Nov. 26--WALTERBORO -- When children arrive at Bells Elementary School, they go straight to the gym and walk laps before heading to classrooms.
Worshipers at Power of Faith Delivery Ministry harvest collards as well as souls, and fried chicken is discouraged at church dinners.
The local farmers market has a sparkling new home and a system set up to accept cards from the Supplemental Nutrition Assistance Program.
Colleton County is a testing ground for methods to combat obesity, a rising scourge in the state and country. Nearly two-thirds of the state's population is either overweight or obese, which contributes to the state's high rates of diabetes, heart disease and stroke and adds an estimated $1.2 billion to the state's annual medical bill, according to the S.C. Department of Health and Environmental Control.
The BlueCross BlueShield of South Carolina Foundation in 2010 awarded a $478,000 grant to Eat Smart Move More Colleton County for a pilot program to promote healthy eating habits and physical exercise. Colleton is considered a good indicator of rural South Carolina. It's populace of nearly 40,000 is 39.1 percent black and 21.3 percent live in households with earnings below federal poverty levels.
The anti-obesity effort began slightly more than two years ago with community meetings aimed at gathering ideas and getting buy-in from local leaders.
The results have been striking.
You hardly can go anywhere in Walterboro, the county seat, without seeing some evidence of what became known as the Let's Go, Eat Smart program. Exercise programs have begun and healthy eating reminders are posted in schools, workplaces, grocery stores and churches.
"The idea is to constantly reinforce the message," said Melissa Buckner, director of Eat Smart Move More Colleton County. "You're hearing it at church. You're hearing it at work and your kids are coming home from school and talking about it."
Convincing people in Colleton to join the program has been easy. They're sick of being sick. According to 2010 state statistics, 35.5 percent of the county's adults are obese, 37.1 percent report no leisure time physical activity and 86.2 percent don't eat the recommended five servings of fruit or vegetables daily.
It might be years before those numbers start to move downward. Changing directions on obesity is like turning an aircraft carrier, a slow process. But the anecdotal evidence points to improvements in the two years since the grant program began.
Whoa on sweets, Go on activity
At the Forest Hills Elementary School cafeteria, signs above the serving line indicate whether items were Go, Slow or Whoa foods.
Students know they can eat all they want of Go foods, need to limit quantities of Slow foods and should eat Whoa foods only in small portions and for special occasions.
Go, Slow and Whoa is a nationwide initiative associated with CATCH (Coordinated Approach To Child Health). Colleton schools are strong advocates for the program. On this day, grapes, carrots and vegetable medley are Go foods. Applesauce (because of high sugar content), baked chicken chips and macaroni and cheese are Slow foods. The cafeteria seldom offers Whoa foods. On special occasions, they might put cake or cookies under the Whoa label, said cafeteria manager Faye Reeves.
Students who don't put at least one fruit or vegetable on their tray are required to go back in line and get one. On this day, only one child in the entire first grade tried to slip through without selecting a fruit or vegetable. He was sent back and grabbed a plastic container of grapes.
"We always had fruits and vegetables, but we never gave them choices like this," said Reeves, who has been at the school 20 years.
French fries, the staple of school cafeterias, are a Go food because they are baked, not fried. In fact, Forest Hills Elementary doesn't even have a deep fryer. "We eliminated them a few years ago," Reeves said. "We knew we were coming to this."
Middle and high schools in the district still offer some fried foods. It's hard to go cold turkey on fried foods when kids have been eating them from the day they started school. But by the time the current elementary school students reach those upper levels, Reeves suspects all fried foods will be off limits in local schools.
"This is all they know now," Reeves said. "They grow up knowing this is how you need to eat."
PE class isn't the only active time
Across the county at Bells Elementary, PE teacher Sharon T. Williams' time with the students used to be limited to her classes.
But when the anti-obesity effort stepped up last year, she started opening the gym before school and encouraged kids to walk before classes. Youngsters now fill the old concrete-block gym, pounding the hard-tiled floor in laps that measure 1-20th of a mile.
"Now it's the first thing they do when they get into school, they walk three laps," Williams said. "We've got some that want to be lazy, but we get them to walk, too."
Some walk longer, often alongside faculty members and even parents.
Debbie Fail likes to join her children, kindergartner Taegan and fifth-grader Trenton, for the morning routine. "It gets them pumped up and ready to go," Fail said. "It's good for the mom in the morning, too."
Many of the children qualify for the free school breakfast program, and they leave the gym to eat breakfast in their classrooms. Then they do an exercise of the week in the classroom, learned in their PE classes and directed by their fellow students. By the time they settle in for their daily lessons, they've had a good workout.
At the start of last school year, one fifth-grader told Williams she had been diagnosed with diabetes and had to take insulin twice a day. "I told her we're going to do something about that," Williams said.
