Tag Archive | "obesity"

Highbridge tackles childhood obesity

Highbridge tackles childhood obesity

Students at P.S. 73 warm up for their health lesson.

At 8:15 am Thursday, nearly 30 4th graders sent mini tremors through P.S. 73. “Who can last longer than Mr. Rios?” said Juan Ramon Rios, director of Healthy Highbridge. He was trying to get children half his height through a warmup routine of jumping jacks. Despite all the activity, 37 percent of the students in this class are overweight or obese, according to body mass index measurements that Rios and his team at Highbridge Community Life calculated this week. Two classes even measured in at 59 percent. The overall rate of overweight students at the Anderson Avenue elementary school is consistent with that of the entire South Bronx, where 40 percent of students are overweight or obese. That percentage is higher than the alarming national level, which the American Heart Association estimates at 33 percent. Healthy Highbridge meets with fourth and fifth graders at P.S. 73 once a week to combat the repercussions of obesity in an area that has a lot of obstacles to staying healthy. In the South Bronx, 38 percent of the residents live below the poverty line, according to the 2010 American Community Survey. Highbridge also has too few supermarkets to meet the needs of its 34,000 residents, a 2008 city study says. Rios said these factors lead to poor food choices and, by extension, poor health for area children. “We’re losing a generation,” Rios said three days earlier from his cramped basement offices at Highbridge Community Life Center. “All of this is going to create a health cost”—that is, unless everyone gets moving. After the exercise, Rios instructed students on how to take their pulses. “Why did we do that?” Rios asked as 60 index and middle fingers pressed against 30 wrists. “To lose some weight,” said Fatumata, 9. “Because it could be fun to exercise,” said Shantel, also 9. “Because we need to get exercise,” said 10-year-old Jonah. These children are all participants in Healthy Highbridge’s year-long health education program, funded by a $30,000 grant from the Communities Impact Diabetes Center, which in turn receives its budget from the federal Centers for Disease Control and Prevention. Before they start their education curriculum, Healthy Highbridge staff must measure the students’ body mass indexes, test their prior health knowledge and survey them on exercise and eating habits as well as their attitudes and beliefs regarding working out and eating. These initial studies will be used as a baseline to track students’ progress, as Rios and team return each week to tackle a different health subject: Michelle Obama’s “My Plate” and “Let’s Move” campaigns, diabetes, nutrition, and exercise, among others.

P.S. 73 students eat a breakfast of sausage, biscuits and orange juice.

The goal is to help youngsters understand what it takes to be healthy, said Michelle Ramos, the diabetes center’s community project manager. “As attitudes around healthy behavior improve, hopefully the behavior itself will improve,” she said from her Harlem office. Ramos said that while she doesn’t encourage children to lose weight, she believes that as they grow, they’ll maintain their weights and their body mass indexes will drop. “Hopefully they’ll pick up healthy habits and go and share them with their families,” Ramos said. P.S. 73’s principal, Jean Mirvil, said sharing health information with the parents is critical to solving the obesity problem. Many of the families, he said, come from different countries and have a hard time making the proper, healthful adjustments in their new homes (34 percent of people in the South Bronx are foreign-born). “The kind of food they’re used to does not present itself in the same way as they are making the adjustment with this country,” Mirvil said. He expects that the children will bring information about what and what not to eat home to their parents. “At school, they are given a full picture of what a regular, healthy meal should look like,” Mervil said. To combat the obesity problem, this September the school instituted a salad bar at lunch, so students can add a rotating variety of produce—spinach, corn, radish—to their meals. The main courses vary according to the Board of Education menu. Recently, Mervil said, students had chicken and a choice of pasta or rice. Students can choose milk—not chocolate milk—or water for a beverage. On the day of the Healthy Highbridge visit, breakfast consisted of a sausage and biscuit sandwich, and orange juice. During this class, students were asked to pick which food choices they would make: chicken with the skin on or off, whole wheat or sweet bread, regular peanut butter or freshly ground.

