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<p align="center"><b><font face="Verdana" size="5" color="#0000FF">Eat
Well/Be Fit</font></b></p>
<p align="center" style="margin-top: 1; margin-bottom: 1"><b>
<font face="Verdana">Environmental Design Changes- Ways to Help Reduce
Childhood Obesity</font></b></p>
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<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Did you know that
physical inactivity has been documented to cause numerous physical and mental
health problems, is responsible for an estimated 200,000 deaths per year, and is
shown to contribute to the obesity epidemic? Among preschool children and
adolescents, obesity has doubled since the 1970s. The percentage of obese
children 6 to 11 years old has tripled. Turning these statistics around means
increasing children�s physical activity and improving what they eat. Much
research has focused on educating children and changing their behavior, but
these approaches have had limited success. Changing the environments in which
children eat and play is now seen as an essential strategy in fighting the
obesity epidemic.</span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2">
<span style="font-family: Univers-Light; color: black"> </span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black">Environmental
barriers to healthy eating and activity</span></b></font></p>
<p class="MsoBodyText" style="margin: 1px 5px">
<span style="font-family: Verdana"><font size="2">A panel of experts convened by
the Institute of Medicine recently identified five factors in the environment
that are barriers to healthy eating and physical activity for children:</font></span></p>
<p style="margin: 1px 5px"> </p>
<ol style="margin-top: 0in; margin-bottom: 0in" start="1" type="1">
<li class="MsoNormal" style="color: black; text-autospace: none">
<p style="margin: 1px 5px"><font face="Verdana" size="2">Pressures on
families to minimize food costs and preparation time, resulting in frequent
<span style="color: black">consumption of convenience foods high in calories
and fat;</span></font></li>
</ol>
<ol style="margin-top: 0in; margin-bottom: 0in" start="2" type="1">
<li class="MsoNormal" style="color: black; text-autospace: none">
<p style="margin: 1px 5px"><font face="Verdana" size="2">Reduced access to
and affordability of fruits, vegetables, and other nutritious foods;</font></li>
<li class="MsoNormal" style="color: black; text-autospace: none">
<p style="margin: 1px 5px"><font face="Verdana" size="2">Urban and suburban
designs that discourage walking and other physical activities;</font></li>
<li class="MsoNormal" style="color: black; text-autospace: none">
<p style="margin: 1px 5px"><font face="Verdana" size="2">Decreased
opportunities for physical activity at school, after school, and reduced
walking or biking to and from school;</font></li>
<li class="MsoNormal" style="color: black; text-autospace: none">
<p style="margin: 1px 5px"><font face="Verdana" size="2">Competition for
leisure time that was once spent playing outdoors with sedentary screen
time.</font></li>
</ol>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black"> </span></font></p>
<p class="MsoBodyText2" style="margin: 1px 5px"><b>
<span style="font-family: Verdana"><font size="2">Listed below are some ways to
change these five environmental factors to help solve the childhood obesity
epidemic</font></span><span style="font-family: Verdana; text-decoration: none"><font size="2">
�</font></span><font face="Verdana" size="2"><span style="text-decoration: none">
</span></font></b></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2">
<span style="font-family: Univers-Light; color: black"> </span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black"> </span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana"><b>
<span style="font-family:Univers-CondensedBold;color:black"><font size="2">
Changing the environment to increase children�s physical activity- </font>
</span></b><i><span style="font-family: Univers-Light; color: black">
<font size="2">Safe places to walk and play help children to be more active</font></span></i></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Many children and youth
lack opportunities to be physically active. Walking or bicycling to school is
increasingly uncommon and daily physical education has been cut from most
schools (only 6 percent of middle schools provide it). More than one-third of
high-school students nationwide are not getting recommended levels of moderate
or vigorous physical activity. </span></font></p>
<p class="MsoBodyText3" style="margin: 1px 5px"><font face="Verdana" size="2">
Children need safe and accessible places where they can be active. Special
attention may be needed for lower-income and minority communities, which tend to
have fewer parks, sports facilities, bike paths, pools, and other places to be
active.</font></p>
<p class="MsoBodyText3" style="margin: 1px 5px"> </p>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">There is strong
evidence that access to facilities, like parks, and activity programs is
associated with more activity for both children and adolescents.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Some studies of
preschool children have found that the more time spent outdoors, the higher
the activity level.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family: Univers-CondensedBold; color: black"> </span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black">Active living for
children: the trip to school</span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Children can get
regular, sustained physical activity walking, bicycling, or skateboarding
between home and school, but distance, traffic, and crime are all barriers.
