Carolina public health

              FAL L 2 0 1 0
VOLUME 1 · NUMBER 9
Jack E. Wilson, PE, MSENV
President
Member of the Board of Directors
TEC Inc.
Delton Atkinson, MPH, MPH, PMP
Vice President
Deputy Director
Division of Vital Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
Barbara K. Rimer, DrPH
	
Executive Vice President
Ex Officio
Dean
Alumni Distinguished Professor
UNC Gillings School of Global Public
Health
Peggy Dean Glenn
Executive Director/Secretary
Ex Officio
Associate Dean for External Affairs
UNC Gillings School of Global Public
Health
Charlotte Nuñez-Wolff, EdD
Treasurer
Ex Officio
Associate Dean for Business and Finance
UNC Gillings School of Global Public
Health
Julie MacMillan, MPH
Member
Ex Officio
Interim Senior Associate Dean
UNC Gillings School of Global Public
Health
David J. Ballard, MD, MSPH, PhD,
FACP
Senior Vice President and Chief Quality
Officer
Baylor Health Care System
Executive Director and BHCS Endowed
Chair
Institute for Health Care Research and
Improvement
Andrea Bazán, MPH, MSW
	
President
	
	
	
Triangle Community Foundation
Fred T. Brown Jr., MPH, FACHE
Group Senior Vice President
	
Eastern Division
Carolinas HealthCare System
Kelly B. Browning, MA
	
Executive Vice President
American Institute for Cancer Research
P. LaMont Bryant, PhD, RAC
	
Manager, Regulatory Affairs
	
Ethicon Endo-Surgery/Johnson &
Johnson
Cynthia H. Cassell, PhD
	
Health Scientist, Epidemiology Team
Birth Defects Branch
Division of Birth Defects and
Developmental Disabilities
National Center for Birth Defects and
Developmental Disabilities
Centers for Disease Control and
Prevention
Deniese M. Chaney, MPH
	
Partner
	
	
	
Accenture Health and Life Sciences
Stacy-Ann Christian, JD, MPH
Senior Director
	
	
Research Administration
New York City Health and Hospital
Corp.
Michael (Trey) A. Crabb III, MHA,
MBA
	
	
President
	
	
	
Health Strategy Partners LLC
Leah Devlin, DDS, MPH
	
Gillings Visiting Professor
UNC Gillings School of Global Public
Health
Cynthia J. Girman, DrPH
Senior Director, Department of
Epidemiology
	
	
Merck Research Laboratories
Sandra W. Green, MBA, MHA, BSPH
President
	
	
	
East Coast Customer Management Group
MedAssets Inc.
C. David Hardison, PhD
Corporate Vice President, Life Sciences
Science Applications International Corp.
Deborah Parham Hopson, PhD, RN
Assistant Surgeon General
	
Associate Administrator
HIV/AIDS Bureau
Health Resources and Services
Administration
Joan C. Huntley, PhD, MPH
	
Adjunct Professor of Epidemiology
UNC Gillings School of Global
Public Health
Joseph F. John, MHA, FACHE
Administrator
Clinical Operations
	
	
The Emory Clinic Inc.
Mark H. Merrill, MSPH
	
President and Chief Executive Officer
Valley Health System
Stephen A. Morse, MSPH, PhD
Associate Director for Environmental
Microbiology
	
	
National Center for the Prevention,
Detection and Control of Infectious
Diseases
Centers for Disease Control and
Prevention
Douglas M. Owen, PE, BCEE
	
Vice President
	
	
Malcolm Pirnie Inc.
Jonathan J. Pullin, MS
President and Chief Executive Officer
The Environmental Group of the
Carolinas Inc.
Roy J. Ramthun, MSPH
	
President
	
	
	
HSA Consulting Services LLC
Laura Helms Reece, DrPH
	
Chief Operating Officer
Rho
James Rosen, MBA, MSPH
	
Partner
	
	
	
Intersouth Partners
Jacqueline vdH Sergent, MPH, RD,
LDN
Health Promotion Coordinator/
Health Education Supervisor
Granville-Vance (N.C.) District
Health Department
Ilene C. Siegler, PhD, MPH
	
Professor of Medical Psychology
Duke University
Jeffrey B. Smith, MHA, CPA
	
Partner
	
	
	
