Childhood Obesity Rates in Israel Similar to United States, According to New Study Conducted by Mount Sinai Global Health and Clalit Health Services in Israel

Mount Sinai and Emek Medical Center announce an agreement to collaborate on future projects.

New York
 – July 24, 2013 /Press Release/  –– 

Photo of the signing of the memorandum of understanding  between Mount Sinai and Emek

Top left to right - Jamie Crystal, board member of Israel Healthcare Foundation.
Dr. Jonathan Ripp, Associate Director, Mount Sinai Global Health; Ambassador Ido Aharoni, Israel's Consul General in New York
Bottom Left to right- Dr. Orna Blondheim, CEO Emek Medical Center; Dr. Philip Landrigan, Dean of Mount Sinai Global Health

Childhood obesity rates in Israel are now similar to those in the United States, according to a new study conducted by researchers at Mount Sinai Global Health, a program at the Icahn School of Medicine at Mount Sinai, and Clalit Health Services in Israel.

As many as one-in-five children in northern Israel--21 to 26 percent of children between the ages of 2 and 18--are either overweight or obese, according to researchers from Mount Sinai and Clalit, the largest private health care organization in Israel. Researchers suspect the causes in Israel are likely similar to the causes in America:  excess consumption of low-cost high-calorie food, as well as an increasingly sedentary lifestyle. In the United States, 16.9 percent of children and adolescents ages two to 19 are obese, according to the U.S. National Health and Nutrition Examination Survey (NHANES).

Extra weight carried by individuals, young and old, is contributing to the growth of diabetes and other obesity-related illnesses worldwide.  One-in-five children are affected by excess bodyweight across all countries, according to the "Obesity Update" issued by the Organisation for Economic Co-operation and Development (OECD) in 2012 (see The United States ranked 18th in the World Fact Book, with 33 percent of its adult population considered obese (in 2008), compared with Israel which ranked 49th with 26 percent of its adult population considered obese (in 2008).  Obesity is defined as an adult having a Body Mass Index (BMI) greater to or equal to 30.0. BMI is calculated by taking a person's weight in kg and dividing it by the person's squared height in meters.

For their study on childhood obesity in Israel, researchers from the U.S. and Israel decided to focus their efforts on the community of Afula, served by Clalit's Emek Hospital. Orna Blondheim, MD, MHA and CEO of Emek Hospital, said, "We were impressed with the level of professionalism and dedication of our Mount Sinai guests and encouraged by their commitment to this important study. "

"Considering the shift in this area from a traditionally Mediterranean diet to a more "Western" diet and lifestyle, we are interested in understanding the impact of this on public health," said Jonathan A. Ripp, MD, Associate Director of Mount Sinai Global Health and site mentor for the U.S. team. "Given the staggering long-term public health implications of childhood and adolescent obesity, studies such as this have critical implications for helping government, health and social institutions develop better policies for the prevention and treatment of obesity and its consequences."

Together, Mount Sinai and Emek plan to investigate and develop effective solutions for the rising public health concerns linked to childhood and adolescent obesity in the region.

The study is the first of many collaborative projects between Mount Sinai and Emek. The two institutions signed a memorandum of understanding in May to form a close collaboration, leading to mutual education, mutual visits of faculty and students and possibly to the initiation and development of additional joint projects. 

The relationship between the two institutions was arranged by James ("Jamie") F. Crystal, son of James W. Crystal, a member of the Board of Trustees of The Mount Sinai Medical Center. Jamie Crystal also serves on the board of the Israel Health Care Foundation, which is a U.S. organization that supports health care in Israel, including Clalit's efforts to improve the health of underserved communities.
Mount Sinai Global Health and Clalit Health Services first partnered in 2011 to explore ways to collaborate based on the two institutions' overlapping missions. Mount Sinai Global Health seeks to improve the health of underserved communities worldwide through research, service, education and human rights advocacy projects. Clalit Health Services is Israel's largest healthcare services provider, with 14 hospitals and 1400 clinics in its network. Clalit provides quality care to over 4 million Israelis, 54 percent of the population. It serves a number of underserved populations throughout Israel, many of which experience considerable health disparities relative to the rest of the country.

After consultation with Philip J. Landrigan, MD, MSc, Dean for Global Health and the Ethel H. Wise Professor and Chair of Preventive Medicine at the Icahn School of Medicine at Mount Sinai and Dr. Ripp, the researchers from the U.S. and Israel decided to focus their efforts on the community of Afula, a microcosm of Israeli society with diverse religious, ethnic and socioeconomic groups, allowing for a cross cultural analysis of obesity, diet, exercise routines and utilization of healthcare resources in the community. Approximately 75 percent of the population is Jewish, 20 percent are Arabs, and the remaining 5 percent include African immigrants, local Christians, and other groups. Emek Hospital serves as the only tertiary care center in the northeast of Israel.

The researchers reviewed over 100,000 electronic medical records of children birth to 18 years of age in order to understand the regional prevalence of childhood and adolescent obesity and its associated risk factors, such as diabetes, high blood pressure and high cholesterol.

The study included an analysis of the availability of nutritional food at local providers and the density of local play and outdoor spaces relative to their proximity to public schools and gathering places for children and adolescents. The researchers mapped the town of Afula and identified 193 food stores and retailers, more than 70 percent of which sold nutrition-poor food. Only 15 stores offered fresh fruits and vegetables. In total, there were three times as many fast food purveyors per thousand children as there were stores where fresh fruit was available.

The U.S field research team included Matthew Harris, MD, Resident, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, and Jonathan Eisen, Second-Year Medical Student, the Icahn School of Medicine. Maya Leventer-Roberts, MD, MPH, a Mount Sinai Pediatric Environmental Health Fellow and Mount Sinai-trained pediatrician, has also been instrumental in data analysis and leadership in designing the next phase of the study to examine parental attitudes regarding access to and consumption of healthy foods.

The Emek faculty worked under the direction of Yardena Rakover-Tenenbaum, MD, Associate Professor in Pediatric Encocrinology and Director of the Pediatric Endocrine Unit and Tal Almagor, MD, senior physician of the Division of Pediatric Endocrinology.

About The Mount Sinai Medical Center
The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai. Established in 1968, the Icahn School of Medicine at Mount Sinai is one of the leading medical schools in the United States. The Icahn School of Medicine is noted for innovation in education, biomedical research, clinical care delivery, and local and global community service. It has more than 3,400 faculty members in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National Institutes of Health (NIH) funding and by U.S. News & World Report.

The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation's oldest, largest and most-respected voluntary hospitals. In 2012, U.S. News & World Report ranked The Mount Sinai Hospital 14th on its elite Honor Roll of the nation's top hospitals based on reputation, safety, and other patient-care factors. Mount Sinai is one of just 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and by U.S. News & World Report and whose hospital is on the U.S. News & World Report Honor Roll.  Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place.

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