Obesity war has allies, many battle fronts

PHOTOGRAPHER: Sara Foss

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New playgrounds. New gardens. A new freezer.

These are some of the Schenectady County anti-obesity projects made possible by a federal grant that seeks to promote physical activity and nutrition.

The measures sound simple, but can make a big difference. At one city school, an assessment revealed that about a quarter of students spent their recess sitting around; after a new playground was installed, that number dropped to 6 percent, according to Glynnis Hunt, the public health education coordinator for Schenectady County. And when a new industrialized cooler was purchased and installed at the food pantry run by the Schenectady Inner City Ministry, the organization was able to distribute an additional 62,000 pounds of fresh produce each year.

Schenectady County is one of four New York counties to receive a Strategic Alliance for Health grant from the U.S. Centers for Disease Control and Prevention. The grant, now in its fourth and final year, has enabled the county to partner with schools, businesses, churches and other local organizations to implement measures designed to promote healthier lifestyles.

Hunt said obesity is a “complex issue,” and that lowering the obesity rate will require “a culture shift away from processed food to fresh produce.” But she said this is easier said than done. Certain parts of Schenectady qualify as food deserts, meaning that residents have little to no access to foods needed to maintain a healthy diet. And people throughout the county are more reluctant to let their children go outside to play due to safety concerns.

A new study suggests that anti-obesity programs have their work cut out for them.

According to the report from the Trust for America’s Health and Robert Wood Johnson Foundation, more than half the people in 39 states will be obese by 2030. The study predicts that New York will see its obesity rate of 25 percent climb to 51 percent over the next two decades.

About two-thirds of Americans are overweight now, and about 36 percent are obese.

Peter Constantakes, a spokesman for the New York State Department of Health, said the percentage of people who are overweight or obese is “a major public health concern in New York and across the nation and increases the risk of developing serious chronic diseases such as diabetes, hypertension, coronary disease and more.”

Constantakes said that DOH is working with local health departments, health care providers, community groups, schools and other organizations to promote healthy eating and physical activity “where people live, learn, work and play.”

Busy and big

Nutritionists said obesity has a number of causes, including diets that are heavy in processed foods, lack of physical activity and the overall busy-ness of contemporary lifestyles, which make it more difficult for people to cook meals and find time to exercise.

“We’re always on the go,” said Karen Ingoldsby, a registered dietitian at Ellis Health Center. “We’re always working. There isn’t much time to cook. We’re fast paced, and we want our food to be fast and easy. We need to come up with a new way of doing things.”

Cornell Cooperative Extension of Schenectady County incorporates messages about healthy eating and the value of physical activity into its programming, which includes WIC, a federal program that provides food, nutrition counseling and access to health services to low-income women, infants and children up to age five.

“Everyone in the United States is probably eating more processed food, more sodium, more fat and more calories than recommended,” said Sarah Pechar, a registered dietitian who serves as assistant director of programs for Cornell Cooperative Extension of Schenectady County. “Our focus is on getting back to the basics.”

Through its education programs, Cornell Cooperative Extension discusses how to make healthy food choices while living on a limited income, and helps with menu planning. They talk about the importance of eating fresh produce, and if fresh produce is too expensive, they advise people to buy frozen fruits and vegetables. They encourage people to drink low-fat milk and discuss physically active games that can be played indoors if neighborhoods are unsafe. One such game involves blowing up a balloon and trying to keep it up in the air for as long as possible.

Pechar said that most of Cornell Cooperative Extension’s nutrition and wellness programs are designed to teach adults and caregivers how to make home environments healthier for children. Children don’t buy groceries; adults do. “If we can get the adults to stop buying soda, the kids will find something else to drink,” she said.

Many bad options

Pechar said rising obesity is caused by “myriad things.”

“When we were kids, we didn’t have all this technology,” she said. “We had TV, and that was it. Today’s kids are more sedentary. We didn’t have as much access to food. Every store now has food, and most of it tends to be unhealthy. Physical education and recess are getting cut back. Less healthy food tends to be less expensive.”