Ernst & Young LLP
Paula Brown Stafford, MPH
	
Executive Vice President
	
Integrated Clinical Services Quintiles
John C. Triplett, MD, MPH
Regional Medical Officer
Bethesda, Md.
G. Robert Weedon, DVM, MPH
Veterinary Outreach Coordinator
Alliance for Rabies Control
Adjunct Faculty
UNC-Wilmington
Veterinarian
New Hanover Co. (N.C.) Board of Health
Alice D. White, PhD
Vice President
Worldwide Epidemiology Department
GlaxoSmithKline
Chen-yu Yen, PhD, PE
President and Chief Executive Officer
TerraSure Development LLC
Vice President
Gannett Fleming Inc.
Senior Vice President
Gannett Fleming Sustainable
Ventures Corp.
Public Health Foundation, Incorporated BOARD OF DIRECTORS
Joan H. Gillings CHAIR, ADVANCEMENT
Donald A. Holzworth, MS
Chair
Chairman
Futures Group International
James Rosen, MBA, MSPH
Public Health Foundation Board
Liaison to Advisory Council
Partner
Intersouth Partners
Marcia A. Angle, MD, MPH
Adjunct Professor
Nicholas School of the Environment
Duke University
William K. Atkinson, PhD, MPH
President and Chief Executive Officer
WakeMed
Joseph Carsanaro, MBA, MSEE
General Manager
Pinehurst Advisors LLC
Gail H. Cassell, PhD, DSc (hon)
Vice President, Scientific Affairs
Distinguished Lilly Research Scholar
for Infectious Diseases
Eli Lilly and Co.
Willard Cates Jr., MD, MPH
President, Research
Family Health International
Keith Crisco, MBA
Secretary of Commerce
State of North Carolina
Ken Eudy
Chief Executive Officer
Capstrat
Robert J. Greczyn Jr., MPH
CEO Emeritus
BlueCross and BlueShield of N.C.
Gillings Visiting Professor
UNC Gillings School of Global
Public Health
James R. Hendricks Jr., MS
Vice President, Environment, Health
and Safety (Retired)
Duke Energy
J. Douglas Holladay, MDiv
Chairman and Chief Executive Officer
PathNorth
A. Dennis McBride, MD, MPH
Health Director
City of Milford (Conn.)
John McConnell
Chief Executive Officer
McConnell Golf
Jesse Milan Jr., JD
Vice President and Director
Community Health Systems
Altarum Institute
Guy Miller, MD, PhD
Chairman and Chief Executive Officer
Edison Pharmaceuticals Inc.
James Patrick O’Connell, PhD, MPH
Chief Executive Officer
Acea Biosciences Inc.
Jane Smith Patterson
Executive Director
The e-NC Authority
Virginia B. Sall
Co-founder and Director
Sall Family Foundation
Charles A. Sanders, MD
Chairman and Chief Executive Officer
(Retired)
Glaxo Inc.
Paul M. Wiles, MHA
President and Chief Executive Officer
Novant Health Inc.
Markus Wilhelm
Chief Executive Officer
Strata Solar LLC
Derek Winstanly, MBChB
Executive Vice President
Strategic Business Partnerships and
Customer Relationships Quintiles
Louise Winstanly, LLB, MSB
Attorney and Medical Ethicist
Chapel Hill, N.C.
Lloyd M. Yates, MBA
President and Chief Executive Officer
Progress Energy
MEMBERS EMERITI
Nancy A. Dreyer, PhD, MPH
Chief of Scientific Affairs
OUTCOME
Carmen Hooker Odom, MS
President
Milbank Memorial Fund
UNC Gillings School of Global Public Health ADVISORY COUNCIL
C A R O L I N A P U B L I C H E A L T H | 1
contents fall 2010
3 FROM THE DEAN’S DESK
	 Let’s get moving!
4 FIT AND HEALTHY FOR A LIFETIME
	 UNC public health faculty, students and alumni discover ways to trim down the obesity epidemic.
6 A HEALTHY START TO LIFE
	 For 30 years, the number of overweight children has crept higher. Establishing good
	 health habits early can reverse this trend and help children lead healthy lives.
9 NAP SACC – HELPING CHILD CARE CENTERS IMPROVE PRESCHOOLERS’ HEALTH
	 This NIH-funded intervention helps child care centers in North Carolina boost food
	 quality and improve opportunities for physical activity for preschoolers.
10 ADOLESCENCE – A TIME TO GROW UP FIT FOR LIFE
	 Adolescence is a time of dramatic physical and emotional changes. It’s also a time
	 when many young people gain weight as their exercise levels and appetites change.
13 EAT YOUR FRUITS AND VEGETABLES – MANGA COMICS GET THE MESSAGE
	 ACROSS TO KIDS
	 Alumna May May Leung uses Japanese comic art to promote positive health
	 behaviors in youth.
14 FAT GENES
	 School researchers identify the genes that affect body weight.
15 LIVING HEALTHY – HOW ADULTS CAN MAINTAIN OR LOSE WEIGHT
	 As we ‘settle down,’ adults are at risk for weight gain and illness, including cardiovascular
	 disease and diabetes.
17 IS PERCEIVED RACISM A RISK FACTOR FOR OBESITY?
	 Dr. Anissa Vines suggests that an emotional response to racism is stress, which increases belly fat.
18 FOR WEIGHT LOSS, WORKING TOGETHER IS OFTEN THE BEST APPROACH
	 Researchers engage churches, community groups and others in
	 programs to improve health and avoid obesity-related illness.
features & news
continued 8
6
15
10
18
4
2 | FA L L 2 0 1 0
THE WORLD IS FAT
Across North Carolina and around the world, we investigate why
obesity rates have ballooned, how the phenomenon affects health
and what to do about it.
21 ACTIVE LIVING BY DESIGN
With an initial Robert Wood Johnson Foundation investment in
2001, ALBD began working within communities to solve
infrastructure challenges around physical activity and healthy eating.
25 SCHOOL NEWS
28 AWARDS AND RECOGNITIONS
31 HONOR ROLL
33 ROSENAU SOCIETY
34 DR. MICHAEL KAFRISSEN
37 MATHILE INSTITUTE
38 BILL AND ROSA SMALL
39 MABEL JOHANSSON
41 CHILDFUND INTERNATIONAL
42 ANNUAL FUND SCHOLARS
44 THE COCA-COLA COMPANY
contents, continued 31
fall 2010 DEAN
Barbara K. Rimer, DrPH
DIRECTOR OF COMMUNICATIONS
MANAGING EDITOR
Ramona DuBose
EDITOR
Linda Kastleman
ASSOCIATE DEAN FOR
EXTERNAL AFFAIRS
Peggy Dean Glenn
DESIGN AND PRODUCTION
Amanda Zettervall
UNC Design Services
CONTRIBUTING WRITERS
Ramona DuBose, Whitney L.J.
Howell, Linda Kastleman, Kathleen
Kearns, Michele Lynn, Chris Perry,
Susan Shackelford, Angela Spivey,
Bobbi Wallace
COVER ILLUSTRATION
John Roman
Articles appearing in Carolina
Public Health may be reprinted with
permission from the editor. Send
correspondence to Editor, Carolina
Public Health, Gillings School of
Global Public Health, Campus Box
7400, Chapel Hill, NC 27599-7400, or
e-mail sphcomm@listserv.unc.edu.
SUBSCRIBE TO
CAROLINA PUBLIC HEALTH
www.sph.unc.edu/cph
18,000 copies of this document were
printed at a cost of $17,021.35 or
$0.95 per copy.
Carolina Public Health (ISSN 1938-
2790) is published twice yearly by the
UNC Gillings School of Global Public
Health, 135 Dauer Dr., Campus Box
7400, University of North Carolina at
Chapel Hill, Chapel Hill, NC 27599-
7400. Vol. 1, No. 9, Fall 2010.
our donors
gatefold 25
gatefold
HONOR
ROLL
SCHOOL
NEWS
C A R O L I N A P U B L I C H E A L T H | 3
In 1980, about 15 percent of Americans were obese;
today, about 34 percent are, and another third are
overweight. Since 1980, the proportion of children
ages 2 to 19 who are obese has tripled.
How did we gain all this weight? Our genes did
not change that fast! Most experts agree that there
are several key reasons: we are eating about 300
more calories every day than we did in 1985, our
portion sizes have increased dramatically, we’re
drinking more sugary drinks, and the majority of
us are getting less exercise. Most children no longer
have regular gym classes, and they are more likely
to be on computers and smart phones after school
than outside playing. Many neighborhoods lack
safe places to walk. Sixty percent of adults don’t get
enough exercise to achieve health benefits.
The tab for our extra pounds is at least $147 billion
a year. Obese people spend 43 percent more on health
care costs than do healthy-weight people.
As you will read in this issue, faculty members in
our Department of Nutrition and across the School
have made fundamental contributions to under-standing
the science of nutrition, determining why
some people are more prone to gaining weight than
others, explaining the worldwide distribution of
obesity and its predictors, and developing, testing
and disseminating evidence-based interventions and
policies to reduce obesity and prevent weight gain in
a variety of populations in the U.S. and elsewhere.
As with other health problems, some minorities and
disadvantaged populations bear a disproportionate
share of the burden.
Nutrition research must be done in labs, clin-ics,
communities and workplaces, with individuals
and in larger units. It is a complex problem with no
“magic bullet” solution. As we have learned from
the smoking arena, it won’t be sufficient to inter-vene
only with individuals. Policies should require
physical education in schools and limit sugary
drinks. Worksite cafeterias should charge more for
less healthy than healthy foods. Health plans should
provide incentives for healthy weight and exercise.
And that’s just a beginning.
At the School, we’ve taken steps beyond our
outstanding research, such as trying to increase
the choices of healthier foods in our café, serving
healthier foods at events, buying local foods wher-ever
possible and reducing portion sizes.
Ultimately, we’re also role models for one another
and the larger community. We should more actively
encourage our faculty, staff and students to exercise
and eat healthily, and reach out to the community
around us. We imagine a time when our grounds
could be turned into great walking trails with water
sculptures and informative trail markers, and we
could become not just a center for knowledge dis-covery
and dissemination but a center for activity.
Let’s get moving!
Let’s Get Moving!
Obesity is a major economic and health threat in North Carolina, the U.S.
and around the world. The fact that obesity is spreading in an almost epidemic
manner means that some countries still could intervene before it is too late –
just as some countries woke up to the potential for intervention on tobacco,
before high smoking rates had overtaken their populations. We are at an
important tipping point on obesity, both in the U.S. and globally.
Dr. Barbara K. Rimer
from the Dean’s desk
PHOTO BY L ISA MARIE ALBERT
We are at an important tipping point on
obesity, both in the U.S. and globally.
4 | F A L L 2 0 1 0
Fit and healthy
for a lifetime
Her mother cringes, hearing echoes of the
taunts from her own childhood. She wants
to spare her daughter the low energy and
poor self-esteem that she endures as an
obese adult. Even more, she doesn’t want her
daughter to face the same high risk of disease.
But her mind races to statistics she’s
read, compiled by the Robert Wood Johnson
Foundation (www.rwjf.org) and the Trust for
America’s Health (http://healthyamericans.
org). In 2010, more than 25 percent of adults
in 38 states are obese. (Just 10 years ago, no
state had an obesity rate above 20 percent.)
More than 12 million American children,
ages 10 to 17, are obese.
Her crisis – her daughter’s crisis – has
become epidemic.
These days, many agents – from First Lady
Michelle Obama to the Centers for Disease
Control and Prevention, from insurance
companies to school nutrition counselors –
seek ways to control the crisis. Mrs. Obama’s
initiative, “Let’s Move” (www.letsmove.gov),
has the audacious goal of solving the obesity
epidemic in one generation. “[Obesity] is a
major public health threat right now,” she
said, announcing the program, “so just imag-ine
what we’re going to be facing in 20 or 30
years if we don’t get on this issue.”
The American Institute for Cancer
Research (AICR) reports that excess body
fat causes approximately 103,000 cases of
cancer in the United States every year.
“Many people are aware of the role of
obesity when it comes to increasing the
risk of cardiovascular disease and type 2
diabetes,” says Kelly
B. Browning, AICR
executive vice presi-dent
and member of
the School’s Public
Health Foundation
board of directors,
“and we at AICR want
to make sure people
know that excess body
fat also increases the risk for cancer.”
For more than three decades, the UNC
Gillings School of Global Public Health has
been a recognized world leader in discover-ing
evidence-based, creative and sustain-able
ways to prevent obesity and to help
people lose weight. Mrs. Obama cited UNC’s
NAP SACC program (see page 9), aimed at
improving nutrition and increasing exercise
in child care centers throughout North Caro-lina,
as an example of a creative, successful
intervention.
“We have a world that consumes more satu-rated
fat and more meat and dairy products
than we could have imagined 10 to 20 years
ago,” says Barry Popkin, PhD, Carla Smith
Chamblee Distinguished Professor of Global
Nutrition at UNC Gillings School of Global
Public Health. “Even in developing countries
now, there are more obese people than there
are hungry people.”
Popkin is one of several School researchers
advocating for policy changes at local, state,
national and international levels that would
help modify behavior,
including a call for
higher taxes on sugar-sweetened
beverages
to discourage people
from drinking them.
Maintaining healthy
weight is not only
about “looking good.”
It’s about feeling good
A 10-year-old girl runs into her house in tears.
During her first day of fifth grade at a new
school, children made fun of her weight. At recess,
nobody chose her for their soccer team, saying she ran
too slowly to keep up. Some boys called her names.
Mommy, she cries, am I always going to be fat?
UNC public health faculty, students and alumni discover
ways to trim down the obesity epidemic
F E AT U R E S A N D N EWS
Kelly Browning Dr. Barry Popkin
– having energy to enjoy life and minimiz-ing
disease risks that strain the health care
system and slow productivity.
Faculty members and students in UNC’s
renowned nutrition department – based in
the public health and medical schools – are
finding solutions. For example, nutrition
professor Melinda Beck, PhD, uses mouse
models to explain the link between obesity
and higher mortality rates from influenza.
Professor Rosalind Coleman, MD, stud-ies
hepatic insulin resistance and inborn
errors of carbohydrate and lipid metabolism.
Researchers including Kari North, PhD, asso-ciate
professor of epidemiology, and Daniel
Pomp, MD, professor of genetics, nutrition,
and cell and molecular physiology, look at
genetic factors that may contribute to obesity
and related diseases.
Other researchers, including Peggy Bent-ley,
PhD, nutrition professor and the School’s
associate dean for global health, Miriam
Labbok, MD, Professor of the Practice of
maternal and child health and director of
the School’s Carolina Global Breastfeeding
Institute, and Elizabeth Mayer-Davis, PhD,
nutrition professor and vice president of the
American Diabetes Association, search for
critical information about what and how
we feed infants and young children. Nutri-tion
professor Dianne Stanton Ward, EdD,
explores ways to increase activity and healthy
eating for children in child care settings.
June Stevens, PhD, nutrition chair, and
associate professors Penny Gordon-Larsen,
PhD, Deborah Tate, PhD, and others, find
interventions to help adolescents lose weight
or avoid gaining extra pounds. Tate’s creative
approaches include text messaging, active
video gaming and nutrition counseling to help
during this critical period of development.
Recent alumna May May Leung, PhD, used
manga comics (Japanese comic art) to pro-mote
positive health
behaviors in youth.
(See page 13.)
Other approaches
are aimed at adults.
Tate and associate
professor Laura Lin-nan,
ScD, assess the
usefulness of work-place-
centered weight
loss programs. Professors Alice Ammer-man,
DrPH, and Marci Campbell, PhD,
teach communities about the benefits of
eating fresh fruits and vegetables. Epide-miology
professor Marilee Gammon, PhD,
examines the connection between weight
and exercise, and the impact both have
upon multiple diseases, including cancer,
diabetes, heart disease and stroke. Oth-ers,
including Anissa Vines, PhD, research
assistant professor of epidemiology, search
for causes of racial disparities in obesity and
related diseases.
Their research is conducted across North
Carolina in towns such as Kinston, Hills-borough,
Clinton and Greensboro. The search
for answers extends throughout the world,
with research projects in China, India, Mex-ico,
Philippines and the Arctic Circle. This
issue of Carolina Public Health describes only
some of the obesity-related work in which
faculty members and students are involved.
“Obesity is a preventable cause of disease
and death that has a huge impact on quality
of life and health care costs,” says nutrition
chair Stevens, AICR/WCRF Distinguished
Professor of nutrition and epidemiology.
“It is important that we train the next gen-eration
of students to build on what we are
now discovering about obesity in order to
create new solutions. There are so few indi-viduals
trained to understand the biologic,
behavioral and population sciences needed
to effectively combat the obesity epidemic.
The School’s approaches address health and
nutrition at all stages of people’s lives.”
To educate doctors about nutrition-related
disease, Steve Zeisel, MD, PhD, Kenan Dis-tinguished
Professor of nutrition at the
School and director of the Nutrition Research
