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Childhood Obesity in Southern Arizona

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Childhood Obesity in Southern Arizona

Picture of Mariana Alvarado

Southern Arizona children are suffering from adult afflictions - and doctors blame it on a troubling surge in childhood obesity.

In Arizona 31 percent of children between the ages of 10 and 17 are overweight or obese, experts say.

Lifestyle, diet and genetics play a role, but the biggest common denominator among them is socioeconomic.

"It's an amazingly paradoxical problem," says Dr. Tracey Kurtzman, an assistant professor of clinical pediatrics at the University of Arizona's College of Medicine. "If you think about poor people in the rest of the world, they are emaciated and skinny and impoverished and malnourished.

Here, our poor population is malnourished with too much."

Cheap food is often unhealthy. There's no Arizona law mandating physical education in schools. High-crime neighborhoods mean running and playing outdoors is discouraged. Gym memberships or club sports are not feasible for families challenged to provide basic necessities.

In a special report in the Arizona Daily Star, experts discuss the issue and offer solutions.

Arizona Daily Star
Friday, May 21, 2010

Part 1 Abundant fat, starch, sugar force adult ailments on kids

Part 2 All at once, Jesús' world is changed

Part 3 Obesity's other health effect: the destruction of self worth

Part 4 Overweight childhood causes debilitating adult disease

Part 5 Eating "whatever we could" took a painful, inexorable toll

Part 6 Healthful traditional foods a hit with O'Odham youths

Part 7 School's "wicked witch" sweeps out the "no" foods

Part 8 "Super chubby" teen now a biking super-role model

Part 9 Greasy Mexican food being converted back into its healthful self

 

 

Abundant fat, starch, sugar force adult ailments on kids

By Mariana Alvarado and Stephanie Innes

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MAMTA POPAT / ARIZONA DAILY STAR  Jenna Fu, right, a diet technician at Tucson Medical Center, leads participants in a FitKids class at TMC. Kids with weight or nutritional issues are referred to the wellness and exercise program by their doctors. The program recently cut back from two sessions a week to one because many parents lacked transportation, underscoring the link between poverty and obesity.
MAMTA POPAT / ARIZONA DAILY STAR Jenna Fu, right, a diet technician at Tucson Medical Center, leads participants in a FitKids class at TMC. Kids with weight or nutritional issues are referred to the wellness and exercise program by their doctors. The program recently cut back from two sessions a week to one because many parents lacked transportation, underscoring the link between poverty and obesity.

MAMTA POPAT / ARIZONA DAILY STAR Jenna Fu, right, a diet technician at Tucson Medical Center, leads participants in a FitKids class at TMC. Kids with weight or nutritional issues are referred to the wellness and exercise program by their doctors. The program recently cut back from two sessions a week to one because many parents lacked transportation, underscoring the link between poverty and obesity.

A 10-year-old boy on medication for high blood pressure.

An 8-year-old treated for high cholesterol.

A 7-year-old girl diagnosed with Type 2 diabetes.

Southern Arizona children are suffering from adult afflictions - and doctors blame it on a troubling surge in childhood obesity.

In Arizona, 31 percent of children between 10 and 17 are overweight or obese, experts say.

Lifestyle, diet and genetics play a role, but the biggest common denominator among them is socioeconomic.

"It's an amazingly paradoxical problem," says Dr. Tracey Kurtzman, an assistant professor of clinical pediatrics at the University of Arizona's College of Medicine. "If you think about poor people in the rest of the world, they are emaciated and skinny and impoverished and malnourished. Here, our poor population is malnourished with too much."

Cheap food is often unhealthy. There's no Arizona law mandating physical education in schools. High-crime neighborhoods mean running and playing outdoors is discouraged. Gym memberships or club sports are not feasible for families challenged to provide basic necessities.

"It's costly to eat a healthy diet," says Tucson writer Reva Mariah S. Gover-Shield Chief, 41, who prioritizes her budget to eat healthy now that she's dealing with myriad health problems linked to being overweight since age 5. "Oyster mushrooms are expensive!

