Obesity 2013 Version | Children’s Health Crisis | NPT Reports

Obesity 2013 Version | Children’s Health Crisis | NPT Reports


IN TENNESSEE, 1 OUT
OF EVERY 5 CHILDREN IS OBESE- THE 5TH HIGHEST
RATE IN THE UNITED STATES. MORE THAN 35% OF
KIDS IN TN REPORTED WATCHING TV FOR MORE
THAN 3HRS ON ANY GIVEN SCHOOL DAY. 7 OUT OF 10 CHILDREN
DO NOT GET THE RECOMMENDED LEVELS
OF PHYSICAL ACTIVITY. ACROSS THE US, ALL BUT
THREE STATES HAVE SEEN CHILDHOOD OBESITY
RATES LEVEL OR DECLINE IN RECENT YEARS. IN TENNESSEE,
CHILDHOOD OBESITY IS STILL ON THE RISE. IF THESE
RATES CONTINUE, TN’S CURRENT
GENERATION OF CHILDREN WILL NOT LIVE AS
LONG AS THEIR PARENTS. MAJOR FUNDING FOR
NPT REPORTS CHILDREN’S HEALTH CRISIS IS
PROVIDED BY: THE HEALTHWAYS
FOUNDATION—ADDRESSIN G THE CRITICAL ISSUES
OF CHILDREN’S HEALTH AND PUBLIC EDUCATION
THE NASHVILLE HEALTH CARE COUNCIL THE HCA
FOUNDATION ON BEHALF OF TRI STAR HEALTH THE
METRO NASHVILLE PUBLIC HEALTH DEPARTMENT
THROUGH A GRANT FROM THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES AND THE
CENTERS FOR DISEASE CONTROL AND PREVENTION
ADDITIONAL FUNDING PROVIDED BY: THE
MONROE CARELL JR. CHILDREN’S HOSPITAL
AT VANDERBILT AND THE BAPTIST HEALING TRUST
AND BY MEMBERS OF NPT. HELLO I’M KIMBERLY
WILLIAMS PAISLEY. LIKE ALL PARENTS, I
HOPE MY CHILDREN LIVE A LONG AND
HEALTHY LIFE. HOWEVER, IN A
RECENT STUDY, TENNESSEE’S CHILDREN
RANKED AMONG THE MOST OVERWEIGHT IN
THE COUNTRY. EXPERTS BELIEVE
THAT IF THIS TREND CONTINUES, THE CURRENT
GENERATION OF CHILDREN WILL NOT LIVE AS
LONG AS THEIR PARENTS. WHY DO OUR CHILDREN
RANK SO POORLY IN OBESITY RATES? WHY HAVE RATES
SKYROCKETED IN JUST A FEW DECADES? HOW CAN WE STOP-
AND EVEN REVERSE- THE EXPANDING WAISTLINES
IN OUR CHILDREN? JOIN ME AS WE EXPLORE
THE ANSWERS TO THESE QUESTIONS ON
THIS EDITION OF NPT REPORTS: CHILDREN’S
HEALTH CRISIS AS A YOUNG GIRL, OLIVIA
ANCHONDO WAS LIKE ANY GIRL HER AGE,
WITH ONE EXCEPTION. SHE WAS VERY
ACTIVE, SHE CHEERED, SHE STARTED WHEN SHE
WAS FIVE // AND SHE PLAYED SOCCER LIKE
ANY GIRL HER AGE, WITH ONE EXCEPTION
SHE’S ALWAYS BEEN OFF THE CHARTS FOR
HEIGHT AND WEIGHT, AND BECAUSE
OF HER HEIGHT, HER WEIGHT
BLENDED EVENTUALLY, OLIVIA’S HEIGHT
COULDN’T ACCOUNT FOR HER ADDITIONAL WEIGHT. THE LAST THREE
CHECKUPS FROM, LIKE 10,11,12, WE
TALKED ABOUT THE WEIGHT, BUT WE TRIED
TO DO IT OURSELVES. WE KNEW THAT MOST OF
THE THINGS THAT WE WERE EATING
WERE NOT HEALTHY, MAINLY IT WAS OUTSIDE,
FAST FOOD BUT I DIDN’T KNOW HOW TO CHANGE
IT BECAUSE WE WERE SO BUSY. AND AS A SINGLE MOTHER
I NEEDED SOMETHING PROFESSIONAL, AND I
NEEDED THE DOCTOR TO TELL THEM HOW TO EAT. ON THE ADVICE
OF HER DOCTOR, WENDY SMITH WORKED
WITH A NUTRITIONIST TO OVERHAUL WHAT AND HOW
SHE FED HER CHILDREN I CHANGED WHAT I BOUGHT. I DIDN’T HAVE A LOT OF
SWEETS IN THE HOUSE, IF WE DRANK COKE,
I CHANGED TO DIET, ICE CREAM TO YOGURT,
FRUITS AND VEGETABLES AND THINGS LIKE THAT. WENDY ALSO ENGAGED HER
DAUGHTERS IN ALL THE CHANGES AT FIRST WE
HAD TO WRITE DOWN EVERYTHING THAT WE ATE
AND THE CALORIES IN THERE. AND THE FUN PART ABOUT
IT IS THAT WE MADE IT A CONTEST TO SEE
WHO COULD EAT LESS CALORIES, THE CALORIES
THAT YOU NEED EVERY DAY. OBVIOUSLY, MOM WON. I LEARNED FROM THE
NUTRITIONIST THAT WHEN YOU LOOK AT THE
NUTRITIONAL FACTS IT MAKES A REALLY BIG
DIFFERENCE BECAUSE A LOT OF PEOPLE
THINK THAT IT SAYS, OH! IT SAYS’ NOT SUGAR
THERE’S NO ADDED SUGAR IN THERE, BUT THERE
COULD BE FAT IN THERE THAT COULD BE
WORSE THAN SUGAR. ONE OF THE THINGS THAT
I LEARNED THROUGH ALL OF THIS IS YOU HAVE
TO TELL YOUR KIDS NO, AND THAT IT IS OKAY
TO TELL YOUR KIDS NO. AND THAT’S A HARD
THING TO INTAKE, BUT UM, WITH THE
NUTRITIONIST IT WAS JUST TO BACK IT
UP, AND TO JUST, YOU KNOW, TELL THE
KIDS FROM HER THAT YOU’RE GOING
TO BE TOLD NO, YOU KNOW SOME THINGS
YOU ARE JUST GOING TO HAVE TO CHOOSE. 9 MONTHS AFTER
CHANGING THEIR EATING HABITS, WENDY TOOK
OLIVIA BACK TO THE DOCTOR. SHE BROKE OUT ON
HER LEG WITH WHAT WE THOUGHT WERE LITTLE
PIMPLES ON HER LEG AND WE TOOK TO THE DOCTOR
AND THEY CHECKED HER BLOOD LEVELS, AND
HER A1C LEVELS WAS 6.7 WHICH IS THE
BORDERLINE DIABETIC AND SO BECAUSE
IT’S BORDER, IT’S RIGHT THERE, YOU
HAVE TO BE CAUTIOUS. THE DIABETES DOCTOR
TOLD US THAT IF I WOULDN’T HAD NOT TAKEN
HER TO A NUTRITIONIST THAT SHE WOULD
PROBABLY BE FULL-BLOWN BY NOW OLIVIA WAS DIAGNOSED
WITH TYPE 2 DIABETES AT THE AGE OF 12 AND
NOW MUST CHECK HER BLOOD SUGARS 4
TIMES A DAY AND TAKE MEDICATION
TWICE A DAY. IN THE LATE
1970S, EARLY 1980S, TYPE 2 DIABETES
WAS NEVER SEEN IN CHILDREN- THAT WAS THE
DISTINGUISHING FEATURE BETWEEN THE
2 DIABETES. WE SEE AS MUCH OR MORE
TYPE 2 DIABETES IN CHILDREN NOW AS WE DO
TYPE 1 AND THE REASON FOR THAT IS BECAUSE
THERE’S OBESITY. SO THERE’S A DRAMATIC
EXAMPLE OF 30 YEARS OF THE CHANGING OF THE
ENTIRE EPIDEMIOLOGY OF A SERIOUS DISEASE,
MOVING INTO CHILDHOOD BECAUSE OF OBESITY. IN TENNESSEE, 34%
OF CHILDREN ARE OVERWEIGHT OR OBESE. AND CHILDREN FOLLOW
THEIR PARENTS- THE GROWTH IN CHILDHOOD
OBESITY RATES PARALLEL ADULT RATES. IN 2004 NO STATES
HAD ADULT OBESITY RATES GREATER THAN
30 PERCENT NOW 13 DO. OF THE 13 STATES WITH THE
HIGHEST RATES SIX WERE IN
THE SOUTHEAST. WE HAVE SIMILAR
POPULATIONS BOTH DEMOGRAPHICALLY
AND ETHNICALLY AND SOCIO-ECONOMICALLY. WE HAVE SIMILAR
CHALLENGES WITH REGARDS TO
EDUCATION AND INCOME DISTRIBUTION. THERE ARE ALSO
CULTURAL INFLUENCES AS WELL AS
SOCIETAL INFLUENCES. WE KNOW IN THE
SOUTH THAT WE USE FOOD FREQUENTLY AS A
MEANS OF CELEBRATION, AS A MEANS OF
GATHERING AND RECREATING AND THE WAY
THAT WE PREPARE FOOD OFTEN CAN BE
LESS NUTRITIOUS. THIS IS AN EPIDEMIC
THAT MOST DEVELOPED NATIONS AROUND THE
WORLD ARE ACTUALLY EXPERIENCING. WE ARE AHEAD OF
MOST OF THEM, AND I THINK THE CAUSES
FOR THAT ARE BECAUSE WE’VE ACTUALLY GOTTEN
OUT OF BALANCE EARLIER THAN THEY HAVE, AND
THEREFORE WERE HAVING A GREATER
IMPACT EARLIER. IT IS