Institute in Kannapolis, N.C., has developed
a groundbreaking Nutrition in Medicine
course for medical students and practic-ing
physicians. (See www.med.unc.edu/nutr/
nim.) The online materials, made avail-able
free to medical students, are used by
more than 100 U.S. medical and osteopathic
schools and by more than 50 international
institutions. Also available is a new online
training program, Nutrition Education for
Practicing Physicians (NEPP), funded by the
National Cancer Institute.
“We have scientific evidence explaining
the role of nutrition in preventing and man-aging
most of the leading causes of death
in the U.S.,” says
Zeisel. “Physicians are
uniquely positioned to
emphasize to patients
the importance of
nutrition in prevent-ing
and managing
chronic disease. How-ever,
physicians must
be prepared to give
specific advice about
nutrition to patients.”
Maybe one day, when the 10-year-old is
grown and has a child of her own, new preven-tion
strategies, combined with better under-standing
of nutrition, genetics and behavior
management, will reduce the chances that
she and her child will face the dangers of obe-sity.
With effort, they will be part of a more
energetic, healthier world.
–Ramona DuBose
C A R O L I N A P U B L I C H E A L T H | 5
Dr. June Stevens
Dr. Steve Zeisel
6 | F A L L 2 0 1 0
F E AT U R E S A N D N EWS
Establishing good health habits early can
reverse this trend and help children have
healthy lives. The UNC Gillings School of
Global Public Health leads the fight against
the obesity epidemic and promotes healthy
behaviors locally, nationally and globally.
“Combating obesity is a key strategic area
for the School,” says Peggy Bentley, PhD,
nutrition professor and the School’s associ-ate
dean for global health. “UNC is playing
a major role in obesity research. We have
faculty and graduate student expertise from
the molecular level through epidemiology,
economics, interventions and policy.”
You are what
your mother eats
Society’s advice to expectant mothers his-torically
has been to “eat for two.” However,
contemporary research shows that eating
unhealthy, high-calorie foods during preg-nancy
can put children at risk for weight
struggles and health complications before
they are born.
For 15 years, Anna Maria Siega-Riz, PhD,
RD, nutrition and epidemiology professor
and associate dean for academic affairs at
the School, has analyzed prenatal nutrition
data to determine which health habits give
children the best start in life.
“Pregnancy is a happy moment in life, but
it’s also when women are most concerned
about the health of their child,” she says. “If
they have bad health habits, many women are
more likely to modify their behavior, at least
in the short term.”
Although most women know to limit
weight gain during pregnancy, 60 percent
still gain more weight than they should,
based on Institute of Medicine recom-mendations.
(Siega-Riz was a member of
the prestigious IOM panel that developed
those guidelines, available at http://tinyurl.
com/iom-guidelines.) Fewer than 25 percent
receive guidance from their doctors about
physical activity. Making and maintaining
behavioral changes is difficult unless women
have positive, consistent support.
Siega-Riz’s team uses the Internet, pod-casts,
chat rooms and cell phones to provide
health information and online support for
pregnant women. One podcast includes a skit
in which four women, all at different parent-hood
stages, advise an expectant mom about
choosing nutritious foods.
Women with healthy habits may avoid
having a baby who is too large for gestational
age (often leading to C-section births), pre-vent
shoulder dystocia for the baby during
birth, and limit the child’s risk for developing
diabetes and obesity.
“Women who aren’t eating right or exer-cising
need assistance,” Siega-Riz says. “We
must help them find balance and give them
all the support they require.”
Choosing healthful foods during preg-nancy
could reduce the burden of chronic
diseases later in life, says Mihai Niculescu,
MD, PhD, nutrition assistant professor.
Whether the “fat gene” exists is debatable
(see page 14), but Niculescu’s epigenetic
work – research that determines how outside
A healthy start
to life
For 30 years, the number of overweight
children has crept higher and higher.
In 2008, the Centers for Disease Control and
Prevention reported 10 percent of children
ages 2 to 5 had an unhealthy body mass index.
Those children have a 70 percent chance of
being overweight or obese adults.
Dr. Meghan Slining
Dr. Margaret Bentley Dr. Cindy Bulik Dr. Miriam Labbok
Dr. Mihai Niculescu Dr. Anna Maria Siega-Riz
C A R O L I N A P U B L I C H E A L T H | 7
influences alter our DNA – shows that high-fat
diets and maternal obesity in mice alter
DNA, shutting down some genes and accel-erating
others. Developmental brain delays
in offspring are the result.
When maternal obesity exists, the neu-rons
in mouse fetal brains at 17 days of
pregnancy appear less developed, according
to Niculescu’s observations. The implications
are worrisome, he says, because the effects
are evident after three or four generations.
“This may have profound consequences
for an offspring’s life, including his or her
mental development and ability to learn,” he
says. “A high-fat, less nutritious diet can also
create food preferences in unborn offspring
that lead them to choose unhealthy foods
later in life.”
Open the hangar –
here comes the airplane!
Parental influence over children’s nutrition
doesn’t end at birth, but little research exists
on what increases obesity risk in children
under two. In 2002, Associate Dean Bent-ley
became a pioneer in this area when she
launched “Infant Care, Feeding and Risk of
Obesity,” a study of strategies used by first-time
African-American mothers to feed their
3-month to 18-month-old children.
With National Institutes of Health fund-ing,
Bentley recruited 217 mother-child pairs
in North Carolina through the Women,
Infants and Children program and vid-eotaped
them at three-month intervals to
identify feeding styles. She and her team
identified five styles: controlling, laissez-faire,
responsive, pressuring and restrictive.
Responsive mothers, she says, are “perfect
moms” who pay close attention to and cor-rectly
interpret child cues of hunger and
satiety. They are very engaged during feeding
and may provide verbal and physical encour-agement
and help, when needed. Other styles
pressure or even force children to eat when
they reject food or overly restrict the qual-ity
and quantity of what children eat, often
because the mother is concerned about her
child becoming fat.
“Many factors play a role in how we feed
infants. However, we believe that it is not
just what children are fed, but also how they
are fed that makes a difference in the child’s
acceptance of food and perhaps in later food
preferences and health outcomes,” Bentley
says. “Understanding the role these styles 8
Women who choose healthful foods during pregnancy may reduce their own
risk of chronic diseases later in life and improve their children���s ability to learn.
Pregnancy is a happy moment in life,
but it’s also when women are most concerned
about the health of their child.
If they have bad health habits, many women
are more likely to modify their behavior,
at least in the short term.
F E AT U R E S A N D N EWS
8 | F A L L 2 0 1 0
play in growth and development outcomes
is a big part of what drives our childhood
obesity study.”
Meghan Slining, PhD, nutrition assis-tant
professor, analyzed data from Bentley’s
study while she was a UNC doctoral student.
Overweight infants – those who measured
greater than the 90th percentile for weight
versus length – were nearly twice as likely as
normal-weight infants to have delayed motor
development, Slining found.
“While baby fat may be cute,” Slining
says, “it increases the chance that a child
could become an overweight adult. We also
have seen more immediate consequences to
extra pudginess. These children have lower
gross motor development.” (See a video
about Slining’s research at http://tinyurl.com/
slining-baby_fat.)
Add a mother with an
eating disorder to the mix,
and feeding a child becomes
even more complex. Jordan
Distinguished Professor of
Eating Disorders Cynthia
Bulik, PhD, used data from
the Norwegian Mother and
Child Cohort Study, which
followed more than 100,000
Norwegian mothers, some
of whom had anorexia or
bulimia nervosa or binge
eating disorder, to deter-mine
how they fed their
children. Bulik followed
the mothers from 17 weeks’
gestation through their chil-dren’s
eighth birthdays.
Although some moth-ers
with eating disorders
experienced a reprieve from
their conditions during pregnancy, this was
not universally the case. In fact, a surprising
number of women developed binge eating
disorder during pregnancy. Eating disorders
during pregnancy expose babies to erratic
eating, Bulik says.
“The impact of roller-coaster caloric intake
certainly affects growth and development,”
Bulik says. “It could also affect obesity and
diabetes risk, as well as the weight trajectory
for later in life.”
Mothers with eating disorders also aban-doned
breastfeeding earlier than did healthy
mothers, Bulik says. After giving birth,
women with eating disorders often feel they
no longer “have a reason to be overweight”
and choose not to consume adequate calories
to support breastfeeding.
Bulik’s study also shows that, as these
children grow, they are more likely to develop
eating problems, such as having stomach
aches, vomiting without cause or not enjoy-ing
food.
According to Miriam Labbok, MD, Pro-fessor
of the Practice of maternal and child
health and director of the School’s Carolina
Global Breastfeeding Institute, a breastfeed-ing
baby will “stop when full,” but bottle
feeding can overpower a baby’s ability to
recognize satiety. When a parent insists that
the baby empty the bottle, the child learns
the habit of overeating, Labbok says. Addi-tionally,
breastfed babies are exposed to the
tastes of foods eaten by their mothers. For a
formula-fed child, food flavors are new and
strange, which could cause the child to be a
picky eater.
Employing research to instill good eating
habits early is paramount to changing the
course of human health, Bentley says.
“It’s harder to intervene and prevent nutri-tion
problems when a child is older. They
have preferences and eating patterns that
make changes more complicated and dif-ficult,”
she says. “But, with the research
ongoing at the School, we know we’re leading
a positive trajectory of implementing healthy
habits early.”
–Whitney L.J. Howell
The impact of roller-coaster caloric intake
certainly affects growth and development.
It could also affect obesity and diabetes risk, as
well as the weight trajectory for later in life.
Karina Agopian, research assistant at UNC’s Nutrition Research Institute in Kannapolis, works with
a toddler to determine what and how much the child has eaten. Research shows that early eating
habits influence later food preferences and health outcomes.
PHOTO BY CHAD W. MITCHELL
C A R O L I N A P U B L I C H E A L T H | 9
WHAT WOULD HAPPEN IF CHILDREN IN
CHILD CARE WERE SERVED GREEN BEANS
INSTEAD OF FRENCH FRIES – OR TOOK
A NATURE WALK INSTEAD OF SITTING IN
A CIRCLE INSIDE?
Then perhaps 26 percent of them wouldn’t be overweight,
as they are now, reasons UNC Gillings School of Global
Public Health nutrition professor Dianne Ward, EdD.
These and other tactics are par t of an intervention
Ward developed called Nutrition and Physical Activity Self
Assessment for Child Care (NAP SACC) to help child care
centers in Nor th Carolina boost their food quality, improve
physical activities of fered and augment staf f-child interac-tions
for children ages 2 through 5.
“Child care center resources are of ten limited, and they
don’t have a lot of leeway to spend time and money on
making changes,” Ward says. “This intervention is designed
to be used by the motivated, savvy child care provider to
institute changes.”
NAP SACC is a free, five-step intervention funded by the
National Institutes of Health. It also has been recognized
and recommended by the White House Task Force on Child-hood
Obesity, led by First Lady Michelle Obama (www.
letsmove.gov) and is par t of Nor th Carolina’s “Eat Smar t,
Move More” initiative (www.eatsmartmovemorenc.com).
Centers conduct a 15-par t self-assessment and select
three or four areas for improvement. A NAP SACC consult-ant
conducts workshops to guide the facility staf f through
changes and is available for follow-up assistance as centers
make alterations. A second assessment helps centers deter-mine
whether they’ve been successful and prompts them
to choose additional areas for improvement.
To access the NAP SACC intervention online, visit
www.napsacc.org.
–Whitney L.J. Howell
Dr. Dianne Ward
Helping child care centers
improve preschoolers’ health
Go
outside
every day,
without
exception.
T I P
PHOTO BY JENNY SANDUM
PHOTO BY LINDA KASTLEMAN
Three-year-old Emily Sandum
enjoys a daily visit to the playground.
10 | F A L L 2 0 1 0
“It’s essential to understand that adoles-cence
is a crucial period for weight gain,”
says Penny Gordon-Larsen, PhD, UNC
nutrition associate professor. In her wide-ranging
research on adolescent obesity,
Gordon-Larsen has studied a representative
group of Americans, starting in their teens
and following them through their early
30s. In 1996, 13.3 percent of adolescents
were obese; by 2008, obesity prevalence had
increased to 36.1 percent. Ninety percent
of the adolescents obese in 1996 remained
obese in 2008.
“With the vast majority of obese adoles-cents
staying that way into adulthood, it is
critical that we develop programs to prevent
the problem in adolescence,” says Gordon-
Larsen. “If we can interrupt that trajectory,
we will save money later in terms of car-diovascular
and other health risks, and we
will help these young
people have healthier
and longer lives.”
Gordon-Larsen is
one of many UNC
Gillings School of
Global Public Health
faculty members who
have long been com-mitted
to addressing
the youth obesity epi-demic.
June Stevens, PhD, nutrition profes-sor
and department chair, was the principal
investigator for “Trial of Activity in Adoles-cent
Girls,” a pioneering National Institutes
of Health-funded study. Known as TAAG,
it explored ways to increase physical activ-ity
among sixth-grade girls between 2003
and 2006. The program continues to serve
as a model for communities throughout
the country.
“Get 60,” another innovative program,
was a partnership between UNC’s pub-lic
health school and athletics department
and The Gatorade Company. Designed to
Adolescence
A time to grow up fit for life
Adolescence is a time of dramatic physical
and emotional upheaval. It’s also a time when
many young people gain weight as their exercise
levels and appetites change.
Leave
off the TV
during
meals.
T I P
Dr. Penny
Gordon-Larsen
leverage student athletes’ influence as role
models, the program brought UNC athletes
to local schools to encourage the children to
be active 60 minutes each day. The program,
now replicated in other parts of the coun-try,
provides materials to teachers, parents
and student athletes describing how to help
young people become more physically active.
Nutrition professor Dianne Ward, EdD, led
the development of the program.
Quantifying the impact of school physical
education (PE) programs on physical activ-ity
patterns was a key part of research by
Gordon-Larsen, along with Barry Popkin,
PhD, and Robert G. McMurray, PhD, both
UNC nutrition professors. They found that
students participating in daily PE classes
were twice as likely to be physically active
than students who were not enrolled in any
school PE. Their study offered empirical
data used to support passage of the national
Physical Education for Progress Act. PEP, as
it was called, was passed in 2000 to provide
expanded physical education programs for
students in kindergarten
through grade 12.
As the fight against ado-lescent
obesity continues,
UNC researchers turn to
newer technologies to help
reduce and prevent weight
gain. For her doctoral dis-sertation,
Elizabeth Lyons,
PhD, and her adviser, Deb-orah
Tate, PhD, associate
professor of health behavior
and health education and
of nutrition, conducted a
Robert Wood Johnson
Foundation-funded study
of video games played by
18- to 35- year olds. The
results can be extrapolated
to younger teens.
“The study’s premise was
not only to determine how
much energy people can
expend playing different
types of video games, but also to consider
how much they enjoyed different types of
games,” says Tate. “The games that use the
most energy expenditure may not be the ones
that people like playing the most.”
“People don’t have to be playing the most
active games to achieve some benefit in terms
of a public health impact,” Lyons adds, “if
they are replacing their TV time with some-thing
that is even slightly more active.”
School researchers are not focused only on
