Issues of Poor Diet and Exercise in Great Falls, MT

 Regular physical activity and proper nutrition are important contributors to preventing chronic disease and having a healthy lifestyle. Physical activity and proper nutrition are also especially important in preventing obesity (Milliken & Iannotti, 2014). Obesity and sedentary lifestyles are major contributors to chronic diseases for both children and adults. The CDC states that being overweight or obese is associated with preventable chronic diseases such as type 2 diabetes, heart disease, stroke, and some cancers (Montana’s Department of Public Health and Human Services, 2018). In 2016, it was reported that nearly two-thirds, or 63% of Montana adults were overweight or obese (Montana’s Department of Public Health and Human Services, 2018). The city of Great Falls struggles with providing adequate facilities that promote health and wellness for its community members.

 The last time there was a major locally funded roadway reconstruction project implemented in the Great Falls metropolitan area was twenty-seven years ago (Great Falls Metropolitan Planning Organization, 2018). There has been some progress made over the last few years in Montana. Stated on the chronic disease prevention and health promotion bureau, in 2009 Montana had one implemented building environment policy, and in 2017 there were twenty-four policies implemented for the entire state. So, on average for the entire state of Montana, that is three proactive policies a year. So, what is a building environment policy? According to the Department of Public Health and Human Services, the Building Environment Policies is intended to promote healthy communities and must adopt policies that include accessibility to communities by foot and bike traffic. There must be complete streets and paths for transportation for bike and pedestrian traffic with a non-motorized component (Montana’s Department of Public Health and Human Services, p. 12, 2018).

Currently in Great Falls, there is the River’s Edge Trail for bike and pedestrian transportation, but this trail system is intended for recreational uses. The trail is almost 60 miles of path along both sides of the Missouri River that ends once it reaches the historic downtown Great Falls (River’s Edge Trail, 2018).While this trail system may be helpful to some people with daily commutes to work and other errands, a better trail system is needed for proper and safe non-motorized transportation for daily commuters throughout the city of Great Falls.

 According to an article in Medicine and science and sports and exercise, one of the most effective approaches for promoting prevention of juvenile obesity in the community is to intervene at the environmental level such as providing exercise facilities and bike paths for recreational use and commuting (Bar-Or,O., et al, 1998). Studies show that active commuting reduces the risk of cardiovascular events, type‐2 diabetes, hypertension and adiposity, and improves a person’s overall fitness (Bauman, A., et al., 2011). It is important to address the correlation between exercise and body weight, especially in youth. Juvenile obesity increases the risk of adult obesity (Leroy, Wallin, & Lee, 2017).

Seventy percent of obese adolescents become obese adults. The obese child is at increased risk for hypertension, hypercholesterolemia, hyperinsulinemia, decreased release of growth hormone, respiratory disorders, and orthopedic problems (Bar-Or,O., et al, 1998).

Students with chronic conditions may face lower academic achievement, increased disability, fewer job opportunities and limited community interactions as they enter adulthood (Leroy, Wallin, & Lee, 2017). ‘An Australian cross‐sectional study analyzed the relationship between the modes of transport to work and overweight and obesity from the data of a health survey among adults in New South Wales. A strong inverse relationship was found between cycling to work and the likelihood of overweight and obesity’ (Bauman, A., et al., 2011). ‘Laura Milliken and Ronald Iannotti conducted a 6‐year‐long observational longitudinal study among Danish school children, who were 9.7 years old at the onset, and analyzed the association between the change of the transport mode to school and the cardiorespiratory fitness in 322 children. The longitudinal analysis showed that fitness improved significantly among those who changed from non‐cycling to cycling during the follow‐up (6% increase in girls and 21% increase in boys). Starting to cycle to school and maintaining cycling were significant predictors of fitness among both girls and boys. Models including skinfolds, baseline fitness, and travel mode explained 60% of the overall variance in the follow‐up fitness in girls and 63% in boys. It was also shown that other physical activity was not consistently higher in those cycling to school compared with other subjects.’ (Bauman, A., et al., 2011). There are hundreds of studies that are done worldwide that prove that commuting to work and school by foot and bike improves a person’s overall physical health. This shows the importance of having designated safe non-motorized transportation paths for Great Falls community members.

Proper exercise is one key element in being happy and healthy, but a person’s diet is also another crucial role in overall health and wellness. ‘A diet rich in fruits and vegetables provides important bioactive compounds and nutrients, is associated with decreased risk of cardiovascular disease, some cancers, and several other chronic diseases, and help manage weight’ (Ammerman, et al., 2017). ‘Despite the benefits of eating plentiful amounts of fruits and vegetables, most Americans do not meet dietary recommendations. There are substantial disparities in fruit and vegetable intake and parallel disparities in obesity and other nutrition-related disease’ (Ammerman, et al., 2017).