The child enthusiastically joined the pre-school walking routine. She walked during recess, too, and took part in the standard PE class exercises. She started feeling healthier, and a visit to her doctor during the Christmas break offered evidence of the progress.
The first day back from the break, the girl ran up to her PE teacher and exclaimed, "Ms. Williams, I don't have to do any insulin now," Williams recalled.
Market encourages healthy eating
The Colleton County Farmers Market didn't start as a Let's Move, Eat Smart program, though it dovetails perfectly with the goals.
A decade ago, a group of Walterboro leaders started looking for a permanent place where local farmers could sell their products. Farmers had set up at makeshift markets that popped up in several places through the years.
Funding for the market has come in spurts. The county in 2009 finally bought a building on East Washington Street that originally was a Colonial Food Store but also has been an auto shop, an auction house and a cell phone shop.
The plan was for the building to house the local Clemson Extension office and a farmers market. But when Clemson cut back on its extension program, county leaders opted for the odd combination of a county museum and farmers market.
"The pairing (with the museum) seemed a little unusual to some, but it has been an incredible pairing," said Marilyn Peters, director of the market. "We help the museum, and they help us. And we're no longer gypsies."
The market opened in fall 2011 and really took off last summer, with all 20 vendor spots often filled when the market was open on Saturdays and Tuesdays.
The market is trying innovative ideas.
Kids in an after-school program at the museum planted small vegetable plots behind the market. The market bought equipment to process Supplemental Nutrition Assistance Program cards, encouraging low-income resident to buy healthy food. They even give out tokens for use only at the market that double the value of SNAP cards.
The market has a mobile component, with a retired postman who takes produce to sell at subsidized housing developments. Next up is installing a commercial kitchen incubator to allow residents to can, freeze, process and bake products for sale. Small farmers often can't afford the commercial kitchens required by health codes to do those things.
Peters, who retired from Clemson Extension and Eat Smart Move More before taking on the market position, has seen the anti-obesity effort take root in Colleton.
"At first, it was a little slow going," she said. "We were ready to go, but we needed some programming to get going. We had plans, but the tools weren't ready yet. Now, we have the tools, and we're just seeing it going like crazy.
"We have the perfect storm in terms of a community for this. Poverty, unemployment, obesity, lack of educational attainment -- we all knew we had some problems here."
But the county's small population meant "we had easy access to the gatekeepers and they all had a willingness to see this community improve."
Small businesses donate time, money and resources to the anti-obesity effort. The local grocery stores allowed nutritionists to go through their aisles and mark the healthy foods with "Lets Go, Eat Smart" labels.
"It's hard to measure success (in terms of health improvement) at this point, but if we could measure attitude and if we could measure commitment, we could show you progress. I don't think you'd find any argument on that."
Collards, exercise and Bible study
The Power of Faith Delivery Ministry is a small church that meets in a simple building behind the home of church pastor Nancy Goff. It's among several churches given $2,000 mini-grants from Lets Move Eat Smart to start their own sustainable anti-obesity programs. One church used the grant to build a walking trail, another set up an exercise room.
The Power of Faith Delivery Ministry went over-and-above the requirements, setting up exercise programs before Bible study classes, pledging to reduce sugary drinks and fried foods from church gatherings, and planting a church vegetable garden on three plots between the church and Goff's home.
Church members gathered in September to plant a winter garden of mustard and collard greens, cabbage and turnips. The bounty of the gardens will be used for church dinners, given to church members to take home or, if there is abundance, offered to other neighbors.
"We saw the need in the church for healthier people," said Barbara Shider, a church prophetess who helps with a nutrition/activity class. "We can teach ourselves to eat right and pass it along to the community."
Shider is typical of the health problems of the state. She's overweight and has fibromyalgia, high cholesterol, diabetes and high blood pressure. But since starting the moderate exercise classes, she's eating healthier and getting more activity.
"I don't feel sick anymore," she said. "I thought I was too physically bound by the aches in my body to move, but as I started exercising, I realized I could do it. Now I exercise every morning. It's spiritual, too."
Church members are buying into the changes. At a recent church celebration, only one person brought fried chicken, and she apologized, Shider said.
Buckner sees Power of Faith as a shining example of how the Let's Move, Eat Smart program can work.
"This is a really excited congregation," Buckner said. "All they needed was a little push, and that's what we're here for."
Buckner thinks the buy-in level is helped by "the fact this is a Colleton County program, not a Nebraska or Arizona program, not even a Columbia program."
The framework for the Colleton program could be coming to other South Carolina communities soon. BlueCross BlueShield this year awarded another $346,500 grant to Eat Smart Move More, partially to continue the Colleton experiment for another year but also to pay for expanding it to other communities.
Leaders of the anti-obesity effort in South Carolina point to Colleton County as a big success, even if quantifying that success in terms of healthier people is difficult.
"It's hard to measure success," Buckner said. "But I do hear a lot of people say they are doing things differently, and that's rewarding."
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