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Ending Childhood Obesity (ECO) Project 2011– 2012 Annual Report

“Lack of family and community involvement has been one of the largest barriers to success of most programs that are addressing childhood obesity. Only 50% of programs directly involved the family and less than 10% specifically engaged families.” —McCarron et al. Pediatrics 2010

CONTENTS

The mission of the ECO Project is to reduce chronic disease and morbidity associated with childhood obesity by empowering children, families, and communities through education to make and have access to healthy choices.

Introduction

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Childhood Obesity Statistics

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Food is Medicine to Naturopathic Physicians

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The ECO Project

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Impact of ECO Project by the Numbers and Locations

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Benefits of ECO Project as Ranked by Participants

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Gratitude

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Cover: ECO Project team member, Nathalie Paravicini, with workshop participants at Roosevelt High School. Dr. Courtney Jackson, ECO Project lead physician, conducts a workshop at Roosevelt High School with team members Nathalie Paravicini, Rachelle Johnson, Adam Hutchison; Dr. Lori Blankinship (NCNM board member); and Lori Sobelson (Bob’s Red Mill).

INTRODUCTION The ECO Project is a collaborative effort between Bob’s Red Mill, the internationally known whole-grain company based in Oregon, and NCNM (National College of Natural Medicine), the nation’s oldest and most respected naturopathic medical school in the country, based in Portland, Ore. The partnership between Bob’s Red Mill and NCNM grew from our shared concern regarding the increased prevalence of childhood obesity and, more importantly, the associated rise of diseases affecting children like diabetes, hypertension, and liver disease. There are many contributing factors influencing children’s health. One of these factors is, of course, food choice. Poor food choices due to problems of access and education have played a role in this epidemic of poor health. The standard American diet is calorie rich, nutrient poor, highly processed and contains few whole foods. Whole foods are foods that have not been highly processed or changed, such as fruits, vegetables, legumes, grass-fed beef, wild salmon, eggs, and whole grains like oats, rice, wheat and corn.

The opposite of whole foods are highly processed foods like fast food, packaged baked goods, sodas, many canned and boxed foods, and fried foods. Choosing whole foods, a mostly plant-based diet can be part of the solution to improve the health of our children and our communities. However, food alone is not enough. Families and communities must make improving nutrition and physical activity in childhood a priority. The ECO Project embraces the understanding that it takes a familybased, community-based effort to sustain healthy behavioral changes. The ECO Project works with families and community members who have recognized the need to be part of the solution: to improve their relationship with food and their nutrition understanding. Through the ECO Project, Bob’s Red Mill and NCNM are promoting the powerful and uniting force that natural foods and community engagement work together to end childhood obesity. Together, WE ARE COMMUNITY. Ending Childhood Obesity (ECO) Project Annual Report

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CHILDHOOD OBESITY STATISTICS While chronic diseases related to obesity like diabetes and heart disease impact all socio-economic and ethnic groups in America, it is well known that certain groups of children are more impacted. To review, look at the sobering facts from the Center for Disease Control: •

Approximately 17% (or 12.5 million) of children and adolescents aged 2–19 years are obese.

Since 1980, obesity prevalence among children and adolescents has nearly tripled.

There are significant racial and ethnic disparities in obesity prevalence among U.S. children and adolescents. In 2007–2008, Hispanic boys, aged 2–19 years, were significantly more likely to be obese than nonHispanic white boys; and non-Hispanic black girls

were significantly more likely to be obese than non-Hispanic white girls. •

One in seven low-income, preschool-aged children is obese.

County obesity rates are variable within states. Even states with the lowest prevalence of obesity have counties where many low-income children are obese and at risk for chronic disease.

Armed with the understanding that certain groups of children are suffering more, the ECO Project reached out to the Portland communities of color, to Spanish speaking groups, to schools and churches, and groups of adolescents who are low income and risk a lifetime of poverty.

ECO Project physician, Dr. Julie Briley (third from right), leads a class at Mt. Olivet Church.

FOOD IS MEDICINE TO NATUROPATHIC PHYSICIANS In Oregon, naturopathic physicians are licensed as primary care doctors. Lack of nutrition training in allopathic medical education is well recognized as one of the barriers to success in addressing the childhood obesity epidemic. Naturopathic doctors (NDs) receive hundreds of hours of nutrition training to understand comprehensively how to use food as medicine and plants as medicine (botanical medicine), in addition to standard medical classes in anatomy, pathology, physiology, microbiology, chemistry, public health, clinical physical diagnosis and pharmacology. They know the role of inflammation in chronic disease and how food contributes to this pathology. They understand environmental medicine and the role of large-scale farming systems on natural resources and pollution, and how pollution contributes to disease. In addition, naturopathic physicians are trained in a philosophy that counsels doctors on the connections between food as medicine for the mind, body and spirit.

