reducing obesity

Minnesota Compass research intern Heather Vinge Hanson recently completed a literature review of evidence-based strategies that combat obesity from a systems-change perspective, rather than those that involve actions individuals can take. The following provides highlights of her findings.

One of the greatest challenges facing health promotion, is translating research into evidence-based public health and clinical practices that are actively disseminated and widely adopted, says the Journal of Rural Health.

There is no disputing the fact that obesity has become a major public health concern. In Minnesota, 25 percent of the population is obese. A person who is obese has an increased chance of having many chronic illnesses such as heart disease and diabetes. There is much research concerning how individuals can prevent and treat obesity, but little about how communities can play a role. However, organizations and communities can be an integral part of the health of their community members.

Community level evidence-based strategies are beginning to be identified as an important part of the fight to reduce the incidence of obesity. These strategies have been evaluated, have had successes in the field, are able to be replicated, and are proven to create a significant impact in the decreasing prevalence of obesity within a population. The strategies are generally implemented by programs within community organizations, local government, and schools.

Programatic features

Many programs that are focused on preventing obesity have youth as the target. Programs and policies in schools, such as reducing the availability of sugar-sweetened beverages, requiring physical education, and having more fruit and vegetable options in school lunches, are designed to prevent obesity by increasing the likelihood that youth will eat healthier and exercise more. These programs may have an impact, but the larger impact occurs when youth are taught to make lifestyle changes. For example, recreation-based after school activities, such as sports and dancing, can improve cardiovascular health and reduce body fat.

It is even more important to ensure that parents are involved in the intervention programs. A research study completed by the Journal of Rural Health compared the effectiveness of programs focused on the whole family compared to programs focused on just educating parents. The results showed that while the family -based approach and parent-only approach had similar results, the parent-only approach was much more cost-effective.

Community approaches

Although diet and exercise are key aspects of the likelihood of obesity, there are many environmental factors outside of a persons’ control that limit access to physical activity opportunities and healthy food. Communities with limited sidewalk access, fewer parks and recreation facilities, and stores spread out over a large area have a larger incidence of obesity. Research has suggested that land use policy changes to increase the mixed use zoning in cities and sidewalk availability can lead to increased physical activity and obesity reduction. This strategy is even more effective when the community members are involved in the planning and recommendation process.

Limited access to fresh food and supermarkets are also a barrier to positive community health. In rural areas or urban areas where convenience stores are more prevalent, the overall BMI (body mass index), a measure to estimate a healthy body weight, of the community is generally higher than where supermarkets are more available.

Disparities

Obesity disproportionately affects low socioeconomic communities. This may be due to several factors: limited grocery store access, less investment in community infrastructure, and little recreational activities. Increasing public safety also increases the chance that community members will participate in outdoor physical activities.

Recommended web sites to learn more:

Centers for Disease Control and Prevention: Overweight and obesity
Robert Wood Johnson Foundation: Childhood obesity

Resources used for this article:

Bolton Oetzel, K., Anixter Scott, A., & McGrath, J. (2009). School-based health centers and obesity prevention: Changing practice through quality improvement. Pediatrics: Official Journal of the American Academy of Pediatrics, 123, S267-S271.

Center for Disease Control and Prevention. (2009). Recommended community strategies and measures to prevent obesity in the united states. Retrieved from
http://www.cdc.gov/obesity/recommendations.html on April 12, 2010.

Griffith, J.R. (2009). Assessing childhood obesity programs in low-socioeconomic and diverse communities. Journal of the National Medical Association, 101 (5), 421-429.

Hassink, S.G. (2009). Weighing risk: The expert committee’s recommendations in practice. Seminars in Pediatric Surgery, 18, 1569-167.

Janicke, D.M., Sallinen, B.J., Perri, M.G., Lutes, L.D., Silverstein, J.H., & Brumback, B. (2009).
Comparison of program costs for parent-only and family-based interventions for pediatric Obesity in medically underserved rural settings. The Journal of Rural Health, 25 (3), 326-330.

Jeffrey, R.W. (1993), Minnesota studies on community-based approaches to weight loss and control. Annals of Internal Medicine, 119 (7) 719-721.

Odkene, J.K., Edgerton, E.A., Teutsch, S.M., Marion, L.N., Miller, T., & Genevro, J.L. et al. (2007). Integrating evidence-based clinical and community strategies to improve health. American Journal of Preventive Medicine, 32 (3), 244-252.

Romon, ,M., Lommez, A., Tafflet, M., Basdevant, A., Oppert, J.M., & Bresson, J.L. (2008). Downward trends in the prevalence of childhood overweight in the setting of 12-year School and community based programmes. Public Health Nutrition, 12 (10), 1735-1742.

Ask a Researcher

Minnesota has some gender issues
Meet new Compass researcher Allison Churilla, who gives insight into gender disparities in Minnesota, now on Compass.