An Apple a Day to Combat Obesity

In New York, a unique private-public partnership is deploying specially-permitted street vendors selling only fresh fruits and vegetables to neighborhoods with significant health problems
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For years, we've been told that "an apple a day keeps the doctor away." While it may be a cliché, it's also quite true. Numerous studies have clearly demonstrated that regular consumption of fresh fruits and vegetables go a long way in combating obesity, hypertension, diabetes, heart disease, and even certain cancers.

Yet, amid what is nothing short of a national obesity epidemic, the Centers for Disease Control and Prevention in the first-ever state-by-state nutrition report card flunked all 50 states last week for failing to meet the national objectives of fruits and vegetables consumed by their residents. Collectively, only one-third of adults meet the fruit consumption target of two or more daily servings and just 27 percent eat the recommended three or more daily servings of vegetables.

Here in New York, where I live, only 27 percent of residents of the so-called "Big Apple" eat the recommended three helpings of vegetables a day and only one in six residents consume the recommended daily five servings of fruits and vegetables. In an earlier report, almost 15 percent said they ate no such food at all.

At the same time, the obesity rate in states across the country has escalated to alarmingly highs. New York's is 59 percent -- that's right, nearly 6 in 10 are grossly overweight. Moreover, the prevalence of diabetes among New Yorkers has doubled during the past decade to 12.5 percent, mirroring surging obesity rates citywide. Nationally, the obesity rate for adults and adolescents has, respectively, doubled and tripled. And obesity-related health care is now approaching $150 million annually, well more than double what it was 10 years ago.

The problems are especially acute among children. A recent study of elementary schoolchildren in New York revealed that just about one in four is obese and another 19 percent are overweight Hispanic schoolchildren, who make up 40 percent of the student body, have experienced the most rapid rise in obesity, with a figure that now is over 30 percent. The rate among African-American children is equally disturbing.

These figures are, pardon the pun, hard to swallow. But they unmistakably validate the need for a comprehensive multi-faceted program, one that harnesses resources at the local, state and national levels to eradicate this health crisis.

Central to any program's success must be increasing access. We know that people who live closer to markets that sell fresh fruits and vegetables at affordable prices eat more of them. Unfortunately, far too many of our country's low income neighborhoods are bereft of such markets. Prior to lending the support of my foundation to the New York City's Green Carts program -- a unique private-public partnership through which specially-permitted street vendors selling only fresh fruits and vegetables are being deployed to neighborhoods with the most significant health problems -- I witnessed these "food deserts" first hand. I was shocked and appalled to see that the overwhelmingly majority of retail food establishments in these areas sold little more than fried burgers and chicken and sugary donuts.

I firmly believe that we can bring about a remarkable transformation, that we can change the trends in unhealthy eating habits that have led to the rapid rise in obesity, diabetes, heart disease and other problems. The Bloomberg Administration in New York is doing a Herculean job through its comprehensive approach that not only includes the Green Carts, but also through other efforts to educate families on healthy eating habits and increase access to fresh fruits and vegetables in schools and retail establishments.

Our simple street vendor program can serve as a national paradigm for good health promotion. From the very outset, this initiative has enabled operators to buy fresh fruit and vegetables in bulk at wholesale prices. We have a micro-loan component to assist interested people with their street cart purchase. We offer mandatory food handling and education classes. We provided thousands of recyclable bags to the vendors for customer purchases. And we are currently piloting a project to enable consumers to use food stamps at the carts.

The good news is that New York City is not alone in developing and implementing programs to increase access to fresh fruits and vegetables. In Detroit, the "Peaches & Greens" van travels to neighborhoods in the same way as an ice cream truck. But instead of fudge bars and popsicles, the van, complete with catchy music blaring from its mounted loudspeakers, offers tomatoes, potatoes, corn and other fresh produce. In Kansas City, volunteer youth are harvesting and distributing vegetables from an inner-city garden through the "Food from the Hood" effort. And in Philadelphia, through a partnership with the University of Pennsylvania, local elementary, middle and high school children design, plant, and harvest fresh fruits and vegetables in a huge community garden, and then sell them throughout the neighborhood out of a small truck.

But the CDC report card clearly shows there is much bad news and, as a result, more that must be done in New York and across the country. Only eight states have legislation that encourages or offers incentives to full-service grocery stores to open in under-served areas, and to small food markets to stock healthier foods. Barely over one in five middle schools and high schools offer fruits and non-fried vegetables in vending machines, school stores or snack bars. And just 21 states have policies to support farm-to-school programs that not only can increase access to fresh produce but can also teach students about nutrition and agriculture.

Access to nutritious foods can't be so severely limited. Fresh fruits and vegetables are not luxury goods. If we want to eradicate obesity and related health problems in America, let's start by making sure all individuals can get that "apple a day" to eat.

Laurie M. Tisch is president of the Laurie M. Tisch Illumination Fund, which works to increase access and opportunity for all New Yorkers by firing imagination, sparking opportunity and strengthening community.

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