"I think the real weight problem we've got going on right now," she says, "is called poverty."

Small budgets, big barriers

Arizona in general has been behind the rest of the nation in its prevalence of obese and overweight residents, but over the past decade the problem here increased at a faster rate than in most other states, says Scott Going, a professor in the UA's Department of Nutritional Sciences who has researched childhood obesity for more than 20 years.

Contributing factors include population growth among Hispanics, an at-risk group. And there's an overrepresentation of minorities among lower-income residents.

Also, Arizona is a transient state, and people are moving here from parts of the country with high obesity rates, he says.

With an estimated 20 percent of U.S. children living in poverty, the health risks are immense.

"Poor people can't afford to buy good fruits, vegetables, good cuts of beef. Basically they eat whatever they get their hands on," says former U.S. Surgeon General Dr. Richard Carmona, who is president of the nonprofit Canyon Ranch Institute in Tucson.

"Identify an at-risk population with high unemployment and a high number of people who are uninsured. Then look at where they get their food," he says, noting a lack of grocery stores within walking distance coupled with a lack of transportation.

One of the biggest problems for leaders of the FitKids program at Tucson Medical Center is attendance. More than 30 students are invited to participate in each session of FitKids, an hourlong weekly exercise-and-nutrition class for physician-referred at-risk kids. About a dozen show up and maybe two finish the program, says Mary Lou Fragomeni, who manages outpatient therapies at TMC.

"I never think it's because families don't want to participate," she says. "There are single parents who work and they can't commit. For those who do, there are transportation issues. But we do still believe the community need is there ... so if we help two children, then we help two children. And that is important."

The program was recently reduced to once a week from twice because parents were having trouble getting their children there.

"How about the mother who says, 'I work eight hours, I come home and then clean, cook, etc. ... How do I make time for my kids to exercise?' " says local internist Dr. Armando Gonzalez, who recently added weight-loss programs at his west-side Mesa Verde clinic. "The father says, 'I get up at 5 a.m., go to work, then I have a part-time job and don't get back home until 9 or 10 p.m. What do you want me to do?' "

Just three public schools in Pima County have daily physical education. Some charter schools don't offer it at all.

Young kids, grown-up illness

Doctors at Southern Arizona's only pediatric-surgery group will start offering lap-band surgery to adolescents once it's approved by the U.S. Food and Drug Administration. Teens must be morbidly obese and have accompanying conditions such as arthritis, high blood pressure or diabetes to qualify.

"Morbidly obese" typically refers to a body mass index of 40 or more, which for many teens would mean 100 pounds or more over their ideal weight. Dr. Ann O'Connor of Arizona Pediatric Surgery Ltd., in conjunction with Tucson Medical Center, expects to perform at least 10 of the surgeries per month.

"We're seeing children with medical problems at age 15 that are like those of a 40-year-old," O'Connor says. "They have gallbladder problems, severe reflux and a fair number with diabetes.

"The hope is that with the lap-band surgery you have a benefit of prevention. It's much harder to treat diabetes over your lifetime than it is to prevent it."

University Medical Center researcher and podiatric surgeon Dr. David G. Armstrong directs the Southern Arizona Limb Salvage Alliance and routinely sees diabetic patients with amputated feet and legs, vision and cardiovascular problems. He sees patients in their 30s who have suffered strokes.

"The most insulin-resistant sort of tissue you have is fat," he says. "It increases whole body inflammation. There's so much that's bad about it."

Diabetics are more susceptible to vascular problems and aggressive methicillin-resistant staphylococcal infections, Armstrong says.

"It used to be the average age of our patients was mid-50s. Now it has skewed 10 years younger," says Armstrong. "It's like a demographic tsunami."

Broaching the subject with young children can be delicate.

"A lot of times they are embarrassed and teased," pediatrician Kurtzman, says. "The hardest thing to recognize is that it's not about what you look like. I always tell these kids: 'You are a beautiful person. You don't have an ugly body, but it's not as healthy as it could be.' "

A question of taste and time

Parents who rely on dollar-menu items at fast-food restaurants to nourish children usually have a hard time changing eating habits later.