AFFECTING OUR ADULTS. OVER 50%, MAYBE
EVEN TWO THIRDS, OF ADULTS IN THE
UNITED STATES ARE OVERWEIGHT OR OBESE. IT’S AFFECTING OUR
HEALTH CARE COSTS. IT’S AFFECTING OUR
ABSENTEEISM AND EVEN PRESENTEEISM-
BEING ON THE JOB, BUT NOT BEING
ABLE TO DO THE JOB. SO THIS IS ACTUALLY
STARTING TO AFFECT OUR WORKFORCE. THE PREVENTABLE
MEDICAL COSTS AS A RESULT OF OBESITY ARE
ESTIMATED NOW AT OVER 145 BILLION A YEAR
IN THIS COUNTRY. I MEAN, LET’S PUT
THAT IN PERSPECTIVE, THAT’S $500 PER
YEAR FOR EVERY MAN, WOMAN AND CHILD IN
THIS COUNTRY FOR A PREVENTABLE SITUATION. IN TENNESSEE ALONE IF
OUR RATES OF OBESITY WERE TO PLATEAU,
JUST TO PLATEAU, AND NOT EVEN A DECLINE
THE STATE COULD SAVE OVER $700 MILLION
A YEAR IN OBESITY RELATED MEDICAL COSTS. THAT’S MEDICAL
COSTS ALONE. SOMETHING LIKE 80% OF
KIDS WHO ARE OBESE BY AGE 15 WILL BE
OBESE AS ADULTS. THEN WHAT HAPPENS IS,
OBESITY DRAMATICALLY INCREASES THE CHANCE
OF YOU GETTING CHRONIC DISEASES
LIKE DIABETES, HEART DISEASE ETC. THE
PROBLEM WITH OBESITY IS, THE EFFECTS OF
IT START RIGHT AWAY, BUT THE SIGNS AND
SYMPTOMS THAT WE SEE ARE MUCH LATER. SO IN SOME WAYS, IT’S
ANOTHER SILENT KILLER. IT’S SOMETHING THAT
PILES UP OVER TIME. THE LATER
IT’S RECOGNIZED, THE LESS LIKELY CHANCE
THAT WE’LL HAVE TO REVERSE THOSE EFFECTS. SO IF A CHILD WHOSE
BEEN OVERWEIGHT SINCE THE TIME THEY
WERE EIGHT OR NINE, AND NOW AS A YOUNG
ADULT OF THIRTY OR THIRTY-FIVE AND THEY
DECIDE TO LOSE WEIGHT, THEY HAVE ALREADY HAD
EFFECTS ON THEIR HEART AND ON THEIR BLOOD
VESSELS WHICH MAY NEVER BE REVERSED. WE LIVE IN A STATE AND
A CITY IN WHICH ASTHMA IS A BIG PROBLEM
AMONG CHILDREN, LOW-INCOME
CHILDREN ESPECIALLY. ASTHMA IS EVEN MORE
OF OUR PROBLEMS IN CHILDREN WHO
ARE OBESE. SO YOU’RE IN A
HIGH-RISK ENVIRONMENT FOR ASTHMA
FOR CHILDREN, AND YOU ADD OBESITY
AND BEING OVERWEIGHT INTO THAT CATEGORY
AND YOU GET EVEN MORE PROBLEMS. ALMOST EVERY
OBESE CHILD I SEE HAS ASSOCIATED
ASTHMA AS WELL. OBESE CHILDREN CAN
ALSO SUFFER FROM: SLEEP APNEA, HIGH
BLOOD PRESSURE, EARLY PUBERTY, BONE
AND JOINT PROBLEMS, AND LIMITATIONS ON
PHYSICAL ACTIVITY. OLIVIA HAD
TROUBLE WITH HER KNEE, WHICH WE…MOST OF IT
WAS FROM WEIGHT AND SO SHE HAD TO GO TO
PHYSICAL THERAPY WE KNOW WHEN WE SEE A
12 YEAR OLD WHO’S MARKEDLY OBESE,
THAT THERE IS NO WAY, UNLESS WE
AFFECT CHANGE, THAT THAT CHILD WILL
NOT ESCAPE THE EFFECTS OF DIABETES AND STROKE
AND HEART ATTACK AND HYPER TENSION IN
THEIR LATE THIRTIES OR FORTIES: BLINDNESS,
VASCULAR PROBLEMS IN THE LEGS,
HEART ATTACKS, STROKE. ALL THE LONG-TERM
COMPLICATIONS WITH A FAMILY HISTORY
OF DIABETES, OLIVIA AND WENDY KNOW
WELL THOSE LONG TERM CONSEQUENCES. EVEN THOUGH OLIVIA
SHOWS NO OUTWARD SIGNS OF HER DIABETES,
THE KNOWLEDGE OF WHAT COULD HAPPEN PROVIDES
MOTIVATION TO MANAGE HER ILLNESS WELL NOW. THE DOCTORS HAVE
TOLD ME THAT DIABETES DOESN’T GO AWAY,
THAT ONCE YOU GET IT, YOU HAVE IT — THE
LOWEST THAT YOU CAN CHECK YOUR SUGAR IS
AT LEAST ONCE A DAY. AND LIKE, YOU
CAN’T JUST GO ON NOT CHECKING YOUR SUGAR. I DON’T THINK THEY
UNDERSTAND THE FUTURE OF IT, IF YOU DON’T
TAKE CARE OF IT NOW. SO THAT’S WHY I’M
SO PASSIONATE ABOUT, YOU KNOW, TO
GET CHECKED, AND IF YOU NEED TO
GO TO THE DOCTOR, GO, GO TO YOUR
APPOINTMENTS. DO WHAT THE DOCTOR
TELLS YOU TO DO. BECAUSE YOU
CAN FIGHT IT, BECAUSE SHE IS…SHE
IS FIGHTING IT. OBESITY CAN ALSO LEAD
TO PROBLEMS BEYOND THE PHYSICAL
COMPLICATIONS. OBESITY LEADS TO
SOCIAL ISOLATION. YOU CAN’T PLAY
ON A SPORTS TEAM, YOU’RE THE LAST
PERSON PICKED, YOU CAN’T BUY CLOTHES
AT THE STORE THE SAME WAY EVERYONE ELSE
CAN BUY CLOTHES. WHEN DATING COMES
YOU’RE NOT THE PERSON PICKED TO DATE. OVER TIME, THAT
BECOMES INCREDIBLY ISOLATING FOR
MOST CHILDREN. AND OBESITY IS SUCH A
PROBLEM SOCIALLY FOR CHILDREN THAT THEY
OFTEN TIMES NEVER FURTHER ADAPT LATER
ON IN THEIR LIVES. EVEN IF THEY
LOSE WEIGHT. GABBY IS A
SOCCER PLAYER. SHE WAS GOALIE BECAUSE
SHE WAS BIGGER AND TALLER THAN THE
KIDS ON THE TEAM, ALWAYS. BECAUSE SHE
WAS BIGGER, SHE DIDN’T WANT
TO RUN AS MUCH. THOUGH WENDY SMITH CHANGED HER
FAMILY’S DIET BECAUSE OF OLIVIA, GABBY HAS
BENEFITED AS WELL. ONCE WE
STARTED DOING THIS, SHE SAW THE
SHE COULD RUN, SO SHE DIDN’T WANT
TO BE GOALIE ANYMORE. BUT SHE SAW THAT. NOT ME, NOT THE
COACH, SHE DID. NOW I CAN RUN LONGER,
I CAN SWIM LONGER, AND YOU FEEL
BETTER WHEN YOU DO IT. LIKE AT FIRST
IT WAS JUST, UGH, I DON’T
WANT TO DO THIS, IS JUST TOO MUCH. LIKE, RUNNING ONE
LAP AROUND THE GYM WAS GOSH I DON’T
WANT TO DO THIS. BUT NOW I CAN
RUN 3 MILES, AND IT’S JUST – YOU
CAN BE UNSTOPPABLE. THERE’S LOTS OF
EVIDENCE THAT EVEN IF YOU DON’T LOSE
WEIGHT, BEING ACTIVE DRAMATICALLY
IMPROVES YOUR HEALTH. SO INCREASING ACTIVITY
IN KIDS IS LIKELY TO HELP THEM ACHIEVE
A HEALTHIER WEIGHT BECAUSE THEY HAVE NOT
YET FINISHED GROWING. BUT ADDITIONALLY,
SIMPLY BEING MORE ACTIVE WILL MAKE
THEM HEALTHIER. FAT IS AN ESSENTIAL
MECHANISM FOR SURVIVAL. IN THE DAYS
BEFORE GROCERY STORES, IF YOU DIDN’T SUCCEED
IN KILLING THAT SABERTOOTH
TIGER, YOU KNOW, FOR A WEEK OR SO, YOU
HAD TO RELY ON FAT TO SURVIVE. SO THE BRAIN, OVER
MILLIONS OF YEARS HAS FIGURED OUT HOW TO
KEEP THOSE ESSENTIAL FAT STORES IN PLACE
AND TO NOT LET THEM BE DEPLETED. ROGER CONE AND HIS
RESEARCH GROUP HAVE BEEN TRYING TO
UNDERSTAND THE COMPLEX INTERPLAY BETWEEN
ENVIRONMENT AND GENETICS IN
DETERMINING A PERSON’S WEIGHT. SOME PEOPLE CAN LIVE
IN THIS ENVIRONMENT THAT WE LIVE IN WITH
LOTS OF HIGH CALORIE FOODS ALL TIME AND
A LOT OF SEDENTARY ACTIVITY AND
YET REMAIN LEAN. OTHER PEOPLE IN
THAT ENVIRONMENT MORE READILY BECOME OBESE. SO GENES DETERMINE
THE IMPACT OF THE ENVIRONMENT ON YOU. IT TAKES THOUSANDS
OF YEARS FOR GENES TO CHANGE AND THE OBESITY
EPIDEMIC HAPPENED OVER THE LAST 30 YEARS. OUR GENES HAVEN’T
CHANGED OVER THE LAST 30 YEARS, BUT THE
ENVIRONMENT HAS. THE BASIC CAUSE OF
CHILDHOOD OBESITY IS RELATIVELY
STRAIGHTFORWARD AND SIMPLE. IT’S THE BALANCE OF
CALORIES THAT OUR CHILDREN ARE TAKING
