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March 30, 2012



State Coordinated Chronic Disease Program Leads and Chronic Disease Program Directors:


Welcome to the Coordinated Chronic Disease Prevention and Health Promotion Program (CCDP) weekly update featuring news, tools, and resources that may be useful for your state-based chronic disease prevention and health promotion efforts.  We developed this weekly update in response to your requests and feedback we received during the Regional Meetings.  Each week we will highlight news and resources from our sister Divisions in the National Center for Chronic Disease Prevention and Health Promotion.  Should you have any questions about the weekly update, please feel free to contact me using the information located at the end of the update.  Enjoy!


Coordinated Chronic Disease Prevention

and Health Promotion Program



Features highlighted in this update include:


Cross-Cutting Updates

·         CDC National Healthy Worksite Program Training and Technical Assistance Overview (webinar): April 20, 2012, 2:30pm


Nutrition, Physical Activity, and Obesity:

·         Retail Food Environment Index Maps

·         Public Health Law and Policy Guides: A Farm Bill Primer for Communities and Food Systems Planning

·         Proposed Rule on Fresh Fruit and Vegetable Program

·         Team Nutrition Training Grants


Heart Disease and Stroke:

·         Sodium Research Project



  • NIH Study Finds that Interventions to Prevent Type 2 Diabetes Give Good Return on Investment





The CDC National Healthy Worksite Program will provide employers and interested organizations nationwide access to worksite health training and resources beginning in summer 2012. Attend this webinar to learn about upcoming events and teleconferences that focus on practical, skill-building training for employers to implement comprehensive worksite health programs.  For more information on the NHWP,

Space is limited. Reserve your webinar seat now at:





Maps of the modified Retail Food Environment Index for 50 states plus Washington D.C. are now posted at  These maps can be used to help identify census tracts within states or communities that either lack access to healthy food retailers such as supermarkets or contain very high densities of fast food restaurants and convenience stores relative to the number of healthy food retailers. States and communities can also use data from the mRFEI Data Table to create their own maps using GIS software or link the mRFEI data to other census-tract level data they may have available.



This basic guide to the farm bill describes provisions related to nutrition and obesity prevention. It connects this major piece of federal legislation to obesity prevention work happening on the ground across the country.



This article, published in the Planning & Environmental Law journal, breaks down the farm bill for urban planners working on food systems issues. As with the farm bill primer, it describes specific policies and programs that affect food system planning at the local level.

[article attached]



The Proposed Rule on the Fresh Fruit and Vegetable Program was published on Friday, February 24, 2012, and is available on the School Meals public Web site.  This proposed rule would establish the basic requirements for the operation of the Fresh Fruit and Vegetable Program (FFVP) in conformance with the Richard B. Russell National School Lunch Act. It would set forth administrative and operational requirements for FFVP operators at the State and local levels. The intent of these provisions is to ensure that the FFVP encourages the consumption of fresh fruits and vegetables by elementary school children, thus improving their dietary habits and long-term health.  Comments on this proposed rule must be received by the Food and Nutrition Service on or before April 24, 2012.



Applications for the 2012 Team Nutrition Training Grants are due April 27, 2012.  The purpose of this grant is for State agencies to expand and enhance their training programs that incorporate and implement the 2010 Dietary Guidelines for Americans and USDA Foods in meals served under the National School Lunch Program (NSLP) or the Child and Adult Care Food Program (CACFP). In the past few years several States have used these grants to implement and expand farm to school efforts.  For more information, please visit this site





The Centers for Disease Control and Prevention (CDC), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division for Heart Disease and Stroke Prevention issues Broad Agency Announcement (BAA) Number 2012-N-14291 under the provisions of FAR 35.016 and FAR 6.102(d)(2) which provides for the competitive selection of research proposals. Contracts that are awarded based on responses to this BAA are as a result of full and open competition and therefore in full compliance with the provisions of PL 98-369.  The BAA can be accessed at:


Eligibility:  Institutions, nonprofit organizations, not for profit organizations, state and local government, and private industry for research and development (R&D) in those areas covered in Part II of this BAA. 



The intent or purpose of this Announcement is to fund a study is to provide current and accurate estimates of the sources (including sodium from processed and restaurant foods, sodium inherent in foods, and salt added at the table and during cooking) of dietary sodium intake in the United States in a large, demographically diverse sample of adults to better inform strategies to reduce sodium intake and ultimately prevent heart disease and stroke.


Scope of Work:

The offeror awarded the contract will work closely with CDC to remain consistent with CDC’s original intent of the initiative.  The work to be performed includes the following eight tasks:

·         Recruit a demographically diverse sample of a minimum of 400 participants from three locations;

·         Collect data on total sodium intake and sources of sodium intake;

·         Collect biomarkers for total sodium intake and sodium from discretionary sources on a subset of participants;

·         Analyze data collected to determine for each individual the usual sodium intake from a variety of sources;

·         Compare estimates by demographic characteristics;

·         Compare estimated (from self-report) with measured amounts of salt added at the table; and

·         Prepare and provide a dataset and code book to CDC with all the data collected from each study participant, and;

·         Summarize information in a final report and publications.


