A study by Matthew Herring, a doctoral student in the department of kinesiology, part of the UGA College of Education, and published in the Archives of Internal Medicine, looked at the impact of regular exercise and anxiety. The researcher limited his analysis to randomized controlled trials, which are the gold standard of clinical research, to ensure that only the highest quality data were used. Participants in the studies suffered from a variety of conditions, including heart disease, multiple sclerosis, cancer and chronic pain from arthritis. The favorable impact of exercise on anxiety and health is described below.

ScienceDaily (Feb. 28, 2010) — The anxiety that often accompanies a chronic illness can chip away at quality of life and make patients less likely to follow their treatment plan. But regular exercise can significantly reduce symptoms of anxiety, a new University of Georgia study shows.
In a study appearing in the Feb. 22 edition of the Archives of Internal Medicine, researchers analyzed the results of 40 randomized clinical trials involving nearly 3,000 patients with a variety of medical conditions. They found that, on average, patients who exercised regularly reported a 20 percent reduction in anxiety symptoms compared to those who did not exercise.
“Our findings add to the growing body of evidence that physical activities such as walking or weight lifting may turn out to be the best medicine that physicians can prescribe to help their patients feel less anxious,” said lead author Matthew Herring, a doctoral student in the department of kinesiology, part of the UGA College of Education.
Herring pointed out that while the role of exercise in alleviating symptoms of depression has been well studied, the impact of regular exercise on anxiety symptoms has received less attention. The number of people living with chronic medical conditions is likely to increase as the population ages, he added, underscoring the need for a low-cost, effective treatment.
The researchers limited their analysis to randomized controlled trials, which are the gold standard of clinical research, to ensure that only the highest quality data were used. The patients in the studies suffered from a variety of conditions, including heart disease, multiple sclerosis, cancer and chronic pain from arthritis. In 90 percent of the studies examined, the patients randomly assigned to exercise had fewer anxiety symptoms, such as feelings of worry, apprehension and nervousness, than the control group.
“We found that exercise seems to work with just about everybody under most situations,” said study co-author Pat O’Connor, professor and co-director of the UGA Exercise Psychology Laboratory. “Exercise even helps people who are not very anxious to begin with become more calm.”
Exercise sessions greater than 30 minutes were better at reducing anxiety than sessions of less than 30 minutes, the researchers found. But surprisingly, programs with a duration of between three and twelve weeks appear to be more effective at reducing anxiety than those lasting more than 12 weeks. The researchers noted that study participants were less likely to stick with the longer exercise programs, which suggests that better participation rates result in greater reductions in anxiety.
“Because not all study participants completed every exercise session, the effect of exercise on anxiety reported in our study may be underestimated,” said study co-author Rod Dishman, also a professor of kinesiology. “Regardless, our work supports the use of exercise to treat a variety of physical and mental health conditions, with less risk of adverse events than medication.”

It is not news that students live busy and sometimes unhealthy lifestyles. Having an irregular pattern of eating, drinking, sleeping, stress, and studying can make it difficult to stay healthy in college. Nicole Patience, a clinical dietitian at Temple Student Health Services, believes that there are not many weight loss plans designed for college students in particular, as the campus setting can be challenging. Melissa Napolitano of Temple’s Center for Obesity Research and Education says that a third of college students are overweight. Patience created a program called Onward to Weight Loss Success (OWLS) years ago and it teaches students about emotional eating, alcohol and weight gain, dining out, healthful cooking, and “mindful eating.”

Philadelphia Inquirer

February 22, 2010

Early in her college career, Kimberly Davidson fell into the typical campus lifestyle, a tailor-made prescription for weight gain: Study hard. Party. Watch TV. Eat junk food.

Davidson, 21, a junior at Temple University, had put on the so-called Freshman 15. Now she would like to lose about 30 pounds, which would place the 5-foot-9 social-work major at 140, well within the healthy weight range for her height.

She will join more than 20 other female Temple students in an 11-week weight-loss program that will aim to break ground and fine-tune methods that work best with the college crowd.

“There are very few weight-loss programs designed specifically for college students, and there isn’t a lot of data about the efficacy of the programs,” said Nicole Patience, a clinical dietitian at Temple Student Health Services.

The campus setting can be particularly challenging – with irregular sleep patterns, budget constraints, the stress of being away from home for the first time, and the prevalence of parties.

In addition, many Temple students work at least 20 hours a week, another stressor that could lead to poor eating habits.

“It’s a unique set of challenges,” Patience said, “compared to someone in the work world.”