As the population continues to grow to measures of being overweight and obese in the United States, the link to serious health problems also continues to grow. Community supported agriculture, such as framer’s markets, food and agriculture coalition, and community gardens have shown to improve access to and consumption of fresh fruit and vegetables. Community supported agriculture participation joined with nutrition education has been proven to positively affect fruit and vegetable intake, weight maintenance, and local agricultural economies (Ammerman, et al., 2017). Great Falls does provide a farmer’s market that runs June through September, and an indoor farmers market from October to May which is open one day a month (Great Falls Farmer’s Market, 2018). Great Falls is still lacking a community garden and food and agriculture coalition which would both benefit our community by providing more healthy food options. These establishments would also provide community service options and agricultural and nutrition education.

Being overweight and obese not only takes a toll on a person’s physical self, but also can affect a person’s psychological self. Overweight and obese people suffer psychologically and socially. Self-esteem and self-image are often damaged by ridicule and mockery (Bar-Or,O., et al, 1998). ‘The psychological and social consequences of being overweight in a society preoccupied with thinness can be both severe and lasting. Core aspects of psychological functioning such as self-esteem and body image can be affected, mood problems such as depression can occur, social discrimination is common, and long-term negative associations of overweight with college admission, employment opportunities, and income have also been documented which, in turn increases mental health issues such as depression.’ (Bar-Or,O., et al, 1998). It is important to know the psychological effects health and wellness can have on a person, such as depression. We must keep in mind the rise of mental health issues in the United States. Sadly, Montana is ranked number one in the United States for suicide in 2016 and 2018 with depression being the biggest factor (Knowles, 2018).                                                                      Obesity and depression are increasingly prevalent and are currently recognized as major public health concerns worldwide. ‘Obesity is one of the leading causes of preventable diseases and disability worldwide, and depression is among the leading causes of burden of disease. Both disorders are increasingly prevalent and comorbid disorders’ (Brennan, Clarke, & Preiss2013). In a meta-analysis of longitudinal studies by The University of Queensland in 2016, the results showed a 70% increased risk of being obese in depressed adolescents; conversely obese adolescents had a 40% greater risk of being depressed’ (Clavarino, Doi, Mamun, & Mannan, p. 11, 2016). With the rise of people being overweight and obese, and the strong correlation to depression there is a need for better mental health facilities in Great Falls and surrounding communities. Mental health needs to be embraced as an issue, and better support is needed.

Looking at Montana’s department of health and human services chronic disease prevention and health promotion bureau report of 2018, mental health was not even mentioned. Montana’s health department is not recognizing mental health as an issue on their report. Mental health needs to be recognized and supported. As with most health issues, some form of mental issues usually follows. As stated above, Montana is the highest-ranking state for suicide. Montanans, whether being depressed from social seclusion, the weather and lack of sun, being overweight, or suffering from some form of health issue need help. Whatever the issue is, the stigma that surrounds mental health needs to be abandoned, and better support for everyone is greatly needed.

Firstly, our community’s overall health could be greatly benefited if more nonmotorized walking and biking paths were added, along with added safer bike routs and pedestrian crosswalks on the roadways. Secondly, our community’s health would improve if more healthy food options were available, such as a community garden or food coalition. Lastly, if our community embraced mental illness and provided better support for those who need it, our citizens would be able to get the proper help that is needed. ‘Therefore, strengthening the health system through appropriate physical exercise, promoting the concept of healthy body image, nutritious and well-balanced diet, not only help prevent obesity but also overcome depression levels too’ (Rathee, 2017).

Reference page

• Ammerman, A. S., Becot, F. A., Connor, L. A., Garner, J. A., Hanson, K. L., Kolodinsky, J.,  McGuirt, J.T., Morgan, E. H., Seguin, R. A., & Sitaker, M. (2017) Farm fresh foods for  healthy kids (F3HK): An innovative community supported agriculture intervention to  prevent childhood obesity in low-income families and strengthen local agricultural  economies. BMC Public Health. Retrieved from http://web.b.ebscohost.com.proxygf.lib.montana.edu/ehost/pdfviewer/pdfviewer?vid=4&sid=48a47cf0-af1d-40b5-98ef-835f8f3b3304%40sessionmgr103