exercise as a means of addressing the issue of
weight. Noel Kulik, another doctoral student
of Tate’s, focuses her dissertation research 8
C A R O L I N A P U B L I C H E A L T H | 11
PHOTO BY KRIS HOYT
(Right) Adolescents don’t have to
play the most active games to achieve
health benefits – as long as they
replace TV time with something more
active. (Below) Brothers Isaiah and
Joe King select fruit for an afternoon
snack. The boys participated in
research conducted by Dr. May May
Leung (see page 13).
It’s essential to understand that adolescence
is a crucial period for weight gain.
12 | F A L L 2 0 1 0
F E AT U R E S A N D N EWS
on adolescent social support for weight loss.
Tate has led a variety of studies with ado-lescents,
including “enerG,” which used the
Internet to help adolescent girls lose weight.
While the researchers found that adding the
Internet was not beneficial to adolescents,
they realized that the intensive face-to-face
program they developed as a control arm of
the study was very effective.
The SNAP (Study of Novel Approaches to
Prevention) program – led by UNC principal
investigator Tate and currently recruiting
people ages 18 to 35 – aims for weight gain
prevention through early adulthood. (See
www.snapstudy.org.) Even if young people
emerge from adolescence at normal weight,
research shows that the aver-age
weight gain for Ameri-cans
in the years between age
18 and 35 is 30 pounds.
Under the direction of
Dr. June Stevens, Dan Taber,
PhD, conducted disserta-tion
research at UNC that
examined whether ado-lescent
weight gain can be
influenced by public policy.
Taber studied the association
between soda consumption
and Body Mass Index (BMI)
in adolescents in states that
changed their policies to
restrict junk food in schools. He also mea-sured
differences across racial and ethnic
groups. The study suggests that changes in
state policies restricting junk food in schools
can reduce soda consumption among ado-lescents,
particularly non-Hispanic blacks,
but there was no impact on BMI percentile.
Taber says the findings support a need for
comprehensive policy change – in and out-side
of schools. He says additional research
is needed to evaluate the impact of compre-hensive
policy change on obesity.
As Stevens notes, “This may be the first
time ever that the next generation of children
will have a shorter life span than their parents,
on average, and that change would be driven
by obesity. Obesity is an extremely important
public health problem that should have a
simple solution: children need to eat healthier
diets and be more active. But it’s actually
quite complicated and challenging to make
that happen. It needs to happen not just in a
few individuals, but in the entire population
of children in our country, because while not
all children are obese, all children need to eat
healthy diets and be physically active.”
–Michele Lynn
The Body Mass Index (BMI) is a measure
that determines percentage of body fat
based on a relationship of weight to height.
A person is considered “overweight” if his
or her BMI is between 25 and 29.9, and
“obese” if the BMI is 30 or above.
There are many BMI calculators available
online,* but here’s one way to determine it:
• A = Your body weight divided
by your height
• B = ‘A’ divided by your height
• BMI = B x 703
Therefore a person who weighs 140 pounds
and is 5’5” (65”) tall has a BMI of 23.2:
• 140/65 = 2.15
• 2.15/65 = 0.033
• 0.033 x 703 = 23.199
A more informal way of calculation suggests
that someone is “overweight” if he is 10 per-cent
above healthy weight for his height, and
“obese” if 30 percent above healthy weight.
*For example, see http://tinyurl.com/bmi-at-cdc.
BODY MASS INDEX (BMI)
Try to
eat two
meals together
at home
each day.
T I P
This may be the first time ever that
the next generation of children will
have a shorter life span than their
parents, on average, and that change
would be driven by obesity.
C A R O L I N A P U B L I C H E A L T H | 13
“Eat your
fruits and
vegetables”
Dominating book sales in China and pump-ing
nearly $100 million into the U.S. comic
book industry, the popular Japanese comic art
known as manga could have potential to pro-mote
behavior change in youth, Leung says.
“Often, interventions don’t properly
engage or maintain the interest of the
intended population,” she says, “so I looked
for a model already successful at engaging
my target population.”
Leung evaluated manga comics and con-ducted
research with preteens in four North
Carolina counties. She asked the youths what
they liked about manga and how they felt about
specific health concepts. She then collaborated
with local artist Kris Hoyt to create and test
a manga comic called “Zen Aku: Fight for
Your Right to Fruit.”
“The characters are drawn in a simplified
manner, allowing more people to identify
with them, which could create a greater level
of audience involvement,” Leung says. “And
because manga comics are sold as entertain-ment,
readers may be more likely to be per-suaded
by the story’s health messages.”
Leung’s research, which has been submit-ted
for publication, showed that young people
who read the manga comic significantly
increased their beliefs in the importance of
fruit intake when compared to a group that
was given the same information in a nutri-tion
newsletter.
Alice Ammerman, DrPH, RD, Leung’s
adviser, agrees that the results are promis-ing,
as increased belief in the importance of
fruit intake may result in changing behavior
to consume more fruit.
Now a tenure-track assistant professor
at The City University of New York School
of Public Health at Hunter College, Leung
envisions taking that next step with future
research and plans to extend her experiment
to other populations.
–Chris Perry
Getting preteens to eat healthy foods
and increase their physical activity
can be a daunting task in today’s fast-food,
multimedia world, but nutrition researcher and
School alumna May May Leung, PhD, RD,
has developed an innovative strategy to capture
their attention – manga comics.
Manga comics get the message
across to kids
Dr. May May Leung used manga comics, a popular
Japanese comic art form, to encourage preteens to
make healthy food choices.
PHOTO BY KRIS HOYT
ILLUSTRATION BY KRIS HOYT
14 | F A L L 2 0 1 0
F E AT U R E S A N D N EWS
Dr. Kari North Dr. Rosalind Coleman Dr. Terry Combs Dr. Daniel Pomp
Fat Genes
• Kari North, PhD, epidemiology asso-ciate
professor, studies risk factors for
cardiovascular disease – and obesity is a
big one. She and colleague Keri Monda,
PhD, proposed a potential location for a
gene that controls waist circumference.
“Then we realized we needed a lot more
samples to discover more loci,” North
says. Through a project called GIANT,
which has 125,000 participants, they have
identified 18 new genetic markers associ-ated
with obesity-related traits. “It helps
us understand on a molecular level how
individuals become obese,” North says.
Now her team is working on how these
genes interact with environmental factors
including gender and physical activity.
• Rosalind Coleman, MD, nutrition profes-sor,
uses “knockout mice,” each of which
lacks a specific enzyme and so a specific
genetic function, to identify precise roles
of enzymes that metabolize fatty acids.
People who are obese or insulin resistant
frequently have fatty livers, but the team
found that mice lacking one particular
enzyme had less fat in their livers, even
when the mice were obese. Another group
of mice that lacked a different enzyme – the
one that activates most of the fatty acids
in fat tissue – got fatter, not thinner. The
surprising discoveries will lead to more
nuanced understanding of the role these
enzymes play in human obesity, insulin
resistance, diabetes and heart disease.
• The more weight a person gains, the more
insulin resistant he or she will be. As
insulin resistance rises, so does glucose
level, which increases the likelihood of
diabetes. Insulin normally controls the
liver’s glucose production, but the liver
of someone with high insulin resistance
keeps producing glucose even when it
shouldn’t. “We’re asking why the liver is
not turning off when glucose is coming in
from the gastro-intestinal tract,” says Terry
Combs, PhD, nutrition assistant professor,
whose team recently identified in mice a
gene they believe plays a critical role in the
process. “What insulin does is turn on the
expression of this gene,” he says, explaining
that when the gene is on, the liver turns
off glucose production. Now Combs’ lab
is working to discover whether the same
genetic mechanism occurs in people.
• Daniel Pomp, PhD, professor of genetics,
nutrition, and cell and molecular physiol-ogy
at Carolina Center for Genome Sci-ences,
wondered why some people run
marathons while others lie around on the
couch. Using specially bred mice, he and
his team are looking for the genes associ-ated
with a predisposition to exercise, a
trait that can prevent or control obesity.
“There is not one single exercise gene or one
obesity gene,” he says. “There are maybe 50,
each with a relatively small impact.” His
lab’s findings may help humans maintain
a healthy weight, but it won’t be a magic
bullet. “We know how much a person
exercises is 30 to 40 percent influenced
by genes,” Pomp says. “But we don’t want
people to use [their genetic makeup] as an
excuse. The information is meant to make
you work harder if you’re predisposed not
to exercise much.”
–Kathleen Kearns
Can we blame extra pounds on our genes?
Several researchers at UNC Gillings School
of Global Public Health are identifying which
genes may have an impact on body weight and
investigating precisely how that impact occurs.
Eat five
servings of
fruits and
vegetables
daily.
T I P
PHOTOS BY LINDA KASTLEMAN
Penny Gordon-Larsen, PhD, nutrition asso-ciate
professor and fellow at UNC’s Carolina
Population Center, and nutrition doctoral
student Natalie The have shown that it’s not
just older, married adults who are at risk of
gaining weight. It’s young adults, too, par-ticularly
if they are married or living with
their romantic partners.
Young heterosexual couples who live
together are at more than twice the risk for
becoming obese than are their dating peers,
their research shows.
Gordon-Larsen and The are the first to
study this age group using a national sample.
Drawing conclusions from the National
Longitudinal Study of Adolescent Health,
nicknamed “Add Health,” they released their
findings in April 2009 in the journal Obesity.
“At baseline, when we started our analysis
(during the early- to mid-1990s), study par-ticipants
were adolescents between 12 and
20 years old,” The says. “Then we followed
them into adulthood, when they were 18 to 27
years of age.” Add Health also recruited the
adolescents’ romantic partners to participate
in the adult phase of study.
The study didn’t address why obesity risk
was higher in this group, but data implica-tions
were clear. “When you establish a
shared household with a romantic partner,
you need to think of ways each partner
can support the other to create a healthy
environment – healthier foods in the house,
working out together and supporting each
other in terms of physical activity in general,”
Gordon-Larsen says.
A healthy, supportive environment on the
job also is important. Laura Linnan, ScD, and
Deborah Tate, PhD, associate professors of
health behavior and health education, have
shown the value of workplace weight-loss
programs.
In a “WAY to Health” study with employ-ees
at 17 community colleges in North Caro-lina,
nearly 20 percent of the subjects lost five
percent or more of their body weight with
minimum intervention over 12 months — a
significant result.
Most of the individuals who lost five per-cent
of their weight fell into two groups – one
that received a Web-based weight-loss pro-gram
or one that received the Web program
and cash incentives for weight loss.
“Losing even five percent of baseline body
weight (roughly 10 pounds for the average
participant in this study) is important from
a public health point of view because the
participants begin to experience positive
health benefits,” Linnan says of the study,
which was funded by the Centers for Disease
Control and Prevention.
Living
Healthy
As young people grow up and settle into
their adult lives, many are at greater risk for
diabetes, heart disease, cancer and other chronic
diseases if they become overweight or obese.
Researchers at UNC Gillings School of Global
Public Health want to know how adults can
manage their weight and stay healthy.
How adults can
maintain or lose weight
􀀛􁭃
C A R O L I N A P U B L I C H E A LT H | 15
Young heterosexual couples who live together double their risk for becoming obese, as compared to their dating peers.
16 | F A L L 2 0 1 0
But the researchers, whose results are
slated for publication in late 2010, still recog-nize
that only about a fifth of the participants
achieved the five percent loss over a year. “It
told us that if people are motivated and get a
self-directed program such as this, they can
be successful, but the results are modest,”
Tate says.
Adds Linnan, “The Web-based weight-loss
program is an important option we need
to make available to those who are interested
in it, but there is no magic bullet. We need
other options to support healthy choices.
This is not about how motivated people are.
It’s more than that. It’s about creating condi-tions
where motivated people can make good
choices and have options that work for them.”
Linnan and Tate were surprised that par-ticipants
who received the Web/cash com-bination
didn’t perform much better than
those who only received the Web program.
“They did a little better, but the results were
not statistically significant,” Linnan says.
She and Tate hope to shine more light
on the role of cash
incentives in 2011
when they release
results from a second
study, funded by the
National Heart, Lung,
and Blood Institute,
which tests the inde-pendent
effects of the
Web-based program
and cash incentives.
Data from the sec-ond
study come from
nearly 1,000 employ-ees
at 12 universities
and community col-leges
across North
Carolina. One of four
study groups received
“cash only,” based on
their percentage of
weight loss over an
18-month study. The
other three groups
received a Web-based
program only, the
Web program and cash, or “usual care” (the
control group).
This study’s results are expected to draw
national attention as it is the first large study
of “cash only” incentives since the 1980s,
Tate says.
In other research related to adults and
weight, Kimberly Truesdale, PhD, nutrition
research assistant professor, has gleaned sig-nificant
findings from the large longitudinal
study known as “ARIC,” or Atherosclerosis
Risk in Communities. The study focused on
four U.S. communities and included both
white and African-American respondents.
Truesdale found no disparities between the
two races in her most recent results, pub-lished
online in January 2009 in Interna-tional
Journal of Obesity.
Looking at adults ages 45 to 64 and how
their health is affected by excess weight
over time, Truesdale discovered that simply
maintaining weight brings benefits. “Weight
loss is something a lot of adults can’t achieve,”
she says. “We found that if people maintain
Dr. Deborah Tate
Dr. Laura Linnan
Dr. Kim Truesdale
Research assistants with “Way to Health,” a workplace weight loss program,
interview a study participant.
When you establish a shared household
with a romantic partner, you need to
think of ways each partner can support the
other to create a healthy environment –
healthier foods in the house, working out
together and supporting each other in terms
of physical activity in general.
PHOTO COURTESY OF UNC CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION
C A R O L I N A P U B L I C H E A L T H | 17
their weight (±3 percent), they still have some
health improvements in total cholesterol,
LDL cholesterol and diastolic blood pressure,
regardless of weight status.”
Truesdale also found that people who lose
a significant amount of weight (≥5 percent)
reap long-term benefits associated with their
lighter physique. “We wondered, if you had
been heavier in the past, do you pay the con-sequences
of that for the rest of your life?” she
asks. The answer, based on some important
criteria, was no.
“People who were heavier in the past
– their blood pressure, lipids and glucose
levels were slightly better or about the
same as someone who always had been
the lighter weight,” Truesdale says, noting
that she didn���t look at hard outcomes like
heart attacks.
Carmen Samuel-Hodge, PhD, another
nutrition research assistant professor, is test-ing
a weight-loss intervention program tar-geted
to low-income women who, as a group,
have the highest rates
of being overweight
or obese.
The intervention
focuses on helping par-ticipants
gain awareness
of how their behavior
contributes to weight
gain. “Once they know