IN EACH DAY EXCEED THE AMOUNT OF CALORIES
THEY BURN OFF THROUGH PLAY, DEVELOPMENT, AND
THEIR REGULAR DAILY ACTIVITIES. THAT BALANCE HAS
SHIFTED OVER THE LAST THREE DECADES. OUR KIDS ARE MUCH
LESS PHYSICALLY ACTIVE TODAY THAN
THEY USED TO BE, WE HAVE LESS PHYSICAL
EDUCATION & ACTIVITY IN SCHOOLS, OUR
PARENTS ARE CONCERNED ABOUT SAFETY SO KIDS
PLAY LESS OUTDOORS AFTER SCHOOL
AND ON WEEKENDS, THEY HAVE FEWER
PLACES TO GO PLAY. AND OUR
NUTRITIONAL SIDE, WE EAT FAR
MORE CALORIES, WE’RE EXPOSED TO SUGAR
SWEETENED BEVERAGES, WE HAVE MUCH MORE
CALORICALLY DENSE FOOD, FAMILIES DON’T
SIT DOWN AT THE DINNER TABLE ANYMORE, WE
SIT IN FRONT OF A TELEVISION. SO, THE ENVIRONMENT
THAT OUR KIDS ARE NOW LIVING IN IS A
MUCH MORE HOSTILE AND POTENTIALLY OBESIGENIC
ENVIRONMENT. TAMMY ALGOOD SPENDS A
LOT OF TIME IN GROCERY STORES- NOT SHOPPING
FOR FOOD BUT ANALYZING HOW PRODUCTS ARE
SOLD TO CONSUMERS. SO IMAGINE A CHILD
IS IN THIS CART, NOTICE WHAT THEY’RE
GOING TO BE SEEING THAT’S AT EYE
LEVEL AND EVEN OLDER CHILDREN ARE GOING TO
BE SEEING THIS AT EYE LEVEL. SO THESE ARE GOING
TO BE THE HIGH SUGAR CEREALS THAT ARE
ALWAYS GOING TO APPEAL TO CHILDREN. THE APPEAL:
CARTOON CHARACTERS, HIGH COLOR,
HIGH ENERGY. WHAT I’VE SEEN IS THAT
THIS DRAMATIC INCREASE IN TARGETING
CHILDREN FOR FOOD. CHILDREN USED TO NEVER
BE TARGETED FOR FOOD. NOW, THEY’RE
CONSTANTLY TARGETED FOR CERTAIN SNACKS,
OR CERTAIN THINGS THEY WANT TO CARRY IN
THEIR LUNCHBOX, OR WHAT THEY WANT
TO HAVE FOR DINNER. PESTER POWER
IS POWERFUL. //MANUFACTURERS
REALIZE THAT IN ORDER TO SOMETIMES
QUIET A CHILD, YOU’LL SAY OKAY FINE,
THAT’S WHAT WE’LL BUY. FOOD MANUFACTURERS
ALSO RESPONDED TO THE INCREASING NUMBER OF
WORKING PARENTS WITH LITTLE TIME TO PREPARE
A MEAL FROM SCRATCH. CONVENIENCE AND FAST
FOOD OPTIONS EXPLODED IN THE LAST 30 YEARS. TYPICALLY, THERE’S
NOTHING WRONG WITH CONVENIENCE OR
PROCESSED PRODUCTS. BUT WHAT WE’RE SEEING
IS THAT THOSE PRODUCTS ARE REPLACING FRESH IN
THE DIET AND WHEN THAT HAPPENS THAT’S WHEN
YOU SEE A SPIKE IN THE NUMBER OF CALORIES
THAT ARE CONSUMED THAT ARE ALWAYS GOING TO
LEAD TO EXCESS WEIGHT. AS FAMILIES EAT
OUT MORE OFTEN, EXPECTATIONS ABOUT
SERVING SIZE HAS CHANGED. RESTAURANTS AND FOOD
SERVICES ADVERTISE THE VALUE GETTING MORE
FOR LESS- IN THEIR PRODUCTS BUT THE
PORTION SIZES ARE BIGGER THAN
ONE SERVING. PORTION DISTORTION
IS A HUGE PROBLEM. WHAT WE’VE SEEN IS
THAT A LOT OF PEOPLE OVEREAT AS
THEY EAT OUT, AND THAT TRANSLATES
INTO EXPECTING THAT SAME SERVING SIZE
EVEN WHEN THEY PREPARE FOODS AT HOME. SO INSTEAD OF LOOKING
AT A 3 OUNCE PORTION OF MEAT AS THE SIZE
OF A DECK OF CARDS, IT SHOULD COVER HALF
OF YOUR PLATE BECAUSE THAT’S WHAT I GET
AT A RESTAURANT, AND THAT’S INCORRECT. SO WE’VE
CHANGED HOW WE THINK, WE’VE CHANGED
HOW WE SHOP, WE’VE CHANGED
HOW WE COOK, AND HENCE WE’VE
CHANGED HOW WE EAT, WHICH HAS
CHANGED OUR SIZE. IF YOU LOOK AT THE
BUILT ENVIRONMENT IN THE SOUTHEASTERN
STATES AND IN TENNESSEE, YOU’LL
SEE WE CAME FROM AN AGRICULTURAL
BACKGROUND, WE HAVE LARGER
EXPANSES OF LAND, CITIES THAT IN GENERAL
WEREN’T DESIGNED TO BE WALKABLE BUT DRIVABLE
IF YOU OVERLAY A CHART SHOWING THE PAST 30
YEARS AND THE RATE OF GROWTH FOR OBESITY,
IT’S THE SAME CHART FOR THE NUMBER OF
MILES THAT WE’RE INCREASINGLY DRIVING
AS US CITIZENS. AND MORE AND MORE
RESEARCH IS COMING OUT, BASICALLY
JUST POINTING OUT THE OBVIOUS. THAT THE MORE WE’RE IN
OUR CARS AND THE MORE THAT WE’RE DRIVING,
THE LARGER OUR BMI’S ARE GROWING. WE LIVE SO FAR FROM
WHERE WE GO TO SCHOOL NOW, WE LIVE SO FAR
FROM WHERE WE WORK NOW, AND WE SPEND A
LOT OF TIME IN THE CAR. IN FACT, OUR CITIES
ARE DESIGNED SO THAT REALLY THE ONLY WAY
TO GET FROM POINT A TO POINT B IS
IN A CAR, OR, TO HAVE A CAR AND THAT
REALLY MAKES IT HARD FOR PEOPLE TO WORK
PHYSICAL ACTIVITY INTO THEIR DAILY LIVES. WHAT WE’VE DONE IS
BUILD MORE ROADS BUT NOT NECESSARILY MAKE
SURE WE HAVE SIDEWALKS OR BICYCLE PATHS,
THINGS LIKE THAT TO GO ALONG WITH THE ROADS. BY ONLY CARTING
CHILDREN AROUND BY CARS, WE ARE REALLY
REDUCING THE AMOUNT OF TIME THEY CAN GET
PHYSICAL ACTIVITY. AND THIS DOESN’T
HAVE TO BE STRUCTURED PHYSICAL ACTIVITY. THIS CAN BE RIDING
YOUR BIKE IN THE NEIGHBORHOOD, WALKING
DOWN TO THE NEIGHBOR’S HOUSE, WALKING TO GET
SOME LEMONADE AT THE CORNER STORE. WE’RE ESSENTIALLY
BUILDING THOSE OPTIONS OUT OF CHILDREN’S
ENVIRONMENT. NEVAEH WALKS TO
SCHOOL EVERYDAY. SHE LIVES ONLY A
FEW BLOCKS FROM HER SCHOOL. I LIKE TO WALK. YOU LIKE TO WALK? NEVAEH IS AN EXCEPTION
TO THE AVERAGE METRO NASHVILLE STUDENT. OUT OF
83,000 STUDENTS, ONLY 15% LIVE WITHIN
WALKABLE DISTANCE OF THEIR SCHOOLS. BUT A GOOD PORTION OF
THESE STUDENTS WILL BE DRIVEN OR TAKE A BUS-
SOME FOR ONLY ¼ MILE- BECAUSE THE STREETS
ARE TOO HAZARDOUS FOR THEM TO WALK OR BIKE. THE EXPERIENCE OF
NASHVILLE’S STUDENTS REFLECT A LARGER
TREND IN THE U.S. WHAT WE’VE
DONE AS A NATION, IS WE’VE MOVED TO
ESSENTIALLY THIS BIG BOX APPROACH TO
BUILDING SCHOOLS. ELEMENTARY SCHOOLS
THAT USED TO HAVE 200 CHILDREN NOW HAVE
800 OR 1000 CHILDREN. AND IN ORDER TO BUILD
A SCHOOL THAT LARGE, AND TO FIND A PIECE OF
LAND AND TO AFFORD IT, SCHOOL SYSTEMS ARE
FINDING THAT THEY HAVE TO GO OUTSIDE OF THE
COMMUNITY WHERE THERE IS NOT AS MUCH
DEVELOPMENT AND THEY PLACE THEIR
SCHOOL THERE. AND THERE’S A FEW
PROBLEMS WITH THAT, THE PRIMARY
ONE IS DISTANCE. YOU’RE BASICALLY,
AUTOMATICALLY, ASSURING THAT CHILDREN
CANNOT WALK AND BICYCLE TO SCHOOL
BECAUSE THE DISTANCE IS SO GREAT. AND FOR A LOT OF KIDS
THAT TYPE OF PHYSICAL ACTIVITY IS REALLY
IMPORTANT BECAUSE CHILDREN- NOT ALL
CHILDREN HAVE ACCESS TO YMCAS, THEY DON’T
HAVE ACCESS MAYBE TO SPORTS. BUT GOING TO SCHOOL IS
SOMETHING EVERY CHILD HAS TO DO. AND SO IT’S JUST A
WONDERFUL WAY TO GET SOME
PHYSICAL ACTIVITY. THE PLACES WE LIVE,
WHERE WE GO TO SCHOOL, WHERE WE WORSHIP,
WHERE WE WORK, REALLY DEFINE OUR
