Category Archives: Obesity Conferences

Day 1 of ICO 2014: Willendorf Award Lecture and Opening Ceremony

I’m in Kuala Lumpur, Malaysia this week attending the 12th International Congress on Obesity. For a person that studies and reads and writes about obesity policy ad infinitum, events like this are a week in Disneyland. Except better. In that vein, I’m so fortunate to have the support of Magdalen College, Oxford, the Institute of Social and Cultural Anthropology at Oxford, the Malaysian Association for the Study of Obesity, and World Obesity. I took pages of notes from the conference, and there are many sessions to write up, but in the brief space between Day 1 and Day 2 I collected my summaries of the Willendorf Award Lecture given by the University of Copenhagen’s Dr. Arne Astrup and the Opening Ceremony.

Willendorf Award Presentation

The 2014 International Congress on Obesity began with the Willendorf Award, given to recognize outstanding clinical research into obesity. This year’s recipient, Dr. Arne Astrup (University of Copenhagen) was recognized for his work on appetite regulation via gastrointenstinal peptides. Setting the tone for his talk, Dr. Astrup said simply: “I do not think all calories are equal for their effect on appetite regulation.” While he certainly believes in the power of calorie restriction, he maintained that such an intervention is not helpful in the long run. He made his case by reviewing what we now know about the hormone glucagon-like peptide-1, or GLP-1. Beginning with studies that demonstrate increased satiety after infusing GLP-1 (while lamenting the still primitive visual-analog scale for measuring satiety) he then moved to link another gut hormone peptide YY (PYY) to the effect of GLP-1 on post-prandial satiety. After briefly reviewing research tying increased satiety following roux-en-y gastric bypass to GLP-1, Dr. Astrup moved on to the next major topic of his talk: diet composition. GLP-1, he noted, might account for at least part of dietary protein’s satiating effect relative to carbohydrates and fat.


To showcase some ongoing insights on dietary protein satiety, he drew on the pan-European DiOGenes Project, a large trial with collaborators across 14 countries and a massive total study population of 140,000 people. The component of DiOGenes Dr. Astrup reviewed initially enrolled 1209 adults (mean age = 41 years, mean BMI = 34 kg/m2), of which 938 began the initial calorie-restriction phase of the diet (800 calories until 8% weight loss, mean = 11.0 kg weight loss). The 773 participants who successfully completed the restriction phase were divided into five ad-libidum groups where weight maintenance or regain was tracked for 26 weeks. The groups included a control arm, a high-protein/high-glycemic-index arm, a high-protein/low-glycemic-index arm, a low-protein/high-glycemic-index arm, and a low-protein/low-glycemic-index arm. Of the 548 participants who completed the intervention, the most compelling results were sighted in the high-protein/low-glycemic-index group. Not only did this group demonstrate the lowest drop-out (22%, compared the the highest drop-out rate of 37% from the low-protein/high-glycemic-index arm), but the significant weight regain only appeared in the low-protein/high-glycemic-index arm. Perhaps just as compelling was a brief tangent by Dr. Astrup into the spontaneous reduction in prevalence of overweight among children of the participating adults, who were not formally participating in the trial intervention.


Dr. Astrup ended his talk with a short cautionary note on blanket solutions to obesity. Drawing on recent research on the interaction between the gene TFAP2B rs987237 and dietary protein/carbohydrate, he showed that high-protein diets were associated with greater weight gain among certain allele carriers.  Ending his talk with the optimistic note that GLP-1 agonists (like liraglutide) may soon receive obesity indication, Dr. Astrup concluded a well-deserved award lecture with the refrain that diet composition matters.


Opening Ceremony:
Recognizing the international context of the conference, Malaysian Association for the Study of Obesity (MASO) President Ismail Noor began the opening ceremony with a moment of silence for the passengers aboard Malaysia Airlines Flight 370. In glowing remarks to the plenary, President Noor said it is a dream for any national or regional obesity organization to host the International Congress. He sees the conference tracks filling out every niche of obesity research, and told students in the crowd that this is their chance to “learn from the horse’s mouth, so to speak.” After thanking conference supports Novo Nordisk, the Cambridge Weight Plan, and the ICO Secretariat, he urged the audience to get to know Malaysia during their stay.


