Wednesday, November 6, 2013

The other local food movement

Most Americans know that nutrition impacts their health. But where you live often determines what you eat — and what you know about healthy food.

The “act local” half of APHA’s 141st Annual Meeting and Exposition theme dominated a Wednesday session on nutrition advocacy in rural, urban and diverse socioeconomic communities. According to presenters, the problem isn’t that people don’t want to eat healthy.

It’s that no one’s educating them on how to do it.

“People aren’t going to go on ( before they chow down on Chinese takeout,” said session presenter Michelle Ramos of the Mount Sinai School of Medicine. “MyPlate and Harvard’s Healthy Eating Plate are great. …But people need prior knowledge of food groups to use them.”

Ramos and her colleagues set out to bring healthier diets to East Harlem, a low-income neighborhood with some of the highest rates of obesity and diabetes in New York City. The community also has an extremely high density of fast food and take-out restaurants.

Researchers attempted to change attitudes with the Healthy Plate for a Healthy Weight initiative, in which restaurant owners were asked to give instructional, bilingual plates — inscribed with nutritional guidelines — to each customer. While many customers didn’t use the plate, 75 percent of those who did reported eating smaller portions, while 100 percent reported eating more vegetables.

A second part of the initiative, called Save Half For Later, called upon restaurant servers to ask customers: “Would you like to save half your meal for later?” If customers answered yes, servers would wrap half the selection in a to-go box.

Across the country, presenters from the University of Iowa sought to promote nutrition through local media. According to researchers, 86 percent of rural adult Iowans read a local newspaper every week.

“To influence rural newspapers to include a great number of, and more, accurate stories about healthy eating, it is essential to understand the perspectives of editors,” said Faryle Nothwehr of the University of Iowa College of Public Health.

The school’s case studies found that 100 percent of editors thought readers were interested in healthy eating topics, but only 43 percent felt encouraged by readers to include nutrition-related stories. Nothwehr said that editors found difficulty “localizing” nutrition stories without a human interest angle.

Prince George’s County “has it all in terms of people,” said presenter Diane Hill Taylor of the Prince George's County Health Department in Maryland. With a mix of affluent and low-income areas, the department has to share information in equally varied ways. But before receiving a Community Transformation Grant from the Centers from Disease Control and Prevention, the task proved difficult.

“People knew their grandma’s health department, but it was important to let (county) residents know we’re a new health department,” said presenter Stephanie Cook McDaniel, also with the Prince George's County Health Department. “Our residents were far more tech savvy than we were, so our leadership said we’ve got to get better.”

Through its grant, the department renovated with a dramatic social media push, including roughly 250,000 messages disseminated to its residents every Friday. Free flu shots and “Take Your Loved One to a Doctor Day” communications are changing attitudes in every pocket of the county, McDaniel said.

“By the time our (grant) ends in September 2014, we’ll just be hitting our stride,” she said.

— D.G.

Above, researchers from the Mount Sinai School of Medicine partnered with the Communities Impact Diabetes Center on a food initiative called Save Half For Later. In East Harlem, restaurant servers ask customers if they would like to save and box half of their order for a later meal. Video courtesy Communities Impact Diabetes Center

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