Shannon takes her pulse after a round of jumping jacks.

Shannon, 9, said she preferred popcorn without butter, low-fat milk to skim, and would eat an apple before a piece of candy most days. “Salt? Ew,” she said, her neat cornrows jostled back as she shook her head. Winston, the largest boy in the class and the first to cease his jumping jacks, said he was less into self denial. He puts butter on his popcorn because, otherwise, “it doesn’t taste like anything.” The nine-year-old did acknowledge that salt isn’t always necessary. “Sometimes, if you don’t add salt, food can still taste good,” he said. Jaheim, 10, said he couldn’t replace french fries with potatoes, nor could he exchange a burger for a salad. “French fries?” he asked rhetorically as his hands shot from his striped hoodie to the sky. “I love them.” As for burgers? “They’re very good,” he said. “You could even put bacon on them.” When asked if all his poor eating choices left him a healthy individual, Jaheim was confident. “Yeah, I do weights.”  

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Struggling to keep Soundview healthy

Barbara Jones remembers her first heart attack like it was yesterday. “Being overweight, I thought it was just asthma,” she says of the day in October, 2001 when she felt so drowsy on her way home from an evening job at Dunkin Donuts that she fell asleep on the bus and missed her stop. Her son found her walking back from Parkchester. The last thing Jones remembers is hearing him tell an operator: “Blood is coming out of my mother’s mouth.” Jones’s heart attack was so severe that she was in intensive care for 20 days, and had a breathing tube for seven. When she emerged from hospital, she had lost two-thirds of her heart’s capacity. She was too weak to return to work at Dunkin' Donuts and the Bronx Family Courthouse, where she had been an office manager for 21 years. Jones describes a daily diet of ice cream, hotdogs and soda that saw her weight shoot above the 350-pound limit on the scales at the Soundview Health Center. She knew things had to change after the death of her husband in 2003 from a stroke brought on by alcohol and medication abuse, and the death of her sister from diabetes the following year. “My GYN doctor, told me, ‘You’re heavy and you’re going to die. You must want to die! I tell you not to eat, you continue to eat,’” Jones said. “He said if I want to live I have to come and see Renata.” Renata Shiloah runs the Soundview nutrition clinic. In 2007, Jones decided to follow her doctor’s advice. With help from Shiloah and the support groups at the clinic, Jones began to lose weight. The clinic provides group sessions on food and healthy eating as well as cooking and exercise classes. Since 2008, Jones has lost 200 pounds. At 63, she now volunteers at the clinic twice a week, calling patients to remind them of their appointments and acting as captain in some of the classes. “On Thursday it’s the heavy-set people and on Tuesday it’s the senior citizens,” Jones says. “I can relate to both!”

Barbara Jones with her grandson in 2001, before her first heart attack.