ECO Project team leader, Cory Szybala, assists with a workshop at Mt. Olivet Church.

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Ending Childhood Obesity (ECO) Project Annual Report

Throughout their four years of medical school at NCNM, naturopathic physicians receive training in the pros and cons of various diets: the anti-inflammatory diet, low glycemic diet, diabetes-specific diet, Mediterranean diet, and a vegetarian diet, just to name a few. Naturopathic

medical students immerse themselves by participating in the various diets and by observing naturopathic doctors in clinic, all of which deepens their knowledge about food and the role of food in health and disease. This depth of understanding is not something one can pick up in a weekend course or via an online tutorial. It requires time, discussion, debate and long-term clinical application and observation. To believe that food is medicine, food must be a central piece of health care and a central piece of all treatment plans. Naturopathic physicians, as experts, stand on a foundation that food can not only heal the body, but the mind and spirit too. If food is part of the problem of obesity and other health concerns, then naturopathic physicians will increasingly be called upon to be part of the solution. The ECO curriculum was developed based on naturopathic medicine’s philosophy that food is medicine and that food must be taken seriously as nourishment for the body. A variety of whole foods prepared with care fills the senses, satisfies the soul, creates closeness among diners, and brings nourishment (and health) to the body.

Ending Childhood Obesity (ECO) Project Annual Report

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THE ECO PROJECT During this second year of operation, the ECO Project continued to offer a series of 12 weekly workshops—90 minutes each—for children, families, and adults in the North Portland and Gresham areas. Many workshop participants came from higher risk groups impacted by childhood obesity and other chronic diseases like diabetes and heart disease. The ECO Project workshops provided health education and hands-on, whole foods cooking instruction. Thanks to a generous donation to NCNM from Bob and Charlee Moore, families attended the ECO Project at no or low cost, removing any financial barrier to those who could otherwise not afford it. The ECO Project workshops continued to be located at churches, schools or community centers; gathering places with a kitchen on site. Drs. Courtney Jackson and Julie Briley, along with a team of naturopathic and classical Chinese medical students, coordinated the workshops in English or Spanish, depending on the community’s needs, and provided nutritional expertise. Each workshop started with a review of the previous class, allowing for Q&A, and then addressed that day’s nutrition

ECO PROJECT CURRICULUM AND MEAL PLANS

topic and recipes. Naturopathic medical students were encouraged to take a topic and develop a presentation with input from the attending physician. Eating alone is linked to an increased likelihood of being overweight and having various health problems. Thus, every class participant, adults and children alike, were invited to prepare and enjoy a healthy and delicious meal at each of the workshops. The ECO Project provided a unique and inspiring resource that bridged the gap that most Americans have in terms of having a healthy relationship with food. People won’t eat food if they don’t know how to prepare it, if it doesn’t taste good, and if there are problems accessing it. Too many people are eating alone or in a rush these days. Together, the ECO Project participants made and shared family style meals filled with fresh fruits, vegetables, whole grains, legumes, dairy and fish. Whole foods were provided for these workshops. Bob’s Red Mill provided a bag of whole grains for participants to take home at the end of every workshop so they could continue to explore different recipes.

• Introduction to Nutrients

[Recipe: beans, greens and rice] • Label Reading [Recipes: vegetarian chili and gluten-free cornbread] • Benefits of Breakfast [Recipe: oatmeal-on-the-go] • Movements for Life [Recipes: raw cookies, protein bars, hardboiled eggs] • How to Create Your Plate [Recipes: delicate squash and broccoli over quinoa] • Finding Pleasure with Food [Recipes: fennel apple potato soup and wholegrain toast] • Cooking for Heart Health and Diabetes [Recipes: millet and chick peas with sautéed chard] • Grains and Greens of Traditional Diets [Recipes: lentils and brown rice, or quinoa black bean salad] • Healthy Substitutions on the Go [Recipe: rainbow nachos] • Exploring Sugar and Sweeteners [Recipes: sweet treat golden delicious granola with breakfast vegetables] • Portland Food Shopping Guide [Recipes: black-eyed peas and collard greens with sweet potato cornbread] • School Lunch and Snacks [Recipes: whole-grain banana butter and jam sandwiches, cucumber turkey roll-ups, hummus and nuts, veggie and fruit kabobs]

