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The Rudd Center Health Digest

November 2008

New Science Emerges on Weight Discrimination

Cover

Widespread prejudice towards obese children and adults is documented in a special supplement issue published in the journal Obesity this month. The supplement, devoted exclusively to the matter of bias and prejudice toward obese persons and the emergence of new science of this significant social problem, was coordinated by the Rudd Center.

“Vast numbers of children and adults are vulnerable to weight bias, and the consequences of stigma and discrimination on public health could be considerable,” says Rebecca Puhl, the Rudd Center’s Director of Research and Anti-Stigma Initiatives, who co-edited the special issue with Janet Latner of the University of Hawaii.

The supplement contains fourteen articles by prominent scientists in North America and Europe, from a range of disciplines including psychology, public policy and the law. This special collection highlights the need for greater awareness of weight bias and its negative impact on health and society.
Among the important findings emerging from the studies are:

•    Increasing rates of obesity have not led to greater acceptance of obese individuals.
•    Children who are at greater risk for obesity show body size stigmatization as early as preschool.
•    Weight-related teasing is prevalent throughout adolescence and is a problem for overweight and obese youth across different racial groups.
•    Overweight youth teased about their weight are at risk for disordered eating and adverse psychological outcomes and overweight girls who internalize negative stereotypes may be particularly vulnerable.
•    Obese professional workers report more perceived interpersonal mistreatment compared to obese persons of lower socioeconomic status.
•    Obese adults report significantly higher levels of mistreatment compared to ‘normal weight’ counterparts, even when demographic, socioeconomic status and health characteristics are controlled.

“Collectively, the studies illustrate the detrimental impact of weight bias in many domains of living,” said Puhl. “It is a compelling social problem that requires efforts from scientists, health professionals and caretakers in order to improve the quality of life for obese children and adults and prevent the social disadvantages associated with stigmatization.”

Rudd Center Releases Policy Report on Access to Healthy Foods in Low-Income Neighborhoods

Veggies

Income, race/ethnicity and location contribute to disparities in access to healthy food, according to a recent policy report prepared by Roberta Friedman, the Rudd Center’s Director of Public Policy. The report, “Access to Healthy Foods in Low-Income Neighborhoods: Opportunities for Public Policy,” also summarizes key studies that support the need for better access to healthy foods and outlines opportunities for policy makers to improve access.

The report reinforces the findings of a recent paper coauthored by Tatiana Andreyeva, a Rudd Center Postdoctoral Research Associate. The paper, “Availability and Prices of Foods Across Stores and Neighborhoods: The Case of New Haven, Connecticut,” was published in the September/October 2008 issue of Health Affairs.

The researchers found that high rates of obesity and diabetes in poor and minority populations are linked to limited access to supermarkets and affordable healthy foods such as fresh fruit and vegetables, low-fat dairy, trans fat free products, whole grains and lean meats. “We want to spread the word that expanding access to healthful foods is a win-win situation for communities, individuals and businesses, as well as policy makers,” said Friedman.

Policy makers can increase access by improving public transportation to grocery stores, providing lighting and police patrols near grocery stores, offering incentives for purchse of refrigeration equipment to store fresher and healthier products and offering tax breaks to appeal to supermarkets. Successful initiatives have taken place in cities across the United States, including New York City, Austin, Milwaukee and Oakland.

Upcoming Seminar Speakers:

November 12, 12:30 pm: Inas Rashad, PhD
Assistant Professor, Department of Economics, Andrew Young School of Policy Studies, Georgia State University
Fast Food Restaurant Advertising on Television and Its Influence on Childhood Obesity

November 17, 12:30 pm: Brian Wansink, PhD
Executive Director, USDA’s Center for Nutrition Policy and Promotion; John S. Dyson Endowed Chair, Applied Economics and Management Department, Cornell University; Director, Cornell Food and Brand Lab
Turning Mindless Eating into Healthy Eating

November 19, 12:30 pm: Hilary Sample, MArch
Assistant Professor of Architecture, Yale School of Architecture
Out of Shape Buildings: Putting Architecture on a Diet

December 3, 12:30 pm: Eric A. Finkelstein, MHA, PhD
Health Economist and Director, Public Health Economics Program, Research Triangle Institute (RTI) International
The Fattening of America: How the Economy Makes Us Fat, If It Matters, and What to Do About It

December 4, 2 pm: Tim Lobstein, PhD
Director, Childhood Obesity Programme, International Obesity TaskForce (IOTF)
Obesonomics: Describing the Obesogenic Economy

Our seminars are held at the Rudd Center, located at 309 Edwards Street in New Haven, Connecticut. They are free and open to the public. The full schedule for our Fall Seminar Series is available online.

To receive a weekly email from the Rudd Center detailing upcoming seminars and schedule changes, please click here.