"The problem with children is if they get an idea, a taste of food being high in fat, high in salt, high in sugar, then that becomes what is expected and the norm," says registered dietitian Nancy Rogers, coordinator of the Worksite Wellness Program at UA Life & Work Connections. "If you get used to a salty flavor, you tend to want more salt."

Rogers says reducing salt and sugar from a child's diet can be difficult, requiring a retraining of one's taste buds and adjusting to feeling satisfied with the flavor.

"The farther it's gone from the farm to our mouths," says Kurtzman, "the less healthy it's going to be."

But with its low cost and long shelf life, processed food may be the only choice for many families.

A bag of white rice or pasta can produce several quick and filling meals for a fraction of the cost of a recommended meal of lean protein with fresh vegetables.

"Most of the time, because they have two jobs, there's no time for cooking, so they do what is easier," Dr. Gonzalez says. " They go to Kentucky Fried Chicken, Burger King and McDonald's. Everything is greasy."

Big Ramifications

As surgeon general, Carmona declared the current generation of children could be the first to live shorter lives than their parents because of the obesity epidemic.

He stands by that comment.

"Seventy-five cents of every health-care dollar spent in the U.S. is for chronic diseases, and most of those are being driven by obesity," Carmona says. "Young men and women are failing to be retained on active duty in the military because of obesity.

"In 10 to 15 years who will be our soldiers, sailors, airmen?" the doctor wonders. "Who will take jobs as police officers, in fire departments, as emergency medical technicians?"

A recent study published by the New England Journal of Medicine found that the heaviest children were more than twice as likely as the thinnest to die before age 55.

Carmona speaks with urgency about addressing the problem, while warning that inaction carries a "huge cost to society."

"The number of obese and overweight children right now is not acceptable and it's a future national security issue," Carmona says. "I can't think of any other topic in contemporary health that is more important."

View the original story at the Arizona Daily Star website

 

All at once, Jesús' world is changed

By Mariana Alvarado

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JAMES GREGG / ARIZONA DAILY STAR Jesús Emilio Adame gets ready to eat lunch at Elvira Elementary School. His grandparents, who are raising him, used to let him eat whatever he wanted despite his growing weight. But with a doctor's warning that he was risking diabetes, Jesús now must live with food portions and restrictions. It's hard on his family's limited income.

Suddenly, the rules have changed for 6-year-old Jesús Emilio Adame.

His grandparents used to let him eat whatever he craved, despite his growing waistline.

Now Jesús ponders food portions and restrictions after a pediatrician warned his grandparents that he was at risk of becoming diabetic.

"It breaks my heart," his grandmother Elisa Ramos, 62 says. "To me, he's just a baby and I feel awful not being able to give him whatever he wants."

She and her husband, Gilberto, 67, are raising Jesús, whose parents were killed in a car wreck five years ago.

The couple are diabetic and both have multiple related ailments. They want to spare Jesús from the same fate.

Changing the first-grader's eating habits is a daily tussle.

He loves tortillas, pizza, hamburgers, bread, macaroni and cheese - heavy on the starch and carbs, low on protein and vitamins.

The couple's fixed income won't budge for club sports memberships. Jesús' school offers PE only once a week. There is no nearby park. And the family's south-side neighborhood is not safe for Jesús to run and play outside.

"Sometimes we go to Reid Park to see the ducks," Gilberto says.

The grandparents have splurged on a Wii video game to encourage Jesús to exercise indoors. He says one of his favorite games is tennis, and he dreams of playing the real game someday.

Because he's on AHCCCS, Arizona's health-care program for the state's poorest residents, Jesús sees different doctors. Some have said he should be allowed to eat whatever he wants, but "just a little."

"When I tell him he shouldn't eat something, he gets upset and reminds me the doctor said yes," Elisa says with a sigh.

Jesús has started shedding pounds, but Elisa says purchasing "good" food with the $260 a month the family receives in food stamps is a chore.