IMPACT OF ECO PROJECT BY THE NUMBERS AND LOCATIONS A total of 173 participants attended the ECO Project series of classes this year; 66% more than in the previous year. Over two years, 2010-2011 and 2011-2012, the ECO Project reached out and trained a total of 262 people in the Portland community. They ranged from babies (10 months), to children (3–10 years), teens, pregnant women, new mothers, parents (average age of mid 30’s) and grandparents (average age in the mid-60’s). Below is a chart showing the five locations, 13 groups, and number of participants who attended the 12-week ECO Project series. These 90-minute classes were led by a physician and five medical students. Location

Number of Groups

Number of Participants /%

Mt. Olivet Church

5

74 (43%)

Roosevelt High School

3

37 (21%)

Gresham High School

2

28 (16%)

Delta Community Center

2

26 (15%)

Open Meadow School

1 8 (5%)

ECO Project participants at Mt. Olivet Church. 6

Ending Childhood Obesity (ECO) Project Annual Report

Ending Childhood Obesity (ECO) Project Annual Report

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ECO Project team leader, Susanna Farahat (second from right), with Ray VanWetten, VP of Unified Grocers (third from right), and other workshop participants at Mt. Olivet Church.

MT. OLIVET CHURCH

Mt. Olivet Church has been one of the longest-standing partners with the ECO Project and is the site for one of NCNM’s 24 community clinics. Located in North Portland and tending to a primarily African-American congregation, the health ministry at the church continues to provide inspiration and motivation to church members to attend these workshops. Pastor Ed Williams supported the ECO Project as part of his ministerial approach to dealing with the health and well-being of his congregation. Mt. Olivet church has a well-equipped industrial kitchen and eating area for the workshops. “My 17-year-old son and I are taking the class. I am making a more focused effort to redo our diet at home. We have definitely increased our intake of vegetables and whole grains. Experimenting with whole grains has been fun. The actual cooking part of the class makes the “trying” new things so do-able. We repeat whatever we cook in class at home each week and have had mostly great responses from the rest of the family.” —Mt. Olivet Church ECO Participant

ROOSEVELT HIGH SCHOOL

GRESHAM HIGH SCHOOL

The ECO Project partnered with the SUN (Schools Uniting Neighborhoods) Program to offer the workshops at Roosevelt High School, located in the St. John’s neighborhood of North Portland. There is a large Latino population here, including 19% of the high school students, and thus the workshops were offered in Spanish. There is a strong Latina Mom’s group at RHS, and many of the first participants were families from that group. The workshops take place in a home economics classroom with three kitchen stations.

The ECO Project partnered with the SUN Program at Gresham High School as well. SUN believes in promoting programs that lead to educational success and family self-sufficiency through an integrated network of social and support services for youth, families and community members. The partnership with SUN allowed the ECO Project to operate in the home economics classroom where workshops were offered to Spanishspeaking families. Gresham High School has a 20% Latino student population.

“Las recetas están bien, el horario es excelente. La ubicación tambien está muy bien. Podría ser en la escuela Cesar Chaves tambien hay muchas mamas interesadas por este programa es muy bueno y excelente. Gracias a todos por enseñar lo bueno y nutritivo.” Translation: “The recipes are good, and the program is excellent. The location is also very good. You could consider Cesar Chavez as a location since the mothers there are very interested in this great program. Thanks for teaching us what is good and nutritious.” —Roosevelt High School ECO Participant

“Gracias por la grán información a mifamilia y yo. Comemos mejor y tenemos más información sobre los enfermededes que puede causar si no come bien.” Translation: “Thank you for the information for me and my family. We eat better and we have information about how not eating well can cause certain diseases.” —Gresham High School ECO Participant DELTA COMMUNITY CENTER

The June Key Delta Community Center was opened in August 2011 as a completed “Living Building Challenge” in Portland, Ore. A group of African-American women, who are alumnae members of the Delta Sigma Theta Sorority, used grant money and donations to turn an abandoned gas station into a community center. Their mission is to provide a center that serves the surrounding multi-cultural neighborhood and encourages healthy social, educational, artistic, economic and environmental awareness. The ECO Project partnered with the Delta Community Center due to a connection with a passionate and motivated ECO Project graduate from Mt. Olivet who is also a member of the Delta Sigma Theta Chapter. This location is a great example of the grass-roots growth of the ECO Project. The workshops at the Delta Community Center took place in the winter and spring of 2012. “The class had done so much for me, where do I begin? Number one, I lost weight. Number two, I learned how to read labels and I can understand what that means. Number three, I learned the importance of breakfast. Now I am passionate about ECO, Ending Childhood Obesity.” —Delta Community Center ECO Participant

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Ending Childhood Obesity (ECO) Project Annual Report

NCNM President, Dr. David J. Schleich (third from right), at an ECO Project workshop at Roosevelt High School.

