Mrs. Obama visited the Fairhill Elementary School in North Philadelphia on Friday afternoon as part of her campaign to curb childhood obesity.

She announced plans for more than $400 million in funding to help bring healthy food retailers to underserved communities.

Obama says Philadelphia and the state of Pennsylvania have done great work to increase access to fresh foods and combat obesity.

She says six years ago, the state invested $30 million in fresh food initiatives that helped fund 83 supermarkets statewide.

She also stopped by a North Philadelphia grocery story earlier Friday.

Researchers led by Jeanne Van Cleave, a doctor at Massachusetts General Hospital for Children in Boston, looked at the prevalence of conditions that lasted a year or longer in three groups of children, starting with a first cohort of more than 2,000 kids in 1988.

That group was tracked for six years, after which a second group was studied between 1994-2000 and finally a third group from 2000- 2006.

Mothers of the children were asked whether their kids had any “physical, emotional or mental condition that prevented him or her from attending school regularly, doing regular school work or doing usual childhood activities, or that required frequent attention or treatment from a doctor or other health professional.”

The information gathered was classified into one of four categories of chronic condition: asthma, behavior or learning disorders, obesity and other physical conditions.

“We found that prevalence of a chronic condition at any point during the study period was very high and increased over time,” the authors of the study, published in the Journal of the American Medical Association, said.

“Many factors may have contributed, including environmental changes, which may affect rates of chronic respiratory conditions and obesity,” and greater access to health care for children during the study period, which would have boosted diagnoses of childhood chronic conditions, the study says.

Reports of all chronic conditions, including the much-talked-about childhood obesity, rose from just under 13 percent at the end of the six-year follow-up for the first group of children to 26.6 percent in 2006, the study shows.

The obesity rate rose from 13.3 percent at the end of the first study group, in 1994, to nearly 16 percent at the end of the third cohort in 2006.

In the third and last group the researchers looked at, 51.5 percent of eight- to 14-year-olds “at one point in the six-year study period reported a chronic condition compared with 27.8 percent in cohort one,” the study says.

But unlike chronic conditions in adults, the childhood conditions were not necessarily long-lasting, the study said.

More than half of children who showed asthma-like wheezing before they were four years old had stopped having breathing difficulties by age six, and children with certain behavior disorders overcame them within a year.

The study also confirms what other recent research has shown: that obesity in the United States has reached a plateau.

There were fewer new cases of obese children reported in the third group of children — between 2000-2006 — than in the second group, a finding “consistent with previous reports of flattening childhood obesity rates in recent years,” the study says.

Four-year-olds in homes that followed these practices had a nearly 40 percent lower prevalence of obesity than children who did none of these things.

Of course childhood obesity - a soaring phenomenon in America - ultimately is fueled by poor diet and lack of exercise. But increasingly scientists have been able to tie other lifestyle factors to weight gain.

Obesity raises the risk of diabetes, heart disease and even cancer. The prevalence of obesity among children aged 6 to 11 years increased from 6.5 percent in 1980 to 19.6 percent in 2008, according to the U.S. Centers for Disease Control and Prevention.

Each routine on its own was associated with lower obesity, and more routines translated to lower obesity prevalence. The links held up even when other obesity risks were factored in.

“The routines were protective even among groups that typically have a high risk for obesity,” said Sarah Anderson, assistant professor of epidemiology at Ohio State University and lead author of the study. “This is important because it suggests that there’s a potential for these routines to be useful targets for obesity prevention in all children.”

Anderson and Robert Whitaker, professor of public health and pediatrics at Temple University, will detail their findings in the March issue of the journal Pediatrics.

Previous studies have conclusively linked poor diet to obesity. Increased consumption of fast food, sugary cereals, soda and other highly processed foods, at the expense of fruits, vegetables, whole grains and lean meats is considered a key cause of weight gain and poor overall health.

