obesity

Obesity and Hunger Are Twin Crises

This article was written by Betty Baboujon, food journalist based in Los Angeles. It was originally posted to TakePart in December 2016.

Despite decades of warnings, obesity poses a growing problem worldwide. Once it was thought to afflict just affluent countries, where excess can easily become a way of life. In reality, obesity is a global issue affecting poorer countries on a grand scale. While there has been progress in reducing hunger globally, the next stage doesn’t look too promising.

One-third of the world’s population—more than 2.1 billion people—is obese or overweight, with the majority in developing countries. What’s more, these countries are grappling with what health experts call the “double burden of malnutrition”: undernutrition and overnutrition. So while one part of the population goes hungry, another is obese and overweight, becoming more prone to chronic conditions such as diabetes, heart disease, and hypertension.

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A study published in October in The Lancet by the Institute for Health Metrics and Evaluation says high body-mass index is the world’s fourth-largest risk factor for disability and death. According to the International Diabetes Federation, developing countries will have the biggest jumps in the number of people with diabetes—globally, it is expected to rise from 415 million in 2015 to 642 million in 2040.

How have obesity and overweight become so common in low- and middle-income countries? In public health–speak, “overnutrition” means eating more calories than the body needs, which leads to extra body fat. But the term is a misnomer. Overnutrition generally isn’t a case of eating too many nutritious foods but those high in everything but nutrients: salt, sugar, fat, and refined carbohydrates that add up to a lot of calories.

“Everyone is eating processed food in developing countries, even children,” says Agnès Guyon, senior nutrition and child health adviser at JSI Research and Training Institute in Washington, D.C. “It is easier to buy a packet of chips than to give fruit.”

Left: Sugar Sweetened Beverage Expenditures                          Right: Fruit and Vegetable Expenditures

This dietary pattern, along with lower levels of physical activity, has resulted in sharp increases in obesity among children, according to the World Health Organization, setting a path for ill health. It’s a trend likely to continue: A World Obesity Federation report in the October issue of Pediatric Obesity forecasts that the childhood obesity rate will climb farther in the coming decade.

Crucially, early or chronic undernutrition is linked with obesity. It begins in childhood, often in the womb: “When a child is undernourished, it does not develop properly. And when a mother is malnourished before or during pregnancy, there is a fetal adaptation where the kidneys are not well developed and the pancreas does not have proper insulin,” explains Guyon, who is also director of JSI’s maternal, neonatal, and child health center. All that conspires to make a person vulnerable to obesity.

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It isn’t unusual for undernutrition and obesity to coexist in the same community or the same household, according to WHO. Or even in the same person. “You can have an obese woman who is malnourished and has anemia,” says Guyon. “She is not getting the right food and macronutrients.”

While urbanization has affected lifestyles—people do less active work, for example—what is available to eat seems to matter more. “The food environment’s role is larger,” says Ashkan Afshin, acting assistant professor of global health at the University of Washington, who collaborated on the IHME study on global disease burden. “Affordability and accessibility of food are main contributors.”

The move toward cash crops over the last half century has also changed the food landscape in developing countries. “We convinced them to do monoculture—cotton, coffee, or cacao, for example—so a lot of people don’t farm subsistence crops anymore, and instead they have to import processed food,” says Guyon. “So now, we are trying to teach them again to cultivate food. I think it’s part of the solution to go back to a better way of eating what is around locally. This is a theory, but in practice it is more difficult.”

Much of what the world eats doesn’t come directly from plants or animals but has gone through food systems that turn it into processed and packaged foods. While many products have been vilified for poor nutrition profiles, processed foods are in demand for many reasons. Not the least of them is food safety—their long shelf life means they can be transported without spoiling and can be stored for longer. Also, they are convenient and affordable: Processed foods are ready to eat (or at least much faster than cooking from scratch) and tend to be cheaper than perishable food.

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To be sure, many processed foods are widely accepted as part of a healthy diet—whole-grain cereals and bread, for example, as well as fruit, vegetables, or legumes that have been canned or frozen. Much of the criticism has been aimed at products that offer low nutritional value, have high quantities of salt and sugar, and are ultra-processed, meaning they include substances not used in normal cooking but that mimic the taste of minimally processed food.