HEALTH IN A VERY IMPORTANT WAY. SO, WE NEED TO REALLY
TAKE A LOOK AT ALL THE PLACES WHERE WE
ARE LIVING AND ASK, WHAT CAN WE DO TO MAKE
THE HEALTHY CHOICES MORE ACCESSIBLE IN
EACH OF THOSE PLACES? WHAT WE HAVE CURRENTLY
IN MIDDLE TENNESSEE AND IN THIS STATE
AND IN THIS NATION ARE POCKETS OF
ENVIRONMENTS, WHERE INDIVIDUALS
DO NOT HAVE EQUAL OPPORTUNITIES TO
MAKE HEALTHY CHOICES. AND TODAY IS OUR KICK
OFF TO SAY THAT WE’RE HERE AND WE’RE
READY TO SIT DOWN WITH PEOPLE AND FORM
STRATEGIES WITH THE HELP OF RESIDENTS WHO
ARE BEING TRAINED AS LEADERS. WE’RE GETTING READY TO
GET IT GOING WE’RE READY (GROUP CHEERS)
WITH ENTHUSIASM UNDIMMED BY
YEARS OF STRUGGLE, BRENDA MORROW HOSTED A
PRESS CONFERENCE AND COOK OUT TO ANNOUNCE A
RENEWED AND CONCERTED EFFORT TO BRING FULL
SERVICE GROCERY STORES TO 4 NASHVILLE
NEIGHBORHOODS. YEARS AGO, THEY TELL
ME THAT THERE OVER 20 DIFFERENT GROCERY
STORES IN THE EDGEHILL COMMUNITY. LIKE CORNER MARKETS
AND THE MOM AND POP STORES, AND STUFF LIKE
THAT JUST THROUGHOUT THE EDGE
HILL COMMUNITY. THEN THERE CAME ABOUT
THIS THING CALLED URBAN DEVELOPMENT AND
IT’S LIKE EVERYTHING JUST DISAPPEARED. EVERYTHING
DISAPPEARED. THERE HAS BEEN SINCE
I’VE BEEN HERE PIGGLY WIGGLY’S, THERE’S
BEEN WINN-DIXIE’S, THERE’S BEEN
A SAVE A LOT, BUT YOU KNOW
NOTHING STAYS… NOTHING STAYS. IN NASHVILLE, THERE
ARE FOUR NEIGHBORHOODS WITHOUT A MAJOR
GROCERY STORE AND WITH LIMITED BUS SERVICE. EXPERTS REFER TO THESE
AREAS AS FOOD DESERTS. IF YOU GO TO AH
CONVENIENCE STORE IN NASHVILLE IN A FOOD
DESERT NEIGHBORHOOD WITH $10 AH YOU KNOW
YOU WILL FIND IT MUCH EASIER TO PROVIDE YOUR
FAMILY AH YOU KNOW CALORIES AH THAT ARE
EMPTY CALORIES CHIPS SODA UM SNACK FOODS
PREPARED FOODS THEN IT IS TO FIND WHAT YOU
NEED TO PREPARE A HEALTHY MEAL AH YOU
KNOW HEALTHY FOOD FREQUENTLY COST
MORE IN GENERAL AND DEFINITELY COSTS MORE
IN KINDS OF STORES WHERE PEOPLE DON’T
HAVE ACCESS TO A FULL SERVICE GROCERY
STORE UM SHOP. I STOOD THERE IN
THE STORE ONE DAY AND WATCHED A YOUNG LADY
COME IN AND SPENT $180 IN FOOD STAMPS… $180 WOULD’VE GOTTEN
HER TWICE IF NOT THREE TIMES AS MUCH
GROCERIES AT A REGULAR GROCERY STORE, BUT TO
WATCH HER SPEND THAT MUCH MONEY AND KNOW
THAT THE ONLY REASON THAT SHE DIDN’T GO TO
KROGER’S WAS BECAUSE SHE DIDN’T HAVE
TRANSPORTATION. THEY ARE RIDING THE
BUS UPWARDS OF THREE HOURS SEVERAL
TRANSFERS GET BACK ON THE BUS WITH GROCERIES
UM MANY OF THE BUSES AREN’T EQUIPPED WITH
BINS OR RACKS AND SO MANY PEOPLE TALKED
ABOUT HAVING KIDS AND HAVING GROCERIES
ROLLING AROUND ON THE BUS UM I THINK THE
CHOICES ARE LIMITED EVEN IN CHOICES YOU
BUY WHEN YOU MAKE A TRIP THAT LONG. IN THE SUMMER TIME YOU
ARE NOT GOING TO BE ABLE TO BUY FROZEN
FOODS OR YOU ARE GOING TO HAVE TO WATCH
THE AMOUNT OF MILK OR LIQUIDS THAT
YOU PURCHASE. FOR PEOPLE WHO LIVE
WITHIN EASY ACCESS OF A GROCERY STORE, UM
THEY EAT UP TO 32% MORE FRESH FRUITS
AND VEGETABLES, UM PREGNANT WOMEN EAT
A MORE HEALTHY DIET WHICH HAS AN IMPACT
ON BIRTH OUTCOMES. CHILDREN, ADOLESCENTS,
AND ADULTS HAVE A LOWER BODY MASS INDEX
AND DECREASED CHANCE OF HAVING
OBESITY, DIABETES, OTHER DIET RELATED
DISEASES WHEN THEY LIVE WITHIN EASY
ACCESS GROCERY STORE. BUT WHEN YOU GO AND
YOU WALK DOWN THE STREET IN THIS
COMMUNITY YOU SEE YOUNG PEOPLE, THAT
ARE EXTREMELY HUGE. YOU KNOW IT’S BECAUSE
THEY HAVE TO GO TO STORES LIKE THE
TOBACCO STORES, THESE HAIR AND DOLLAR
STORES AND JUST LOAD UP ON JUNK THAT’S GOT
NO NUTRITIONAL VALUE, BUT STILL IT HAS A
BUNCH OF CALORIES, CARBOHYDRATES, AND
ALL THAT KIND OF STUFF THAT’S DETRIMENTAL
TO THESE KIDS. NASHVILLE’S FOOD
DESERT NEIGHBORHOODS SHARE A SIMILAR
DEMOGRAPHIC MAKE UP. THE RESIDENTS ARE
PREDOMINANTLY POOR AND MINORITY POPULATIONS. THESE TWO FACTORS CAN
SIGNIFICANTLY IMPACT OBESITY RATES. YOU BEGIN TO ASK THE
QUESTION OF WHY IF YOU ARE POOR, ARE
YOU FATTER? AND THE ANSWER IS YOU
GO BACK TO THE ISSUE OF ACCESS. IN THE HEART OF
NORTH NASHVILLE, AT MEHARRY
MEDICAL COLLEGE, DR. XYLINA BEAN MUST
CONFRONT THE REALITIES OF HER PATIENTS’ LIVES
IN ORDER TO TREAT THEM. WE CAN FOCUS ON
MEETING THE CHILD’S NEEDS OR TRYING TO
MEET THE CHILD’S NEEDS BUT UNLESS WE MEET
THE PARENT’S AND THE FAMILY’S NEEDS, THEN
WE AREN’T GOING TO BE VERY
SUCCESSFUL ULTIMATELY. AND SOMETIMES THOSE
NEEDS CAN CONSIST OF: I’M LIVING IN
A BAD PLACE. THERE IS NO PLACE
AROUND WHERE I CAN TAKE THIS CHILD TO
SAFELY EXERCISE FOR AN HOUR. SO HAVING HIM STAY
INSIDE OR HER STAY INSIDE AND WATCH
TV IS ACTUALLY, FROM MY POINT OF
VIEW, THE BEST AND THE SAFEST THING THAT I
CAN DO FOR MY CHILD. SO YOU HAVE TO BEGIN
TO ADDRESS THOSE KIND OF ISSUES. TO ADDRESS SOME OF
THE ACCESS ISSUES, DR. BEAN HELPED BUILD
A FITNESS CENTER AT THE CLINIC, AND
RECRUITED MEHARRY MEDICAL STUDENTS TO
MENTOR CHILDREN TRYING TO IMPROVE THEIR
HEALTH PHILIP, WHEN I FIRST MET
HIM HE WAS KIND OF SLOUCHING DOWN
IN THE CORNER. I THINK AT THIS POINT,
HE KNEW HE HAD A PROBLEM, BUT HE DIDN’T
NECESSARILY WANT TO…YOU KNOW KIND
OF LET ME IN REALLY, HE WAS REALLY
FIGHTING ME. WE DID OUR INITIAL
ASSESSMENT OF HIM WALKING A MILE ON THE
TREADMILL IT PROBABLY TOOK 52 MIN, IT
WAS VERY LENGTHY. AT THAT POINT I THINK
HE WAS 14 YEARS OLD AND FOR A 14 YEAR OLD
TO RUN A MILE IN 52 MIN THAT’S JUST
UNACCEPTABLE BECAUSE THAT CAN ONLY GET
WORSE AS HE AGES. BRANDON MET WITH
PHILLIP WEEKLY, BUILDING THEIR
RELATIONSHIP AND IMPROVING HIS
KNOWLEDGE OF EXERCISE AND NUTRITION. WE INITIALLY, BEFORE
ALL THE WORKING OUT, WE JUST SAID HEY YOU
KNOW – WHAT DO YOU EAT ? WHEN ARE YOU EATING? HOW MUCH OF IT
ARE YOU EATING? WHAT SHOULD
YOU BE EATING? AND KIND OF JUST
LET THEM BE ABLE TO UNDERSTAND THAT THESE
ARE CORRECT FOODS THAT WE NEED YOU
TO BE EATING, THIS IS THE
RIGHT PORTION SIZE. SOME OF OUR
LOWER SOCIOECONOMIC FAMILIES, SOME OF
THE REVERSE HAS BEEN INSTILLED IN THEM- IF
IT’S CHEAP LET’S EAT IT. THE CHEAPEST THING
AS WE KNOW HERE IN AMERICA IS NOT ALWAYS
THE BEST THING FOR US. AND SO WHEN YOU EAT
