Weighing the evidence: Strategies to end obesity provide plenty of food for thought

Minnesota Compass research intern Heather Vinge Hanson recently completed a literature review of evidence-based strategies that combat obesity from a systems-change perspective, rather than those that involve actions individuals can take.

In this special guest edition of Ask a Researcher, Heather shares her findings: What works to address obesity, what doesn't, and why.

There is no disputing the fact that obesity has become a major public health concern. In Minnesota, 25 percent of our adult population is obese. A person who is obese has an increased chance of having other chronic illnesses, such as heart disease and diabetes.

While there is a host of research on how individuals can prevent and treat obesity, little exists about how communities can play a role. However, organizations and communities can play an integral role in the health of community members. Community-level evidence-based strategies are beginning to be identified as an important part of the fight to reduce the widespread prevalence of obesity in our population.

Why did you do a literature review and how did you go about it?

For this project, Compass wanted to identify evidence-based strategies that organizations can use as models to prevent and treat obesity in their communities.

In order to find programs and strategies that made a significant impact, I reviewed dozens of journal articles in publications such as American Journal of Preventive Medicine and The Journal of Rural Health. Strategies that "made the cut" had been evaluated to have made significant changes to the obesity level of a population and were community-based in their approach. In other words, I was not looking for ways individuals can make healthy choices, but rather strategies communities and organizations can implement that would allow for individuals to make positive choices.

Was there any special reason you chose the obesity indicator?

I chose to focus on obesity for several reasons. First, it has become a "hot topic" over the last few years, and rightly so; it has quickly become a major public health concern. Second, because the topic is so relevant, organizations and communities are eager to implement programs that focus on reversing this alarming trend. I hope that providing strategies will guide this important work so that groups can develop strong and effective programs based on what works. Last, I have a personal interest in nutrition and looking at obesity at the community level was interesting to me and a new way for me to view prevention. It opened my eyes to new ways to fight the obesity epidemic.

Did you notice any themes in your findings?

The most prominent theme that arose was the importance of parental involvement in any program directed toward children. This may seem obvious, but there are so many programs that focus solely on children, such as school nutrition education, having healthier food choices in vending machines, lowering the prices of healthier food choices, or simply eliminating vending machines in schools altogether. However, programs that involve parents allow for changes to take place in the home as well, and therefore have a higher rate of success. These programs can vary greatly but often involve families working together to create daily or weekly dietary and physical activity goals.

A second theme that emerged was the concept of community planning and its effect of obesity reduction. For example, research has shown that when there are more sidewalks in a neighborhood, people are more physically active. However, if a neighborhood is unsafe, residents are less likely to be active outdoors. So the way a community plans (or doesn't) can have a big effect on the behavior of individual residents.

Finally, limited access to fresh food and supermarkets are also a barrier to positive community health. In rural areas or urban areas where convenience stores are more prevalent, the average Body Mass Index (BMI) of the community is generally higher than where supermarkets are more available. The plain fact is that where there are limited fresh and healthy foods available within a community, it is nearly impossible for individuals to make healthy choices.

How can these ideas be applied?

There are many ways these strategies can be applied. For instance, cities can plan more mixed-use developments that encourage community members to walk more and drive less. Youth programs can involve parents in the programming and include activities/suggested changes at home. Planners and developers can put grocery stores in more communities to make fresh foods more accessible.

Are there any reports you would recommend?

The Center for Disease Control published a report that identifies strategies that communities can implement to prevent obesity that has some great ideas. There is also a complementary implementation guide. Also, anyone interested in learning more about community approaches to obesity prevention should check out the Robert Wood Johnson Foundation web site. It has a wealth of information.

What's next?

Now that the strategies have been identified, I will be researching Minnesota programs that are implementing these evidence-based strategies. Those will be featured in the "Ideas at Work" on the Health section of Minnesota Compass.