what they are doing,
they can start figuring
out how to change,”
Samuel-Hodge says. “A
lot of the sessions were
about problem solving.
The participants were the ones who solved
their own problems.” (For more on Samuel-
Hodge’s study, see page 22.)
	 — Susan Shackelford
Is perceived racism a risk factor for obesity?
“Right now, the literature is not at all consis-tent
on the question of whether exposure to
racism increases obesity risk,” says Anissa I.
Vines, PhD, epidemiology research assistant
professor at UNC Gillings School of Global
Public Health.
Vines co-authored a study published in
American Journal of Epidemiology (March
2008), which found that higher levels of
perceived racial discrimination might be
protective against hypertension. She also
was lead author for a study that found a rela-tionship
between a larger waist-to-hip ratio
and daily life stress and passive emotional
responses to racism but could not support
the hypothesis that racism, a chronic stressor,
was associated with increased abdominal fat
(American Journal of Public Health, March
2007). “Other researchers have shown a
positive association between racism-related
variables and obesity,” Vines says.
Vines continues to explore some of these
associations with the help of a questionnaire –
the telephone-administered perceived racism
scale – which she developed in collaboration
with clinical psychologist Maya McNeilly, who
designed the original perceived racism scale.
“I am beginning to explore what it really
means when an African-American person
reports limited or no experiences of racism,”
Vines says. “Maybe being able to acknowl-edge
and report racism provides a protective
psychological effect.”
Vines also is examining early life expo-sures
to stress and perceived racism.
“We don’t know very much about how per-ceived
racism acts as a stressor,” Vines says.
“Multiple stressors can be in play at any given
time. How one perceives those stressors, and
how those stressors interact with other social
and environmental factors, are important
to explore.”
–Angela Spivey
Does perceived racism contribute to higher
rates of obesity among African-Americans?
The question is complicated.
Dr. Anissa Vines
PHOTO BY LINDA KASTLEMAN
Maintaining a healthy weight throughout middle age may
result in lower blood pressure and cholesterol levels.
For weight loss, working together
is often the best approach
Researchers at UNC
Gillings School of
Global Public Health
have found that, for
many, community
support helps make
those behaviors stick.
The School has a
long history of cre-ating,
testing and
implementing programs designed to engage
groups of people to work together to improve
their health.
One long-running effort based at the UNC
Center for Health Promotion and Disease
Prevention and led by a School researcher –
HOPE (Health, Opportunities, Partnerships,
Empowerment) Works – brought together
low-income women in several rural counties
in eastern North Carolina to form “Hope
Circles” to support each other in healthier
habits. Researchers reported that women who
participated in the circles for six months lost
an average of 4.5 pounds and also increased
their physical activity significantly. Women
in control groups didn’t lose weight.
UNC nutrition professor Marci Campbell,
PhD, who led the effort, now studies the
same intervention over a longer time period.
Campbell’s project, Seeds of HOPE, centers
the support circles around churches or other
formal groups, as her initial study found
these settings more effective than informal
meetings in private homes. Findings by
Campbell and colleagues appear in Journal
of Women’s Health (October 2007).
Feedback from the communities involved
in HOPE Works has led researchers to
focus on improving economic as well as
physical health.
“People were saying you can’t tackle obe-sity
if women don’t have jobs or education,
The prescription for losing excess weight and
avoiding heart disease and diabetes sounds
simple – eat less in general, eat more fruits and
vegetables, and move more. The hard part is helping
real people fit those changes into their lives.
18 | F A L L 2 0 1 0
The Active Living by Design (ALBD) grantee in Columbia, Mo., has worked hard to mobilize the community to bike more often.
Here, several families enjoy a crisp fall morning. Read more about ALBD on page 21.
PHOTO COURTESY OF ACTIVE LIVING BY DESIGN
Dr. Marci Campbell
C A R O L I N A P U B L I C H E A L T H | 19
because they don’t have hope for the future.
People will improve their health as part of an
effort to improve their lives,” Campbell says.
She and colleagues helped launch a model
business, Threads of HOPE NC Inc., in
Salemburg, a small town in Sampson County,
N.C. The business provides women with
management experience and draws on the
sewing skills some had developed when the
textile industry was vital in the eastern part
of the state. Participants make custom tote
bags from organic cotton and have filled
orders for clients including the 2009 National
Conference on Chronic Disease Prevention
and Control.
Input from HOPE Works participants
also led to HOPE Accounts, which com-bines
HOPE circles with a matched savings
program to help women meet a goal such
as going back to school or starting a small
business. That project is funded by a grant
from the American Recovery and Reinvest-ment
Act.
Listening to people in communities we
serve is crucial if we are to solve complex
health problems such as obesity, says Leah
Devlin, DDS, MPH, former North Carolina
state health director and a Gillings Visiting
Professor of health policy and management
at the School.
“The problems we face in North Caro-lina
are complex and multifactorial, and
they require creative solutions that engage
all types of expertise that we have in the
public health school. But those solutions
also must include the will and desires of
the community,” Devlin says. “We have to
listen to communities
to understand what
they see as priorities
and what ideas they
have for solutions that
will help us be more
successful together.”
Campbell and
Marlyn Allicock,
PhD, research assis-tant
professor of nutrition, also are applying
strategies proven to help people eat more
fruits and vegetables to an intervention
in which military veterans are trained to
counsel each other. They use motivational
interviewing, which focuses on reflective
listening and positive affirmations rather
than on persuasion or advice giving. Those
strategies were shown to help veterans eat
more fruits and vegetables than did the stan-dard
Veterans Affairs weight-management
program, in a pilot study published in the
May–June 2010 issue of Preventive Medicine.
“We found that, due to other clini-cal
responsibilities and time constraints,
nurses are not necessarily the best people
to do the counseling,” Allicock says. So she,
Campbell and colleagues developed manuals
and DVDs that train veterans to conduct the
motivational interviewing for other veterans.
The researchers currently are evaluating
that intervention.
The problems we face in North Carolina are
complex and multifactorial, and they require
creative solutions that engage all types of
expertise that we have in the public health
school. But those solutions also must include
the will and desires of the community.
Dr. Marlyn Allicock
Production manager Mae Tuggle
assembles a Threads of Hope tote
bag. The organic cotton bags
were sold last year at The Regulator
Bookshop in Durham, N.C.
PHOTOS BY SALLI BENEDICT
F E AT U R E S A ND N EWS
Active Living by Design (ALBD), founded
in 2001 by the Robert Wood Johnson Foun-dation,
works with communities to build
environments for active living and healthy
eating. (The program is featured on page 21.)
ALBD staff members provide technical
assistance to towns that have received grants
from “Fit Community,” an initiative of the
N.C. Health and Wellness Trust Fund.
“Our role is to help communities identify
those resources that are going to help make
their project successful, not just over the
course of the grant period, but beyond,” says
Joanne Lee, a program officer with Active
Living by Design.
For example, Lee worked with a commu-nity
in Black Mountain, N.C., which planted
gardens connected by walking trails. “They
were able to get a permanent position estab-lished
that included in its duties managing
the gardens,” Lee says. “We also worked with
the community to help establish a nonprofit
coalition to generate funding.”
Another community intervention is led by
Carmen Samuel-Hodge, PhD, research assis-tant
professor of nutrition. Samuel-Hodge is
testing a modified group weight-loss inter-vention
to determine whether it is effective
for low-income women when administered
by county health department staff members
rather than research team staff members. For
example, to accommodate some women’s low
literacy skills, she had them break into groups
and choose a designated person to do any
required writing. A prelimi-nary
analysis of her ongoing
study in six North Carolina
counties found that 40 percent
of the women lost 5 percent or
more of their body weight, a
clinically significant amount.
“This was a better result
than other studies targeting low-income
populations have gotten,” Samuel-Hodge
says. “A key element was the women helping
each other,” she says. “A lot of the sessions
were about problem solving, and the women
solved their own problems. These were not
teaching sessions. If the interventionist did
more than 50 percent of the talking in a ses-sion,
it was considered ineffective. The goal is
for interventionists to guide the discussion. A
lot of times the women are learning from each
other. One person will come in and say, ‘I had
a wonderful week, and here’s what I did.’”
Finding ways that people in communities
can work together to get healthy is becoming
ever more important as public health officials
try to fight obesity with fewer resources. For
example, Samuel-Hodge points outs that in
July 2011, the North Carolina State Health
Plan, through its Comprehensive Wellness
Initiative, will begin requiring members
with a body mass index above 40 to enroll in
weight-loss programs or pay higher insurance
co-pays. But how many state employees can
afford the hundreds of dollars that private
weight-loss programs may cost? Can com-munities
provide other options that cost less
but are still effective?
“We are finding that they can,” Samuel-
Hodge says.
–Angela Spivey
The School also collaborates with towns
and communities to develop programs
for healthy living.
20 | FA L L 2 0 1 0
Threads of HOPE NC Inc.
www.threadsofhopenc.org
Seeds of HOPE
http://tinyurl.com/hpdp-seeds-of-hope
Weight Wise Works at Health Departments
http://tinyurl.com/hpdp-weightwise
Active Living by Design
www.activelivingbydesign.org
Websites for further information:
In Santa Ana,
Calif., the Healthy
Eating by Design
program provides
opportunities for
healthier eating to
families in an urban
Latino neighborhood.
Here, a child hones
his skills in the
community garden.
PHOTO COURTESY OF ACTIVE LIVING BY DESIGN
Active Living by Design partners in Louisville, Ky., transformed a once-barren patch of land into a safe and fertile garden space.
The garden became a community gathering place, where children learn about growing and eating healthy foods.
But now, thanks to a Fit Community grant
administered by UNC Gillings School of
Global Public Health’s Active Living By
Design (ALBD), the Yancey County com-munity
is turning the tide.
Using the $60,000 grant as seed money,
the community partnership, known as
“Healthy Yancey,” renovated a previously
closed gymnasium, bought park playground
equipment for young children, added a side-walk
to connect a local swimming pool to
Ray-Cort Park and hired a director to oversee
the projects.
The technical assistance Healthy Yancey
received from ALBD was as critical as the
seed money.
“The five Ps they stress – Preparation,
Promotion, Programs, Policy and Physical
Projects – helped us tremendously,” says Kin-nane,
who wrote the grant application. “They
make you think things through. Because of
that, I feel like we’ve been successful.”
Although there is no hard data yet on
youth weight loss or maintenance, it appears
Healthy Yancey is making a difference.
“Changes like this take a long time; the prob-lem
is so multifactorial,” says Kinnane, direc-tor
of the Toe River Health District, which
covers Yancey, Avery and Mitchell counties.
“I believe our community is more fit. Our
gym is busy all the time; the park is busy, too.
All of these things are helping.”
Funded by the North Carolina Health and
Wellness Trust Fund, Fit Community is one
of many grant programs administered by
ALBD, an organization based in the School’s
North Carolina Institute for Public Health.
What all ALBD
programs have in
common is a focus
on supporting com-munity
partnerships
to create environ-ments
that foster good
health. “We are taking
public health to the
streets,” says ALBD
director of communications Mark Dessauer.
ALBD was one of the first organizations
in the country to zero in on the importance
of the built environment and its potential
impact on health. “Our relationship with the
Robert Wood Johnson Foundation and the
focus of our first initiative together was inno-vative,”
says ALBD director Sarah Strunk,
MHA. “We were early adopters that helped
communities translate a growing area of
research into practice. We looked at how
In the mid-2000s, Lynda Kinnane – and others
in the beautiful mountain town of Burnsville,
N.C. – had a major concern. “We were seeing a lot
of children who were overweight,” Kinnane recalls.
Active Living
By Design
Sarah Strunk
8
We wanted neighborhood groups to
determine what their communities needed
and to work with others to make it happen. …
With a small amount of money, these partner-ships
can accomplish something significant.
PHOTO COURTESY OF ACTIVE LIVING BY DESIGN
C A R O L I N A P U B L I C H E A L T H | 21
F E AT U R E S A N D N EWS
22 | F A L L 2 0 1 0
The World is Fat*
Across North Carolina and around the world, researchers
from UNC Gillings School of Global Public Health are
investigating why obesity rates have ballooned, how this
phenomenon affects health and what to do about it.
Research synopses reported by Kathleen Kearns
*Our article uses the title of a popular treatise by Dr. Barry Popkin, The World is Fat: The Fads, Trends, Policies and Products That
Are Fattening the Human Race (New York, Penguin Books, 2008). For more information, see http://tinyurl.com/theworldisfat.
C A R O L I N A P U B L I C H E A L T H | 23
The School conducts research, provides public service and par ticipates in engaged
scholarship in all 100 Nor th Carolina counties.
29.4 percentage of Nor th Carolina
adults who are obese
10of 11 states with highest rates of diabetes
and hyper tension are in the South
38states in the U.S. with adult obesit y
rates above 25 percent in 2010
12 million obese children in the U.S.
0states with adult
obesity rate above
20 percent in 1991
56percent of voters who think
preventing childhood obesity will
save taxpayers money in the long run
8states with obesity rates
above 20 percent among
10- to 17-year-olds
(N.C. is not among them.) 41.1 percentage of African-Americans
in Nor th Carolina who are obese
20states with nutritional
standards for school meals
(N.C. is among them.)
73percent of voters who
say preventing childhood
obesity is an impor tant
priority for government
f e at u r e s a n d n ews
National chair for the SEARCH for Diabetes in Youth
study, nutrition professor Elizabeth Mayer-Davis, PhD,
leads the first long-term evaluation to track trends
and incidence rates for all types of diabetes among
young people from major racial and ethnic groups in
the U.S. The large, multicenter study collects information about
who gets diabetes and what kind, what care they receive and how
the disease and its complications af fect their daily lives. Among
the study questions: Why is type 2 diabetes rising so rapidly among
adolescents, par ticularly minority adolescents? And does obesit y
– not previously linked with type 1 diabetes – accelerate that form
of the disease?
While those in the U.S. who identify themselves as Hispanic die less often from
heart disease than non-Hispanics, they have higher rates of obesity and diabe-tes.
Lisa LaVange, PhD, biostatistics Professor of the Practice, leads the Hispanic
Community Health Study, a comprehensive, nationwide assessment of how adapting to the U.S.
environment and culture af fects the health of 16,000 Hispanic adults with family roots in Mexico,
Cuba, Puer to Rico, the Dominican Republic, Central America and South America.
Barry Popkin, PhD, Carla Smith Chamblee Distinguished Professor of
Global Nutrition, has served on the Mexican Ministry of Health’s
National Beverage Panel and has written three papers with the
Instituto Nacional de Salud Publico related to beverage intake
among Mexican children. He conducts studies in China, Russia, Brazil,