Obesity is a problem of particular relevance because about a third of college students are overweight, said Melissa Napolitano of Temple’s Center for Obesity Research and Education, which will evaluate and monitor the program run by Patience.

Michelle Obama came to Philadelphia on Friday to promote her “Let’s Move” national campaign to lower childhood obesity.

Patience began her program – Onward to Weight Loss Success (OWLS) – 21/2 years ago after hearing from students how much they wished they could lose weight in a healthy way. This semester will be different in that the program will be monitored and evaluated by the obesity center.

In the program, students learn about such topics as emotional eating, alcohol and weight gain, dining out, healthful cooking, and “mindful eating” – being in the moment, so to speak, rather than being distracted in front of a TV. All the discussions are geared toward college students, their lifestyles, and their budgets.

Participants set goals and keep “food records” as part of the weekly one-hour meetings, Patience said.

The students will receive physicals before and after the program. Their weight loss, attitudes, moods, and body images also will be assessed.

Twenty-six students have signed up. Half will get the program immediately; the rest become a control group, then will get help in the next cycle.

To be eligible, students must exceed weight limits for their body mass index. A 5-foot-5 woman, for example, would have to weigh 150 pounds or more to be eligible.

Just how much weight they can expect to lose is uncertain. In the past, those in Patience’s program still living the college life have lost about a half-pound a week, compared with working-adult programs in which people shed one to two pounds a week, said Napolitano, an associate professor of kinesiology and public health at the obesity center.

Napolitano hopes the study will yield best weight-loss practices for students that can be rolled out to other campuses nationally.

“We want to get to people earlier,” she said, “before poor habits are established.”

Students will receive a $20 gift card for participating in the study, but Patience expects “internal motivation” – not the gift card – will keep them involved.

“One of my big motivations was just going there every week and seeing the other girls. We were each other’s motivations,” said Shuntelle Stephen, 23, who was in the program a year ago.

Stephen, who gained weight after taking steroids for asthma, lost 25 pounds in the program and has since lost 15 more by continuing to follow what she learned.

A public-health major, Stephen began going to the gym daily with her new friends. Information presented in the sessions also helped, she said. She learned, for example, that a margarita has about as many calories as 90 Gummy Bears.

Stephen, who has transferred to a New York state university, said she had entered the group a “very bad eater,” relying on frozen and fried foods. She exited eating more healthfully, enjoying fruits and vegetables, controlling portions, and having small meals or snacks regularly during the day rather than loading up once or twice.

Temple junior Kimberly Davidson has struggled with her weight since her senior year in high school. Lately, she has been biking more and buying fresh foods at the grocery store that recently opened near campus.

“I cook every day for myself. I’ve been doing a lot better,” she said.

She looked forward to beginning the group this week and getting a boost.

“I just kind of want to feel better and be in better shape,” said Davidson. “It’s something I’ve wanted to do for a long time. It will be good to have someone helping.”

In a study, published in the CDC’s Morbidity and Mortality Weekly Report, researchers analyzed data collected from 3,125 youths by the National Health and Nutrition Examination Survey, which is conducted every two years to gather a variety of health information. Ashleigh May, an epidemic intelligence service officer in the Centers for Disease Control and Prevention division for heart disease and stroke prevention, led the analysis. Previous studies have found that the obesity epidemic has been accompanied by a variety of health problems, including high blood pressure, diabetes, and arthritis. Heart disease is the leading cause of death in the United States, which makes the obesity epidemic of urgent concern.

By Rob Stein
Washington Post
Thursday, January 21, 2010; 1:02 PM

At least one out of every five U.S. teenagers has abnormal cholesterol levels, boosting the risk of heart disease, federal health officials reported Thursday.

A national survey of blood cholesterol levels in American teenagers found that more than 20 percent of those ages 12 to 19 had at least one abnormal blood fat level and the rate jumped to 43 percent among those adolescents who are obese.

Although previous studies had indicated the abnormal cholesterol levels — once a condition thought isolated to people who were middle-aged and elderly — had become a problem among the young, the new data documents the problem on a national level.

The findings provide new evidence underscoring the health threat posed by the nation’s obesity epidemic. Although the latest government data suggest the epidemic might be leveling off, at least one-third of youths are overweight or obese and the heaviest boys continue to get heavier.

Previous studies have found that the obesity epidemic has been accompanied by an increase in a variety of health problems in youths once found only in adults, including high blood pressure, diabetes and arthritis. Heart disease is the leading cause of death in the United States.

