Denver health workers go house to house to fight Latino obesity
November 14, 2012
By Michael Booth
The Denver Post
Smacking the Gatorade bottle with all the sugar cubes down on the kitchen table does the trick every time.
Ana Muñoz shakes the plastic bottle holding cubes amounting to 14 cucharaditas - teaspoonfuls - of sugar, and Myrna Morales says what nearly every mom says at this point in the obesity lesson: "Wow," needing no translation.
"We thought Gatorade was a good substitute for soda!" says the Spanish-speaking Morales through a translator. Just a few visual aids in Muñoz's presentation "raise a red flag" about how serious the sugar problem is, Morales says.
And so Muñoz can pack up her pictures, charts and contracts knowing she has gotten the message across to one more family.
Muñoz is one of dozens of "promotoras" trained by Padres y Jovenes Unidos to spread anti-obesity education door to door in Denver's Latino neighborhoods.
The fight against a weight surplus and an exercise deficit in America goes on among all races, and increasingly among all income classes. But the community organizers at Padres y Jovenes Unidos draw on previous pushes for education and immigration rights to bring a personal message directly into Latino homes: Escape the trend. Get fit.
One in seven low-income, preschool-age children is obese in America, and one-third are either obese or overweight. While 36 percent of all U.S. adults were obese in 2010, the Centers for Disease Control and Prevention warns that Latino boys and African-American girls are particularly vulnerable to joining those ranks.
As a trained health promotora, Muñoz draws on her own family experience when talking to Latino neighbors. Months ago, her doctor warned that her 4-year-old, Neftali, was gaining too much weight. She put a fresh fruit bowl in the middle of the kitchen table on West Dakota Avenue and cut Neftali's daily yogurt snacks from two to one. Turns out Yoplait is another big sugar offender.
Parent promotoras such as Muñoz receive a stipend for about 20 hours of work a month.
Morales came to the Muñoz home for the sugar presentation because her own family is in the middle of a move. She said, through Padres y Jovenes Unidos interpreter Monica Acosta, that she thought her family was doing well in its dietary habits.
That's when Muñoz pulled out the sugar cubes, and the photos of 50-pound sugar sacks.
The promotoras tell families the average American eats more than 100 pounds of added sugar a year.
"The one that always surprises parents is Gatorade, and Sunny Delight," Acosta said. Latino families sometimes shorten the phrase for diabetes to "tengo azucar," or "I have sugar," Acosta said, so they are receptive to facts about sugar and obesity.
Health and nutrition researchers said the Denver group's approach is sending the right messages in the most effective way, with the only limitation being the labor intensity required by the visits.
"Everyone is very sensitive about not trying a one-size-fits-all strategy for all of America," said Marlene Schwartz, deputy director of the Rudd Center for Food Policy & Obesity at Yale University. "So the idea of a community working within itself, it's so personal, it sounds like a great idea."
When Muñoz finished, Morales signed a "contract" promising that she and her three kids would eat less processed food and exercise more. Morales was less certain about convincing her husband to give up soda, as well as how to get outdoors enough in winter.
Muñoz, who also gives talks to families about fatty foods and fitness, tells Morales she'll check in once a month to see how the family progresses.
"I'll bring a tape measure," she adds, with a sly smile.
Key advice to families:
Padres y Jovenes Unidos "promotoras" advocate a simple "5-2-1-0" reminder:
- 5 or more servings of fruits and vegetables each day
- 2 hours or less of screen time with TV, computers, etc.
- 1 hour or more of physical activity
- 0 sugary drinks