By Ella Nilsen Sentinel Staff - home of the Keene Sentinel

High rates of childhood obesity are slowing, according to federal data. That trend is mirrored in Cheshire County, where a community health initiative is making strides to combat the issue.

A recently released study by the N.H. Department of Health and Human Services shows that rates of childhood obesity have declined in the Monadnock Region and that Cheshire County has one of the lowest rates of childhood obesity in the state.

In 2008-2009, a state study found that 32 percent of Cheshire County schoolchildren were overweight or obese. By 2013-2014, that number dropped to 25 percent, better than the state’s average of 28 percent.

Local health experts attribute this to coordinated efforts by Healthy Monadnock 2020 and area schools to emphasize good nutrition and lots of exercise for their students.

Healthy Monadnock 2020 is a community initiative involving Cheshire Medical Center/Dartmouth Hitchcock Keene, the city of Keene, and local schools and businesses. All aim to make Keene and the surrounding towns the healthiest community in the nation by 2020. The initiative focuses on five components, including healthy eating, active living, improving income and jobs, education attainment and mental health.

Healthy Monadnock Director Linda Rubin said the state’s report is “validating that we’re on the right path.”

“I think it speaks to the interests of the people of Cheshire County in improving the health of the community,” she said.

The combined efforts of Healthy Monadnock 2020 and local schools to emphasize exercise and nutrition include changing school policies to add regular activity breaks during the day, encouraging kids to walk or bike to school, requiring at least 20 minutes of recess each day and rewarding student achievement with things that don’t involve food.

In addition, some area schools are offering healthier options for school lunches, including salad bars and whole grain pasta.

Like obesity in adults, childhood obesity has grown dramatically in recent decades. Nationally, the rate has doubled in children and quadrupled in adolescents over the past 30 years, according to the Centers for Disease Control.

In 2012, more than one-third of children and adolescents were overweight or obese, the CDC said.

These children face a wide range of health problems, according to Dr. Geraldine Rubin, a pediatrician at Cheshire Medical Center/Dartmouth-Hitchcock Keene.

In addition to medial woes such as strain on the back and knees, as well as diabetes and sleep apnea, overweight children can suffer mental and emotional issues.

“There’s a lot of psychological stuff, teasing and bullying,” Geraldine Rubin said.

If a child is overweight, the chances he or she will continue to be overweight with age is high. Oftentimes, it can be worse for girls, Geraldine Rubin said. The reason? Hormones.

As boys go through puberty, the boost of testosterone they get helps build muscles and shed fat. But for girls, puberty means more estrogen, which naturally promotes fat.

To combat this, Geraldine Rubin recognizes both nutrition and exercise as important components to being healthy, but she really emphasizes nutrition.

“Exercising alone isn’t going to help you lose weight,” Geraldine Rubin said. “Probably nutrition is the No. 1 thing.

There are a number of pitfalls with a lot of the food available today, she added.

First, there’s the fact that “we sort of live in a fast-paced, fast food society,” Geraldine Rubin said. “There’s also ... in America, bigger is better. Portions are so inflated.”

There’s also the issue of cost. Fresh fruits and vegetables are much more expensive and take more time to prepare than microwavable dinners and Happy Meals.

There are some silver linings, though — namely, an increased awareness for what kinds of foods are nutritious, Geraldine Rubin said. Some supermarkets, including Hannaford, highlight the healthy food they carry, and many schools have put a strong emphasis on teaching kids good nutrition.

But it’s not just about changing what we eat, it’s also about changing how we eat, she added.

From the beginning of a child’s life, “there’s such an emotional component to feeding,” she says.

Geraldine Rubin says she sees many parents come into her office, complaining that their toddler or young child is “too skinny,” which she said surprises her.

The idea of plump, chubby babies equaling healthy babies can sometimes be misleading, she said.

“I feel like people, they want to push their kids to eat and don’t want to honor their kid’s internal ‘I’m not hungry,’” she added. “I feel we could do a lot better and society could do a lot better on what’s normal for an infant, what’s normal for a toddler.”

Linda Rubin said she believes it’s important for the community to invest in its children right from the start.

“Our children are the adults of tomorrow and investing in them at the earliest possible age, right from infancy and before they are born is important,” she said. “Having environments in which they can be healthy from an early age, they’ll continue to have ... healthy behaviors.”


Ella Nilsen can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it. or 352-1234, extension 1409. Follow her on Twitter @ENilsenKS

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