On a recent shopping trip, Elisa visits the deli, where she picks up chicken sausages and light cream cheese. Then she goes to the produce section and gets bananas, apples and romaine lettuce.

"No, this is not enough to afford a healthy diet. I make the most out of our money," says Elisa, who makes wheat tortillas to save.

"We don't eat out," she says, "and we only buy pizza and burgers for him once a month."

Back home, Jesús rushes into the kitchen after school to show off a green Saint Patrick's Day necklace he received from his PE teacher.

"I ate my veggies. That's why they gave it to me," he announces.

A couple of weeks ago, Jesús had his medical checkup.

"The doctor said he is doing good ," Elisa says. "Now he is again wearing clothes that didn't fit because he was very heavy."

She hasn't declared victory. Instead, Elisa says she is collecting information and advice to continue the battle.

How much exercise do children need?

Children and adolescents should do one hour or more of physical activity each day, the U.S. Centers for Disease Control and Prevention says. Most of that activity should be moderate aerobic, such as brisk walking, or a vigorous activity such as running. The CDC says it's important to include "vigorous-intensity" aerobic activity at least three days per week. Vigorous-intensity means the child's heart will beat much faster than normal and the child will breathe much harder than normal. Nearly 70 percent of Arizona children between 6 and 17 are not meeting the CDC's recommendation for physical activity, the nonprofit Trust for America's Health says.

View the original story at the Arizona Daily Star website

 

Obesity's other health effect: the destruction of self-worth

By Stephanie Innes

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KELLY PRESNELL / ARIZONA DAILY STAR Kelsey Rentchler, right, looking like a different woman now, works out at SWAT Fitness. As a schoolgirl, "I was the fat kid, and I was a very sad kid," she says. Those days are gone now - as anyone can see.

Lifting a cast-iron weight called a kettlebell during a workout demonstration, 24-year-old Kelsey Rentchler appears strong, confident and impervious.

Her looks belie a past of self-loathing.

Rentchler was always the biggest child in her class. She remembers spending recess watching kids run from her, yelling that they were scared she would sit on them.

She would find places in the schoolyard where she could be by herself, or give presents to other kids so they'd be her friends.

Desperate to fit in, she took laxatives and drugs as a teen. She thought about taking her own life.

"Kids can be really mean. Kids' parents can be mean," Rentchler says. "But it was more that they just wouldn't talk to me. I was the fat kid, and I was a very sad kid."

By the time she was 9 years old, she weighed 140 pounds, had breasts and was menstruating. In middle school she surpassed 200 pounds. At age 21, she weighed 312.

The excess weight took a toll on her 5-foot-5-inch body. The emotional damage was just as severe, says Rentchler, who now teaches first aid and computer applications at Apollo College.

About 80 percent of people who are overweight experience depression, and that includes children, the National Alliance on Mental Illness of Southern Arizona says.

Rentchler's parents divorced when she was 12, and she often got meals for herself. She remembers summers of doing little except for eating - bologna, white bread, ice cream, Hamburger Helper, fast food.

She took only one semester of physical education in her freshman year of high school. A walk across the street left her panting.

"I was definitely depressed," Rentchler says.

On March 17, 2007, at age 22, she had lap-band weight-loss surgery, in which a surgeon uses an adjustable, inflatable band to shrink the stomach.

Within six months she lost nearly 60 pounds.

Then her friend, personal trainer Danny Sawaya, convinced her that being fit and active was more important for her overall health than being thin.

It wasn't easy for Rentchler.

The thought of going to a gym and working out in front of others frightened her. And getting over that anxiety was scary.

"It's like jumping off a diving board for the first time," says Sawaya, the general manager of SWAT Fitness in Tucson.

Sawaya says Rentchler was like two people - extroverted and confident in her work life, but negative and defensive when it came to personal matters.

He knew she was capable of confidence in all areas of her life, so he stood by as she worked out - in a busy gym. Her body became stronger and Sawaya says Rentchler became more positive.

She's lost more than half her body weight and feels much happier. But Rentchler still struggles with remnants of her old self.