This BAA is open and in effect for 21 days from the date of release (March 26, 2012 through April 16, 2012).  THIS IS AN IMMEDIATGE CALL FOR WHITE PAPERS for the program entitled, "Sodium Research Project.” Prior to submission of a white paper offerors are strongly encouraged to contact the CDC BAA Technical Coordinator, Dr. Mary Cogswell, at (770) 488-8053. White papers must be received by April 16, 2012 in order to be considered for further evaluation.  White papers should be submitted electronically to the CDC BAA Technical Coordinator, Dr. Mary Cogswell, at


The complete package can be accessed via Fed Biz Ops:





Programs to prevent or delay type 2 diabetes in high-risk adults would result in fewer people developing diabetes and lower health care costs over time, researchers conclude in a new study funded by the National Institutes of Health. 


Prevention programs that apply interventions tested in the landmark Diabetes Prevention Program (DPP) clinical trial would also improve quality of life for people who would otherwise develop type 2 diabetes.  The analysis of costs and outcomes in the DPP and its follow-up study is published in the April 2012 issue of Diabetes Care and online March 22 at <>.


The DPP showed that lifestyle changes (reduced fat and calories in the diet and increased physical activity) leading to modest weight loss reduced the rate of type 2 diabetes in high-risk adults by 58 percent, compared with placebo.  Metformin reduced diabetes by 31 percent.  These initial results were published in 2002.  As researchers monitored participants for seven more years in the DPP Outcomes Study (DPPOS), they continued to see lower rates of diabetes in the lifestyle and metformin groups compared with placebo (  Lifestyle changes were especially beneficial for people age 60 and older.


The economic analysis of the DPP/DPPOS found that metformin treatment led to a small savings in health care costs over 10 years, compared with placebo.  (At present, metformin, an oral drug used to treat type 2 diabetes, is not approved by the Food and Drug Administration for diabetes prevention.)  The lifestyle intervention as applied in the study was cost-effective, or justified by the benefits of diabetes prevention and improved health over 10 years, compared with placebo.   


"Over 10 years, the lifestyle and metformin interventions resulted in health benefits and reduced the costs of inpatient and outpatient care and prescriptions, compared with placebo.  From the perspective of the health care payer, these approaches make economic sense," said the study's lead author William H. Herman, M.D., M.P.H., a co-investigator of the DPP Research Group and director of the Michigan Center for Diabetes Translational Research, Ann Arbor. 


The DPP enrolled 3,234 overweight or obese adults with blood sugar levels higher than normal but below the threshold for diabetes diagnosis.  Participants were randomly assigned to a lifestyle intervention aimed at a 7 percent weight loss and 150 minutes per week of moderate intensity activity, metformin treatment, or placebo pills.  The groups taking metformin or placebo pills also received standard lifestyle recommendations.


"We don't often see new therapies that are more effective and at the same time less costly than usual care, as was the case with metformin in the DPP.  And while the lifestyle intervention was cost-effective, we would see greater savings if the program were implemented in communities," said Griffin P. Rodgers, M.D., director of the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). "This has already been demonstrated in other NIDDK-funded projects, including one in YMCAs, where a lifestyle-change program cost $300 per person per year in a group setting, compared to about $1,400 for one-on-one attention in the DPP."


In the DPP, direct costs over 10 years per participant for the lifestyle and metformin interventions were higher than for placebo ($4,601 lifestyle, $2,300 metformin, and $769 placebo).  The higher cost of the lifestyle intervention was due largely to the individualized training those participants received in a 16-session curriculum during the DPP and in group sessions during the DPPOS to reinforce behavior changes.


However, the costs of medical care received outside the DPP, for example hospitalizations and outpatient visits, were higher for the placebo group ($27,468) compared with lifestyle ($24,563) or metformin ($25,616).  Over 10 years, the combined costs of the interventions and medical care outside the study were lowest for metformin ($27,915) and higher for lifestyle ($29,164) compared with placebo ($28,236).  Throughout the study, quality of life as measured by mobility, level of pain, emotional outlook and other indicators was consistently better for the lifestyle group.


"The DPP demonstrated that the diabetes epidemic, with more than 1.9 million new cases per year in the United States, can be curtailed. We now show that these interventions also represent good value for the money," said study chair David M. Nathan, M.D., director of the Diabetes Research Center at Massachusetts General Hospital, Boston.


In the United States, nearly 26 million people have diabetes, and up to 95 percent of them have type 2 diabetes.  About 7 million people have type 2 diabetes but do not know it.  In addition, about 79 million adults have prediabetes, with high blood sugar levels that are not yet in the diabetic range.  Prediabetes substantially raises the risk for developing type 2 diabetes.  Learn more about diabetes at <> and at <>.


The full NIH News Release is available online at: <>.