The bittersweet truth about sugar labeling regulations: they are achievable and overdue.

The recent Institute of Medicine recommendation to the Food and Drug Administration to include added sugar in a new front-of-package system provides new justification for reviewing outdated regulations pertinent to sugar and analyzing whether the government's previous resistance to sugar labeling remains valid given new and robust science. I have provided an overview of US sugar consumption, its public health implications, and the science related to added sugar detection. I reviewed US and international sugar intake recommendations and suggested revised regulations to better inform and protect consumers.

Obesity and motor skills among 4 to 6-year-old children in the United States: nationally-representative surveys.

Background: Few population-based studies have assessed relationships between body weight and motor skills in young children. Our objective was to estimate the association between obesity and motor skills at 4 years and 5-6 years of age in the United States. We used repeated cross-sectional assessments of the national sample from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B) of preschool 4-year-old children (2005-2006; n = 5 100) and 5-6-year-old kindergarteners (2006-2007; n = 4 700).

Protecting young people from junk food advertising: implications of psychological research for First Amendment law.

In the United States, one third of children and adolescents are overweight or obese, yet food and beverage companies continue to target them with advertising for products that contribute to this obesity crisis. When government restrictions on such advertising are proposed, the constitutional commercial speech doctrine is often invoked as a barrier to action. We explore incongruities between the legal justifications for the commercial speech doctrine and the psychological research on how food advertising affects young people.

Federal Trade Commission's authority to regulate marketing to children: deceptive vs. unfair rulemaking.

Food and beverage marketing directed at children is of increasing concern to the public health and legal communities. The new administration at the Federal Trade Commission and abundant science on the topic make it a particularly opportune time for the government to reconsider regulating marketing directed at youth. This Article analyzes the Commission's authority to regulate food and beverage marketing directed at children under its jurisdiction over unfair and deceptive acts and practices to determine which avenue is most viable.

Obesity: a public health approach.

Obesity is an epidemic that likely will worsen without substantive changes to the current environment. Although treatment of the individual has conventionally been the focus of the obesity field, prevention using a public health model will be essential for making progress on a population level. There are encouraging signs that communities across the country are acknowledging the complex causes of obesity and making impressive reforms to improve their health and that of their children.

Weight-based victimization toward overweight adolescents: observations and reactions of peers.

Background: Weight-based victimization has become increasingly reported among overweight youth, but little is known about adolescents' perceptions and observations of weight-based teasing and bullying. This study examined adolescents' observations of and reactions to weight-based victimization toward overweight students at school.

Methods: Adolescents (N = 1555) at 2 high schools in central Connecticut completed a questionnaire that examined their perceptions of how common weight-based victimization is compared to other forms of teasing at school, what types of weight-based teasing are frequently observed, who typical perpetrators of weight-based victimization are, and their own reactions to observed teasing incidents.

Parental perceptions of weight terminology that providers use with youth.

Objectives: Little research has been performed to examine patient perceptions of weight-related language, especially related to childhood obesity. In this study we assessed parental perceptions of weight-based terminology used by health care providers to describe a child's excess weight and assessed perceived connotations associated with these terms including stigma, blame, and motivation to reduce weight.

Methods: A national sample of American parents with children aged 2 to 18 years (N = 445) completed an online survey to assess their perceptions of 10 common terms to describe excess body weight in youth (including "extremely obese," "high BMI," "weight problem," "unhealthy weight," "weight," "heavy," "obese," "overweight," "chubby," and "fat").

Validity of a measure to assess the child-care nutrition and physical activity environment.

Background: Licensed child-care centers represent an opportunity to positively influence children's health behaviors. Valid and easy-to-use measures of the child-care environment are needed to assess the influence of environmental change on health.

Objective: To develop and validate a self-administered survey to assess the nutrition and physical activity environment of child-care centers, and to identify domains that may be evaluated adequately through self-report.

Child and adolescent exposure to food and beverage brand appearances during prime-time television programming.

Background: The food industry disproportionately markets to young people through product placements. Children and adolescents may be more susceptible to these disguised persuasive attempts.

Purpose: Quantify incidence and youth exposure to food and beverage brand appearances within shows on prime-time TV.

Protecting children from harmful food marketing: options for local government to make a difference.

The obesity epidemic cannot be reversed without substantial improvements in the food marketing environment that surrounds children. Food marketing targeted to children almost exclusively promotes calorie-dense, nutrient-poor foods and takes advantage of children's vulnerability to persuasive messages. Increasing scientific evidence reveals potentially profound effects of food marketing on children's lifelong eating behaviors and health.

Choosing front-of-package food labelling nutritional criteria: how smart were 'Smart Choices'?

Objective: The 'Smart Choices' programme was an industry-driven, front-of-package (FOP) nutritional labelling system introduced in the USA in August 2009, ostensibly to help consumers select healthier options during food shopping. Its nutritional criteria were developed by members of the food industry in collaboration with nutrition and public health experts and government officials. The aim of the present study was to test the extent to which products labelled as 'Smart Choices' could be classified as healthy choices on the basis of the Nutrient Profile Model (NPM), a non-industry-developed, validated nutritional standard.

Obesity stigma in online news: a visual content analysis.