Now, Soundview Health Center is threatened with closure, a move that could rob local residents of the kind of local, clinical care that saved her life. In August, the Department of Health and the Inspector General for Medicaid took separate measures to impose sanctions upon the clinic that would stop their participation in Medicaid for the next three years, after they discovered that Soundview lacks a Medicaid compliance program. The state also took issue with the continued involvement of the clinic’s founder and president, Pedro Espada, after he remained involved in operations despite an indictment for embezzling half a million dollars of Medicaid money. As the majority of patients at Soundview rely on Medicaid to afford healthcare, the decision would force the center to close. “Soundview is the only major health clinic in the neighborhood,” said Francisco Gonzales, district manager for Community Board 9. “We need more health facilities here, not less,” Gonzales said. With Soundview under threat of closure, the future of Jones’s health care is uncertain. If the center closes, there is no guarantee that Jones will find the same level of personal support and community spirit elsewhere. Residents in the South Bronx face an estimated 85 percent higher risk of obesity than people in Manhattan. And it can take more than a few appointments at a clinic to break the habits of a lifetime. Shiloah’s constant encouragement and support has been vital to Jones. When she had a reaction to the flu vaccination in December 2008 resulted in congestive heart failure, Shiloah was by her side at the hospital. “I was on deathbed watch, I was on a breathing tube,” said Jones. “But I heard Renata. I heard my friend who used to come to the clinic with me. I heard all the grandkids and I was trying to take the tube out to let them know I could hear them. They had to tie me down,” she said. When the doctors let Jones leave the hospital, she went to stay with a friend in upstate Woodstock and ate hot dogs, her favorite food. “I had to have hotdogs with chili and cheese – no salad – and my daughter had to rush me back because of the water build up,” she says. With lots of support from the clinic, Jones began to change her ways. She stopped eating hot dogs and switched from fruit juice to real fruit. Jones is a avid cook, and has learned to cut out butter and oil in her recipes and swap bleached white for whole wheat flour. She feeds her grandchildren, three of whom are in her care, gluten-free lasagna. “Now I can run with the grandkids, beat them up the stairs, play ball,” Jones said. “I used to hear Barbara’s breathing when she was coming,” Shiloah said. “She used to take 22 pills!” Shiloah and Jones have become close. Shiloah checks Jones is taking her heart medication, which is down to five pills a day, and gives her asthma inhalers so she doesn’t have to buy them at the pharmacy. “You become family,” said Shiloah. “It’s more than just a patient visit, especially in my area because we meet every week and we talk about personal things.” “I rely on doctors like Renata,” Jones said. “They were the ones who helped.”

Posted in Bronx Life, Bronx Neighborhoods, Bronx Tales, Health, Southern BronxComments (0)

Sen. Gillibrand wants more fresh-food infrastructure in ‘food deserts,’ NY Daily News

Sen. Kirsten Gillibrand (D-N.Y.) focused on the Bronx's "food deserts" during Tuesday's annual Farm Day, calling for more fresh fruits and vegetables in impoverished areas, New York Daily News. Gillibrand sits on the Senate Agriculture Committee and is pushing for "food hub infrastructure" funding initiatives into the 2012 Farm Bill. The Daily News reports that such funding would help places like the Hunts Point Terminal Produce Market. The Bronx is the worst borough in the city when it comes to obesity and diabetes, according to the city Health Department.

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Bronx food stamp recipients say no to ban on sugary drinks

Bronx food stamp recipients say no to ban on sugary drinks

At some Bronx grocery stores, drinks like Coca-Cola Classic, Fanta Orange, Nestea and Seagram’s Ginger Ale are cheaper than water. A recent weekly special at C-Town Supermarket in the Belmont neighborhood offered five 1.5-liter bottles of Coca-Cola for $5, while advertising the same-sized bottles of Poland Spring water for $7.45. The incentive to buy drinks that promote obesity and diabetes can be seen and heard loud and clear on the supermarket shelves in the Bronx.
Sugary drinks on sale at C-Town Supermarket in the Belmont neighborhood. Photo: Brent Ardaugh

Sugary drinks on sale at C-Town Supermarket in the Belmont neighborhood. Photo: Brent Ardaugh