"When you have a bad body image," she says, "you just pick yourself apart."

View the original story at the Arizona Daily Star website


Overweight childhood caused debilitating adult disease

By Stephanie Innes

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JILL TORRANCE / ARIZONA DAILY STAR Reva Mariah S. Gover-Shield Chief, 41, has been overweight since age 5, was diagnosed with diabetes at 15 and had a quadruple bypass at 35. Diabetes complications last year cost her part of her left foot.

It's a weekly routine: her mother wheels Reva Mariah S. Gover-Shield Chief into the vascular clinic at University Medical Center, where a medical team works at healing what remains of her left foot.

The 41-year-old writer and Tucson resident has been overweight since she was 5, was diagnosed with Type 2 diabetes at 15, had a quadruple bypass at 35, and has had circulation and vision problems.

Last year she lost part of her left foot including all five toes because of complications from a diabetes-related infection. She now uses a wheelchair to get around.

Gover-Shield Chief is American Indian, an ethnic group that is at higher-than-average risk for obesity and diabetes. She is part Tohono O'odham and part Skidi-Pawnee, an Oklahoma tribe.

At least half of O'odham adults have Type 2 diabetes. That rate is expected to be 75 percent or more for O'odham children born in 2002 if there's no intervention, says Tohono O'odham Community Action, a nonprofit tribal group.

Only half a century ago, the O'odham thrived on foods they gathered and grew with irrigation from rivers that now run dry.

And for nearly 2,000 years, diabetes among tribal members was rare.

Some scientists believe what helped them survive in the desert was a so-called "thrifty gene" that slows metabolism and rapidly stores food as fat to get them through famine.

Some have theorized that the thrifty gene, which once kept the O'odham alive, backfired when combined with a more sedentary lifestyle and a high-fat, high-calorie American diet.

By the 1960s, Southern Arizona's tribes - the O'odham, the closely related Pima Indians and the Pascua Yaqui - were 10 times more likely to develop Type 2 diabetes than the rest of the country.

Gover-Shield Chief believes her weight climbed when she was young for a combination of reasons - genetics, emotional eating and lack of exercise. Once she got to high school, physical education was not mandated and she didn't do any activities outside of school.

By age 36, Gover-Shield Chief, who is 5 feet 8 inches tall, weighed "north of 300 pounds." She has since had gastric-bypass surgery and now weighs about 200.

Now living with her mother, Gover-Shield Chief, who has a master's degree in American Indian studies, devotes much of her time to staying healthy.

She has an 18-year-old son and monitors him for signs of pre-diabetes.

"When you are young," she says, "you don't know what the future might hold for you."

The cost in dollars

The U.S. Centers for Disease Control and Prevention says it costs $11,744 per year to care for someone with diagnosed diabetes - more than twice the cost of caring for a non-diabetic.

socioeconomics

The unemployment rate on the Tohono O'odham Nation is 35.5 percent; 28 percent on the Pascua Yaqui Reservation. Statewide it's 9.5 percent.

SOURCE: Arizona Department of Commerce

View the original story at the Arizona Daily Star website

 

Eating 'whatever we could afford' took its painful, inexorable toll

By Stephanie Innes

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JILL TORRANCE / ARIZONA DAILY STAR Patrick Conrow gets drops in his eye from technician Maria Rosas after a laser treatment. He has also lost part of his left foot and suffers with foot infections that continue to require medical attention.

Growing up in a family that lived on a tight budget, Patrick Conrow ate whatever was available.

He became accustomed to canned fruit, beans and orange-yellow blocks of processed government cheese provided by food boxes.

"You'd just eat whatever was there. It was whatever we were able to get and afford," says Conrow, 39. Later, he developed a taste for fast-food meals that were cheap and filling, drank giant-sized sodas to help him stay awake during the night shift at a convenience store and snacked on chips and candy.

The 6-foot-1 former football player ballooned to 365 pounds.

By 34 he was suffering from fatigue and occasional blurred vision. A sore on his left foot wouldn't heal and made it difficult to work.

