Overweight and obesity is a challenging public health issue. And while the "obesity epidemic" is a term frequently seen in the press, the health concern is not weight in and of itself, but rather the long list of chronic disease and disabilities associated with unhealthy weight. Overweight is associated with chronic disease conditions, including coronary heart disease, type 2 diabetes, cancer, hypertension, stroke, liver disease, sleep apnea, respiratory problems, osteoarthritis, gynecological problems, and poor health status and increasingly this chronic health conditions once almost entirely associated with adults are being seen in children. Early onset of chronic disease means many children experience the debilitating side effects of these diseases at a much early age leading to a decreased life expectancy and quality or life. Children who are overweight are far more likely to become overweight adults.

Description: Percent of children in grades K-5 (public health) below the 85th percentile of Body Mass Index measurement for age and gender.

Source: School Health annual health screening. Contact Population Health Coordinator, BC Public Health, in January each year for data update.

Overweight and obesity is a very complex issue to address given the many factors that influence eating behavior and physical activity, not to mention genetic factors associated with unhealthy weight. Research strongly links the social and built environment to unhealthy weight and, while it may seem counter intuitive, food insecurity is strongly associated. Over the past few years Buncombe County has had the unwelcome distinction of being on the top ten list of most food insecure communities and several low-income communities do not have any retail outlets for healthy food. This high degree of food insecurity is in stark contrast to the growing local food movement and increasing support for area farmers. School, local government, and community organizations are working to provide healthy food and economic resources for those who are food insecure, to increase access to healthy foods in low-resource communities and increased access to local and healthier choices in our schools and throughout the community through initiatives such as farm to school programs, farmer support initiatives and our many tailgate and farmer's markets.

While Buncombe County has abundant natural resources and many facilities and programs to promote physical activity, more than a third of adults fail to get the recommended level of physical activity. Barriers to physical activity for children include the distraction of digital devices, unsafe (or perceived unsafe) neighborhoods, decreasing recess and PE in schools, and more car-centric communities that prevent children from easily getting activity walking or biking to school or to visit friends. The good news is that Buncombe County is making progress in improving community infrastructure and programs such as Watch for Me NC and the Bicycle Friendly and Pedestrian Friendly Cities initiatives to make it safer for walking and biking and schools are beginning to support Safe Routes to Schools programs.

Asheville Buncombe Community Christian Ministries , Asheville Buncombe Food Policy Council (and member organizations) , Asheville Buncombe Institute for Parity Achievement , Asheville Buncombe Youth Soccer Association, Arc of Buncombe County , Asheville Greenworks , ASAP (Appalachian Sustainable Agriculture Project) , Asheville City Schools , Asheville Area Bike & Pedestrian Task Force , Blue Ridge Bicycle Club , Buncombe Bike Ed Network , Bountiful Cities Project , Buncombe County Cooperative Extension , Buncombe County Parks, Greenways and Recreation, Buncombe County Schools Child Nutrition , Buncombe County Health and Human Services School Health Nutrition/WIC Office of Minority Health Equity Grant , CarePartners Health Services , City of Asheville Parks & Recreation Transportation , Community Care of WNC, FEAST/ Slow Food Asheville , Healthy Buncombe Eat Smart Move More Coalition , Innovative Approaches Land of Sky Regional Council , Mountain Area Health Education Center, MANNA Foodbank , Mission Health Community Benefits Health Education Children's Hospital Weight Management , North Carolina Center for Health and Wellness, Rainbow in My Tummy, Smart Start – Shape NC , Town of Black Mountain Greenways Health Initiative , Mountain True , WNC Pediatric Care Collaborative, WNC Trips for Kids, Youth Empowered Solutions (YES!) , YMCA of Western North Carolina, YWCA of Asheville

Outside of the home, children spend more time in schools than anywhere else. And schools, in the way they touch so many facets of a child's life, have a unique opportunity to address healthy behaviors and prevention of childhood obesity. Strategies that have been shown to be effective include:

• Increasing access and availability of healthy foods and beverages. This broad approach can include making changes to what is served in school nutrition programs. Guidelines that limit the availability of nutrient poor foods in celebrations, rewards, and in fundraisers.
• Nutrition education programs in the school present as direct nutrition education or integrated into academics as a vehicle to introduce concepts related to curriculum in areas such as math, science, social studies or literature.
• Programs that introduce students to a variety of fruits and vegetables and help connect students to where their food comes from, such as school gardens and farm to school programs
• Limiting the exposure students have to marketing of unhealthy foods and beverages and/or shifting marketing to favor healthier choices;
• Policies and practices that increase opportunities for physical activity and quality physical education as well as promoting active transportation by making it safe, accessible and fun to walk or bike to school,
• Schools can also provide information about student health through strategies such as annual BMI assessment that can be used to help educators and policy makers make decisions to support student and community health.
• School health can also use annual screenings to identify students at greatest risk for health conditions associated with overweight and help connect students and families with clinical resources and information on healthy behaviors.