Two Views • Families need help on their path to better health
by: CHRISTOPHER ONSTOTT Could the day be coming when children under 18 won't be able to buy their own fast foods and snack foods? At least one physician thinks certain "addictive" unhealthy foods may eventually go that route.

The Tribune's July 28 story 'Obesity wars hit Portland' highlighted the challenges health practitioners face in tackling childhood obesity. There is reason to be concerned.

Two decades ago, public health workers uncommonly saw children who were significantly overweight. Today, surveys show one in four children is overweight or obese. Kids who weigh too much face emotional and physical challenges and an increased risk of developing Type 2 diabetes, heart disease or stroke. They even have an increased risk of some cancers.

Yet obesity didn't just 'hit' our community. It took decades of complex and often subtle shifts in what children eat and how much they move. Families today consume more processed food. They eat more meals prepared outside the home and served in large portions.

Children spend more time sitting in front of televisions, computers and video game screens. The more time kids spend watching TV, the more advertising they're likely to see. Studies show that almost all food ads seen by children are for food that is high in fat, sugar or sodium. Anyone who has ever stood in a grocery checkout with a frustrated child understands a parent's lonely battle against the power of suggestion.

In Multnomah County, we believe the most effective approach to support families and reverse the trend is to provide healthier food choices and opportunities to get moving.

Our work begins before birth. Babies who breastfeed at least six months are far less likely to become obese. Oregon has among the highest rates of starting breastfeeding in the nation, but that drops to the national average after five weeks.

So, to increase the length of time a child is breastfed, we've enrolled hundreds of expectant mothers in peer-support groups. The women meet for months before and after their babies are born to learn the benefits of breastfeeding, share challenges and celebrate solutions.

In our public health clinics, our staff developed a toolkit to train health care providers to effectively counsel families around obesity, determine their readiness to change and help them do so. The parent of a toddler, for example, may learn to offer non-food rewards, while a high school student may work toward his or her goal of cutting down on soda.

Parents - and doting grandparents - learn that they don't have to eliminate treats and favorite foods, but provide them in moderation.

In the past year, we launched an unprecedented campaign to increase students' access to healthy food and physical activity at school. Using federal money, we're working with Portland, Parkrose, David Douglas, Centennial, Reynolds, Riverdale and Gresham-Barlow school districts to adopt new nutrition guidelines, boost activity during the school day and link with local farmers to provide fresh produce.

Wellness coordinators in each district are working to meet local needs, such as adding bike racks, safe walking and biking routes or more water fountains. County-supported after-school programs in the Schools Uniting Neighborhoods community schools adopted new nutrition guidelines and limits on screen time.

Families in neighborhoods with high rates of obesity-related disease told us their corner stores often lack choices such as fresh fruit or skim milk. So Multnomah County began offering mini-grants to help owners who voluntarily want to offer healthier choices. More information can be found at

Others told us their children cannot safely walk or bicycle. So public health workers are building an atlas to pinpoint where the lack of sidewalks, transit routes and parks discourage movement. We've joined with our community partners and Gresham and Portland planners to prioritize transportation projects over the next 20 years to boost options for all neighborhoods.

We believe that by supporting families, we can make Multnomah County the best place in the United States for a child to grow up.

Dr. Gary Oxman is the public health officer for Multnomah, Clackamas and Washington counties.

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