California First State in Nation to Pass Menu Labeling Law

The movement to require restaurant menu labeling achieved another milestone on Sept. 30. California Gov. Arnold Schwarzenegger signed the nation’s first statewide bill mandating that all California restaurants with at least 20 locations post calorie information on indoor menus and menu boards. The rules for posting calories will take effect in January 2011, but do not apply to drive-through menus. Restaurants must also have brochures at registers and drive-throughs with calories, saturated fat, carbohydrates and sodium information by July 2009. Locations found in violation of the law could be penalized up to $500.

"This legislation will help Californians make more informed, healthier choices by making calorie information easily accessible at thousands of restaurants throughout the state,” Gov. Schwarzenegger said at a press conference, according to The Washington Post.

The law was supported by the American Cancer Society, California Center for Public Health Advocacy and California Restaurant Association.

One concern with the law is that it preempts local governments from enacting stronger regulations.

Spotlight on Rudd Center Affiliated Faculty: Colleen L. Barry, PhD, MPP

Dr. Colleen L. Barry, Assistant Professor in Yale’s Department of Public Health and Epidemiology, collaborates with Rudd Center researchers on how the media shape opinions about obesity and food policy. She is currently the principal investigator on a Robert Wood Johnson Foundation grant to study how messages used to frame the issue of childhood obesity affect public attitudes about regulation of food marketing to children.

Dr. Barry’s research focuses on regulatory policy affecting stigmatized health conditions including obesity, mental health and substance abuse. Much of her work addresses the political dimensions of regulatory policy.

In other research, Dr. Barry has examined the effects of behavioral health parity regulation. Parity regulations aim to eliminate historical inequities in private coverage for mental health and substance abuse treatment by requiring insurers to offer the same level of coverage for behavioral and physical illnesses. She also collaborates with colleagues at Yale on a study funded by the National Institute of Mental Health on the impact of the recent Food and Drug Administration regulatory policy on pediatric antidepressant use and suicide risk.

Dr. Barry is the Director of the Division of Health Policy and Administration’s Health Policy Program and teaches a health policy and politics course. Dr. Barry earned her PhD in health policy from Harvard University. Dr. Barry has published her research in numerous peer-reviewed health policy and medicine journals, including Health Affairs, New England Journal of Medicine, Health Services Research and Journal of Policy Analysis and Management.

The Latest Rudd Center Podcasts

Walter C. Willett, MD, MPH, DrPH
Chair of the Department of Nutrition and Fredrick John Stare Professor of Epidemiology and Nutrition at the Harvard School of Public Health
Eliminating Trans Fat from the Food Supply: The Tortuous Road from Science to Policy

Alberto Cormillot, MD
Founder of the Cormillot Health Network
Obesity, Nutrition, and Health Education Network

Derek Yach, MBChB, MPH, DSC
Director of Global Health Policy for PepsiCo; former Executive Director of the World Health Organization (WHO)
Towards a 21st Century Agenda for Nutrition

Robert I. Berkowitz, MD
Psychiatrist-in-Chief at The Children’s Hospital of Philadelphia and Associate Professor of Psychiatry and Pediatrics at the University of Pennsylvania
Behavioral and Pharmacological Treatment for Overweight Adolescents

Our collection of podcasts is available for download on iTunes U, under the Yale University Health & Medicine – Nutrition & Obesity section, or you may subscribe to a RSS Feed that will automatically update whenever new content is released. Podcasts can be listened to on a computer or downloaded to a music player.

Library of Podcasts (Partial List)

Michael Pollan, MA
Knight Professor of Journalism; Director of the Knight Program in Science and Environmental Journalism at UC Berkeley; Contributing Writer to The New York Times Magazine
In Defense of Food: The Omnivore's Solution

Mark S. Gold, MD
Donald Dizney Eminent Scholar, Distinguished Professor and Chair of Psychiatry at the University of Florida
Could Food Addiction Explain Rising Obesity Rates?

Eric Stice, PhD
Senior Scientist at Oregon Research Institute; Research Professor at the University of Texas
Relation of Obesity to Disturbances in Reward from Food Intake and Anticipated Intake: An fMRI Study

Gary D. Foster, PhD
Director, Center for Obesity Research and Education; Professor of Medicine and Public Health, Temple University
Preventing Obesity: Schools and Beyond

Daniel C. Esty, JD, MA
Hillhouse Professor of Environmental Law and Policy, Yale School of Forestry and Environmental Studies; Clinical Professor of Law, Yale Law School
Environment, Agriculture and Obesity: New Thinking on Sustainability

Gina Kolata, MS
Science Journalist for The New York Times
Rethinking Thin: The New Science of Weight Loss - and the Myths and Realities of Dieting

Marion Nestle, PhD
Paulette Goddard Professor of Nutrition, Food Studies and Public Health at New York University
Food Politics: The Perfect Storm

Mary K. Engle, Esq
Associate Director for Advertising Practices for The Federal Trade Commission
The FTC's Study on Food Marketing to Children

John H. Cawley, PhD
Associate Professor of Policy Analysis and Management at Cornell University
Raising Red Flags: The Impact of the Federal Trade Commission Initiative to Decrease Deceptive Advertising for Weight Loss Products

Front Burner News

Genetic Link Ties Obesity and Colon Cancer Risk

Researchers at the University of Alabama are the first to make a triple association among genetics, obesity and colon cancer risk. The findings highlight the importance of weight loss and maintenance. Read the full article.
Tomatoes

FDA Creates Guidelines on Genetically Modified Food

The FDA has drafted guidelines about genetically modified beef and fish. While concerns exist about the environmental and health risks, the modification could create food that is more nutritious and easier to produce. Read the full article.

