Bariatric Times

NOV 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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27 News and Trends Bariatric Times • October 2017 NEW REPORT FINDS PROGRESS TO PREVENT OBESITY AT RISK WASHINGTON, District of Columbia—Adult obesity rates are showing signs of leveling off, a ccording to the 14th annual State of Obesity: Better Policies for a Healthier America report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF)—but progress could be eroded if programs are cut and policies are weakened. This year, adult obesity rates exceeded 35 percent in five states, 30 percent in 25 states, and 25 percent in 46 states. As of 2000, no state had an obesity rate above 25 percent. In the past year, adult obesity rates increased in four states (Colorado, Minnesota, Washington, and West Virginia), decreased in one state (Kansas), and remained stable in the rest. This supports trends that have shown steadying levels in recent years. Last year was the first time this annual report recorded any declines in adult obesity rates, with four states experiencing declines, and, over time, growth has started to slow. In 2006, rates increased in 31 states; in 2010, rates increased in 16 states. In addition, the report reviews other studies that have found childhood rates of obesity have stabilized over the past decade and decreased among low-income preschoolers between 2011 and 2014. State-by-state adult obesity rates and a new web-based interactive, featuring more than 20 policies focused on preventing and reducing obesity, are available at http://stateofobesity.org/. "Obesity rates are still far too high, but the progress we've seen in recent years is real and it's encouraging," said Richard E. Besser, MD, president and CEO of RWJF. "That progress could be easily undermined if leaders and policymakers at all levels don't continue to prioritize efforts that help all Americans lead healthier lives." T he State of Obesity also found that: • Colorado had the lowest adult obesity rate at 22.3 percent, and West Virginia had the highest at 3 7.7 percent. • Nine of the 11 states with the highest obesity rates are in the South and 23 of the 25 states with the highest rates of obesity are in the South and Midwest. • Adult obesity rates have striking racial and ethnic inequities—with rates above 40 percent for African-Americans in 15 states and rates at or above 35 percent among Latino-Americans in nine states, compared with rates above 35 percent among Caucasians in one state. • Obesity rates are about 30 percent higher among adults without a college education and with annual incomes below $15,000, compared to other adults. • One in four young adults who try to join the military are ineligible due to fitness and weight concerns. To accelerate progress in addressing obesity, RWJF and TFAH urge policymakers to do the following: • Invest in prevention at the federal, state and local levels, including full funding for the Centers for Disease Control and Prevention and the Prevention and Public Health Fund • Prioritize early childhood policies and programs, including support for Head Start and the Child and Adult Care Food Program • Maintain progress on school- based policies and programs, including full implementation of current nutrition standards for school foods • Invest in community-based policies and programs, including nutrition assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), and transportation, housing, and community d evelopment policies and programs that support physical activity • Fully implement menu labeling rules and the updated Nutrition F acts label • Expand healthcare coverage and care, including continued Medicare and Medicaid coverage of the full range of obesity prevention, treatment and management services. "It's clear that the progress we've made in fighting obesity is fragile and that we're at a critical juncture where continuation of the policies that show promise and increased support and resources could truly help bend the rising tide of obesity rates," said John Auerbach, president and CEO of TFAH. "We're far from out of the woods when it comes to obesity. But we have many reasons to be optimistic thanks to parents, educators, business owners, health officials and other local leaders. Our nation's policymakers must follow their example to build a culture of health." The obesity rate analyses are based on the United States Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). (Note: the methodology for BRFSS changed in 2011.) The State of Obesity report (formerly known as F as in Fat), with state rankings, interactive maps, charts, and graphs, is available at http://stateofobesity.org. WIRELESS FOOD STAMP TRANSACTIONS TIED TO HEALTHIER SHOPPING NEW YORK, New York—New research links the equipping of mobile fruit and vegetable stands with wireless banking devices programmed to accept food stamps to the buying of more healthy foods by people with low incomes. This is the finding of a survey of 779 shoppers in the Bronx—a New York City borough with many low- income communities—who bought f ood at four of the city's nearly 500 mobile sellers of fresh produce, known as Green Carts. Some of these food carts were licensed to handle electronic bank transfers ( EBTs), the technical term for the transactions, while others were not. The survey results are summarized in a report set to publish in the journal Preventing Chronic Disease. Started in 2008, the city-wide Green Carts program was designed to encourage healthy eating among residents by making it more convenient to buy fresh produce. Many of the carts are easily set up from the back of a van, but most cannot process wireless purchases. To find out whether EBT processing would boost usage, researchers from NYU School of Medicine focused on the Bronx, which also has New York state's highest rate of obesity at 30 percent. Forty-two percent of people included in the new survey, conducted in late 2013 and early 2014, said they received monthly assistance from the Federal government's Supplemental Nutrition Assistance Program (SNAP), informally known as food stamps. The SNAP program is restricted to people whose annual income is roughly no more than $32,000 for a family of four. On average, SNAP households currently receive about $255 a month to help purchase food. Survey results showed that SNAP beneficiaries purchased on average 5.4 more cups of fruits and vegetables—the equivalent of almost one cup more per day for those shopping every week for just themselves—when they used food stamps at EBT-equipped vendors when compared to similar shoppers who paid with cash. "Our study results underscore the importance of using modern technology to provide easy access to healthy food options," says study senior investigator Brian Elbel, PhD. Previous research by the same News and Trends NOVEMBER 2017 B ariatric Times. 2017;14(11):27–28. E xploring the Latest Bariatric and Metabolic Medicine in the Media

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