Friday, April 11, 2008

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I have been a general pediatrician for 14 years and became interested in childhood obesity when a colleague asked me to consider beginning a treatment program for overweight children in Baton Rouge. That was 13 years ago. I began the Committed to Kids® Pediatric Weight Management Program and treated more than 250 children and adolescents from 1996-2006. It was a successful program in which we helped many children and families learn to live a healthier lifestyle to improve there health and reduce their weight.

During the latter part of conducting this treatment program, it became apparent that prevention of obesity is going to be the way to reverse the epidemic of obesity. While our team truly enjoyed helping individuals and their families, my interest turned to working on prevention of obesity in the public health arena.

To reverse the trend of childhood obesity, we have to treat the community as a whole, not just patients. By we, I mean everyone – not just medical and health care-related professions. It has been said that the problems of some are the responsibility of all, and the epidemic of obesity is one of these problems.

Whether or not one becomes obese seems to be based on a simple equation that balances energy intake with energy expenditure. Many variables affect this balancing act. These include individual factors (genetics, psychosocial personal factors), behavioral factors (at home, school, community, work site), sectors of influence (media, government, food and beverage industry, public health systems, healthcare system, etc.) and social norms and values.

The environment we live in contributes to the incidence of obesity as does our behavior. Our convenient, technologically advanced world does not require us to move (burn calories) as much as we have in past generations. Our children have fewer opportunities for free play. Some of this is due to safety. Some of this is due to developers’ building neighborhoods without sidewalks or bike paths and limited green space (parks) and to community planning commissions’ allowing this to happen. Additionally, many schools have displaced daily physical activity from the curriculum in exchange for the push towards academic success. Sixty percent of children have a television set in their bedroom. All of the above reduce opportunities for burning calories.

The two best places to positively influence the environment in which our children live are home (during the first five years of life) and at school (after the first five years of life). After their 5^th birthday, children spend half their awake life away from the home environment – in school. If we have not done our part in our homes to develop a child with health in mind, then our schools provide the next best environment to do so. We must stress the importance of physical health with academic success and model the habits of a healthy lifestyle in the classroom, halls, playground, faculty lounges and cafeteria.

Fortunately, we are making progress in stressing the importance of this environment with the recent passage of federal legislation requiring all schools that participate in the federal lunch program to have a school wellness policy. This is a start.

Louisiana has been leading the nation in legislation to address health in schools. In 2005, we passed the most aggressive and progressive school vending policy in the country. In 2004, we passed a mandatory PE bill requiring 30 minutes of daily physical activity for grades K-6. The issue with both of these laws is in enforcement. Parents and communities need to work with their local school systems to make it so.

Obesity is considered the next tobacco. We cannot afford to reduce the incidence of obesity slowly over the next 20-30 years as we’ve done with tobacco usage. Alarmingly, for the first time in our history, scientific research is predicting a reduced life expectancy for children born today because of the epidemic of obesity. This should not be the legacy we leave for our children or the story we want told about the most developed country in the world.

If we don’t begin treating the communities in which we live, we are jeopardizing our very existence. The future lives of our children depend on us to act now. There are many ways in which you can become involved. See the list below, which was adapted from Institute of Medicine’s ecological model, and act today!

• Demand all food in school meet USDA guidelines.
• Require daily PE and active recess for K-12, and promote school nutrition and exercise.
• Help parents and kids organize energy-burning “walking school buses” along safe routes.
• Campaign for sidewalks, playgrounds, bike paths and recreation facilities, especially in low income and underserved communities.
• Advocate for elimination of advertising of unhealthy foods to children.
• Call for adequate numbers of supermarkets in low-income neighborhoods, thereby increasing access to affordable produce.
• Insist the local hospitals eliminate fast-food outlets just as they ban smoking.
• Advocate healthy lifestyles and healthy communities using public venues.

Thursday, April 10, 2008

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I had a wonderful walk this morning. Fifty minutes at level four. That’s more than three miles! Now that the weather is warm and not overly hot, we can get outside and do some rigorous exercise without having to deal with the extreme heat. There are a lot of things going on around our state regarding healthy lifestyles. I saw a billboard this morning, the Louisiana Two Step. Step one is to eat right and step two is to move around. As was reported to you earlier, the LSU AgCenter had a wonderful response to the fitness challenge. More than 70 teams and 400 individuals are participating. Impressive!

The decision to adopt a healthier lifestyle by these 400 individuals is admirable, but the hard part is just around the corner. As I have discovered over the past six months, this is not a short-term commitment. It’s a long-term lifetime challenge. MyPyramid.gov is a wonderful Web site that helps you with meal planning. The AgCenter Web pages are filled with enough information to guide anyone through a healthy lifestyle change. Go to Smart Choices and Smart Portions for starters. Think long-term. Take the bad days in stride.

Spring time also gives us a great supply of fresh vegetables. Visit your local farmer’s market and pick up some of the produce from the farmers. Explore many different healthy ways to prepare your vegetables. Vegetables are about the only thing that you don’t have to watch your portion control. Perhaps we should change the Louisiana motto from vote early and vote often to eat your vegetables early and often. Just a thought.

We have a great guest blog for you tomorrow. You will not want to miss this one.

Bill Richardson

Wednesday, April 09, 2008

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As a dietitian, I frequently get asked the question, “What do you do? “ or “What is the secret?” There is no magic potion you can take to meet your fitness goals. But with careful planning and a little motivation, anyone can lead a healthy lifestyle. I wanted to share with you some tips I find helpful.

