

The "Smart Snacks in Schools" nutrition standards, announced last month by the Department of Agriculture, require any food sold in public schools to meet calorie, fat, sugar and sodium limits. The changes shouldn't be very significant for Kentucky students because the state already prohibits vending machine sales during the school day. And, a few existing state regulations, like fat content, are tougher than the federal changes and will remain in place, Sue Bartenfield, nutrition program manager for the Kentucky Department of Education, told Stu Johnson of the Kentucky Public Radio bureau in Frankfort. The new federal limits on calories and sodium are tighter, and the federal law will also keep vending machines shut down for a half-hour after school, Bartenfield told Johnson.

AMA calls obesity a disease; could spur coverage for treatment

The American Medical Association now recognizes obesity as a disease, which may make it easier for Kentuckians to fight the state's obesity epidemic by gaining insurance coverage for necessary medical treatment. Under the leadership of newly elected President Ardis Hoven of Lexington, the physicians' group voted to approve this new obesity policy June 18 during its annual meeting in Chicago. Click here to read the report by the AMA’s Council on Science and Public Health.

Kentucky ranks 10th highest in the U.S. for adult obesity, and the state's obesity rate is predicted to jump from 30 percent in 2011 to more than 60 percent in 2030. This year, $2.3 million is expected to be spent on medical costs linked to obesity, and that number is estimated to rise to $6 billion in 2018, says a report by the College of Public Health at the University of Kentucky.

Read more here: http://www.kentucky.com/2012/09/24/2349167/recent-report-on-kys-obese-future.html#storylink=cpy

Being overweight or obese greatly increases the risk of developing other chronic diseases like diabetes, stroke, arthritis, sleep apnea, asthma, heart attack and certain cancers or other complications like asthma, joint problems and psychological issues, says the report. Kentucky children also suffer from high rates of obesity, and if the current trend continues, one in every three American children will develop Type 2 diabetes.

"Recognizing obesity as a disease will help change the way the medical community tackles this complex issue," AMA board member Dr. Patrice Harris said in a statement. Although Medicare and Medicaid do cover obesity treatment associated with another disease or disorder, they do not cover interventions and counseling about lifestyle changes necessary to fight obesity. The AMA declaration could lead to coverage and help increase funding for obesity research, reports Jacque Wilson of CNN. With the AMA now calling obesity a disease, "insurers can stop ducking their responsibility" in paying for obesity treatments, Dr. Virginia Hall, an obstetrician from Hershey, Pa., said in a Forbes magazine report by Bruce Japsen.

Also, identifying obesity as a disease help reduce the stigma often associated with being overweight, Joe Nadglowski, president of the Obesity Action Coalition, told Wilson. "Obesity has been considered for a long time to be a failure of personal responsibility -- a simple problem of eating too much and exercising too little," he said. "But it's a complex disease. . . . We're hoping attitudes will change."

Mayors and AMA say food stamps shouldn't pay for soft drinks

Louisville's Greg Fischer is among 18 mayors asking Congress to ban sugary drinks from purchase under the Supplemental Nutrition Assistance Program, commonly called food stamps.  One day after their June 18 letter, the American Medical Association adopted a policy supporting the removal of sugar-sweetened drinks from SNAP.

In a the letter sent to congressional leaders, the mayors said it is "time to test and evaluate approaches limiting" the use of the subsidies for sugar-laden beverages to fight obesity and diseases linked to obesity, reports Jennifer Peltz of The Associated Press.

At its annual meeting, the AMA took several steps toward controlling the country's increasing obesity problem, including calling obesity a disease, an action that may prompt insurers to cover medical treatments aimed against obesity. “The AMA is working to improve the nation’s health care outcomes, particularly cardiovascular disease and diabetes, which are often linked to obesity,” said AMA President Dr. Ardis Hoven of Lexington. “Removing sugar-sweetened beverages from the Supplemental Nutrition Assistance Program will help encourage healthier beverage choices.”

This isn't the first attempt to ban soda from SNAP. The Department of Agriculture, where the program is housed, turned down such a request from New York City's Mayor Michael Bloomberg in 2010. The city had proposed a two-year experiment to see if a sugary beverage ban would reduce obesity among food-stamp recipients. But, the department rejected the plan and said a soda ban would “perpetuate the myth” that food stamp users make poor shopping decisions, The New York Times reported. Read about Kentucky's SNAP program here.

The soda lobby, the American Beverage Association, said sugary drinks shouldn't be singled out as a cause of obesity. It called obesity "a complex health condition that affects Americans of all income levels." Last year, more than 47 million low-income Americans used food stamps.

