This issue of the UC ANR Nutrition Policy Institute's Research to Action examines the Healthy Communities Study, a 10-year National Institutes of Health-funded study investigating the impact of community-based nutrition and physical activity programs on childhood obesity.
Research to Action - The Nutrition Policy Institute news brief

February 2019 | Vol. 3, No. 1

Ten-Year Study Reveals That What Communities Do Impacts Child Health

What is the issue?
When a journal dedicates an entire supplement to one study, you know it’s important. When a study is featured in two journal supplements, it’s an even bigger deal. That’s the case with the Healthy Communities Study, a 10-year NIH-funded nationwide investigation probing the impacts of community-based nutrition and physical activity programs on childhood obesity. Eleven articles revealing the first comprehensive set of findings were published recently in a special supplement to the journal Pediatric Obesity.
Typically, studies involve researchers implementing interventions and then measuring the impacts, but the Healthy Communities Study, or HCS, is “naturalistic and observational.” That means there were no a priori interventions; researchers studied what had already happened in 130 selected U.S. communities, and then related community efforts to changes in children’s body weight over the prior 10 years as well as to children’s current nutrition and physical activity behaviors.
The Nutrition Policy Institute was part of the large HCS team that includes researchers from Battelle, the University of Kansas, the University of South Carolina, the National Institutes of Health, and several other federal agencies.

Why is this important?
Child obesity is at an all-time high and most U.S. children fail to meet diet or physical activity recommendations. With poor nutrition now the leading cause of chronic disease, and health care for treatment costing nearly one-fifth of our nation’s GDP, helping children be healthy and stay that way has never been more urgent. Previous interventions have shown modest success, yet little is known about what communities are doing and which efforts are most promising for obesity prevention and health promotion.
The goal of the HCS, the largest national study of its kind, was to fill that gap in order to inform future efforts to improve child diet and physical activity. From 2013 to 2015 researchers interviewed over 1,400 key community members, visited the households of over 5,000 children in grades K-8, and abstracted over 30,000 weights and heights from medical records. Over 9,000 community programs and policies were scored on their “intensity” with higher ratings for ones that provided “more” — more time, greater reach or more compulsory participation. Efforts over the prior one-, three-, six-, and 10-year periods were then tallied and related to changes in body mass index (BMI) and to children’s diet and physical activity.
What can communities do? 
The HCS revealed that the greater the intensity of a community’s efforts, the bigger the change in child BMI.  In other words, putting more effort on children’s health is working.  However, not all communities are seeing the same effect. Looking at just communities with at least one-third African American or Latino population, the trend was the same — the more intense the efforts, the lower the BMI — but not to a degree that was statistically significant. This suggests that programs and policies in those communities need to be tailored to make them more impactful.

Other lessons learned included that:
  • Different features of community programs and policies were related to better child nutrition and physical activity suggesting that there is likely no ‘single’ or ‘simple’ solution to address all the behaviors that contribute to excess weight gain.
  • Improving healthy options for children where they go to school and in their communities and homes is needed to improve diets. Giving information and enhancing skills in making dietary choices should accompany environmental changes.
  • In addition, helping children make healthier choices involves limiting less healthy options, such as sugary drinks, sweets and fast food, as well as promoting more fruits and vegetables and whole grains.
  • Similarly targeting multiple physical activity behaviors — such as increasing physical activity in Physical Education at school and reducing screen time at home — appears important for improving child physical activity.
  • Finally, it appears to take several years for communities to reap benefits, so sustained efforts over time are warranted.
This landmark research provides evidence to community decision-makers that investments in child nutrition and physical activity have value, and, when done over time and through coupling different approaches across multiple settings, are making kids healthier. These findings validate that what communities do can make a difference in improving the health of the next generation.
Pediatric Obesity
Volume 13, 
Issue S1, Pages 1-112, October 2018
Supplement: The Healthy Communities Study: Examining Community Programs, Policies and Other Characteristics in Relation to Child Weight, Diet, and Physical Activity. Guest Editor: Shiriki K. Kumanyika
Other publications on the Healthy Communities Study:

Research to Action is a periodic news brief from the Nutrition Policy Institute. Please share Research to Action with colleagues who would be interested in receiving it, and please subscribe if you haven't already done so.