Following his address, the Deputy Health Minister of Malaysia Hilmi Yahaya spoke on behalf of Health Minister Subramaniam. Right at the outset Deputy Minister Yahaya recognized the peril of Malaysia’s non-communicable disease crisis, citing their 2011 National Health and Morbidity Survey to raise alarm at the country’s 2.6 million adults living with diabetes, 5.8 million with hypertension, 6.2 million with hypercholesterolaemia, and 2.5 million with obesity. In response, he highlighted the country’s National Strategic Plan for NCDs and the “whole-government approach” Malaysia is taking to integrate many public efforts for the promotion of health. These actions have led to food and beverage marketing guidelines for products targeting children, currently being implemented via industry self-regulation. A more recent initiative is KOSPEN, or Komuniti Sihat, Perkasa Negara (Empowering Communities, Strengthening the Nation) seeks to build  on grassroots efforts. Noting these policies, the Malaysian government recognizes there is still more to do.


Rounding out the Opening Ceremony were talks by World Obesity President Philip James and ONEGOAL representative Mr. Liew Tong Ngan. President James meditated on the significance of ICO 2014 being held in Malaysia as obesity continues to rise there and more generally in Asia. Citing the need to go beyond studying obesity, he explained the rebranding of the International Association for the Study of Obesity to World Obesity, an apt identity for an organization that studies in addition to organizes, advises, advocates, trains, communicates, and more. Mr. Ngan spoke to the campaign ONEGOAL, which seeks to improve grassroots support for childhood physical activity and nutrition for all of Asia. Among the many driving factors of this campaign was a good-humored, candid ask: How will Asia win its first World Cup without proper nutrition and exercise? His presentation closed with a high-energy demonstration by ONEGOAL trainers showing their football skills. Following them was a multicultural dance drawing on the many cultures of Malaysia. Together, these performances ended the first day of the conference with a great deal of momentum for the meeting ahead.

PHA 2013 Summit Breakout #3: Play Deserts

These are my rough notes from Day 2 of the conference. This session was nothing short of incredible for its appeal to my wonkish sensibilities. The notes might be cleaned up in a few days’ time.


Play Deserts

9:45 – 11:00 AM



Marice Ashe, Executive Director, ChangeLab Solutions


Carmen Harris, Epidemiologist, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention

Tom Harrington Jr., Director of Marketing, Applied Geographics, Inc.

Zarnaaz Bashir, Director of Health Initiatives, National Recreation and Park Association


The breakout session did not have as many folks, so took on an intimate setting where everyone introduced themselves. Many folks from the parks community and the policy community where present in the audience.

What is a play desert? There is a huge debate going on as to whether this is a good term or not? When you visualize a play desert, what do you see? Marice builds a tactile sense of what the term entails, so that when we see the data and learn what the CDC is trying to do about this, we get a sense of what real people are going through.

Brief introductions: ChangeLab Solutions is a group of lawyers, urban planners and educators who work on childhood obesity, with funding from the Robert Wood Johnson Foundation. Carmen Harris has been at CDC since 2004, with a background in mathematics and physical activity, combining the two by way of epidemiology. Zarnaaz Bashir has been at the National Recreation and Park Association since 2009.

Zarnaaz begins by speaking about the NRPA. The three pillars of the NRPA include conservation, health and wellness, and social equity. She then asks “What is a play desert?” With briefly restating the statistics that define the obesity epidemic, she notes that one problem is that most are not reaching the recommended level of physical activity per day. NRPA began talking to the CDC about play deserts a year ago.

Why they got involved in this effort: We know that there are benefits of physical activity—prevents the development of T2D, lowers your blood pressure, reduces obesity, and so on. Living close to parks is consistently linked to higher levels of physical activity. Adolescents with easy access to recreation areas are more likely to use them. Research verifies all of these claims. Park distribution and access and conditions and attributes varies across different populations and communities. These factors can determine the frequency of park use and physical activity levels.

