Biting into obesity
SDSU program introduces nutrition strategies for kids
By Lisa Petrillo
UNION-TRIBUNE STAFF WRITER
October 16, 2006
EARNIE GRAFTON / Union-Tribune
The frog leap, led by second-grader Carlos Ruiz at Smythe Elementary School in San Ysidro, and other playground activities are part of a San Diego State University program to promote healthy eating and combat adolescent obesity.
The pudgy preteen steps outside El Tigre market in San Diego's South Bay clutching a super-size pack of Flamin' Hot Cheetos as if it were a prize and not a nutritionist's nightmare. He runs smack into the Aztec Food Police deployed at the store's entrance. This group of mothers patrols the front line of a $3.7 million federal research project, trying to keep children from a lifetime of obesity and its many inherent ills – diabetes, cancer, early death.
Food cop Reyna Torres tries to persuade the boy to trade his junk food for fresh fruit, but he won't bite.
The encounter is a small moment in a battle with huge stakes, said John Elder, a veteran San Diego State University public health researcher and project team leader. If it works, government officials will consider changing public policies to mirror the team's successes in schools nationwide. “Sure, the government can't dictate to families to take the GameBoys away from the kids and get them up off the couch,” Elder said. “But if you change the culture, that will come.”
The challenge is formidable. Overweight adolescents face a 75 percent chance of growing into dangerously fat adults.
About 14 percent of Caucasian children are overweight and obese – a rate that has more than doubled in 20 years, according to the U.S. Centers for Disease Control and Prevention. Among Latino children, the obesity/overweight ratio is nearly one in three.
How to intervene in the growing epidemic is a challenge. Several health outreach groups in San Diego County said they don't have projects specifically targeting recent immigrants, as the SDSU project does. Instead, their efforts tackle diseases, such as diabetes and hypertension.
Karen McCabe, who runs a program for women from Somalia, said that for many immigrants, a lifestyle that used to be active and agrarian becomes sedentary when they come to the United States. “They eat the wrong foods and gain weight. Many foods and vegetables that we have here aren't similar to what they have at home, so they don't try them.”
Elder of the SDSU project is four years into his five-year National Institutes of Health grant, one of the agency's first forays into obesity prevention.
Elder is a co-investigator in another major grant from the NIH's National Heart, Lung and Blood Institute, a $9.7 million contract for a six-year study on the health of Latinos of all ages. San Diego's South Bay will serve as one field center; others will be in Chicago, Miami and New York.
For his grant focused on childhood obesity prevention, Elder's team used dozens of fat-fighting strategies in South Bay communities and schools.
“What we want to do is to change their environment,” research team member Susan Duerksen said.
To expand their reach, the team has partnered with the California 5 A Day Program, which educates consumers about the importance of the food pyramid and the need to eat five servings of produce daily.
SDSU's grocery store outreach, like the one at El Tigre, aims to change what's in the refrigerator. While fruits and vegetables are plentiful in markets catering to Latinos, Duerksen said, the problem is the heavily marketed invasion of unhealthy choices. The Cheetos factor.
To evangelize nutrition, the SDSU team developed offers in partnership with merchants, like giving shoppers frequent produce-buyer cards: Buy 10 pounds, get one free.
They're offering families healthy recipes with a Latino emphasis: dessert tacos filled with low-fat ricotta cheese and blueberries; rice spiked with fresh peas.
As Aztec Food Police captain, Duerksen cruises El Tigre to ensure the bright signs the SDSU nutritionists have created are posted prominently. Small notes sit by the junk food aisle: “Try crunchy carrots and celery.” By the cookies, she's posted one pushing fruit as a sweet alternative.
Outside the market, Spring Valley parent Mereida Nuñez listens to the Food Cops and collects the goodie bag of freebies, recipe books and lunch coolers she gets for healthy choices like ceviche makings: onions, limes, fresh fish.
While Nuñez and her children have no apparent weight problem, she said she struggles to do the right thing nutritionally.
“The hardest thing is tradition, the greasy foods of our culture,” said Nuñez, glancing at her cart with deep-fried tortilla shells lurking amid the produce.
What's crucial on the front lines of changing behavior is not to act like some know-it-all outsider lecturing people to eat their greens, Duerksen said.
She has staffed the troops in SDSU's anti-obesity war by relying on a Latino cultural model. She recruits prominent neighborhood women, like Torres and Maria Elena Aguilar, as representatives, or promotoras, whose advice carries more weight in their communities.
Duerksen's promotoras work with South Bay schools to spruce up playgrounds and supply cash-strapped campuses with more jump ropes, hula hoops and utility balls. They started after-school walking and running clubs to get parents moving, too.
“The kids do it (walk laps) for awhile and get bored, but when they see the mothers walking, too, they stay,” said Aguilar, who said she has seen many children slim down in the program.
One of SDSU's biggest successes has been its partnership with South Bay restaurants to provide something simple but effective: a nutritious children's menu.
Menus are square pieces of plastic the size of a first-grader's shoe that sit on tables with the salt and pepper. Healthy kids' options include fruit salad, chicken breast and green salad, and beverage choices such as low-fat milk.
The menus make children feel special because it's something just for them, Aguilar said.. Most places the Aztec Food Police have visited, such as the mermaid-themed Las Sirenas in Chula Vista, never had menus para los niños.
Without choices for children, parents fed their kids from their own plates, or ordered adult portions for them. Those are Bad health options, Aguilar said.
The SDSU-supplied healthy kid promotion has proven popular among small independent restaurants looking for any competitive edge to lure customers from chain establishments. What parent wouldn't feel guilty bypassing a fast-food joint for a mom-and-pop restaurant with a big sign boasting, “Special Healthy Kids Menu,” and university-approved notations everywhere?
At one participating “healthy kids” restaurant, Tropical Fruits Deli in Chula Vista, the specialty is a smoothie-style drink made with fresh fruits blended with ice instead of higher-fat ice cream.
Children have surprised her, said Tropical Deli owner Alma Arce. They choose the healthy offerings with little fuss – the omelets, the club sandwich, the junior-size shrimp cocktail.
“They're pretty smart about what's good,” Arce said.
SDSU Obesity Program
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