Read more here: http://www.kentucky.com/2013/06/18/2683656/18-mayors-limit-use-of-food-stamps.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/06/18/2683656/18-mayors-limit-use-of-food-stamps.html#storylink=cpy

Covington schools show 'Fitness Rocks' by lowering body mass, lifting the bars of nutrition, wellness and academic achievement

Sparks are flying in Covington Independent Schools. The schools' Fitness Rocks program, which combines fitness and wellness activities in an after-school program four or five days a week to create a healthier community for students, is the reported cause of fire.

The district's after-school student activities are based on the SPARK (Sports, Play and Active Recreation for Kids) curriculum for out-of-school-time, and the district reports great success since the program launched three years ago.

Since then, students' body mass has shrunk 4 percent, and there has been a 6 percent increase in the number of students who engage in at least an hour of daily physical activity and the number of students eating fruits two or more times a day, and vegetables three or more times a day, reports Julie Wohlleb of the Kentucky School Boards Association.

Students in Fitness Rocks also saw a greater increase in their math and science MAP (Measure of Academic Progress) scores than students not participating. “It’s been demonstrated how students who are active 60 minutes or more a day have increased academic success,” Haggard told Wohlleb.  

The program is also being used for professional development for physical education teachers, and "The SPARK curriculum has been really helpful in giving our fitness coaches and PE teachers ways to get all kids engaged no matter their skill level,” Haggard told Wohlleb.

The district started Fitness Rocks three years ago at each of its seven schools through a Carol M. White Physical Education grant from the U. S. Department of Education. The program encourages a range of activities to keep students active, from playing flag football to video games, and so far, 55 percent of elementary students and 19 percent of high school students across the district have participated in the program this year.

In addition to after-school activities, Fitness Rocks provides healthy snacks and sponsors family nights at every school that focus on fitness, wellness and nutrition, and program coordinators are witnessing changes in health behaviors across the district. “We’ve been really working hard, especially this year, at finding a sustainability model because it has been so impactful for the community and parents and students alike; they just love it,” Haggard said. (Read more)

Floyd County newspaper editor calls on readers to make lifestyle changes to address area's diabetes health crisis

The editor of an Eastern Kentucky newspaper has joined an advocacy group's call for residents in his county to make simple, healthy lifestyle changes, serving as an example of how local newspapers and community members can engage the public to confront poor health status of the area, which is often put on the back-burner despite alarming warning signs.

Recently, the Tri-County Diabetes Partnership declared the rate of diabetes in Floyd, Johnson and Magoffin counties (map) "a crisis of epidemic proportions." The rate in 2002-10, the latest available, was 14 percent.

If the federal Centers for Disease Control and Prevention "saw a similar increase in any other illness, they would probably declare a national emergency,” said J.D. Miller, vice president of medical affairs for Appalachian Regional Healthcare, who chaired the meeting.

The group's statement was an appropriate response to direct public's attention to the imperative of addressing the area's skyrocketing rate of the disease, Ralph Davis of The Floyd County Times wrote in an editorial.

Diabetes will remain a crisis unless we do something about it, said Davis, and "if you have been waiting for a crisis before making healthy lifestyle changes, we’ve got one for you. In fact, we have several," Davis said.

The Central Appalachian region suffers from disproportionate rates of diabetes, cancer and heart disease, and Floyd, Magoffin and Johnson counties have much higher rates of obesity than state and national averages, Davis notes. Floyd County ranks last among the state’s 120 counties in overall health measures, and Johnson and Magoffin counties are ranked 108th and 104th, respectively.

To do something about this problem, Davis calls for concentrated attention by health care providers and government officials, but the problem won't be solved without action from the community and individuals, he says. Simple, healthy lifestyle changes are needed.

"It’s going to require the conscious decision by everyone in the region to do what they can to improve their diet and exercise habits, and to encourage their friends and family to do the same," said Davis.

Calls like Davis's are needed even more in most of the counties that surround the three counties, based on data from the CDC's Behavioral Risk Surveillance System. The counties in dark blue had rates above 14 percent; the highest was Greenup, at 17 percent.

Medicaid expansion would have 'a big health impact,' and critical-access hospitals need to change, rural-health expert says

Expansion of the Medicaid program under federal health-care reform would have a major beneficial impact on the health of Kentucky, a doctor who ran the state and national rural-health agencies told a rural-health meeting in Louisville Tuesday.

"Medicaid expansion has a big health impact," Dr. Wayne Myers, left, told those at "Doing Care Differently in Rural Kentucky," a seminar sponsored by the Foundation for a Healthy Kentucky and the Kentucky Rural Health Association in Louisville, just before the opening of the National Rural Health Association's three-day conference in the city.

