Research of Note for December 2003-January 2004

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Youth obesity is a hot topic, and researchers are examining every aspect of its causes and consequences, as well as how to combat it. A recent issue of the medical journal for pediatricians, Archives of Pediatrics & Adolescent Medicine (Vol. 157, August 2003), was devoted entirely to obesity and physical activities. Following are a few of the interesting results:

Sticks and Stones: Does Teasing Hurt?

Associations of Weight-Based Teasing and Emotional Well-being Among Adolescents
Marla Eisenberg, Sc.D., M.P.H., Dianne Neumark-Sztainer, Ph.D., M.P.H., Mary Story, Ph.D.
Pgs. 733-738.
Available free from Eisenberg, Division of General Pediatrics and Adolescent Health, School of Public Health, University of Minnesota, 200 Oak St. SE, Suite 260, Minneapolis, MN 55455, or

Despite the claim that “names will never hurt me,” every youth worker knows that name-calling does hurt. This study shows the pervasiveness of teasing about weight among adolescents, and how that teasing influences a youth’s self-esteem, depression and thinking about suicide – regardless of how much the youth actually weighs.

The study was conducted on more than 4,700 ethnically diverse adolescents in grades seven through 12 in 31 public middle schools and high schools in Minneapolis/St Paul.

Approximately half were female, half were white, half were middle class or upper middle class, and two-thirds were high school students.

Thirty percent of the girls and 25 percent of the boys reported being teased about their weight by their peers, and almost as many (29 percent of girls and 15 percent of boys) reported being teased about their weight by family members.

The kids were assessed on five emotional health measures: body satisfaction, self-esteem, symptoms of depression, suicidal thoughts and suicide attempts. On all five measures, kids who reported being teased about their weight by peers or relatives had more problems than kids who were not teased at all. If they were teased by both peers and relatives, they reported even more problems than those teased only by one or the other.

These differences are substantial. For example, more than half the girls teased by peers and family members reported that they had thought about suicide, compared with one in four of those not teased. Also, almost one in four had attempted suicide, compared with 9 percent of those not teased. Boys teased by peers and family were three times as likely to attempt suicide (12 percent) as those not teased (4 percent).

These results are shocking, but the question arises: Are these adolescents having problems because they are being teased or because they are overweight? Or perhaps adolescents who are overweight might tend to be from certain ethnic groups, and might have problems because of other types of discrimination. The researchers statistically controlled for these possible influences, and found that kids who were teased about their weight still had more negative views of themselves and were more suicidal than kids who were not teased.

In fact, when the amount of teasing was controlled for, kids who were overweight did not have lower self-esteem, more suicidal thoughts or more suicide attempts than other kids. Although boys who were overweight were more depressed than boys who were not, this was not true for girls. And the negative influence of teasing was apparent in every ethnic group.

The one major shortcoming of the study is that the teasing is reported only by the youths. It is certainly possible that kids who are depressed or who have lower self-esteem or poor body image are more sensitive to teasing and therefore more likely to report it. Nevertheless, it seems likely that teasing itself has a negative impact.

What youth worker hasn’t seen kids teased about their weight? Although such remarks may not seem as demeaning as ethnic or racial slurs, this study suggests that these remarks deserve the same kind of attention from youth workers. The rates of suicidal thoughts and attempts were alarmingly high for all the youths, and especially frightening for girls who reported being teased about their weight.

Do Food Programs Contribute to Obesity?

Lower Risk of Overweight in School-aged Food Insecure Girls Who Participate in Food Assistance
Sonya Jones, Ph.D., Lisa Jahns, R.D., Barbara Laraia, Ph.D., R.D., and Betsy Haughton, Ed.D., R.D.
Pgs. 780-784.
Available free from Jones at Dept. of Nutrition, University of Tennessee, 1215 Cumberland Ave., Room 229, Knoxville, TN 37996-1920, or

Not too many policy-makers openly oppose child nutrition programs, but in the past year some people have blamed the food stamp and subsidized school lunch programs for obesity among low-income children. This study, however, indicates that these programs are improving the health of poor children, not making it worse.