Turns out Conrow is diabetic. The sore ate into the bone and he lost three toes and part of his foot.

He requires a retinal specialist for his eye problems and suffers foot infections that continue to require medical attention.

He measures his blood sugar with a prick to his finger every time he eats, then calculates how much insulin he needs to inject into his body. The single father's health problems prevent him from working, but he's insured through Medicare because of his disability.

Conrow's father is diabetic, and so were two of his grandparents.

He is trying to protect his pretty, dark-eyed 11-year-old daughter from the same diagnosis.

He and his daughter lived in a south-side apartment complex on a busy street. Because of traffic and crime, Conrow would not let her play outside. They didn't live close enough to his daughter's school for her to walk, and, like most children, she loves television and video games. Earlier this year, school officials voiced concern about her rising weight.

So Conrow has made changes. He and his daughter have moved into a house with his parents. His mother makes home-cooked meals, and the neighborhood is safe for his daughter to play outside.

Conrow remains diligent about buying fresh produce and now weighs under 200 pounds.

"I don't have the mobility to run, stuff like that," Conrow says, pointing to his orthopedic shoe. "I see people in the grocery store filling their carts with chips and soda. ... I want to tell them to eat right and exercise to avoid the kinds of issues I have."

View the original story at the Arizona Daily Star Website

 

Healthful traditional foods a hit with O'odham youths

By Mariana Alvarado

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MIKE CHRISTY / FOR THE ARIZONA DAILY STAR Demauri Carlos and Beth Enriquez choose a healthful option of brown-bean quesadillas and green-chile chicken stew for lunch at Indian Oasis Elementary School. Tohono O'odham Community Action is working to change the eating habits of O'odham youths by introducing traditional foods into school lunch programs.

A nonprofit organization is working to change the eating habits of youths of the Tohono O'odham Nation by introducing traditional foods into school lunch programs.

"All the traditional . . . foods are actually really good for regulating blood-sugar levels and for helping address diabetes and obesity," says Tristan Reader, co-director of Tohono O'odham Community Action (TOCA).

A couple of weeks ago, students in the Indian Oasis Baboquivari-Unified School District tried brown-tepary-bean quesadillas and white-tepary-bean green-chile chicken stew in their lunches, says Karen Blaine, project director of the Tohono O'odham Food and Fitness Initiative with TOCA.

"There was pepperoni pizza, and then there were traditional foods, side by side. The kids had that choice, and I'd say that two-thirds" chose the traditional foods, Reader says.

About 1,000 traditional meals are being served to students from elementary to high school once a month as part of this pilot program.

"And then by next year, the school district will try to move back to once a week to really interest these kids," Reader says.

TOCA is working with the W.K. Kellogg Foundation and its Community and Food Initiative on the program, which includes fitness, Blaine says.

Students also are encouraged to learn traditional O'odham games and gardening.

"Gardens in school are just outstanding tools for education, for anything, for math, for science," Blaine says.

Obesity among tribal members is a concern, as is the high rate of diabetes.

"More than half of the adults have it," Reader says. "Six- and 7-year-old kids have it."

Indian Health Services reports that 76 percent of students from sixth to eighth grade on the reservation are overweight or obese.

The pilot program has been well-received. "Some grandparents . . . said their grandkids came home talking about how great the foods were," Reader says. "That's very encouraging."

View the original story at the Arizona Daily Star website

 

School's 'Wicked Witch' sweeps out the 'no' foods

By Stephanie Innes

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MIKE CHRISTY / FOR THE ARIZONA DAILY STAR Jesus Aguilera, 5, left, and Jose Echeverria, 6, snack on fish sticks, popcorn, chicken and juice at Children's Success Academy. Founder Nanci Aiken has a zero-tolerance policy for white flour, refined sugar and processed food.  

As her second-grade students take out their lunches, teacher Leticia Moreno quickly spots two with forbidden food - a burrito and quesadilla made with white flour tortillas.

"I will get them peanut butter and honey on whole wheat," Moreno says, taking away the offending meals.

