Remember that old saying about leading a horse to water? The bottom line of course is that you can't make him drink.
That wisdom seems to hold true, too, when it comes to preventing obesity and its serious medical consequences.
You can create greater access to fresh fruits and vegetables - by building supermarkets in food deserts, changing the offerings at corner stores, adding more farmers' markets and subsidizing costs there, offering cooking demonstrations, and distributing recipes.
You can engage public schools and medical schools, celebrity chefs and gourmet food trucks. You can promote exercise and even have first lady Michelle Obama act as a national cheerleader for the cause.
But can you really influence what goes on behind the kitchen door?
Jennifer Orlet Fisher of Temple University and a colleague from Virginia Tech will spend $3.7 million over the next five years answering that question.
Fisher, who heads the Family Eating Lab at the Center for Obesity Research and Education at Temple University, and Elena Serrano of Virginia Tech received a grant from the U.S. Department of Agriculture's National Institute of Food and Agriculture in March and are poised to recruit participants for their study.
Their project, as yet unnamed, aims to prevent obesity among low-income preschoolers - who are especially vulnerable - by giving mothers simple strategies to promote appropriate food choices and portion sizes.
Through group discussions with mothers, the researchers hope to learn how factors such as income, stress, time, transportation, and access may influence diet - and then develop ways to get around those barriers.
Later, the researchers will test their findings in an urban experiment near Virginia Tech's Blacksburg campus.
Fisher says the study will be the first of its kind. But it's certainly not the research center's first study of childhood obesity.
Last year, Gary Foster, the center director, showed that school-based nutrition programs could be helpful in reducing rates of overweight and obesity in middle-schoolers.
Before that, researchers at the center worked with the Food Trust on a study looking at spending habits of schoolchildren at local corner stores. That project, later lauded by Michelle Obama, found children were spending a little over a dollar a day per visit, which amounted to about 300 extra calories per day.
Meanwhile, Lynne Snyder, Sara Solomon, and D-L Wormley are among the local professionals who already have antiobesity strategies in place, supported with grants from the USDA and the W.K. Kellogg Foundation.
Snyder, at the Health Promotion Council, works with Solomon at the city health department; Wormley, at the Philadelphia Urban Food and Fitness Alliance.
"You can't get people to change their eating habits by lecturing about how much better off they'll be in the future," says Snyder, who creates customized recipes and runs cooking demonstrations at community gardens, church-run food cupboards, senior centers, and public health centers.
"You're better off just showing them how really delicious food can be."
Snyder says what she calls "the grandma factor" keeps families at all levels of income and education from eating better.
"A lot of middle-income people don't know their way around a kitchen as well as their grandmothers did," Snyder says.
And finding the time to shop and cook is a problem that cuts across all income levels.
But money is probably the biggest obstacle for the families she works with. So Snyder shops the local dollar stores to see what those low-income families might find.
When she noticed thyme wasn't on the dollar-store shelves, for example, Snyder changed her recipes to use the spices that were available, oregano and parsley.
And her pesto recipe calls for walnuts, now that pine nuts are so pricey.
"The social workers who know these families tell me they are accustomed to cooking with canned vegetables, not fresh. And as a result, they don't even have the most basic equipment."
That's something Fisher, at Temple, and Serrano, at Virginia Tech, might find out, too.
"These families don't have colanders," Snyder said. "They don't have cutting boards, or sharp knives."
Spicy Greens and Beans
Makes 6 servings
1 large or 2 small bunches
greens - collard, |
mustard, turnip, kale, or
1 tablespoon vegetable oil
1 large onion, chopped
2 cloves garlic, finely
11/2 teaspoons paprika
1/2-1 teaspoon red pepper
flakes, amount depending
on spiciness desired
2 fresh tomatoes, chopped
(or one 141/2-ounce can
chopped tomatoes, not
1 cup chicken or vegetable
1 (15-ounce) can white beans
(cannellini), drained and
1 tablespoon vinegar
1. Strip the leaves of the greens from the stems. Discard the stems (if using Swiss chard, do not discard the stems; slice and cook them along with greens).
2. Wash the greens by placing in a large bowl of cold water; swish gently to remove any dirt. Lift the greens out of the water and drain in a colander or strainer. Wash again if the water is still dirty. Do not dry the leaves. Tear the leaves into large bite-size pieces and set aside.
3. Heat a large heavy saucepan or pot over medium heat; add the oil.
4. Add onion and cook, stirring often, until softened and lightly golden, about 5 minutes.
5. Add garlic, paprika, and red pepper flakes. Cook for one minute, stirring often.
6. Add tomatoes and their juice, and chicken or vegetable broth. Cover pan and bring to a boil.
7. Add the greens in batches, adding more as they wilt. After all the greens are wilted, cook, covered, until tender, about 5 to 6 more minutes, stirring occasionally.
8. Stir in the white beans and vinegar. Cook, covered, until beans are heated through, about 2 to 3 minutes.
Per serving: 322 calories, 20 grams protein, 62 grams carbohydrates, 4 grams sugar, 4 grams fat, no cholesterol, 207 milligrams sodium, 13 grams dietary fiber.
Beet and Apple Slaw
Makes 6 servings
Juice of 1 lemon (about 2
3 tablespoons cider or white
11/2 teaspoons sugar
1/4 teaspoon ground black
1 teaspoon finely chopped
fresh ginger, or 1/4 tea- spoon powdered ginger
1 bunch fresh beets
2 medium carrots, peeled
and coarsely grated
2 scallions (green onions),
trimmed, sliced very thin
1 medium apple
1. Place the lemon juice, vinegar, sugar, black pepper, and ginger in a large bowl. Mix with a fork or whisk to dissolve the sugar.
2. Trim the greens from the beet roots. Reserve the greens for another use.
3. Scrub the beet roots. Peel them and coarsely grate into the bowl with the dressing.
4. Add the carrots and scallions to the bowl.
5. Do not peel apple. Coarsely grate apple into the bowl.
6. Mix all ingredients well. Adjust seasonings to taste.
7. Chill in the refrigerator for an hour before serving, to allow the flavors to blend.
Per serving: 75 calories, 2 grams protein, 18 grams carbohydrates, 13 grams sugar, trace fat, no cholesterol, 88 milligrams sodium, 3 grams dietary fiber.