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'Let's Move' aims to cut childhood obesity, diabetes

This article first appeared in the St. Louis Beacon, April 25, 2010 - Lady Bird Johnson championed highway beautification. Laura Bush had a passion for reading. Now Michelle Obama is capturing the public's imagination by shining a light on runaway childhood obesity.

The first lady's "Let's Move" exercise and action program didn't come a day too soon, says Debra Haire-Joshu. Haire-Joshu is a Washington University professor with an international reputation for successfully reducing obesity and preventing diabetes, especially among poor youth. She is grateful that Obama has taken on this cause. Haire-Joshu says the solution to high rates of obesity and diabetes is creating environments "where it's easy to be healthy."


Washington University has worked closely with the Department of Health and Human Services in setting priorities for addressing childhood diabetes, triggered in part by obesity. The department's recommendations are said to have helped shape Obama's "Let's Move" campaign, which aims to reverse childhood obesity within a generation.

Haire-Joshu says tackling this problem is urgent. Childhood obesity rates have more than doubled in three decades. It raises the specter, Haire-Joshu says, that this could be the "first generation that may not outlive its parents."

The obesity epidemic began in the late 1970s and early 1980s when "we had a whole generation that learned to overeat," she says. Overweight parents with diabetes started passing the problem on to their children.

In the past decade, the Missouri Department of Health and Senior Services has found that the prevalence of overweight children in Missouri is higher than the national average: 18.6 percent of adolescents screened in Missouri were overweight, compared to the national average of 14 percent. Black and Hispanic children appear to be at a higher risk for being overweight.

One problem, not surprisingly, is what the kids eat. French fries, for example, are the second largest contributor to a student's total fat and caloric intake, according to state data. Soft drinks are the second largest contributor to a student's total carbohydrate intake.

Yet simply changing what's being served in school lunchrooms won't solve the epidemic, says Haire-Joshu, who calls for a comprehensive response to obesity. That includes setting up safe school, home and community environments and programs to promote exercise and eating healthy foods. It also includes programs to counteract media messages pushing poor eating habits.

People are beginning to pay more attention to environmental factors that might help explain why obesity and diabetes are more widespread in some high-poverty zip codes, such as some of those in north St. Louis.

"Obesity is a complex problem," Haire-Joshu says. "We tend to look at individuals and say individuals are responsible for what they take in and how active they are. (But) the settings people live in make a huge difference in their ability to take responsibility."


Michelle Obama's message

Even when people are taught what to do to reduce their weight, "it didn't make a difference because they were in an environment that really fought against them doing it," Haire-Joshu says.

"If people live in an areas where there are no sidewalks, or broken sidewalks, or where there are public safety issues, it may be difficult for them to exercise," she says. "If you live in a physical environment where you have safe streets, good sidewalks, nice parks, and walking trails, then you're probably going to have a more active community, more active individuals."

Also, society must come to grips with what children eat, Haire-Joshu says.

"If you go to school, or live in a neighborhood, with only fast food restaurants, then the odds are that those are the kinds of foods that you are going to learn to like and eat more of," she says.

She's encouraged by the federal government's push for companies to restrict some ingredients, such as salt, in the food they sell.

In addition, Haire-Joshu says the public has to address the negative impact of media messages in an era when children are exposed to 24/7 television and hundreds of channels. Parents need to monitor what their children watch, she says, noting that studies have pointed to the hundreds and thousands of advertisements that children are exposed to.

She says society has an opportunity to start the campaign with children.

"The good place to start is with the school environment. Children need to be active and learn to make healthy choices that allow them to develop patterns that will carry them through life."

She's encouraged by the "public realization that we need to make changes. There seems to be a groundswell with parents, especially parents who are dealing with the issue of (their own) weight, and (who want) to make sure it (being overweight) doesn't happen with their children."

She's also encouraged that Obama wants to solve the problem in a generation.

"What I get concerned about is that it took us a while to get here and it will take us a while to get out of it. I'm optimistic and gratified that we want to make change. But I'm concerned that the changes won't be quick enough and we will go back to where we are."

In other words, back to a life where an overweight child is the norm.

Funding for health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization whose vision is to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.