The U.S. Department of Health and Human Services (HHS) awarded more than $119 million to states and U.S. territories to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking-the four most important actions for combating chronic diseases and promoting health. This money supports the one of several components in the Department’s comprehensive prevention and wellness initiative, Communities Putting Prevention to Work, which is funded under the American Recovery and Reinvestment Act of 2009.

“Our goal through these statewide projects is to help make healthy choices the easier choices for all Americans, no matter where they live,” said HHS Secretary Kathleen Sebelius. “When we improve obesity-related and tobacco policies, we make it that much easier for people to eat right, to get more physical activity, and to avoid or stop smoking.”

The more than $119 million in funding — provided to 50 states, the District of Columbia, Puerto Rico and six Pacific territories — will focus on efforts to help communities and schools support healthy choices through a variety of methods including using media to support healthy food and beverage choices and increased physical activity, and increasing access to healthy choices and safe places to be active.

Awards will also support efforts to increase tobacco cessation through quit-lines and media campaigns and additional funding was provided to 13 states to support special initiatives.

Awards to states and territories are in three major categories:

1. Statewide policy and environmental change. All 58 applicants will receive funding for efforts in nutrition, physical activity, and tobacco control. The state, Washington, D.C. and Puerto Rico award amounts range from $335,801 to $2.2 million. Territory award amounts range from $99,980 to $100,000.

2. Competitive special policy and environmental change. Thirteen states were funded to implement 15 projects. The award amounts range from $1 million to $3 million per state.

3. Tobacco cessation through quitlines and media. CDC received applications-from all 50 states, Washington, D.C., Puerto Rico and Guam. 53 applicants will receive funding to expand tobacco quit-lines in concert with expanded cessation media campaigns. The award amounts range from $50,000 to $2.5 million. 53 applicants will receive funding to expand tobacco quit-lines in concert with expanded cessation media campaigns. The award amounts range from $50,000 to $2.5 million.

Awards for other Communities Putting Prevention to Work initiatives, including community-based health promotion initiatives, will be announced in the coming weeks.

To learn more about Communities Putting Prevention to Work, visit http://www.cdc.gov/chronicdisease/recovery.

So you or your patient needs to lose weight, however it seems like working out and dieting do nothing to improve their health.  Maybe the problem could be medical.

The American Society of Bariatric Physicians (ASBP) works with physicians so they’re better prepared to deal with society’s obesity epidemic. Even though people focus on weight loss more in January than any other month, successful weight loss is a year-round long-term initiative that goes far beyond just diet and exercise. The ASBP has highlighted five questions everyone who needs to lose weight should ask their physician.

1. Do I have other conditions that may be keeping me from losing weight?

It is important when you begin any weight loss program that you visit with a bariatric physician who can identify any weight-related conditions that can slow or stop successful weight loss. A bariatric physician will do a complete medical work-up to assess your overall health and metabolic state.

2. Do I have hypothyroidism?

Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. Since the main purpose of thyroid hormone is to “run the body’s metabolism,” it is understandable that people with this condition usually have a slow metabolism and thus, difficulty losing weight. A bariatric physician can identify a thyroid problem and provide a treatment plan that addresses hormonal and metabolic problems.

3. How are my Vitamin D levels?

Vitamin D levels are almost always low in patients who are overweight. Low Vitamin D levels can cause fatigue, muscle pain, bone pain and an overall feeling of lethargy, making it hard to lose weight.

4. Am I insulin resistant?

Insulin resistance turns off fullness signals to the brain. Typically, the heavier a person is, the more insulin resistant they may be, making them feel less full, causing them to continue to overeat. It is a complex condition that can be treated with the use of medications, exercise and dietary changes. Once it is treated, patients can feel more satiated, leading to more effective weight loss.

5. Am I ready for exercise?

This question may seem obvious, but exercise can be dangerous cardiovascularly in patients who are severely overweight. The heavier a person is, the more prone they are to injury. Often, it makes more sense medically for a patient to lose weight first and implement an exercise program when it is safe to do so, using exercise to maintain weight.

According to Dr. Wendy Scinta, a board certified family physician, a board certified Diplomate of the American Board of Bariatric Medicine (ABBM) and a member of the Board of Trustees of the ASBP, there is a skill set to managing obesity.

