Cell Phones and Weight
At first glance, a cell phone may not seem like the most effective tool for helping adolescents take off weight, but pediatrician Susan Woolford, MPH ’06, medical director of the UM Pediatric Comprehensive Weight Management Center, is betting otherwise. With assistance from SPH Professor Ken Resnicow, who serves as mentor on the project, Woolford and a team of researchers are using cell phones to send individually tailored messages about nutrition and health to a group of overweight adolescents who have said they want to adopt healthier behaviors.
The researchers first survey the project participants and then create messages designed to address each individual’s specific situation and goals. For example, a high school student who has told the team she’s tempted to eat fast food on her way home from school every day may receive a text message saying, “Remember what you said about feeling better about yourself when you make healthy choices? Try packing a piece of fruit to eat on the way home.”
In another year, Resnicow says, “We should be able to use GPS. If someone walks by a McDonald’s, we can send out a preemptive message saying, ‘Watch it.’” He and Woolford hope the technology can eventually be used to reach millions of people.
Schools and Obesity
Schools can be an important venue for lowering the prevalence of obesity in young people. In part, that’s because schools reach over 95 percent of American children. Schools also serve meals and can provide students with opportunities for physical activity. Karen Peterson, professor of environmental health sciences and director of the SPH Human Nutrition Program, has collaborated on several school-based interventions aimed at reducing obesity, and she says that with modest investments, “schools can actually make an enormous difference in creating a healthy environment and systematically incorporating very basic behavioral messages.”
One intervention on which Peterson has collaborated is Massachusetts-based Planet Health, a fully integrated, interdisciplinary curriculum for middle schools. The program emphasizes four messages:
- Eat at least five fruits and vegetables a day
- Be active for an hour on most, if not all, days of the week
- Watch fewer than two hours of TV a day
- Decrease foods high in saturated and trans fats
Peterson and her collaborators have found that girls enrolled in schools where Planet Health is taught halved their chances of becoming obese over two school years, as compared with girls in control schools. The program also reduced the risk of girls developing disordered eating behaviors.
Peterson is now leading the evaluation of a related program, Massachusetts Healthy Choices, in over 100 public middle schools, and in collaboration with SPH Professor Marc Zimmerman and Kim Eagle and Caren Goldberg of the UM Cardiovascular Center, she will be evaluating the effectiveness of a Michigan intervention called Project Healthy Schools. The researchers want to know whether the intervention works, and if so, how, before implementing it more widely. “These questions need to be answered before you can devote public resources to upscaling something like this
The Economic Consequences of Obesity
Obesity leads to serious health consequences, but it may also impose considerable economic consequences, says Edward Norton, a professor in the departments of Health Management and Policy and Economics, who studies obesity and labor outcomes. “But it’s very tricky to try to sort out,” he says. “Does obesity lead to lower wages, for example, or do lower wages lead to obesity?”
Norton and researchers Euna Han and Lisa Powell of the University of Illinois, Chicago, are tackling the problem by looking at people’s body-mass index (BMI) at age 18—before they’ve had a chance to control their own diets and before they’ve earned significant wages—and trying to gauge how that affects their wages at age 30, a typical mid-career point. “Hopefully this approach gets rid of the potential reverse causality,” he explains. It also allows him to see whether BMI is related to education and occupation choice.
Norton’s findings are striking. Being overweight or obese has no effect on wages or employment for men, he says. But with women things change. For every one-unit increase in BMI, women at age 30 receive approximately one percent less in hourly wages. (One unit of BMI in a woman who stands 5’0” equals roughly five pounds.) “That means that 10 pounds would lead to two percent lower wages,” Norton says. “You add up two percent over years, and that ends up being a lot of money.”
No one knows why the discrepancy exists. Norton has found, in fact, that as women get older the “wage penalty” from obesity gets even stronger. Going forward, he is especially interested in seeing how obesity affects promotions.