This study conducted a content analysis to examine the types of images that accompany online news stories about obesity and to determine how obese people are portrayed in news photographs. Images were selected from news articles about obesity obtained from 5 major news Web sites, during a 2-week period in September of 2009. Images accompanying news stories about obesity (N = 549) were systematically coded.

Taxation as prevention and as a treatment for obesity: the case of sugar-sweetened beverages.

The contemporary American food environment makes energy-dense, nutrient-poor foods and beverages the "default" option for most consumers. Economic interventions like taxes can shift the relative prices of unhealthy foods to nudge consumers towards healthier options. Beverages with added sugar are a good starting point for food taxation; they constitute over 10 percent of caloric intake nationwide and provide little or no nutritional value.

Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue.

Objective: Beverage taxes came into light with increasing concerns about obesity, particularly among youth. Sugar-sweetened beverages have become a target of anti-obesity initiatives with increasing evidence of their link to obesity. Our paper offers a method for estimating revenues from an excise tax on sugar-sweetened beverages that governments of various levels could direct towards obesity prevention.

Food retailer practices, attitudes and beliefs about the supply of healthy foods.

Objective: Non-supermarket food retailers can be a promising channel for increasing the availability of healthy foods in underserved communities. The present paper reports on retailer practices, attitudes and beliefs about the supply of healthy foods before and after the introduction of new subsidies for healthy foods by the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in October 2009.

Design: We designed and conducted in-person standardized interviews with store owners and managers to assess perceptions of demand and profits for different foods, supply networks, barriers to stocking healthy foods and their changes following implementation of the new WIC packages.

Negative weight-based attitudes in treatment-seeking obese monolingual Hispanic patients with and without binge eating disorder.

Objective: The aims of this study were to compare weight-based attitudes in obese Latino adults with and without binge eating disorder (BED) and to examine whether these attitudes are related to indices of eating disorder psychopathology and psychological functioning.

Method: Participants were a consecutive series of 79 monolingual Spanish-speaking-only obese Latinos (65 female, 14 male) participating in a randomized placebo-controlled trial performed at a Hispanic community mental health center. Participants were categorized as meeting the criteria for BED (n = 40) or obese non-binge-eating controls (n = 39) based on diagnostic and semistructured interviews administered by fully bilingual research clinicians trained specifically for this study.

Effects of serving high-sugar cereals on children's breakfast-eating behavior.

Objectives: To test (1) whether children will consume low-sugar ready-to-eat (RTE) cereals and (2) the effects of serving high- versus low-sugar cereals on the consumption of cereal, refined sugar, fresh fruit, and milk.

Participants And Methods: Using an experimental design, we randomly assigned children (n = 91) who were attending summer day camp to receive a breakfast that included either the choice of 1 of 3 high-sugar cereals (high-sugar condition) or low-sugar cereals (low-sugar condition), as well as low-fat milk, orange juice, bananas, strawberries, and sugar packets. Participants served themselves and completed a background questionnaire after eating.

Framing messages about weight discrimination: impact on public support for legislation.

Objective: To assess the public support for potential legislation to prohibit weight-based discrimination against obese individuals in the United States, and to examine whether certain message frames about weight discrimination influence public support.

Design: Participants were randomly assigned to read one of the four paragraphs that framed the topic of weight discrimination in a distinct way (or a control condition with no paragraph). Participants were then asked to indicate their level of support for six antidiscrimination laws.

The humbling experience of treating obesity: Should we persist or desist?

Obesity has humbled one research group after another. Some of the field's brightest scientists have attempted to subdue obesity by treating it, but now, after decades of work, treatment gains remain small, maintenance is poor, and the field produces effects far below what patients want or expect. This can be explained by strong biological and environmental forces that oppose weight loss and foster regain.

Influence of licensed characters on children's taste and snack preferences.

Objective: The goal was to study how popular licensed cartoon characters appearing on food packaging affect young children's taste and snack preferences.

Methods: Forty 4- to 6-year-old children tasted 3 pairs of identical foods (graham crackers, gummy fruit snacks, and carrots) presented in packages either with or without a popular cartoon character. Children tasted both food items in each pair and indicated whether the 2 foods tasted the same or one tasted better.

Public opinion about laws to prohibit weight discrimination in the United States.

Weight discrimination is pervasive in American society and impairs quality of life for obese persons. With approximately two-thirds of Americans now overweight or obese, vast numbers of people are vulnerable to weight prejudice and its consequences. Currently, no laws exist to prohibit weight discrimination.

Television food marketing to children revisited: the Federal Trade Commission has the constitutional and statutory authority to regulate.

The evidence reveals that young children are targeted by food and beverage advertisers but are unable to comprehend the commercial context and persuasive intent of marketing. Although the First Amendment protects commercial speech, it does not protect deceptive and misleading speech for profit. Marketing directed at children may fall into this category of unprotected speech.

An observational study of consumer use of fast-food restaurant drive-through lanes: implications for menu labelling policy.

Objective: Some versions of restaurant menu labelling legislation do not require energy information to be posted on menus for drive-through lanes. The present study was designed to quantify the number of customers who purchase fast food through drive-in windows as a means of informing legislative labelling efforts.

Design: This was an observational study.