Baltimore Healthy Eating Zones


Joel Gittelsohn, Principal Investigator,
Ahyoung Shin, former project coordinator,

Intervention Materials


Baltimore Healthy Eating Zones (BHEZ) was a multi-level, youth-targeted obesity intervention program among African American adolescents held in recreation centers and corner stores in the Baltimore City. The project was funded by the Robert Wood Johnson Foundation and Urban Health Institute in Johns Hopkins University.

Project Goal

  • Promote healthy foods and healthy eating habits in seven recreation centers and 21 surrounding corner stores in the Baltimore City using interactive sessions (cooking demonstration and taste tests), point-of-purchase promotion materials (shelf labels, posters, etc), and peer education.
  • Increase healthy food availability and affordability in corner stores using the intervention strategies above and monetary incentives.
  • Evaluate the impact of the intervention using dietary and behavioral surveys.

Project features

  • Multi-level obesity intervention targeting youth, caregivers, and policy-makers
  • 8-month intervention (Oct. 2009 – May 2010) divided by five phases; Healthy Beverages, Healthy Breakfast, Cooking at Home/ Healthy Lunch / Healthy Snacks / Carry-out
  • Point-of-purchase materials in recreation centers and corner stores; shelf label, poster, flyer, giveaway, buttons.
  • Interactive sessions in recreation centers and corner stores; cooking demonstration, taste test
  • Education component; education of recreation center staffs, store owners, and youth study participants by peer educators and interventionists
  • Connection to policy makers; cooperation with the Baltimore City Health Department

Intervention Approaches

Project phases



Name of the phase

Promoted Behavior

Promoted foods



Increasing awareness of BHEZ program in local stores


Healthy beverage

Choose healthier and low calorie drinks- water or diet sodas over regular sodas

Diet sodas, 100% fruit juice, water, low-calorie drink mix (Crystal Light, Wyler’s Light)


Healthy breakfast

· Consume low-sugar, high-fiber cereals and low-fat milk.· Try fruit in cereal

Low-sugar cereals: Cheerios, Wheat Chex, etc.

High-Fiber Cereals: Wheaties, Raisin Bran, etc.

Milk: 1% And Skim Milk


Cooking at home/ Healthy Lunch

· Use cooking spray when making eggs, pancakes and vegetables· Drain-and-rinse excess fat from ground beef· Buy healthier foods· Add vegetables into cooked meals· Pack a healthy lunch

Cooking sprays, fresh/canned/frozen vegetables, fresh/canned (in light syrup/juice) fruit, 100% Whole wheat bread


Healthy snacks

· Eat fruits or vegetables for snacks· Try new ways to eat fruits and vegetables· Choose baked instead of fried snacks


Fresh fruits: Apple, bananas, tangerines, strawberries, raisins

Vegetables: celery, carrots

Low fat snacks: baked chips, pretzels, Sun Chips, yogurt, granola bars

Low sugar snacks: trail mix, nuts, seeds




· Choose lower-fat carry-out meals· Request less mayonnaise on foods· Choose whole wheat bread over  white bread· Choose healthier sides

Whole wheat bread, low fat and fat free mayonnaise, ketchup, mustard,

healthy sides: fruits, vegetables


Surkan PJ, Coutinho AJ, Christiansen K, Dennisuk LA, Suratkar S, Mead E, Sharma S, Gittelsohn J. (2010) “Healthy food purchasing among African American youth, associations with child gender, adult caregiver characteristics and the home food environment,” Public Health Nutrition, Oct 5:1-8. [Epub ahead of print].

Gittelsohn J, Dennisuk LA, Christiansen K, Bhimani R, Johnson A, Alexander E, Lee M, Lee SH, Rowan M, and Coutinho A. “Development and implementation of Baltimore Healthy Eating Zones: A youth-centered intervention trial to improve the food environment around recreation centers in Baltimore City” (Manuscript submitted to Public Health Nutrition, February 2011).

Coutinho AJ, Suratkar S, Dennisuk LA, Surkan PJ, Sharma S, Gittelsohn J. “Associations of youth and caregiver psychosocial factors and the home food environment with youth high-fat, high-sugar food-purchasing in low-income African American households” (Manuscript submitted to Health Education & Behavior, February 2010).

Dennisuk LA, Coutinho AJ, Suratkar S, Surkan P, Christiansen K, Riley M, Anliker JA, Sharma S, Gittelsohn J. (2011) ” Food expenditures and food purchasing among low-income urban African-American youth.” Am J Prev Med, 40(6): 625-628.

Kramer RF, Coutinho AJ, Vaeth E, Christiansen K, Suratkar S, Gittelsohn J. “Healthier home food preparation methods and youth and caregiver psychosocial factors are associated with lower BMI in African American youth,” Journal of Nutrition, (in press).

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