Childhood Obesity Prevention in Texas: Workshop Summary (2009)

The second day of the workshop began with a series of presentations given by individuals representing various initiatives operating within Austin to combat childhood obesity.

Paul Carrozza, owner of RunTex, a store supplying running shoes, gear, apparel, and accessories, described how his personal call to physical fitness blossomed into community action and outreach. As a child, Carrozza suffered from asthma and chemical allergies. He discovered that limiting his time indoors, maintaining an active lifestyle by running, and eating organic foods dramatically improved his symptoms. This way of life segued into a career when he moved to Austin and opened his running supply store with his wife in 1988. Their business is now the nation’s largest store devoted exclusively to running. In addition to RunTex, Carrozza founded RunTex University and RunTex Events. RunTex Events produces more than 120 events each year and raises more than $5 million annually for local charities. Carrozza is also a co-founder and sponsor of the Marathon Kids program, described below.

Carrozza noted that we live today in a still environment with effortless transportation, a constant food supply, and air-conditioned rooms. “In our current lifestyle, most people are motivated to move externally, not internally,” he said. As a consequence, it is important to be around people or in programs that motivate one to move. Early on, Carrozza found that he was a natural catalyst for encouraging others to move. He now regularly offers coaching programs to help runners train for an event, and through

these efforts he has identified four elements that make his running programs a success:

• Having an effective leader

• Assembling a team of people with similar athletic abilities to offer each other moral support

• Training for a cause or goal

• Having the proper equipment

Marathon Kids is a 12-year-old grassroots initiative that has grown to become a national nonprofit organization. The program was the vision of Kay Morris, who came up with the idea for Marathon Kids while participating in one of Carrozza’s inspirational running classes. Marathon Kids is a voluntary, free, school- and community-based program in which children in grades K–5 of all physical abilities are engaged to make a pledge to physical activity by running or walking 26.2 miles over 6 months. Children are given a running log in which they tally their miles on one side and record on the other the 26.2 days of every month that they eat five servings of fruits and vegetables a day. Each year, the Marathon Kids program culminates in a final mile medal celebration held at a college or university with Olympians in attendance to sign autographs. Access to the program is promoted through school activities and free transportation to events.

Morris pointed out that the program represents an excellent model of adaptability, particularly in inner cities. Marathon Kids currently registers 60,000 children in grades K–5 in Austin; 41,000 in Dallas; 20,000 in Houston; nearly 20,000 in Los Angeles; and about 5,000 in the Texas Lower Rio Grande Valley. The program recently expanded to include Baltimore and Chicago; another 300 towns and cities are on the waiting list, along with cities in 14 foreign countries. Morris attributes much of the program’s success to “the perfect intersection of substance and symbolism.” Both children and parents readily understand the concept of the program, and the excitement elicited in the children often is transferred to the parents.

Morris noted that the Michael & Susan Dell Foundation has provided funding to study measurable changes over 2 years of Marathon Kids. Endpoints to be evaluated include changes in BMI, as well as shifts in children’s self-perception.

ACTIVE Life is a first-of-its-kind social movement launched in Austin to combat the youth obesity epidemic. ACTIVE Life regards obesity as one

symptom of a broken culture. Therefore, it views itself not as an anti-obesity program but as a program to drive greater demand for healthy lifestyles by changing people’s culture, targeting children, families, and industry. “We want to inspire people to want to live healthier lives, and then we want to make those lifestyles more accessible,” said Baker Harrell, founder and Executive Director of the ACTIVE Life movement. He identified four keys to the success of the ACTIVE Life approach:

• Innovation—focusing on what has not yet been done

• Collaboration—serving as the glue to bind disparate elements

• Inspiration—providing the motivating force for change

• Mobilization—inspiring people to become evangelists for health

The ACTIVE Life recipe for success also includes scalability, sustainability, adaptability, and the ability to be measurable.

ACTIVE Life interprets the word active holistically by focusing on physical fitness, nutrition, and the environment. The 5-year-old organization provides health- and fitness-based programs, products, media, and events to 400,000–500,000 youths and their family members throughout Texas. One of ACTIVE Life’s many innovative approaches to preventing childhood obesity is to work with corporations, such as soft drink companies, to show them how they can generate more revenue by increasing the demand for healthier products. Through these efforts, corporations are enlisted to become part of the solution.

David Davenport, President and CEO of the Capital Area Food Bank, began his presentation by highlighting the following information:

• One in five Texas children is obese.

• One in four Texas children lives in poverty.