The meeting between CDC and NRPA initially sought to create synergy by setting a definition of play deserts that is measurable, feasible and actionable. So they:

  • Identified and prioritized key constructs that should be considered in developing a definition that is useful for national, state and community-level data collection.
  • Identified the available resources and gaps in resources needed to measure and map play deserts on a national, state and community level.
  • Identified key elements to be included in a play desert research agenda.

They then asked what’s the public health impact of including or excluding a construct from the definition? Is the construct measurable on different scales?

The expert panels were convened in August and September 2012. It used the Delphi Method between and after calls to engage panelists, prioritize, and build consensus. The method entails surveys, subgroup activity. Finally they engaged other stakeholders through open forums, some of which included local parks officials. Thankfully, they got a positive reaction—they would not negatively react if their community was called a play desert. At the Active Living Research Conference last week they got still more inputs on the nuances between play and physical activity.

What they heard:

  • Consider a name everyone understands. Play Deserts is a popular term.
  • Important to consider a continuum of constructs inclusive of access, quality and use
  • Data availability & feasibility should be considered. Make sure it’s something we can collect data easily on.
  • Multiple audiences uses, implications for the definition. They know it’s going to drive policy decisions and media interest.
  • Important to develop an intentional research agenda. How can they capture what communities are doing to support their work with the construct?

They’re moving forward with a manuscript. In so doing, they will be engaging and extending collaborations with NPOs and private sector groups. Under consideration is a database or repository of resources or data on play deserts.

Related efforts: Alexandria, VA is responding to childhood obesity by doing a study with funding from KP to investigate the reality of play and physical activity in relation to various factors. Using GIS they were able to map the location of play spaces and the characteristics of play among children. The Darden Foundations and Longhorn Steakhouse is working to improve trails. REI is working also on trails and park cleanup. NPRA has developed PRORAGIS to map and benchmark park and recreation agencies.

Carmen Harris begins by saying that every story has a beginning, middle and end. Her own story of play begins with soccer. She had increased access that led to opportunities for play. But her increased access came from educated, privileged, and attentive parents. Not all the youth in her community had that opportunity. Her hometown of Powell, TN is very much a play desert. The question this begs is, Do all youth in your community deserve access to play? If they do, how can we define and measure the opportunity for active play?

The panel included:

  • Breece Robinson, Trust for Public Lands
  • Candace Rutt, CDC
  • Brian Saelens, Seattle Children’s Hospital and University of Washington.

They came up with four criteria

  1. Availability—is it there?
    • Ex. of variables: parks, rec facilities, green spaces, joint-use agreements
    • Geo-measures include national, state and community
    • Other factors: Are there urban and rural differences? If not youth live there, can it be considered a play desert?
  2. Environmental access—can you get to it?
  3. Quality—is it up to par?
  4. Use—are people using it?

For each criteria they asked:

  • What do we know about the variable?
  • How can we measure it?
  • What geographical measures are available?
  • What other factors must we consider?

Proposed definition: A geographical area that does not have a play space such as an outdoor parks, public recreation center, green space present and accessible for play by youth and active play.

Each component comprising this definition was operationalized with a more in-depth explanation. For example, “present” means “the presence or absence of the play spaces within walking distance from the youth’s residence.”

But there’s something that goes deeper—one definition does not fit all. They also talked about additional play space destination data. There are many things that could follow the part of the definition that begins “such as.” They also talked about the multivariate metrics to define and track the quality and safety of the play space for communities. Play spaces not in use for active play was a heated point of debate among the panelists. They will be continuing to explore this point. Rural community considerations including walking differences across landscape. A high prevalence of obesity also helps contextualize the data, so it should be included if available. There was consideration of including objectively crowd-sourced data.

Refining the definition:

  • What do we do with public and private spaces?
  • Schools as play spaces
  • Walking and biking
  • Collecting data over time
  • Are we excluding toddlers?
  • Where do organized sports fit into the definition?

