If you want to know why Americans and Minnesotans are struggling so much with weight and the problems that come with it, consider what kids today know about food.
"What we're seeing is that children have really lost a connection to food, dietitian Mary Story said. "A lot of food now is so heavily processed, that many kids have never seen a cabbage."
Today's food landscape is dramatically different than just 50 years ago. Processed foods loaded with salt, sugar and fat are everywhere. And they're cheap. In contrast, much healthier fruits and vegetables are more expensive and not easily found in many low-income neighborhoods.
But there's more to the problem than just access to nutritious foods. Some health experts believe many Americans have become food illiterate - meaning they don't possess the knowledge or skills needed to make healthy food choices.
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Story couldn't help but notice that lack of knowledge at a dinner with some friends and their son.
"I pulled a baked potato directly from the oven, put it on his plate and he kind of shrieked and said, 'What's that?' " she said. "He was a 9-year-old and had never seen a baked potato. And I said, 'Now, do you know what French fries are?' Which he did, but he had no idea what a potato was."
That could be a sign that mom and dad don't cook much. They may even be food illiterate themselves.
But if children never see a baked potato or don't know what a cabbage is, they're far less likely to eat those foods or like them when they are offered to them, said Story, co-director of the Obesity Prevention Center at the University of Minnesota.
For severely overweight children, learning about foods and how to make healthy choices can't begin too soon. That's where dietitians like Christine Melko step in.
On a recent night, she gave a group of 7- to 12-year-olds about 90 seconds to choose something from the produce section of a Byerly's store in St. Louis Park. The children are at Park Nicollet clinic's weight management program because a doctor has diagnosed them as obese.
"I want you to just look around, and tell us one fruit and one vegetable that you've never tried that you'd like to maybe give a shot trying," Melko said.
When Katelyn Barthel, 10, of Andover, points to a heap of red tomatoes, her mother Sue is surprised.
Sue Barthel has tried getting her daughter to eat tomatoes, but couldn't convince Katelyn that she would like them.
"She eats salsa. I keep telling her, 'You eat salsa. Why don't you eat tomatoes?'" Barthel said. "She won't eat them singly. She thinks they're different."
But Katelyn is feeling brave now. Perhaps it's the excitement of participating in the challenge with other kids. Nearly everyone in the group found a fruit and a vegetable they're willing to try. Whatever the reason, Melko hopes the exercise will add a new healthy food option to their menus that wasn't there before.
If children learn to like even a few healthier foods while ditching some of the bad things they eat, they can profoundly affect their weight over time.
"A hundred calories a day over the entire year makes an enormous difference," said Ben Senauer, an economist at the University of Minnesota's Food Industry Center.
Senauer says on average, Americans eat at least 100 calories more per day than people in Japan, who have a very low rate of obesity.
He finds it interesting that even with substantially higher food costs, the Japanese make very different food choices. On average, Japanese consumers spend 37 percent of their food budget on fruits, vegetables and fish. U.S. Consumers spend only 15 percent on these healthier foods.
"We actually have the cheapest food in the world, as measured by the share of the average household's budget spent on food. It's less than 10 percent for food at home in the United States," said Senauer.
Inexpensive food is not necessarily a bad thing. It makes it easier for people with very low incomes to feed their families. But Senauer says cheap food is often low in nutrients and high in calories, and that can take an enormous toll on a person's health over time.
That's another reason it makes sense to teach families about food. In a classroom next door to a Minneapolis Head Start program, Chef Seth Bixby Daugherty decides on a vegetable pizza recipe, holds up a pepper and asks his students to gather around his table.
Daugherty shares simple tips that will make it easier and faster for mothers to make home-cooked meals. He knows that if a recipe takes too long, his students aren't likely to make it again.
"When I'm cutting a pepper, it's easier to cut through it when you cut through the flesh side of it rather than the shiny side," he said.
Three years ago, Daugherty gave up his job as a chef at Cosmos restaurant in Minneapolis to create Real-Food Initiatives. Today, most of his customers are schools. He helps them figure out ways to minimize the processed foods they serve and add more locally grown products to their menus. He also teaches cooking classes to low-income families.
"What we're really teaching them to do is cook with real foods," Daugherty said. "What's healthy for them, what's healthy for their kids."
Fardowsa Warsame came to the class because she has a daughter in the Head Start program.
"She keep telling me, 'Mom, come here and learn how to cook,'" Warsame said. "'Everybody's coming.'"
Warsame arrived in the United States from Somalia in the early 1990s. She says her two children love American-style food. But she doesn't know how to make it.
"Never make a pizza. Usually I order," she said. "Easy to order, so, not make it."
Those pre-made pizzas are probably filled with everything that's wrong with the average American diet -- too much saturated fat, sugar and salt. But Warsame has never really looked at the ingredients.
While the healthy vegetable pizzas cook in the ovens, dietitian Chris Diebele from the University of Minnesota Extension Service helps the students read a food label.
"So when you're looking at your label, you want these numbers for total fat, saturated fat, salt and sugar to be low -- 5 or less," she said.
Still, food labels have been around for years and there's not much evidence that they've had an effect on the nation's obesity epidemic.
Nutritionists say better labels are needed. Some have even proposed adding a front-of-the-pack symbol or rating system to foods, that would make it easier to identify healthy food choices.
"Doesn't it make you wonder what's wrong with our food supply when you have to search that hard to find what's healthy, and that you even have to have a symbol on food to indicate that it's healthy?" Story said. "That's really a sign that things are not good."
Story thinks better labeling will help. But she said food companies also need to reformulate their products.
Last fall, General Mills announced it would reduce sugar in its 10 sweetest cereals to 9 grams or less per serving. Story says 9 grams is still too much sugar per serving.
Recently, Pepsi said it will remove sweetened drinks from schools in more than 200 countries within two years. It's the first major soft drink producer to take that action.
Story says those are positive steps. But if we don't take it even further, she says kids are going to pay for it with shorter lives.
"We're raising a generation of children that -- unless things change, may be the first generation of children to lead sicker lives and die earlier than the previous generation," she said.
Despite the enormity of the challenge, the United States may have reached a tipping point in the fight against obesity. Dietitians and others say the rising cost of health care, attributable in large part to obesity-related diseases, is forcing the nation to address the problem.
Minnesota Idea Open
Minnesota Public Radio News reported this story as part of a project being directed by the Minnesota Community Foundation. Along with other partners, the foundation has launched a contest -- the Minnesota Idea Open -- that asks Minnesotans to offer ideas to help combat obesity in their communities. Implementation of the winning idea is funded with a cash award. April 9 is the last day to submit ideas. For more information visit: www.mnideaopen.org