The Kentucky obesity epidemic is striking in its dimensions and frightening in its potential. In Kentucky, a third of children, 60% of women, and 80% of men are overweight or obese. Our overweight and obesity rates are the highest in the nation for teens, the third highest for children, and the sixth highest for adults. Health care costs attributable to obesity in Kentucky will reach an estimated $2.3 billion dollars in 2013.
Though Kentucky’s obesity statistics are troubling, sustainable approaches can start to turn the tide of this epidemic. Sustainable approaches change the rules, the physical surroundings and the way day-to-day tasks are accomplished, tipping the scales in favor of healthy choices so we can prevent, rather than treat, childhood obesity.. The Tweens Coalition works to change the environments, systems and policies so the healthy choice becomes the easy choice for Lexington kids.
Increasing access to healthy food is identified as a key strategy for reducing obesity in Accelerating Progress in Obesity Prevention, an 2012 expert report from the Institute of Medicine. When we began this work we found a dearth of healthy food options available to Lexington youth in public places: public pools, ball parks, after school shops, KY State Parks. camps, and neighborhood stores. When the Tweens Coalition began working with Parks and Recreation in 2010 to increase the number of healthy offerings on the pool concession stand menu, bottled water was the only healthy item on the menu and it was priced higher than soda. Now the public pool menus include 65% healthy items and they are priced lower than the unhealthy items. Better Bites sales have increased consistently over a four-year period and in the summer of 2014, fruit outsold chicken nuggets 3 to 1 at public pools. The Southern Middle School after-school fundraising snack shop had no healthy offerings prior to had a “Better Bites makeover”. Now snacks sold meet Better Bites’ nutritional specifications. Revenue has dropped an average of $4 a week in this transition, a small financial loss the school partners are happy to bear in exchange for the gain of a healthier school environment.
The work of the Coalition is an uphill battle. We are attempting to shift deeply rooted habits of unhealthful eating and sedentary activities. It is increasingly hard to challenge those norms with an incredibly small staff and limited resources. However, given these limitations, the Coalition continues to do tremendous work. We can use your help to make healthy eating and regular physical activity the norm in Lexington!
Better Bites, a healthy snacking initiative, was developed in 2011 by the Tweens Nutrition and Fitness Coalition and Lexington Parks and Recreation in an effort to shift the balance of foods, from unhealthy to healthy, at Lexington public pools. Better Bites sales consistently increased over the four year trial period.
The existing food environment in Lexington is characterized by hyper-palatable, energy-dense, nutrient poor food that is not only inexpensive but extremely accessible. Research suggests that food consumed away from home is less nutritious (i.e., higher in calories, fat and sodium and lower in fiber, calcium, and iron) and is served in larger portions than food prepared at home. The community context plays an important role in shaping health behaviors. Although decisions regarding food-related behavior operate in a series of “nested environments” (i.e., nation, region, community, family, etc.), the greatest capacity for change and collective action arguably lies at the community level. Research suggests that the community food environment provides a particularly powerful site for reducing childhood obesity as it combines a geographic location with groups of people who are linked by social ties, share common interests and cultural characteristics, and engage in interaction in that setting.
The TNFC has worked with 32 partners to adopt Better Bites and increase the number of healthy offerings on their menus. This includes five public pools, five restaurants, two after-school shops, one ballpark, two summer camps and 17 state park resorts. We have a Better Bites "Good to Go" bike that we bring to bus stops and community events. A nutritionist currently working on contract for 14 hours a week coordinates this work along with the Coalition Director.
The Good Neighbor Store (GNS) initiative partners with small stores to bring healthier food to Lexington food deserts. Studies show that people who live closer to stores that carry healthy food have reduced risk of diet-related diseases.
Our work is based on two years of formative research that included listening to neighborhood youth and adults, store owners and staff, small business consultants, food wholesalers, farmers, police, elected officials and program champions from around the country who have done similar work successfully. A strategy document based on this research was developed and guides the work.
Stores that agree to make specific changes are designated as “Good Neighbor Stores”. This designation shows the store’s commitment to being a more positive neighborhood influence. The GNS coordinator currently working 20 hours a week helping store staff increase the amount of healthy food they stock and sell, as well as helping them make changes in store safety, appearance, marketing and community relations. The Lexington Market (corner of Race and Third Streets) made significant changes to increase produce sales. With the support of the Good Neighbor Store coordinator, they moved the produce cooler from the back of the store to the front, tripled the produce cooler space, added a counter- top fruit display next to the cash register and added local produce to their offerings. This has resulted in a more than 200% increase in produce sales. In addition, “What’s Cooking?” events are held twice monthly featuring local chefs selling healthy prepared items for a reasonable price.
Two new projects include working with Food Chain to open a neighborhood store/produce processing center in Smithtown neighborhood on 6th and Jefferson Streets and offering Bluegrass Double Dollars to SNAP recipients to increase their local produce purchasing power.
The SWAP team works with Fayette County Public Schools to adopt school wellness policies including: 1) end the use of food as reward, 2) ensure that all elementary school students get at least 20 minutes of recess every day and 3) include at least 50% healthy food in school celebrations.
The Coalition supports schools in implementing these changes with an online School Wellness Toolkit that includes a variety of practical materials. (http://tweenslex.org/school-wellness/school-wellness-action-plan-tookkit/) A SWAP You Tube channel features videos with school representatives that have successfully adopted the three proposed policies. A Wellness Program Champion booklet (online and hard copy) lifts up the good work being done in the district and helps other schools replicate those initiatives.
Special trainings on alternatives to using food as rewards, incorporating 60 minutes of physical activity into a school day and running an effective school wellness council are also offered.
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