Mayor Bloomberg and Gov. David Paterson want to discourage people -- that is, poor people -- from consuming too much sugar, by banning food stamp recipients from using their benefits to buy certain sugary drinks. Many Bronx residents believe this effort unfairly targets the poor, and worry about what's next on the mayor's hit list. “If you drink too much of anything it’s not a good thing,” said Irving Scott, a Bronx carpenter, who receives food stamps and believes he's responsible enough to moderate his own behavior. “Let people have the freedom to buy what they want.” Outside a Fine Fare Supermarket in Hunts Point, another construction worker said the proposal felt like discrimination. “I think we should be able to have the same benefits as everyone else,” said Richard Cruz, who also relies on food stamps. “We aren’t even able to get hot sandwiches right now; they have to be cold.” On Arthur Avenue, Virginia Martinez, who uses her food stamps to buy soda, found the proposal invasive. “Bloomberg is over-doing it,” she said. “This time it’s soda – what’s next?” Under the two-year plan, food stamp recipients would not be able use their electronic benefit transfer cards – the card recipients use to buy subsidized food – to buy drinks that contain more than the equivalent of one packet of table sugar in a 12-ounce serving. The only exceptions would be milk products, milk substitutes and fruit juices without any added sugar. “The [food stamp] program has always excluded certain categories of products without nutritional value – like cigarettes and alcohol – and we believe that a strong case can be made for adding sugary drinks to that list,” Bloomberg said. Many New York City residents are asking how far is too far, but particularly in the Bronx, where according to the U.S. Census, nearly one-quarter of Bronx residents received food stamps in 2007. If approved by the United States Department of Agriculture, food stamp recipients in New York City could not use their benefits to buy sugary drinks. Other items already excluded from the food stamp program, also called the Supplemental Nutrition Assistance Program, include tobacco, liquor, vitamins, medicine, pet food, paper products, hot food and household supplies. This proposal is not the first time elected officials have tried to block access to sugary drinks. In 2004, the Minnesota Department of Human Services asked the United States Department of Agriculture to ban sugary drinks and candy from food stamp purchases. The federal agency rejected the proposal, claiming it would cause customer stigma at supermarket cash registers and the belief that low-income people do not buy nutritious foods. According to the department of agriculture, research showed that food stamp recipients are wise shoppers and their nutrient intakes are similar to those of higher income consumers. In a related attempt earlier this year in New York, Gov. Paterson pushed for a penny-an-ounce tax on sugary drinks to help narrow the state’s $9.2 billion budget gap, but lawmakers eventually slashed the proposal from the revenue bill after the New Yorkers Against Unfair Taxes released series of unrelenting anti-tax ads. One of the ads featured a woman saying, “Tell Albany to trim their budget fat, and leave our grocery budgets alone.” Now Bloomberg and Paterson are preparing for round two – this time with a proposal that applies to only food stamp recipients in New York City. “There’s no denying that childhood obesity is an epidemic, and there’s no denying that it’s hurting our children in low-income communities the most,” said Bloomberg. “Eliminating these beverages from allowable food stamp purchases would give New York families millions of more dollars to spend on food and drinks that provide real nourishment to them and their children." Unlike the Minnesota plan, the current proposal focuses only on sugary drinks, not both candy and sugary drinks. But health officials say it is enough to put a dent in sugary drink sales, especially those coming from food stamp users. According to the New York City Department of Health and Mental Hygiene, $75 million to $135 million in nutrition assistance benefits were spent on sugary drinks in New York City last year. Many store owners and managers, some of whom are just starting to rebound from the recession, are concerned their sales will drop if the ban goes into effect. Wally Hassen, the manager at Day & Night Deli Grocery in Little Italy, said his store makes about $700 a week from sugary drinks, and most of his customers use food stamps. “It’s going to affect the small businesses,” Hassen said. “They [the government] are not fixing the economy like that.” Spokespeople for the department of health and mental hygiene would not comment on whether a plan is in place to reimburse small businesses for sales lost because of the ban. A statement issued by the American Beverage Association, the trade association representing companies that manufacture and distribute non-alcoholic drinks, criticized the proposal saying it is just another attempt by government to tell New Yorkers what they should eat and drink, and will only have an unfair impact on those who can least afford it. Carl Smith, a food stamp user who was recently shopping with his wife at a Key Food Supermarket on Westchester Avenue, said the ban would affect what drinks he buys. “I won’t be able to buy it [soda] because I have no money,” Smith said. “I think it’s stupid. We should be allowed to buy food.” Carl’s wife, Lori, said she buys four cases of soda a month, and Coca-Cola, Pepsi and Sprite are among her favorites. She, too, thinks the ban goes too far. “What’s next? Coffee?” she asked. Although