THINGS THAT ARE JUST INSTILLED IN YOU SINCE
YOU’RE KID- HE JUST DIDN’T KNOW THAT ALL
THESE THINGS ARE BAD. HE CAN GO TO
THE 99CENT MENU, GET THREE THINGS
THAT HE WANTS AND HIS FAMILY CAN BE
FULL OFF OF THAT. THAT’S KIND OF THE WAR
THAT WE PLAY IN THE COMMUNITY AND SOME OF
THE MAIN CHALLENGES THAT I THINK
THEY HAVE. THEY SHOWED ME JARS
THAT HAD FAT AND SALT, IN THE FOODS
THAT I WAS EATING, AND I NEEDED TO CUT
BACK ON THE FOODS I WAS EATING:
HAMBURGERS, HOT DOGS,
PIZZAS, FRENCH FRIES, AND A LOT MORE THINGS. AFTER THREE MONTHS
OF EDUCATION AND INCREASINGLY
ACTIVE EXERCISING, PHILLIP MADE STEADY
IMPROVEMENT ON HIS TREADMILL TIME. HE WENT FROM
52 MINUTES TO, I THINK 30 OR 35
MINUTES OR SOMETHING. IT WAS ALMOST
CUT IN HALF, AND THAT WAS SOMETHING
THAT WE REALLY WERE PROUD OF, AND YOU
KNOW I TOLD HIM, I SAID, “HEY
BUDDY, THAT WASN’T ME. YOU PAT YOURSELF ON
THE BACK FOR THAT.” THE PSYCHOLOGICAL
ASPECT- YOU CAN’T TAKE IT AWAY PRETTY MUCH
FROM ANY OF THE WEIGHT AND OBESITY THAT WE
HAVE HERE BECAUSE THEY’RE ONE IN
THE SAME PROBLEM. IF YOU DON’T HAVE
SOMEBODY WHO’S REALLY SUPPORTING YOU, IF YOU
DON’T HAVE SOME TYPE OF SUPPORT SYSTEM,
THEN YOU’RE LESS LIKELY TO THEN GO
AHEAD AND KIND OF KICK YOURSELF UP THERE AND
KIND OF SEE SEE SOME IMPROVEMENT. THERE ARE
OTHER ISSUES. THERE’S
CULTURAL ISSUES, THERE’S OUTLOOK FOR
THE FUTURE ISSUES, THERE MAY BE EVEN
DIFFERENCES IN FOOD PREPARATION
AND OTHERS. MANY OF THOSE ARE
TIED BACK TO POVERTY. WE HAVE GOT TO MAKE
ADDITIONAL INVESTMENTS IN LOW-INCOME
COMMUNITIES AND COMMUNITIES OF COLOR,
IF WE EXPECT THEM TO BE ABLE TO MAKE THE
CHANGES THAT THEY NEED TO MAKE TO
REVERSE THIS EPIDEMIC. WE HAVE TO CHANGE THE
SENSE THAT DISEASE AND OBESITY AND EARLY
DEATH ARE INEVITABLE FOR ME BECAUSE I GREW
UP IN THIS POPULATION, BECAUSE NOTHING IN
THERE IS IMMUTABLE, WHERE I LIVE, THE
ENVIRONMENT IN WHICH I LIVE, THE
OPPORTUNITIES TO MOVE AND RECREATE,
THE FOODS THAT ARE AVAILABLE TO ME, ALL
OF THESE ARE THINGS THAT CAN BE ADDRESSED
BY SOCIAL CHANGE, BY COMMUNITY
DEVELOPMENT AND COMMUNITY BUY-IN
AND INITIATION, BY
WELL-WRITTEN POLICIES. THE SOLUTIONS TO
OBESITY ARE NOT IDENTIFYING A PILL,
OR IDENTIFYING A SHOT, THE SOLUTIONS TO
OBESITY ARE MORE COMPLEX. WHAT WE’RE BEGINNING
TO REALIZE IS THAT WE NEED TO GET OUT IN THE
COMMUNITY TO CHANGE LIFESTYLES. WITHIN
INDIVIDUAL FAMILIES, CHANGE BEGINS WITH
PARENTS WHEN A PARENT TELLS ME THAT THE
CHILD WON’T EAT THIS. AND I SAY TO THEM
IF THEY GET HUNGRY, THEY’LL EAT WHAT
YOU GIVE THEM. THE CHILD DIDN’T GO TO
THE GROCERY STORE AND BUY PEPSI, THE CHILD
DIDN’T MAKE IT’S OWN DINNER. I MEAN, YOU CONTROL
WHAT IT IS THAT THE CHILD IS EATING AND
YOU CAN DECIDE TO MAKE HEALTHY FOOD CHOICES
FOR YOUR CHILD, I FEEL LIKE I
GAINED BACK THE RESPONSIBILITY
OF THEIR EATING. YOU HAVE TO CHANGE
YOUR WHOLE LIFESTYLE; WHAT YOU BRING
IN YOUR HOUSE, HOW MANY
TIMES YOU EAT, THE PORTION OF
WHAT YOU EAT, AND DRINK. I DON’T WANT THE
BUSY PARENTS TO GET DISCOURAGED BECAUSE
THEY DON’T HAVE THAT TIME. YOU HAVE TO
MAKE THAT TIME, IT’S EASIER
SAID THAN DONE, BUT YOU HAVE
TO MAKE IT. IT’S A SACRIFICE, AT
FIRST IT WAS VERY HARD TO MAKE THE CHANGES
BECAUSE YOU’RE SO USED TO GOING OUT EVERY
NIGHT AND GETTING SOMETHING TO EAT,
BUT TO LIVE LONGER AND LIVE A HAPPIER LIFE
YOU HAVE TO BE ABLE TO TELL YOURSELF: I
HAVE TO DO IT, IT’S FOR ME. I WOULD SAY, THERE IS
AN ELEMENT OF PERSONAL RESPONSIBILITY HERE,
WHERE PARENTS NEED TO BE EDUCATED AND
UNDERSTAND AND TAKE RESPONSIBILITY, BUT WE
HAVE TO MAKE IT WHERE THE ABILITY TO
EXERCISE THAT RESPONSIBILITY IS
BOTH ACHIEVABLE, SUPPORTED, AND IS AN
EASY CHOICE TO MAKE, IF WE WANT THAT
CHANGE TO HAPPEN. NAT POP SHARI BARKIN
IN CLINIC I SAW A THREE-YEAR-OLD
CHILD IN THE CLINIC, WHO WAS
MORBIDLY OBESE. HE HAD DIFFICULTY
WALKING HE WAS SO OVERWEIGHT AND HIS
FAMILY SAW HIM AS BEAUTIFUL AND REALLY
ABUNDANTLY HEALTHY. AND WHEN I
EXAMINED HIM, I COULD FEEL THAT HE
HAD AN ENLARGED LIVER. AND WHEN WE
IMAGED HIS LIVER, MUCH OF HIS LIVER HAD
BEEN REPLACED BY FAT. THAT HAPPENED BEFORE
THE AGE OF THREE FOR THAT CHILD. AND THIS IS
WHY PREVENTION, AND THE CULTURE
OF PREVENTION, NEEDS TO BE A PARADIGM
SHIFT FOR US AS AN AMERICAN SOCIETY. WHEN DR. SHARI BARKIN
STARTED NOTICING THE RISING TREND OF
OBESITY IN HER PATIENTS, SHE DID WHAT
A GOOD SCIENTIST WOULD DO- DESIGNED A STUDY
TO FIND THE BEST WAY TO COMBAT THE PROBLEM. WE STARTED ACTUALLY
WITH PREADOLESCENTS EIGHT TO 11-YEAR-OLDS. THE IDEA WAS THAT IF
WE COULD INTERVENE PRIOR TO PUBERTY THAT
WOULD REALLY IMPACT THE DEVELOPMENT
OF LATER OBESITY. WHAT WE FOUND IN THAT
STUDY IS THAT IT WAS TOO LATE. IT’S NOT TO SAY
THAT IT DIDN’T WORK. IT’S A LOT HARDER
TO MAKE IT WORK. ONCE YOU START MOVING
IN THE DIRECTION OF OVERWEIGHT AND OBESITY
IT’S VERY DIFFICULT TO GO BACK. IT’S DIFFICULT TO GO
BACK BIOLOGICALLY, AND IT’S DIFFICULT TO
GO BACK BEHAVIORALLY. DR. BARKIN AND
OTHER RESEARCHERS HAVE RETOOLED THEIR STUDIES
TO FOCUS ON YOUNGER AND YOUNGER CHILDREN
EVEN THOSE IN UTERO. WE HAVE A LOT OF
INTERESTING RESEARCH ABOUT, ABOUT HOW
PREGNANCY CAN IMPACT THE GROWING FETUS. FOR EXAMPLE, WE KNOW
THAT MOTHERS WHO ARE EXPOSED TO HIGH FAT
DIETS AND HIGH REFINED SUGARS DURING
PREGNANCY IMPACT THE WAY THAT THE
HYPOTHALAMUS DEVELOPS. THE HYPOTHALAMUS IS AN
ESSENTIAL PART OF HOW WE LEARN TO
REGULATE OUR FEEDING. HOW WE LEARN TO
RESPOND WHEN WE’RE FULL AND STOP EATING. UNDERSTANDING HOW MUCH
A CHILD SHOULD EAT AND WHEN A CHILD IS
FULL NEEDS TO BEGIN IN INFANCY. BOTTLE-FEEDING MAKES
IT EASIER FOR PARENTS TO OVERFEED, WHICH
CAN DEFEAT A CHILD’S INNATE SENSE OF
WHEN TO STOP EATING. RESEARCH HAS SHOWN
THAT BREASTFEEDING IS LINKED TO LOWER
OBESITY RATES IN CHILDREN. PARENTS AREN’T SO
GOOD AT KNOWING WHEN THEY’RE FULL, BUT
CHILDREN ARE ACTUALLY QUITE GOOD AT IT. BREAST-FEEDING IS THE
BEST THING YOU CAN DO FOR YOUR CHILD. NOT ONLY IS IT
COMPLETE NUTRITION, BUT IT ALSO
