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April 15, 2005

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Publication Date: Friday, April 15, 2005

Health for health care workers Health for health care workers (April 15, 2005)

Medical group encourages healthy diets for everyone

By Diana Reynolds Roome

A colorful spread was laid out at a recent lunchtime meeting of Camino Medical Group's family practice department: shrimp and snow peas, salad with red cabbage and bean sprouts, brown and white rice, noodles with beef and vegetables, tofu with vegetables, and gloriously green lettuce leaves just asking to be used as edible dishes.

At the end of the line were deep fried spring rolls and won tons. But by the time people reached those high cholesterol items, they had filled their plates with so much other tasty stuff there was little space left.

Healthy eating habits are at the top of the agenda here these days, as healthcare workers strive to get fit and set a good example. This lunch was carefully chosen by healthcare industry sales professionals, who are learning CMG's new culture of fitness and healthy food along with everyone else.

A new Fitness Initiatives Team (FIT) has been working on changing attitudes throughout CMG's seven sites, including those from related industries who work with them. Now food carts, vending machines, and free catered breakfasts and lunches are all displaying choices with less fat, sugar and salt, and a bigger nutritional punch.

With obesity identified as a leading cause of death and disability, Camino Medical Group is among 10 major California health care organizations that recently made a commitment to address this growing problem in their own workplaces. One third of all premature deaths are related to poor diet and inactivity, according to the Integrated Healthcare Association.

Obesity can directly contribute to high blood pressure heart attack, stroke, diabetes, and other illnesses, which cost California $28 billion annually in medical costs, lost productivity and disability.

Changes began a year ago at CMG, putting it well in the forefront as FIT started educating healthcare staff about how to recognize and choose healthy foods instead of tempting items that are often loaded with cholesterol, sugar, and empty calories. A bigger challenge was helping them develop enough willpower to bring bananas instead of cookies to work, keep portion sizes in check, and maybe even reach for the fresh fruit instead of croissants at a departmental breakfast.

"Patients like people who model what they promote, and they notice when healthcare workers are too fat," said Arlene Schmidt, RN, manager of family practice, who lost 40 pounds recently and won't permit a doughnut in her department.

"It's hard to resist the temptation to eat chocolate, candy and desserts," admits Catherine Resngit, referral coordinator, who was one of several healthcare workers to receive a red FIT visor from Education Officer Sally Twesten at the lunch meeting. Visors are awarded to CMG workers who have demonstrated special dedication to fitness and tried to encourage others along the road too.

At the Los Altos Camino Medical Group, staff members are also revving up their activity level. During lunch-break, they exercise to an aerobics video in the break room, and are often joined by Dr. Fannie Huang.

One of the first and most visible steps on the road to a healthier environment was to put the vending machines on a diet. Now, at the Sunnyvale CMG site, Fig Newtons, peanuts, and low-fat granola bars are next to the Doritos, Milky Way and Snickers bars. In the drinks dispenser, there's unsweetened apple juice and water, alongside the sodas, which typically deliver an unhealthy wallop of sugar (or artificial sweetener, which can also cause weight gain) and other undesirable elements such as caffeine, phosphorus and carbon acids.

Good choices are usually hard to find, Twesten said, because the companies that supply vending machines fret that healthy items will not sell. Water is often priced much higher than soda, and empty calories are typically cheaper than nutrition. "At the moment we're aiming for one healthy item to each three or four candy bars," said Twesten. "We need to create a demand, and to educate our people that these are good choices."

Despite the challenges, the effort seems to be working.

"Now they have a list of healthier choices (posted) on the vending machine, so I'm more aware," said Yen-Yen Hu, a family practice medical assistant. "I still make bad choices, but not as bad as before. I eat half a box instead of a whole box of chips. I feel healthier, and that feels good."

"It's a slow cultural change," said Twesten, who has been in the forefront of the FIT initiative. "Some people just take it and run. Others are hard to reach, but we chip away."

One good way to influence more people is by identifying and honoring good role models. Twesten asks employees to nominate co-workers who are committed to healthy living and convince others to do the same. The FIT campaign is not just about food, but tries to be all-encompassing. "You don't have to be perfect, but you have to visibly exhibit a healthy lifestyle," she said.

FIT is encouraging people to do this every way it can. Last Year, CMG's campuses became smoke-free. At a recent Healthy Snack Day, 300 people picked up a free healthy food item they had not tried before. A CMG bookmark packs some savvy guidelines on portion sizes: 50 percent vegetables, 25 percent protein and 25 percent starch. It shows how to judge a moderate portion of several different types of food, and suggests trying out new fruits and vegetables as well as putting many colors on your plate (an easy way to ensure a wide variety of nutrients and vitamins). T N Spice, the outdoor food cart at the main CMG campus, now carries string cheese, hard-boiled eggs, apples, bananas, oatmeal, sunflower seeds and nuts.

The 12 members of the Fitness Initiative team include doctors, nurses and phone operators, as well as people from radiology, customer services and finance. They work with a nutritionist to develop education materials, and initiate mini-jazzercise, tai chi, resistance training sessions, and meditation during lunch hours. One pediatrician went to local grocery stores with a notebook to find and report back on good, nutritious snacks.

Free weight management programs and nutrition handouts are also available to employees.

"I see more energy, a happier attitude and better use of break time," said Schmidt. "People are out there doing something healthy rather than hiding in an office eating junk food."

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