With funding, they hope for face-to-face meetings with experts. They want to further refine and rewrite the definition, as well as engage partners and stakeholders for informal feedback. With all this done, they want to write a manuscript.

Unlike the decentralized and democratic development of the definition of food deserts, they want to capture the definition before it hits the public discourse. With a cohesive definition that many can engage and collaboratively develop, the construct can be mobilized for policy, programs, and communications in the service of community well-being.

You can partner with them by contacting:

Carmen Harris




C: (Susan from Sunday Streets of SF) They took the model of the temporary space and know that there are robust benefits for the people who attend them. They do one neighborhood for 8 months out of the year, but they’re developing technical support that will help communities to do this themselves. Like Portland, they connect their Play Streets to routes, and they’re working with Green Connection in SF to provide transportation alternatives. Finally, they’re looking into making temporary spaces into permanent ones.

Q: How do we engage the private sector?

C (from biking organization): Open streets and temporary measures are the beginning of the story, connecting to parks is the middle of story. What’s most important about Open Streets is that it gets people to imagine how things could be different.

Q: Have you talked to kids?

A: Not yet, we’re at baby steps right now. If you have an idea for engaging youth they want to know.

C (Jim from Kaboom, playground company): They give away four million in grants each year to eliminate play deserts. To him, the definition signifies the minimum level of consensus about which they can move forward. Using web apps, they’re also soliciting crowd-sourced data from parents in the community that rate play spaces. On the private funding front, they have support from Mattel and Disney Foundations.

C: It’s important for parents and children to play together. You can’t just have kids playing while they’re parents are in lawn chairs. Parents are also how you achieve user input from their children.

C (from CEO of NRPA): Planners have the power—they’re looking at the space eight years down the road. The private sector can be engaged on the livability factor, they want their workers to live in good communities.

PHA 2013 Summit: Breakout Session #2: Working Across Borders to Improve Health

These are my rough notes from Day 1 of the Summit. I had a blast learning and connecting with people. In some time these notes will be organized. 


DSC01608Working Across Borders to Improve Health: This breakout session will seek to inform a U.S. audience about the global picture of childhood obesity, and to discuss lessons learned from programs and policies other countries and multilateral organizations have implemented to address this growing health concern.

Moderator: Dr. Nils Daulaire, Assistant Secretary for Global Affairs, US Department of Health and Human Services


Dr. Kim Elmslie, Director-General, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada

Christina Holub, Institute for Behavioral and Community Health, San Diego State University

Dr. Irene Klinger, Senior Advisor, Partnerships and Multi-Sector Collaboration, Pan American Action Forum on NCDs, Pan-American Health Organization (PAHO)

Dr. Richard Visser, Minister of Health and Sport, Aruba


Dr. Nils Daulaire begins by talking about obesity 20 years as a problem of the rich. Today the problem still effects high and middle incomes, the fastest rise in obesity in occurring in low-income countries. The rise in obesity owes to the increase prevalence of nutrient-poor, calorie dense foods and the sedentary incentives of the urban environment. In the past 2 decades, childhood obesity rates in the US have tripled. In Mexico and the Caribbean, obesity is also on a steep rise. Children today are on path to face health complications from their chronic obesity, including diabetes and hypertension. Countries in Latin America have taken leadership in addressing the epidemic. Caribbean countries put this issue on the map for some major international organizations.

Aruba Minister of Health and Sport, Richard Visser says his country is a perfect lab. They have 110,000 people, of whom there are 50 nationalities. The average citizen speaks four languages. Their childhood obesity rate exceeds that of the US. Since they began focusing on this issue six years ago, nine percent of the population was engaged in regular physical activity. Now that number is closer to a third. Visser says this is by intentional design. They started by building a simple health guide for children. This is shown as a picture of a pirate ship, where different colors and ship parts symbolize the components of a healthy lifestyle. He emphasized that this is the only symbol Aruba uses, and they use it as much as possible. He makes a brief critique of the panoply of American symbols and certifications.

