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Chula Vista students slim down

Published: April 30, 2013 | No Comments

Fruits and vegetables replace cupcakes at Myrtle Finney Elementary, one of 44 schools in the Chula Vista Elementary School District.

By Marty Graham
California Health Report

When the Chula Vista Elementary School District south of San Diego surveyed the physical condition of the 25,000 students enrolled in 2010, the results were worrisome. About 40 percent of the kids were at an unhealthy weight – with the highest rates among fifth and sixth graders.

The survey prompted the district to act. The schools overhauled their menus, banned birthday cupcakes, integrated movement into recess and the classroom, and focused on educating students about better nutrition in the neighborhoods where obesity rates were highest.

By the time the survey was repeated this year, the programs put in place had had an impact, according to Sharon Hillidge, resource teacher for wellness. Body mass indexes were down 3 percent and fitness levels had improved.

“We were hoping for maintenance, we thought it would be five to 10 years before we saw improvement,” Hillidge said. “We were so pleased to see improvement – we have made an impression either on the students or the parents.”

The school district learned a lot devising the new program – garnering headlines with a “No Cupcakes” policy and startling everyone involved by finding they could draw obesity on a map. And, Hillidge said, they discovered that a lot of their stereotypes fell away and that new ideas for food-based activities like fundraising and parties came forward.

But they also found that everyone, the students, parents and teachers really engaged in the new approach to emphasizing the health of the students and that the small steps can yield big results.

“The biggest change was the sixth graders, who were in fourth grade when we did the survey,” Hillidge said. “They went down
five percent – and the two schools with the biggest losses were the most unhealthy – they improved by 10 percent.”

Chula Vista is a city with a clear east-west divide. The east side is mostly newer, planned development with more parks, higher family incomes and less access to fast food. The west side, old Chula Vista, includes more commercial development, including strip malls and a high concentration of fast food restaurants.

“We used the Center for Disease Control (and Prevention) maps for adult obesity as a base and then did overlays of where the fast food restaurants and parks are,” Hillidge explained. “It was a shock to see that where you live has such a profound impact on your health.”

Five schools in west Chula Vista had more than 30 percent obesity rates – the five closest to fast food outlet concentrations. Two years later, only two of the original five are still at that level, she said.

When the results for the 2010 survey came in, the school district mobilized to look at the food and activity environments, Hillidge said.

“Our concentration had been on scholastic testing, on keeping the kids at their desks learning,” she explained. “We realized we really need to be concerned about long-term health issues. We all worked in our silos so we didn’t have a connection with the Health and Human Services programs.”

The schools worked with the county’s department of Health and Human Services, which had launched a 10-year Child Obesity Initiative in 2006 in response to the alarming national increase in obesity and unhealthy weights – mirrored in the county population.

County Supervisor Greg Cox, who represents Chula Vista, has been active in promoting the county’s goals and tracking progress since the school district gathered its baseline data.

“The Chula Vista Elementary School District has done incredible work lowering childhood obesity rates among their students and creating a healthy, safe and thriving school district,” Cox said last week. “This district is a role model for school health and wellness, both locally and nationally.”

Jeffrey Thiel, the school district’s executive director for operations and instruction, said that it’s too soon to overthink the data.

“We see the data as a baseline and we are figuring out how to take this momentum and go forward,” he said. “I don’t think any of us can pinpoint a single cause for the improvement but we know that awareness has increased – what our students talk about at lunch has completely changed.

“We are giving them healthier choices and we are educating them on why it matters – we even hear from the parents, and that is very powerful,” Thiel added. “We had a lot of buy-in and less pushback, but we have plenty more to learn and plenty more to do.”

The first step in improving students’ health was the complete revision of the district’s wellness policy. A committee led by the district’s superintendent looked at nutrition and the food environment, physical activity levels and physical education and began communicating with families about their concerns and plans.

“Some of the changes seem so small – we no longer have flavored milk – it turned out not to be the big issue we thought it might be,” Hillidge said. “We changed to non-food birthday parties – that was the most controversial decision for parents and students.”