“The current epidemic of childhood obesity makes this a matter of significant and urgent concern,” said Ashleigh May, an epidemic intelligence service officer in the Centers for Disease Control and Prevention division for heart disease and stroke prevention, who led the analysis.

The findings come as first lady Michelle Obama has announced plans to help lead the nation’s efforts to reduce childhood obesity. During a speech Wednesday to the U.S. Conference of Mayors, Obama called for better eating habits, improved nutrition and more physical activity.

In the new study, published in the CDC’s Morbidity and Mortality Weekly Report, researchers analyzed data collected from 3,125 youths by the National Health and Nutrition Examination Survey, which is conducted every two years to gather a variety of health information.

The analysis, from data collected in surveys conducted between 1999 and 2006, found that 20.3 percent had abnormal “blood lipid” levels, which includes high levels of low-density lipoprotein (LDL), the so-called “bad cholesterol,” low levels of high-density lipoprotein (HDL), which is known as the “good cholesterol” and high levels of triglycerides, which can also clog arteries.

The percentage of teens having an abnormal blood lipid level varied by weight, ranging from 14.2 percent of those whose weight was normal to 22.3 percent among those who were overweight and 42.9 percent among those who were obese, the researchers reported.

The findings support a 2008 recommendation by the American Academy of Pediatrics that children and adolescents get blood tests to see whether they need to be treated for abnormal lipid levels if they are at risk for heart disease because of a family history of high blood cholesterol, early heart disease or if they are at risk because they smoke, have high blood pressure or diabetes, or are overweight.

The analysis showed that about a third of youths would be eligible for screening based on their weight alone, and about a fifth would be eligible for at least counseling to try to reduce their risk. The first step would be to try to improve diets, increase exercise and reduce weight before drug therapy was considered, May said.

The analysis found that boys were more likely than girls to have an abnormal blood test, with 24 percent of males having an abnormal reading compared with 16 percent of girls. Fourteen- and 15-year-olds and 18- and 19-year-olds were more likely to have low levels of the HDL “good” cholesterol levels than 12- and 13-year-olds. White teens were more likely to have low HDL levels and high triglycerides, compared with black teens.

Dieting? Lifestyle changes? Cutting calories? What to do when trying to lose weight. Well there is not one simple answer it turns out. Bonnie Taub-Dix, a registered dietitian and spokeswoman for the American Dietetic Association, argues for an “introspective approach.” In a country where two thirds of the population is overweight, it is crucial to understand the best way to go about losing weight healthfully and successfully; most importantly, losing weight in a manageable way. People are busy, life can get in the way, but taking care of your health is number one.

By Jennifer LaRue Huget
Thursday, February 4, 2010

Washington Post

Are we done dieting?

Many of us want to lose weight, and many more probably should. But in recent months I’ve seen a subtle shift in the diet-guidance market: Instead of prescribing eating regimens, many weight-loss experts are suggesting that we reevaluate our relationship with food, focus on eating healthful whole foods and use psychology to aid our efforts to shed pounds.

Books such as “The End of Overeating,” “Mindful Eating” and “Overcoming Overeating” omit the word “diet” from their titles. Others, such as “The Beck Diet Solution” and “The 9-Inch ‘Diet,’ ” retain the word but rebel against it; first book’s subtitle is “Train Your Brain to Think Like a Thin Person.”

Of course, there are still plenty of conventional diet plans. There’s no escaping the “Biggest Loser” series or the “Flat Belly Diet!” Some people will always prefer to be told what to eat and when to eat it. And for those who like to count, be it calories, fat, carbs or protein grams, options still abound.

In fact, the research firm Marketdata Enterprises shows that the dieting industry earned $55 billion in 2006, a number that’s expected to rise to $68.7 billion this year. High-profile programs such as Weight Watchers and Jenny Craig continue to do big business; Marketdata says they made $1.2 billion and $462 million, respectively, in 2006.

But at the same time, the research firm reports that of an estimated 72 million American dieters, 70 percent are trying to lose weight on their own.

Those people, many of whom might seek guidance from books, now can choose resources that offer a holistic and, to my mind, more realistic approach than the standard diet guide. Rather than dictate consumption of specific foods (and avoidance of others) according to a strict schedule, non-diet approaches encourage us to seek a healthful balance of nutrients in our meals and snacks and to recognize and learn to overcome the triggers that lead us to overeat. They urge us to pay close attention to food as we eat it so we feel fully satisfied with a modest amount, and they press us to monitor portion sizes more than calorie counts. These habits may sustain us in our weight control better than the latest fad diet will.

