By Steve Hendrix and Hamil R. Harris
Washington Post Staff Writers
Tuesday, May 20, 2008
Latrisha Avery knows losing weight could head off the diabetes that runs in her family. But the fifth-grader has a more immediate reason for her goal of losing 20 pounds before she starts middle school next year: So kids will stop calling her "King Kong."
Although many children in her neighborhood are overweight, Latrisha knows she stands out. At 12, she is almost 5-foot-7 and weighs 220 pounds, making her taller than most of her classmates and heavier than any.
"They pick on me all the time," she said in a quiet voice. "I let it go, but I do not need a bigger crowd of people talking about me. I do not need to be the heaviest girl in middle school."
And so Latrisha is working hard to become a smaller target. At a Boys and Girls Club in Southeast Washington, she spends four hours a week at a free fitness and nutrition program sponsored by the District's Project Health initiative. She runs in the gym and then learns about "sometimes foods" and "all-the-time foods." She has cut her visits to Popeyes Chicken to one a month and she has become a calorie counter who baffles her mother with talk of hydrogenated oils and trans fat. Latrisha has lost 15 pounds since beginning the program last fall.
"If I can lose about 20 more, that will put me back in the 100s," she said.
Latrisha is determined, but she is also a child of Ward 8, where a poor young African American trying to lose weight faces unique challenges. More than half the children in the ward are overweight or obese, according to Rand Corp.
Almost all the food choices in Latrisha's neighborhood are bad ones, with corner stores and takeout joints serving fatty calories through bulletproof glass windows. A 2007 study by the National Urban League found that 81 percent of the food vendors in Ward 8 were either convenience stores or fast-food outlets. Until a new Giant opened in December as the only full-service grocery in a ward of 70,000 residents, Latrisha's sole source of fresh produce was a bus ride away.
There was no playground near Latrisha's house on Brandywine Avenue SE. And because of drug dealing and gunfire, Latrisha's mother would let her play outside only when she could keep watch. Sixty percent of the residents live within two blocks of a public park, the Urban League study showed, but 56 percent of parents would not allow their children to play outdoors, mostly because of safety concerns.
When it comes to overcoming obesity, "there are some particular problems in D.C., where so many kids live in poverty," said James Weill, president of Food Research and Action Center (FRAC), a Washington nutrition advocacy group. "They have fewer resources for physical education in school and in the neighborhood. And poor neighborhoods often don't provide any healthy nutrition options at all."
Research has begun to confirm how fattening the inner city can be. A recent Carnegie Mellon study examined how the mix of fast-food outlets, parks and playgrounds affected obese children at a Pittsburgh weight-loss center. The closer the children were to outdoor recreation, and the farther away from junk food, the slimmer they became.
"Where they live turns out to be one of most important factors in how much success they will have in achieving significant improvements in health," said Kristen Kurland, a researcher in the university's Heinz School of Public Policy and Management.
Washington has awakened to the idea that neighborhoods can make kids fat. A range of government, community and nonprofit organizations are working to reduce urban barriers to weight loss, from a U.S. Transportation Department's "Safe Routes to School" project to licensing food carts that sell hummus and salads. The department will soon test a free "borrow-a-bike" project based on a popular program in Paris.
The D.C. Council has funded an "International Fitness Diplomats" program to have professional athletes visit high schools, and Mayor Adrian Fenty just announced a $100,000 grant for fitness programs.
The HSC Foundation, part of a new childhood obesity campaign, recently opened Healthy Living Center at Martin Luther King Jr. Avenue and W Street SE, offering free nutrition classes, dance, exercise and yoga.
"There's just been an explosion of activity," said Ruth Perot, executive director of the Summit Health Institute for Research and Education, a health advocacy group. Her organization recently compiled a list of 700 programs targeting obesity and similar healthy lifestyle issues in the area.
In September, the District's Health Department hosted an obesity summit. Five months later, the department released an 80-page "Child Health Action Plan" that included 20 initiatives. The proposals included teaching child-care providers, many of whom work in private homes, how to serve lighter lunches and hold recess in a basement; putting more farmers markets or truck-based produce vendors into poor neighborhoods and ensuring that they accept food stamps; and tracking young people's body mass index in schools, doctors' offices and child-care centers.
The agency's efforts come after years of complaints from Perot and other advocates that the department has failed to take the lead on fighting obesity.
"We're hopeful, but we'll have to see," Perot said.
Nathaniel Beers, a pediatrician at Children's National Medical Center and a former Harvard Medical School instructor, recently joined the department as deputy director of community health programs. "For many years, the department of health was not leading the way -- that day is done," Beers said.
