Showing posts with label obesity. Show all posts
Showing posts with label obesity. Show all posts

AMERICAN FORUM

By Sen. Dede Feldman

Anselm Roanhorse’s eyes grow large when he talks about his childhood on the Navajo reservation, herding sheep. “As a boy, I was out there for days, by myself, chasing sheep, protecting them, covering miles and miles of terrain,” he recalls. Now the Director of the Navajo Division of Health, Roanhorse explained to an obesity summit here in June that exercise was part of the traditional Navajo lifestyle, not an “add-on.”

“Our grandparents were not recreationally-oriented,” said Paul Pino, the chair of the health committee at Laguna Pueblo, a smaller settlement of Native Americans near Albuquerque. “But they were active, digging ditches for irrigation, plastering adobe walls or putting a new floor in the kiva, the center of traditional ceremonies.”

In as little as 15 years, all that has changed.

For Native American youth, digging ditches and herding sheep has been replaced by video games and chillin’ in front of the TV. Double Whoppers and Big Gulps, sold at local fast food outlets, have replaced fresh fruits and vegetables. The results of the cultural shift are dramatic.

On the sprawling Navajo reservation, for example, Roanhorse says 23,000 (out of approximately 250,000) Navajos, are now affected by diabetes; in 1940 there was only one documented case.

New Mexico’s Native Americans have two to three times the rate of obesity and diabetes than the overall population does; Indian youth are consistently more overweight than young people in the U.S. Most alarmingly, Native Americans here have the highest death rate from diabetes. The high death rate is particularly perplexing since American Indians are more likely to receive recommended screenings through the Indian Health Service.

Tribal communities, though, are tackling these chronic diseases. They are creating school and community programs to increase physical activity, encourage a return to traditional agriculture and promote healthy food choices. Their efforts are boosted by the cohesiveness of their communities and the commitment of their leaders.

At San Ildefonzo Pueblo, outside of Santa Fe, the Pueblo’s Governor, Perry Martinez, has issued at 5-2-1-0 challenge that has tribal members eating 5 fruits or vegetables per day, logging less than 2 hours of screen time, 1 or more hours of physical activity and 0 sweetened drinks. It’s part of “Keeping Po Woh Healthy—One Child at a Time.” The program uses garden mentors, walking trails and native language to deliver the message to children and their parents.

At Santa Clara Pueblo, elders are teaching kids how to identify medicinal plants, as well as edible ones. There’s a running club and lessons on how to prepare nutritious food. A University of New Mexico mobile health clinic brings health screening opportunities, and diabetes monitoring is done via cell phone. A wellness center is on the drawing board.

A more massive assault on the problem is underway on the Navajo reservation. “Just Move It,” is a series of runs and walks that depart each week from chapter houses and spread out through New Mexico and Arizona. Approximately 10,000 people participated last year with 30 to 150 participating in each event. The runs complement a more coordinated approach to school health in Northern Navajo schools.

For Native Americans and others confronting the obesity epidemic, it may require more. Citing escalating health care costs for the public, a number of states and local governments have attempted to use the same tactics against the junk food lobby that were used against Big Tobacco. New York and California now require food labeling for fat and sugar content echoing the FDA’s warning label on cigarettes.

In the past few years, Arkansas and Washington have taxed soda pop. Earlier this year, New York was unsuccessful at implementing a soda tax.

In New Mexico, beverage taxes present a particular challenge due to tribal sovereignty issues, which can cause a dual tax structure on and off reservations. It’s a challenge that the state and tribes overcame when the state raised tobacco taxes by 75 cents per pack in July. The new tax applies both on and off the reservation. It could serve as a model for a sugar sweetened beverage tax.

Meanwhile, tribal and community efforts continue with friends in high places. First Lady Michelle Obama has taken up the obesity cause, encouraging community gardens and even planting heirloom Native American seeds in the White House garden.
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Feldman (D-District 13) is a State Senator and Chairman of the Senate Public Affairs Committee.
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Copyright (C) 2010 by American Forum. 9/10

NEW MEXICO EDITORIAL FORUM

By Jane McGrath, M.D.

You may hear a lot of talk about taxing soft drinks and other sugar-sweetened beverages. A new tax never sounds like a good idea, but this one is well worth considering. The proposal would add an excise tax of 1 cent per fluid ounce on sugar-sweetened beverages. The tax would be levied on the manufacturers and would show up as a small price increase on the drinks on the supermarket shelf.

I don’t think anyone needs reminding that we are in the middle of an obesity epidemic in New Mexico, as well as in much of the rest of the world. Obesity is a complex problem with multiple causes that result in very high medical costs—which is unsurprising given that complications from obesity include diabetes, heart disease, liver failure, sleep apnea and orthopedic problems. In fact, we spend an estimated $147 billion dollars nationally each year on obesity-related medical costs, half of which are paid with taxpayer dollars through Medicaid and Medicare. Strategies such as an excise tax on sugar-sweetened beverages will help decrease obesity rates and save taxpayer money by reducing medical costs.

Fixing the problem of obesity will involve many different kinds of strategies—much as we are doing with smoking. We have anti-smoking public information campaigns; taxes on cigarettes; age restrictions on buying cigarettes; and policies that restrict smoking in many public places, including the workplace. It takes this kind of multi-pronged approach to make an impact. So a targeted tax on sugar-sweetened beverages is part of how we can begin to deal with obesity from a legislative perspective.

Soda/soft drinks are considered “sugar-sweetened beverages,” which are defined by the Rudd Center for Food Policy and Obesity at Yale University as beverages sweetened with naturally derived caloric sweeteners such as sucrose (table sugar), high fructose corn syrup or fruit juice concentrates. The beverages include soda, sports drinks, sweet teas and coffees, flavored waters, energy drinks and the syrup used to make such drinks in soda dispensing machines.

Sugar-sweetened beverages have been shown in multiple independent studies to add significantly to the risk of obesity. (Studies funded by the beverage industry have not demonstrated a correlation.) This happens in part because, unlike solid food, liquid calories are not satiating so you don’t adjust your caloric intake at your next meal the way you might if you had, say, a large cookie before dinner instead of a soda.

The benefits of an excise tax on sugar-sweetened beverages are pretty compelling. New Mexicans drink an estimated almost 75 million gallons of sugar-sweetened beverages a year. At that level of consumption, the proposed 1 cent per fluid ounce tax would add $95 million a year to the state’s coffers, reducing our projected state budget deficit by 20 percent.

Increasing the cost of a product on the shelf directly affects consumers and changes their behavior: They buy less. Some people say that such a tax is regressive and disproportionately affects children and the poor—and that is true. But it’s also true that obesity disproportionately affects children and the poor. Changing our behavior so that we drink fewer sugar-sweetened beverages will make us all healthier.
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McGrath is a pediatrician based in Albuquerque.
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Copyright (C) 2010 by the New Mexico Editorial Forum. 2/10