Nashville Children Eating Well (CHEW) for Health
The Center for Prevention Research (CPR), directed by Dr. Jan Emerson, organized and planned the first annual Nashville Children Eating Well (CHEW) for Health conference held on Thursday, November 10, 2011. A total of 119 registered for the conference, including 23 students, and a total of 92 attended. The attendees included 15 students, 18 public health workers and healthcare providers, 23 non-profit organization representatives, and 26 university staff and faculty, and 10 other community members.
Dr. Jan Emerson, the TSU CHEW Co-PI, moderated the program. Dr. Chandra Reddy and Dr. Baqar Husaini welcomed the attendees on behalf of Tennessee State University, The College of Agriculture, Human, and Natural Sciences, and the Center for Prevention Research. Dr. Husaini, as CHEW Principal Investigator, enumerated the reasons for the concern with childhood and adult obesity by sharing the growing prevalence in the U.S. of obesity-related illnesses and resulting mortality. Drs. Hull and Levine, the Vanderbilt and Meharry CHEW Co-PIs, gave an overview of the CHEW project and reported on the activities that will be implemented in the Nashville area with the participants in the WIC (Women, Infants, and Children) program. The research component will develop culturally-tailored educational materials that, after testing, will be available for use by the Tennessee Department of Health. Additionally, the extension component will work with WIC vendors and their consumers to encourage more access and purchase of fruits and vegetables, while the education component will train medical students, residents, practicing physicians and nutrition students in the prevention and management of obesity. Therefore, while all activities for the project will be local, the results may have far-reaching effects.
Next, there were seven presentations from researchers from various universities, including Vanderbilt, University of California – Davis, Colorado State University, University of Alabama and Tennessee State University. Speakers presented on the following topics: factors associated with poor health literacy; factors in the social environment that contribute to overconsumption of high caloric foods; what approaches help children to establish health eating habits; how energy expenditure is related to weight gain; how to make introduction of novel foods fun; and what are food deserts and how they contribute to the obesity problem.
Time was allowed when possible for questions and answers after each presentation. Additionally, to evaluate the impact of the conference, CPR had attendees fill out a pre and post survey to determine whether the attendees increased their knowledge of the topics presented. The CHEW team will now begin planning for a community day to be held in April 2012 designed to attract the targeted community of WIC families and their children for a day of food preparation demonstrations, food tasting and nutrition-related games.
CHEW Symposium 2011 Abstracts
Russell L. Rothman, MD MPP, Associate Professor and Chief of Internal Medicine & Pediatrics, Vanderbilt University School of Medicine
“Addressing Health Literacy and Health Communication in Pediatric Obesity Prevention”
In 2003, Surgeon General Richard Carmona stated that low health literacy was “one of the largest contributors to our nation’s epidemic of overweight and obesity.” This assertion is supported by recent studies which have found that low health literacy or numeracy is associated with poorer caregiver breastfeeding knowledge, incorrect mixing of infant formula, difficulty understanding food labels and portion sizes, and higher Body Mass Index (BMI) in adults and children. Of particular concern is the impact of the obesity epidemic on our youngest children. Over 26% of preschool children are now overweight (BMI≥85%) or obese (BMI≥95%). Rates of obesity in preschool children have doubled over the past decade, with the highest increases among low income and minority children-- the same communities most affected by low health literacy. This presentation will discuss the importance of health literacy and health communication in pediatric obesity prevention, and will share the details of an ongoing multi-site randomized controlled trial addressing health communication to address pediatric obesity prevention in children 0-2 years of age.
Monica L. Baskin, Ph.D., Associate Professor Division of Preventive Medicine, University of Alabama School of Medicine firstname.lastname@example.org
“The Influence of the Food Marketing Environment on Calorie Overconsumption Among African American Children and Their Families” Social and environmental inequities in food environments may contribute to a greater burden of obesity among African American children. Targeted marketing of high caloric foods to African Americans have been recognized by researchers, but perceptions of community members have yet to be explored. The purpose of our research was to assess caregivers’ perceptions of the food environments contributing to overconsumption of calories among African American children (ages 3-11). Using a communitybased participatory research (CBPR) framework, 30 community members participated in depth interviews and a Photovoice project to document community concerns. Content analysis was used to summarize qualitative data. Our findings suggest that an abundance of “junk food,” lack of healthy foods, and limited skills in preparing healthy foods were recognized by caregivers as primary contributors in the home environment. Outside of the home, high presence of marketing (in-store ads, billboards), limited products in food stores, and lack of full service grocers were implicated in the neighborhood environment. Actions to address these issues were proposed including social marketing, a moratorium on new fast food restaurants, and incentives for wholesale/discount stores to locate in these communities. Caregivers perceive their home and neighborhood environments as contributing to the overconsumption of calories among young African American children. As such, we believe that communities armed with local data and action strategies can help galvanize the demand for healthy food and eliminate environmental inequities.