So along with lackluster nutritional quality—inferior to “real food,” as critics say—the quantity of unhealthy processed foods being consumed is problematic for the world’s waistlines and long-term health.

For this reason a vocal critic of processed foods says the practical solution is not to do away with nor heavily tax and regulate them but rather to improve the offending products. Jack Winkler, a former nutrition policy professor at London Metropolitan University, has argued that special diets don’t work and education doesn’t motivate good habits. He says it proves that people are not truly interested in healthy eating. “We must start from the foods they actually eat most of the time, then improve their nutrient profiles,” he wrote in the British Medical Journal.

Afshin says the problems generally have to do with “low intake of healthy food rather than high intake of unhealthy foods, other than sodium.” In other words, it’s more about what people are not eating. What’s often missing are whole grains, fruits, vegetables, nuts, seeds, and omega-3s, he says.

Improving the quality of processed foods could benefit people in all countries, whatever their income or status. But in the developing world, education is key.

“We always go back to the education and empowerment of women,” says Guyon. Research has shown that in the hands of women, an increase in family income improves children’s health and nutrition, according to the World Food Programme, and that providing women farmers with the same resources as their male counterparts could reduce the number of hungry people in the world by up to 150 million.

“In many countries that suffer from the double burden…most of the focus is on undernutrition because this is more pressing,” says Afshin.

While tackling undernutrition in theory should alleviate the rise of obesity, they remain different problems that require different solutions. Global programs have been addressing hunger for decades, and though they have made inroads, an estimated 795 million people don’t have enough to eat.

Obesity and diabetes, meanwhile, are largely uncharted territory for most of the world. No country—not even a developed one—has succeeded in reducing its obesity rates, according to the landmark 2015 IHME study that found one-third of the world is obese or overweight. “In developing countries, there is not a system to deal with these diseases,” says Guyon. “Every country is facing this complexity.”

It’s particularly vexing for countries with large numbers of hungry people and limited resources. Ensuring that the world has enough to eat is daunting in itself, but will the food we produce sustain us healthily? Consider that the global indicators of food security are primarily starchy foods: wheat, corn, potatoes, rice. “A country might be food secure, but it might not have enough nutritious food,” says Guyon. “The world in general is missing the quality of nutritious foods like fruits and vegetables.”

Reversing the Risk of Diabetes

The US is in the midst of a diabetes epidemic. Just within the last six years, 2.2 million Americans have been diagnosed with diabetes. That brings the total number of Americans with diabetes to nearly 30 million.

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Majority of diabetics have type 2 diabetes, which means their body can’t use insulin properly, preventing blood glucose from staying at normal levels. Much less common is type 1 diabetes. With type 1, the body does not produce insulin. Unlike type 2 diabetes, it can’t be prevented.

Because of the health consequences associated with diabetes like blindness, heart disease, kidney problems, and more, it’s important for diabetics to monitor blood glucose levels on a daily basis. The A1C test measures the average blood glucose level. Unfortunately, there are barriers that prevent many diabetics from properly monitoring their diabetes, whether it be the cost of test strips required for the A1C test, fear of needles, stigma, or lack of knowledge and/or motivation needed to monitor their diabetes. Diabetes can affect anyone, though there is a heavier burden of the disease among African Americans, Latino, Native Americans, and Asian Americans.

diabetic-monitoring

While a lot of attention is paid to diabetes, not as much has focused on prediabetes, which puts people on the path to diabetes, but is reversible with lifestyle changes. It occurs when blood glucose levels are higher than normal, but not yet in the diabetic range. There are no clear symptoms, which is why it’s easy for those with prediabetes to progress into the irreversible diabetes. Astonishingly, not only do one in three Americans have prediabetes, but it’s estimated that as many as 90 percent don’t know it and are unaware of their risk- that’s 86 million Americans!