Share your meals when eating out at a restaurant. My fiancée and I share our entrees. Not only does this prevent us from overeating, but also saves money.

Grow your own vegetables and herbs. What a great low-calorie way to flavor your food! You don’t need a big yard either. The majority of my herbs and vegetables are grown in pots. I grow spearmint, peppermint, chives, chocolate mint, rosemary, thyme, basil and Thai basil. Hosting a dinner party? Harvest some of the herbs, wash them and make a parting gift for your guests. I tried this for the first time last year, and my guests raved for the next week how delicious the herbs made their meals.

Get outdoors. Our vacations focus on spending quality time together. What better way than to go camping, fishing, hiking or canoeing (talk about a good upper body workout!). My dog loves it too. Before you go, check to see if pets are allowed.

I eat what I want. If I feel like having a piece of chocolate, I have a piece of chocolate — in moderation, of course. By doing this, I am not depriving myself of what I want; therefore, temptations to overindulge are minimal.

Don’t be too hard on yourself. If you do overindulge or fail to accomplish your daily goals, it’s OK. Learn from the experience and move on. If you dwell on what you should have done, you are setting yourself up for failure. You can’t change the past, but you can learn from it.

Make your goals known. Set up a weekly goal for yourself, put it in writing and hang it in a place that you frequently view. When I wanted to increase my physical activity, I scheduled the activities on a calendar and posted it on my refrigerator.

What works for you? Share your ideas and tips.

Denise Holston

Tuesday, April 08, 2008

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The latest blood test results are in and still looking very good. Total cholesterol was down to 162, a 44-point drop since last October. The HDL/LDL numbers remained static and the ratio remained at 2. I have room for improvement in raising the HDL and lowering the LDL.

Looking back over the past six months since the inception of the blog, I have become a true convert to the interaction of nutrition and exercise. The synergistic relationship is crucial to a long-term lifestyle change. The smart choice nutrition spelled out in great detail in the LSU AgCenter Web pages offer wonderful advice on all aspects of proper nutrition. But nutrition alone, as we have discussed in previous blogs, will only do so much if you are not exercising. Exercising, while greatly beneficial to the fitness of the body, will only do so much if you are not eating properly. The smart choice is to make smart choice in your nutrition and exercise.

What a beautiful day Sunday was. I was able to get in a very brisk walk around the LSU Lakes. Since I walked faster than my last time out there, my reward (situational nutrition ethics) was a yogurt cone after the salad at the deli. The weather was perfect for walking, and we had better enjoy the cooler days because the heat is right around the corner. In a future blog we will discuss exercising in the high heat and humidity we experience in Louisiana.

Given the information from the DXA and weigh-in and the blood test, my revised April goals are to get my total body weight below 220 and get the waist size to 38 or lower. I would like to see the HDL increase and the LDL decrease. Reachable goals for April.

The media continue to write and report on research dealing with obesity. Now the schools are getting involved with nutrition. Good public information is so important, and I hope this blog can become one of those vehicles to educate the public of the benefits of nutrition and exercise. We can make a difference in obesity, but it does call for all of us to make an effort. Start with yourself and then reach out to someone else.

Bill Richardson

Get outside while you can! Louisiana is notorious for hot, humid summer days. Take advantage of the great weather now and bring your family and friends along, too! Listed below are great outdoor activities and locations that promote active lifestyles.

Gardening

Spring is the perfect time to plant your fruit, veggies and herbs. Get the entire family involved – kids who “actively” participate in growing their food will likely eat the food. Where should you start? Visit https://www.lsuagcenter.com/en/communications/news/get_it_growing/

Hiking

Explore Louisiana’s beautiful landscape while exercising. Always remember to bring drinking water and wear sunscreen, even if it is cloudy. Visit http://www.crt.state.la.us/parks/iparkslisting.aspx or http://www.hikelouisiana.org/

Canoeing

This is a great family activity that will give you a great upper body workout. To do this activity, you will need to rent a canoe, paddle and lifejacket. http://www.paddling.net/places/LA/ or http://www.tubingboguechitto.com/

Fishing

http://www.wlf.louisiana.gov/fishing/recreational/

Monday, April 07, 2008

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(Editor’s note: Today’s guest blog is by state representative Regina Ashford Barrow who serves as the vice chair of the Municipal, Parochial and Cultural Affairs committee and is a member of the Commerce and Health and Welfare committees.)

Recently, I attended the Women in Government conference where I participated in health screenings. To my surprise, I was overwhelmed by my diagnosis. I was borderline everything – hypertension, diabetes and cholesterol. Initially, I was depressed, but after a few weeks, I decided to do something about this. I started a weight-loss program that included exercising and changing my eating habits. I set a goal to lose at least 30 pounds, which will place me in a healthy state.

After realizing that many other individuals may be facing some of the same challenges, I decided to launch a weight-loss campaign in my legislative district on March 29 entitled, “District 29 Loses 2900.” The program is primarily for constituents in District 29 who are 10 years of age or older; however, others can participate but will not be eligible for the many incentives and grand prizes.

In an effort to keep participants involved and engaged, the campaign will host monthly health and nutrition workshops and distribute a monthly newsletter, acknowledging the biggest loser for the month. My goal in this campaign is to promote a healthier and a more physically fit district by September 29, while I, too, get healthier and more physically fit by shedding those unwanted pounds. If you are interested in participating in the District 29 Loses 2900 Weight Loss Campaign, feel free to call my office at (225) 362-5837 or visit us on the Web at www.reginabarrow.com.

Regina Ashford Barrow