For teachers, the policy changes affected little things like not carrying cups with Starbucks logos, and big things, including all the fundraising for classrooms that involves selling food that usually isn’t very healthy.

“That takes away from our classrooms,” Hillidge said. “We still haven’t found a good answer there.”

Teachers worried that planned steps to get the kids more active inside the school would turn the classrooms into chaos, Hillidge said.

“We found we can integrate math and science with physical activity, and we had to show teachers it was doable without turning things into chaos,” she said. “Our teachers really care about the health of their students and we’re finding that as their health improves so does their ability to learn.”

And the schools revised recess to make it active by setting up activity stations – from playing basketball to walking around the track with friends, rather than just socializing or waiting for recess to end. The kids can still socialize – they just have to move while they’re doing it, Hillidge said.

Some of the survey findings were surprising and remain a surprise, Hillidge said. For example, boys were much more obese than girls.

“At the elementary school age, they’re the ones who are much more engaged in video technology, games and apps, than girls,” Hillidge said. “It would be interesting to see middle school results, when the kids are getting their own cell phones, and more girls are engaged with the technologies, but at this age, the cultural stereotype that boys are more active is not happening.”

Educating the kids about healthy eating and living has become a mission at the schools – down to choosing wellness as the topic for the schools’ speech contest.

“It gave kids a chance to work on their story-telling and to educate each other,” Hillidge said. “Information is power, especially when you give it to kids.”

 

Bringing Fresh Produce to Food Banks

Published: March 22, 2011 | No Comments

Leslie Sunny, executive director of Food Bank for Monterey County, picks up a bag of freshly gleaned fruit

By Michelle Santos

Leafy green vegetables, Brussels sprouts, beets and leeks aren’t typically the kinds of foods available at food banks. Fresh foods are hard to salvage for people in need, even though perfectly edible produce that doesn’t meet grocery store standards is often left to rot in the fields. But a Salinas organization, Ag Against Hunger, has developed some innovative methods for distributing fresh produce to food banks.

The organization runs a unique volunteer gleaning program, collecting surplus fruits and vegetables that would otherwise be left behind and plowed back into the soil. The produce is perfectly edible, but usually nearing expiration, said Karen DeWitt, executive director for the organization.

“It’s not just a bag of lettuce here and there,” said De Witt. “Last year we collected and distributed 12 million pounds of produce.”

Last year volunteers gleaned 450,000 pounds of fresh food left behind by commercial harvesters. That food was not bruised or spoiled. Produce fit for consumption is left behind for subtle reasons, like the age of the field or the prohibitive cost of harvesting a particular crop. Last year, for instance, a grower contacted DeWitt to ask if Ag Against Hunger would harvest a cherry orchard. A late rain ruined about half of the fruit, and paying pickers to sort it would have resulted in a loss for the farm.

Ag Against Hunger distributes to nonprofits and the food banks serving Salinas, Monterey, San Benito and Santa Cruz Counties.

“There’s a social obligation for us to give out nutritious foods,” said Leslie Sunny, executive director of the Food Bank for Monterey County. While fifty years ago food banks mostly distributed canned goods, “produce is the food of the future,” Sunny said.

Giving out fresh produce is especially important because of growing obesity and diabetes numbers. According to the U.S. Centers for Disease Control and Prevention, California carries a particularly high obesity burden, with approximately 36 percent of its adult population considered overweight and another 25 percent obese. The Monterey County Obesity Study revealed a 120 percent increase over a twelve-year period for Hispanic children, and sixty-four percent of Salinas’ population is Hispanic.

The keys to maintaining healthy weight, according to the National Center for Chronic Disease Prevention and Health Promotion, are physical activity and healthy eating, which includes consumption of fruits and vegetables. California’s Central Valley is known as the salad bowl of world, yet only 42 percent of Californians reported eating at least five fruit and vegetable servings daily—a recommended starting point—and less than 20 percent of children, according to the 2009 California Dietary Practice Survey.