the proposal has many Bronxites fired-up, it is part of a larger citywide effort to fight obesity and Type 2 diabetes, two conditions exacerbated by eating or drinking too much sugar. A 2007 neighborhood report from the Bronx District Public Health Office found that obesity is more common in the Bronx than in New York City overall. The long-term care required to treat these conditions puts stress on the health care system, causing local and national health expenditures to skyrocket. The New York State Department of Health estimates that treatment for obesity-related diseases – like Type 2 diabetes – costs the State more than $7.6 billion every year and the U.S. $150 billion. In 1998, Medicare and Medicaid financed approximately half of the costs of obesity-related diseases in the U.S., according to a study published in the Health Affairs journal by Eric Finkelstein and his colleagues. Obesity-related diseases affect more than just the patients; these diseases also affect current and future generations of taxpayers. “We feel strongly that the government should not be subsidizing or promoting a product that we know makes people sick, especially in the name of nutrition,” said Dr. Thomas Farley, the New York City Health Commissioner. Farley said the proposal targets drinks that are essentially nothing more than sugar water. A 12-ounce serving of water contains no sugar, but original lemon-lime Gatorade has the equivalent of about five packets of table sugar and Coca-Cola Classic has nearly 10. Under the ban, most drinks with more than one packet of sugar would be excluded from allowable food stamp purchases. Sugary drinks contain empty calories, which pump extra energy into a person’s diet without providing nourishment, just like a roommate who takes up space in an apartment but does not help with chores. Most sugary drinks run up calorie intake without giving the body a satisfied appetite in return, causing people to consume even more calories than they would by drinking water alone. These extra calories promote excess weight gain, a risk factor for Type 2 diabetes. Type 2 diabetes occurs when the body does not produce enough of the hormone insulin – the ticket sugar uses to gain admission into cells – or when the body ignores it. When sugar cannot move into cells, it backs up in the blood, sometimes with insulin, acting like a line of people waiting to get inside a movie theatre. Over time, high levels of blood sugar can damage the kidneys, eyes, heart and blood vessels. There is a clear, independent link between sugar consumption and risk of developing Type 2 diabetes, according to Dr. Frank Hu, a professor at Harvard Medical School, who studies the effect of diet on Type 2 diabetes. “The increase in consumption of sugar has paralleled with the epidemic of obesity and Type 2 diabetes in the U.S.,” Hu said. “Sugar-sweetened beverages have not been on the radar screen for most health professionals until recently. In the past, so much emphasis was put on fat, but now we recognize that sugary drinks are more deleterious.” Hu said the evidence against sugary drinks is now strong enough to start making public health recommendations. But is the best way for a city government to combat obesity and diabetes through restricting soda for the poor? Another solution to tax all soda drinkers crumbled earlier this year after Paterson’s penny-an-ounce tax faced opposition from the New Yorkers Against Unfair Taxes. Reducing the size of cans and bottles in vending machines is also an alternative, according to Dr. Robert Kushner, a professor at the Northwestern University Feinberg School of Medicine. “It makes intuitive sense that the key is to reduce access,” Kushner said. One of the challenges of reducing access, though, is identifying the many different sources of sugar available to consumers. According to Kushner, sugar is not like cigarette smoke, which comes from a single source. Other experts, and some food stamp users, argue that restricting access alone is not enough because it does not teach people how to adopt healthier behaviors. “There needs to be education to complement the SNAP program,” said Amy Lesh, the clinical nutrition manager at St. Barnabas Hospital. “Nothing is going to work without education.” Food stamp recipient, Richard Cruz, a 34-year resident of Hunts Point, said he understands what the mayor is trying to do, but he does not think Bloomberg is going about it the right way. “If he would have a class on things that make you fat, then may be people would relate to that better,” Cruz said. “I would attend one even though I’m not overweight – it’s for my health.” Bloomberg admitted in early October that banning soda from food stamp purchases is not a perfect solution, but after a failed tax proposal, he said it is another way of going about the problem. Dr. Peter Selwyn, a professor at the Albert Einstein College of Medicine of Yeshiva University, said political officials should speak with different stakeholders in the affected population before making policies. “This should inform the decision making,” said Selwyn. “I’m not aware this was part of the process or not.” The proposal is currently in Washington, D.C., where it is undergoing thoughtful and careful review, according to Hans Billger, a public affairs specialist at the United States Department of Agriculture. Some Bronxites said even if the federal agency does approve the proposal, they are not convinced it will actually stop people from buying sugary drinks. “If they don’t buy it with food stamps, they’re going to buy it with cash,” said Ivette Lee, a food stamp user who buys ginger ale at C-Town. “Are they going to stop making cash, too?”