Even Weight Watchers has tuned in to this phenomenon: The program’s current tag line is “Stop Dieting. Start Living,” and supporting text notes that “Weight Watchers works because it’s not a diet,” though the program still has participants tally “points” for the foods they eat and dictates how many points to consume to achieve weight loss. That sounds like a diet to me.

Dieting for weight loss is a relatively recent phenomenon. For much of human history, simply keeping enough flesh on our bones to survive winter was feat enough. Even once we’d moved indoors, a bit of pudge was long viewed as a sign of wealth and well-being. Only in the past century and a half has “diet” come to mean a means of making ourselves skinny.

But if diets have increased in popularity since the late 1800s, well, they haven’t worked. An astounding one-third of Americans are obese, according to federal data released last month, and more than two-thirds of us are at least overweight.

Bonnie Taub-Dix, a registered dietitian and spokeswoman for the American Dietetic Association, says she encourages people to take what she calls a “more introspective approach” to weight loss, one that takes into account the outside influences that contribute to eating habits. “You need to learn to eat for life,” she says.

“A lot of people think following a diet plan makes things easier, more mindless,” Taub-Dix says. “But the reality is that it’s not easy to eat that way.”

“Dieting is very often like a magnet attached to the word ‘deprivation,’ ” she continues. “When you’re on a diet, you feel deprived, outcast, and you can’t wait for it to end.”

“I’m glad fad diets come and go,” Taub-Dix says, “and I’m happiest when they go. Most are unhealthy, anyway,” in that they tend to “emphasize one food group over another” rather than promoting a balanced mix. Such schemes, she says, are “doomed to fail. They only work on a temporary basis.”

Taub-Dix, who says she lost 30 pounds as a teenager and has maintained a healthy weight ever since, asserts that the most successful weight-management program is one that’s as close as possible to what you normally do. Even so, she notes, losing weight’s not easy. “It’s not easy to raise kids. It’s not easy to hold on to a job. It’s not easy to drive in heavy traffic. There’s a lot of things we do every day that aren’t easy. Why should food be different?”

The dietitian is clearly not alone in embracing her no-diet philosophy. Still, I don’t really believe the demise of the diet is in sight. Even as I was writing this column, FedEx delivered a package to my door. In it was a review copy of a new book: “The New Atkins for a New You,” an updated version of the popular low-carb diet plan, to be published March 2.

Lead researcher of a study published in the New England Journal of Medicine, Paul William Franks, an associate professor of experimental medicine and head of the genetic epidemiology and clinical research group at Umea University Hospital in Umea, and his team investigated the effects of early prevention and childhood obesity. In their analysis, the researchers looked for a correlation between weight, blood sugar, blood pressure and cholesterol and premature death. Dr. William C. Knowler, chief of diabetes epidemiology and clinical research at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases and a study co-author and Edward W. Gregg, chief of epidemiology and statistics for the diabetes program at the U.S. Centers for Disease Control and Prevention, who wrote an accompanying journal editorial, emphasized the deadliness of childhood obesity.

They have double the odds of dying before age 55, study finds

By Steven Reinberg HealthDay Reporter

WEDNESDAY, Feb. 10 (HealthDay News) — Obese children are at a greater risk of dying young, a new study finds.

In fact, obese children are twice as likely to die before age 55 as are normal-weight children. In addition, because many people who die in early adulthood leave behind young families, this poses a multigenerational, societal problem, the researchers point out.

“The results of this study suggest that obesity prevention should begin in early childhood,” said lead researcher Paul William Franks, an associate professor of experimental medicine and head of the genetic epidemiology and clinical research group at Umea University Hospital in Umea, Sweden. “This will involve ensuring our children eat healthy, well-balanced diets and maintain physically active lifestyles.”

If the rates of obesity, high blood pressure, and high blood sugar continue to increase in today’s children, “human life span may decrease,” Franks said.

The study’s findings are reported in the Feb. 11 issue of the New England Journal of Medicine.

For the study, Franks and his colleagues collected data on 4,857 American Indian children, born between 1945 and 1984. About 29 percent of the children, from the Pima and Tohono O’odham communities in Arizona, were obese — a prevalence comparable to that of African American and Hispanic children in the United States today and making the findings applicable to other ethnic groups, the researchers said.

In their analysis, the researchers looked for a correlation between weight, blood sugar, blood pressure and cholesterol and death before age 55. Over almost 24 years, 166 people in the study died.

People who had been obese as children had more than double the risk for dying before age 55, compared with those who had not been obese as children, the researchers found.