The study was based on a 1997 government survey with the snappy title, “Panel Study of Income Dynamics Child Development Supplement.” It focused on households that would be eligible for at least some food assistance programs. All of the households were below 185 percent of the poverty level and had children between the ages of 5 to 12.

The researchers found that 39 percent of the children in the study were “at risk of overweight” and 26 percent of the households were “food insecure.” Food insecurity was based on a standard measure developed by the U.S. Department of Agriculture, and ranged from anxiety about food shortages in the household to children going hungry.

The stereotype is that food stamps, food subsidies and worry about lack of food encourage children to eat too many fattening foods. But children in households that were secure about food were more likely to be overweight than those in households that were insecure about food. Kids from food insecure households were even less likely to be overweight if their families participated in the food stamp, free school breakfast or free school lunch programs. In addition, children who participated in none of the food assistance programs were more likely to be underweight.

When boys and girls were studied separately, the programs were found to be more advantageous to girls. Girls living in households that were insecure about food but participated in all three programs were 68 percent less likely to be overweight than girls in similar households who did not participate in the food programs. In contrast, boys’ weight was not influenced by whether they participated in food programs.

Does this put to rest the idea that food programs are part of the obesity problem? Not exactly. The greatest shortcoming of the study is that weight was estimated by the parents, not objectively evaluated. It’s impossible to know if these estimates are accurate, and underestimates of weight might be more likely in households that are insecure about food.

It is also worth noting that obesity is a problem nationwide, and government food programs could probably do more to encourage healthful eating in order to help reduce obesity, even if current programs aren’t contributing to the problem.

Recreation Programs Work

Physical Activity in Middle School-Aged Children Participating in a School-Based Recreation Program
C. Lawrence Kien, M.D., Ph.D., and Andrew Chiodo, M.A.
Pgs. 811-815
Available free from Dr. Kien at Division of Gastroenterology, Department of Pediatrics, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, or

It seems perfectly logical, but it’s still reassuring that a new study shows that an organized, noncompetitive, leisure-time program can increase kids’ physical activity.

This very small study evaluated only four 12-year-old boys and girls who participated in a summer program at least 75 percent of the time, and eight 10- to 11-year-olds who participated in a fall after-school program at least 75 percent of the time. Both programs were outdoors on public school grounds in Columbus, Ohio.

The activities included gardening and an “adventure education” program. In the gardening program, held for 30 to 45 minutes each day, children assisted in planning, cultivating, planting, maintaining and harvesting in the summer, with some activities continuing into the fall. The school cultivated the ground, and local nurseries donated the herbs and other plants. The produce was sold at a farmer’s market, and the proceeds went to the school. The children were paid $25 each for participating in the evaluation.

The Adventure Education program was an hour each day, and consisted of adventure games to teach kids to solve problems (including succeeding in an athletic contest) by playing with other kids. The games required constant movement. For example, in a version of “sharks and minnows,” the shark stands near a water sprinkler that the other kids must run through to stay wet while they try to avoid being tagged. Those who are tagged become sharks, so all kids stay in the game until there is only one minnow left.

During the summer, the weather was hot and there were frequent water breaks, during which the children were not physically active.

Physical movement was measured by a uniaxial accelerometer strapped to the wrist to measure calories burned, and a breath test used to measure carbon monoxide production. For the summer program, physical movement was significantly increased, and carbon monoxide production was increased by 60 percent, compared with what happened when the kids were watching a video. In the fall program, there was a 95 percent increase in physical movement compared with what happened when the children were home.

Although it is hardly surprising that recreation programs result in increased physical activity, the authors point out that the results are encouraging because the programs were not designed for children with athletic interest or skills. All they needed to participate was “a reasonable desire to socialize with other children and adults.” For that reason, these kinds of recreation programs could attract the kinds of children who most need them – those who are not good at competitive sports and not especially athletic, and who are therefore less likely than other kids to be involved in physical activities.

Diana Zuckerman, Ph.D., is president of the National Center for Policy Research (CPR) for Women and Families. Contact: Information about many Research Watch columns is available at