Aruba’s Health Bus screens for noncommunicable diseases (NCDs) and performs health promotion. It can track BMI, has an electronic patient file system connected to primary health care providers, and is mobile. Aruba is heavily involved in PACO—the Pan-American Conference on Obesity. They are hosting PACO III June 6-8, 2013.

Dr. Kim Elmslie of Canada’s public health department also begins by noting the georgraphic, linguistic, and demographic characteristics of her country, tying these to the increasing challenge of childhood obesity. Because of their northern population in remote and rural areas, health care and access to traditional foods is difficult in the modern age. Canada released a report in 2010 titled Creating a Healthier Canada: Making Prevention a Priority, that lists the principles for public health moving forward. Curbing childhood obesity was launched in 2010 as a national prevention priority. They thought to coordinate three policy priorities:

  • Support social and physical environments
  • Identify the risk of overweight and obesity and address it early
  • Increase the availability and accessibility of nutritious foods.

Then they sought to actively measure and report on the collective progress, learning from successful initiatives and modifying strategies where appropriate. She highlights the role of public health as a federal convener, promoting shared leadership. Dr. Elmslie notes that she is wary of Canada being known as “the country of pilot projects,” preferring instead to create and then modify long-term programs and policies.

As an example of engaging across sectors, they have pioneered a program to reward trips to the YMCA with air miles. Air miles are an excellent tool for tracking consumer habits via a reward system. The dieticians of Canada are designing an app to get kids to learn about food while having fun.

Professor Christina Holub of San Diego State University gives an overview of Project GOL. The aim of aim of GOL is to build partnerships between the US, Mexico and Latin America to increase awareness about obesity and obesity interventions. The project began with a large literature review, so as to learn about the manifestation of obesity interventions in Latin American countries. 6 strategies were included in the final review. Three strategies applied particularly to children.

  • Water for Kids: The first strategy is to increase water consumption among children in elementary schools. They worked to pilot these kinds of programs in Mexico and America, simultaneously creating the intervention and a evaluation process. The preliminary analysis indicates that at the end of the 6-week intervention, a higher percentage of kids had water in the classroom, and water at lunch time. They identified the need for small water bottles (so kids didn’t have to keep going to bathroom, missing class in the process) and water filters (to better the taste and hygiene). The journal article will be published this May in AJPM.

Chelsea Lutter, Senior Adviser in Food and Nutrition to the Pan-American Health Organization. PAHO is one of six WHO regional offices, this one serving 37 nations. PAFNCD (the Pan-American Forum for Action on Noncommunicable Diseases) is a platform to

  • Promote dialogue
  • Strengthen collaboration and partnerships
  • Promote synergy and address the underlying risk factors of disease
  • Support member states in implementing regional strategy and mandates
  • Promote and scale up successful practices
  • Mobilize partners and resources

One example is the Salt Smart Consortium. Its features a social marketing campaign and product reformulation. The next step is to finalize a strategic plan.

She displays a graphic showing trends indicating that overweight is rising while underweight is falling. This challenge makes the goal of international organizations to hold the line, much less decrease obesity. They would be happy just to stop the increase.

Continuing a topic of discussion from the Aruba Health Minister, she noted the importance of increasing the practice of breastfeeding. She also notes the work across Latin America over the last two years to increase regulation over food and marketing.

Q: Are you using cross-cultural methodologies to address obesity? What lessons can you share?

A: Canada has embraced the need for “working appropriately” in the public sector—this means working from a position of honesty. Part of being a federal convener means balancing a harmonious tone from an accusatory one. They’re also really interested in promoting social innovation. As a methodology, that is driving change, but is not seen much in the health sector.

Q: How do you get governments to carry out the policies they’ve passed?

A: Countries retain their autonomy, so we can’t do so much until they ask. Once they do we can give them tools to monitor and evaluate their policies. It still is most important to get those regulations on the books first, so we can work from there. Many academics and NGOs are monitoring and compiling data for use in future advocacy. Right now, though, it’s baby steps.

Q: How do you convert policy at the national level into action?