In addition, children who had high blood sugar levels had a 73 percent increased risk for dying, versus children with the lowest levels.

“This is more evidence that childhood obesity is a serious problem,” said Dr. William C. Knowler, chief of diabetes epidemiology and clinical research at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases and a study co-author.

Other factors, such as cholesterol levels and blood pressure, were not significant in these deaths, the researchers noted. However, high blood pressure coupled with high blood sugar were deemed to play a role in the premature deaths.

“Children living today who are obese, who have high blood pressure or who have high blood glucose levels may be more likely to die prematurely than healthy children,” Franks said.

“We do not know what the impact is of childhood obesity, hyperglycemia and hypertension on mortality rates later in life,” he noted. “Nor do we know by how many years these childhood risk factors shorten life span.”

But the hope, Knowler noted, is that by reducing childhood obesity you will also reduce the risk for early death.

“Avoiding becoming obese is certainly better than becoming obese and then reducing weight,” he said. “Once someone is obese, restoring normal weight is exceedingly difficult.”

Franks added that weight loss in children is not generally recommended, especially if this involves crash dieting.

Simple ways to fight the obesity battle include eating less, reducing portion size and becoming more physically active. In addition, parents should be a model for their children when it comes to healthy eating and exercise, Franks noted.

Edward W. Gregg, chief of epidemiology and statistics for the diabetes program at the U.S. Centers for Disease Control and Prevention, who wrote an accompanying journal editorial, said that “we have seen increasing obesity in youth for a while and we’ve seen concerning levels of pre-diabetes in youth, but we haven’t really known what the implications are.”

The question now is how to respond to these findings, Gregg said. However, he said it’s not clear how to identify and find programs that work for children in preventing disease or death in adulthood.

“We need to find ways to prevent obesity in children,” he said. “The challenge is getting the right interventions.”

Gregg thinks the answer lies in a complex combination of programs for families and schools, nutrition and physical activity that will change lifestyles.

“This is ultimately going to require a full-court press of multiple approaches to make a difference,” he said. “This is not something that is going to get fixed in a year or two. We have to look at this over the long haul. It’s going to take slow steady efforts. That’s where we are with obesity and diabetes right now.”

According to the American Academy of Child & Adolescent Psychology, more than 300,000 people die annually from “unhealthy weight gain due to poor diet and lack of exercise.” That rising number of obese individuals leads to increased spending  to the tune of $100 billion a year in medical care.

BY JAMES H. BURNETT III

JBURNETT@MIAMIHERALD.COM

In a week that has seen Michelle Obama, first lady of the United States, unveil a national plan to help get kids fit, it should go without saying that an apple a day really can keep the doctor away . . . along with an hour of exercise a day, a healthy diet, and reasonable sleep.

But lest you stop reading now with an exasperated sigh, while muttering to yourself, Duh!, consider that the United States, which leads the world in many categories of achievement, is fast approaching a new record, with as much as 33 percent of its juvenile population severely overweight or obese.

South Florida has its share of obese folks, and while some folks have sheepish or sad memories of poking fun at portly friends back in the day, or being picked on, the weight of their children and their children’s children is fast becoming a national crisis.

Medical experts say obese kids grow into obese adults 80 percent of the time, and extra weight dominoes into asthma, diabetes, bad joints and backs, and heart disease.

ONE CHILD’S EXPERIENCE

If you get no other epiphanic words this month, get these by 13-year-old Nicholas Perello of Miami, a now-healthy kid who was obese and faltering health-wise till last summer, when he attended Wellspring, which runs residential weight-loss centers.

“I just had a real problem with the food,” Nicholas says matter-of-factly. “I didn’t necessarily eat low quality food. But the foods I ate were too rich. My blood pressure was really high and my cholesterol, and like sometimes my heart raced.”

While at a six-week Wellspring program in Vancouver last summer, Perello became an enthusiastic disciple of Wellspring’s hardly glam plan: personal responsibility through “low-fat diet, walking 10,000 steps per day, [and] self-monitoring food activity.”

In Broward County, Sheryl Woods, chief executive officer of the YMCA, says her organization has “made childhood obesity and healthcare a priority,” through new fitness programs and family classes in proper diet and lifestyle organization, among other things.

The Broward County Y even placed a YMCA branch inside Lauderhill Middle School — the first such arrangement with a school in Florida.

“We’re building climbing walls in our buildings. We’re replacing traditional video games with Wii Fit games,” Woods says.

“It’s all about activity and healthy living. It sounds so simple.”