CREATES BONDING. AND BECAUSE YOU ARE
LOOKING AT YOUR CHILD, YOU’RE PROBABLY
NOTICING INSTINCTUALLY A LOT OF CUES THAT ARE
ACTUALLY THE SATIETY CUES, RECOGNIZING WHEN
YOUR CHILD IS DONE. THE CHALLENGE IS THAT
FAMILIES ARE UNSURE IF THEIR CHILD IS FULL,
SO IN ADDITION TO BREAST-FEEDING THEY
WILL ALSO FORMULA FEED. SO A CHILD CAN BE
OVERFED QUITE EASILY, WHEN YOU COMBINE
THAT APPROACH. WE’RE TRYING TO HELP
FAMILIES SET UP HABITS THAT ALLOW THEM TO BE
HEALTHY AS A FAMILY UNIT. OBESITY LIVES IN
FAMILIES AND IT LIVES IN COMMUNITIES AND SO
THE SOLUTION WILL ALSO LIE IN FAMILIES
AND IN COMMUNITIES. WE GOT TO WHERE WE
ARE BECAUSE OF A WHOLE HOST OF TENS OF
MILLIONS OF INDIVIDUAL DECISIONS THAT WE ALL
MAKE ON A DAILY BASIS. WHAT POLICY CAN DO
IS NUDGE US IN A DIRECTION THAT’S MORE
BENEFICIAL IN THE LAST TEN YEARS, TENNESSEE
HAS IMPLEMENTED SEVERAL POLICIES
DIRECTLY TARGETING OBESITY. 2006 SAW
LAWS SUPPORTING BREASTFEEDING IN
PUBLIC SPACES AND WORK ENVIRONMENTS. THAT SAME YEAR
TENNESSEE BECAME THE FIRST STATE TO
INSTITUTE COORDINATED SCHOOL
HEALTH STATEWIDE. IN 2010, TENNESSEE
RELEASED A STRATEGIC PLAN TO ENCOURAGE
HEALTHIER EATING AND INCREASED
PHYSICAL ACTIVITY. WHEN WE MAKE
POLICY, WE ARE REALLY AFFECTING OUR HEALTH. YOU CAN HAVE AN
EXERCISE CLASS, AND IT WILL
TOUCH 10 KIDS, OR IT WILL
TOUCH 30 KIDS, IT’LL TOUCH 100 KIDS,
BUT IF YOU CHANGE A POLICY SO THAT AN
ENTIRE SCHOOL DISTRICT IS GOING TO HAVE MORE
PHYSICAL ACTIVITY THAN YOU’RE TOUCHING
THOUSANDS OF KIDS. SO POLICY
WHETHER IT’S STATE, LOCAL BUT EVEN IN
WORK PLACE EVEN IN CHURCHES, PEOPLE CAN
HAVE POLICIES THAT KIND OF CHANGE
THE PLAYING FIELD, IF THERE WAS ONE THING
THAT I COULD ACTUALLY WAVE A WAND
AND HAVE HAPPEN, IT WOULD BE THAT
SOMEWHERE IN ALL POLICY DECISIONS
HEALTH IS CONSIDERED. I THINK FOR TOO LONG
WE HAVE THOUGHT ABOUT BUILDING ROADS
WITH TRANSPORTATION DOLLARS, THINKING
ABOUT EDUCATIONAL PERFORMANCE WITH
EDUCATIONAL DOLLARS. BUT IF WE COULD
ACTUALLY THINK ABOUT HOW DOES THIS AFFECT
THE HEALTH OF THE CITIZEN, IN
EVERYTHING, TRANSPORTATION,
ZONING, EDUCATION,
NUTRITION, HEALTH, HEALTHCARE,
EVERY POLICY. IF WE JUST HAD A
PLACEHOLDER TO SAY HOW DOES THIS
AFFECT THE HEALTH, THEN OVER TIME WE
WOULD MAKE A HUGE IMPACT BECAUSE
HEALTH IS IMPORTANT TO EVERYONE AND THERE ARE
OPPORTUNITIES FOR US TO MAKE POSITIVE
CHANGES THAT DON’T COST ANY MORE MONEY. NASHVILLE MAYOR KARL
DEAN SEES INCREASING PHYSICAL ACTIVITY, AND
IMPROVING HEALTH AS VITAL TO A CITY’S
GROWTH AND ECONOMIC SUCCESS. WE INVEST
MILLIONS OF DOLLARS, AND WE CONTINUE TO DO
SO IN OUR PUBLIC PARKS AND RECREATION
SO, PEOPLE HAVE THE ABILITY TO
GO SOMEWHERE, AND TO GET EXERCISE. WE HAVE PUT A
LOT OF MONEY, AND WE WILL CONTINUE
TO DO BECAUSE I THINK IT’S IMPORTANT
INTO OUR GREENWAYS. WE NEED TO HAVE SPACES
WHERE PEOPLE CAN RIDE BIKES, THEY CAN
RUN, THEY CAN WALK, THEY CAN GET OUTDOORS. APART FROM
RECREATIONAL SPACES, MAYOR DEAN HOPES
THAT INVESTING IN PEDESTRIAN AND BIKE
FRIENDLY ROADWAYS WILL MEAN FEWER
TRIPS MADE BY CAR. I SIGNED AN EXECUTIVE
ORDER SAYING THAT NASHVILLE WOULD FOLLOW
A COMPLETE STREETS POLICY, WHICH MEANS
THAT WHEN WE BUILD A NEW STREET, OR WHEN WE
DO A LOT OF CORRECTIVE ACTION ON AN EXISTING
STREET AND WE’LL LOOK AT ALL FORMS OF
TRANSPORTATION AND BE UTILIZED ON
THAT STREET, AND THAT WOULD INCLUDE
PEDESTRIANS BEING ABLE TO WALK THERE. IS IT WALKABLE,
AND IS IT BIKABLE? SO, WHEN YOU LOOK
AT TRANSPORTATION SOLUTIONS WE WOULD
ALSO INCLUDE IN THAT THE ABILITY TO
HAVE A BIKABLE CITY, AND A WALKABLE CITY. AND CLEARLY THE MORE
WE DO THOSE TWO THINGS BIKE, AND WALK, AND
GET AWAY FROM BEING AN AUTOMOBILE ALL THE
TIME THE HEALTHIER WE ARE GOING TO BE. I THINK THAT IT’S ALL
THE RESPONSIBILITY OF ALL THE MEMBERS OF
THE COMMUNITY TO THINK ABOUT THE FUTURE AND
WHAT WE ARE GOING TO LEAVE BEHIND, AND WE
WANT OUR CHILDREN TO BE HEALTHY, AND
THAT’S JUST A VALUE. IF YOU HAVE
HEALTHY KIDS, YOU HAVE KIDS THAT ARE
TO BE DOING BETTER IN SCHOOL. KIDS WHO ARE HEALTHY
ALSO MORE LIKELY TO BE ABLE TO JOIN THE
WORKFORCE WHEN THEY’RE OLDER, AND DO WELL,
AND THEY ALSO DON’T REQUIRE AS MUCH
MEDICAL CARE. BUT, HEALTHY CHILDREN
IN AND OF ITSELF IS A NOBLE GOAL THAT I
THINK IT’S PRETTY OBVIOUS THAT ANY CITY
SHOULD STRIVE FOR. ONE BIG OPPORTUNITY
THAT WE SEE FOR HAVING AN IMPACT HERE
IS CHANGING THE ENVIRONMENT
IN SCHOOLS. WE REQUIRE KIDS TO GO
SCHOOL AND WE TEACH THEM ABOUT HEALTH AND
WE TEACH THEM ABOUT HEALTHY EATING BUT
WHAT DO WE ACTUALLY SERVE THEM? THE SAME FOR
PHYSICAL ACTIVITY. THE STATE OF TENNESSEE
HAS INCREASED THEIR REQUIREMENTS FOR
PHYSICAL ACTIVITY DURING THE SCHOOL DAY. IT’S ALWAYS COMPETING
WITH OTHER THINGS. WHAT ARE THE THINGS
THAT WE CAN DO TO MAKE HEALTHY FOOD AND
REGULAR PHYSICAL ACTIVITY JUST A NORMAL
PART OF THE SCHOOL DAY? THOUGH VASTLY
DIFFERENT SCHOOLS, GLENDALE ELEMENTARY
SPANISH IMMERSION SCHOOL AND GLENCLIFF
COMPREHENSIVE HIGH SCHOOL SHARE A
COMMITMENT TO IMPROVING NOT ONLY THE
ACADEMICS BUT ALSO THE HEALTH OF
THEIR STUDENTS. MY PRIMARY JOB AS
PRINCIPAL IS TO EDUCATE THE STUDENTS
BUT I’VE RECOGNIZED THAT HEALTH AND
RECREATION AND ACCESS TO OPPORTUNITIES FOR
KIDS IS ALSO EQUALLY AS IMPORTANT
FOR MANY YEARS, THERE WAS A PHILOSOPHY
THAT THE CHILDREN REALLY SHOULD BE
SPENDING MORE TIME INSIDE, THAN OUTSIDE,
AND THAT RECESS WAS TOO LONG. AND SO NOW THAT WE’RE
LOOKING AT CHILDHOOD OBESITY,
DIABETES, ASTHMA, PHYSICIANS ARE ALSO
TELLING US THAT IT’S JUST AS IMPORTANT
FOR THEIR BRAIN DEVELOPMENT FOR
THEM TO HAVE PHYSICAL ACTIVITY. EVEN HAVING TWO
RECESS PERIODS A DAY, THEY COME IN AND
THEY ARE ABLE TO FOCUS BETTER AND THEY ENJOY
SCHOOL MORE BY HAVING THAT FREE TIME. COMING FROM AN UNDER
RESOURCED COMMUNITY, GLENCLIFF’S STUDENTS
FACE NUMEROUS HEALTH ISSUES. THEY ARE NO DIFFERENT
THAN THE NATIONAL EPIDEMIC OF
CHILDHOOD OBESITY, ASTHMA, DIABETES. ALSO JUST NUTRITION
AWARENESS JUST BASIC UNDERSTANDING OF GOOD