“If it were as simple as just eating less, we wouldn’t have an obesity epidemic in this country,” said Dr. Scinta. “Obesity is a medical condition, and it should be treated as such.”

Physician supervision is necessary to detect and treat weight-related medical conditions. A program supervised by a physician who is a member of the ASBP and who has completed specialized training in bariatric medicine, offers a comprehensive and effective approach to maximizing overall health and reversing co-morbidities.

To find a bariatric medical practice near you, visit www.asbp.org and click on the “Find a Physician” link.

General Mills announced today a public commitment to reduce sugar in cereals advertised to children to single-digit grams of sugar per serving. The initiative is in place and progress has been made, the company said, “with further reductions to continue until single-digit levels are reached on all cereals advertised to children.”

“Ready-to-eat cereals, including presweetened cereals, account for only five percent of the sugar in children’s diets,” said Jeff Harmening, President of General Mills’ Big G cereal division. “Still, we know that some consumers would prefer to see cereals that are even lower in sugar, especially children’s cereals. General Mills has responded – and we are committing to reduce sugar levels even more.”

General Mills has been reducing sugar in cereals advertised to children, while increasing key nutrients, such as calcium and vitamin D, and providing whole grain. “We have already made meaningful changes across our cereal portfolio,” noted Harmening, “and we have reached and exceeded our original goals. So today we are strengthening our goal – by publicly committing to further reduce to single-digit levels of sugar per serving every cereal advertised to children under twelve.”

The company’s commitment is among the most aggressive goals advanced in the food industry. The initiative will extend globally to 130 countries, with Cereal Partners Worldwide – the global cereal joint venture in which General Mills is a partner – adopting similar commitments.

General Mills has led numerous health and nutrition initiatives in cereal. The company was a pioneer in fortifying cereals with vitamins and minerals, and continued its leadership by fortifying its entire line of children’s cereals with calcium and vitamin D in 2008.

General Mills’ 2005 whole grain initiative has been called one of the biggest health initiatives in the food industry. The company committed to ensuring that every Big G cereal would help deliver the benefits of whole grain. As a result, every Big G cereal now provides at least 8 grams of whole grain per serving, with many cereals providing 16 grams of whole grain or more.

Announcing that initiative, General Mills said it would deliver 26 million servings of whole grain every day across America. Today, General Mills’ Big G cereals are delivering 35 million servings of whole grain daily across America. Other companies in the food industry followed with initiatives of their own, and America’s whole grain intake has increased as a result. Ready-to-eat cereal is now the No. 1 source of whole grains in a child’s diet – and whole grain is the number one ingredient in every cereal that General Mills advertises to children.

“Ready-to-eat cereal really is one of the best breakfast choices you could make,” said Susan Crockett, Ph. D, vice president, Health and Nutrition, and director of the Bell Institute of Health and Nutrition at General Mills. “More frequent cereal eaters tend to have healthier body weights – and lower Body Mass Index measures (BMIs). It’s true of men. It’s true of women. It’s true of kids. And that includes people who eat presweetened cereals.”

Ready-to-eat cereal eaters consume less fat, less cholesterol and more fiber than non-cereal eaters. Cereals also deliver important vitamins, minerals and essential nutrients, such as vitamins A, B6, iron, niacin and zinc, making cereal a top source of key nutrients in children’s diets.

“Our first target was to reduce sugar in cereals advertised to children to 12 grams of sugar or less,” explained Harmening. “Many were already lower, but some were not. So we put in place a plan to reduce sugar levels in a series of steps in those cereals and others, while continuing to deliver great taste. As a result, we have already reduced sugar in many cereals, some by as much as 20 percent, and by spring General Mills cereals advertised to children will all have 11 grams of sugar per serving or less.

“Today, we are strengthening our goal,” Harmening added. “We are committing to reduce sugar in cereals advertised to children under 12 to single-digit grams of sugar per serving.”

To ensure the cereals continue to taste great, reductions will continue in a series of smaller steps. “Maintaining great taste while continuing to reduce sugar is a challenge,” noted Harmening. “It requires technology, time and investment. But we’re doing it. We are committed to reaching single-digit levels.”