Every weekend hundreds of volunteers show up to glean—pick remnant fruits and vegetables—to help bring fresh food to people who can’t afford to buy it. A gleaning session lasts from about 9:00 a.m. till noon. At the beginning of the day, volunteers are taught how to harvest, and then they don gloves and hairnets for a day of work in the fields.

The food and field labor are free, thanks to the more than 700 volunteers. But transporting the food to people who need it costs money. Bins must be purchased, a driver must be hired to transport the full bins of food, and then there are fuel and transportation costs. “We have to move the produce really quickly. We hold it at our cooler, and food banks and other nonprofits come and pick it up,” said DeWitt.

When their 5000 square foot cooler is overflowing and food banks from these counties have all the food they need, Ag Against Hunger reaches out to other California counties and has even provided food to Arizona and Washington food banks, according to the warehouse manager, Cesar De La Torre.

The fresh food needs to be picked and shipped quickly—usually within one or two days—and there is a lot of it to manage, according to De La Torre.

The variety of produce is a boon to food banks across the valley. “We get yams, onions and stone fruit that we normally wouldn’t,” DeWitt said.

One of the ways the Food Bank for Monterey County distributes that healthy food they receive from Ag Against Hunger is through open-air markets, similar to farmer’s markets—but all the food is free.

Once a month, from April through October, at ten Monterey County locations, 200 to 400 families have the opportunity to choose what they take home. Each household walks away with between 50 and 100 pounds of produce.

The help, Sunny said, couldn’t be better timed. According to the Bureau of Labor Statistics, at its peak in December of 2010, 16.4 percent of Salinas’ population was out of work. Unemployment is highest in Salinas and the Central Valley when growing season halts—December through March.

According to DeWitt, food banks are seeing more working poor—people who have some income, but not enough to feed a family. The Food Bank for Monterey County and Ag Against Hunger work together to meet the needs of one-fifth of Monterey County’s population, according to Sunny, and 18 percent of that population are children under five, living in poverty.

“We’ve seen a tremendous increase,” Sunny said, “in people standing in line to get food.”

 

Fighting Childhood Obesity with Bikes

Published: March 10, 2011 | Comments (2)
One of almost 70 bikes given away to students at Fresno's Susan B. Anthony Elementary School.

One of almost 70 bikes given away to students at Fresno's Susan B. Anthony Elementary School.

By Derek Walter

At Fresno’s Susan B. Anthony grade school, located in one of the most impoverished areas of the city, 78 percent of fifth graders don’t meet the state’s requirements for healthy fitness. Fresno pastor Mike Slayden decided to tackle the problem by encouraging students to walk or bike to school. Through his not-for-profit, he offers them a shiny prize for their work: a brand new bike.

Health statistics from the Susan B. Anthony Elementary School in Fresno highlight the scope of the childhood obesity in California. Fresno’s obesity numbers reflect a national trend—childhood obesity has tripled in the last 30 years, according to the Centers for Disease Control and Prevention.

The obesity problem, however, is especially difficult in areas such as Fresno. The city has the highest concentration of poverty in the nation, according to the Brookings Institute. The children’s advocacy group Children Now gives the Fresno area a D+ grade on its most recent report card of child health. One of the factors in this poor rating: more than 35 percent of children in Fresno County are overweight, according to the U.S. Department of Health and Human Services.
 

Off The Front founder Mike Slayden with a group of students from Susan B. Anthony Elementary School in Fresno to celebrate the giveaway of new bicycles.

Off The Front founder Mike Slayden with a group of students from Susan B. Anthony Elementary School in Fresno to celebrate the giveaway of new bicycles.

These disheartening numbers helped to spur Slayden, a cycling enthusiast, to launch his non-profit, Off The Front, nearly one year ago. The organization’s goal is to stimulate healthy living by mentoring students from Fresno-area elementary schools. Mentors help students meet the goals that eventually earn them a new bike. The phrase “off the front” is a cycling term; it refers to a cyclist who has broken away from his competitors during a race.
 