The new research was based on data collected in 2005 on 8,550 4-year-olds around the United States. Benchmarks for healthier children were set at: eating the evening meal as a family more than five times per week; obtaining at least 10.5 hours of sleep per night; and watching less than two hours per day of TV on weekdays.

Based on body mass index (BMI), 14.3 percent of the children whose households practiced all three routines were obese. In contrast, 24.5 percent living in households without any of the routines were obese. None of the three routines seemed to offer more health benefits than the others.

“Each one appears to be associated with a lower risk of obesity, and having more of these routines appears to lower the risk further,” Anderson said.

The research was funded by the U.S. Department of Agriculture’s Economic Research Service.

In a new study, the researchers report that using a standard 1-inch needle to immunize obese adolescents against hepatitis B virus produced a much weaker effect than using a longer needle.

“As obesity rises in the U.S., we need to be aware that the standard of care may have to change to protect obese youth,” study co-author Dr. Amy Middleman of Baylor College of Medicine in Houston told Reuters Health.

Over three years her team vaccinated 22 young women and two young men in the shoulder, randomly assigning them to be injected with either a 1-inch or a 1.5-inch needle.

Once injected, vaccines trigger production of small molecules called antibodies, which kick-start our immune system if we are ever attacked by the virus again.

The two groups turned out to have different antibody counts depending on the needle used. In those injected with the short one, the number was almost halved.

Although everyone in the study had enough antibodies to be considered protected against hepatitis B, a lower count generally means a less robust response.

“It gives us more evidence of the importance of choosing the right needle length,” said Middleman, “because we just don’t know what the impact could be in other vaccines.”

The results are no surprise, said Dr. Gregory Poland, who studies vaccines at the Mayo Clinic in Rochester, Minnesota. For years, doctors have known that vaccines tend not to work as well in heavy people. Whether the obese have weaker immune systems, or fat keeps shorter needles from reaching muscles, where the vaccines can affect immune cells, was unclear.

The introduction of the hepatitis B vaccine in the 1980s offered some clues. Soon after doctors began using the vaccine, they realized that it was failing to protect some female nurses.

At the time, the shot was given in the buttock, Poland told Reuters Health, and was thwarted by the padding there.

Instead of entering the muscle as it was supposed to, the vaccine apparently was broken down in the fat tissue, where it had little chance to affect immune cells. So doctors began giving the shot in the less-padded shoulder.

With the obesity epidemic now adding extra insulation to the shoulder, “our needles are going to have to be longer,” Poland said.

And those long needles aren’t as unpleasant as they sound. In fact, Poland said, “they turn out to be less painful and have fewer side effects.”

The Centers for Disease Control and Prevention recommends longer needles in obese patients, but it is unclear how many doctors follow these guidelines, or even know about them.

Women are more affected by needle length than men, because their fat distribution is different. But even obese women shouldn’t be overly concerned until more research has been done, Middleman cautioned.

“Should you go back and get all your immunizations repeated?” she said, “No, I don’t think so.”

SOURCE: Pediatrics, March 2010 (published online February 8, 2010).

The recommendations from the U.S. Preventive Services Task Force (USPSTF) update those issued in 2005. At that time, the group said there was insufficient evidence to recommend routine obesity screening in children.

However, “since 2005, a series of randomized clinical trials have demonstrated that there is effective therapy, so we felt compelled to change the recommendations,” said the UPSTF panel chair Dr. Ned Calonge, chief medical officer of the Colorado Department of Public Health in Denver.

“This is an encouraging message. There’s hope for successful treatment, and we hope that parents will ask their pediatrician if their child needs intervention,” said Calonge.

He said it’s better to address the problem as early as possible in childhood instead of waiting until your child is grown.

“Once you become an overweight adult, it’s more difficult to change your behavior,” Colange said. “We do believe that childhood behaviors can be changed, and investing in changing these behaviors in kids is an investment that can pay off lifelong.”