“General Mills strives to be the health leader in every category in which we compete,” said Harmening, “Big G is going to continue to lead in cereal as well.”

You wouldn’t send your children to school with a lunchbox full of candy bars, but you might be packing almost as much sugar when you send them off with some popular lunchtime classics. Considering most children brush their teeth in the morning and before bed, the sugar they put in their mouths at lunchtime could stay there for a while, and that worries some dentists.

“When you start adding up the sugars found in some common lunchbox items, you might be shocked,” said George Koumaras, DDS, dental director for Delta Dental of Virginia. “Simple changes can lower the sugar count, which is better for children’s oral health and, ultimately, better for their bodies.”

Take the classic peanut butter and jelly sandwich. Add a box of raisins, a small container of applesauce and a single-serve carton of chocolate milk. While it sounds healthy, the sugar total is a whopping 98 grams. An average candy bar contains about 25 grams of sugar.

Without drastic changes, give this same lunch a sugar makeover:

• Choose natural peanut butter (no added sugar) and low or no sugar added jelly.
• Replace white bread with whole wheat, and regular applesauce with natural applesauce.
• Swap raisins for mini carrots–raisins’ stickiness can hold sugars against teeth for prolonged periods.
• Trade chocolate milk for white milk.

The new total? A more tooth-tolerable 31 grams of sugar.

Alternatives to lunchbox standards:

• A tube of yogurt boosts calcium with only 10 grams of sugar.
• String cheese offers calcium and zero grams of sugar.
• Fruit roll-up snacks have 7 grams of sugar versus fruit snacks in a pouch with 14 grams.
• Three vanilla wafer cookies have 4 grams of sugar versus three chocolate, crème-filled cookies with 13 grams.

Most of us would like to think that we’re in charge of how much we eat. We trust our bodies to tell us when we’re full, and that after we’re done, we have a good sense of how much we’ve eaten.

If only it were true. “Research tells us that subtle cues in our environment can pressure us to dish up more than we need and eat more than we should,” said Luigi Gratton, M.D., vice president of medical affairs at Herbalife. “Larger plates – even larger serving utensils – can prompt over-consumption.” In a self-serve ice cream experiment¹, people given large bowls and scoops doled out 57 percent more ice cream than those given smaller dishes and serving utensils.

So, how much we’re going to eat is generally decided before we even take that first mouthful. The reality is we pretty much eat whatever we’re served – whether it’s a little or a lot. From a supersized fast-food meal to a dainty portion in an upscale restaurant, we’re generally satisfied as long as we’ve polished off every morsel. Rather than letting our stomachs decide, we let an empty plate signal an end to the meal.

Controlling how much you put on your plate really becomes the first step in controlling how much you put in your stomach. But other cues can trigger overeating, too. Just smelling or seeing food – anything from the smell of fresh-baked bread to the sight of stale donuts in the company lunchroom – can trigger your desire to eat, even if you’re not hungry. Here are some ways to take charge:

• Think spoon, not shovel – It’s an old trick, but it really works – using smaller plates and tall, skinny glasses gives the illusion that there is more food on the dish and more to drink in the glass. Smaller serving utensils help keep you from loading up, too – think spoon, rather than shovel.
• Single-serving sizes – As serving containers get larger, so do portions. Those huge bargain-priced cereal boxes may be leaner on your wallet, but studies show you’ll pour yourself a lot more cereal – as much as 20 percent more – than you would from a regular-sized package. Go for the single-serving sizes.
• Out-of-reach sweets – Make it inconvenient to eat the unhealthy stuff. You may not make the effort to bake brownies from scratch when the mood strikes, but if you keep the microwavable version around you’ll have to constantly fight the urge. Get the candy dish off your desk and the cookie jar off the counter – set out a bowl of fruit instead.
• Mix it up, but not too much – Studies show that the more variety on your plate, the more you’ll eat – all that stimulation keeps your taste buds in high gear. An array of low-cal fruits and veggies is fine, but when faced with a buffet or a dinner served family-style, limit yourself to just a couple of items on your plate at one time.
• Shake it up – Try a protein shake for breakfast or lunch. Made from a set amount of milk, protein powder and fruit, it’s a natural when it comes to portion control. Add some ice cubes, and whip it up to increase the volume without adding calories – and enjoy from a tall glass.