The Grub Box pilot: Combating child obesity with access to veggies

February 23, 2012: In a unique pilot project on pediatric obesity, Alameda County Medical Center's Highland General Hospital and People's Grocery of Oakland, a non-profit that promotes healthy and economically viable communities through local food systems, have teamed up to provide a free "Grub Box" to 15 families who agreed to participate in the 6-month healthy eating study. 

A Grub Box contains about 12 items of fruits and vegetables (12 - 16 pounds worth of produce) depending on what is being grown at local farms. Each week there are about 4 types of fruit, herbs and/or onions, at least one bunch of greens (kale, collards, chard, or mustards), and the remaining 6 items are seasonal vegetables.

Robert Savio, M.D., chief of pediatrics, above middle, and Michele Bunker-Alberts, above left, a family nurse practitioner and lactation consultant, designed the healthy-eating project with a $10,000 grant from the American Academy of Nurse Practitioners.

"We see a disproportionate number of families that are struggling with pediatric obesity," said  Bunker-Alberts. "They typically live in neighborhoods where they have less access to the type of foods we're asking them to eat."

To qualify for the project, at least one child in the family had to meet the definition of obesity (a Body Mass Index in the 95th percentile or higher: e.g., a child who is 4 feet tall and weighs 100 pounds is considered obese).

To begin, Savio measured the children's weight and other indicators of their health, such as cholesterol and glucose levels. Savio and Bunker-Alberts stressed that with children, the goal is typically not to reduce weight but to focus on maintaining it so that when the child grows, his or her BMI will drop.

The project also included workshops by nutrition educators:

The families learned how to prepare vegetables like chard and kale and often shared information with each other. The workshops also focused on such issues as portion control and how to read food labels, said Raheemah Nitoto, a holistic health and nutrition educator who ran workshops with a hospital nutritionist. Some of the participants weren't able to recognize leafy green vegetables such a chard or kale. "So handing them that and telling them to go off and eat that wouldn't be helpful," she said.

Savio and Bunkers-Albert are still collecting data from the project (which ended in November). But they hope to expand it to more patients and their families.

Ultimately their goal is to track patients for years to see if jump-starting new eating habits by providing them with healthy foods made a long-term difference in their lives.

Written for California's Children by Elizabeth J Carlyle.