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Bronx Clinics Battle Obesity With Bite-Sized Tips in Texts and Ads

By Patrick Wall | August 2, 2013 11:22am
 Maegan Ratliff, Community Healthcare Network's director of nutrition, teaches patients that small diet and lifestyle changes can have a big impact.
Maegan Ratliff, Community Healthcare Network's director of nutrition, teaches patients that small diet and lifestyle changes can have a big impact.
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DNAinfo/Patrick Wall

TREMONT — A healthcare network with clinics in The Bronx is hoping to convince its patients that, for all the unhealthy options on their borough's medical menu, it's still possible to whip up a healthy lifestyle.

Kema One could be Exhibit A.

From a family of big eaters, One watched her mother develop high blood pressure and her father battle ever-worsening diabetes, which led to chronic kidney disease and, finally, impelled One to donate one of her kidney’s to her father.

Galvanized, One overhauled her own lifestyle — she took a nutrition class, renounced the fast food that surrounds her apartment and became a regular at her local gym and farmers market.

Ask One how to get other Bronxites to follow her lead, and she won’t sugarcoat the struggle.

 An advertisement that is part of Community Healthcare Network's nutrition campaign.
An advertisement that is part of Community Healthcare Network's nutrition campaign.
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Community Healthcare Network

“That’s hard," One, 36, said recently, sitting in the nutritionist’s office in the network's Tremont clinic, near where she lives. "You’ve got to change their whole life.”

But, she added, it can be done: "Train them to start little by little.”

That, in fact, is what the Community Healthcare Network is aiming to do with a new nutrition campaign of advertisements, recipes and text-message tips that promote better living one baby step and bite at a time.

The nonprofit operates clinics in low-income neighborhoods across the city, but the Bronx sites confront the grimmest conditions — The Bronx has higher rates of obesity (30.5 percent) and diabetes (13.1 percent) than the city as a whole or any other borough, according to the Health Department's latest surveys.

Experts eye many causes for these health woes, most stemming from poverty, some tied to culture, and a large portion linked to what one activist calls the borough’s “food swamp” — tons of cheap, fried, fatty and sugary food for sale, but far less fresh, affordable, wholesome fare on offer.

“It really is the food choices,” said Maegan Ratliff, CHN’s director of nutrition.

One traces many of her family’s medical misfortunes back to the dinner table.

Both parents and all nine children piled on the greasy meat and carbs — oxtails with peas and rice and fried plantains was a favorite — mound by mound, about three or four proper portions of each per person, and weren’t allowed to leave the table until all was eaten.

Then there is the environment — from her apartment window, One has clear views of a McDonald’s, Burger King, Popeye’s and several Chinese take-out restaurants.

After the kidney transplant four years ago, One found ways to avoid these tasty traps.

Instead of buying fast food, she cooked, substituting spices for salt, fish for red meat and the farmers market for the bodega. The gym saw her smiling face five days a week.

Unlike some people who fail to grasp the gravity of a poor diet and limited exercise until it’s too late, One had watched those choices consume her father, and decided not to follow his path.

“When it’s so close to you, it wakes you up,” she said. “Like, ‘That could be me.’”

If personal health is a well-balanced meal, then CHN’s nutrition campaign suggests achieving it one side dish at a time.

Ads posted in community newspapers explain how slightly smaller portions and steamed vegetables instead of fries can melt 430 calories from a meal.

The cookbook offers healthier versions of local favorites — “oven-fried” chicken, for example, or mashed plantains.

And the daily text messages try to nudge, not prod — try doing jumping jacks during TV commercials, one suggests, or ordering veggies on your pizza slice with salad on the side.

With her patients, Ratliff acknowledges the difficulty of eating well on a busy schedule and a tight budget, but doesn't accept excuses — she recently led a grocery outing where she showed families how to buy a weeks worth of healthy meals with $130 in food stamps.

The message, Ratliff said, is that “quick and easy” doesn’t have to mean “fatty and greasy and salty and sugary.”

One visited the clinic this week because she is 10-weeks pregnant and her cravings have threatened to derail her healthy habits — she’s fallen off the good-food wagon, gaining 10 pounds in as many weeks.

But this time she knows that, for her and her baby, she will climb back up again.

“I’m not trying,” she said on her way out of Ratliff’s office. “I’m going to make the change.”