Diverse: Issues in Higher Ed
GAO report tackles issues of food insecurity among college students

Lead in school water: Less than half the states test for It, and fewer require it

Washington Post
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NBC News
Lead in water: Study shows many schools have far too much

The Nation
With the government shut down, is your water safe?

The Guardian
Revealed: how big dairy pushed fattier milks into US schools

Hungry U.S. college students are going without food stamps amid confusion over eligibility

Report: College students are hungry and government programs could do more to help

Daily Californian
UC Board of Regents hears updates from committee on basic needs


February 22, 2019
CSPI Webinar: Case Study on Healthy, Hunger-Free Kids Act of 2010
Join the Center for Science in the Public Interest for a webinar sharing results of a case study that provides insights on how policy strategy and advocacy resulted in better school food.


Read the latest news from the National Drinking Water Alliance to access helpful resources on drinking water, including fact sheets, toolkits, webinars, workshops and much more. Be sure to read our latest research, in collaboration with the Prevention Research Center at the Harvard T.H. Chan School of Public Health, on state policies and state approaches to testing school drinking water for lead in the United States.

The Nutrition Policy Institute is part of the UC Global Food Initiative Healthy Vending Work Group, which aims to improve access to healthy food and beverage options sold in vending machines for students and employees throughout the entire UC system. Through research of existing healthy vending policies and extensive outreach with stakeholder groups throughout UC, the work group has developed the UC Healthy Vending Guidelines and a Best Practices Implementation Toolkit. See the UC Healthy Vending Policy section of our Resources page for more information.


U.S. Senators Patty Murray (D-WA), Elizabeth Warren (D-MA), Debbie Stabenow (D-MI) and Ed Markey (D-MA), released a new report from the U.S. Government Accountability Office (GAO) showing that college students around the country are struggling to afford food and basic nutrition. The report reviewed 31 studies on college student food insecurity, including groundbreaking studies conducted by the Nutrition Policy Institute. The report is the first time a federal government agency confirms that food insecurity among college students is a widespread issue.


Au LE, Paolicelli C, Gurzo K, Ritchie LD, Weinfield NS, Plank KR, Whaley SE. Contribution of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-Eligible Foods to the Overall Diet of 13- and 24-Month-Old Toddlers in the WIC Infant and Toddler Feeding Practices Study-2. Journal of the Academy of Nutrition and Dietetics. Jan 9, 2019, e-pub ahead of print. DOI:

[Abstract]  [FullText]

Cradock AL, Hecht CA, Poole MK, Vollmer LY, Flax CN, Barrett JL. State approaches to testing school drinking water for lead in the United States. Boston, MA: Prevention Research Center on Nutrition and Physical Activity at the Harvard T.H. Chan School of Public Health; January 2019.

[Abstract]  [Full Text]

Cradock AL, Poole MK, Vollmer LY, Barrett JL, Flax CN, Hecht CA. State Policies on Testing Drinking Water for Lead in U.S. Schools. Research Brief. Durham, NC: Healthy Eating Research; January 2019.

[Abstract]  [Full Text]

University of California Healthy Vending Policy: Implementation and Best Practices Toolkit. University of California Global Food Initiative Healthy Vending Working Group. University of California Global Food Initiative, 2018. 

[Full Text]

United States Government Accountability Office. Better Information Could Help Eligible College Students Access Federal Food Assistance Benefits. December 2018.

[Abstract]  [Full Text]  [Accessible Version]  [Website]

Hewawitharana SC, Thompson FE, Loria CM, Strauss W, Nagaraja J, Ritchie LD, Webb KL. Comparison of the NHANES dietary screener questionnaire to the Automated Self-Administered 24-Hour Recall for Children in the Healthy Communities Study. Nutrition Journal, Nov 27, 2018. DOI:

[Full Text]

Calancie L, Cooksey-Stowers K, Palmer A, Frost N, Calhoun H, Piner A, Webb K.  Toward a Community Impact Assessment for Food Policy Councils: Identifying Potential Impact Domains. Journal of Agriculture, Food Systems, and Community Development. Published online September 24, 2018. DOI:


For a complete list of NPI publications, please visit

The Nutrition Policy Institute (NPI) conducts research on the impact of nutrition and physical activity on public health. NPI translates research findings into recommendations to provide a basis for effective decision-making, particularly related to the federal nutrition assistance programs.

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