IT IS SO SIMPLE

And that’s because it is so simple, like saving yourself a major roof repair bill later by cleaning the leaves from the gutters regularly now, or making your car last longer — and saving yourself the high cost of replacing its engine later — by maintaining it regularly now.

I hope that logic translates to “maintaining” your kid’s health, when food options are low-fat, high-protein, high-fiber meats and/or veggies vs. Crusty Burgers.

Because it will take a Moses-style miracle for Congress to reform anything. And if it ever does fix anything, it won’t be healthcare.

That starts at home.

It will be the application of medical care and medical insurance.

And if the logic of “home healthcare maintenance” doesn’t click with you, dig deep in both your emotional and piggy banks.

According to the American Academy of Child & Adolescent Psychology, more than 300,000 people die annually from “unhealthy weight gain due to poor diet and lack of exercise.”

AACAP says those obese people who manage to stay alive require another $100 billion a year in medical care, a significant portion of which the most obese among us can’t pay for alone.

Suddenly, that value menu isn’t such a good deal.

The first lady, Michelle Obama, has an ambitious goal for America, to get on track to solve the childhood obesity problem in a generation. She contends that this plan will require stepped-up effort from parents, schools, businesses, nonprofit groups, health professionals and governments. Obesity expert Dr. David Katz, director of Yale University’s Prevention Research Center, and Clyde Yancey, president of the American Heart Association, explains that this problem cannot be fixed overnight, but Michelle Obama’s efforts will be a positive step in the right direction. Jeff Levi, executive director of the Trust for America’s Health, a Washington-based public health research organization, argues that this problem must be fixed via a collaborative effort. Dora Rivas, president of the School Nutrition Association and director of food services for the Dallas public schools, said Michelle Obama can be a ”great motivator” for parents and kids. With all the people who are working towards helping America’s childrens’ health, it creates a hopeful outlook that this epidemic is moving toward healthier changes.

By THE ASSOCIATED PRESS

February 8, 2010

WASHINGTON (AP) — By now, it is abundantly clear that Michelle Obama loves french fries.

The first lady talks about this ”guilty pleasure” all the time, trying to ward off any notion that she is a nutrition nanny even as she cajoles Americans to eat better.

Now, her conversation with the public about the nation’s health and fitness is about to get a lot more pointed.

After laying the groundwork for nearly a year, she launches a campaign on Tuesday against childhood obesity that she hopes will change the way millions of Americans eat, exercise, look and feel.

To succeed, she will have to take on powerful forces that have left one-third of children overweight:

–busy parents who hit the fast-food drive-thru rather than cook a balanced dinner.

–schools where cafeteria meals compete with vending machines and a la carte lines stocked with soda and candy bars.

–food companies that spend billions hawking fatty snacks to children.

–poor neighborhoods where nary a banana nor a head of broccoli can be found on store shelves.

–the screens — computer, TV, video — that keep kids off their bikes.

The first lady’s goal is ambitious: to put America on track to solve the childhood obesity problem in a generation. It’s a far cry from the days when Dolley Madison, the first first lady to associate herself with a specific cause, helped to found a District of Columbia home for orphaned girls.

”Thank God it’s not going to be solely up to me,” Obama said recently, stressing that the solution will require stepped-up effort from parents, schools, businesses, nonprofit groups, health professionals and governments.

To underscore that point, she’s bringing together Cabinet members, mayors, sports and entertainment figures, business leaders and more to announce the details of the administration’s effort. That will involve promoting healthier schools, increasing physical activity for kids, improving access to healthy foods and giving people more nutrition information.

Health advocates couldn’t be happier to have a popular first lady adopting childhood obesity as her cause. They’re also keenly aware of how difficult the problem will be to solve.

”You don’t just go from epidemic obesity to epidemic leanness,” says obesity expert Dr. David Katz, director of Yale University’s Prevention Research Center.

Still, Katz says, Obama can provide the inspiration to help ”shift the massive momentum of our society in the right direction.”

Lofty goals have come and gone before.

A decade ago, the government’s ”Healthy People” program set a 2010 target that just 5 percent of children would be overweight or obese. The most updated government figures, released last month, weighed in at 32 percent for 2007-2008. The childhood obesity rate has at least held steady in recent years, but at levels that still leave today’s children on track to die younger than their parents.

The first lady has prepared for the obesity campaign by falling asleep over briefing papers, consulting with legislators, Cabinet members and policy experts, and speaking about the challenges that overstressed parents face in doing right by their children. And, famously, by hula hooping on the South Lawn to promote the need to get kids moving.