HEALTHY AND WELLNESS PRACTICES AMONGST
YOUTH IS VERY VITAL. BUT EVEN AFTER
EDUCATING THEM THEY TO HAVE ACCESS TO THE
SERVICES IN ORDER TO TAKE
ADVANTAGE OF THEM. BOTH SCHOOLS
HAVE EMBRACED THE COORDINATED SCHOOL
HEALTH INITIATIVE THAT AIMS TO IMPROVE
ACADEMIC ACHIEVEMENT BY ADDRESSING THE
HEALTH NEEDS OF STUDENTS
ACROSS ACADEMICS, RECREATION AND THE
BROADER COMMUNITY. TO ACHIEVE AND
SUSTAIN THIS GOAL, COMMUNITY
ORGANIZATIONS PROVIDE SUPPORT AND WORK
WITHIN THE SCHOOLS TO ADDRESS EVERYTHING
FROM SCHOOL LUNCH NUTRITION TO ACCESS
TO HEALTH CARE TO RECREATIONAL
ACTIVITIES. AT GLENCLIFF, UNITED
NEIGHBORHOOD HEALTH SERVICES ESTABLISHED
A COMMUNITY CLINIC TO PROVIDE BETTER
HEALTH CARE ACCESS. AT GLENDALE, A LOCAL
FARM AND NON PROFIT ORGANIZATION HELPED
START RAISED GARDEN BEDS THAT CAN BE USED
AS A TEACHING TOOL AND TO EXPOSE
CHILDREN TO NEW FOODS. WE TALK ABOUT A
CULTURE OF WELLNESS. AND I THINK THAT’S ONE
THING WE’D LIKE TO DO AT GLENDALE AND THIS
IS JUST WHAT WE DO. WE DON’T HAVE CUPCAKES
WITH 6 FEET ICING AT OUR BIRTHDAY PARTIES,
INSTEAD WE HAVE BOOK PARTIES. OR THE GARDENS
BECOME THE NORM. IT’S NORMAL TO GO
OUTSIDE EVERY CHANCE WE GET, IT’S
NORMAL TO RECYCLE, SO THAT WHEN
THEY GO HOME, THE HOPE IS THEY’RE
USED TO RECYCLING OR PLAYING OUTSIDE OR
EATING BETTER AND A VARIETY OF FOODS. WITH A BACKGROUND
IN PUBLIC HEALTH, SELENA CARPENTER
SPENT SEVERAL YEARS ADVOCATING FOR
HEALTHIER FOODS IN SCHOOLS. WE THOUGHT IT WOULD BE
A MATTER OF LET’S JUST CHANGE THE FOOD
IN OUR SCHOOL. OF COURSE NOW WE KNOW
IT’S THE HUGE METRO SYSTEM, SO WE
STARTED WORKING WAYS, WHAT COULD WE CHANGE,
WHAT IS UNDER OUR CONTROL. I THINK ONE OF THE
THINGS OUR GROUP AND WHAT I’M REALLY
INTERESTED US FOR THERE TO BE
MORE WHOLE FOODS, NON-PROCESSED,
REAL FOOD, AS MICHAEL POLLAN
WOULD SAY THAT OUR GREAT-GRANDMOTHERS
WOULD RECOGNIZE. IN 2010, FOOD
ADVOCATES LIKE CARPENTER WERE PLEASED
TO FIND MANY CONCERNS RESOLVED WITH ONE
CHANGE IN FEDERAL POLICY. WITH PASSAGE OF THE
HEALTHY HUNGER FREE KIDS ACT, THE USDA
PLACED MORE STRINGENT NUTRITIONAL
REQUIREMENTS ON ALL FOODS
AVAILABLE IN SCHOOLS. SCHOOLS HAD MEET
REDUCTIONS OF SUGARS, FATS AND SODIUM IN
FOODS AND INCREASE THE AVAILABILITY OF FRESH
FRUITS AND VEGETABLES. WHEN THE HEALTHY
HUNGER FREE KIDS ACT HAPPENED FOR FOOD
ADVOCATES ALL OVER THE COUNTRY. IT WAS A HUGE WIN. IT TOOK OFF OUR PLATES
A LOT OF THE REALLY BIG THINGS LIKE
MORE FRESH FRUITS AND VEGETABLES LESS
PROCESSED FOOD AND ALLOWED US TO
CONCENTRATE ON THE NUANCES OF
THE CAFETERIA. FOR MOST CHILDREN,
SCHOOL FOOD ACCOUNTS FOR A THIRD OF THEIR
DAILY DIETARY NEEDS. FOR SOME CHILDREN, THE
BREAKFAST AND LUNCH PROGRAM AT THEIR
SCHOOL WILL BE THE ONLY MEALS THEY
EAT IN A GIVEN DAY. NUTRITION, AS WE KNOW
IT IS STRONGLY RELATED TO DISEASE, AND
HEALTH OUTCOMES, SO THIS TO ME,
IS A NO-BRAINER. SCHOOL LUNCH IS A
PLACE TO REACH MOST CHILDREN
ACROSS THE COUNTRY, IT’S A PLACE THAT WE
CAN REACH OUR MOST VULNERABLE CHILDREN. SINCE PASSAGE OF THE
HEALTHY HUNGER FREE KIDS ACT, SCHOOLS HAVE
HAD A FEW YEARS TO FULLY IMPLEMENT THE
NEW REQUIREMENTS, BUT IN METRO NASHVILLE
PUBLIC SCHOOLS, NUTRITION SERVICES
DIRECTOR SPENCER TAYLOR JUMPED IN WITH
BOTH FEET FROM DAY ONE. WE ARE IMPLEMENTING
PRETTY MUCH 100% OF THE ACT, WE ACTUALLY
IMPLEMENT IT 100% LAST YEAR. IN METRO
NASHVILLE SCHOOLS, 72.4% OF STUDENTS ARE
ELIGIBLE FOR FREE AND REDUCED
BREAKFAST AND LUNCHES. WITH THE
IMPLEMENTATION OF THE NEW FEDERAL
NUTRITION STANDARDS, METRO HAS INCREASED
THE NUMBER OF FRESH FRUITS AND VEGETABLES
SERVED IN THEIR SCHOOLS. LAST YEAR, NUTRITION
SERVICES SPENT ABOUT $400,000 DOLLARS ON
FRUITS AND VEGETABLES. ONE YEAR LATER, THEY
SPENT MORE THAN ONE MILLION DOLLARS ON
FRESH FRUITS AND VEGETABLES. I PERSONALLY, ME AS A
REGISTERED DIETITIAN, I FOUND THESE
NEW CHANGES TO BE EXCITING. WERE NOT ONLY GIVING
KIDS AN OPPORTUNITY TO PROVIDE ACCESS
TO BETTER FOODS. IT’S ALSO SOMEWHAT
OF AN EDUCATION. IMPLEMENTING THE NEW
STANDARDS IS NO SIMPLE TASK. METRO NASHVILLE IS THE
49TH LARGEST SCHOOL SYSTEM IN THE NATION. THAT MEANS 138
CAFETERIAS SERVING AROUND 47,000
MEALS EVERY DAY, OR ABOUT 8 MILLION
MEALS EACH YEAR. THIS INDUSTRY EVOLVED,
JUST LIKE THE FOOD INDUSTRY EVOLVED
OUTSIDE OF SCHOOLS, WE WENT TO A MORE
FAST-PACED QUICK SERVE FAST FOOD HEAT AND EAT
TYPE OF INDUSTRY AND SO NOW WE ARE GOING
BACK TO THE OLD DAYS WHERE WE ARE TRYING
TO DO MORE SCRATCH COOKING, SO
THE CHALLENGE OF PURCHASING FRESH ITEMS
AS WE HAVE TO LEARN HOW TO USE THEM. MAKING SURE THAT
EMPLOYEES KNOW HOW TO PREPARE, HOW TO
CUT FRESH FRUITS AND VEGETABLES
EFFICIENTLY. OFFERING HEALTHY
FOODS IS ONE THING, WHAT CHILDREN END UP
ACTUALLY EATING IS ANOTHER MATTER. ONE CHILD WILL HAVE
BEEF FINGERS AND A BREAD ROLL AND A
JELL-O CUP AS THEIR FRUIT. AND MAYBE COLLARD
GREENS THAT THEY DON’T TOUCH AND THEN ANOTHER
STUDENT WILL HAVE HEALTHY CELERY STICKS
AND A SIDE SALAD AND BREAD ROLL WITH
WHOLE GRAIN AND THE DIFFERENCES BETWEEN
THOSE LUNCHES ARE PRETTY DRAMATIC IN
TERMS OF NUTRITIONAL CONTENT AND VALUE. FOR MEGAN MORTON
WITH COMMUNITY FOOD ADVOCATES, NEW DIETARY
GUIDELINES MEAN SHE CAN SHIFT HER FOCUS
FROM ADVOCATING FOR HEALTHIER FOODS ON
THE LUNCH LINE TO MONITORING WHAT IS
SELECTED AND CONSUMED BY STUDENTS. WORKING WITH
DIETETIC INTERNS FROM VANDERBILT UNIVERSITY
AND METRO PUBLIC SCHOOLS, HER
ORGANIZATION IS COMPILING DATA ON WHAT
KIDS CHOOSE AND EAT. SO WE TOOK THE
MY PLATE MODEL, WHICH IS THE NEW
FEDERAL REGULATION AND PUT IT ON A PIECE OF
PAPER AND WE SIMPLY MARKED THE BOXES OF
WHAT IS ON THEIR PLATE WHEN THEY COME OUT OF
THE LINE AND WHAT’S ON THE PLATE WHEN THEY
DUMP THEIR TRAY WE ARE LOOKING AT THINGS
LIKE ARE THEY CHOOSING FLAVORED MILK ARE
THEY BUYING À LA CARTE ITEMS AND THEN
NOT EATING THEIR VEGETABLES. THE THINGS THAT
HAVE BEEN TOTALLY INTANGIBLE TO US
AT THIS POINT, BECAUSE ALL THE
DATA THAT WE’VE BEEN GETTING IS PRODUCTION