A: Canadian says we try not to legislate in this area. Some provinces even prohibit this kind of legislation. So we’re seeing a lot of jurisdictions experimenting with their own policies. At the federal level they’re providing incentives like tax credits. With childhood obesity they’re starting with the political commitment to work together. The approach overall is as collaborative as it is respectful of jurisdictions.

PHA 2013 Summit: The Great American School Lunch Challenge

These are my rough notes from Day 1 of the Summit. I had a blast learning and connecting with people. In some time these notes will be organized. 

DSC01603Teams: James Beard, Award winning chef Jose Garces and Food Network Star Anne Burrell with representatives from two school districts. Host: White House Assistant Chef and Let’s Move! senior advisor Sam Kass Judges: Tim Carman, food writer, Washington Post, Debra Eschmeyer, co-founder and director, Policy and Partnerships, FoodCorps; Scott Mowbray, editor-in-chief, Cooking Light; Amie Valpone, editor-in-chief, The Healthy Apple, Cooking up Change, Grand Prize Winners 2011.

Children eat most of their calories when they’re in a school environment. The School Lunch Challenge takes us back to the school cafeteria, where real school food service administrators are preparing healthy foods on stage in a makeshift kitchen. The challenge to school food is that not a lot of resources are available even as a number of food safety and nutrition regulations are levied upon school districts. Schools need to get creative to meet these demands and keep their meals healthy and appealing. By having a number of rules, DSC01601the PHA School Lunch challenge mimics the difficult environment of school cafeterias.

The makeshift set-up on stage was really cool. PHA assembled a Top-Chef-meets-School-Cafeteria installation, where the competing teams prepared the food live to the commentary of White House Assistant Chef and Executive Director of the First Lady’s Let’s Move! Initiative. The audience was able to watch the cooking process from the overhead video cameras. Mr. Kass was an especially personable host of the competition.




Here was a view of the cooking process on screen and my salad (I got too excited / was too hungry to remember my hipster inclinations and snap a photo of the entrees:


PHA 2013 Annual Summit: Breakout Session #1: Get Out!(side)


These are my rough notes from the first breakout session of Day 1 of the Summit. In some time these notes will be organized. 


Get Out!(side): A look at programs that work to get kids active outdoors and how to replicate them in communities across the country.

Moderator: Katie Adamson, Director of Health Partnerships and Policy, YMCA of the USA


Chris Fanning, Executive Director, Outdoor Foundation

Jackie Ostfeld, Mission Outdoors Policy and Operations Manager, Sierra Club

Kirk Bailey, Vice President, Outdoor Industry Association, YMCA of the USA


Katie recognizes that the Y does good work, but not enough is done to engage and connect, which is one of the reasons why she’s here today. She cites a study from the Children Nature Network research study, that when kids go outside, they grow more independence, develop social skills for structured and unstructured settings, and connect to nature. The outdoors can help prevent or reduce a list of ailments, like ADHD. More research is needed to discover further benefits.

Chris speaks to the link between getting kids outdoors and jobs. She says the lack of political attention paid to the outdoors is appalling. In her work she gets to partner with companies like REI and Northface. She covers (1) the facts, (2) a new approach and (3) funding opportunities.

