Community-based Programs to Prevent Obesity
Since receiving her DSc in nutrition from Harvard University's School of Public Health in 1979, Kennedy has managed to balance academic teaching and research with a deep involvement with public and private nutrition policy institutes. She taught and conducted research at Tufts, Columbia, Cornell and Johns Hopkins universities. She gained policy experience at the US Department of Agriculture (USDA), working in the Nutrition Policy Branch of the Food and Nutrition Service, the Center for Nutrition Policy and Promotion, and as deputy undersecretary and then acting undersecretary of the USDA. She has also maintained an involvement with think tanks, including the International Food Policy Research Institute, the Global Nutrition Institute, and the International Life Sciences Institute.
Kennedy has an optimistic but pragmatic philosophy for altering the world's health and nutrition climate. She believes in discovering and implementing the small changes that work, and that the cumulative effect of these small changes will lead to success. To discover small changes that would work in the diverse communities of the world, she believes in listening to people and working within the existing community and government infrastructure. “There's a disconnect between what the public health community sees as advantageous and what consumers want,” Kennedy says. “From a public health point of view, a healthful diet is based on whole grains, fruits, and vegetables, with some dairy and some meat. Consumers want more variety and more convenience at a good price. As soon as households have a little bit more income, they add more fats, more sugars, more meats.” The challenge is to provide easy access to exercise and a choice of tasty, convenient and inexpensive foods that are also healthful. The goal is to create an environment in which people find it easy to move and easy to choose good foods.
“The difficulty is that so much in past health and nutrition research on overweight and obesity has been in a clinical setting, doctors advising patients,” Kennedy explains. “But this problem of overweight and obesity is so complex that we have to get out of the clinical setting. Yet we don't have enough models of what has worked in communities. One piece of community research going on here at Tufts, Shape Up Somerville, is exactly that. Shape Up Somerville models what we're trying to do globally. So it's exciting.”
Shape Up Somerville is a community approach to obesity prevention that targets 1st through 3rd graders in Somerville, Massachusetts. The program has enabled schools, teachers, parents, and local businesses to join together to change the children's environment in small ways that promote healthy eating and physical activity. From healthy school lunches, to walk-to-school coordinators, to new menu choices at local restaurants, small changes are being made and embraced in Somerville.
Recently the USDA invited Kennedy down to Washington, DC, to discuss Tufts’ research on overweight and obesity. The federal nutrition researchers and policymakers were so impressed that they expressed interest in sending a team here to see first hand how Tufts has implemented projects such as Shape Up Somerville and to discuss possible interactions. “They were very interested in the role of the federal government vis-à-vis statutes and regulations, and then what needs to happen at the community level,” Kennedy says. “There really is a lot of enthusiasm at the moment for collaborations between government and academia, because government realizes there are certain activities that they can move forward on, such as creating an enabling policy environment. But there really needs to be collaboration for the broader agenda to deal with overweight and obesity to go forward.”
Kennedy is very excited about a multi-school proposal to study links between diet quality, exercise, obesity, and cancer outcomes which has just been submitted to the National Cancer Institute. The five-year project, called TREC for transdisciplinary research on energetics and cancer, will focus on children, prevention, and community-based interventions. “Working together to develop the proposal has already been a success in that colleagues have said they've learned so much about what other people are doing,” Kennedy says.
Kennedy would welcome the involvement of researchers from other disciplines in developing better methods for assessing dietary intakes and energy expenditures. People expend different amounts of energy while doing the same activities because of differences in body composition and metabolism. So saying that someone burns 100 calories doing a particular exercise is inaccurate. Because the assessment methods currently available for use in a free-living population (people not confined to a clinical research environment) are flawed, the data are imprecise. “We really have to look at better ways of measuring not only overall caloric intake but also individual components of the diet,” Kennedy says. “Possibly people from Engineering or Computer Science could invent a device that could help an average person estimate amounts of food.” Kennedy says that most people have a hard time keeping track of their caloric intake because food labels give nutrition facts for a serving of the food, but it’s difficult to know what constitutes a serving. For example, a pound box of spaghetti says a serving is 2 ounces or 1/8 of the package, but estimating that amount when you put it on your plate is difficult. Huge, restaurant-size portions have led many people to think that a normal portion of meat should fill a dinner plate, when in fact nutritionists describe a portion of meat as being about the size of a deck of cards.
Nutrition is such an all-encompassing field that collaborations across disciplines are numerous. Dean Kennedy invites psychologists, economists, engineers, and anyone else interested in working with Friedman School faculty or joining the Tufts research team on overweight and obesity to contact her at firstname.lastname@example.org.
For more information, go to http://nutrition.tufts.edu/about/dean.html