The day McDonald’s added apple slices to the Happy Meal was the day any lingering denial about America’s obesity epidemic died. Houston, we get it. We have a Big Mac problem.
Our First Lady plants gardens and dances the “Dougie” with middle school students, and Cookie Monster now teaches our kids that cookies are a “sometimes food.”
It’s hard to imagine a time when concerns about childhood obesity were shrugged off with “It’s just baby fat,” but that’s exactly what Barbara Yager faced in 1999 when she helped found Charlottesville’s Community Action on Obesity (CAO), a taskforce-turned-coalition created to aid in the prevention and reduction of childhood obesity.
“When we first started, there was a lot of disbelief that it really was a problem,” said Yager, a registered dietitian. With the help of a few partners, she had collected the height and weight of third-grade students in Charlottesville City and Albemarle County schools and found that about 35 percent of the children were overweight. She followed those students through fourth and fifth grades and discovered that the numbers didn’t drop.
This wasn’t just baby fat or a third-grade growth spurt.
“And you have to remember that ’99 was before Surgeon General Thatcher said that obesity was a problem,” Yager added. “It was before CDC said it was an epidemic.”
So where do we stand after years of national and local efforts to increase awareness of childhood obesity? And in Charlottesville—where walkers and runners and cyclists abound, where farmers markets stay packed, and bumper stickers remind us to “Eat Local”—are our children any healthier?
“We’re certainly not going up, but we’re not going down significantly either,” said Yager. ”So in health terms, that’s sort of a win that we’re not getting worse.”
The percentage of overweight and obese fifth-graders in Charlottesville City and Albemarle County schools has hovered around 35 percent over the last decade.
In that sense, Charlottesville mirrors the nation. According to a report called “The State of Obesity” (formerly titled “F as in Fat”), things are looking up for American children. Sort of.
“After decades of alarming increases, this year’s report shows us that childhood obesity rates have stabilized in the past decade,” the study reads. Still, 31.8 percent of children in the U.S. are either obese or overweight.
O.K., so maybe a cautious pat on the back?
Not so fast. There’s still the issue of race.
“The State of Obesity” reports that in the U.S., 20.2 percent of black children are obese, compared to 14.3 percent of white children.
When Yager disaggregated her data by race, she also found a significant disparity. In Charlottesville City Schools, 27 percent of fifth-grade white children are overweight or obese, compared to 48 percent of black fifth-graders. In Albemarle County schools, those percentages are 30 and 51, respectively.
“My assessment of that is that we don’t have enough treatment opportunities for African-American children who are obese,” said Yager.
There’s still so much we don’t know, she explained, about the children represented by these numbers, except for their grade level and race. Are they from low-income families? What is the education level of their parents? The information Yager does have leads her to believe this city needs more resources. Though she probably won’t be the one to garner them.
As Yager heads toward retirement, she is passing the torch. Community Action on Obesity dissolved this fall—but not before launching Move2Health, a campaign to encourage Central Virginians to increase their physical activity levels and create healthier eating habits. Last year, participants logged the number of minutes they’d moved on the campaign’s website; this year, it’s how many fruits and veggies they’ve eaten. You might have seen human-sized vegetables and a flash mob promoting the benefits of healthy eating this fall at Fridays After Five. If you did, you saw a hint of the collective impact model Yager would like to see Charlottesville embrace. In September, she and members of CAO presented recommendations to City Council with a white paper.
“We thought rather than just quietly die, we should make a public statement about how we’re not letting go of obesity as an issue; we’re actually asking that the community take it on through their agencies and organizations and continue the advocacy.”
The local level
The Boys & Girls Clubs of Central Virginia is one organization that Yager believes can greatly impact the community. The Charlottesville branch has ramped up the variety of physical activities it offers, including yoga for its younger participants.
Seeing a need to reach teens in a new way, the staff launched a program this fall called FitKid. Twice a week, trainers from Club Mo Fitness visit the Cherry Avenue site and lead participants through body weight exercises for about 40 minutes. As a reward, the kids get to play basketball for the rest of the day.
“They hem and haw about it, but once they get into it, they enjoy it,” said Bill Tyler, who runs FitKid. “They compete with one another. It’s really taken off.”
Currently, Tyler sees 20 to 25 kids at each training session and hopes that he’s helping them to create a lifelong habit of health and fitness.
“I want the exercise and bettering yourself to be second nature to a lot of these kids, because it comes hand-in-hand with your physical, your mental, and your spiritual health,” he said.
Tyler’s willingness to try something new with kids is a quality shared by Diane Behrens, health and P.E. coordinator for Charlottesville City Schools. Though Behrens was part of CAO for years and is now on the Move2Health planning committee, she doesn’t pretend to have one answer or activity that will work for all students.