The new recommendations will be published in the February issue of Pediatrics, and are available online on Jan. 18 on the Pediatrics Web site.

Although recent statistics suggest that the rate of childhood obesity may be leveling off, one out of every six U.S. children is still obese, according data from the U.S. National Center for Health Statistics released last Wednesday.

The new recommendations now urge doctors to screen all children between 6 and 18 years of age for obesity. Screening should be done using height and weight measurements used to calculate body mass index (BMI), and findings should be compared to other children of the same sex and age. Kids whose BMI is over the 95th percentile for their gender and age are considered obese.

For children or teens who meet the definition of obesity, the task force recommends that doctors refer children and teens to intensive weight-management programs. Such programs should include more than 25 hours of contact with the child or teen over the first six months, and include three components:

* Counseling for weight loss
* A physical activity program or counseling on physical activity
* Behavioral management counseling, such as teaching goal-setting and self-monitoring behaviors

In an editorial in the same issue of the journal, Dr. Sandra Hassink, a member of the American Academy of Pediatrics’ board of directors, wrote that the current USPSTF report is “significant because it provides evidence that obesity treatment can be effective and beyond the immediate intervention.” However, she also wrote that the recommendation fell short because it should have included younger children, from age 2 and up.

Another concern is that there may not be enough weight-management treatment programs available for all the children who meet the task force’s threshold for obesity.

“The recommendation is that any program for children should be at least 25 hours over six months, and it’s not easy to find programs that are 25 hours in duration,” explained Dr. Goutham Rao, clinical director of the Weight Management and Wellness Center at Children’s Hospital of Pittsburgh.

“Very intense programs like this are usually very expensive and private-pay, and they may take in few kids,” he said.

Calonge said that at least for now, there may be a shortage of programs. But, he said, as more children are referred, and more insurers start reimbursing for the treatment, more programs should become available. He pointed out that when mammograms were first recommended, few centers were available to address this need, but that hospitals and private companies quickly filled the gap.

Rao agreed that more programs will likely become available, and said that new ways to help children change their behaviors may be developed. At his own center, they’ve recently developed on online weight-loss program where children keep daily food logs and have email contact with a dietician.

And, despite the potential shortage of treatment programs, Rao said, these recommendations “are a major step in the right direction. The longer you wait to address obesity, the more habits are entrenched. The younger children are, the easier it is to make changes.”

Everyone is familiar with scents that arouse the appetite, as well as odors that turn the stomach. But apparently molecules that make up a food’s aroma can also activate areas of the brain that trigger the feeling of fullness.

As people chew food, scents wafting up to the back of the nose from inside the mouth help quench the sensation of hunger, food technologist Rianne Ruijschop at NIZO Food Research in Ede, The Netherlands, and her colleagues found.

“These were quite unexpected results,” Ruijschop told LiveScience. “Everyone was quite astonished and very energetic about them.”

Variety of findings

Certain aromas, flavors and textures were especially effective at making people feel full.

• Solid foods that required chewing and swallowing - thus offering a lingering release of aromas - proved more satiating than liquid foods.
• When odors linked either with fat, carbohydrates or proteins were tested, adding scents linked with carbohydrates or protein significantly increased the feeling of fullness, perhaps because they suggest food is high in energy.
• Complex aromas with multiple components were more filling than others with just one component. Complex aromas might tell the brain it’s eating a variety of food and thus a large meal.
• The size of food samples had an impact, as smaller bite sizes prolonged the amount of time in which odors could have an effect.

In experiments, the researchers could modify how filling various foods were. For instance, making a beverage release aromas much like solid foods would significantly increased the feeling of fullness.

Feeling full

These findings could help researchers develop a new generation of foods that release aromas that help people feel full, therefore fighting overeating and obesity. Scientists might add capsules that boost or prolong aftertaste or release of aromas. They might also introduce chewy ingredients, or reduce bite size to increase the amount of chewing people have to do. Complex odors could be added, as well as scents that suggest the food is rich in energy.

