With children in some of New Jersey's poorest cities being encouraged to eat their fruits and vegetables, a Rutgers University research team will follow 1,200 kids to see how changes in how they play and what they eat can help policymakers carry out successful strategies to battle the nation's childhood obesity epidemic.
The Rutgers team has received a $3 million grant from the National Institutes of Health (NIH) to follow the children for five years. Dr. Michael Yedidia of the Rutgers Center for State Health Policy is leading the research with Dr. Punam Ohri-Vachaspati of Arizona State University. The study builds on their previous work in 2009 and 2010, funded by the Robert Wood Johnson Foundation (RWJF), which documented the level of childhood obesity in five cities – Newark, Camden, New Brunswick, Vineland and Trenton.
Their work explored the challenges children in those cities face to gain access to physical exercise and healthy food, factors that played into an initiative by the New Jersey Partnership for Healthy Kids. The Partnership, also funded by RWJF, is now bringing stakeholders together to advocate for changes in policy and local environment to make it easier for families to adopt healthy lifestyles.
The NIH research project is not designed to evaluate the Partnership, Yedidia said. Rather, it will assess the impact of changes being advanced by the Partnership and other organizations engaged in combating childhood obesity. The five cities have become a laboratory for dozens of initiatives and programs aimed at reversing childhood obesity, a national epidemic. For example, in Camden, Campbell Soup Co. is working along side the Partnership to increase physical activity during school recess periods. Newark Beth Israel Medical Center is working on nutrition and fitness education in city schools, while also expanding its "Beth Challenge" weight loss program citywide.
As a result of the baseline studies that have already been conducted, a great deal is already known about how close children live to parks and playgrounds and their proximity to stores that sell healthy foods. As the grassroots efforts to fight obesity unfold, the Rutgers team will assess the changes as they continually occur, Yedidia said.
For example, several cities are working with schools to improve the nutritional quality of foods served and the opportunities for physical activities. Others are improving lighting and safety in parks so families will use them for exercise. And efforts are being made to encourage corner stores to sell fruits and vegetables so children have an alternative to buying candy and chips. The will also assess unintended changes, such as the closing of a supermarket due to changes in the local economy.
Most of the research in the past has looked at either changes in physical activity or the food environment, but this study looks at both, Yedidia said. The research may reveal "it is a combination, a constellation of changes [that have a positive impact]: fixing the sidewalks, having a park with better lighting and bicycle trails, and healthier corner stores."
In years past, efforts to combat obesity were focused almost exclusively on education. "You've got to get exercise, you don't want to eat so many empty calories, and so forth," Yedidia said. The current thinking is that "unless you look at what people have access to in their neighborhoods, as well as income and other personal resources to take advantage of opportunities, then you really are not going to be very effective." It might be that families live near parks but are concerned about safety and lighting. "It's not enough to put in a new park, but you have to upgrade existing parks and make them more usable for people," he said.
Numerous efforts are underway to both bring supermarkets to cities and improve the food at corner stores. "But we have to acknowledge that if people don't have the income to access these options, then their effect might not be great," Yedidia said.
"We don't know the threshold at which these things have an impact on childhood obesity, both in terms of the number of things that are available to people, but also just what people can afford or otherwise avail themselves of," Yedidia said. "We need to make prudent choices in our allocations of resources and focus on what will have the most impact in our communities."