While genetics is a significant player in the likelihood of being diagnosed with diabetes, lifestyle changes while in the prediabetic range can decrease that likelihood. Increasing physical activity, eating healthy, and taking care of overall health can help stave off a diabetes diagnosis. As you can see in the map below, many areas in the US with a high prevalence of diabetes also have low physical activity levels and high obesity prevalence.

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The Diabetes Prevention Program research study found that even modest changes could reverse prediabetes. It could be as modest as losing 5 to 7 percent of body weight, that’s 10 to 14 pounds for a 200 pound person. In people with prediabetes, these changes reduced their risk of developing type 2 diabetes by 58 percent. It’s not just preventing type 2 diabetes, it’s also reducing the risk of developing other chronic conditions like heart disease and disabilities like blindness.

The CDC’s National Diabetes Prevention Program (NDPP) has community-based partnerships that offer evidence-based, lifestyle change programs that can not only help prevent type 2 diabetes, but improve participants’ overall health. So far, it has been very successful. There are hundreds of NDPPs across the country and also a number of online programs. The CDC offers resources for organizations who want to implement their own NDPP in their communities. Prediabetes and diabetes impacts millions of Americans, but awareness is growing the public’s knowledge through media campaigns and community-based prevention programs like the NDPP.

Improving Early Care and Education Settings to Prevent Obesity in Children

Last week, the CDC’s Division of Nutrition, Physical Activity, and Obesity released its first ever state indicator report on obesity prevention efforts in Early Care and Education (ECE) settings. The report provides data for all 50 states and highlights state-specific case studies that have proven to be successful.

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CDC’s Spectrum of Opportunities for Obesity Prevention in ECE Settings

What is an Early Care and Education Setting?

According to the CDC’s website, “Early care and education (ECE) is a key setting to address childhood obesity for children under 5.” Broadly defined, an ECE setting is anywhere a child under the age of 5 receives care outside of the home. More specifically, the CDC highlights:

  • Child care centers
  • In-home daycare
  • Pre-kindergarten programs
  • Headstart facilities

headstart and obesity

What metrics do they use?

The report looks at a wide variety of programs, interventions, and policy changes.

Table 1 Table 2

What does the report discover?

Some positive findings of the report include:

  • Forty-five states support “farm to early care and education” (F2ECE) programs through state or local activities.
  • Forty states have a group or task force that meets regularly to address obesity prevention in ECE settings.
  • Forty-two states offer professional development training for ECE providers that incorporate obesity prevention topics.

But there is room for improvement. Of the 47 high impact obesity prevention standards, the most any state fully met in 2014 was 15. Moreover, only 24 states reported having a recognition or designation program like “Breastfeeding Friendly Child Care.”

Is your state, county or community embracing policies and programs that support obesity prevention in ECE settings? Tell us about your efforts in the comments! Read the full report here and learn more about the CDC’s Spectrum of Opportunities for Obesity Prevention in ECE Settings.

Salud America! Launches New Report for Members

SA-logoCommunity Commons and its partner Salud America! are excited to announce the release of a new, custom tool: The Salud Report Card!

This new tool is designed to help identify and communicate what health issues are important to you and your community. The report can be downloaded, printed and shared online making it easy to provide vital information to key figures like local and state PTA, health departments, city leaders, friends, and family.

Know the Issues, Start a Change

Want to begin to address and help solve health issues facing Latinos and their children? Learn more about Salud America! by watching our recent webinar where we first announced the Salud Report Card.

The Salud America! Hub provides comprehensive content, resources, and research; which suggests lots of achievable healthy changes. You can also view some of the many posts about policy changes happening now, or follow the footsteps of the many Salud Heroes making an impact in their communities. For example, building a fitness trail!

Create a Report in Your Area

The Salud Report Card highlights key health issues in your county with data, policy solutions, research, and stories so you can start and support healthy changes for Latino kids. One of the largest hubs on the site, members of Salud America! are able to create these geo-located reports, using mapping and data tools on the provided by Community Commons.

SA! Report Highlights

Simply select your state and county and the Report Card will specifically exam the following in your county:

  • Obesity
  • Food Access
  • Physical Activity Issues
  • Health Equity
  • Vulnerable Populations

The Report Card can help you quickly get data and research in to the hands of those who need it most, and can be used to justify and advocate for grant funding and policy change. Which of the topics in the Report Card stand out in your county? Comment below and tell us what you think of this new tool.

