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A gap in childhood obesity research

A study in today's new issue of Archives of Pediatrics & Adolescent Medicine takes a close look at food for sale in more than 3,800 public and private elementary schools across the U.S. between 2006 and 2010. The findings are discouraging: During a period when school menus have generated lots of attention as contributors to childhood obesity, kids' access to sugary foods at school remained high, while healthy options remained less available.

Not surprisingly, the authors suggest that schools should take a hard look at the foods kids can buy on campus and provide more healthy options while removing unhealthy choices.

But an accompanying editorial by Packard Children's Hospital's Thomas Robinson, MD, a nationally-recognized childhood obesity researcher asks: "How do we know that those changes would make a dent in childhood obesity rates?"

Unless we conduct studies that compare different health policies head-to-head in rigorously designed experiments, we can't be sure what actually works, Robinson writes. He proposes implementing randomized controlled trials that make use of existing state and national health-surveillance programs (21 states already have laws that mandate measuring children's body mass index in school, for instance) and that assign schools to different proposed health-policy changes so that the policies' effects can be evaluated.

If this idea sounds daunting, Robinson has prepared an answer for potential critics:

Too difficult? Too expensive? Not when compared with the unrecoverable costs of getting policies wrong. [...] Federal, state and local governments and nongovernmental organizations are already spending many hundreds of millions of dollars per year to implement policy interventions that may or may not have any impact on childhood obesity. If evaluated at all, it is usually with nonexperimental designs. It would be a terrible lost opportunity if we learned several decades from now that most of these dollars produced no health benefits.

The entire editorial is definitely worth a read.

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