Before forming Off The Front, Slayden led church members volunteering at Susan B. Anthony in activities like fixing bicycles. He saw first-hand that students struggled with weight and their performance in school. They also exercised less than their more affluent counterparts, he said.
 
Other statistics paint a grim picture. One hundred percent of students qualify for free or reduced lunch. The school is surrounded by a neighborhood where more than 40 percent of the families live below the poverty line.
 
Susan B. Anthony became the model for the kind of school Off the Front wants to help by encouraging kids to be more active in terms of exercise and performance at school.

“You don’t have to be an A student, but you have to demonstrate some effort. But it is not so hard that it is unattainable,” Slayden said of the point system. “We wanted to strike a fine balance between this doesn’t need to be the moon but we wanted them to feel like ‘I paid for the bike. I earned it with my labor.’”

Off The Front partners with schools in two phases: The first phase targets fourth graders, who have the opportunity to earn a new bicycle, lock and helmet through a combination of increased fitness, better academic performance and service to others.

During phase two, Off The Front seeks to improve the health of all students at the school by encouraging everyone to walk or bike daily. One of the unconventional incentives is giving students a scanner to wear in the backpacks. Each time they arrive to school in an active way, like walking or biking, they are scanned and earn points. These points are then turned into credits towards a new bike.

Throughout the year they earn wristbands, which are color coded based on how far students have walked or ridden during the year.

Slayden was initially concerned that wristbands or other treats might not be enough to get kids to participate. But he found that the more he visited and talked to the kids, the more they embraced the concept.

“They get fired up. It almost becomes a positive peer pressure environment,” he says. “We have kids that are fit doing it. We have others that are morbidly obese doing it. It has been phenomenal.”

Students who want to earn bicycles can also earn points for a wide variety of activities. Volunteers help students document point-earning activities like better test scores on district benchmarks, helping parents with chores, or good behavior at school.

Joy Nunes, the principal of Susan B. Anthony, said there was an unforeseen benefit from the program. “We have seen an increase in attendance since we started Phase Two,” Nunes said. “Kids want to come to school to get zapped.”

Kids at both Susan B. Anthony and nearby Pinedale Elementary were ecstatic at ceremonies held to award bikes, Slayden said.

Off The Front plans to launch a Phase I program at four elementary campuses during the next school year. If he can find the funding, Slayden would like to expand to even more schools. Until then, the battle of fighting childhood obesity will be fought one elementary school at a time.

 

Obesity, diabetes, more prevalent among poor and less educated Californians

Published: September 1, 2010 | No Comments

By Daniel Weintraub

The latest look at obesity and diabetes trends in California from the UCLA Center on Health Policy Research shows how closely the twin maladies are tied to income and education levels.

The report notes that more than a quarter (27.7 percent) of adults living below the poverty line are obese, compared to 19.6 percent of higher-income adults. Diabetes was also more prevalent among adults whose incomes are less than 200 percent of the federal poverty level.

The numbers for education levels are even more dramatic.

Adults with no more than an 8th grade education are twice as likely to be obese as those who graduated from college (30.3 percent versus 14.9 percent). And diabetes is three times as common among adults with no high school education (14.8 percent) as among those who graduated from college (5.1 percent).

The report suggests that the concentration of fast-food restaurants and relative scarcity of markets that sell fresh food are likely factors in leading to the disparities in the prevalence of obesity and diabetes among the poor and lesser educated. Another factor: a lack of parks and open space.

See the full report here.

 

Obesity rates levelling off among some children

Published: August 17, 2010 | No Comments

By Daniel Weintraub

Childhood obesity rates in California are showing signs of leveling off or even declining among some adolescents, a new study led by UC San Francisco researchers has found.

But the rates continue to climb for some ethnic groups, and the worst cases are as numerous, and as serious, as ever.

The study, published online today in the journal Pediatrics, was the first to find differences in obesity trends over time by race and ethnicity, according to the authors.