         Bar-Or,O., Foreyt, J., Bouchard, C., Brownell, K.D., Dietz, W.H., Ravussin, E., & Torun, B.  (1998): Physical activity, genetic, and nutritional considerations in childhood weight  management.Medicine & science in sports & exercise, 30(1). Retrieved from http://ovidsp.tx.ovid.com.proxygf.lib.montana.edu/sp-3.31.1b/ovidweb.cgi?&S=BECNFPKFAJDDEBIJNCEKMEIBODBOAA00&Link+Set=jb.search.32%7c1%7csl_10

• Bauman, A., De Geus, B., Kohlberger, T., Krenn, P., Oja, P., & Titze, S. (2011) Health  benefits of cycling: a systematic review. Scandinavian Journal of Medicine & Science in  Sports, 24(4). Retrieved from https://onlinelibrary-wiley-com.proxygf.lib.montana.edu:3443/doi/full/10.1111/j.1600-0838.2011.01299.x

         Brennan, L., Clarke, D., & Preiss, K. (2013) A systematic review of variables associated with the  relationship between obesity and depression. Obesity Reviews. Retrieved from https://onlinelibrary-wiley-com.proxygf.lib.montana.edu:3443/doi/epdf/10.1111/obr.12052

• Clavarino, A., Doi, S., Mamun, A., & Mannan, M. (2016) Prospective associations between  depression and obesity for adolescent males and females: A systematic review and meta- analysis of longitudinal studies. PLOS One, 11(6) Retrieved from http://gfcmsu-primo.hosted.exlibrisgroup.com/primo_library/libweb/action/display.do?frbrVersion=7&tabs=detailsTab&ct=display&fn=search&doc=TN_doaj_soai_doaj_org_article_ef5a2a1e88874be799da79056457142a&indx=1&recIds=TN_doaj_soai_doaj_org_article_ef5a2a1e88874be799da79056457142a&recIdxs=0&elementId=0&renderMode=poppedOut&displayMode=full&frbrVersion=7&frbg=&&dscnt=0&scp.scps=scope%3A%28TRAILS-PRINT%29%2Cscope%3A%28D-01TRAILS_MSU_GFC%29%2Cscope%3A%28E-01TRAILS_MSU_GFC%29%2Cprimo_central_multiple_fe&tb=t&mode=Basic&vid=01TRAILS_MSU_GFC&srt=rank&tab=all_libraries&dum=true&vl(freeText0)=Obesity%20and%20depression%20are%20increasingly%20prevalent%20and%20are%20currently%20recognized%20as%20major%20public%20health%20concerns%20worldwide&dstmp=1542040870425
• Great Fall’s Farmer’s Market (2018) Schedule. Retrieved from  ..http://www.farmersmarketgf.com/Schedule.html
• Great Falls Metropolitan Planning Organization. (2018) Great Falls transportation improvement  program FFY 2014-2018. Retrieved from
• https://greatfallsmt.net/sites/default/files/fileattachments/planning_and_community_development/page/41061/great_falls_tip_2014-18_admin_mod_1.pdf

         Knowles, M. (2018) US states ranked by suicide rate. Retrieved from

•  ..https://www.beckershospitalreview.com/population-health/us-states-ranked-by-suicide-rate.html
• Leroy, Z., Wallin, R., Lee, S. (2017) The Role of School Health Services in Addressing the  Needs of Students With Chronic Health Conditions: A Systematic Review, 33(1). Retrieved  from https://journals.sagepub.com/doi/pdf/10.1177/1059840516678909

         Milliken, L. A. & Iannotti, R. (2014) Nutritional and physical activity behaviors predict life  satisfaction in school age children: The health behavior of school age children.  Retrieved from https://journals.lww.com/acsmmsse/fulltext/2014/05001/Nutritional_And_Physical_Activity_Behaviors.934.aspx

• Montana’s Department of Public Health and Human Services. (2018) Chronic disease prevention  and health promotion bureau progress report July 2016-Julne 2018. Retrieved from https://dphhs.mt.gov/Portals/85/publichealth/ChronicDisease/ChronicProgressReportWEB.pdf?ver=2018-09-26-135826-240
• Rathee, N. (2017) Obesity and depression: Are they related? Indian Journal of Health and Well- being, 8(12). Retrieved from http://web.b.ebscohost.com.proxygf.lib.montana.edu/ehost/pdfviewer/pdfviewer?vid=1&sid=999f3de3-6799-4360-8362-dd73ef049be6%40sessionmgr103
• River’s Edge Trail. (2018) The trail and foundation. Retrieved from http://thetrail.org/