In recent, as-yet unpublished work, Ruijschop said that by controlling aroma, they could in fact lower the amount of food people consumed by roughly 10 percent. They are now conducting long-term studies to see what effects months of changes in aromas can have on people.

Although aromas could contribute to the fight against obesity, “they’re not really the solution by itself,” Ruijschop noted. “It’s also very much about changes in lifestyle.”

Ruijschop and her colleagues detailed their findings in the November 11 issue of the Journal of Agricultural and Food Chemistry.

Original Story: Anti-Hunger Smells Could Battle Obesity

The paper, written by doctors in Britain and Sweden, seeks to finetune a well-known tool — the body mass index (BMI) — which is used to measure obesity and ill-health.

BMI entails taking one’s weight in kilos and dividing it by the square of one’s height, in metres. A BMI of 25-30 is generally considered overweight. while a figure of above 30 indicates obesity.

Previous studies have already found a big link between BMI and higher risk of death from cardiovascular disease, diabetes and some cancers.

In contrast, a low BMI — in other words, people who are very skinny — is associated with increased mortality from respiratory disease and lung cancer.

But many experts have questioned the findings about low BMI, arguing that the figures could be skewed by something called reverse causality.

For instance, diseases such as lung cancer, which cause weight loss, are being factored in as low BMI, they argue. And smoking and poor socioeconomic circumstances may also cause bias.

Seeking to find out more, specialists from Britain’s University of Bristol and the Karolinska Institute in Sweden set out to get a wider view of the BMI benchmark.

They measured BMI and mortality among more than a million pairs of Swedes, comprising mother-and-son pairs and father-and-son pairs, over 50 years.

They found strong patterns of mortality and BMI.

The link was especially noticeable in cardiovascular disease — for which prevailing estimates may be “substantially underestimated” — as well as diabetes and kidney cancer.

But there was no evidence of an association between low BMI and an increased risk of respiratory disease and lung cancer mortality.

The findings are important, because they imply that obesity programs could yield major health benefits, says the study.

“Suggestions to the contrary are probably misguided,” it adds.

Topping the list: too little exercise, too much weight.

In fact, 59 percent of adults surveyed last year reported no activity vigorous enough to prompt sweating and a significant increase in breathing or heart rate, according to the update. The findings are published online Dec. 17 in the journal Circulation.

“The things people need to focus on are our weight and our waist,” said Dr. Donald M. Lloyd-Jones, chair of the heart association’s statistics committee. “Those are driving a lot of other risk factors, such as cholesterol and diabetes.”

Tackling inactivity and overweight will be key to turning heart health statistics around said Lloyd-Jones, who is also chairman of the department of preventive medicine and staff cardiologist at Northwestern University Feinberg School of Medicine.

The American diet also demands more attention, he said. “There is just too much availability of very calorie-dense food,” he said. “We’re not doing anything to burn off those extra pounds.”

Data from 2003-2006 shows that 11.3 percent of children and teenagers were at or above the 97th percentile in body mass index for their age. That’s ominous, because overweight teens have a 70 percent chance of becoming overweight adults, the report notes.

Preventive measures should be emphasized for younger people, Lloyd-Jones said. “We need to be thinking about this as a life-long problem, not just when you turn 50,” he said.

Cholesterol control is ignored by many who would benefit from it most, according to the Heart Disease and Stroke Statistics 2010 update. Fewer than half the Americans with symptomatic heart disease are receiving treatment to lower their blood levels of fats, and only a third of people getting treatment are achieving the target levels of LDL cholesterol, the “bad kind” that clogs arteries.

“Everything is coming together in the worst way — obesity, inactivity, smoking,” said Dr. Clyde W. Yancy, heart association president and medical director of the Baylor Heart and Vascular Institute in Dallas. “In our younger group, instead of seeing improvement, it is getting worse.”