Need Help?

Email Salud America! digital curators, Eric, Lisa, and Amanda at saludamerica@uthscsa.edu. They can answer questions and help you access information and data/maps on many other topics.

For Latinos, Access to Healthy Foods Can Be Sporadic

The following was published on bread.org by the National Council of La Raza

Healthy food choices are much easier to make in a supportive food environment—where healthier foods, such as fresh fruits and vegetables and foods that are less processed, are available and affordable. Too many Hispanic families do not live in a supportive food environment. Counties with large Hispanic populations have a greater proportion of people with limited access to grocery stores (29 percent) than other counties do (21 percent). Latino children and low-income people are at particular risk (see figure to the left).

In a national survey, more than 10 percent of Hispanics reported difficulty in accessing affordable fresh fruits and vegetables—a higher rate than any other racial/ ethnic group. The survey also found that access to fresh produce is linked with better health: people who reported that they were in poor health were four times as likely to face access barriers as people who said they were in excellent health (20 percent vs. 5 percent).

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Research shows that larger chain supermarkets tend to carry more healthy food items, such as produce, at lower prices, while smaller convenience stores tend to carry less fresh produce and more snack foods that are calorie-rich but nutrient-poor. Thus, neighborhood convenience stores typically cannot compensate for the lack of a supermarket that offers healthy foods.

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Hispanic neighborhoods, particularly those in nonurban areas, have almost one-third fewer chain supermarkets but more convenience stores than non-Hispanic neighborhoods. Better access to chain supermarkets has been associated with lower adolescent body-mass index (BMI) scores and lower rates of overweight. Greater access to convenience stores, in contrast, has been associated with higher BMI and frequency of overweight. Latino children have high rates of overweight and obesity and are consequently more likely to develop largely preventable diseases such as diabetes. All signs indicate that any discussion of public health should include a look at the local food environment.

The National Council of La Raza—the largest national Hispanic civil rights and advocacy organization in the United States—works to improve opportunities for Hispanic Americans. This story originally appeared on page 26 of the 2016 Hunger Report: The Nourishing Effect.

Six Things to Expect from the FDA’s New Food Labels

In May, the FDA finalized changes to the nutrition facts label for the first time in 20 years. By summer of 2018, consumers will notice a difference on the labels of food products. These changes reflect new scientific information, such as the link between diet and chronic diseases. The FDA hopes that the new label will help consumers make better-informed food choices and begin to build awareness right at the point where food purchases are made.

foodlabel

Image courtesy of Food and Drug Administration

1. Sugars Added

The new labels will include added sugars in grams and the percent daily value.  While natural sugars are perfectly healthy, the American Heart Association recommends only consuming 6 teaspoons/24 grams of sugar per day.  This can be hard, as many foods contain both natural sugars and added sugars.  There are hopes that this addition will help reduce the risk of obesity, type 2 diabetes, and heart disease.  It will also help the public understand just how much sugar they are consuming in a day.  For example, a consumer will now know that when they drink a 20 ounce soda, they are also drinking  130% of the suggested daily added sugar limit.

2. Vitamin List

Food manufacturers will now be required to state the actual amount and percent daily value of vitamin D, calcium, iron, and potassium. The daily value of these nutrients are being updated based on new scientific evidence.  Vitamin D and potassium are getting added to the labels because they are nutrients that Americans are often lacking.  Although vitamin A and vitamin C are important, deficiencies are rare so there is less need to focus on them.

3. Serving Sizes

Have you ever eaten just 4 potato chips or drank just 8 ounces of a 12 ounce soda?  Research shows that not many Americans do.  The average American eats more today than they did in 1994 (the last time the labeling was changed), so the new serving sizes will better reflect what the average American actually consumes.  By law, labels must reflect what Americans typically consume, not what they should consume. Food and drinks that are between one and two servings, such as a 20 ounce soda, will now be considered one serving since most people would finish it in one sitting.