Myers said that in the three states that expanded Medicaid eligibility since 2000, one life was saved for every 176  people added to the program, according to a study by the Harvard University School of Public Health, published in the New England Journal of Medicine. If that figure were extrapolated to the entire nation, the number of lives saved would be greater than if breast, prostate and stomach cancer were eliminated, Myers said.

Skeptics argue that Kentucky can't afford the estimated 6.3 percent annual cost increase for expanding Medicaid eligibility up to 138 percent of the federal poverty level, but Myers said, "It would be nice to shift that argument from dollars to health impact." He said that if the three cancers were curable with a certain amount of money, and you argued that the nation should not spend it because of the cost, "You'd have an uphill argument."


Myers also said Eastern Kentucky would be an ideal place for Medicaid and Medicare to start rewarding small, rural hospitals for increasing their role in health promotion and disease prevention.

The federal designation of "critical access hospital" has kept open many rural hospitals, which get greater Medicare and Medicaid reimbursements in return for limiting beds, procedures and patient stays, but President Obama's proposed budget calls for revoking the CAH status of some hospitals, and rural political clout has declined with the rural share of the nation's population, Myers noted.

"The old models aren't working too well," Myers argued, saying "What people don't realize is that [critical-access] hospitals get three-fourths of their money from the outpatient department" and have relatively few traditional admissions. He said half of them have fewer than four acute-care patients per day, and fewer than two patients who are recuperating or getting skilled-nursing care.

Then he displayed maps showing that life expectancies of rural Americans are not keeping pace with the rest of the country, and in some areas, including Eastern Kentucky, are declining. "That's really scary," he said.

Myers said those trends mean that CAHs should add health promotion and disease prevention to their job description, and Medicare and Medicaid -- which provide 85 percent of their revenue -- should pay them for performing that function.

He said hospitals have space, expertise and equipment to serve as exercise and medical-education centers, while most rural health departments are "overwhelmed" with a wide array of duties.

The federal payments for disease prevention and health promotion could be limited to hospitals in counties that have a certain percentage of their population on government-subsidized insurance, he said.

"If it makes sense anywhere, does it not make sense in Kentucky?" Myers asked, reiterating the question to focus on the state's Fifth Congressional District, which he said has the nation's lowest life expectancy. When a questioner mentioned the district's congressman, House Appropriations Committee Chairman Hal Rogers, Myers suggested the program could be named for the Somerset Republican.

Other speakers at the seminar called for new approaches in rural health, despite obstacles.

"Change is not easy. . . . Almost all federal policy tends to shortchange rural, at least initially," said Craig Blakely, dean of the University of Louisville's School of Public Health and Information Sciences.

He said two important targets for prevention activities in rural America are smoking and obesity, which he said is exacerbated by high soft-drink consumption. Soft drinks are a $57-billion-a-year industry, jhe said, "so there's a lot of pushback we're going to be facing if we want to take that on."

Blakely added that much of rural America is poor, and that is associated with poor health, so rural health providers also need to focus on education and employment opportunities for their communities.

To keep kids from getting fat, use smaller plates and portions, limit TV viewing and make sure they get 10 hours of sleep a night

Kentucky ranks high in child obesity. Parents can make sure their children maintain a healthy weight with three simple suggestions highlighted in recent studies: Serve them meals on smaller, child-size plates, pay attention to what they watch on TV, and make sure they get enough sleep.

In Kentucky, almost 18 percent of middle-school-age children and 16 percent of elementary-age kids are obese, and every third child born who was in the U.S. in 2000 will develop Type 2 diabetes if current trends continue, says a recent report from the University of Kentucky's College of Public Health.

The three suggestions are based on three new studies in the April issue of Pediatrics.

One study found first-graders served themselves larger food portions and consumed almost 50 percent of the extra calories they put on their plates when using adult-sized dinner plates instead of child-sized salad plates, reports Michelle Healy of USA Today.
A second study examined the relationship between heavy use of media  and increased body mass index,  a measure based on height and weight that can classify someone as being overweight or obese. It found that TV usage is the most problematic and leads to higher BMI scores, reports Healy. One reason for this may be that TV advertising includes commercials for unhealthy snack foods. Or, perhaps kids are missing out on exercise because they watch so much TV. 

A new sleep study adds to research saying that insufficient sleep may contribute to the rise in adolescent obesity because it changes hormone levels that could lead to overeating and weight gain, reports Healy.

These findings support existing recommendations to help children attain and keep a healthy weight according the UK report. Portion sizes should be a third of adult portions for younger children and two-thirds of adult portions for older children; children's TV screen time should be limited to two hours per day; and children should get 10 hours of sleep each night.