She says she spent the past year figuring out how to talk about all of this ”in a way that doesn’t make already overstressed, anxious parents feel even more guilty about a very hard thing.” That’s where the french fries come in, part of the first lady’s message that nobody’s perfect and that there’s plenty of wiggle room in a healthy diet.

Obama caught some criticism by talking openly about having to watch the weight of her own daughters, a sign of just how touchy the subject can be.

Clyde Yancey, president of the American Heart Association, said Obama’s focus will help generate the ”noise” needed to change attitudes. But he said lots of organizations need to be involved to make substantive changes such as reducing fatty snacks and sodas in schools, providing better nutrition labeling of processed foods and more.

”Anything she can do would be helpful because the burden of the problem is just that profound,” Yancey said.

Her challenge will be to give her message more bite than last year’s gentle prodding, without coming on too strong and sounding like a national scold. She’ll have to find creative ways to keep the message fresh so people don’t tune out.

”It has to be a pretty aggressive bully pulpit,” says Jeff Levi, executive director of the Trust for America’s Health, a Washington-based public health research organization. ”It has to be much more than cajoling, and how do we solve this problem together.”

Levi said the first lady, who speaks as a mother as well as a public figure, can have a huge impact by helping change parents’ and kids’ attitudes toward food and exercise. But an effective campaign against childhood obesity also will require more money to carry out programs to help families turn changed attitudes into action.

”We already have in place a constellation of programs that together can provide the opportunity to make the changes in schools and communities that would make a difference,” he said. ”The problem is that they are not fully funded.”

Ideas abound for addressing the problem:

–increase federal money to make healthier school lunches for poor kids.

–improve nutrition standards for school lunches; get the chips and doughnuts out of school vending machines.

–expand time for school recess and physical education.

–use federal incentives to encourage low-income families to buy healthier foods.

–prod food makers to stop targeting children with ads for high-calorie treats on TV and in online video games.

–get more restaurants to print nutrition information on menus.

–do more medical screening for obesity in children.

–improve food labeling.

–provide more behavior counseling to overweight kids.

The list goes on.

The school lunch program, which is up for an overhaul by Congress this year, is one sure area of focus, and the administration is working with legislators on how to revise it. There should be some extra money available: President Barack Obama’s proposed budget calls for an additional $1 billion a year for child nutrition programs. Last year’s economic stimulus package included $500 million for one-time grants to help states and communities tackle smoking, obesity and various preventable health problems.

Dora Rivas, president of the School Nutrition Association and director of food services for the Dallas public schools, said Michelle Obama can be a ”great motivator” for parents and kids. But, he said, schools need more federal dollars to work more fresh fruits and vegetables and whole grains into lunches, and to keep up with the growing numbers of children who qualify for free or reduced-cost meals.

Katz, the Yale obesity expert, said that while more money always helps, much can be done through sheer will and low-cost ingenuity to help build more physical activity into daily life and to motivate people to eat better.

As people demand better food, companies will respond with better choices, he says.

Like the first lady, though, Katz identified ”food deserts” — poor areas where it’s hard to find stores that offer healthy foods — as a particularly tough problem, one that will require addressing broader social inequities in society.

The first lady said last month she won’t be satisfied unless she knows she’s made a difference.

”That’s the legacy I want,” she said. ”I want to leave something behind that we can say, because of this time that this person spent here, this thing has changed.”

A new study from the Kaiser Family Foundation, and expert Dr. Michael Rich, a pediatrician at Children’s Hospital Boston who directs the Center on Media and Child Health, examined the potential link between the increased use of media products by America’s youth and the effects on their behavior and health. Physical activity is important for children to stay healthy. People wonder and worry that the increased amount of time young people spend playing with electronics could have negative social and health related impact

By TAMAR LEWIN
New York Times

The average young American now spends practically every waking minute — except for the time in school — using a smart phone, computer, television or other electronic device, according to a new study from the Kaiser Family Foundation.

Those ages 8 to 18 spend more than seven and a half hours a day with such devices, compared with less than six and a half hours five years ago, when the study was last conducted. And that does not count the hour and a half that youths spend texting, or the half-hour they talk on their cellphones.

And because so many of them are multitasking — say, surfing the Internet while listening to music — they pack on average nearly 11 hours of media content into that seven and a half hours.

“I feel like my days would be boring without it,” said Francisco Sepulveda, a 14-year-old Bronx eighth grader who uses his smart phone to surf the Web, watch videos, listen to music — and send or receive about 500 texts a day.