In Latrisha's neighborhood, two improvements are clear: the new Giant, which opened after the city sold the land to a developer on the condition that the development include the grocery store; and the free biweekly program. The FitNut program, operated in conjunction with Children's Hospital, holds classes for girls 6 to 9 and 10 to 16. With about a dozen children in each class, volunteers from George Washington University lead running games and nutrition lessons.
At a recent session, after a primer on the least-bad menu items at McDonald's (plain hamburger), KFC (grilled chicken breast) and Wendy's (ultimate chicken sandwich), Latrisha and her classmates sat down to snacks that might have been from another planet: baked veggie puffs, carrots, celery and organic natural peanut butter. Some of the girls looked dubious, but Latrisha's plate was clear in minutes. "That peanut butter was good," she said.
Learning to like healthier foods will do little if no one in the neighborhood sells them. FRAC's Hunger Solutions program has produced a map of Washington's "food deserts," whole swaths without a single place to buy fresh produce within one-mile radius of a population mostly without cars. In wards 7 and 8, there is only one full-service grocery store for every 23,269 residents, compared with one store for every 13,610 residents in the rest of the city.
In these areas, the children's daily sustenance comes from two sources: school meals and the corner shops and takeouts. In a survey of the fresh produce offered by 21 corner stores, FRAC found no grapes, no apples, no dark leaf lettuce.
"Usually it was just a cardboard box with onions and potatoes," said Alexandra Ashbrook, director of Hunger Solutions. "Most of these are one- or two-person operations without the cooler space for produce or the shelf space for a lot of perishable goods."
It took more than a decade to lure the new Giant to Ward 8. While the city is working to attract more full-time grocery stores, policymakers are betting they can spread fresh produce faster by targeting smaller shops. With a $188,000 grant from the Health Department, Ashbrook's group launched the Healthy Corner Store Initiative to persuade markets to provide space for fresh produce, low-sugar snacks and other nutritional upgrades.
The project, based on a successful effort in Baltimore, will help set up produce distribution to the stores, steer owners to grants to install refrigeration and market healthier items.
In March, FRAC hosted a meeting of almost 50 representatives from distributors, nutritionists, community groups and store owners to start designing the program. Organizers plan to begin with a smaller-scale Healthy Snack Initiative that will add low-fat chips and other lighter munchies at five pilot stores in wards 7 and 8.
Store owners are wary of stocking food that teens might not buy, said Gary Cha, president of the D.C. Korean Grocer's Association, who has signed up as a partner.
"If it's just going to sit on the shelves, they are wasting their time and efforts," said Cha, owner of four Yes! Organic Markets in Adams Morgan, Brookland, Capitol Hill and Cleveland Park. "Everyone needs to be educated about why these foods are better for them."
Danielle Dooley, a pediatrician who runs a weekly clinic at Eastern High School, said eating habits can be changed. When she realized that 60 percent of her students were overweight, she launched Eastern's 10-session seminar Charm School -- Choosing Healthy and Rewarding Meals.
A survey at the start of the session showed that most participants, on average, skipped breakfast; drank four sodas a day; ate at a corner store or had takeout food twice a day; had a television in their bedroom; and did not have a grocery store in their neighborhood. By the end of the seminar, Dooley found that students who had attended at least five classes had cut their consumption of fast food and sweetened beverages, watched less television and ate more fruits and vegetables.
"We found when we provided a really simple snack, fruit or a cereal bar, they really loved it," Dooley said.
Customers say the new Giant has made it easier to eat better.
Brian Bowling, 37, leaving with two of his children, proudly displayed a bag of apples. "I got apples -- I didn't come and get candy," said Bowling, who is raising six children. "I am trying to make a difference."
For the past year, Latrisha has lived a few miles away in Capitol Heights with Veronica Gray, who Latrisha calls "Godmother."
Gray is Latrisha's biggest weight-loss advocate. She attends most of the FitNut sessions with the fifth-grader, noting the tips and trying them in her kitchen.
Gray said discipline is hard to maintain in the face of the family's monthly "Soul Food Sunday." She and Latrisha still do their power cooking -- lining the table with fried chicken, macaroni and cheese, roasted potatoes, mashed potatoes and yams.
"If I see a whole rack of that food in front of me, I'm going to eat it, even if I'm not hungry," Latrisha said. "It's a habit."
Gray tries to lighten the fare at her house, occasionally serving turkey ham and leaving the fatback out of the greens. She also presses Latrisha to serve herself sensible portions, on "lady plates" instead of "truck driver plates."
On the other hand, she said, "we're not big drinkers or big smokers, but we have food," drawing out the word for emphasis. "That's the joy; that's the good feeling. Food is comforting. But in the long run, it is only hurting us."