  • Outdoor Recreation—Impact on Health
    • Children who spend time outdoors are healthier than not.
    • Being outdoors is the strongest correlate of physical activity in children.
    • An $10 spent per capita on parks and rec is associated with a third of a day more per week of vigorous exercise.
    • The recreation economy is huge. It employes 6.1 million people. Outdoor recreation spending exceeds pharmaceutical spending, at 646 billion dollars.
    • While it is a powerhouse, they haven’t invested resources in collectively lobbying state or federal legislation. This explains the decreased attention to the outdoors.
  • A new approach
    • What if we led young people the resources and power to engage the issue themselves? Many believe (falsely) that millennials are inactive, lazy and clueless. The vision behind Outdoor Nation is to train a millennial generation of outdoor leaders.
    • Since 2010, they’ve had 25 leadership summits
    • The first outdoor summit was held in NYC’s Central Park—the largest and most diverse summit of its kind. This is great news, because the outdoors is not especially associated with diversity.
    • Some outcome include: Leadership Council of young people who meet with public officials, Youth-Led projects (250 of them) that have come out of their summit and website—including things like school gardens and guerrilla gardening, and Campus Clubs that bring youth outdoors via their peers.
    • In 2013-14, they’re ready to scale, taking from the TED model to pilot 10-15 “ON It Summits.” Next year they want to do 50 summits. They’re actively looking for partners, and have resources and tool kits ready to go.
  • Funding Opportunities
    • She spends most of her time fundraising.
    • Outdoor Nation awards hundreds of thousands online for ideas that get kids outdoors.
    • ESA (Entertainment Software Association) has done a lot of work in the health area, longtime foes of the outdoors community, but has recently come around by connecting the outdoors with gaming apps on mobile platforms.
    • Northface and The Pack charitable foundations also support with large grants and microgrants. Camelbak provides a similar measure of support.

Jackie is one of the co-founders, along with the other panelists of OAK, the Outdoors Alliance for Kids. It is a strategic partnership of organizations from diverse sectors with the interest in expanding the number and quality of opportunities for children, youth and families to connect with the outdoors. They have the Sierra Club, AHA, the Y, Outdoor Foundation, The North Face, Children Nature Network, REI and National Recreation and Park Association.

The framework for their work takes place in the environmental education space, community health and wellness, and environmental stewardship. They seek to raise awareness, build and empower networks and alliances, and assess and disseminate best policies and practices.

Another project is the 50-State Policy Assessment Project, in which they seek to find and replicate and develop and support multi-sector state collaborative efforts, multi-sector state healthy kids outdoors plans, environmental literacy plans, safe routes to school/complete streets, and public awareness campaigns. 47 states are in the process of developing environmental literacy plans, and they want to support them.

Switching gears, Jackie speaks about her organization. The Sierra Club’s outdoors programs reach 200,000 people a year. Some of their initiatives focus on communities of color and military/veteran communities. Each year they reach 14,000 low-income youth. At its heart the Sierra Club is a grassroots organizing group, with thousands of chapter and many more organizing campaigns. The North Star chapter in MN is working to reduce fossil fuel reliance by getting more bikes and walking paths in Minnesota.

Q: Has the assessment tool already started?

A: We designed the tool, but it takes on more sectors than just the outdoors, so the tool is in itself an education tool. They learned that you need a lot of people at the table just to do the survey. They have 7 pilot states and lots of feedback, and already they’ve learned that it will take too much time to get that level of detail. Another challenge is that their best sites are not doing as well as they thought. They have more work to do, and they need more funding to scale it. They have a letter of intent to seek more resources.

Q: How do you work with communities that can’t go outside or don’t go outside?

A: They worked with the National Parks Service to go outside. They found with Hispanic communities, uniforms at the parks services look like immigration uniforms. They also found that many families are telling kids to be afraid of the world outside their home. Jackie says that we need to redefine the outdoors to not just the Grand Canyon, but city parks and pocket parks. She sees a huge lack of demand from young people. We also need to think about gateway activities like hiking and fishing that will get kids into other outdoors activities. They also work with Ideo on program design, and found that single moms want to go outdoors with their kids, but don’t have the time between their two jobs. So they designed a camp for kids that has a spa-like space for the mom. This happened in Detroit.

PHA 2013 Annual Summit: Sanofi Innovation Challenge

These are my rough notes from Day 1 of the Summit. I had a blast learning and connecting with people. In some time these notes will be organized. 


Ms. Moscov begins with a menu of daunting statistics, then notes that we all know this. Sanofi is committed to bringing forward new ideas in the service of better health. She cites Play 4 Health, designed to educate kids and their parents on obesity, chronic disease, and nutrition. It’s a partnership of health organizations, sports organizations, and so on. It combines the once-in-a-lifetime opportunity to play on a real minor league baseball team for a day. This is the fourth innovation challenge supported by Sanofi. The Data-Design-Diabetes initiative is another innovation challenge in its second year. She recognizes the finalists for this year before introducing journalist Bonnie Burnstein.