Kristine Madsen, MD, MPH, an assistant professor of pediatrics at UCSF, and colleagues examined the body mass index (BMI) among adolescents in California from 2001 through 2008. The data for 8 million 5th, 7th and 9th graders were available from records kept as part of school fitness exams.

The study found that obesity rates among white and Asian girls and boys peaked in 2005, then dropped through 2008. Rates for Hispanic children also peaked that year and then leveled off, even as obesity rates for Hispanic boys declined. Rates among black boys were stable through the entire period.

Obesity rates for black and American Indian girls climbed throughout the period. And these groups were more than three times as likely as white girls to be severely obese.

And when comparing groups at the 99th percentile of body mass index — severely obese — only Asian youth and white boys showed any signs of decline after 2005. All other groups – including Hispanic boys and girls, white girls, black boys and girls, and American Indian boys and girls – peaked in 2005 and then remained at a plateau through 2008.

“When you look at the very heaviest end of the spectrum, the picture is pretty bleak, and we do not yet know if severe obesity rates for these groups will remain at a plateau or continue to increase,” Madsen added.

While the results suggest that anti-obesity campaigns are having an effect, Madsen said more change is needed at home, at school and in after-school gathering places to encourage healthier eating habits and reduce food consumption.

“While the decline and stabilization of obesity among certain groups is encouraging, we are seeing an increase in disparities that is troubling, especially among the most severely obese youth,” Madsen said. “As our country becomes increasingly diverse, it is critical that we act quickly to address these disparities.”

 

Obesity rates keep climbing in US

Published: August 3, 2010 | No Comments

By Daniel Weintraub

A record number of US adults are now obese, with 2 million more people crossing that unhealthy weight threshold between 2007 and 2009, according to new numbers released by the US Centers for Disease Control and Prevention.

More than 72 million adults are now classified as obese, which is defined as a body-mass index of 30 or more, a calculation based on the relationship between a person’s weight and height.

No US state has a population with an obesity rate of less than 15 percent, which is the official US government goal for the country. In nine states, the rate is greater than 30 percent. Just 10 years ago, no state had an obesity rate of greater than 30 percent.

California’s obesity rate is 24.8 percent. Sixteen states have lower rates.

Non-Hispanic black women (41.9 percent) and Hispanics (30.7 percent) have the highest rates of obesity.

Government agencies and non-profit groups across the country and in California are placing intense focus on the obesity issue, in part because the condition contributes to so many other health problems. The direct and indirect costs of obesity were estimated at $147 billion in 2008 dollars.

One example of a group fighting the epidemic is the Health Education Council. The council has launched a variety of initiatives to educate people about obesity and try to change their behavior. Many are aimed at children because so many children are overweight and destined for obesity and other health problems if they continue on their present course.

The council’s Rethink Your Drink” initiative works with medical professionals, agencies targeting children five years old and younger, schools, employers and local officials to provide training and education to get consumers to reduce or eliminate the consumption of sweetened beverages, which are associated with obesity, and Type 2 diabetes.

The council is also working with local farms to bring boxes of fresh produce to worksites, schools and community-based organizations, and working with employers to provide healthier food at meetings.

The council’s In the Grow program offers parent education and teacher training about healthy food choices and physical activity as well as how to start a school or community garden. And the council is working more broadly to ensure that all Californians have access to healthy and affordable foods and beverages, especially fresh fruits and vegetables.

To see the full CDC report, go here.

 

Putting walkability to the test

Published: June 2, 2010 | No Comments

ashby wolfe

Ashby Wolfe MD, MPP, MPH

By Ashby Wolfe

I recently returned from a very interesting few months working in the hospital and traveling to various conferences around the country. The topic at many of these meetings was, of course, health reform. It is no secret that I am a big fan of much of what is in the legislation, especially the emphasis on preventive health care, and funding for primary care to assist patient in the treatment of chronic disease.

