With the warmer weather comes the realization that ‘bathing suit season’ is just around the corner. Once upon a time, this was enough to strike fear in the hearts of both men and women who hoped to lose five pounds by Memorial Day. It didn’t bother kids in the least … because children were already lean and strong from playing outdoors and eating healthy, family meals.

 

Today, this scenario seems like a fairy tale. Instead of five pounds, many need to lose 20, 50 or 100-plus pounds to approach their normal weight range, and a rapidly growing segment of children are overweight and get little physical activity. According to 2007 Behavioral Risk Factor Surveillance System data, approximately 37 percent of adult Tennesseans were considered overweight and another 31 percent obese. That means more than 3 million of the state’s 4.7 million adults are overweight or obese. Additionally, only 26 percent of adults report eating fruits and vegetables at least five times a day and 30 percent said they had no leisure time activity in the month prior to the survey.

 

The problem also impacts the state’s teens. The 2007 Youth Risk Behavior Survey data showed 18 percent of the state’s ninth-12 grade students are overweight with another 17 percent being categorized as obese. At this same grade level, less than half of the youth (42 percent) are meeting current physical activity recommendations, 38 percent watch three or more hours of television each day, and almost half drink at least one non-diet soda daily.

 

Simply accepting the status quo wasn’t an option for a number of healthcare, education and fitness professionals across the state. Recognizing the toll this alarming national trend was taking on health, productivity and quality of life, small groups worked to attack a portion of the multi-factorial problem in communities throughout Tennessee. Still, the uphill battle felt a bit like fighting the mythological seven-headed Hydra. For each bit of ground gained, another barrier to optimal health seemed to pop up.

 

Fortunately, the first Southern Obesity Summit was called in 2007. Concerned professionals from 16 states convened in Arkansas to share resources, policy strategies and successful intervention tactics. The conference also fostered a desire for more collaboration and cooperation. The ‘strength in numbers’ message resonated with Tennessee delegates who were excited to find others working toward similar objectives in pockets all across the state.

 

From this meeting, the Tennessee Obesity Task Force (TOT) was loosely formed. In the ensuing years, the group has gained strength, numbers and significant grant funding. “In July 2008, we were successful in receiving a five-year funding grant from the CDC,” noted Joan Randall, MPH, chair of the Tennessee Obesity Task Force, which now includes approximately 50 member organizations.

 

Randall, who is also administrative director of the Vanderbilt Institute for Obesity and Metabolism, said the result of the grant is annual funding of $450,000 from the Centers for Disease Control & Prevention. The first step for TOT was to bring people together and create a sustainable infrastructure. Now, the group is moving forward to develop a coordinated state effort to attack the issues contributing to the root causes of obesity.

 

“The second step is developing this state plan for nutrition, physical activity and obesity, but the focus is to address these through policy and environment,” Randall explained. She added the CDC has found these types of changes to be more effective than single projects of short-term duration. “If we can initiate some population-based changes that make it easier for people to make healthy choices, it will be more sustainable,” she noted.

Randall continued, “There are six target areas — increase physical activity, increase the consumption of fruits and vegetables, decrease the consumption of sugar-sweetened beverages, increase breastfeeding initiation and duration, reduce the consumption of high-energy-dense foods, and decrease screen time.”

To meet these goals, TOT has put together a number of work groups focused on specific targets such as food systems, worksite wellness, the built environment, and schools. Tennessee Coordinated School Health (CSH), which was launched in 2001, is now the centerpiece of TOT and a national model for other states looking to stem the tide of the obesity epidemic.

Ensuring continued funding for CSH and updating legislators on priority issues was the impetus behind the recent Day on the Hill. Representatives from TOT, the Tennessee Department of Health and Save the Children appeared before the House Health and Human Resources Committee at the end of March to discuss long-term efforts to fight childhood obesity.

Andrew Hysell, associate vice president of policy and advocacy for Save the Children U.S. Programs, noted, “The focus of Save the Children U.S. is targeting resources and attention to the plight of poor children living in rural areas in the United States.”

Although at first glance, international work to feed malnourished children and domestic work to fight obesity might seem to be on opposite ends of the spectrum, Hysell said both are actually centered on helping children live healthy lives. The organization’s national programming is centered on 14 states with the greatest need, including Tennessee.

Like TOT, Hysell said his organization’s focus has been on creating change through policy. In January, Save the Children launched “The Campaign for Healthy Kids” with support from the Robert Wood Johnson Foundation. “We feel like it’s so important for their (children’s) future that we’re investing a lot of time and resources into this issue and into changing policy to address this issue,” he said.

His reason for appearing before legislators in Tennessee was to support the efforts of TOT and the Department of Health. As is the case with many chronic public health issues, he noted, the problem progresses over a long period of time. These issues, he continued, don’t always resonate with the same sense of imperative need as something like a flu pandemic.

“One of the major obstacles we face is trying to communicate to the public and to opinion leaders the urgency of this issue,” Hysell said. “This generation of children could be the first to live shorter lives than their parents.”

After the adversarial nature of last year’s menu labeling debate, Randall said this recent meeting was a chance to start with a clean slate and ask legislators to work with TOT to reduce the burden of obesity on the state. “We believe that in order to put policies in place and to change our environment, we need to partner with them,” Randall said of the opportunities ahead.

Although there is a daunting amount of work to be done to reverse mindsets, Randall said there are also many reasons for hope. “There’s so much going on right now that is good and that is furthering the obesity efforts,” she said.

Chattanooga, for example, has taken on a leadership role with initiatives around biking and walking. Similarly, Blount County’s Maryville-Alcoa Greenway has turned a floodplain into nine miles of fitness opportunities. “People that wouldn’t normally integrate health into city planning are now thinking about that from the beginning,” Randall said of partnerships forged with city planners and parks and recreation officials. “It makes a huge difference to give people access to the outdoors.”

She also pointed to the YMCA’s national effort, “Pioneering Healthier Communities,” which takes the Y outside of its bricks and mortar buildings and into the communities served. There are six pilot sites in Tennessee — Dyersburg, Memphis, Nashville, Chattanooga, Kingsport and Bristol. Last month in Nashville, the YMCA hosted “Healthy Kids Day 2010” at the Nashville Zoo. The event featured healthy food samples, activities, and a Kid’s Zumba class with Tennessee State Health Commissioner Susan R. Cooper, MSN, RN.

“There’s just stuff going on all over the place,” Randall said with evident excitement. “The purpose of the plan is to coordinate these efforts, align resources, and then measure the impact of what we’re doing.”

With a coordinated effort, perhaps bathing suit season won’t be so scary in the near future.