Mexico and the United Arab Emirates to examine factors underlying dietary and
physical activity pat terns and their ef fects on health.
In Egypt, Iran, Mexico, Brazil, South Africa, Thailand, China, Chile, India and
Indonesia, Popkin studies the relationship of massive shif ts in diet, activity and
obesity to noncommunicable diseases.
Penny Gordon-Larsen, PhD, nutrition associate
professor, and Kari North, PhD, epidemiology
associate professor, are working together to
understand how genetic and environmental
risk factors interact to influence weight gain
as teens become young adults. They have shown
that this developmental period is one of par ticular risk
for weight gain. Understanding how genes and environ-ment
interact can bet ter inform obesity prevention and
treatment by tailoring such interventions to individuals who
might benefit most.
For a more comprehensive look at where in the world we are making a difference, see our interactive map at www.sph.unc.edu/globalhealth.
Nutrition professor Peggy Bentley,
PhD, conducts research on infant and
young child nutrition in a number of
countries, including Honduras, Malawi and India.
Musk ox, caribou and other traditional foods of the Cana-dian
Arctic have high nutritional value. But as the Inuvialuit
of Nunavut have moved away from physically active ances-tral
ways and started eating more processed, store-bought
foods, their rates of obesity and other ills have climbed.
Sangita Sharma, PhD, former UNC nutrition associate professor, now at
University of Alber ta (Canada), worked with local groups to develop the
Healthy Foods Nor th intervention program. Af ter collecting baseline health
data, the team promoted vigorous traditional activities and nutritious foods
that are both af fordable and culturally acceptable.
Women who are obese
when they are diagnosed
with breast cancer have
a greater risk of dying
from the disease, Re-becca
Cleveland, PhD,
nutrition research as-sistant
professor, has
found. She has identified
genes associated with breast
cancer, obesity and diabetes and
is now working to understand the
connections among them. Her working
hypotheses – that many of the genes associated with high
levels of insulin also are associated with breast cancer and
that breast cancer outcomes are worse for women with
diabetes – drive her investigations of genes related to
insulin resistance, estrogen and other factors. Cleveland’s
findings are based on data collected by epidemiology
professor Marilie Gammon, PhD, through Gammon’s Long
Island Breast Cancer Study. (See www.sph.unc.edu/cph/
long_island_breast_cancer.)
The Healthy Weight Commitment is a voluntary food indus-try
effort, linked with First Lady Michelle Obama’s child-hood
obesity initiative, to reduce obesity by changing
what Americans eat. Nutrition professor Barry Popkin, PhD,
leads a UNC-based team evaluating the impact of the Com-mitment’s
attempt to remove 1.5 trillion calories a year
from the U.S. marketplace by 2015. The independent team will track
whether the calorie reductions result in American children and adoles-cents
taking in significantly fewer calories each day. The evaluators will
look par ticularly closely at whether the overall diet of 2- to 18-year-olds
improves and at whether they take in less solid fats and added sugars.
A 40-year-old journal article on Chinese Restaurant Syndrome grabbed the
attention of nutrition associate professor Ka He, MD, ScD, when he read that
study animals given monosodium glutamate (MSG) weighed more than the con-trol
group. Intrigued, He examined data from both a small study and the large China Health and
Nutrition Survey and discovered that humans’ MSG intake also is related to weight gain. Now, he is
testing his theory that MSG causes resistance to leptin, the hormone that regulates energy balance. He
is planning an intervention study to determine whether MSG intake can cause obesity.
Having led two large national trials examining obesity
and physical activity in children and adolescents, June
Stevens, PhD, professor and chair of the nutrition de-partment,
continues her research on obesity in differ-ent
populations. She has found links between mental exhaustion,
obesity and hear t at tacks among African-American and white men
and women. Other studies showed that the ef fects of obesity on the
risk of diabetes and hyper tension in Chinese may be even greater than
in blacks and whites. Recent work by Stevens and Kimberly Truesdale,
PhD, nutrition research assistant professor, showed that af ter losing weight,
previously obese individuals enjoy a lowered risk of hear t disease similar to
those who were never obese. Their innovative studies are the first to show that,
similar to the lowered risk of lung cancer in people who quit smoking, the ef fects of obesity on hear t disease
appear to be reversed by weight loss and maintenance of a healthy weight. Adults who lose weight and be-come
normal weight have about the same risk of hear t disease as people who were never obese.
Stevens also conducts research comparing body mass index and rates of diabetes and other conditions
among African-Americans, whites and Chinese. That project is suppor ted by a supplement to the UNC Nutri-tion
and Obesity Research Center, one of 12 national centers of research funded by the National Institutes of
Health. Steven Zeisel, MD, PhD, Kenan Distinguished Professor of nutrition and director of the N.C. Nutrition
Research Institute, is the Center’s principal investigator.
In Mexico, Miroslav Styblo, associate professor, studies which arsenic exposure may induce and examines effects of diet on the metabolism of arsenic. his National Institutes of Health-funded been conducted in Bangladesh and Alice Ammerman, DrPH, RD, nutrition professor and
director of UNC’s Center for Health Promotion and
Disease Prevention, directs a Gillings Innovation Lab
investigating – among other things – whether children
eat more fruits and vegetables when their parents buy
locally grown food. Using data from the Nor th Carolina Child
Health Assessment and Monitoring Program, the team has found the
answer may be yes. Teaching children where their food comes from
and eating more meals at home also may af fect how likely children
are to eat healthy food. In Nor th Carolina, it appears that families
who are Hispanic and/or of lower socioeconomic status may be just
as likely to buy local food as wealthier whites.
Spurred by the World Health Organization,
food companies worldwide are placing a uni-versal
logo on food and beverage packages
to help consumers make healthier choices.
Barry Popkin, PhD, Carla Smith Chamblee Distinguished
Professor of Global Nutrition, works with an international
board of scientists to ensure the logo goes on products
that really do promote health. The Choices International
Foundation Programme aims to reduce diseases related to
obesity by raising consumer awareness and by encourag-ing
companies to market products that meet evidence-based
benchmarks for trans fats, saturated fats, salt, sugar
and – in most locations – fiber and energy intake.
For more than 20 years, the China Health and
Nutrition Survey has monitored the diet
and body composition of 19,000 people in
nine Chinese provinces. During that time,
economic and social changes have altered what
Chinese people eat and how much they move.
Obesity in China has risen dramatically. Numer-ous
School faculty researchers – among them
Linda Adair, PhD; Margaret E. Bentley, PhD;
Shufa Du, MD, PhD; Penny Gordon-Larsen, PhD,
and study principal investigator Barry Popkin, PhD
– track the changes. The information they gather
helps Chinese of ficials identify and respond to the
public health challenges that result.
Since 1983, the Cebu [Philippines] Longitudinal
Health and Nutrition Survey has followed a
cohort of 3,000 women and their children. Origi-nally
focused on maternal and infant health,
the study – now led by nutrition professor Linda
Adair, PhD – tracks a range of ma-ternal
and child health issues,
including a significant rise
in obesity that parallels
Cebu’s rapid growth and
economic development.
“There’s a clear trend from
underweight to overweight
and to hyper tension and dia-betes,”
says Adair. Unlike
in the United States, women
from Cebu’s wealthier fami-lies
tend to gain more weight.
Poorer women and those with
physically demanding jobs gain less.
PhD, nutrition
studies mechanisms by
induce diabetes
diet and obesity
arsenic. Research for
funded work also has
and Taiwan.
24 | F A L L 2 0 1 0
F E AT U R E S A N D N EWS
we could increase physical activity through
community design.”
With an initial foundation investment of
$15.5 million in 2001, ALBD selected part-nerships
of key players within communities
to solve infrastructure challenges around
physical activity and, later, healthy eating.
“We wanted neighborhood and grassroots
groups determining what their communities
needed and working with others, including
local government entities such as public
health, transportation, and parks and recre-ation,
to make it happen,” Dessauer says. The
approach struck a chord. “We expected 300
to 350 to apply, but we had 966. The response
broke all foundation records,” he says.
The first 25 community grantees received
technical assistance and $40,000 annually
for five years. The money seeded partner-ships
that leveraged nearly $260 million in
additional community investments.
“The lesson we learned was that with a
small amount of money, these partnerships
can accomplish something significant,” Des-sauer
says. “It gave them an opportunity to
pause and think about community health
and how they could work together.”
With such success, the N.C. Health and
Wellness Trust Fund, Kellogg Foundation,
Blue Cross Blue Shield of Minnesota and
other groups soon engaged ALBD to work
with their grants programs.
In 2008, the Robert Wood Johnson Foun-dation
made an even bigger commitment to
ALBD, asking it to lead the new $33 million
Healthy Kids, Healthy Communities pro-gram
– the foundation’s largest investment
in community-based change related to child-hood
obesity, Dessauer says.
Among the 50 Healthy Kids, Healthy
Communities grants made so far, one for
$400,000 in Baldwin Park, Calif., continues
to fuel a childhood obesity fight launched
more than a decade ago.
The largely Latino suburb of Los Angeles
has seen children lose weight and increase
test scores as the community has instituted
salad bars and mandatory physical education
levels in schools, increased fresh produce in
stores, banned drive-through windows at
new fast-food restaurants and launched a
website called www.werefedup.com, created
by and targeted to young people.
The grant is helping the partnership
implement “People on the Move,” focused
on decreasing unhealthy food marketing
and advertising, increasing access to healthy
foods in corner groceries near schools and
boosting “walkability” and green space in
the downtown area.
In Somerville, Mass., ALBD also is advanc-ing
a longtime initiative. Since the early
2000s, “Shape up Somerville” has spurred
new parks, walking paths, recreational
facilities, community gardens, low-fat menu
options at restaurants and education of
parents about healthy eating.
A $400,000 Healthy Kids, Healthy Com-munities’
commitment is helping the town
make changes in public policy to sustain
health over time – a major ALBD emphasis.
“To truly reverse the epidemic of childhood
obesity, we need to address policies, environ-ments
and systems, not just individual behav-ior,”
says ALBD director Strunk. “This means
working to create community-level changes
that can be sustained for generations to come.”
–Susan Shackelford
Active Living by Design fosters community-led change by working with local and
national partners to build a culture of active living and healthy eating. Above,
elementary students in Seattle enjoy a snack provided by the local Healthy Eating
by Design program. Below, South Bronx (N.Y.) youth celebrate their borough’s
newest park. The ALBD grantee engaged local young people to clean up trash in
the park and make landscaping changes.
To truly reverse the epidemic of
childhood obesity, we need to address
policies, environments and systems,
not just individual behavior.
PHOTOS COURTESY OF ACTIVE LIVING BY DESIGN
School reaccredited by
CEPH for maximum
period, seven years
the unc gillings school of
global public health was reac-credited
in June by the Council on Education
for Public Health (CEPH) for seven years, the
maximum period of renewal.
Leading the school’s accreditation team
were Peggy Leatt, PhD, associate dean for
academic affairs and chair of the Department
of Health Policy and Management; Anita
Farel, DrPH, associate chair for graduate
studies in the Department of Maternal and
Child Health; Laurel Files, PhD, associate
chair of the Department of Health Policy and
Management; Felicia Mebane, PhD, assistant
dean for students; and Dave Potenziani, PhD,
former senior associate dean.
SCHOOL NEWS
For more information on these topics and other news, please see www.sph.unc.edu/news_events.
unc gil l ings school of globa l publ ic hea lth
vangie a. foshee, phd, professor of
health behavior and health education, has
received a grant of nearly $1.2 million from
the U.S. Centers for Disease Control and
Prevention to evaluate a program aiming to
prevent psychological, physical and sexual
dating abuse by adolescents who have been
exposed to domestic violence.
“Moms and Teens for Safe Dates” was
developed by Foshee and health behavior and
health education colleagues, Professor Susan
Ennett, PhD, and Beth Moracco, PhD, and
James Michael Bowling, PhD, both research
associate professors,
with funding from the
National Institute of
Justice. Mothers who
have left an abusive
partner obtain pre-vention
information through the program
and participate in interactive activities with
their 12- to 15-year-old adolescents who were
exposed to the abuse. Adolescents exposed
to domestic violence are at increased risk
for being abused by and abusing the people
they date.
Foshee receives award to study
prevention of dating violence
C A R O L I N A P U B L I C H E A L T H | 25
Dr. Vangie Foshee
thomas ricketts, phd, professor of health policy and management,
is one of 15 national experts appointed to the new National Health Care
Workforce Commission. The Commission is an independent body that advises Congress and
the administration on health workforce policy.
“This commission gives us the opportunity to develop new ways to modernize our workforce
to meet the challenges of increasing access and quality of health care while we control costs,”
Ricketts said. “We need to examine how we prepare and deploy our doctors, nurses, dentists,
pharmacists and the many other health care practitioners to meet the nation’s future health
care needs. In many ways, we have been trying to run a system for the 21st century with 20th
century approaches.”
Ricketts also serves as deputy director for policy analysis at UNC’s Cecil G. Sheps Center
for Health Services Research and is co-director of American College of Surgeons Health Policy
Research Institute. He is a Gillings Visiting Professor with Ecole des Hautes Etudes en Sante
Publique in France.
Ricketts named to
national Health Care
Workforce Commission
Dr. Thomas Ricketts
march ��� september 2010
although april’s bp oil spill in
the Gulf of Mexico did not affect the North
Carolina coast, it provided opportunity to
evaluate local, state and federal readiness.
More than 130 participants at the School’s
July 29 “One Health” forum interacted with
state and federal partners who described
how to train and use volunteers and identi-fied
areas requiring additional planning.
Bill Gentry, director of health policy and
management certificate programs, arranged
and led the forum. Read more at www.sph.
unc.edu/oilspill.
School sponsors
oil spill forum
26 | F A L L 2 0 1 0
S C H O O L N EWS
Maternal and Child Health
offers online degree
the school’s maternal and child health
department will offer an online master’s
degree program in spring 2011 to comple-ment
its established residential training
programs. The degree will increase working
professionals’ access to graduate education
focused on improving the health of women,
children and families.
Developed with support from the U.S.
Health Resources and Services Administra-tion’s
Bureau of Maternal and Child Health, the
new curriculum builds upon an online certifi-cate
(MCH Ole!) introduced earlier this year.
rebecca fry, phd, assistant professor of environmental sciences
and engineering, has received two prestigious awards recognizing her
potential to make substantial contributions throughout her career. The
honors include the Outstanding New Environmental Scientist (ONES)
Award, presented by the National Institutes of Health’s National Institute
of Environmental Health Sciences (NIEHS), and selection as a PopTech Science and Public
