- Author: Jeannette E. Warnert
The research, funded by the Robert Wood Johnson Foundation, shows that more preschool-aged children have ready access to water during all activities, mealtimes and snacktimes, indoors and out, when they are in Head Start, private and public centers and licensed family home daycare.
“This is so important for child nutrition and obesity prevention,” said Lorrene Ritchie, the director of the UC Nutrition Policy Institute and the study's principal author. “We've learned from older children that many of them never drink plain water, so they're not used to it and don't like the taste.”
In fact, national surveys in the early 2000s found that, on any given day, 84 percent of 2- to 5-year-old children drank sugar-sweetened beverages like sodas, sports drinks and fruit punch. The calories amounted to 11 percent of the children's total energy intake. At the same time more than one-quarter of young children in the U.S. did not drink plain water on any given day.
“Humans evolved to drink water, so our bodies don't register very well the calories in juices, sodas and sweetened beverages,” Ritchie said. “Giving a child a cup of Hi-C, Capri Sun, SunnyD or other sweetened beverage is like setting a sugar bowl in front of them. It's sweet and goes down easy, but they're consuming calories very quickly without realizing it.”
In 2008, University of California researchers documented the types of beverages served to children in childcare settings. They found that one-fifth of the childcare providers served whole milk, 2 percent offered flavored milk, and 27 percent gave children juice more than once per day. A small fraction, about 8 percent, served sugar-sweetened beverages to the children. Only 28 percent always served water with meals and snacks, and 36 percent served no water at all.
“Fully one-quarter of children are already overweight or obese when they enter kindergarten,” Ritchie said. “It was clear from the research that we needed to focus on the beverages in childcare.”
The UC research informed the writing of Assembly Bill 2084 by Rep. Julia Brownley in early 2010. The measure passed, was signed by Gov. Brown and went into effect in January 2012. Also in 2010, Congress enacted legislation, based on UC and other research, that requires drinking water be available all day in childcare facilities that take part in the federally funded Child and Adult Care Food Program.
“The UC Nutrition Policy Institute's research was tracked provision by provision into groundbreaking state legislation,” said Kenneth Hecht, Nutrition Policy Institute coordinator. “NPI research is now the basis for the law of the land.”
After the state and federal laws went into effect, Ritchie and her research team embarked on a second study to determine the impact of the legislation on beverages served in childcare settings. At the time of the second survey, 77 percent of providers had self-serve water available indoors and 78 percent had it available outdoors. Nearly half of the providers served water with meals and snacks.
Children in programs following the new law have access to drinking water throughout the day and at meal and snack times. Children are no longer offered whole milk (after age 2), flavored milk or sugar-sweetened beverages and given no more than one glass of 100 percent juice each day.
“We've made great strides using research to inform policy, but there is still much to do to improve the nutrition of young children,” Ritchie said. “We are sticking with it.”
- Author: Janet White
Original research and literature reviews on these subjects appear in the January-March 2013 California Agriculture, UC’s peer-reviewed research journal of research in agriculture, natural and human resources (http://www.californiaagriculture.ucanr.edu).
UC Agriculture and Natural Resources (ANR) has launched a strategic initiative to help California youth. Called Healthy Families and Communities, it includes research and programs to encourage healthy lifestyles, boost science literacy, and foster positive youth development. Delaine Eastin, former State Superintendent of Public Instruction, notes, “At the end of the day, the Healthy Families and Communities Strategic Initiative is about change, scientifically measurable change, yielding concrete evidence of youth improvement due to these efforts.”
In addition, each year about 100,000 California youth who reach graduation age fail to graduate from high school, a predictor of their future social and financial difficulties as well as a missed opportunity for training skilled workers to replace those close to retirement. Finally, California’s eighth-grade science scores ranked 47th among the states in the National Assessment of Educational Progress’s 2011 report. A workforce with the knowledge and skills for scientific careers is critical to the state’s economy, and to full participation in today’s technological society.
Confronting these complex issues requires a multifaceted approach that leads to strategic change, says David Campbell, UC Cooperative Extension specialist in the Department of Human and Community Development at UC Davis and leader of ANR’s new youth-focused initiative.
“We’re bringing a lot of people together across disciplines,” he says. “If our work is going to be relevant to the real world, we need to reflect its complexity.”
As part of the initiative, UC researchers are partnering with schools and youth organizations in controlled studies to learn what works in the real world.
Summaries of projects and links to articles:
Integrating local agriculture into nutrition programs can benefit children's health (page 30). Sheri Zidenberg-Cherr, UCCE specialist in the Department of Nutrition at UC Davis, leads a K-6 nutrition education effort, called Shaping Healthy Choices. Designed to both improve child health and support local agriculture, the program incorporates serving regional fruits and vegetables, a school garden, and classroom nutrition and physical fitness lessons. In this controlled four-year study, investigators have matched schools in Northern and Central California, and will compare those that are implementing the program with those that are not.
Communitywide strategies key to preventing childhood obesity (page 13). According to Pat Crawford, UCCE specialist in the Department of Nutritional Science and Toxicology at UC Berkeley, increasing consumption of fruits and vegetables is important but not enough by itself to combat obesity. Two of the strongest factors driving obesity are sweetened beverages and fast food, and decreasing their consumption is just as important as increasing the consumption of healthy foods. “You have to do both,” she says.
Her team at the Center for Weight and Health in Berkeley, with funding from ANR, is evaluating Team Up for Good Health, a community-based approach to preventing obesity in elementary school children. Investigators are studying fourth- and fifth-grade participants in school and after-school obesity prevention programs, using body mass index (BMI) reductions after two years as a measure of success.
