What is Our Role as ATCs in Curbing Diabetes?

I recently watched a podcast that CNN had put on their website - America's Problems with Diabetes.  I have place the link here -
http://www.cnn.com/video/#/video/podcasts/gupta/site/2011/04/11/sgmd.diabetes.epidemic.cnn?iref=allsearch

Some of the startling information that Dr. Gupta provides is as follows:

1. Americans are more sedentary 
2. Americans have poor dietary habits
3. Americans are lacking in regular exercise
4.  By 2020 (tens years from now), one-half of Americans will either be diagnosed with diabetes, or will be considered pre-diabetic
5.  Some consider diabetes to be an epidemic in the 21st Century

Diabetes has been considered a 'twin epidemic' closely tied to obesity.  Where we see one, we more than likely will see the other. Sadly, we are now seeing Type II Diabetes, a traditional adult disease, being diagnosed more and more in our pediatric population.

The questions then arises, hmmm . . . . what can we do as athletic trainers?  What should we do as athletic trainers?  Do we have the content knowledge to be able to assist with this potential epidemic?  It is my belief that we have an obligation to step forward and share the knowledge we have as health care providers to our populations in which we provide health care.  There are several avenues in which we can assist in bringing change to our respective work environments.

Get involved in the culture of your workplace.  Find out who the stakeholders, policy makers and decision makers are.  "Bend" their ear with regard to what data is demonstrating is happening and what the suggested outcomes will be if we do not address the issues of poor food choices on an individuals' part; lack of healthy selection of food choices on the part of the school, college, workplace; sedentary lifestyles; limited access to recess and physical education for children; limited accountability on university's part for addition of activity courses as 'core' curriculum; and  limited access to be able to exercise.  These, of course, are only a few barriers that must need to be addressed.  Others we need to consider include: an individual's value of exercise; one's access to healthy and economical foods; access to exercise - either a safe place and/or time availability; childcare or adult care (family issues); cultural issues revolving around food, exercise, health and medical care.

As athletic trainers we are formally educated on nutrition.  Being educated, and being healthy, however can be two dichotomous variables.   Just because we have knowledge, does not necessarily mean we know how to create behavior change in individuals.  Therefore, I believe it is also imperative that as athletic training professionals we also have an understanding of theories of human behavior.  We need to have a working knowledge of theories like the Transtheoretical Model, the Precede/Proceed Model and the Social Belief Model to name a few.  Once we are 'armed' with this information, we can begin to utilize it to assist others in creating healthy changes in their lives.

I realize that diabetes and obesity are out of control in numbers.  Much more needs to be completed on a community, regional and national level to aid in curbing these numbers.  People need better access to safe environments in which they can bike, walk, rollerblade, exercise.  City and Town Boards need to do better at legislating for federal dollars in order to make exercise and lifetime wellness a priority for their constituents.  Food companies need to be held accountable to place on their food labels all appropriate information to better educate consumers. School districts need to push to have better food choices available, recess AND physical education for all.  Universities must consider the addition of physical education and/or lifetime wellness classes to their 'core'.

This is an uphill battle and one that is most certainly going to be a difficult one as our culture does not seem to value lifetime wellness -- if we did, I believe we would see more pro-active types of programming available.  That being said, I do believe that as athletic trainers we can begin to make change, even if small, within our respective communities.