No abstract

Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. We estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: a sugar-sweetened beverage excise tax; elimination of the tax subsidy for advertising unhealthy food to children; restaurant menu calorie labeling; nutrition standards for school meals; nutrition standards for all other food and beverages sold in schools; improved early care and education; and increased access to adolescent bariatric surgery. We used systematic reviews and a microsimulation model of national implementation of the interventions over the period 2015-25 to estimate their impact on obesity prevalence and their cost-effectiveness for reducing the body mass index of individuals. In our model, three of the seven interventions--excise tax, elimination of the tax deduction, and nutrition standards for food and beverages sold in schools outside of meals--saved more in health care costs than they cost to implement. Each of the three interventions prevented 129,000-576,000 cases of childhood obesity in 2025. Adolescent bariatric surgery had a negligible impact on obesity prevalence. Our results highlight the importance of primary prevention for policy makers aiming to reduce childhood obesity.

Using smartphones, tablets, computers, and videogames is associated with several obesity risk factors. Although further study is needed, families should be encouraged to limit both TV viewing and newer screen devices.

Adequate hydration is essential for health. Water is crucial for the proper function of several physiological processes, including circulatory function, metabolism, temperature regulation, and waste removal.1 Dehydration, a state in which total body water is inadequate for proper cell, organ, and system functioning, is associated with poor health. Although excessive dehydration is associated with serious health problems, such as impaired renal, immune, and gastrointestinal functioning, confusion, and delirium, even mild dehydration can worsen health and well-being. 2 Mild dehydration is associated with headache, irritability, poorer physical performance, and reduced cognitive functioning among both children and adults.2---5

Objectives We evaluated a low-cost strategy for schools to improve the convenience and appeal of drinking water. Methods We conducted a group-randomized, controlled trial in 10 Boston, Massachusetts, schools in April through June 2013 to test a cafeteria-based intervention. Signage promoting water and disposable cups were installed near water sources. Mixed linear regression models adjusting for clustering evaluated the intervention impact on average student water consumption over 359 lunch periods. Results The percentage of students in intervention schools observed drinking water during lunch nearly doubled from baseline to follow-up compared with controls (+9.4%; P < .001). The intervention was associated with a 0.58-ounce increase in water intake across all students (P < .001). Without cups, children were observed drinking 2.4 (SE = 0.08) ounces of water from fountains; with cups, 5.2 (SE = 0.2) ounces. The percentage of intervention students observed with sugar-sweetened beverages declined (−3.3%; P < .005). Conclusions The current default of providing water through drinking fountains in cafeterias results in low water consumption. This study shows that an inexpensive intervention to improve drinking water’s convenience by providing cups can increase student water consumption.