Bonnie also makes fun of the weather. She too introduces the honorees, the three finalists for the innovation challenge. Dennis Ai (JiveHealth), Jason Dreyzehner (Aurri Health Network) Carter Kostner (Define Bottle) . Judges include: Blogger Elisa Page, Segway Inventor Dean Kamen (also created the first wearable insulin pump), Fortune writer Torrey Newmeir. Audience is also the judge. We vote with our blue chips. We have until 9:30 tomorrow to vote. The winners will receive hours of counseling with marketing experts, a cash prize of $10,000, and an opportunity to pitch to Fortune.

JiveHealth: Video notes that childhood obesity isn’t the problem, but the symptom of children not eating healthy, a product of craving high fat and high sugar foods. The video game is a role-playing game to incorporate behavior change. The game starts with the characters, which can be upgraded in the game as kids submit recipes. Some features are unlocked by taking pictures of healthy foods (like apples) at home or the grocery stores. It is free to download and start playing on smartphones. Dennis, in his live pitch to the audience, begins with his personal story with weight-loss that speaks to his motivation for JiveHealth. The judge asks him to clarify the statistic noted that the app can reach 46% of low-income households. Kamen asks how he can measure results. Dennis says they can track immediate changes in the game through proxies in the game, but ultimately they want to do a pilot study with something like 100 kids to seek long-term behavior change. Fortune judge asks for other kinds of games that do this. Dennis cites three of them. He says his game goes one step further to get the food into the hands of those kids. Page asks how he can compete with the thousands of other apps—and who is the audience, the kids or parents who get it for the kids? Dennis says the strategy is brick-and-mortar, noting that a restaurant is partnering to promote the app to their costumers. They’d love to partner with additional stakeholders. The game is just the beginning, they want the characters to be larger than the game. The bear Hugo, who loves apples, should be to apples what Tony the Tiger is to frosted flakes.

Aurri Health Network: Jason is a freshman at the University of Virginia. The video begins with the menu of daunting statistics and health complications and economic costs, noting that while products and services are being developed to reach people, low-income folks who suffer from obesity the most cannot afford them. The Network works with schools to empower student success via the Live Golden System, with applications for touchscreens, and programs for schools. Students can earn Aurri Gold (Au) through healthy behaviors, which can be redeemed for rewards in schools. The drive of Aurri is to be accessible to all children by working through schools, like a corporate wellness program for schools. Kamen asks how he’s going to measure results. Jason says everything is trackable, citing tracking cafeteria choices. Students can also work together as a class for rewards. It’s children motivating other children to change their behavior for the class. Fortune writer asks about the costs and who pays for it. Jason says the costs are low, saying touchscreens are under a hundred. Most of the products are not hardware, but software. Per school it’s low, less than 20-30 cents per students. Page was intrigued that the program adapts to kids, but how do we encourage children without shaming them or promoting bullying. Jason says the incentive system discourages those problems. They make sure there is no environment for bullying. He wants to make wellness a core component of academic criteria.

Define Bottle: Carter Koestler is 14 years old. The bottle provides an alternative to junk foods like soda and juice. It’s a cool-looking fruit-fused water bottle, where you add fruit to the bottom chamber, letting it infuse with the water above. The product is patent pending. He talks about the difference the product made on his best friend Henry, who lost five pounds after two weeks of use. Fortune says it’s a beautiful product, but asks if it makes more sense for the low-income family to eat the fruit? Carter says that you can use canned fruit too. Page notes the passion for style and cause, but asks of the materials of the bottle and its environmental impact? Carter made sure the materials have a “green-side.” The classic model is glass and bamboo, the sport model is BPA-free. Kamen notes that the internet is a key component of the other products, and that this is more scalable than a physical product, asking how he can credibly create scale? Carter says they have a multi-tiered distribution plan. First they’ll get the product on a website people can use. The second tier co-branding with organizations like Nike, to co-opt existing advertising power.