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School & Program Updates

School & Program Updates

UNC Obesity Initiatives

Good nutrition helps improve health and prevent or control disease throughout the life cycle – from birth to older age. Faculty members and students at the University of North Carolina Gillings School of Global Public Health are engaged in a number of projects that support healthy eating habits for people in North Carolina communities and around the world.

Dr. Alice Ammerman, Mildred Kaufman Distinguished Professor of nutrition and director of the UNC Center for Health Promotion and Disease Prevention, leads several such efforts.

She is principal investigator for the UNC team of a multi-site U.S. Department of Agriculture-Funded “Farm-Fresh Food for Healthy Kids: An Innovative Community-Supported Agriculture (CSA) Intervention to Prevent Childhood Obesity in Low-Income Families and Strengthen Local Agricultural Economies.” The project aims to assess the impact of subsidized CSA participation coupled with tailored nutrition education for low-income families with children.

[Photo: Farmers and volunteers box fruits and vegetables for delivery to CSA participants. Photo credit to Cultivate Oxford.]

The project has potential to address many of the underlying determinants of poor diets among socio-economically disadvantaged groups. In so doing, the work can have a positive impact upon fruit and vegetable intake, weight maintenance and local agricultural economies. It will contribute new evidence about ways local food initiatives can effectively meet the needs of low-income households and will produce information and resources to help farmers and public health advocates develop and sustain subsidized CSA programs while training the next generation of nutrition researchers.

Read more about the project in an April 8, 2017 article in BMC Public Health.

Dr. Ammerman also studied weight loss among people with diabetes in the “Heart Healthy Lenoir” project. In Lenoir County, N.C., where rates of cardiovascular disease and diabetes are disproportionately high, Dr. Ammerman and colleagues examined weight change by diabetes status among study participants receiving a Mediterranean-style diet, physical activity and weight-loss intervention.

The researchers determined that participants with diabetes experienced sustained weight loss at the 24-month follow-up. “High-risk U.S. populations with diabetes may experience clinically important weight loss from this type of lifestyle intervention,” the authors wrote.

Read more about Heart Healthy Lenoir in a March 2017 article in BMJ.

Doctoral students working with Dr. Ammerman, along with undergraduate volunteers, conduct “Cooking Matters for Kids” classes in local schools. The classes aim to introduce and support healthy eating habits that ultimately will prevent obesity. More than 50 children participate each semester at two rural N.C. schools.

[Photo: Children from a rural North Carolina school wear their ‘chef’s hats’ during a ‘Cooking Matters for Kids’ class. Conducted by UNC graduate students, the classes support healthy eating habits by teaching children about food and recipes.]

[Photo: Left to right are Drs. Shuwen Ng, Lindsey Taillie and Barry Popkin.]

Globally, the UNC Gillings School team of Drs. Barry Popkin, Shuwen Ng and Lindsey Taillie are leading policy-based obesity initiatives.

In South Africa, in collaboration with Wits University (Johannesburg) and University of Western Cape (Cape Town), Dr. Ng led research efforts to support the recent legislation of a Health Promotion Levy, a new tax charged for sugar sweetened beverages (SSB’s), effective April 2018.

The World Health Organization’s representative to South Africa, Dr. Fufaro Chatora, praised the effort.

“By passing this bill, South Africa’s lawmakers have shown that feasible measures exist to beat diet-related noncommunicable diseases, such as diabetes. They must be commended for their steadfastness in the face of immense industry pressure, as well as their foresight and determination to put the health of their citizens before the profits of corporate entities.”

The SSB tax will increase the cost of a regular can of soft drink by about 11 percent.

In Chile, in collaboration with the University of Chile at Santiago’s Institute of Nutrition and Food Technology, Dr. Taillie leads an effort for clearer labeling and marketing regulations.

Chile passed an 8 percent tax on sugar-sweetened beverages (SSBs) in 2014. Effective in 2016, foods and beverages with added sugars, sodium, saturated fat or calories that exceed set thresholds are subject to front-of-package warning labels and marketing restrictions, including no appeals to children in any marketing or advertisements and no television or website advertising that targets children or in an advertising venue in which children under age 14 years make up more than 20 percent of the audience.

In 2017, the advertising ban was extended to all television programming and cinema from 6:00 a.m. to 10:00 p.m.

In the future, Chile will be considering whether to implement a “mega-tax” on processed foods and beverages. UNC is providing simulation studies to examine different tax options – i.e., whether to tax sugar (specifically, nonessential foods and beverages) or link the tax to marketing law.

Most recently, Drs. Popkin and Ng have worked with Mr. Juan Carlos Caro, doctoral student in the UNC Gillings School’s department of health policy and management, worked to evaluate the projected impact of a tax on SSBs in Colombia.

The team projected that a 20 percent tax would decrease purchases of SSBs by 32 percent.

“In addition,” Dr. Popkin said, “our estimates showed that, following the tax, consumers likely would purchase grains, dairy-based products, and fruits and vegetables in place of sugary drinks. This represents a move toward healthier food choices. Low-income households were predicted to decrease their purchases of sugary drinks more than mid- and high-income households, which forecasts greater health benefits for lower-income Colombians.”

The researchers also used sales data from Euromonitor International to project how the predicted changes in average per-capita consumption of SSBs might affect potential revenue. Their models estimated that a 20 percent tax on sugary drinks would raise $480 million USD in government revenue by 2020.