Killing obesity without coercion

In the high-profile (and highly vulgar) film "The Interview," CIA agents enlist two TV talk-show journalists to use an on-camera interview to assassinate Kim Jong-un, the dear leader of North Korea.

But once there, the journalists get some inside help from Kim Jong-un’s press secretary, who tells them the more effective route to changing things in the Communist nation would be to show the North Korean people that Kim Jong-un is not a god.

So actor James Franco gets the fictional Kim Jong-Un to cry on camera by singing him pop star Katy Perry’s anthem “Firework."

That subtler, less direct approach—call it singing instead of requiring—is also the strategy of a new effort to fight childhood obesity in central Indiana. Jump IN for Healthy Kids has been visiting day cares, school gyms, employer cafeterias and even church kitchens to find ways to get kids to eat healthier foods and exercise more.

“You can’t change a culture top down, except in North Korea,” said Ron Gifford, a local attorney who is CEO of Jump IN for Healthy Kids. The group launched last year with $1.5 million from Lilly Endowment, the Eli Lilly and Co. Foundation, the Fairbanks Foundation and the Riley Foundation

That’s why, Gifford said, Jump IN isn’t pushing—a la former New York Mayor Michael Bloomberg—a ban on oversized sodas. Nor is he calling for corporations to get rid of candy bars in their break rooms or for state government to place taxes on unhealthy foods.

“It can’t just be the one thing. You can’t just change one behavior. You’ve got to the change the whole environment,” Gifford said.

And clearly a lot of change is needed. Obesity in general has been soaring in the United States AND around the world since the 1970s.

Some of that change may be economic, as the cost of food as a percentage of Americans' income has dropped consistently over the past century to an unprecedented low.

Some of it may be scientific, as food additives added to pre-packaged foods in the mid-20th century have, according to a new study, been shown to increase obesity-related conditions.

And some of the change may be social, as video games and daytime kids television have supplanted physical activities kids used to engage in. As of 2009, kids aged 8 to 18 spent 7.5 hours per day looking at some sort of screen—TV, computers or mobile devices—up more than an hour per day from the previous decade.

And some of the change may be structural. Suburbanization has sometimes come at the expense of sidewalks, while efforts to improve schools have sometimes cut down on time spent in PE classes.

Whatever the causes, the statistics are staggering.

In central Indiana, 43 percent of kids—221,000 residents aged 0 to 19 years—are either overweight or obese, according to 2013 data from the Behavioral Risk Factor Surveillance Survey. In 10 years, that rate is on pace to hit 53 percent—resulting in 75,000 more overweight and obese kids than there are now.

Jump IN’s goal is to break that trend, and get the central Indiana obesity rate down to 38 percent by 2025. If it succeeds, that will mean nearly 84,000 fewer kids being overweight or obese than currently expected.

If it doesn’t, it means more than half of central Indiana residents will be starting their adult lives—and their first jobs—already suffering the health complications that come from being overweight.

Employers and health insurers, used to balancing out the expensive health claims of older workers with premiums from younger workers, will have health claims coming from both ends of the age spectrum.

Health care providers and drugmakers will have to figure out if things that have worked so far—bariatric surgery for obesity or insulin for diabetics—will remain effective during 40, 50 or even 60 years of obesity and diabetes.

The Jump IN initiative is forming committees to work on six fronts at once: nutrition, physical activity, communication and public awareness, employer wellness, public policy and data and analytics.

From 33 daycares in central Indiana, Jump IN is collecting kids’ heights and weights, so it can calculate their body mass indexes and track how those figures improve—or don’t—over time.

For the same reason, Jump IN is raising money so it can offer the FitnessGram physical fitness assessment free to schools around the state for one year and then at a discounted price after that.

Jump IN is also looking at how it can help schools add curriculum to their academic days that also squeeze in some of the recommended 60 to 120 minutes per day of physical activity. For example, some schools already use video programs that teach math or reading using physical activity. Jump IN is exploring ways to make those materials available to all central Indiana schools.

Among youth-serving groups, such as Big Brothers Big Sisters, Jump IN wants to encourage the adult mentors to have their meal-time chats over healthy foods. If that still ends up being at McDonald’s, it’s trying to encourage them to choose the healthier items on McDonald’s menu.

And Jump IN is even aiming at adults, hoping as they improve their eating and exercise habits, it might influence their kids. Or at least that they won’t hinder the healthy efforts their kids are learning at school. Jump IN wants to help employers make healthy foods an option in their break rooms, cafeterias and staff meetings.

And Gifford has been talking to pastor groups, hoping to start up healthy food tasting and cooking classes at church kitchens around the city. Eastern Star Church is piloting just such a program, with the cooking classes taught by staff from the Purdue Extension.

“Our vision,” Gifford said, “is to be a community whose culture of health inspires children and their families to lead healthy lives.”