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6/4/2014 Anew prescription: Eat your veggies I Star Tribune And those costs can be staggering. A study late last month estimated that an obese child will incur $19,000 in additional lifetime medical costs, given the elevated risks for diabetes and heart disease as adults. "Obesity ... affects our communities. It's raising our health care costs," said Dr. Ed Ehlinger, Minnesota's state health commissioner. "I think physicians should be very concerned about it." Fruit pizza Miller's daughters differ in their eating habits, though both craved treats like Nutty Bars and gummy snacks as much as the next kid. Her oldest girl, Alena, is picky. She tolerates apples, though, so she used her prescription to buy multiple varieties and took a chance on spinach. Now the family uses her favorite apples in applesauce and to make a substitute for cooking oil. She even liked the spinach and soon progressed to zucchini in salads and bread. "If I had even said that before," Miller said, "it was like, `Ewwww, egh!' " Her younger daughter, Amelia, is more adventurous. She used her prescription on tropical fruits such as kiwi and papaya for a yogurt -based fruit "pizza." "I think it was [successful] because it was their thing," Miller said. "It wasn't me encouraging them to do it. It was their choice." Whether a one-time opportunity to test new fruits or vegetables will be equally transformative for other families is unclear. HealthPartners will study that question after the two clinics use up their 100 trial prescriptions. Research on the issue has been inconclusive. Last month, a British study of fruit and vegetable prescriptions for 1,184 people in a low-income neighborhood found that most were used, but that they didn't change long-term habits because people still considered fresh produce too expensive. Ehlinger said such strategies will work only in conjunction with broader efforts to make healthier choices easier. Some lower-income parents, for example, find it hard to choose fresh produce when it is more expensive than high -calorie packaged foods that fill their families up for less money. Junk food marketing and fast-food availability — compared to the scarcity of produce markets in some communities — also present challenges, he said. "We have to change the policies and systems in an environment, in a community, if we are going to get people to move and eat properly. It's not just about an individual choice." Kids' choice The prescription trial is part of Bear Power, a collaboration of HealthPartners, Children's Hospitals and Clinics of Minnesota, and schools and civic groups in White Bear Lake to improve community health. School "move-a-thons" and Bear Power bracelets are among the tools to spread awareness. Local grocers have already been participating in a variety of ways, such as putting healthy options in the "impulse buy" shelves next to the registers. This "is about being proactive about health," said Tom Clasen, a vice president for Knowlan's Supermarkets, which has three Festival Foods stores that accept the prescriptions. "Our medical system is so built around a reactive stance to problems." Clasen said children have used prescriptions to buy everything from cilantro to mangoes to jicama. While cost is a barrier to healthier eating, Kottke said there are other barriers that the prescription program might address. Even doctors tiptoe around subjects such as personal diet and weight with patients, so the prescriptions give them an excuse to be more direct. The prescriptions also appeal to the American desire to sample foods first, and to children's love of gifts and opportunities to pick things out for themselves "without having to put 10 bucks at risk," Kottke said. http://wuwv.startribune.conVIifesty e/health/258776831.html 2/3