OPEN MEADOW SCHOOL

The ECO Project partnered with an organization called Betties360, a nonprofit whose mission is to inspire confidence, well-being, and a sense of community in underrepresented girls through action sports and outdoor adventure. Betties360 partnered with Open Meadow School of North Portland; a private, nonprofit, accredited, educational organization serving youth who have not fared well in public school. Since 1971, Open Meadow has offered a personalized educational experience for middle and high school youth. Their mission is to educate youth in small, relationship-based programs that emphasize personal responsibility, academics, and service to the community. “Dr. Jackson and I conducted our second workshop with a group of eight teenage girls. They did really well in the kitchen, staying engaged from start to finish. We were able to let them do every step in the cooking process to experience the kinesthetic learning of cooking. Their teacher had them look at food labels in their homes as an assignment and two girls brought in Hostess doughnuts. They were able to look on the label and find trans fats and high fructose corn syrup. “We talked about the role of breakfast, blood sugar regulation, and the role of fats, carbs, and proteins in a healthy breakfast. One of the girls made a meaningful connection when she stated that there is a recommendation to eat something with fat and protein prior to getting a tattoo or piercing because the recipient is less likely to faint. We were able to transfer this example to the importance of breakfast to regulate mood, energy and performance. Thanks again for bringing wisdom, nourishment, and an open heart to our young women. I KNOW they’re eating it up!” —Associate Director, Open Meadow School Ending Childhood Obesity (ECO) Project Annual Report

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Dear ECO Team, Thank you all for your dedication and hard work in making this project a success. We love reading the highlights from each class as they are each so unique. It was great to hear of how well versed in nutrition the young women from Open Meadow are. These young mothers have such an important role in teaching their children about eating well, and what better way than to hear it from the ECO Project.

BENEFITS OF ECO PROJECT AS RANKED BY PARTICIPANTS At the end of the twelve-week series we asked our ECO participants to tell us what changed for them, what were the major benefits they experienced by attending the three months of classes. By far, most felt their biggest benefits were: understanding the nutrition of foods, being more creative with meals, and having bodies with more energy because they had become better nourished. Below is a chart that shows how participants ranked their experience of ECO benefits in their lives:

GRATITUDE We wish to thank Bob and Charlee Moore and Bob’s Red Mill for their vision in making the ECO Project possible. Thank you for empowering NCNM with the ability to reach so many families with crucial disease prevention information. Our shared belief that food is medicine is the backbone of the ECO Project and the business proposition of Bob’s Red Mill. Thank you for allowing us to share our expertise with 262 people whose lives will be changed for the better because of the ECO Project.

And how awesome to hear that Pastor Ed Williams wants the ECO Project to be a permanent program in his church. It’s so exciting to have this type of commitment that is, and will continue, making such a positive impact in so many lives. Isn’t this exactly what ECO is all about? Reaching out to our community and educating family by family about proper nutrition. Great job, ECO Team! Lori Sobelson Director of Community Outreach Bob’s Red Mill

BENEFITS EXPERIENCED BY ECO PARTICIPANTS Nutrition understanding

81%

Creativity with meals

75%

Energy

64%

Sense of well-being

58%

Blood sugar balance

56%

Mood

52%

Confidence in the kitchen

48%

Digestion

48%

Blood pressure control

44%

Movement

44%

Stress management

36%

Skin health (hydration)

25%

In addition, when asked to list their top four favorite workshops they were: Label Reading, Benefits of Breakfast, Cooking for Heart Health and Diabetes, and Traditional Diets. 10

Ending Childhood Obesity (ECO) Project Annual Report

Team leader, Adam Hutchison, gets cooking with a young ECO Project workshop participant.

“I truly feel the ECO program is making headway in the community. It seems so worthwhile in making our part of the world a little better place. Keep up the great work!” Bob Moore May 1, 2012 Ending Childhood Obesity (ECO) Project Annual Report

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049 SW Porter Street Portland, OR 97201 503.552.1555 www.ncnm.edu


ECO Annual Report