Healthy Body Healthy Mind

I was able to watch the DVD entitled Healthy Body, Health Mind, which is a TV series. The particular episode I watched was focused on overcoming obesity. The TV series is produced by the Information Television Network (http://www.itvisus.com/programs/hbhm/ ). The series is centered on doctors making home visits to average Americans and discussing their health issues with them and then advising them how to make healthy changes.

I thought this program was a unique idea of discussing obesity with the public. Instead of being a health DVD that someone might only find at a library, the producers of this series was able to reach television watchers across the country. In this particular episode the doctors made visits to obese adults and one overweight child. One of the main priorities the doctors had was to inform the individuals about the danger of having excess carbohydrates in the diet. Several of the individuals ate low fat foods and enough fruits and vegetables, but they were not losing any weight. The doctors and other health professionals taught them how to count carbohydrates and which foods to avoid. Some of these recommendations were to avoid white flour products, rice cereals, pastas, and certain fruits like raisins, pineapples, and bananas. I thought this was an interesting focus to take on obesity. Usually counting carbohydrates is associated with diabetes, but it also pertains to eating a healthy, balanced diet. To learn how to count carbohydrates, check out this website, http://www.diabetesnet.com/diabetes_food_diet/countcarbs.php.

Often times we hear “eat a healthy diet” as a response to how to overcome obesity; however, from this DVD I learned that focusing on a specific part of a healthy diet can possibly be more effective and manageable. They stressed the idea of food substitution, and that dieting does not have to become a chore, but rather a conscious effort to be healthy. I liked this emphasis because remaining on a diet for a lifetime is usually not possible. Small dietary changes are more effective and sustainable for weight loss.

After watching this DVD, I had a greater interest to learn how to count carbohydrates. I want to learn more about the difficulty level of counting carbohydrates and how sustainable this program is. Last weekend I was able to attend the Diabetes Expo in Sandy and I heard a lot of diabetics talk about the difficulty of counting carbohydrates at each meal and snack. It would be very helpful to find an easier way to do this in order to help diabetics and others eat healthier and lose weight. It would be interesting to follow up on other interventions using carbohydrate counting to lose weight and compare the success with other types of diet interventions.

Community Gardens

In preparation for the grant proposal (due today!), our group has looked over the Community Gardens project, and even modeled our own grant proposal around some of the main tenets of the Community Gardens project. Here is a brief overview of Community Gardens.

The vision of the project is to increase opportunities for Utahns in low-income neighborhoods to participate in gardening to improve health.

Goals:
1. Educate the public about the value of gardening to improve healthy eating and physical activity patterns and the availability of community and at-home gardening resources.

2. Create new community partnerships and a policy team to develop community gardens and home gardens in low-income neighborhoods in Salt Lake and Weber Counties.

3. Improve access to healthy options by working together with low-income neighborhood leaders and community members to develop community gardens, offer gardening workshops, and provide technical assistance for at-home and community gardens.

Stakeholders for this project included KUTV2 News and Univision (a Spanish language media partner), Governor Huntsman's Office, Utah DOH, Wasatch Community Gardens, Utah Department of Agriculture and Food, Utah Department of Human Services, Utah Commission on Aging, the SLC Mayor's Office, Weber-Morgan Health Department, 5 A Day Association of Utah, IFA, Girl Scouts of America, University of Utah, Utah State University - Extension, and Borski Organic Farms.

It is obvious that this project reached far into community organizations to build support among those who were already plugged into potential community resources.

The project's activities included collecting proposals from community organizations throughout the state to start community gardens. 10 proposals were selected and funding was provided to develop community gardens associated with schools, churches, low-income housing communities, and boys and girls clubs. The aim of the project was to target low-income communities, and with the exception of a charter school, all of the projects had access to low-income participants. A tool library was maintained in case additional supplies were needed. They could be borrowed by an individual project and then returned.

The intitiative can be compared to Wasatch Community Gardens, which is a group of community gardens thoughout the state. One of the aims of this program was to strengthen the capacity of Wasatch Community Gardens.

As far as evaluation, the final report from the project states that evaluation fell outside the timeline of the project. That sounds like a cop-out, and I hope that evaluation has been performed to determine if future efforts should be made to expand upon this program.

Supersize Me!

Every time I eat at McDonalds, I feel sick afterwards. This is not to say that the food doesn't taste good (because it does), but there is something about that food which my body likes to reject. Because of its effect on me, I avoid eating at McDonalds at all costs. In the past 5 years, the only times that I've eaten at McDonalds were in China when either my wife or my visiting mother couldn't take eating any more Chinese food. So when I rented "Super Size Me" a couple of weeks ago, I knew that it likely couldn't increase my repulsion for the double arches; however, the documentary while not increasing my disgust, did give me some wonderful facts to throw around about what McDonalds' food will do to your body.

The director and star of this documentary, Morgan Spurlock, decided to eat nothing but McDonalds food for 30 days. He had to try everything on the menu at least once and had to super size his order every time that the cashier invited him to do so. Before he started this experiment, he was medically tested by 3 doctors and found to be in remarkable health. By the end of the month, he had gained nearly 25 pounds (17 of these pounds were gained in the first 12 days), consumed 5,000 calories a day, and ruined the health of his body. All 3 of his doctors warned him that if he continued on this diet, he would soon die. His cholesterol, triglyceride, and liver enzyme levels were off the charts.