• High-carbohydrate junk food costs $1.76 per 1,000 calories.

• Healthy produce and protein foods cost $18.46 per 1,000 calories.

According to Davenport, people often associate food banks with unwanted, unhealthy surplus food that is redistributed to low-income families. At the Capital Area Food Bank, however, 80 percent of the food provided to low-income areas is rated 1 or 2 on a scale of nutritional quality (with 1 representing most nutritious and 4 representing least nutritious).

As a whole, the Texas Food Bank Network consists of 19 member food banks that provide emergency food assistance to all Texas counties. The network encompasses 3,600 partner nonprofit organizations that in 2006

provided food for 681,000 children. Flowing through the Texas Food Bank is the Texans Feeding Texans Surplus Agriculture Program, a collaboration between all of the food banks in Texas and the Department of Agriculture. The program captures surplus agricultural products in the fields that farmers and ranchers do not take to market because they want to maintain certain price levels.

Davenport explained that the Capital Area Food Bank is a member of Feeding America and the Texas Food Bank Network. It provides emergency food assistance to 21 central Texas counties through a network of 355 partner nonprofit organizations. Recognizing that children living in poverty lack access to high-quality, nutritious foods, the food bank endeavors to increase access to such foods for low-income children and families through several locally based programs (Box 7-1). Through its nonprofit partners

and local programs, the Capital Area Food Bank collected and distributed 17.5 million pounds of surplus fruits, vegetables, and meats produced by farms and ranches in 2008, and it anticipates distributing 22 million pounds of healthy foods in 2009.

Katie Deinhammer of EnviroMedia, a public relations and advertising agency dedicated solely to improving public health and the environment, defined social marketing as a mechanism to achieve behavior change. The prelude to such change is usually a period of social unrest, which can be leveraged to encourage different behaviors. Deinhammer suggested that the tipping point for childhood obesity prevention may be the projection of the Texas state demographer, noted in Chapter 1, that nearly 15 million Texans will be obese by 2040 without more aggressive prevention efforts.

EnviroMedia has found that comprehensive social marketing campaigns successfully incorporate six critical factors: (1) science-based research, (2) messaging, (3) creative advertising, (4) outreach, (5) media relations, and (6) evaluation of results. This approach has achieved significant results for many of EnviroMedia’s clients, including enrollment of 94 percent of eligible children in a children’s health insurance program with Insure a Kid and a nearly 40 percent reduction in teen smoking through messaging carried out under the Texas Tobacco Prevention Initiative.

Deinhammer noted that, in addition to efforts to promote physical activity and access to nutritious foods, stakeholders seeking to prevent childhood obesity need to fund and advertise the right messages to children through television ads. “Today … a typical child sees 40,000 commercials a year, and more than half of those are for fast food, candy, soft drinks, and sweetened breakfast cereals,” she stated. She noted that the deceptive use of communication to hide unpleasant facts has been applied in many contexts. In politics, this tactic is called whitewashing; in the environmental context, it is called greenwashing; in public health, it is called leanwashing, and it is becoming increasingly prevalent in the advertising world.

According to Executive Director Ronda Rutledge, the Sustainable Food Center is a little-known organization that has existed for about 30 years. The center seeks to cultivate a healthy community by strengthening the local food system and improving access to nutritious, affordable food. The various programs supported by the Sustainable Food Center follow a grow–share–prepare continuum (Box 7-2). The center wants to teach people to grow their own food in whatever space they can find—their back-

yard, containers on the front porch, a community garden—because doing so provides affordable access to healthy food. To this end, the Grow Local program addresses the grow portion of the continuum. The share portion of the continuum is represented by the Farm Direct program, which provides farmers with numerous outlets for partnering with organizations and distributing fresh, healthy food to various venues in the community. The

Happy Kitchen program deals with the prepare portion of the continuum by offering a 6-week cooking class that addresses every element of the Food Guide Pyramid.

Rutledge explained that the Sprouting Healthy Kids program combines the best aspects of all three of the above programs in the school setting to tackle the issue of childhood obesity. Sprouting Healthy Kids broadly addresses children’s relationship to food through farm-to-school initiatives, nutrition education, and community/youth gardening. According to Rutledge, students who gain knowledge of food systems and have access to high-quality foods are more likely to make positive dietary choices, as are their families. Through additional funding, the Sustainable Food Center is conducting a pilot project aimed at accomplishing a comprehensive community intervention by implementing all of its programs in specific communities near Sprouting Healthy Kids schools.

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