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Center Receives $200,000 to Fight Obesity and Hunger

When she received the call yesterday afternoon, Aida Martinez couldn’t believe her own ears. State Senator Pedro Espada Jr. was calling the Davidson Community Center chairwoman in person, to announce that a $200,000 grant would be delivered this week to improve nutrition conditions in the Bronx. Excellent news for a borough that was recently ranked as the least healthy county in the state.

Espada speech

Senator Pedro Espada Jr., made a speech on the necessity to change nutrition habits in the borough. (Photo by: Yasmine Guerda)

“We pay now with money, or we pay later with diabetes, obesity, cholesterol and cardiovascular diseases,” the senator said in front of a crowd of 50 people from the neighborhood.

As the founder of the Soundview Health Network, Senator Espada says he has been aware of the health problems in the Bronx for several years. “We know the challenge," he said. "The Bronx is the obesity capital of America, the asthma capital of America, and many other titles that we don’t want anymore.”

The Davidson Community Center had been applying for a grant for five years. “We haven’t worked out all the specifics yet, but what we know so far is that we are going to use the money to buy a van so we can distribute food in various places, like senior residences, health centers and schools,” said Angel Caballero, executive director of the community center.

The money will be used to distribute free fruits and vegetables to residents in need but, more importantly, to organize healthy nutrition workshops. “We want to show people that they can keep eating what they eat but that with slightly different methods of cooking, it can be better for their health,” Martinez said. The workshops will be organized weekly, in Spanish and in English, and will include ethnic recipes, “so nobody is excluded,” she said.

Feat_Espada

The money will be used by the community center to distribute free food and to teach Bronx residents how to eat healthily. (Photo by: Yasmine Guerda)

According to a survey released at the beginning of this month, the 16th Congressional District in the Bronx , encompassing several South Bronx neighborhoods, has the highest hunger rate of the United State.  In the survey, 36 percent of the residents  said they did not have enough money to buy food in the last year.

“The situation has been getting worse and worse lately,” Martinez said. She explained that the group used to be able to put together three food distributions per week; but last year, because of the recession, it barely made it once a week. “Last week, we received two bags of potatoes, two bags of onions and a box of apples. What can we do with that?” she said. This scarcity  made residents lose faith in the community center, she said.

While in previous years the center was able to serve more than 300 families a week, fewer than 50 families a week received free food in the last couple of months. “And it’s really hard, you know, to have people come ask for food and not be able to give them any,” Martinez said.

She claimed that the $200,000 could potentially benefit close to 10,000 people in one year, depending on their needs. "We are confident that this initiative is also going to encourage business owners  to give us more food as well and participate in this effort to create a healthier Bronx,” said Angel Caballero, of the community center. “It’s about creating a positive dynamic in the neighborhood, and this money is going to help us do that. We gotta stick together!”

Posted in Bronx Neighborhoods, FoodComments (2)

What Does It Take to Go from Fat to Fit?

by Sarah Wali
Mohamed Islam manages one of the 175 new Green Carts in the Bronx in East Tremont.

Mohamed Islam manages one of the 175 new Green Carts in the Bronx in East Tremont.