4. Calorie Counts

More than 77% of Americans use the nutrition facts label when shopping, however, most shoppers only glance at it for a few seconds. Calories and servings per container will now be in a larger type and bolded in hopes to positively impact the consumers choice.  “Calories from Fat” is being removed because recent research shows that the type of fat is more important than the amount of fat.

5. Dual Column

Instead of only listing calories and nutrients per serving, manufacturers will now have to also list calories and nutrients per package, hence adding an extra column to the label.  The change is also due to the fact that many Americans eat the entire package of what they are eating in one sitting.

6. Footnotes

The footnote about percent daily value will now say: “The % Daily Value tells you how much a nutrient in a serving of food contributes to a daily diet.  2,000 calories a day is used for general nutrition advice.”

Foods imported to the U.S. will also need to meet the new label requirements. And many in the industry, like the Grocery’s Manufacturer’s Association, have already been making the shift towards including better information on their food packaging.

Air Pollution: A Trigger for Obesity and Diabetes

We know air pollution is linked to cancer and respiratory diseases, but can it also increase your risk for obesity and diabetes? That’s what the latest research from The Official Journal of the Federation of American Societies for Experimental Biology suggests.

In a study out of Duke University, researchers analyzed rats who were given the same diet and exposed to either samples of Beijing’s polluted air or to filtered air for 19 days. Rats exposed to the polluted air were found to have 50% higher bad cholesterol levels, 46% higher triglyceride levels, higher insulin resistance, and male and female rats were heavier (18% and 10%, respectively) than rats exposed to filtered air.

All of the conditions experienced by the rats breathing polluted air are factors that can lead to obesity and diabetes.  One of the study’s researchers, Junfeng “Jim” Zhang, a professor of global and environmental health at Duke University and Duke Kunshan University explained why this matters to humans in a recent press release:

“Since chronic inflammation is recognized as a factor contributing to obesity and since metabolic diseases such as diabetes and obesity are closely related, our findings provide clear evidence that chronic exposure to air pollution increases the risk for developing obesity. If translated and verified in humans, these findings will support the urgent need to reduce air pollution, given the growing burden of obesity in today’s highly polluted world,” said Zhang. 

Air pollution in the U.S. affects more than just urban areas

Given the new evidence that air pollution may contribute to obesity, it’s important to consider which populations are most affected. While urban areas have gotten a lot of the spotlight as highly polluted areas, there have been some improvements.  In fact, after the Clean Air Act (1970) was adopted, the six main pollutants monitored by the Environmental Protection Agency have dropped 69% in aggregate. To what is this success owed?  Urban areas have cut down on harmful emissions from factories by implementing clean technologies and introducing cleaner fuels and engines. These changes have benefited urban areas, however rural air pollution is often overlooked. Rural America is exposed to pollutants from natural sources like coal fires, forest fires, and dust storms, but also toxins from man-made sources like insecticide/pesticide sprays, diesel-fueled machines, biomass fuels, cigarette smoke, and “trans pollution”, or pollution that is carried by wind from urban to rural areas.

When you look at the concentration of Fine Particulate Matter (PM 2.5), one of the six main pollutants the EPA monitors, many urban and rural areas are afflicted with high average concentrations. Rural areas from Idaho to West Virginia see not only higher concentrations, but also experience a higher percentage of days above the National Ambient Air Quality Standards (NAAQS) for some of these pollutants.

Fine Particulate Matter Concentration

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Moving forward, it is important  to not only study the impact of air pollution in urban areas like Beijing or Los Angeles, but also rural parts of the U.S., where chronic diseases like obesity and diabetes are especially prevalent.

Diabetes and obesity in rural America

Eighty-six million Americans have prediabetes, but 90 percent of them don’t know it.  There are a number of genetic factors that can contribute to diabetes, but behaviors like unhealthy eating and physical inactivity increase the likelihood of prediabetes progressing to type 2 diabetes (and obesity). The hardest hit areas are in rural America. Arkansas, West Virginia, and Mississippi have the highest rates of obesity while West Virginia, Tennessee, and Mississippi have the highest rates of diabetes.

diabetes prevalence map

When it comes to preventing and managing chronic diseases like diabetes and obesity, rural Americans face unique barriers. In addition to air pollution, they must contend with, limited transportation, poor access to health care and health care educational opportunities, inability to afford health care, and limited access to environments that enable healthy behaviors (i.e. fresh food, walkable areas).