Part of the reason I am so excited about the national push for prevention is because our country continues to move slowly towards becoming the most overweight nation in the world. Our rates of heart disease and diabetes are sky rocketing. It is my hope that funding for preventive care can help get our health back on track.

However, it is going to take more than national legislation to reduce our collective body mass index. This was never so apparent to me as when I recently attended a two-day conference in Washington DC. I began my trip reading more about the Let’s Move Campaign, an ambitious federal program aimed to reduce childhood obesity by promoting physical activity and healthful eating in schools. Motivated by the opportunity to meet some of the people behind the creation of the program, I eagerly reviewed the action plan. Seeing the words “food desert” and “complete street” in a national policy brief was exciting – especially since many dedicated community members, academic researchers and patient advocates have been using this terminology for decades without much national attention.

I was properly motivated as I deplaned in DC, and being a fan of public transportation, I decided to do as much walking as possible in our nation’s capital and really embrace the spirit of Let’s Move. I decided to keep track of my efforts and see just how easy it was to stay physically active while on a highly scheduled two-day business trip.

I had no trouble walking through National Airport, and made it to the METRO train (conveniently located across the street from the airport) without incident. One fifteen minute ride later and I had arrived in Alexandria, Virginia. I had just a short 10 minute walk to the place I would be staying, but this walk proved rather difficult in a business suit and suitcase. A sidewalk was available for the first three minutes of my walk, but then ended abruptly at the busiest intersection in town, without a cross walk in sight. Undeterred, I continued along the safest side of the street, half in grass and half in dirt. I eventually made it to another section of sidewalk, which then took me to the driveway of my destination.

The remainder of my trip was spent mostly in the downtown areas of DC near the Capitol, where the METRO stops regularly and sidewalks are plentiful. However, my return to the airport again involved a walk along a rather dismal stretch of road that only the bravest of souls would consider traveling with a suitcase. Needless to say, a street complete with sidewalk and bike lane is always welcome.

As the country continues to focus on prevention as a key part of our improved health, many local groups are starting to discuss complete streets, and smarter growth development policies, to make communities safe for outside activity that is not dependent on the automobile.

For health professionals like me, who tend to recommend walking as a key activity to promote weight loss and healthy lifestyles, the importance of campaigns like Let’s Move and community coalitions supporting smart growth cannot be overstated.

If you are curious, you can test the “walkability” of your city or town and find handy routes to exercise or explore. Consider supporting local community efforts; many cities are developing tools for smart growth advocacy to support such change. You can also visit the Let’s Move website (see link above) to see how you and your community can get involved.

Or, do your own walkability test and see for yourself!

Ashby Wolfe is a resident physician in the Department of Family and Community Medicine at the UC Davis Medical Center in Sacramento. She holds an MD as well as masters degrees in public policy and public health. She blogs at www.ashbywolfe.com and is a guest blogger for HealthyCal.org on issues of family medicine and community health. Her opinions are her own and do not necessarily represent the views of UC Davis or HealthyCal.org

 

State Senate bans sport drinks in high schools

Published: May 27, 2010 | No Comments

The state Senate has approved a bill to ban the sale of sugar-sweetened sport drinks in the public schools during school hours.

The bill, SB 1255, would tighten a restriction that already forbids the sale of soft drinks but did not include electrolyte replacement beverages in the ban.

The author of the bill, Sen. Alex Padilla, called it a “common sense step” in the effort to address obesity in California. Gov. Arnold Schwarzenegger also supports the bill, which now moves to the Assembly.

Childhood obesity is the primary cause of type-2 diabetes and other long-term health problems. Studies have found that greater consumption of sweetened beverages is associated with weight problems and obesity among children and adults.

Padilla said California Department of Public Health studies show that electrolyte replacement beverages are replacing sodas as the beverage of choice for school-age children. Instead of replacing soda with water and other healthier beverages, Padilla said, students are buying sport drinks. Eight of the top 10 beverages sold a la carte in California public high schools are electrolyte replacement beverages, he said.

 
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