March 11, 2005

Perspective change needed in obesity prevention

March is National Nutrition Month

The idea that eating right and getting physical activity are solely governed by personal responsibility is a concept of the past, according to University of California nutrition experts. Terms such as “environment” and “community” are now creeping into the lexicon of obesity prevention.

“We live in an environment that promotes a sedentary lifestyle and eating foods of poor nutritional quality,” said Joanne Ikeda, co-director of the UC Berkeley Center for Weight and Health.

Human taste preferences for fat, sugar and salt are biological in origin. However, the federal Dietary Guidelines for Americans 2005, which is based on the most recent scientific findings on healthful eating, recommends diets that “limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.”

“We know that eating right doesn’t come naturally for most people. This underscores the need to modify environments so that making healthful choices is easier for adults and children,” Ikeda said.

As the country marks National Nutrition Month in March, the UC Berkeley Center for Weight and Health and UC Cooperative Extension continue their campaign to take a broader view of the increasing overweight and obesity problem in California.

According to the U.S. Centers for Disease Control and Prevention, the percentage of children and adolescents who are defined as overweight has tripled since the early 1970s. Results from the 1999-2002 National Health and Nutrition Examination Survey indicate that more than 15 percent of 6- to 19-year-olds are overweight.

According to a 2002 report from the California Center for Public Health Advocacy, 26.5 percent of the children in California are overweight. This rate coupled with California’s population make the state home to the largest number of overweight children in the nation.

UC experts say making the environment a healthy food and fitness zone requires the involvement of individuals, organizations, businesses and government in ways that haven’t traditionally been related to the health and welfare of the population.

“We need to bring together people in all areas of society,” said Patricia Crawford, another co-director of the UC Berkeley Center for Weight and Health. “People working in parks and recreation departments, city planning, our transportation system, heath care, the food and beverage industries, law enforcement, the public health arena and education must realize they can all have a role in reducing obesity.”

The steady decline in cigarette smoking shows how the environment, rather than just personal responsibility, can effect change. Particularly in California, smoking is no longer a convenient habit. Laws have relegated all public smoking outdoors, taxes have increased the price, educational campaigns have taught children the dangers, insurance companies have offered non-smoking incentives, advertising has discouraged the habit, and agencies and employers have offered stop-smoking programs. The nutritionists acknowledge, however, that overweight prevention is a little trickier.

“With tobacco, the message was easy: Don’t smoke,” Crawford said. “However, everybody has to eat. The similarity with tobacco is this: The first step in our change in tobacco was that we had to learn there was a problem. We are at that level now. We are definitely aware of obesity and we are hearing more about it everyday. The next phase is making environmental changes that make it easier for people to eat healthy and be active. That’s the step we’re trying to move into.”

Besides the family home, children’s primary environment is school. The State of California requires concepts in nutrition and physical activity to be part of the curriculum from kindergarten through high school, but it offers great latitude to school districts and individual campuses about the environment they provide for children and adolescents.

“Schools are an example of environments that used to promote healthy lifestyles and now, they may promote it in words, but not in action,” Ikeda said.

To transform schools into an environment where children can learn and practice healthful eating and physical activity certain barriers must be overcome. For example, Crawford said, schools are often closed after classes have been dismissed and the grounds and facilities are not available for free play.

“It’s not just the school’s fault. It’s a problem that has to be solved by many because it may be something like litigation that the schools are concerned about,” Crawford said.

Schools also feel compelled to accept contracts with soda companies and vend candy because their activities are not sufficiently funded with public money. Forced to keep their food service programs self-supporting, the schools have become purveyors of junk food. According to the 2002 California High School Fast Food Survey, french fries, chips, cookies, yogurt, bagels, ice cream and sodas accounted for 70 percent of all food sales at 71 percent of the school districts surveyed. Brand-name products proliferate: more than half the schools carry Taco Bell, Subway, Dominos, Pizza Hut or other branded foods. More than 85 percent of the districts that sell fast foods as a la carte items use the profits from sales of these foods to support their food service operations. Others use the profits to support other aspects of school functioning, including extracurricular activities, athletics and educational programs.

The Center for Weight and Health offers suggestions for groups and agencies to modify the environment:

Health care and health insurance providers — Offer weight management services, monitor patients to identify unhealthful trends toward overweight early, and educate patients and the community on healthful eating and physical activity.

Urban planning — Make parks, sidewalks, walking paths and bike trails a part of the community. Plan cities so that schools, parks and services are within walking distances of residences.

Urban development — Encourage and offer incentives for supermarkets and farmers’ markets in areas that have limited access to fresh fruits and vegetables.

Government legislation — Regulate food sales at schools and food and beverage advertising to children. Require nutrition information on restaurant menus.

Law enforcement — Increase law enforcement visibility at parks. Step up residents’ involvement in community safety programs.

Individual families can also have an impact on the healthfulness of the environment in which they live. Following are activities that can be undertaken to begin transforming the environment into one that promotes a more healthful lifestyle:

• Draw a map of walking paths and bike riding trails in the community and distribute it to community members.

• Clean up local parks.

• Put up a basketball hoop.

• Form a neighborhood watch program with the police department.

• Plant a vegetable garden.

• Bring vegetables or fruit salad to a pot luck meal.

• Hand out oranges or apples as an after-game snack.

• Join the parent-teacher group at the local school and promote nutrition and physical activity.

• Support fund raisers that involve physical activity, such as car washes and jog-a-thons, rather than candy or cookie dough sales.

• Buy more produce.

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