These barriers coupled with chronic exposure to air pollutants, exacerbates health issues people in rural communities already face. That’s why the findings out of the Duke University study add an important discussion point to the ongoing conversations about preventing and managing obesity and diabetes in urban and rural communities.

Data Viz of the Week: Obesity, Diabetes Most Searched in 2015

In January, our team reviewed the past twelve months of site data to better understand our online community.  While we’re still learning what members of Community Commons are doing with the site one piece of information we were recently able to take a closer look at was search terms.

What are members searching for on Community Commons?  While a variety of search terms were entered on the site in 2015, we noticed a high amount of searches related to chronic disease. This week we are highlighting some of that data, specifically: obesity and diabetes.

Obesity

Obesity Map

‘Obesity’ was the most frequently searched term on Community Commons in 2015. Besides the map above, here are other obesity-related data sets available on Community Commons:

Diabetes

The third most searched term in 2015 was diabetes. Here are three data sets illustrating  incidence, prevalence and mortality.

Diabetes IncidenceDiabetes Prevalence

Map: Diabetes Mortality

You can also create a CHNA Report on the Commons to visualize trends over time. Just select your State and County, then choose the health outcomes category in your report!

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Getting the Fat out of ‘Food Deserts’ Will Take Time

This was previously published by the Chattanooga Times Free Press and written by Steve Johnson. The online version of this article has a Community Commons map embedded that allows readers to visualize the areas discussed.

It’s not difficult finding where Chattanooga’s heaviest residents live.

Drive out 38th Street in Alton Park, or swing northeast through Churchville and Bushtown. The houses are smaller and some are likely to be in need of repair. Local businesses tend to be small mom-and-pop affairs, and good luck finding a grocery store.

There’s even a name for these neighborhoods—“food deserts.”

John Bilderback, a nutrition expert with the Chattanooga-Hamilton County Health Department, has helped prepare a map showing the extent of Chattanooga’s food deserts. He’s plotted the location of grocery stores, and there are obvious blank spots where there is no easy access to fresh produce.

They generally match up with the poorest parts of town, so residents there are not a promising target for grocery stores. And they can’t afford a car to drive to a grocery store.

This map is a great example of how a community added local data to a Commons map and then shared that map with the residents of that area.

This map was created by John Bilderback in a Hub on Community Commons. It’s a great example of how a community added local data to a Commons map and then shared that map with area residents.. Learn more about uploading your own data here.

“Communities with low median income—grocery stores tend to not set up operations in neighborhoods like that,” Bilderback said. “So you have a higher incidence of corner stores and restaurants, but no access to healthy foods.”

Food deserts are not the only reason why low-income people tend to be overweight, but they’re an important reason, say health officials who are trying to address the nation’s growing obesity problem.

Obesity is deadly—and expensive. Its rapid rise is a major factor driving up health care costs nationally.

According to the Campaign to End Obesity, about a third of all cancer deaths are linked to excess body weight, poor nutrition and a lack of physical activity. Obesity is blamed for three-fourths of all high-blood pressure cases. Two-thirds of all adults with Type 2 diabetes are overweight. And, per capita, medical spending for obese people is $2,741 greater than for people of normal weight.

Making healthy choices is a lot harder for those with limited access to transportation.

“While a market may be within walking distance, the safety issues in rough neighborhoods make it unlikely most people will make the effort to trek a distance from home to buy food,” said Pamela Kelle, a local registered dietitian and nutritionist who runs the Your Own Food Coach website. “Other transportation may be available, but have you ever tried to carry several bags of groceries on your lap on a bus?”

Food deserts started getting attention locally in 2012 after Food Lion closed most of its Chattanooga stores, according to the YMCA’s Bill Rush, who manages the organization’s Pioneering Healthy Communities project.

