The tote bag next to Bonnie Held’s desk at the Panhandle Health District in Coeur d’Alene brims with food, and Held keeps it close.
There are dishes of applesauce, cereal and corn, servings of spaghetti, even a medium-size apple. The food is fake, but that doesn’t matter. It’s the size that’s important.
“They’re reasonable portions,” Held said last week after returning from a conference with the governor on Idaho’s growing weight problem. “I use these particularly to teach my teen classes how much they really need.”
Apparently Idahoans don’t know how much to eat. Not only is the number of people in the state growing every year, so is the size of the people. In 2003, the latest year for which statistics are available, 59.3 percent of Idaho’s adults fit the definition for overweight; 22 percent also fell into the obese category.
Overweight people had a body mass index – a measure of weight based on height – between 25 and 29.9, and obese people had higher BMIs. According to the Centers for Disease Control and Prevention, a healthy BMI range is 18.5 to 24.9.
In Idaho’s five northern counties, 59.6 percent of adults were overweight, and 20.4 percent were obese. More men than women were overweight, but more women than men were obese. In Washington, 59 percent of the population was overweight. In Oregon and Montana, 57 percent was overweight.
The numbers come from an annual CDC survey. At least 4,000 people are called in each state and asked about their physical activity, weight, seat belt use and tobacco and alcohol use. The same questions are asked every year, so trends become obvious.
In 1990, 29.5 percent of Idaho residents were overweight and 11.9 percent obese. Washington’s numbers were similar, with 33.2 percent of its population overweight in 1990 and 9.4 percent of its population obese.
“You see a lot of different scenery now, more big people,” said Tom Tracy, Idaho’s head advocate for fitness. Tracy is the state Department of Health and Welfare’s director of the Physical Activity and Nutrition Program established last year.
Tracy’s program was Health and Welfare’s response to the high cost Idaho is paying for its poor eating habits and physical inactivity – about $852 million per year that is picked up mostly through Medicaid and Medicare. That money goes toward management of more diabetes cases and treatment for high blood pressure, osteoarthritis and sleep apnea that overeating often causes. Obesity also contributes to coronary heart disease, strokes, gallbladder malfunctions and endometrial, breast and colon cancer, according to the National Center for Health Statistics.
Tracy began his assault on Idaho’s sagging stomach with regional forums last March. Each health district gathered educators, providers of health care, senior and fitness services, business peo-ple and others to collect a database of services available and generate ideas on the challenges each community faces.
Participants said families are too busy to fit physical activities into their schedules. Parents don’t teach their children about fitness, and low-income families perceive exercise as unaffordable, according to a report that Tracy compiled on the March forums.
Participants also said seniors worry they’ll get hurt exercising, and employers don’t support health-related programs. People stay ignorant of the risks of not exercising while exercise facilities are too far away. Idaho’s long winters and short daylight limit outdoor activities for much of each year.
On nutrition, they pointed out that schools don’t feed kids well but make available vending machines usually filled with unhealthy snacks. Many families don’t have time to cook quality meals anymore. Additionally, senior centers serve institutional-type food, employers don’t encourage healthy eating or weight management, and fast and unhealthy food is inexpensive. People look for quick fixes, like gastric bypasses, instead of learning to manage their weight.
At the Governor’s Physical Activity and Nutrition Summit last week in Boise, Tracy urged a solid plan to shape up the state. One of the nation’s health goals by 2010 is to reduce the obesity rate by 15 percent. Now, more than 60 million adults – 30 percent of the nation’s population – are obese. The CDC has encouraged states to implement their own weight-loss plans and has backed up the encouragement with funding.
This year, 23 states received $300,000 to $450,000 each to create strategic plans, and five states received $800,000 to $1.5 million each to continue plans already in action. Washington joined the program in 2001. Part of its plan includes improving bike trails in Moses Lake and a community garden project that encourages consumption of fresh fruits and produce.
Washington is building sidewalks and trails in senior communities to promote walking and biking. It also began training child care providers to teach children the value of physical activities and an educational program about the inactivity television inspires.
“Idaho is not different from other states on this issue,” Tracy said. “The plan that develops won’t look much different from Washington’s or Oregon’s or Connecticut’s.”
He envisions a strategy that includes building awareness with education, then changing policies to create environments friendlier to physical activities. Schools could replace unhealthy snacks in vending machines with fruit and other healthy snacks, he suggested. Employers can alter the workday slightly to give employees time to work out at lunchtime, he said.
“We have a huge bubble of baby boomers aging,” Tracy said. “If that group doesn’t get more active and make better food choices, health costs will be unbelievable.”
A strategic plan will emerge later this year. Tracy said he knows there’s no quick fix to America’s fixation with food.
But, he said, “When I get negative, I think about smoking. Frankly, 20 years ago if you’d told me the status quo around tobacco use is what it is today, I would have said you’re nuts.”
People change, particularly when they learn their futures are at stake, he said.
Held has hope a new community center likely to take shape in Coeur d’Alene in the next year will inspire people in Kootenai County to skip the pastries for the pool.
“We need a buy-in from the people for this to work,” she said. “We’re talking about doing a weight-loss challenge between health districts.”
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