Research shows environmental changes can help.</span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px"> </p>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">More children
walked to school where there were sidewalks.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">For example, A Safe
Routes to School program in Marin County, California, that included both
safety improvements and encouragement, increased the number of children
walking to school by 64 percent in two years.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Children whose
route to school passed a completed Safe Routes to School safety project at
10 elementary schools in California were more likely to increase walking to
school (15%) than children whose route did not pass the improvement (4%).</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black"> </span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black">Creating
activity-friendly environments at school</span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Once at school,
research shows the environment influences children�s activity levels. This
environment includes the presence of effective PE classes and opportunities to
be active during recess and the lunch break.</span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px"> </p>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">A Centers for
Disease Control review of 14 studies found that enhancing PE classes by
increasing </span>their length, or having students be more active throughout
the class, consistently improved students� <span style="color: black">
physical fitness.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Five- to
seven-year-old British students spent 18 additional minutes per day in
active play after the pavement on school grounds was marked for play.
Providing balls and other equipment to ten- and eleven-year olds increased
their active play during recess by 24 percent.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Middle school
students were more active throughout the school day if school activity areas
had more facilities and if equipment and supervision were provided.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2">
<span style="font-family: Univers-Light; color: black"> </span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2">
<span style="font-family: Univers-Light; color: black"> </span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black">Improving safety to
increase activity</span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">In at least one study,
adolescent girls were less active outdoors when they lived in high-crime
neighborhoods. Parental concerns about traffic and �stranger danger� are clearly
linked to children�s activity levels.</span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px"> </p>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">A Chicago study
found children were physically active for an extra 49 minutes a week in
safer neighborhoods than in unsafe neighborhoods.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Traffic safety is
critical: pedestrian injuries are a leading cause of injury death for
children five years and older. Several studies show that specific street
improvements can improve child</span> pedestrian safety.</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Speed bumps reduce
the chance of child injury. Children were about half as likely to be injured
by a car in their neighborhood if they lived within a block of a speed bump.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">It is more
important to reduce speed than to reduce traffic volume to improve child
safety.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black"> </span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><b>
<span style="font-family:Univers-CondensedBold;color:black">Changing the
environment to reduce screen time</span></b></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Kids spend more time
watching TV than in school. While the results are somewhat mixed, studies show
that TV and video time may encourage obesity both by displacing time that might
be spent being physically active and through exposure to advertisements that
encourage children to eat high-calorie, low nutrition foods. The American
Academy of Pediatrics and Healthy People 2010 recommend no more than 2 hours per
day of TV.</span></font></p>
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px"> </p>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Interventions aimed
at decreasing sedentary behavior can increase physical activity and reduce
body mass index.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">Eliminating screen
time for 10 days, and then restricting it to 7 hours a week was linked to
lower body mass indexes for 3<sup>rd</sup> and 4<sup>th</sup> graders who
also took classroom lessons and had a �TV budget� device to use at home.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/copy-of-blends/blebul1a.gif" width="15" height="15" hspace="13" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
<font face="Verdana" size="2"><span style="color: black">If children must
ride a stationary bicycle to activate the TV at home (1 min. pedaling = 2
min. viewing) TV viewing drops dramatically. At the end of one study the
children were watching 1.6 hours of TV weekly, compared to 21 hours for a
control group.</span></font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<p class="MsoNormal" style="text-autospace: none; margin: 1px 5px">
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<font face="Verdana" size="2"><span style="color: black">The research to define
healthier food and physical activity environments for children and adolescents
is starting to suggest some fruitful strategies. Studies have shown correlations
between environmental factors and physical activity levels or eating habits, and
several have demonstrated that changing the environment can change behavior. Few
studies show a direct link between environments, or environmental changes, and
reduced obesity. Nonetheless, the limited research to date does point to
environmental change as a promising strategy in fighting childhood obesity.</span></font></p>
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<font face="Verdana" size="2"><i><span style="color: black">This article
contains a compilation of excerpts prepared by Barbara McCann and Karen Glanz,
PhD, MPH, from Active Living Research. Active Living Research is a national
program of the Robert Wood Johnson Foundation, which encourages and supports
cross-disciplinary research about environmental factors and policies with the
potential to substantially increase physical activity among Americans of all
ages, incomes and ethnic backgrounds. You can check them out on the web at:
<a style="color: blue; text-decoration: underline; text-underline: single" href="http://www.activelivingresearch.org/">
www.activelivingresearch.org</a>. </span></i><b><i>This article was brought to
you by the Eat Well/Be Fit Committee. This town-wide committee is composed of
concerned professionals consisting of the Needham Board of Health, Needham
Public Schools, Beth Israel Deaconess Hospital Needham, Nutritionists,
Physicians, Needham Park and Recreation Department, TRIAD, Needham Physical
Therapy, the Massachusetts Department of Public Health and others.</i></b></font><span style="font-size:10.0pt;font-family:Verdana"> </span></p>
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