The company had three stores in inner-city Chattanooga, and when they shut down, no one rushed in to take their place.

Several groups in Chattanooga have been trying to solve the problem by bringing fresh produce to areas where it previously has not been available.

For several years, the YMCA has sponsored produce trucks that have made regular rounds in food desert neighborhoods, offering fresh fruits and vegetables. But YMCA officials realized they needed a longer-term solution, so they have begun working with local food store owners to expand their produce offerings. The Y offers advice and financial assistance in purchasing coolers and also helps store owners find local farmers who can supply fruits and vegetables.

Rush says he is negotiating with two other store owners and hopes to have a fourth in place within a few months.

But everyone involved in the battle against obesity concedes that the problem is greater than merely giving everyone access to fresh fruits and vegetables.

It’s no surprise that the South is the most overweight region in the U.S., said Dr. David Schlundt, a Vanderbilt University psychology professor who has studied the problem. He argues that while the way we work has changed, our diets have not.

“When most people were employed in agriculture, you needed lots of calories to get you through all of that hard work,” he said. “But now, you’re going to drive your car and sit on a chair at a 7-Eleven all day, so you don’t need biscuits and gravy, or fried chicken or other fried foods.”

Breaking away from that diet may not be easy.

“The DNA we inherit on how to prepare food is important,” Rush said. “Even if we have access to healthy food, how do we fix it healthier? Does it taste good? Our taste buds are developed when we’re young. Learning and appreciating new tastes can be challenging.”

“If you are a single mother, head of household raising children at poverty level, you’re having to scramble to get a lot done just to survive,” Schlundt said. “You don’t have the time or energy to do a salad with a low-fat dressing.”

“Sometimes eating or overeating is a way of coping with stress or adversity,” he added. “And some people just really like to eat.”

And all around us there is advertising, touting the latest fast-food special.

“When you take a look at what’s being marketed dollar-wise and who it’s being marketed to, that has a direct correlation to the epidemic we’re in,” Rush said.

Countering that message takes a big educational effort. The Chattanooga Area Food Bank has launched a pilot program at Orchard Knob Elementary School to teach second- and fourth-graders the importance of healthy food choices, including giving them a “Sack Pack” of nutritional snacks to take home over the weekend.

The health department has helped fund dozens of community gardens to promote food awareness.

“When a kid is involved in growing fruits and vegetables, they are much more likely to at least try those fruits and vegetables,” Bilderback said. “If you have grown broccoli, you are much more likely to eat broccoli.”

But changing bad eating habits is not going to be easy.

“There has to be an incentive to eat healthy foods,” Kelle said. “It may take another entire generation to address the culture issues surrounding foods and teach our young why it is the best insurance policy for a healthy life.”

Contact staff writer Steve Johnson at sjohnson@timesfreepress.com.

ALBD: Ten Years of Lessons Learned

Join Community Commons in congratulating Active Living By Design on their ten years of pioneering work in active living and healthy eating. Over the course of several weeks, the Commons will highlight ALBD’s commemorative milestones in a series of Features.

Pioneering projects don’t come with a guidebook; it is written along the way so that others may have an easier path. ALBD offers these lessons learned to help clear the way for continued work. Read more

ALBD: Ten Years of Partnerships

Join Community Commons in congratulating Active Living By Design on their ten years of pioneering work in active living and healthy eating. Over the next several weeks, the Commons will highlight ALBD’s commemorative milestones in a series of Features.

It takes a village to create community change. Active Living By Design is fortunate to have had an wide array of villagers take up the cause of making the healthy choice the easy choice. The graphic below, followed by reflections from individual partners, celebrates what working together can do for the common good. Read more

ALBD: Ten Years of Reflections

Join Community Commons in congratulating Active Living By Design on their ten years of pioneering work in active living and healthy eating. Over the next several weeks, the Commons will highlight ALBD’s commemorative milestones in a series of Features.

Reflection allows us to create meaning and transfer learning to new context. Images reflected through a camera lens, combined with words of reflection by ALBD staff, paint a vivid picture of the impact this movement has, and will continue to have, on creating healthy communities. Read more