The study’s findings shocked its authors, who had concluded in 2005 that use could not possibly grow further, and confirmed the fears of many parents whose children are constantly tethered to media devices. It found, moreover, that heavy media use is associated with several negatives, including behavior problems and lower grades.

The third in a series, the study found that young people’s media consumption grew far more in the last five years than from 1999 to 2004, as sophisticated mobile technology like iPods and smart phones brought media access into teenagers’ pockets and beds.

Dr. Michael Rich, a pediatrician at Children’s Hospital Boston who directs the Center on Media and Child Health, said that with media use so ubiquitous, it was time to stop arguing over whether it was good or bad and accept it as part of children’s environment, “like the air they breathe, the water they drink and the food they eat.”

Contrary to popular wisdom, the heaviest media users reported spending a similar amount of time exercising as the light media users. Nonetheless, other studies have established a link between screen time and obesity.

While most of the young people in the study got good grades, 47 percent of the heaviest media users — those who consumed at least 16 hours a day — had mostly C’s or lower, compared with 23 percent of those who typically consumed media three hours a day or less. The heaviest media users were also more likely than the lightest users to report that they were bored or sad, or that they got into trouble, did not get along well with their parents and were not happy at school.

The study could not say whether the media use causes problems, or, rather, whether troubled youths turn to heavy media use.

“This is a stunner,” said Donald F. Roberts, a Stanford communications professor emeritus who is one of the authors of the study. “In the second report, I remember writing a paragraph saying we’ve hit a ceiling on media use, since there just aren’t enough hours in the day to increase the time children spend on media. But now it’s up an hour.”

The report is based on a survey of more than 2,000 students in grades 3 to 12 that was conducted from October 2008 to May 2009.

On average, young people spend about two hours a day consuming media on a mobile device, the study found. They spend almost another hour on “old” content like television or music delivered through newer pathways like the Web site Hulu or iTunes. Youths now spend more time listening to or watching media on their cellphones, or playing games, than talking on them.

“I use it as my alarm clock, because it has an annoying ringtone that doesn’t stop until you turn it off,” Francisco Sepulveda said of his phone. “At night, I can text or watch something on YouTube until I fall asleep. It lets me talk on the phone and watch a video at the same time, or listen to music while I send text messages.”

Francisco’s mother, Janet Sepulveda, bought his phone, a Sidekick LX, a year ago when the computer was not working, to ensure that he had Internet access for school. But schoolwork has not been the issue.

“I’d say he uses it about 2 percent for homework and 98 percent for other stuff,” she said. “At the beginning, I would take the phone at 10 p.m. and tell him he couldn’t use it anymore. Now he knows that if he’s not complying with what I want, I can suspend his service for a week or two. That’s happened.”

The Kaiser study found that more than 7 in 10 youths have a TV in their bedroom, and about a third have a computer with Internet access in their bedroom.

“Parents never knew as much as they thought they did about what their kids are doing,” Mr. Roberts said, “but now we’ve created a world where they’re removed from us that much more.”

The study found that young people used less media in homes with rules like no television during meals or in the bedroom, or with limits on media time.

Victoria Rideout, a Kaiser vice president who is lead author of the study, said that although it has become harder for parents to control what their children do, they can still have an effect.

“I don’t think parents should feel totally disempowered,” she said. “They can still make rules, and it still makes a difference.”

In Kensington, Md., Kim Calinan let her baby son, Trey, watch Baby Einstein videos, and soon moved him on to “Dora the Explorer.”

“By the time he was 4, he had all these math and science DVDs, and he was clicking through by himself, and he learned to read and do math early,” she said. “So if we’d had the conversation then, I would have said they were great educational tools.”

But now that Trey is 9 and wild about video games, Ms. Calinan feels differently.

Last year, she sensed that video games were displacing other interests and narrowing his social interactions. After realizing that Trey did not want to sign up for any after-school activities that might cut into his game time, Ms. Calinan limited his screen time to an hour and half a day on weekends only.

So last Wednesday, Trey came home and read a book — but said he was looking forward to the weekend, when he could play his favorite video game.

Many experts believe that media use is changing youthful attitudes.

“It’s changed young people’s assumptions about how to get an answer to a question,” Mr. Roberts said. “People can put out a problem, whether it’s ‘Where’s a good bar?’ or ‘What if I’m pregnant?’ and information pours in from all kinds of sources.”

The heaviest media users, the study found, are black and Hispanic youths and “tweens,” or those ages 11 to 14.

Even during the survey, media use was changing.

“One of the hot topics today is Twitter, but when we first went into the field and began interviewing, Twitter didn’t exist,” Ms. Rideout said.