I spent the morning in the garden.  I put in a new blueberry bush, and spent several hours trimming, pruning, and weeding.  New lettuce is coming up, and one of these days we’ll have sweet and hot peppers, cucumbers, tomatoes and squash (zucchini, butternut, and spaghetti) in abundance.  I am looking forward to seeing how the watermelon, cabbage and cauliflower turn out.  After many years of a nice little garden, filled mostly with herbs and a few vegetables, I finally have the garden I’ve always dreamed of having.  Alongside the garden, under a beautiful slender magnolia tree tucked into a corner of the house, sits a little table with 2 chairs.  Late in the day the garden is flooded with light, but I can sit in the shade under the magnolia, and drink a glass of iced tea.  It hardly sounds like Cleveland, Ohio.  But it really is.

Lately I’ve been meeting lots of people who are being charged with working on reversing the childhood obesity epidemic.  It looks like we’re finally getting the message:  If present trends continue, we expect 30% of current 10-year-olds to become diabetic.  From so many standpoints, that is not okay.  The cost of suffering on that scale will be staggering.  

This week I was remembering the children who used to come along with their parents to their appointments at my former job.  I cared for many adult patients, and taught them to decrease their risk of becoming diabetic and/or obese.  My patients were very pleased to discover that their pants were fitting better and better, their complexions looking healthier and smoother, their double chins disappearing very quickly once they began to make smart (and relatively simple) changes in their diets.  But they also noticed that they themselves weren’t the only ones to benefit.  An additional, unexpected side benefit was that their children were losing weight and becoming healthier as well.  

I taught patients to increase the nutritional density of the meals they were eating and, when possible, to take more pleasure in preparing and eating their meals.  Patients slowly changed the way they shopped and cooked those meals.  Some of my patients cooked only for themselves.  But some of them weren’t preparing meals for just themselves.  They were feeding everyone in their family, including, of course, the children.  So when they changed their own purchasing and eating patterns, the children did, too.  And once the children began to eat differently, their bellies, too, began to disappear. 

Abdominal obesity, you may recall, is a marker for high insulin levels, which increases one’s risk of developing diabetes, high blood pressure, and coronary artery disease (heart attacks).  The bigger your belly, the greater your risk.  And vice versa.  The risk shrinks with your belly.

The children are the thing I’ve been thinking about this past week.  It came to me just this week that the unit of change for our society’s obesity problem is not the individual.  It is the family. 

The person who is responsible for purchasing and preparing meals is the one to be identified and supported.  This person, often the mom but not always, is the one who, ultimately, will effect the greatest change in a family’s way of eating.  

We can begin to move resources in this direction, providing education and support for the individual in each family who maintains primary responsibility for purchasing and preparing meals.  This is a way to establish a foothold in communities across the United States so that we can begin to reverse the diabetes and obesity epidemics.  Remember:  the time to think about healthy eating is not when you start dinner but, rather, when you make your grocery list or start shopping.  Shoppers, start your engines!
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