Moreno is a teacher at the Children's Success Academy, a 10-year-old charter school on Tucson's south side for children in kindergarten through the fifth grade. The school is unique for its food rules - it bans not only white flour, but refined sugar and anything it defines as processed food.

"It has to say 100 percent juice. If it just says 'natural,' that's not allowed," 8-year-old third-grader Jacob Price says as he bites into an apple. "I wish we could bring more kinds of food. I like Oreos."

But Oreos will never blight the Children's Success Academy as long as school director and founder Nanci Aiken is in charge.

Aiken, a scientist who holds a doctorate in cell physiology and once worked as a cancer researcher at the Arizona Cancer Center and Johns Hopkins Medical School, is an unabashed food cop.

"I feel like the Wicked Witch of the West a lot of times, but it makes such a big difference," says Aiken, who is also president of the governing board for Tucson's El Rio Community Health Center - Arizona's oldest and largest community health center.

"When you eat sugar, especially by itself like a candy bar, you get a rush and crash. An apple will not give you instant gratification or a rush, but it lasts longer," Aiken says. "An apple and a piece of cheese is ideal - your blood sugar will go up gradually and then will go down gradually over a period of hours."

The rules seem drastic to many parents sending their children to the school for the first time. Since the school has no cafeteria, all students must bring their own lunch.

"It is challenging mainly because in grocery stores it's so hard to find anything without sugar. When you look at the label, so many things aren't allowed," says Breanna Chacon, 30, who has two children at the school.

"It really does make a difference. It balances them out," says teaching assistant Isabelle Medeiros as she confiscates a student's packaged Ritz crackers and cheese spread. "I will send this home with a note, explaining why it isn't allowed."

The school's emergency food supply of "yes" foods like peanut butter and honey is provided through donations and fundraisers.

Among the "no" foods: flavored yogurt, canned fruit, American cheese, processed meats, white bread, peanut butter made with sugar, and virtually all packaged crackers except Triscuits, because they are baked with whole grain.

Not everyone supports such extreme food rules - especially if they extend to the home.

"There are all kinds of emotional and behavioral problems that can happen if you tell a child to never, ever eat a cookie. They may do just the opposite once they are at a rebellious stage," says registered dietitian Nancy Rogers, coordinator of the Worksite Wellness Program for the University of Arizona's UA Life & Work Connections.

"Food is in such abundance here. It's not like living on an island where you are never going to see an Oreo. You want to train kids to make good choices to keep their bodies healthy."

Rogers recommends moderation. Sugar is not bad in small amounts, she notes. It's a carbohydrate that is burned for energy.

"The studies don't substantiate that additives or preservatives would cause behavioral problems in children. However, there is anecdotal evidence," Rogers says of Aiken's approach. "If the parents are wanting to try it, there's no harm in that."

Aiken does not relent. Not for Halloween nor Valentine's Day. Not even birthdays.

"I always say no. It makes them think and be more creative," Aiken says. "You don't need a cake. They can have nuts, or fruit."

If all U.S. families followed her school's food rules, Aiken believes, childhood obesity would be a rare problem.

"There is also the physical activity aspect to consider," she says. "However, it is much more difficult to become obese by overeating fruits and veggies."

Preventing obesity is only one reason behind Aiken's rules. Overall health is the key factor - particularly for children who, like many of her students, have behavior problems.

“A lot of kids who are challenged and diagnosed as having attention deficit disorder biochemically maybe are more sensitive to sugar — it’s possible they metabolize it differently,” Aiken said.

“The kids with ‘behavior problems’ are usually very bright. I’m not a fan of medications for behavior. Only one to two percent of kids on them really need them.”

Andreina Barrios, 6, often brings plain unflavored Fritos corn chips, which are a "yes" food because it's a whole-grain food. One recent lunch included scrambled eggs wrapped in a whole-wheat tortilla, as well as water and tomato juice.

Her classmate, 5-year-old Luz Michel, brought whole-wheat noodles, plain chips, juice and sliced peaches.