Leadership Fellow. Fry’s ONES award includes a $2.2 million grant to study health effects of
prenatal arsenic exposure in newborns in Gomez Palacio, Mexico.
PopTech, a global community of interdisciplinary leaders, each year selects young scientists
who work in critical public health areas and provides them with advanced leadership and com-munications
training. Fry also has received support from the University Cancer Research Fund
and a Gillings Innovation Lab (see page 28).
two school researchers received a five-year, $2.2 million
grant to study how pregnancy and obesity may promote susceptibility
to an aggressive subtype of breast cancer more prevalent in young,
African-American women.
Melissa Troester, PhD, assistant professor of epidemiology, and Liza
Makowski, PhD, assistant professor of nutrition, are principal inves-tigators
for the National Institute of Environmental Health Sciences’
Breast Cancer and Environmental Research Program.
heather mun-roe-
blum, phd,
principal and vice-chancellor
of McGill
University in Mon-treal,
gave the keynote
address at UNC’s Uni-versity
Day celebra-tion
Oct. 12. The text
of the presentation is
available at http://tinyurl.com/munroe-blum.
Munroe-Blum received a doctorate with dis-tinction
in epidemiology from UNC in 1983.
Researchers to study pregnancy,
obesity, breast cancer disparities
Munroe-Blum speaks at
University Day event
ESE’s Fry honored as
‘outstanding young researcher’
Dr. Melissa Troester (left), Dr. Liza Makowski
Dr. Munroe-Blum
the water institute at unc (http://
waterinstitute.unc.edu), housed in UNC Gill-ings
School of Global Public Health, was
launched Oct. 25 during UNC’s conference,
“Water and Health: Where Science Meets
Policy.” The conference, co-sponsored by
the new institute and the UNC Institute
for the Environment,
attracted more than
350 attendees. Experts
from more than 50
countries provided
a wide range of per-spectives
on drink-ing
water, sanitation,
hygiene and water
resources.
UNC has longstanding expertise in the
areas of water, policy and health, with many
faculty members engaged in associated
research and recognized as international
leaders. The Water Institute was established
by the School to leverage this broad, interdis-ciplinary
experience.
“The Water Institute at UNC brings
together individuals and institutions from
diverse disciplines and empowers them to
work together to tackle critical global issues
in water and health,” says Jamie Bartram,
PhD, Institute director and professor of envi-ronmental
sciences and engineering.
Water Institute at UNC
launched in October
Dr. Jamie Bartram
Dr. Rebecca Fry
PHOTO BY DIANNE SHAW
C A R O L I N A P U B L I C H E A L T H | 27
unc-chapel hill has been named coordinating center for a National Institutes
of Health-funded study to examine ways to curtail the nation’s childhood obesity epidemic.
June Stevens, PhD, AICR/ WCRF Distinguished Professor of nutrition and epidemiology and
chair of the nutrition department, is principal investigator for the center.
The NIH’s $49.5 million Childhood Obesity Prevention and Treat-ment
Research (COPTR) program is among the first long-term obesity
prevention and treatment research studies in children. COPTR will test
methods for preventing excessive weight gain in non-overweight and
moderately overweight youth, and methods for reducing weight in obese
and severely obese youth.
Stevens also was a featured speaker at the 2010 American Institute of
Cancer Research (AICR) Conference on Food, Nutrition, Physical Activity
and Cancer, Oct. 21–22, in Washington, D.C.
Nutrition’s Stevens coordinates national study
of ways to prevent, treat childhood obesity
kelly b. browning, member and for-mer
president of the School’s Public Health
Foundation board, and alumnus Richard
Vinroot Jr., MD, MPH, will serve four-year
terms on the 160-member UNC Board
of Visitors, which assists the Chancellor
and trustees in activities that help advance
the University.
Browning, Vinroot elected to UNC Board of Visitors
Dr. June Stevens
Kelly Browning Dr. Rich Vinroot Jr.
a new unc study that follows patients
with lung cancer is one of the first to suggest
why patients choose not to have life-preserv-ing
lung surgery and why such surgery is
sought less often by blacks.
Samuel Cykert, MD, associate professor in
the UNC School of Medicine, is lead author
of the American Cancer Society-funded
study, published in the June 16 issue of the
Journal of the American Medical Association.
Study authors from UNC Gillings School
of Global Public Health include Peggye Dil-worth-
Anderson, PhD, professor of health pol-icy
and management, and Lloyd J. Edwards,
PhD, associate professor of biostatistics.
Cykert says explanations for differences
in surgical rates for blacks may include black
patients’ perception of poor doctor-patient
communication. Black patients also were
less likely to have primary care providers
who could help them reconsider a decision
about surgery.
UNC study helps explain why black patients with lung
cancer have surgery less often than whites
Physicians can improve
children’s oral health
school researchers have provided
the first national data on the effectiveness of
dental referrals by physicians.
Heather Beil, MPH, doctoral student,
and Gary Rozier,
DDS, MPH, professor,
both in the School’s
Department of Health
Policy and Manage-ment,
co-authored
the study, published
in the August issue of
the journal Pediatrics.
Researchers sam-pled
children to determine whether a medi-cal
health care provider had recommended
that a child be seen by a dentist and whether
the child actually had a dental visit. The
most significant finding was in the group of
two- to five-year-olds. Of the 47 percent of
the group advised to have a dental check-up,
39 percent did.
Dr. Gary Rozier
For more information about these and
other events, contact Jerry Salak at
(919) 843-0661 or jerry.salak@unc.edu.
Feb. 18 – Lecture by Isabel
Wilkerson, author of The Warmth
of Other Suns: The Epic Story
of America’s Great Migration
Feb. 24 – Minority Student
Caucus Alumni Reception
Feb. 25 – Minority Health
Conference
(www.minority.unc.edu)
March 31 – Foard Lecture
(www.sph.unc.edu/foard)
Speaker: Richard A. Vinroot Jr.,
MD, MPH
Coming soon!
F E AT U R E S A N D N EWS
FACULTY
Sobsey invited to NASA��s first
LAUNCH event
Mark Sobsey, PhD, Kenan Distinguished
Professor of environmental sciences and
engineering, was one of 10 innovators chosen
to participate in NASA’s inaugural LAUNCH
event, held March 16–18, at the Kennedy
Space Center in Florida.
Sobsey presented his proposal for simple,
accessible and affordable tests to assess water
quality and safety.
Sen selected for prestigious Wilks Medal
Pranab K. Sen, PhD, Cary C. Boshamer
Distinguished Professor of biostatistics,
was selected as the 2010 recipient of the
American Statistical
Association’s S.S.
Wilks Medal, one of
the most prestigious
awards in the field.
His research, pub-lished
over the course
of 50 years, has influ-enced
generations of
statisticians. Sen, a
member of the UNC biostatistics faculty
since 1967, is the first from the department
to receive the medal.
Gillings Innovation Labs awarded
The School funded four new Gillings Innova-tion
Laboratories last spring.
Awardees, all assistant professors, include:
• Eric Donaldson, PhD, epidemiology;
• Rebecca Fry, PhD, environmental sciences
and engineering;
• Suzanne Maman, PhD, health behavior
and health education; and
• Jill Stewart, PhD, environmental sciences
and engineering.
Read more about the Gillings Innovation
Lab Awards at www.sph.unc.edu/accelerate.
Randolph
reappointed to
national board
Susan Randolph,
MSN, RN, was
reappointed to the
National Advisory
Committee on Occu-pational
Safety and
Health (NACOSH).
Randolph is clinical assistant professor in
the Public Health Leadership Program.
Swenberg honored with Greenberg Award
James A. Swenberg, DVM, PhD, Kenan Dis-tinguished
Professor of environmental sci-ences
and engineering, received the School’s
Bernard G. Greenberg Alumni Endowment
Award for excellence in teaching, research
and service. Director of the UNC Cur-riculum
in Toxicology, Swenberg studies
AWAR DS &
R ECOGNITIONS
unc gil l ings school of globa l publ ic hea lth
march – september 2010
Read more at www.sph.unc.edu/recognitions_and_awards.
Dr. Mark Sobsey
Dr. Eric Donaldson
Dr. Suzanne Maman Dr. Jill Stewart
Dr. Rebecca Fry
Dr. Pranab Sen
Susan Randolph
28 | F A L L 2 0 1 0
C A R O L I N A P U B L I C H E A LT H | 29
the mechanisms of carcinogenesis, with an
emphasis on the role of DNA damage and
repair. He has mentored more than 40 gradu-ate
students during his two decades at UNC.
The award was presented at the School’s 2010
Foard Lecture in April.
LaVange
reappointed to
health commission
Lisa M. LaVange,
PhD, was reappointed
to the N.C. Health
and Wellness Trust
Fund Commission.
LaVange is Professor
of the Practice of bio-statistics
and director of the Collaborative
Studies Coordinating Center. The com-mission
works to improve North Carolin-ians’
health by establishing partnerships to
address access, prevention, education and
research issues.
Herring, Preisser,
Zhou elected
as ASA fellows
Three UNC biostatis-tics
faculty members
have been elected as
fellows of the Ameri-can
Statistical Asso-ciation.
They are Amy
Herring, ScD, associate professor; John Pre-isser
Jr., PhD, research professor; and Haibo
Zhou, PhD, professor.
Popkin awarded honor by Britain’s
Nutrition Society
Barry Popkin, PhD, Carla Smith Chamblee
Distinguished Professor of Global Nutrition,
is the 2010 recipient of
the United Kingdom
Nutrition Society’s
Rank Prize, the soci-ety’s
highest honor.
He accepted the
award in June 2010 in
Edinburgh, Scotland.
Popkin’s Nutrition
Society Lecture was
titled, “Contemporary Nutritional Transi-tion:
Determinants of Diet and its Impact on
Body Composition.”
Zelman, Herring
honored for
teaching, mentoring
Two prestigious fac-ulty
awards were pre-sented
at the School’s
70th commencement
ceremony last spring.
William Zelman,
PhD, professor of
health policy and management, received the
John E. Larsh Jr. Award for Mentorship, and
Amy Herring, ScD, associate professor of
biostatistics, received the McGavran Award
for Excellence in Teaching.
Gentry awarded
Moldova medal
Bill Gentry, lecturer
in health policy and
management and
director of the Com-munity
Preparedness
and Disaster Man-agement
program,
received Moldova’s
“Honorary Rescuer” medal in May 2010.
Gentry has a long history of emergency pre-paredness
and response efforts in the country.
Gordon-Larsen
receives Obesity
Society award
Penny Gordon-
Larsen, PhD, associate
professor of nutrition,
has won The Obesity
Society’s 2010 Lilly
Scientific Achieve-ment
Award. Gordon-
Larsen accepted the
award, funded by the Eli Lilly Pharmaceuti-cal
Co., at the Society’s October conference
in San Diego.
Peterson presented with prestigious
Allan Rosenfield Award
Herbert B. Peterson, MD, Kenan Distin-guished
Professor and chair of the Depart-ment
of Maternal and Child Health, received
the 2010 Allan Rosenfield Award for Life-time
Contributions to International Family
Planning. The award
is presented annually
by the Society of Fam-ily
Planning (SFP).
Peterson, also pro-fessor
of obstetrics
and gynecology in the
UNC School of Medi-cine,
is known inter-nationally
for his work
in women’s reproduc-tive
health, epidemiology, health policy and
evidence-based decision-making.
Dr. James Swenberg (left), Dr. Mike Aitken
Dr. John Preisser
Dr. Barry Popkin
Dr. Halbo Zhou
Dr. Lisa LaVange
Dr. Amy Herring
Bill Gentry
Dr. William Zelman
Dr. Penny
Gordon-Larsen
Dr. Herbert Peterson
PHOTO BY TOM FULDNER
30 | FA L L 2 0 1 0
Halpern honored for
leadership, teaching
Carolyn Halpern,
PhD, associate profes-sor
of maternal and
child health, received
the national Associa-tion
of Teachers of
Maternal and Child
Health’s 2010 Loretta
P. Lacey Maternal and Child Health Aca-demic
Leadership Award.
STAFF
Cilenti leads NC Healthy Start, receives
women’s health award
Dorothy Cilenti,
DrPH, deputy direc-tor
of the School’s
N.C. Institute for
Public Health, was
appointed chair of
the N.C. Healthy Start
Foundation��s board
of directors in July.
She has served on the
Healthy Start board since 2007.
Cilenti also received a $305,000 grant
from the U.S. Health Resources and Services
Administration’s Maternal and Child Health
Bureau. The project, Women’s Integrated
Systems for Health (WISH) Distance Learning
Initiative, will address the need to better inte-grate
public health and mental health systems
to improve women’s health.
Stevens honored for local health efforts
Rachel Stevens, EdD,
RN, received the 2010
President’s Award
from the National
Association of Local
Boards of Health
(NALBOH) in August
in recognition of her
service. Stevens was
deputy director of the School’s N.C. Institute
for Public Health and clinical instructor of
public health nursing before retiring in 2003.
Perry receives Staff Excellence Award
Chris Perry, assistant director of School
communications, was selected for the
School’s 2010 Staff Excellence Award, which
acknowledges excel-lent
attitude, leader-ship
and initiative.
Perry is credited with
“beyond-the-call ”
efforts on the School’s
website content,
including a recent
major redesign of
the site.
STUDENTS
Public health students recognized for
work benefiting North Carolina
UNC Gillings School
of Global Public
Health students won
four of 16 Impact
Awards, presented
by UNC’s Graduate
School in spring 2010
to recognize student
research that benefits
North Carolina citi-zens.
The awards, sponsored by the Graduate
Education Advancement Board, were given
last spring to:
• Jennifer Gierisch, PhD, health behavior
and health education alumna;
• Maiysha D. Jones, environmental sciences
and engineering doctoral student;
• Kathryn Remmes Martin, PhD, health
behavior and health education alumna;
and
• Stephen Richardson, environmental sci-ences
and engineering doctoral student.
Read more at http://tinyurl.com/nc-impact.
Two inaugural Gillings Dissertation
Awards presented
Stephen Richardson (environmental sciences
and engineering) and Natalie The (nutrition)
received Gillings Awards in spring 2010 for
their research, respectively, on solutions
to soil contamination and the associations
among weight, diabetes and physical activity
across race and ethnicity in the United States.
Three students win Fulbright awards
Jacqueline S. Knee, MSPH, and Bachelor of
Science in Public Health alumnae Melissa
Asmar and Erin Shigekawa were selected to
receive Fulbright public health scholarships.
Knee is examining sanitary conditions of
stored rainwater in Thailand; Asmar con-ducts
research on nutritional changes in the
national diet in Germany; and Shigekawa
studies chronic kidney disease in Taiwan.
ALUMNI
Brostrom selected for Barr Award
Richard Brostrom, MD, MSPH, received
the 2010 Harriet Hylton Barr Distinguished
Alumnus Award for his achievements and
contributions to the field of public health.
Brostrom, medical director of the Division
of Public Health for the U.S. Common-wealth
of the Northern Mariana Islands,
is also medical director of the common-wealth’s
programs in tuberculosis control,
public health bioterrorism preparedness and
tobacco control. His award was announced
at the School’s 2010 Foard Lecture.
Dr. Dorothy Cilenti
Dr. Rachel Stevens
Chris Perry
Maiysha Jones
Dr. Carolyn Halpern
Stephen Richardson Natalie The
AWARDS A N D R ECOGNI T I O N S
C A R O L I N A P U B L I C H E A L T H | 31
DONOR S
$1,000,000 to
$5,000,000
Anonymous
GlaxoSmithKline
Robert Wood Johnson
Foundation
sanofi-aventis
$500,000 to
$999,999
Anonymous
Columbia University
John D. & Catherine T.
MacArthur Foundation
Merck & Company
John & Virginia Sall
$250,000 to
$499,999
Avon Foundation
Boston University
The Duke Endowment
Estate of Mabel Smith
Johanssen
Government of Nunavut
University of Bristol
University of California –
San Francisco
Water Research Foundation
$100,000 to
$249,999
American Diabetes
Association
American Heart
Association
Anonymous
Association of Schools of
Public Health
Centers for Disease Control
Foundation
The COPD Foundation
Edward A. & Joanne Dauer
Dauer Family Foundation
Duke University
Elizabeth Glaser Pediatric
AIDS Foundation
EngenderHealth
Golden Leaf Foundation
King Abdullah University
Science & Tech
Penn State University
Pfizer Inc.
San Diego State University
Research Foundation
UNICEF
The Wistar Institute
W. K. Kellogg Foundation
$50,000 to
$99,999
Alaska Native Health
Consortium
American Institute for
Cancer Research
Bryson Foundation
Vaughn & Nancy Bryson
Children’s Hospital of
Philadelphia
Coca-Cola Company
Exxon Mobil Corporation
International Agency
Research on Cancer
Makhteshim-Agan of
North America Inc.
Medical University of
South Carolina
Mount Sinai School of
Medicine
NARSAD
Novartis
University of Massachusetts
University of Nevada Reno
University of Virginia
WaterAid
$25,000 to
$49,999
Abbott Diabetes Care Inc.
Anonymous (2)
Brigham and Women’s
