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Dartmouth Medical School Dartmouth-Hitchcock Medical Center

Vital Signs

Dartmouth supports effort to HEAL the region

By Jennifer Durgin

Benjamin Lin is enjoying a lunch of vegetable soup at a local day care, thanks to the DHMC-supported HEAL initiative.

How big was a typical cookie when you were growing up? That's a question that Kristen Coats, coordinator of the Upper Valley Healthy Eating Active Living (UV HEAL) partnership, likes to ask teachers and administrators when she's visiting their schools. With that simple question, she helps them tune in to portion sizes and the nutritional quality of the food available in their schools.

"People are used to the 'super-size me' mentality," says Coats, who has a master's degree in public health. Extra-large cookies, along with sugary drinks and processed foods, have become the "cultural norm," she adds.

Changing that cultural norm is one of the goals of UV HEAL, and three other HEAL partnerships throughout New Hampshire. UV HEAL, funded in part by Dartmouth-Hitchcock and several large foundations, is made up of more than 20 local organizations, including day-care centers, schools, health-care providers, businesses, and nonprofits.

Slow: Changing cultural norms can be "a slow process," Coats admits. That's why she celebrates the small steps that UV HEAL has helped its partners make in the past two years.

One partner, the Children's Center of the Upper Valley, a day care in Lebanon, N.H., has replaced Fruit Loops with healthier cereals, created gardens for growing vegetables that go into the kids' snacks and lunches, and secured a grant to purchase tricycles for its playground, among other changes.

Other partners, such as the Upper Valley Trails Alliance and the Lebanon Parks and Recreation Department, have worked with planning boards, city councils, and private landowners to create a four-mile greenway for biking and walking.

Fruits: In another UV HEAL project, students are competing in a game called Reach the Peak, in which they earn points for eating fruits and vegetables.

"Our students are very excited," says Joni Butler, who's been a physical education teacher at Enfield, N.H., Village School for 21 years. "They are jumping up to tell me . . . that they are eating their fruits and vegetables when I enter the lunch room." In mid-January, 105 of the school's 210 children were playing Reach the Peak. And some of their older siblings, at Enfield's Indian River School, post messages on UV HEAL's interactive website about their own efforts to stay active and improve their diets.

One day care has replaced Fruit Loops with healthier cereals.

Having that kind of influence in Enfield, a town in the Mascoma Valley, is particularly important because that area is "a food desert," explains Coats, meaning there is no local place to buy fresh fruits and vegetables.

Last year, Vital Communities—a regional nonprofit and a UV HEAL partner—surveyed Mascoma Valley residents about their access—or lack thereof—to fresh produce. "We see strong evidence that Mascoma residents are interested in attracting or developing a local 'bricks and mortar' store that is large enough to provide quality, moderately priced fruit and vegetable options," Vital Communities reported in December 2010. UV HEAL and its partners are now helping to figure out a way to meet that need.

While a single survey or a single greenway may not be enough to create a wholesale shift in the cultural norms of the region, Coats sees promise in the sum of such initiatives.

Sustain: "It is less about one particular program and more about how we are working together to create communities that sustain us," says Coats. Addressing overweight and obesity problems requires "a community-wide approach," she adds. "Everybody matters."


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