RECORDS IN TERMS OF HOW MUCH LETTUCE GOT
SHIPPED TO A SCHOOL INSTEAD OF SEEING HOW
MUCH LETTUCE THE KIDS ARE CONSUMING. MORTON STILL SEES
COMPETITION FOR HEALTHY FOOD ON
THE LUNCH LINE. ALA CARTE ITEMS,
PURCHASED BY FOOD SERVICES AND
SOLD TO STUDENTS, GENERATED MORE THAN
4 MILLION DOLLARS OF REVENUE LAST YEAR. TODAY, AL A CARTE
ITEMS MEET THE NEW DIETARY GUIDELINES,
BUT BY MAKING PORTION SIZES SMALLER OR
CHANGING THE WAY ITEMS ARE COOKED. IN DAYS PAST., YOU
COULD GET REAL CHIPS. NOW, THEY ARE BAKED. YOU USED TO BE ABLE
TO GET BROWNIES AND COOKIES AND OTHER
ITEMS NOW THEY ARE ONLY A COOKIES AND
SMALL RICE CRISPY TREATS INSTEAD OF A
LARGE BROWNIE THAT THEY USED TO BE ABLE
TO GET THEY ARE STILL THE HIGH-END SUGAR
HIGH IN FAT AND HIGH IN SODIUM. EVEN THOUGH THOSE
ITEMS ARE HEALTHIER THAN THEY ONCE
WERE, WE ARE STILL NOT MODELING THE BEHAVIOR
THAT IS INDEED HEALTHY. FOR SPENCER TAYLOR,
THE PRESENCE OF THOSE ITEMS IS NOT
THE PROBLEM. IN MY OPINION, MY
PERSONAL OPINION, PART OF WELLNESS
AND HEALTH IS PORTION CONTROL. WE ARE HUMAN. WE STILL WANT TO ENJOY
THINGS THAT WE LIKE. WE STILL HAVE
FAVORITE FOODS. IT’S AMAZING THAT WE
WERE PROBABLY A MORE HEALTHY
COUNTRY DECADES AGO, WE HAD SMALLER
PORTIONS AND IF IT WORKS THEN HOW COME
IT CAN’T WORK NOW. BOTH MORTON AND TAYLOR
AGREE THAT SCHOOL NUTRITION IS
IMPROVING; HOPEFULLY ENOUGH TO
MAKE A DIFFERENCE. I THINK THAT THE
CHANGES THAT ARE HAPPENING NOW WILL
DEFINITELY HAVE AN IMPACT ON
CHILDHOOD OBESITY. WE ARE ALREADY SEEING
SOME TRENDING TOWARDS REDUCTIONS IN OBESITY
AFTER SOME EFFORTS THAT HAVE HAPPENED
OVER THE PAST SEVERAL YEARS. WE ARE SEEING KIDS
CHOOSING MORE FRESH FRUITS AND VEGETABLES
AND HAVING KNOWLEDGE OF WHAT THOSE ARE
BECAUSE THEY ARE BEING EXPOSED TO THE MORE
FREQUENTLY AND A LOT OF THE BEHAVIOR CHANGE
THAT WE ARE LOOKING FOR LONG-TERM AND
CHILDREN IS BEING ABLE TO RECOGNIZE AND ENJOY
PICKING HEALTHIER OPTIONS AND JUST
GIVING THEM THE ACCESS TO THAT INCREASES OUR
PROBABILITY THAT THEY ARE GOING TO HAVE
THAT BEHAVIOR CHANGE LONG-TERM. THERE IS NO REALLY
EFFECTIVE TREATMENT FOR OBESITY RIGHT NOW. IT WOULD BE MUCH MORE
EFFECTIVE TO PREVENT IT AND SO WE DO NEED
TO HAVE A MAJOR FOCUS ON PREVENTION, WE NEED
TO RETHINK OUR MEDICAL CARE WHEN IT COMES TO
THIS ISSUE OF OBESITY. AS NOT ONE THAT
IS SOLELY MEDICAL, BUT ONE THAT IS
INSTEAD SOCIETAL. THAT MEANS THAT WE
HAVE TO CONSIDER WHAT EVERY SECTOR OF
SOCIETY NEEDS TO DO TO MAKE HEALTHY LIVING
THE DEFAULT OPTION, TO MAKE IT
SIMPLE, ACCESSIBLE AND AFFORDABLE TO LIVE A
HEALTHY GOOD LIFE ONE WAY TO LOOK AT THIS
OBESITY EPIDEMIC IS THAT WHAT IT HAS
ALREADY COSTING US. IT IS
COSTING US LIVES. THE COHORT OF CHILDREN
BORN IN THE YEAR 2000 WOULD BE THE FIRST
GENERATION OF CHILDREN IN THE UNITED STATES
TO NOT LIVE AS LONG AS THEIR PARENTS IF
CURRENT TRENDS CONTINUE IN OBESITY
AND OBESITY RELATED DISEASES, CAN WE
AFFORD NOT TO DO SOMETHING ABOUT THIS? WHILE EVERY PARENT
MUST HELP THEIR CHILD LEARN HEALTHY HABITS,
OUR STATE’S OBESITY RATES ARE NOT JUST
ABOUT HOW MUCH FOOD A CHILD IS EATING OR HOW
MUCH EXERCISE HE OR SHE GETS IN A DAY. THE RATES ALSO REFLECT
A COMMUNITY WHERE FRESH FRUITS AND
VEGETABLES MAY BE HARD TO GET, WHERE PHYSICAL
ACTIVITY MAY BE LIMITED DUE TO SAFETY
AND WHERE MEDICAL INTERVENTION IS VALUED
OVER PREVENTION. IF WE FAIL TO REVERSE
CHILDHOOD OBESITY RATES, OUR COMMUNITY
WILL SUFFER RIGHT ALONG WITH OUR
CHILDREN’S HEALTH. THE SOLUTIONS REQUIRE
ALL OF US TO ENGAGE IN MAKING TENNESSEE A
HEALTHY PLACE TO LIVE. PLEASE JOIN ME IN
LEARNING MORE ABOUT THE CHILDREN’S HEALTH
CRISIS IN TENNESSEE AND WHAT YOU CAN DO
ABOUT IT BY TUNING INTO NPT’S ONGOING
COVERAGE AND BY GOING TO WNPT.ORG SLASH
CHILDREN’S HEALTH. MAJOR FUNDING FOR NPT
REPORTS: CHILDREN’S HEALTH CRISIS HAS
BEEN PROVIDED BY: THE HEALTHWAYS FOUNDATION
ADDRESSING THE CRITICAL ISSUES OF
CHILDREN’S HEALTH AND PUBLIC EDUCATION THE
NASHVILLE HEALTH CARE COUNCIL THE HCA
FOUNDATION ON BEHALF OF TRI STAR HEALTH THE
METRO NASHVILLE PUBLIC HEALTH DEPARTMENT
THROUGH A GRANT FROM THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES AND THE
CENTERS FOR DISEASE CONTROL AND PREVENTION
ADDITIONAL FUNDING PROVIDED BY: THE
MONROE CARELL JR. CHILDREN’S HOSPITAL
AT VANDERBILT AND THE BAPTIST HEALING TRUST
AND BY MEMBERS OF NPT. THANK YOU.

10 thoughts on “Obesity 2013 Version | Children’s Health Crisis | NPT Reports

  1. I am tired of hearing that genes determine if u get obese or not.It doesnt.Genes give u a predisposition to storing up fat just as they give u predisposition to adiction,but genes alone dont make u fat,it is the combination between genes, environement, education and choices u make,the last two being the most important factors.

  2. What about some real nutrition density like, fresh game meat, organ meat, fish, eggs, full fat dairy, leafy green vegetables such as kale, mustard greens, collard greens, spinach, arugula etc?

  3. "big box" school, big box stores, big box shopping centers, big box churches. America has perfected industrial expedience and efficiency. It's an industrial feedback loop that generates profits (through cheap product) but destroys the health of the environment and the population.

  4. I do not understand. If some states have such high childhood obesity, why does the doctor say obese children are isolated when dating? Can't an obese adolescent date another obese adolescent? There should be an equal number of obese boys and obese girls?

  5. Take a 22 day vegan challenge! ➝ http://bit.ly/22veganed they will help you. The animals you consume are ill. The Raw Vegan Style: A Celebration of Life with Dr. Gina Shaw check out Dr. Gina Shaw

  6. Hey, I'm a UK Nutrionist and have setup a business to combat Diabetes & Obesity-we should talk as soon as possible please. I live in London, UK

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