"We are what we eat. It's true," Aiken says. "If you buy a new car you aren't going to put sand in the gas tank. Why would you want to do that to your body?"

View the original story at the Arizona Daily Star website

 

'Super-chubby' teen now a biking super-role model

By Mariana Alvarado

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KELLY PRESNELL / ARIZONA DAILY STAR Seventh-grader Riley Breedlove at Imago Dei Middle School. He cycles at least 40 miles a week - not to mention running and swimming.

Two years ago, Riley Breedlove, 13, rarely rode a bicycle.

Today he is preparing for his first triathlon.

"I used to be super-chubby," says Riley, who has lost 20 pounds since last year.

The student from Imago Dei Middle School - a tuition-free school for children of low-income families - cycles at least 40 miles a week and runs and swims in preparation for the May competition.

The transformation began when Riley was introduced to the ProActive's Jr. El Tour Program, which trains children 11 to 13 to ride and rewards them with a bicycle if they complete the 12-week program.

The teen says he always liked riding in his neighborhood but couldn't afford a good bike, and was motivated by the program to earn one and to get in better shape.

Riley "is a perfect example of someone who really had never cycled before … and then went on to really be riding in a regular basis on his own," says Anne Sawyer, head of Imago Dei Middle School, where most children in the program come from.

Because a lack of transportation limited attendance to the follow-up rides in the past, the program - sponsored by ProActive Physical Therapy, Pyramid Coaching, the Perimeter Bicycling Association of America and TriSports.com - now comes to the school.

"We understand that kids are underactive, in large part because schools are challenged to provide physical education," says John Woolf, co-director of the Jr. El Tour Program and owner of ProActive Physical Therapy. "We are committed to providing the community bike solutions to minimize the effects of obesity and underactivity."

The program also encourages riders to return as mentors to younger kids.

It's a role Riley has proudly taken on.

In 2009, he rode 66 miles of El Tour and hopes to increase the distance in 2010.

Riley worries about his friends.

"(They) are really not active," he says. "It's tough at first, but you have to find the (sport) you like.

"I can ride for miles," Riley says, "and it's just awesome because I like the way it feels."

View the original story at the Arizona Daily Star website

 

Greasy Mexican food being converted back into its healthful self

By Mariana Alvarado

Cick to return to table of contents

Regarded as greasy and unhealthy, Mexican food dishes are getting an image upgrade.

A group of Tucsonans recently began meeting to learn about nutrition and share traditional Mexican recipes that are low in fat and calories.

Some tips are simple: using agave syrup instead of refined sugar, for instance. But participants emphasize that reducing sugar - regardless of its type - is most important.

Organizers say the 20-person group - some members are diabetic - shares a concern for their health and the health of their children. The meetings are held in Spanish.

Salvador Barajas, one of the organizers, says the yet-to-be-named group is made up mostly of friends and neighbors and started about a month ago.

Thanks to high interest and attendance, the group is preparing to do presentations at public libraries.

"OK, so we need to come up with the list of Mexican dishes we'll include in our presentations," Barajas tells the group at a recent meeting held at Valencia Branch Library.

Mary R. Tasho, whose idea to use prickly pear in ceviche was a hit, has diabetes, and so does her daughter.

"Not everyone who has diabetes likes fish or chicken, so ceviche with nopal (prickly pear) instead of fish is a good idea," says Tasho, who just returned from a nutrition conference in Mexico.

Barajas has been studying Mexican food and its origins and says it's been modified into unhealthy recipes.

In its original form, it's not as unhealthy as people think, he says.

"We need to learn that our food is rich," he says. "We need to go back to our roots."

View the original article at the Arizona Daily Star website

 

Este reporte especial fue producido como un proyecto del California Endowment Health Journalism Fellowships, un programa del Annenberg School for Communication & Journalism de University of Southern California.

This special report was produced as a project for the California Endowment Health Journalism Fellowships, a program of USC's Annenberg School for Communication & Journalism. MARIANA and STEPHNIE did reporting and writing for the section.