The Bronx has seen its share of problems.  It was burning in the 1970s and stricken with a drug epidemic in the 1980s.  As the crime rates went down throughout the 1990s, a new statistic made headlines: the Bronx was getting fatter. According to the New York City Community Health Survey,  obesity rates had more than doubled by the end of the 1990s to 24 percent.  By the time Mayor Michael Bloomberg took office in 2002, it was the fattest borough in New York City, and by 2003, almost 62 percent of the Bronx was either obese or overweight. In response to this health crisis, Mayor Bloomberg introduced a number of initiatives, including a law that requires all restaurants with 15 or more locations in New York City to display calorie counts on their menus, and 1,000 new licenses to Green Cart vendors, small carts selling fresh fruits and vegetables in areas with the least access to healthy food. “It is the job of the government, if something is detrimental to your health to a, warn you and b, if it’s serious, try to prevent it,” he said at the Oct. 13 mayoral debate. Mayor Bloomberg’s use of calorie count to warn diners that McDonald’s, KFC and other fast-food restaurants were unhealthy did little to deter shoppers from their cravings.  According to an Oct. 6 web article in Health Affairs, Bronx residents may have been shocked to find that a muffin at Dunkin’ Donuts they once thought was a healthy alternative for a 220-calorie glazed donut was actually 630 calories, but that doesn’t necessarily mean they will buy lower calorie food.  Rather, researchers from New York University found that customers were, on average, buying 846 calories per meal, up from 825 before the implementation of the program. Clearly, the Bronx is not slimming down. Karen Washington, a long-time health activist in the South Bronx, says that the main issue in the Bronx today is food  and obesity. “The overall concern throughout the Bronx is health and nutrition,” she said.   “Lack of quality food need(s) to be addressed.” Washington, who sits on the board for Just Food, an initiative to bring healthy community grown food the Bronx, has started the East Tremont Farmer’s market and is currently working on establishing a farmer’s school to help people learn how to grow their own food. She says she and her neighbors are limited by the fatty choices offered in their area.   Plus, with the financial crisis hitting the Bronx especially hard, residents are forced to consider expenses. “When you don’t have money and you can’t provide for your family you are going to buy the cheapest food items,” she said.  “You need to feed your family." Bloomberg has tried to create an opportunity for Bronx residents to make healthier decisions.  In 2007, his administration began pushing legislation to license 1,500 fresh fruit and vegetable vendors in the fattest boroughs, including the Bronx. The Bronx is now home to 175 of the 1,000 Green Carts in the city.  It's a promising idea, but it has only been in effect since this July.   The true impact of the Green Carts has yet to be seen. The little carts covered by yellow and green umbrellas imprinted with the logo "NYC Green Carts" carry an array of fruits and vegetables.    From apples and oranges to okra and peppers, the carts are supposed to offer a healthy alternative for residents, and open doors for employment. Mohamed Islam, who runs the Green Cart in front of Bronx-Lebanon Hospital, makes the hour-and-a-half trip every morning from his home in Queens because he loves produce, and believes in the Green Cart program. Islam, 44, arrived in the United States almost a year ago.  He waited years for an opportunity to leave his home in Bangladesh.  Finally, in October, 2008, his brother’s sponsorship was accepted, and he and his wife boarded the plane excited about the chance for a better life. Now, he makes the long trek from Queens to the Bronx hoping he will one day be able to own his own Green Cart.   Although he struggles to find the words in English that describe his passion for food and produce, his smile radiates with emotion and his eyes light up as he explains that fresh produce is often overlooked by many in this country.  His is an expert opinion. In Bangladesh, he was a government employee who focused on teaching and promoting the importance of agriculture. He feels that the Green Cart program is a great way to promote healthy produce decisions in the Bronx.  As he waits for approval from the city for his own license, he manages the Bronx cart and for $80 per day, sells $250 to $300 worth of fruits and vegetables per day at the corner of Mt. Eden Avenue and Grand Concourse. But for activists like Karen Washington, the waiting game is over.   Washington and the Northwest Bronx Community Coalition have started a program to teach youth the importance of urban gardening, and have just launched a new farmer’s market in the East Tremont area.   She says these initiatives are designed to put the power of change back in the community’s hands. “I felt really lucky that we started a farmer’s market,” she said,  “which not only produces locally grown produce, but we teach people in the neighborhood, not only how to grow it but how to use it and how to cook it, which is very, very important.  “

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