CHILDHOOD OBESITY PREVENTION IN TEXAS

Workshop Summary

Kara Nyberg, Annina Catherine Burns, and Lynn Parker, Rapporteurs

Food and Nutrition Board

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
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CH ILDHOOD OBESITY PREVENTION I N TEXAS Workshop Summary Kara Nyberg, Annina Catherine Burns, and Lynn Parker, Rapporteurs Food and Nutrition Board

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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee respon- sible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Grant No. 61747 between the National Academy of Sciences and The Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number-13: 978-0-309-14417-9 International Standard Book Number-10: 0-309-14417-5 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2009 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Cover credit: Top and second from bottom: courtesy of Marathon Kids, www. marathonkids.org. Background image: courtesy of Matthew B. Spear. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. Suggested citation: IOM (Institute of Medicine). 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press.

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“Knowing is not enough; we must apply. Willing is not enough; we must do.” — Goethe Advising the Nation. Improving Health.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Acad- emy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineer- ing programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is presi- dent of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Insti- tute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sci- ences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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PLANNINg COMMITTEE FOR A WORkSHOP ON CHILDHOOD ObESITy PREvENTION: AuSTIN, TExAS* EDuARDO J. SANCHEZ (Chair), Vice President and Chief Medical Officer, Blue Cross and Blue Shield of Texas LEANN L. bIRCH, Distinguished Professor of Human Development and Director, Center for Childhood Obesity Research, Pennsylvania State University WILLIAM H. DIETZ, Director, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention THOMAS N. RObINSON, Associate Professor of Pediatrics and Medicine, Stanford Prevention Research Center, Stanford University Study Staff ANNINA CATHERINE buRNS, Co-Study Director LyNN PARkER, Co-Study Director NICOLE FERRINg, Research Associate MATTHEW b. SPEAR, Senior Program Assistant ANTON L. bANDy, Financial Associate gERALDINE kENNEDO, Administrative Assistant LINDA D. MEyERS, Director, Food and Nutrition Board * Institute of Medicine (IOM) planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution. v

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Reviewers This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report: ALICE AMMERMAN (Non-attendee), Director, Center for Health Promotion and Disease Prevention, University of North Carolina TRACy FOx (Non-attendee), President, Nutrition & Policy Consultants, LLC, Washington, DC DEANNA HOELSCHER (Attendee), Director, Michael & Susan Dell Center for Healthy Living, University of Texas DONNA NICHOLS (Attendee), Community Health Specialist, Michael & Susan Dell Center for Healthy Living, University of Texas Although the reviewers listed above provided many constructive com- ments and suggestions, they did not see the final draft of the report before its release. The review of this report was overseen by EILEEN kENNEDy, Dean, Friedman School of Nutrition Science and Policy, Tufts University, vii

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viii REVIEWERS Boston, MA. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

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Contents SuMMARy 1 1 INTRODuCTION 7 References, 9 2 OPENINg SESSION 11 References, 14 3 CHILDHOOD ObESITy IN TExAS: AN OvERvIEW 15 References, 20 4 TExAS STATE gOvERNMENT: SuCCESSES TO DATE 21 Reference, 24 5 TExAS STATE gOvERNMENT: WHAT THE FuTuRE HOLDS 25 6 A LOOk AT THE TExAS LANDSCAPE 31 City of Austin/Travis County Health and Human Services Department, 31 Paso Del Norte Health Foundation, El Paso, 34 Children and Neighbors Defeat Obesity (CAN DO) Houston, 35 Lean Coalition, Henderson, 37 ix

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x CONTENTS 7 A LOOk AT THE AuSTIN LANDSCAPE 39 RunTex, 39 Marathon Kids, 40 ACTIVE Life, 40 Capital Area Food Bank, 41 EnviroMedia Social Marketing, 43 Sustainable Food Center, 43 8 LIvE SMART TExAS PANEL PRESENTATION 47 9 MAJOR THEMES 53 Garnering Support for Childhood Obesity Initiatives, 53 Modeling Healthy Behaviors Throughout the Community, 54 Leveraging the Power of Partnerships, 55 Implementing Comprehensive Approaches, 55 Using Social Marketing, 56 Identifying a Champion, 56 Recognizing the Power of Community Data, 57 Implementing Federal Policy Change, 57 Securing Funding, 57 Closing Thoughts, 57 APPENDIxES A Workshop Agenda 59 B Biographical Sketches 61 C Workshop Participants 73