GREENSBORO, N.C. - Almost 30 percent of adults in North Carolina are considered obese, and a report released by survey company WalletHub names four metro areas, Greensboro, Charlotte, Winston-Salem and Asheville, among its top 50 Fattest Cities in America.

The survey analyzed the percentage of people who are inactive, amounts of fruits and vegetables consumed and, of course, weight.

Registered dietitian Pam Kelle says while traditional southern foods may be partly to blame for the obesity rate of southern states, there are other socioeconomic factors.

"I think that habitual eating in the southern eating style is true, but if you tease it apart," she says. "I think you'll find a lot of those numbers fall into the poverty perspective, more than just a food preference perspective."

"parent">The Support Center of North Carolina says there are 349 "food deserts" in the state - areas in 80 counties that lack convenient access to healthy, affordable foods.

And the most recent State of Obesity report from the Robert Wood Johnson Foundation says North Carolina has more than 540,000 heart-disease cases and 142,000 obesity-related cancers.

No matter where a person lives, Kelle says healthier choices start with small steps.

"Try to talk within the family unit about making small changes overall, and it might be meal by meal," she says. "It might be, 'Let's have dinner at home three times a week.' But I think looking at your own plate and your habits, and thinking about hunger and fullness, little bitty changes can make a big difference."

Other diet changes to try include selecting lean meats, replacing fat-laden dips and sauces with choices like hummus, guacamole and yogurt, and increasing the number of "whole foods" consumed daily.



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California's program helping low-income families buy fresh fruit and vegetables is on the chopping block and health care advocates are asking legislators to save the Market Match program.

Gov. Gavin Newsom has proposed cutting most of the program's $35 million budget to help close the state's budget shortfall.

Sophia Vaccaro, a participant in Market Match from Echo Park, said she depends on Market Match in more ways than one.

"It helps people being able to stretch their budget further," Vaccaro explained. "Then, I think it helps the community, in that it creates a sense of camaraderie at the farmers' market and makes people more invested in the community itself."

The program matches every dollar CalFresh customers spend on fresh fruits and vegetables at a farmer's market up to between $10 and $20 per day. It is active at 294 sites across the state and is partially paid for through federal matching funds.

Dr. John Maa, surgeon at Marin Health Medical Center and board member of the San Francisco Bay Area chapter of the American Heart Association, said Market Match promotes healthy eating and boosts the local farm economy.

"An improved diet really will have long-term meaningful impacts on health, and also reduce health care costs," Maa explained. "It really helps to sustain the growers and the merchants. I guess it's a win-win-win."

Siu Han Cheung, outreach coordinator for the Tenderloin Neighborhood Development Corporation and board member of the Heart of the City Farmers' Market, argued the program is vital to residents across the state.

"If the Market Match will be cut, that is terrible," Cheung stressed. "That means they have less money to buy their food. So, Market Match is very important for the low-income families and the seniors."

Legislators and the governor are working toward the May budget revisions, and must pass a balanced budget by June 15.

South Dakotans face high prices at the grocery store and some are working to ease the burden.

A new report from the Federal Trade Commission finds some grocery retailers used the supply-chain disruptions of the pandemic to raise prices and collect bigger profits, even after supply chains regulated.

One South Dakota group is trying to reduce sticker shock by targeting the state sales tax on groceries. Dakotans for Health is sponsoring a citizens ballot initiative to repeal the 4.2 % tax.

Rick Weiland, co-founder of the group, said lower food bills would make a meaningful difference for some.

"People of modest means, or low income hardworking families, disproportionately spend upwards of 30% on food," Weiland pointed out. "This is going to be helpful."

South Dakota is one of only two states in the country to apply its full state sales tax rate to groceries with no exemptions, Mississippi being the other. More than 9% of South Dakotans are considered food insecure, meaning they do not always have access to enough healthy food.

The grocery tax has been a popular topic among state legislators in recent years. Republican Gov. Kristi Noem even campaigned on the promise to repeal it. Critics have said proposing a tax cut without a way to finance it is irresponsible.

Weiland pointed out Gov. Noem had a formula spelled out when she brought forward her bill in 2023, which was voted down.

"She had no problem defending her position in front of the Legislature, in terms of how much revenue the state was going to lose and where they could make it up," Weiland recounted.

The initiative needs about 17,500 signatures by next month to appear on the November ballot.

Colorado families must sign up before the end of April to receive $120 per child to buy food through the new Summer EBT program approved by Congress. Families with incomes that qualify for free and reduced-price school lunches - up to around $49,000 a year for a family of three - must enroll through their school.

Anya Rose, public policy director with Hunger Free Colorado, said as school cafeterias close their doors for summer, EBT cards can help kids get the nutrition they need to return to school in the fall ready to learn.

"A lot of families will be automatically enrolled, if they are enrolled in programs like TANF, SNAP, Medicaid. If you are unsure, then talk to your school about filling out the household income form to make sure you can qualify this year if you're income eligible," she said.

EBT grocery cards can be used to buy fruits and vegetables, milk, cheese, eggs, breads, meat, fish and other food at all grocery stores that accept SNAP, the Supplemental Nutrition Assistance Program formerly known as food stamps.

Rose noted grocery cards will be sent by mail, so it's important to make sure schools have your correct address.

Some 337,000 Colorado children are eligible for the program that is expected to generate up to $72 million in economic activity across the state. Grocery cards are available to all income-qualifying households regardless of their immigration status.

"There are no immigration eligibility requirements. And accessing Summer EBT and school meals do not impact immigration status in any way," she explained.

Filling out your school's household income application, sometimes called a school meal or benefit form, will also bring critical federal dollars into Colorado's Healthy School Meals for All initiative. It's currently running $24 million over budget. Rose adds there are other benefits for families who participate in Summer EBT.

"That same form can also qualify students to get discounts on school-related fees for things like SAT or ACT testing, or athletics or band or field trips or other activities," she said.