One relatively bright spot is better control of high blood pressure, a major cardiovascular risk factor, Lloyd-Jones said. “In the last few years, we have taken a bump up, and that gives us reason to hope, especially in prevention of heart failure,” he said.

Other findings:

• Death rates from cardiovascular disease declined about 30 percent between 1996 and 2006, as treatments improved.
• In 2006, 7.2 million in-hospital cardiovascular procedures were performed, a 33 percent increase over the 1996 level.
• The cost of treating cardiovascular disease is expected to rise 5.8 percent in 2010, to $503.2 billion, a figure that lends real urgency to prevention efforts, Lloyd-Jones said.

“So we are spending half a trillion dollars on cardiovascular disease,” Yancy said. “And we recognize that, as in our younger population the incidence of sedentary life style, obesity and smoking are going up, that expenditure will continue to rise.”

By 2020, the association hopes for a 20 percent improvement in the cardiovascular health of all Americans and a 20 percent reduction in deaths from cardiovascular diseases and stroke.

In sleep tests conducted on 234 white children, aged 2 to 18, who were referred for evaluation of snoring and possible obstructive sleep apnea, the researchers found that among those aged 12 and older the risk of obstructive sleep apnea increased 3.5-fold with each standard-deviation increase in body-mass index (BMI) score. But, increasing BMI did not significantly increase the risk of obstructive sleep apnea in younger children.

The increased risk of obstructive sleep apnea in overweight and obese teens may be linked to developmental changes, such as anatomic changes and reductions in upper airway tone, the study authors noted in the Dec. 15 issue of the Journal of Clinical Sleep Medicine.

“These results were a little surprising to us initially, as obesity is generally considered to increase the risk of sleep apnea amongst all children. Previous results have been inconsistent, however, and appear to be confounded by using mixed ethnic populations and different ages of children,” principal investigator Mark Kohler, research fellow at the Children’s Research Center at the University of Adelaide, said in a news release from the American Academy of Sleep Medicine.

He and his colleagues said developmental changes in the association between obesity and obstructive sleep apnea may occur at different ages in children of other races and ethnicities. They noted that black American children appear to be at higher risk for obstructive sleep apnea independent of obesity and they may begin puberty earlier than white children.

Tonsil size may be another factor that interacts with obesity to affect the risk of obstructive sleep apnea, they added.

The British researchers checked the DNA of 300 children who’d become very fat, on the order of 220 pounds by age 10. They looked for deletions or extra copies of DNA segments.

They found evidence that several rare deletions may promote obesity, including one kind they studied further and found in less than 1 percent of about 1,200 severely obese children.

That deletion, on chromosome 16, apparently causes trouble because it removes a gene that the brain needs to respond to the appetite-controlling hormone leptin, said Dr. Sadaf Farooqi of Cambridge University.

In her study, children with a chromosome 16 DNA deletion “have a very strong drive to eat,” said Farooqi, who co-led the research. “They’re very, very hungry, they always want to eat.”

The work, reported online Sunday by the journal Nature, has already produced a real-world payoff. Farooqi said four children with the chromosome 16 deletion had drawn the attention of British child welfare authorities, who blamed the parents for overfeeding them.

“We were able to intervene” and get the parents of two children off the hook, and the other two cases are under discussion, she said.

That’s happened before when the scientists uncovered genetic causes for severe childhood obesity, she said.

“It’s a slightly unusual outcome of our research, but one we think is very important,” she said.

While scientists had previously discovered particular genes that promote obesity when damaged, the new work looked at larger chunks of DNA that can span several genes. The chromosome 16 deletion includes nine genes.

Eric Ravussin, an obesity expert at the Pennington Biomedical Research Center in Baton Rouge, La., who wasn’t involved in the study, said the work provides “a gold mine of information.” That’s because it identifies specific chromosome areas that scientists can explore to discover obesity-related genes, he said.