Marilyn S. Townsend, Ph.D., Cooperative Extension Specialist, Department of Nutrition, University of California-Davis
“Obesity Among Preschool Children: Research to Guide and Evaluate Community Prevention programs”
This presentation will focus on recent research targeting obesity prevention among low-income families with young children. Results will be presented on two visually enhanced tools Healthy Kids and My Child at Meal Time designed for pediatric obesity risk assessment and program evaluation. Results of new behavior change strategy adapted for this parent audience will be hared. Funding for this research was provided by the University of California Cooperative Extension, NIFA NRI, and NIFA AFRI.
Veronica J. Oates, Ph.D., RD, LDN, Assistant Professor of Nutrition, Tennessee State University
“Youth Active and Media Savvy (YAMS) Pilot Camp: Process and Feasibility“
Using an integrated approach, Youth Active and Media Savvy (YAMS) aims to promote weight management behaviors by counteracting the harmful effects of negative cultural values on African American youth. The camp is designed to teach an appreciation of African culture and reinforce it on multiple levels (individual, interpersonal, organizational, and community). The goal of the intervention is to empower African American children ages 8 to 14 years to improve their dietary behaviors and practices regarding (1) media literacy knowledge; (2) healthy cooking and food preparation skills; and (3) daily physical activity. The pilot camp held July 2011 provided a methodical run-through of the proposed intervention as well as an existing media literacy curriculum to determine its cultural appropriateness. The pilot group of four males and four females attended the pilot camp for one week. Debriefing of the youth regarding their experiences allowed us to adapt the curriculum, materials, content, schedule and other aspects of the camp format. Pilot study participants received $30 for their time and effort. Eligible youth were deemed at risk for adulthood obesity as evidenced by any of the following: (1) A BMI at or above the 85th percentile for age and sex; (2) At least one obese parent (BMI ≥30); (3) Low family income as evidenced by eligibility to receive free or reduced lunch; and (4) Identify or classify themselves as Black /African American.
Maciej S. Buchowski, Ph.D., Research Professor of Medicine and Pediatrics, Director of Energy Balance Laboratory, Vanderbilt University Medical Center
“Can We Balance Calories? Yes, We Can!”
Childhood obesity is associated with various health-related consequences. Obese children and adolescents may experience immediate health consequences and may be at risk for weight-related health problems in adulthood. The goal for obesity prevention is to maintain a healthy weight in children. To achieve this goal energy from foods and beverages must be balanced with the energy used for physical activity and normal growth. The goal for intervention in overweight and obese youth is to reduce the rate of weight gain while allowing normal growth and development. This could be done by reducing energy from food or increasing energy for physical activity. Definite relationship between physical activity, nutrition, and obesity in children remains unclear and the knowledge gap is related, in part, to methods used to assess energy intake and expenditure.
Jennifer Anderson Ph.D., R.D., Professor and Extension Specialist, Colorado State University
“Overcoming Picky Eating with Food Friends: Fun with New Foods®”
The Food Friends® program (visit: foodfriends.org) is the most recent nutrition education program designed for the preschool age child, their teachers and parents. The Food Friends consists of two programs Food Friends: Fun with New Foods® and Food Friends: Get Movin’ with Mighty Moves ® to address obesity by overcoming picky eating and enhancing gross motor skills. Jennifer has served as President of the Society for Nutrition Education and two terms as President of the Rocky Mountain Affiliate of the American Heart Association. In addition she has served on the national board of American Heart Association. Food Friends: Fun With New Foods is a 12-week classroom program for pre-school aged children. The program introduces children to new foods through dynamic, tactile, and engaging activities. Through this fun, interactive journey with new foods, children become more willing to try other new foods, ultimately leading to improved diet quality. This presentation will present the 10 years of research and evaluation data that has been collected attesting to the success of this program.
David G. Schlundt, Ph.D., Associate Professor of Psychology, Vanderbilt University
“Obesity and Food Deserts in Tennessee: A Tale of Two Places”
There has been much recent interest in the idea of food deserts. Food deserts are areas in which residents have little or no access to healthy foods. Food deserts are created by lack of food resources, poverty, and lack of access to affordable transportation. The idea of food deserts has been applied to urban areas, but little attention has been given to rural food deserts. I will explore food deserts in Nashville using data from the REACH 2010 project. Differences between food deserts and other areas on eating behavior, exercise, obesity, and chronic illness will be examined. For the entire state of Tennessee, food deserts will be identified at the zip code and county level. These data will be compared to the Behavioral Risk Factor Surveillance System (BRFSS) data and to Tennessee Mortality data from nutrition related disease. The presentation will use maps to illustrate relationships between food deserts and health indices at both levels (within Davidson County and Statewide). Different strategies may be needed to address urban and rural food deserts as a way to reduce the burden of obesity