Lessons of Fresh Start can guide schools seeking to boost student fruit consumption (page 21). In 2005, California became the first state to address the availability of fresh and local produce in the federal School Breakfast Program through state funding. This evaluation of the California Fresh Start program reveals lessons that are especially important now, as schools across the country prepare to increase the number of fruits and vegetables offered in the School Breakfast Program by July 2014 as part of the Healthy, Hunger-Free Kids Act.
Inquiry-based learning (pages 47 and 54). Another innovative aspect of these UC programs is the curriculum. Based upon inquiry-based learning, it captures the attention of students by focusing on the real world and children’s day-to-day lives. For example, in the Shaping Healthy Choices program (page 30), a lesson on food labels at school will be followed by students comparing food labels on their own, at home and in grocery stores. “Application is what makes learning stick,” says Martin Smith, UCCE specialist in the School of Veterinary Medicine who works on youth science literacy. “Inquiry-based learning takes longer, but it’s deeper — kids own the knowledge because they figured it out themselves.”
Positive youth development merits state investment (page 38). A team of UC researchers reviews studies supporting a new paradigm for youth programs, and proposes increased state investment in this area. Research over the last 30 years has shifted thinking away from the deficit model, in which researchers and practitioners considered high-risk youth behaviors to be their focus, and toward promotion of positive patterns. “Far too many California youth are not thriving,” the authors note. “Promotion of healthy pathways to college, work and community engagement is of urgent concern.” They cite findings that positive youth development is linked to improved school achievement, higher graduation rates, and fewer risk behaviors.
The entire January-March 2013 issue can be downloaded at http://californiaagriculture.ucanr.edu.
California Agriculture is the University of California’s peer-reviewed journal of research in agricultural, human and natural resources. For a free subscription, go to: http://californiaagriculture.ucanr.edu, or write to firstname.lastname@example.org.
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Called "Ninos Sanos, Familia Sana" (Healthy Children, Health Family), the center is a collaborative effort of the University of California, Davis, the University of California Cooperative Extension, and local communities and organizations.
"Opening this center really gives us an opportunity to work with the community -- to be there for children and families and show we are committed to promoting good nutrition and physical activity," said Adela de la Torre, professor of Chicana/o studies and director of the Center for Transnational Health at UC Davis. "We want to help them learn the best approaches to preventing obesity now and in the long term."
Part of a five-year, $4.8 million study aimed at identifying effective approaches to combating obesity, the center will address a problem that affects more than four in 10 children born to parents of Mexican heritage, putting them at greater risk of early diabetes, high blood pressure and heart disease.
Planning for the study, which is funded by the U.S. Department of Agriculture, began last year. The study will conclude in 2016.
During the study, 400 Firebaugh children and their families will receive practical tools, education and incentives to help them eat healthy diets and get sufficient exercise. Interventions will include:
- $25 monthly in vouchers for families to buy fruits and vegetables at participating markets;
- classroom instruction for children on nutrition and physical activity;
- 10 family education nights per year in which parents will learn how to select and use fresh ingredients to prepare healthy meals for themselves and their children; and
- twice-yearly health screenings to monitor weight, blood pressure, body-mass index, skinfold thickness and waist circumference.
At the same time, 400 children and families in the town of San Joaquin will receive:
- twice-yearly health screenings
- a series of forums designed to assist parents in supporting their children's education
The San Joaquin community will also benefit from these outreach
- UC Davis will collaborate with area schools to enrich the science curriculum.
- A community mural project will depict the rich cultural heritage and history of the community. (The mural, painted on an outdoor wall of a community learning center in San Joaquin, will be unveiled on Sunday, Sept. 16).
At the study's conclusion, de la Torre and her research colleagues will have data to show whether the food vouchers and health education programs tested in Firebaugh are effective, using San Joaquin as a control. San Joaquin families and schools will then receive much of the same intervention used in Firebaugh, with assistance from UC Cooperative Extension specialists.
Both Firebaugh and San Joaquin are located in Congressional District 20, an area with the nation's lowest human development index, an international measurement of wellbeing based on longevity, standard of living and other factors.
"The irony here is that their parents may harvest vegetables in the fields -- some of the richest agricultural land anywhere in the world -- but their children rarely share in this bounty," de la Torre said. "We need to provide better access to fresh vegetables and fruit in stores and teach these families how to prepare these foods in easy and convenient ways, to make these good foods part of their lives. That is what this program is about."
An agricultural economist, de la Torre has studied Latino health issues in the U.S. and Mexico for more than 25 years.
Throughout the study, an advisory committee made up of school, community and parent representatives from each community will provide feedback on program strategies, approaches, concerns and solutions to the barriers that prevent children from maintaining healthy weights.
Participants include parents who have volunteered to have their families take part; grocery stores; health professionals (Sablan Medical Clinics); a nonprofit, community-based program of promotoras, or outreach workers (Proteus, Inc.); school teachers and administrators (Firebaugh-Las Deltas Unified School District and Golden Plains Unified School District in San Joaquin).
Also participating are about 20 educational specialists, economists, nutritionists, psychologists, physicians, and graduate and undergraduate students from UC Davis and the University of California Cooperative Extension.
Lucia Kaiser, Cooperative Extension specialist in the UC Davis Department of Nutrition and a co-investigator on the study, said:
"This project is an exciting opportunity for UC Davis and UC Cooperative Extension to pull a multidisciplinary team of social scientists, nutritionists and other professionals to work in partnership with an underserved community to prevent a pressing health problem -- childhood obesity."
- Interviews will be available in Spanish. Lean en espanol: http://www.news.ucdavis.edu/search/news_detail.lasso?id=10329]