By: Sheila Kun RN, BSN, MS, CPN, FCCP
Salesian Cooperator

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“Knowing the situation or problem without intervention is a futile exercise.” I totally agreed. This was the reaction from my husband Louis when he read about the contributing factors of childhood obesity. Little did he know that Anet Piridzhanyan, MS, RDN has a lot to say about how to approach the problem.

Multiple strategies and components and a multilevel approach that focuses on diet and health-related activities have provided the most sustainable and beneficial effects on childhood obesity intervention.

Notice the key words: multiple strategies, in another words, not just one approach works. And it is not just food that we are going to focus on. Health-related activities are part of the elements of success. Also notice the word sustainable effects. Anyone can rush to a week crash diet, but is this sustainable?

Therefore, let us examine the model that seems to work the best per Ms. Piridzhanyan:

 2015-2020 Dietary Guidelines for Americans identifies the Social-Ecological Model (SEM) as a framework to understand how all sectors in society influence food and physical activity choices.

–Evidence shows changes at multiple levels, in combination and over time, is effective in improving healthy behaviors (diet and exercise).

Social-Ecological Model (SEM) focusing on 3 approaches:

• Individual level: an example would be receiving nutritional education or information in person or in a group situation. The social support is important; a strong word of encouragement, great coaching and caring messages are all good tools to make a difference on an individual base.
• Institutional/Organizational level: I remember our hospital used to have a McDonald to provide fast food for employees and visitors. However, when we critically address the issue of obesity as an institution, our administrators decided that fast food had to go.

We said goodbye to McDonald, and ushered in our weekly Farmers’ Market, showcasing fresh products and fruit.

• Environmental layer: I cannot help to think of New York City when it comes to the environmental layer. Former Mayor Bloomberg attempted to cap the size of sugary soft drinks in restaurants, movie theaters, etc. I don’t remember how successful he was. But this is a good example of someone at the top level, looking at society as a whole and tried to promote healthy diet. Years ago, our endocrine doctors testified in Sacramento about childhood obesity and requested meal planning changes in school. Our doctors noticed not only the type of food provided in school was not the healthy ones, they noticed the serving portion was huge. “No wonder our kids are obese, look at the portions they serve!” – lamented our doctors when they made school site visits.

Goal of nutritional interventions is to teach families how to make better choices. Living a healthy lifestyle vs dieting; and making it enjoyable. We are not depriving food, just simply providing healthier options and tools to help reach healthy goals.

An example of nutritional goal:

• Encourage healthy choices of 5 vegetable or fruit per day.
• Minimize sugary drinks.
• Eat breakfast.
• Eat most meals at home and as families.

Your homework from the Care Ministry this week: what healthy choices can you make this week?

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