Obesity’s roots in poverty noted

SEATTLE – Laurieann Cossey has always struggled with her weight. Four years ago, she was diagnosed with diabetes. Now, 6 months pregnant and struggling to get by, the single mother tries to make sure her 1-year-old son gets the fruits and vegetables he needs.

“I worry a lot about my son being obese,” said Cossey, whose mother and grandmother also had diabetes.

Cossey, 43, of Lynnwood, a full-time community college student, and her son, Andrew, survive on food stamps, trips to the food bank, and a state program that provides a few essentials, including dairy products, fruit juice and cereal, to pregnant women and their children.

She knows they should both be eating more fruits and vegetables. But the foods recommended by the government’s new food pyramid are simply too expensive. Boxed macaroni and cheese costs less than a dollar to feed the whole family, while a fresh chicken breast and steamed vegetables cost about $2.60.

“I’m sure we’d all like to feed our children a nice healthy chicken breast and asparagus,” she said a recent visit to a vegetable market north of Seattle. “If we are low on fruits and vegetables, my child gets his first.”

But pasta, canned vegetables and hamburger are much more likely to be on Cossey’s table.

Scientists, doctors and government officials all over the nation are working on ways to get families like Cossey’s to eat healthier food. Some innovative new programs are making progress, but the results are not coming fast enough as Americans get fatter and fatter.

Doing something as simple as removing soda machines from schools is a change that can make a big difference, said Dr. Donald Shifrin, a Bellevue pediatrician who is chairman of the communications committee of the American Academy of Pediatrics.

“Small, measurable changes are better than Draconian I’m-never-going-to-have-it-again change,” Shifrin said. School districts across Washington state have decided to evict pop machines and unhealthy food from vending machines, despite thousands of dollars in lost revenue from the decisions. They were encouraged by a new state law requiring them to review their nutrition and physical education policies before school started this fall.

Bellevue School District decided to ban junk food and soft drinks from its schools about a week before school started this fall, replacing candy and soda in vending machines and school stores with beef jerky, granola bars, nuts, water and fruit juice.

Dr. Lydia Tinajero-Deck, who works on an obesity program at Children’s Hospital &Research Center in Oakland, Calif., applauds such action. A soda a day for two weeks can add a pound of fat, she said. When nutritionists in her clinic meet with families, the first questions they ask are about soda.

The poor have more barriers to dealing with obesity, eating healthy and leading an active life, Tinajero-Deck said.

Fast food restaurants are more common in areas where they live. Grocery stores selling a variety of fruits and vegetables are rare. Corner stores that sell no fresh fruit are more common. Many parents work one or two jobs and don’t have the time to cook healthy meals.

The Center for Public Health Nutrition at the University of Washington is working with a number of local agencies to promote healthy eating and exercise by offering grants for promising projects.

In Moses Lake, a rural town in Eastern Washington, community agencies are working with citizen volunteers to improve walking trails and a community garden is giving residents a place to grow their own fruits and vegetables.

The state Department of Transportation is working with 11 school districts around the state to promote walking and biking to school through its Safe Routes to Schools program. The government agency supplies funding to improve walking and biking safety and even paid to complete a sidewalk near one elementary school.

In Connecticut, Dr. David Katz’s Yale-Griffin Prevention Research Center is finding creative ways to encourage more physical activity.

Some of the ideas from fitness experts included dancing to the radio for a half an hour each day instead of watching TV, and making walking safer by finding partners through postings at churches and health clinics. Katz also wants to see “energy bursts” in classrooms – five minutes of aerobic activity many times a day could help kids stay healthier and also decrease behavior problems.

“That’s the kind of the thing I think we should investigate: creative solutions that ask the question how, rather than whether,” Katz said.

Katz also advocates more sweeping measures, including subsidies for vegetables, a junk food tax and color-coded food labels, green for foods that are really good for you and red for junk.

“The food industry will have none of it,” Katz said.

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