“We’re giving a lot of choice now in terms of activities,” Behrens said. “What we’ve found out is if we give two or three choices, then those who don’t like to do one activity may choose a different activity.”
Behrens seems to place the pressure on herself and her staff to reach students, rather than expect students to fall in line.
“We’ve worked on our approach to teaching students, as well,” she said. Her mindset, especially when working with older students, is, “Let’s figure out ways to be active that meet your approval.”
It looks like things have come a long way since stinky gym shorts and badminton tournaments. Charlottesville City Schools recently experimented with a virtual physical education class where students wore fitness bands and logged their activity online. A teacher monitored progress as students completed modules.
“We’re trying again to offer people as many opportunities as we can to be educated about physical activity and why it’s so important,” said Behrens. “The idea is that if we can educate early and change behaviors early, then we will have fewer adults that tend to be obese.”
If P.E. class comes with a Fitbit in 2014, then what comes in a school lunch? In Albemarle County, the answer is hummus.
Christina Pitsenberger, the director of child nutrition for Albemarle County Schools, says a hummus platter on the lunch menu has gained popularity among students. But it didn’t happen overnight.
“I think with the kids, what I’ve found that’s important is getting their input, taste testing, and promoting it,” said Pitsenberger. Before hummus ever appeared on the menu, The Farm at Red Hill visited schools to show students the ingredients and allow them to taste samples.
After listening to student input, Pitsenberger also added a “Make It Mine” entrée salad to the menu. Students wanted the freedom to choose their own protein, so now they start with a base salad and can add sunflower seeds, cheese, hardboiled egg, chicken, turkey, and other toppings.
Even though Pitsenberger works on the “food” side of keeping kids healthy, her bottom line sounds much like Behrens’.
“I think really the key for us is that when you offer variety, it gives children more options to find something that they do like that’s nutritious,” she said.
In some ways, the fight to reduce and prevent childhood obesity is not your mother’s. It’s not her Jane Fonda step aerobics or the peas she was forced to eat as a young girl. It’s about innovation and options, flexibility, and feedback.
But in other ways, maybe we are seeing a return to earlier practices. Childhood obesity has tripled in the last 30 years. Our portions are bigger, our ingredient lists longer. Most of us have no idea what’s in our corn—that is, unless we grow it ourselves.
In Charlottesville City Schools, students plant, grow, and harvest their own crops through City Schoolyard Garden, which launched in 2010 with a garden at Buford Middle School. Now the nonprofit organization manages gardens at all six elementary schools as well, with garden educators who work directly with students and teachers.
The link to reducing childhood obesity and gardening might not be direct or obvious, explained Jeanette Abi-Nader, executive director of City Schoolyard Garden. “No one says, ‘It makes me less likely to eat bad food,’” she said, referencing a video in which students share what gardening means to them. According to Abi-Nader, it’s all about the experience.
She gave the example of a carrot. Students plant or harvest carrots, then look up recipes and talk about what’s healthy, and finally cook dishes and taste them. “They have an experience with this vegetable which makes them much more likely to have it and use it in the future,” she said.
And that’s not just a hypothetical. Every year Buford Middle School students compete in a Veg-Off competition, in which teams cook dishes that include a secret ingredient from the school’s garden. Two or three of those recipes are prepared for the entire student body, which votes on the winning dish. This year’s ingredient was, in fact, the carrot, and the winning recipe, vegetable fried rice, was prepared by Whole Foods and served at the school’s Fall Harvest Festival.
Lydia Tewksbury, now a sophomore at Charlottesville High School, took a break from grinding corn at the Harvest Festival to recall an experience as a Buford student that changed her mind about one leafy vegetable.
“I never really liked Swiss chard,” she said. “But [the garden coordinator] let me and a couple of friends take some home. Every time I harvested and ate it, it tasted better. Something about growing it yourself makes it more special.”
Lydia’s personal experience illustrates research that children who grow their own food are more likely to eat it.
For Abi-Nader, the gardens are also an opportunity to build equity within education and food systems that are “inherently unequal.” She and her staff have witnessed kids touching soil for the first time in their lives, and that, in itself, is a win. But she knows equity means more than having a garden at every school. It means ensuring students have the same gardening opportunities regardless of their school’s location or the median income of their neighborhood.
“We’re really interested in creating parity across the school district,” said Abi-Nader.
If it was hard for some to fathom a childhood obesity epidemic 15 years ago, perhaps it’s harder now to imagine life without one. In Charlottesville, an active city that lands on “Healthiest Cities” and “Best Places to Live” lists, local childhood obesity data tells a story of both stability and racial disparity. Reversing the trend, it seems, will not just take more effort or more great programs, but targeted efforts and programs that reach the communities and children we’ve somehow missed.—Taylor Harris