Obesity rates tend to be higher in limited-income families, because “families with better income might be better able to make better choices,” but “you could go into any school and find overweight and obese kids,” she said.

Pechar said she believes it is possible to prevent the sharp rise in obesity rates, noting that efforts to reduce the smoking rate had proven successful. “At one time, it seemed like everybody smoked, and people wondered how we were ever going to reverse that tide,” she said.

Another anti-obesity program that focuses on children is Eat Well Play Hard, an initiative of the state Department of Health that is administered locally by the Capital District Child Care Council.

There are two different Eat Well Play Hard programs: One focuses on child care centers, and the other on day care homes. The child care center piece involves visiting programs such as Head Start and providing lessons on healthy eating and fitness to children, parents and staff, while the day care home piece provides workshops to caregivers and children.

According to Jenna Depew, a registered dietitian who coordinates Eat Well Play Hard, the programs have four key messages: increase fruit and vegetable consumption, increase low fat dairy consumption, increase physical activity and decrease “screen time,” a category that includes TVs, computers and other technologies.

With the parents, Eat Well Play Hard staff might provide recipes and cooking lessons, while children might learn how to prepare healthy snacks such as fruit smoothies and fruit kabobs. They discuss how to buy fruits and vegetables at a lower cost, and the benefits of eating produce when it is in season. Another discussion topic is juice, which should be limited to between four and six ounces a day because of its sugar content and impact on teeth, Depew said.

Through the Strategic Alliance for Health, three Schenectady parks, Jerry Burrell, Vale and Carrie Street, have all received new playground equipment, as have seven city elementary schools and one parochial school. At the Schenectady ARC, which serves people with intellectual and developmental disabilities, a raised bed, wheelchair accessible vegetable garden has been created, and a garden-based nutrition education curriculum was adopted, with the goal of teaching the ARC’s clients how to create healthier meals.

“Each project has been special in its own way,” Hunt said.

Under the knife

The Bariatric Care Center at Ellis Hospital in Schenectady has seen a sharp rise in the number of patients it serves every year. Six years ago, the center administered 168 surgeries; that number has risen to about 700 a year for the past three years. The average surgery patient is about 100 pounds overweight, according to Anne Jones, the center’s clinical coordinator.

People who undergo weight-loss surgery at the Bariatric Care Center are people who have been overweight or obese “pretty much their whole lives,” Jones said. “They are broken. They’ve tried diets. They’ve tried exercise.” When these people arrive at Ellis, they are experiencing serious health problems as a result of their weight, such as Type II diabetes, high cholesterol and sleep apnea, or are at risk of developing them.

Jones attributed the Bariatric Care Center’s rising patient numbers to several factors, including the program’s strong reputation and the public’s growing awareness of the benefits of weight-loss surgery. “Most of our referrals are word-of-mouth,” she said.

The most successful patients maintain a connection to the Bariatric Center through post-surgery support groups, which address a whole range of questions, such as how to purchase a whole new wardrobe without breaking the bank and the importance of taking protein supplements, Jones said. “The process doesn’t stop,” she said.

Losing weight is difficult, and some people find it more difficult than others, Jones said. “There are a lot of things preventing weight loss,” she said. “Our bodies are designed not to lose weight. They’re preparing for the next famine.” Genetics, she said, are also a factor.

Ellis Health Center also offers one-on-one counseling with a registered dietitian; many of the patients who opt to participate in this program are struggling with obesity. “We try to educate patients, to motivate them,” Ingoldsby, the Ellis dietician, said. “The first thing we do is an assessment. We ask, ‘What are the issues? What’s in the way? Are they pretty much clueless about what they’re eating?’ People often come in and say that they have no idea how to eat healthy.”

Ingoldsby said she often gives patients individualized meal plans to follow, and discusses how to incorporate healthier meals into their daily lives. She encourages her patients to eat smaller portions and more fruits and vegetables — “the majority of people I see are low in that category” — and to increase their physical activity by walking more throughout the day.