Restaurant Chains to Post Calories

Yum Brands, the owner of Taco Bell, Pizza Hut and KFC, has announced a plan to voluntarily list calorie information on company-owned indoor menu boards, but not on drive-through menu boards. The company will encourage its franchisees, who own 16,000 of the 20,000 restaurants in the United States, to take a similar step. For the full article, click here.

Subway Riders Get Calorie Advice

Many New York City subway cars have begun displaying ads about daily caloric recommendations. The goal of the ads, sponsored by the city health department, is to supplement the required calorie listings on chain restaurant menus. The posters also report the calorie counts for a number of food items. Click here for the full article.
Cereal

Few Popular Cereals Receive Top Marks

Consumer Reports recently rated cereals marketed to children based on nutritional values, more than half of which are consumed by those ages 18 and over. Of the 27 cereals evaluated, just four were rated as “Very Good”: Cheerios, Kix, Life and Honey Nut Cheerios. Click here for the full article.

A Silver Lining in an Economic Turndown

Studies show that the state of the economy can have a significant impact on our health habits. But prosperity doesn’t necessarily bode well for individuals. A Stanford researcher notes that in good financial times, because of work-related responsibilities, some people engage in fewer health-promoting behaviors such as exercising and eating at home. Click here for the full article.

Dieters Are at Higher Risk of Weight Gain During Pregnancy

Overweight and normal weight women with a dieting history are at an increased risk of surpassing weight gain guidelines during pregnancy, according to researchers at the University of North Carolina at Chapel Hill. Women who gain more weight than recommended are more likely to have a large baby, a Caesarian section and increased difficulties in post-partum weight loss. For the full article, click here.

Group Suggests Taxes and Subsidies as Obesity Weapons

The American Dietetic Association recommends providing subsidies on healthy food to prevent obesity and diet-related causes of death. In addition, food manufacturers should be encouraged to develop healthy products. Click here for the full article.

New Labeling Law Has Big Holes

A new law forces food vendors in New York City to label certain produce, meat and nuts as homegrown or imported. Concern exists over the exclusion of vendors based on annual sales and the difficulty in enforcing the law. For the full article, click here.

Obese Women Face Mental Hurdles to Exercise

Researchers at Temple University found that obese women were more likely to have psychological obstacles to exercising than normal weight women. Barriers included fearing injury and failure, feeling self-conscious and believing they are too overweight to exercise. Click here for the full article.

Brain Reacts Differently in Milkshake Study

When obese people drink a milkshake, their brains release lower levels of pleasure chemicals compared to their normal weight peers, according to a new study by the Oregon Research Institute. The lower response may cause obese people to overeat. The same group also was at an increased risk for unhealthy weight gain the year following the study. Read the full article.

China Wrestles with Smoking, Chronic Diseases

Higher consumption of fatty foods is taking a toll on cancer and heart disease rates in China, according to a new study published in The Lancet. With Chinese men comprising one third of the world’s smoking population, smoking-related illnesses are also of grave concern in China. Read the full article.

Heart Attacks Increased with Western Diet

In a recent article published in Circulation, researchers reported that a Western diet high in fat, meat and salt created a 35% increased risk of heart attack. The protective factors of an Oriental diet rich in tofu and soy sauce outweighed the effects of its high salt quantity. Read the full article.

Coke CEO Says Obesity Is a Lifestyle Issue

At the recent InterBev 2008 conference, Coca-Cola Company's CEO Muhtar Kent implored food industry leaders to address obesity as a lifestyle concern instead of the effect of any particular behavior such as soda consumption. Economic problems and health concerns have contributed to declining sales of carbonated beverages, including those produced by Coca-Cola. Read the full article.

Weight Discrimination Reported More by White Adults

Researchers found a link between white adults’ perceived discrimination based on weight and high-risk waist measurement, according to a new study in the American Journal of Public Health. Weight discrimination can lead to harmful health outcomes. Read the full article.

New Diabetes Cases in Adults Almost Doubles

The Centers for Disease Control and Prevention reported that 90% more adults have been recently diagnosed with diabetes than 10 years ago. Southern states had the highest rates of new cases of diabetes, which is caused by poor diet and inadequate physical activity. Read the full article.