After the experiment was over, it took about 15 months for Morgan's body to return to how it was before the experiment started. BAD NEWS.

Lesson learned? Fast food is not good for you, and it will kill you if you eat it all the time. I know that this food is really cheap and calorie dense, and because of that readily becomes a staple to those of lower socio-economic class. This shows that there is a need for policy to help people have the freedom to make better eating decisions.

There is, however, a matter of free will in the matter. Should people be allowed to eat whatever they want? Isn't it their life? Morgan did find that he was becoming dependent (addicted) to the food, though, and that is another thing to consider when weighing policy options.

In summary, go rent "Super Size Me" and let me know what you think about it. It will be a well-spent $1.99 at Blockbuster.

Targeting the Taqueria

Steps to a Healthier Salinas

Targeting the Taqueria: Implementing Healthy Food Options at Mexican American Restaurants

http://hpp.sagepub.com/cgi/reprint/10/2_suppl/91S.pdf)

I love this intervention for many reasons. First, it is a perfect example of a culturally tailored message. Instead of attempting to change Mexican cuisine, this intervention encourages taqueria owners to simple make a few food preparation changes to make their menu items healthier. They also tailored all of the educational material to the proper audience, which helped diffuse the information more effectively. Second, this intervention empowers members of the community to take responsibility for the health of others. I feel that if the whole community came together to promote good health we would see much lower rates of obesity, diabetes, and other health problems. It will be interesting to read the results of this intervention when the analysis is complete and to see how this intervention can be implemented in other areas.

Vision and Goals

The vision of this intervention was to develop partnerships to promote healthy communities with nontraditional partners, such as the owners of taquerias in Salinas, California. The intervention was aimed to use community health workers to help foster cultural links between underserved communities and efforts to improve health outcomes. The goal was to empower the owners of taquerias to offer healthier menu options as well as encourage their customers to choose the healthier options. In the beginning of the study only 16 taquerias were chosen to become partners; however, an end goal of the intervention was to include all taquerias in Salinas in the partnership.

Stakeholders and Leaders

The stakeholders in this intervention were the CDC because they funded the program as well as the owners of the taquerias and their staff members. Another stakeholder could be the people living in Salinas who frequent taquerias because they were affected by the intervention. The initial leaders of the intervention were members of the Stanford Prevention Research Center; however, their goal was to empower the taqueria owners to become the eventual leaders of the intervention

Actions Taken by the Program

• The first step was to become familiar with taquerias and their owners and then to stress current health issues in their community that they could help prevent.
• Partnering with local taquerias to help them become promoters of healthy foods for their community.
• To educate taqueria owners about offering healthier food options such as whole beans, whole wheat tortillas, and fresh fruit.
• To provide food preparation suggestions such as using less fat in food preparation, increase vegetables in menu items.
• Improving access to healthy food options in disadvantaged communities.
• Providing taqueria owners with a “healthy nutrition tool kit” which included information about diabetes, social marketing of healthier foods and health education visuals (such as portion size posters).
• A small grant program was developed through the ‘Steps to a Healthier Salinas’ that allowed taquerias to apply for funds to help change their photo menus to look more appealing and healthy.

Comparable Programs and Possible Partnerships

This intervention is one of the eight initiatives funded by the CDC to help foster healthy communities in the United States. I have read a few of the articles and all of them focus on community partnerships and empowerment. A similar intervention to “Targeting the Taqueria” was an intervention entitled “Rock on Café” (http://hpp.sagepub.com/cgi/reprint/10/2_suppl/100S). This intervention also worked with nontraditional partners to improve the nutrition of a specific group of people. Instead of taqueria owners, cafeteria workers were empowered to make healthy changes in the school lunch menu to help prevent obesity and diabetes among children. The target audiences were different, but the principles of the intervention were very similar. I feel like the taqueria intervention would partner very nicely with a community garden effort. Fruits and vegetables are often not included in one’s diet due to economic barriers or not having access to these foods. Having a community garden in the disadvantaged areas of Salinas would allow individuals to cook with and eat more vegetables and fruits when they dine at home. Taqueria owners could also use the community gardens to supply their vegetables and fruit for their menu items. This could reduce costs and enhance feelings of community ownership. A great article on a community garden intervention in an underserved community can be found here: http://hpp.sagepub.com/cgi/reprint/10/2_suppl/146S.

Measurement of Success

The results of this intervention have not been published yet and they have not defined how they will measure their success. In the conclusion statement they mentioned, “It is hoped that this innovative, tailored intervention, which is responsive to community needs, will have a sustained positive influence on the large and growing Mexican American population that is at high risk for obesity, diabetes, and other chronic diseases.”

I feel that success could be measured in a variety of ways:

*The percentage of taquerias that have adopted healthier food options in Salinas

*Feedback from the taqueria customers about the healthier food, their health, etc. gathered through qualitative data (surveys or in-depth interviews)

*Increased awareness of diabetes and obesity among taqueria customers in Salinas

*The percentage of customers choosing healthier menu items