Hospital
Fred Hutchinson Cancer
Research Center
International Association of
Plumbing and
Mechanical Officials
International Water
Association
Michael E. Kafrissen
Methanol Foundation
Susanne Moulton &
Thomas Wong
Orica Watercare Inc.
Otsuka Maryland Medicinal
Lab Inc.
Research Triangle Institute
Schering-Plough Research
Institute
Schwarz BioSciences Inc.
Pranab and Gauri Sen
Tellus Educational
Foundation Inc.
Theratechnologies Inc.
University of Georgia
University of Texas –
Houston
Wake Forest University
School of Medicine
Washington University –
St. Louis
Derek & Louise Winstanly
$10,000 to
$24,999
Abbott Laboratories
Amgen Inc.
Anonymous (3)
Marcia Angle &
Mark Trustin
Astellas Pharma US Inc.
AstraZeneca
Pharmaceuticals LP – US
Edward Carroll Bryant
“YOUR GIFTS ARE INVESTMENTS, AND WE THANK YOU FOR EVERY
ONE OF THEM. The return on your investment is far more than the gratitude of
public health researchers, teachers and students, though you have that in abundance.
Your return is your gift’s impact – discoveries made, students trained, faculty recruited
and retained, publications made possible, clinics supported, lives touched and the pub-lic’s
health transformed. Your gift – your investment – has made a difference in the
protection of the world’s health and America’s future. We are grateful to you and all our
partners as we work together to engineer clean water, prevent obesity, cancer and other
diseases, eliminate health disparities, and lower health care costs.”
– D E A N B A R B A R A K . R I M E R
JULY 1, 2009 – JUNE 30, 2010 of Donors and Partners
HONOR ROL L Gi l l i n g s S c h o o l o f Gl o b a l Pu b l i c He a l t h
32 | F A L L 2 0 1 0
DONOR S
Canadian Institute for
Advanced Research
Celgene Corporation
Deniese May Chaney
Dainippon Sumitomo
Pharma America Inc.
Nancy Ann Dreyer
Eisai Research Institute
Florida State University
Forest Laboratories Inc.
George & Bodil Gellman
The Gellman Foundation
Dennis B. Gillings
Sandra Bartholomew
Greene
Donald & Jennifer
Holzworth
Peter Bert Imrey
InterMune Inc.
Esther Maria John
JVC Enterprises
Momentum Research
MPEX Pharmaceuticals Inc.
James E. Nix
NSF International
Orexigen Therapeutics Inc.
Quintiles
Barbara K. Rimer &
Bernard Glassman
Benedict & Philomena Satia
Schwab Fund for
Charitable Giving
Sigma-Tau Pharmaceuticals
Inc.
Synteract Inc.
Triangle Community
Foundation
University of Arkansas
University of Florida
Research Foundation
University of Minnesota
University of Wisconsin –
Madison
XenoPort Inc.
Arnold & Maryanne Zaks
$5,000 to $9,999
Sheryl Wallin Abrahams
in memory of
Linda Southern
Anonymous (2)
Anonymous
in honor of
James Imhotep Irving
H. Michael &
Barbara Arrighi
Bergen County (N.J.)
United Way
The Boston Foundation
Deshpande Foundation
Leah McCall Devlin
in honor of parents
Fred & Pearle McCall
Cynthia Girman
Peggy & Cam Glenn
Ellen Diane Habermacher
Johns Hopkins University
Gary & Carolyn J. Koch
Stephen Allen Morse
Douglas M. Owen
Karl E. Peace
Greg & Paula Brown
Stafford
William & Michele A.
Sollecito
David Marc Turner
Jack Eugene Wilson
Brian A. Zaks
Jason Zaks
$2,500 to $4,999
Accenture Foundation Inc.
Anonymous
Delton Atkinson
David J. Ballard &
Michela Caruso
in memory of Harry Guess
Howard J. Dunn
Susan T. Ennett &
Wayne E. Pein
Fidelity Charitable
Gift Fund
Bob & Kristen Greczyn
Paula Billingsley
Harrison
Waldo B. Harshberger
Ronald W. Helms
Joan Cornoni Huntley
John P. McConnell
Foundation
Hong Li
John & Kit McConnell
Felicia Mebane
David & Julie Potenziani
Rebecca Raymond &
Michael Stangl
Rho
James & Jennifer Rosen
SAS Institute Inc.
Anna Pittman & James
Simpson Schenck IV
Ilene C. Siegler &
Charles D. Edelman
Allen & Susan Willey Spalt
Maura Ellen Stokes
Lydia Lansangan Tiosejo
in honor of
Dr. Norman F. Weatherly
Ronald & Ann Wooten
$1,000 to $2,499
Accenture Foundation Inc.
Michael Aitken &
Betsy Rudolph
American College of
Epidemiology
Lynda Anderson &
J. Kenneth Conover
Anonymous
Association of N.C. Boards
of Health
Edward L. Baker
Jeffrey Propes Baker
Kathleen D. Barboriak
Frank H. Barr
Sterling Wilson Bell
Deborah Bender &
John Curry
Peggy Bentley
Mark Dean Beuhler
Michael N. Boyd
Antonio Braithwaite
Fred & Laura Brown
Jianwen Cai & Haibo Zhou
Joseph & Jenifer Carson
Ward Cates
in honor of
Barbara K. Rimer
Ching Kuang Chen
Terri Colangelo
Ralph & Joann C. Cook
in memory of Al Tyroler
Georgia G. dela Cruz
Chester W. Douglass
Ramona & Alan DuBose
Todd Alexander Durham
Jo Anne & Shelley Earp
Kenneth L. Eudy Jr.
in honor of
Dave Potenziani
MaryAnn Cross Farthing
Edwin B. Fisher
Lyne Gamble &
Kathryn Yandell
Richard Gargagliano &
Joan Hedgecock
in memory of
Diane Hedgecock
Jay Marshall Goldring
Sherri Lynn Green
Andrea & Michael Griffin
Jim & Barbara Grizzle
in memory of
Bradley Wells
Priscilla Alden Guild
C. David & Lucy S.
Hardison
James R. Hendricks
Hendricks Consulting LLC
Suzanne Havala Hobbs
Deborah Parham Hopson
Amelia Horne
Sallie Craig Huber
Joseph G. Ibrahim
Inspire Pharmaceuticals
Inc.
International Lactation
Consultant Association
Mary Ellen James
Raymond James Charitable
Endowment Fund
Young-Ho Khang
in memory of H.A. Tyroler
James D. Kinard
Bill Kingsbury
Lynn Koss Knauff
Michael & Pamela Kosorok
Kubwater Resources Inc.
Miriam Labbok
Kenneth Ladrach
Don & Marie Lauria
Lisa Morrissey LaVange
in honor of Gary Koch
Peggy Leatt & George Pink
Danyu Lin
Douglas S. Lloyd
Julie MacMillan
Sandy Martin &
Larry Kupper
Theresa A. Martino
Danita McAllister
A. Dennis McBride
James A. & Mary L.
Merchant
Mark H. Merrill
Wilbur & Virginia
Milhous
Robert C. Millikan
Bill & Susan Milner
Mona Marie Moon
Alan Coningsby Moore
Sarah Taylor Morrow
Dara Lee Murphy
The National Christian
Foundation
Jeanenne Little Nelson
Sharon Nicholson-Harrell
Charlotte & Miguel
Nuñez-Wolff
Jeffrey Oberhaus &
Brent Wishart
James P. O’Connell
Andrew Olshan &
Linda Levitch
Phillip & Rachel Olsson
Leonard Oppenheimer
John E. Paul
Herbert B. Peterson
Alan & Linda Rimer
Rotary Club of Chapel Hill
R. Gary & Jeanette Rozier
John & Kelly Russell
Patricia D. Saddier
Linda M. & Brian O.
Sanders
Sanford Pediatric Dentistry
Helen C. Schaefer
James K. Schaefer
Jacqueline van der Horst
Sergent
Ruth Ann Shults
Anna Maria Siega-Riz
Gladys Siegel
in memory of Earl Siegel
Brian Springer
Paul Edward Stang
State Employees’ Combined
Campaign
David Steffen & Jill Kerr
June Stevens
in memory of
Jessie A. Satia
Joel & Donna Storrow
Rosalind Thomas &
David Strogatz
in honor of Linda Cook
Chirayath M. Suchindran
Mary Charles Suther
Mary S. Thompson
Russell Barner Toal
John Chester Triplett
Douglas Blair Tully
William J. Tyroler
UNC Student Activities
Fund Office
Bobbi Wallace
Dianne Stanton Ward
G. Robert Weedon
Alice D. White
Paul & Janet Wiles
David Winterle &
Carey Dawson
in memory of
Leonard Dawson
Kuan-Mu Yao
Chen-Yu Yen
$500 to $999
Stella Adamu
Jerrold M. Alyea
American Legacy
Foundation
Anonymous (3)
Anonymous
in honor of Linda Cook
Gordon Berry
in memory of
Katherine Wildman
William Cudd Blackwelder
Michael Austin Boyd
Douglas Donaldson
Bradham
Lynda Bryant-Comstock
James Paul Bulman
Jennifer Carr
in memory of
Mary Rose Tully
David A. Charnes
David Erwin Cooper
Deborah Lee Covington
Carol Jane Dabbs
Dannon Institute
Keith Allen Demke
Janice M. Dodds
Estate of Dorothy Fay Dunn
C A R O L I N A P U B L I C H E A L T H | 33
DONOR S
Stephen John Dunn
George Roy Elmore Jr.
Experience Inc.
Mary Beth Fasano
Lynn Schueler Fitzgerald
Joyce M. Gallimore
Stuart Gansky
Jerry Gray Gentry
Michael Craig Griffiths
Anders W. Hall
in memory of Frances Hall
Healthsouth Men’s
Clinic Inc.
Gerardo & Jo Eaddy Heiss
Robert Lee Hines
David Lee Hlavac
Omar Hopkins &
Teresa Savarino
Jonathan V. James
Nalin Johri
Thomas V. Jones
Juhaeri Juhaeri
Jane Kingsbury
Warren Kingsbury
Michael & Marilyn
Knowles
Margaret Edith Layne
Mazie Jones Levenson
Marcia Joanne Levenstein
Catherine Rowland
Liemohn
Robert Martin
David & Gladys McNelis
William Clarence Miller
Timothy James Mukoda
N.C. Citizens for
Public Health
Zoe Henderson Parker
Stephen Praissman
Paul Joseph Rathouz
in honor of
Lawrence Kupper
Thomas Cleveland
Ricketts III
Rachel F. Robbins
Mark Graham Rodin
Joan Siefert Rose
Michael Gerard Schell
Robert E. Silverman
Philip C. Singer
Ellison & Electa Smith
C. Jean Spratt
Rachel Humphries Stevens
Jeanine Hamlin Stice
Tamaurus Jerome Sutton
John Henry Sweitzer
Myduc L. Ta
David & Jeanie Taylor
in memory of
Professor David Fraser
Richard & Vanessa Thorsten
Fredrick Seymour Whaley
Jun-Guo Zhao & Yu Lou
President’s Circle
($5,000–$25,000)
Marcia Angle & Mark Trustin
Anonymous
Deniese May Chaney
George & Bodil Gellman
Peggy & Cam Glenn
Donald & Jennifer Holzworth
Esther Maria John
Michael E. Kafrissen
Gary G. & Carolyn J. Koch
James E. Nix
Barbara K. Rimer &
Bernard Glassman
John & Virginia Sall
William A. & Michele A. Sollecito
Derek & Louise Winstanly
Chancellor’s Circle
($2,000–$4,999)
Sheryl Wallin Abrahams
in memory of Linda Southern
Michael D. Aitken &
Betsy Rudolph
Sterling Wilson Bell
Fred & Laura Brown
Leah McCall Devlin
Bob & Kristen Greczyn
Andrea & Michael Griffin
Paula Billingsley Harrison
Joan Cornoni Huntley
James D. Kinard
Peggy Leatt & George Pink
Hong Li
Julie MacMillan
John & Kit McConnell
Felicia Mebane
Dara Lee Murphy
Charlotte & Miguel Nuñez-Wolff
Douglas M. Owen
David & Julie Potenziani
Rebecca Raymond &
Michael Stangl
James & Jennifer Rosen
Linda M. & Brian O. Sanders
Anna Pittman &
James Simpson Schenck IV
Ilene C. Siegler &
Charles D. Edelman
Allen & Susan Willey Spalt
Joel & Donna Storrow
Lydia Lansangan Tiosejo
in honor of
Dr. Norman F. Weatherly
Jack Eugene Wilson
Ronald & Ann Wooten
Kuan-Mu Yao
Dean’s Circle
($1,000–$1,999)
Lynda Anderson &
J. Kenneth Conover
H. Michael & Barbara Arrighi
Edward L. Baker
David J. Ballard &
Michela Caruso
in memory of Harry Guess
Kathleen D. Barboriak
Frank H. Barr
Deborah Bender & John Curry
Peggy Bentley
Antonio Braithwaite
Jianwen Cai & Haibo Zhou
Joseph D. & Jennifer Carson
Ward Cates
in honor of Barbara K. Rimer
Ching Kuang Chen
Ralph R. & Joann C. Cook
in memory of Al Tyroler
Ramona & Alan DuBose
Jo Anne & Shelley Earp
Susan T. Ennett & Wayne E. Pein
Kenneth L. Eudy, Jr.
in honor of Dave Potenziani
Edwin B. Fisher
Lyne Gamble & Kathryn Yandell
Jay Marshall Goldring
Priscilla Alden Guild
C. David & Lucy S. Hardison
James R. Hendricks
Suzanne Havala Hobbs
Deborah Parham Hopson
Amelia Horne
Sallie Craig Huber
Joseph G. Ibrahim
Michael & Pamela Kosorok
Miriam Labbok
Kenneth S. Ladrach
Lisa Morrissey LaVange
in honor of Gary Koch
Danyu Lin
Douglas S. Lloyd
Sandy Martin & Larry Kupper
Theresa A. Martino
Danita McAllister
A. Dennis McBride
James A. & Mary L. Merchant
Mark H. Merrill
Wilbur & Virginia Milhous
Robert C. Millikan
Bill & Susan Milner
Mona Marie Moon
Sarah Taylor Morrow
Jeanenne Little Nelson
Sharon Nicholson-Harrell
Jeffrey Oberhaus &
Brent Wishart
James P. O’Connell
Andrew Olshan & Linda Levitch
John E. Paul
Herbert B. Peterson
John & Kelly Russell
Patricia D. Saddier
James K. Schaefer
Jacqueline van der Horst Sergent
Ruth Ann Shults
Brian Springer
Paul Edward Stang
David Steffen & Jill Kerr
June Stevens
Mary Charles Suther
Russell Barner Toal
John Chester Triplett
Bobbi Wallace
Dianne Stanton Ward
G. Robert Weedon
Alice D. White
Paul & Janet Wiles
THE ROSENAU SOCIETY IS NAMED IN HONOR OF MILTON J. ROSENAU, THE FIRST DEAN OF
THE SCHOOL OF PUBLIC HEALTH. MEMBERSHIP IN THE ROSENAU SOCIETY IS LIMITED TO
BENEFACTORS MAKING A MINIMUM UNRESTRICTED CONTRIBUTION OF $1000 TO EITHER
THE UNC GILLINGS SCHOOL OF GLOBAL PUBLIC HEALTH OR ONE OF ITS DEPARTMENTS.
MEMBERSHIP MUST BE RENEWED ON AN ANNUAL BASIS.
Rosenau Society
Membership July 1, 2009–June 30, 2010
34 | F A L L 2 0 1 0
DONOR S
$250 to $499
Omid & Julie Ahdieh
Anonymous
Mary Susan Anthony
John Anton &
Renee Schwalberg
Stephen Charles Ayala
Patricia Michel Backus
Harriet Hylton Barr
Eileen Danielle Barrett
Edmund Gerald Barron
Sheri Ruth Bates
Stephen & Elaine Berman
Lynn W. Blanchard
Jo Ellen Brandmeyer
Carolina Trust
Robert & Helen Clawson
Coastal Community
Foundation of S.C.
Francoise Marie Cornet
Katherine Elizabeth
Crosson
Thomas Lawrence Crowe
E. Stewart Crumpler
Pedro & Carol Cuatrecasas
Ronnie McConnell Davis
Clifford Earl Decker Jr.
Pamela France DeLargy
David Louis Dodson
Leroy & Kay Doughty
Tom & Jenifer Faulkner
Richard & Karen Fields
Laurel Ann Files
David Bernard Fischer
Barbara J. Fleck
Hilton Thomas Goulson
Gretchen Groebel
Kerry Brent Hafner
Carolyn Cantlay Hart
Richard John Heggen
W. Howard Holsenbeck
Essam Ibrahim
in memory of Laurel Zaks
Barbara Anne Israel
in honor of Linda Cook
W. Joe Jacumin
Harvey Edward Jeffries
James Joseph Jetter
Baxter Lee Jones
Michelle Crozier Kegler
Oliver & Maighread Kelly
Amy Hyonju Kim
John & Judy Klaas
Jacquelyn Hoffman Koehler
in memory of
Rebecca James Baker
Michele Cherry Larson
Peter Lauria &
Kathleen Sheehan
Sheri Johnson Lawrence
David Ernest Layland
Joseph Gilbert Louis Lee
Kelvin K. Lee
Wilbert Liou-Lang Lee
James Robert Leserman
Mike Kafrissen and Bert Peterson have been friends and colleagues for
more than a quarter-century. As obstetrics and gynecology physi-cians,
members of the U.S. Centers for Disease Control and Prevention’s
Epidemic Intelligence Service and faculty members at UNC Gillings School
of Global Public Health, they have worked in concert to improve the health
of women and children around the world.
Kafrissen, School alumnus, research scientist at Massachusetts Institute
of Technology, Chief Scientific Officer for Johnson & Johnson’s North
American Pharmaceutical Company, and adjunct professor of maternal
and child health at UNC, says UNC-Chapel Hill has been instrumental in his career path.
“During a recent visit to the campus, I felt led to increase my involvement with our
school,” Kafrissen says. “I was moved by my conversations with Bert [Herbert Peterson,
MD, Kenan Distinguished Professor and chair of the School’s Department of Maternal
and Child Health] and his passion for and optimism about the current effort to reduce
maternal mortality.”
As a result of those conversations – and subsequent ones with Dean Barbara K. Rimer
and UNC Chancellor Holden Thorp – Kafrissen presented the School with a generous
gift, which was matched 2-to-1 by his former employer, Johnson & Johnson.
The funding helps support Peterson’s efforts as director of the UNC-based World
Health Organization (WHO) Collaborating Center for Research Evidence in Sexual and
Reproductive Health. The Center helps WHO and other leading United Nations health
agencies as they develop and implement science-driven solutions for preventing mater-nal
deaths in the 25 countries in which most such deaths occur.
“Mike has helped us immensely,” Peterson says. “His wisdom and expertise have been absolutely invaluable,
and his generous gift is key in getting this important work off the ground.”
– Linda Kastleman
Michael Kafrissen, MD:
Giving back
to support a cause I believe in
Dr. Michael Kafrissen
Dr. Bert Peterson
holding Nikhil Gomez
PHOTO BY ANU MANCHIKANTI GOMEZ
C A R O L I N A P U B L I C H E A L T H | 35
DONOR S
Juliana Meimei Ma
Allen Martin Mabry
Craig Stephen Maughan
William Sheffield McCoy
The MidSouth Lactation
Consultants Association
Beverly Mirman
Philip Keith Mitchell
Hannah Yang Moore
Hal Morgenstern
John Bertrand Mulligan Jr.
Mary Margaret H. Mundt
J. Richard Navarre &
Melissa McPheeters
Jacob Alan Neufeld
Raymond Joseph Nierstedt
Julie Truax Nunez
Donald & Mary Oberlin
Timothy Wade Okabayashi
Richard Davis Olin
Richard Jay Osborne
Jane Therese Osterhaus
Anne Townsend Overman
Ruth Woodenberg Patterson
in memory of Jessie Satia
Brian E. Pedersen
Jamie Perin
Helen Peters
David Edward Pinsky
Lewis William Pollack
Barry Michael Popkin
in memory of Jessie Satia
Lanny & Cleta Puckett
Xiang Qin
Irving & Joan Rimer
Susan Wenger Robbins
in honor of Miriam Labbok
Charles Eric Rodes
Ruth Rothman
in honor of Miriam Labbok
Eris Hamrick Russell
William & Donna Rutala
Susan Marie Sanders
Victor & Marion
Schoenbach
Chuan-Feng Shih
Mary Kate Shirah
in honor of Linda Cook
Linda Simoni-Wastila
William Thomas Small Jr.
Fraser B. Smith
Jeffrey Boyd Smith
Amy Kathryn Spangler
in memory of
Mary Rose Tully
Scott & Ann Stoioff
Anne Nelson Stokley
Susan E. Strunk
Lisa Ann Sutherland
James & Sandra Swenberg
Robert Charles Sykes
J. Chi-Chung Tang
Gabriel Kodzo Tanson
M.J. Territo
Willem A. Van Eck
Wanda Kay Wilkins
Deborah Marie Winn
Richard Vance Wolfenden
Beverly Ann Young
$100 to $249
Rashmi Agarwal
Daniel & Kathryn Ahlport
Alan & Barbara Alexander
Jean Elizabeth Alexander
M. Taylor Alexander Jr.
William & Mary Allshouse
Amgen Foundation
Terry P. Anderson
Anonymous (4)
Lenore Arab
Nikita Arya
Annella Jean Auer
Carolann Dineen Augustine
A. John Bailer &
Jennifer Faris-Bailer
Samuel J. Barone
E. Byrd Barr
C. W. Bartholomai
Valentine R. Bauer
Melinda A. Beck
Bruce Anthony Behringer
Ronald Benson &
Nellie Hansen
Carl Levon Biggs
Richard E. Bilsborrow
Elizabeth Hardaway
Birkenbeuel
Michelle Jones Blackmon
Aaron Earl Blair
J