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Prevention Research Centers Take an Environmental Approach to Address Obesity Among Youth

April 2013

Childhood obesity has more than tripled in the past 30 years. In 2008, more than one third of children and adolescents were overweight or obese. 1 Obese young people are more likely to become obese adults and more at risk for heart disease, diabetes, and certain types of cancer.2,3 Efforts to promote healthy choices regarding nutrition, physical activity, and obesity contribute towards a CDC Winnable Battle. Many times, progress in this area is made through environmental initiatives that make healthy choices easily accessible. One potentially substantial area of importance is to increase the availability and consumption of water among young people.

Studies have shown water—

Girl drinking water from a bottle
  • Replaces sugar-sweetened beverages (thereby lowering caloric intake).
  • Improves cognitive function.4
  • Prevents cavities (if water is fluoridated).
  • Improves overall health.

Two Prevention Research Centers (PRCs) have evaluated the effect of providing drinking water to young people in an effort to reduce obesity.

  • Harvard University PRC researchers evaluated an initiative to increase access to water during Boston after-school programs.
  • New York University PRC evaluated the provision of water jets in New York City public school cafeterias.
Boy drinking a glass of water

The Harvard University PRC developed and tested the Out of School Nutrition and Physical Activity Initiative (OSNAP) in Boston after school programs. The OSNAP study involved three learning collaborative sessions with afterschool program staff, encouraging communication with families and activities to increase child enthusiasm for water. Researchers also collaborated with Boston Public Schools Food and Nutrition Services to include water on snack menus and provide cups, pitchers, and jugs. After 6 months, researchers found that programs participating in OSNAP served water more frequently, served 3.6 more ounces of water during snack time, and served 60.9 fewer beverage calories on average per child each day than programs without OSNAP.3 Boston Public Schools Food and Nutrition Services has used the findings from the OSNAP study to extend similar citywide efforts throughout all of their after-school programs that provide snacks.

“We worked with organizations that serve children and focused on improving access to drinking water. This simple, sustainable change has improved children’s access to water and promoted a healthy food and beverage environment for them,” said Katie Giles, MPH, Project Manager at the Harvard PRC and the study’s lead author.

Water jets in a New York City public school cafeteria

Water jets were placed in New York City public school cafeterias by the NYC Department of Health and Mental Hygiene funded by a CDC Communities Putting Prevention to Work grant. The New York University School of Medicine PRC was supported through the PRC’s Nutrition and Obesity Policy Research and Evaluation Network to evaluate the effect of the water jets. Researchers surveyed nearly 3,000 students (5th, 8th, and 11th graders) about lunchtime water and milk consumption and overall opinions about water. Preliminary results have revealed students increased their water consumption during lunchtime.

“Water jets are relatively easy to put into action and have shown promising results. Even with this relatively simple intervention of water availability, students were still using the water jets a year after the follow-up surveys were conducted,” said Brian Elbel, PhD, the study’s lead author. Dr. Elbel and colleagues are working on final analysis and a scientific journal article.

Environmental approaches to promote healthy behaviors are powerful, as they have the potential to remove barriers for everyone in that environment. Addressing obesity among American youth requires concerted efforts directed toward nutrition and physical activity, and providing water as a healthy beverage option is a valuable component to such efforts.

  1. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA 2010;303(3):242-249.
  2. National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: the Evidence Report. Bethesda, MD: National Institutes of Health, US Department of Health and Human Services; 1998.
  3. Centers for Disease Control and Prevention. Basics About Childhood Obesity. http://www.cdc.gov/obesity/childhood/basics.html. Accessed February 5, 2013.
  4. Edmonds CJ, Burford D. Should children drink more water? The effects of drinking water on cognition in children. Appetite. 2009;52:776-779.
  5. Giles CM, Kenney EL, Gortmaker SL, et al. Increasing water availability during afterschool snack. Am J Prev Med. 2012;43(3S2):S136-S142.

 

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