War against obesity in kids starts earlier
Published: Wednesday, January 7, 2004 at 6:01 a.m.
Last Modified: Tuesday, January 6, 2004 at 9:56 p.m.
NEW YORK - In a cheery elementary school classroom with red window panes and crayon drawings tacked on the walls, a class of 3-year-olds are doing their "yoga," transforming themselves into lions and butterflies.
"Let's be froggies!" instructor Anne Jeffries says, spurring the children to happily hop up and down from a squatting position. They're having fun, but they're also tackling a serious problem that is drawing the attention of doctors, educators and the federal Centers for Disease Control and Prevention.
The JumpStart program, a pilot program that teaches nutrition as part of the Head Start curriculum at P.S. 5 in Manhattan's Washington Heights neighborhood, is the youngest nutrition program in the nation. JumpStart organizers believe early education could be the key to fighting a trend that has seen the number of overweight and obese children double in the past 20 years.
"If it were up to me, I'd be in the doula program with prenatal education,'' says Dr. Paula Elbirt, medical director of The Children's Aid Society, the sponsor of the JumpStart initiative. None of the children in the class are obese, and JumpStart officials hope to keep them that way. "We're trying to intervene as a prevention, not as a cure. So we're not looking to make them thinner."
According to the American Academy of Pediatrics, the number of overweight and obese children has doubled in the past two decades, with 15.3 percent of 6- to 11-year-olds and 15.5 percent of 12- to 19-year-olds defined as obese, according to their body mass index. The BMI measures weight compared to height, and a BMI of 30 or higher - at or above the 95th percentile, usually 30 or 40 pounds overweight - is considered obese.
"We're really caught up in a cycle: Eat sweets, eat fat, feel better," Elbirt says. "We have to remember that they're not just eating too much fat and getting too fat. They're not getting enough nutrition and getting unhealthful food."
The Children's Aid Society hopes to convince Head Start to add it to its curriculum nationally. In addition to weekly classes for the children, the program offers cooking and nutrition classes at the same time for parents, whose perception of serving sizes in many cases has been warped by super-size restaurant portions, Elbirt says.
In 25 years as a pediatrician, Elbirt says the most startling change has been the rise in type 2 diabetes.
"When I was starting, type 2 diabetes was unheard of in children. It was called adult-onset diabetes. Even 10 years ago, I'd never heard of it," Elbirt says. "It's a new phenomenon, based on our intake of the wrong foods."
Children with type 2 diabetes present a looming health crisis, says Janet Collins, acting director of the CDC division of adolescent and school health.
"Of all babies born in 2000, it's estimated that one out of three will have diabetes in their lifetime," Collins says. "We don't even know what the life course is going to be for a 10-year-old with diabetes. We've seen it in 40-year-olds but not 10-year-olds before so we don't know what it'll be like for them by the time they're 40."
Last year the CDC launched its biggest public awareness campaign since the antidrug campaign of the 1980s to encourage exercise and a healthy lifestyle. The program, called VERB, is aimed at "tweens" age 9 to 13 and urges children to "pick a verb" - such as running, jumping or skateboarding - and do it regularly. The hope is that children who become active will maintain an active lifestyle into adulthood.
"If we can sell McDonald's using marketing and media strategies, we can sell good health the same way," Collins says.
The VERB program started in 2003 with an ad campaign in magazines, newspapers and on television that featured teen hip-hop artist Bow Wow and NBA star Tracy McGrady. VERB's push in phase two is to get the children to track their behavior.
"One thing that has to be addressed is the screen time," Collins says, referring to time spent playing video games, watching television or working on a computer. "Some average four and a half hours a day. For adults, our message is to turn off screen time."
Both Collins and Elbirt cite the dwindling number of physical education classes in schools as a major obstacle in improving children's health. Illinois is the only state that requires schools to have physical education programs, and the CDC reports that just 25 percent of eighth-graders are required to take physical education.
"Some of these kids are not moving at all, some are sitting eight hours a day," says Marilyn Tanner, a pediatric dietician for St. Louis Children's Hospital in St. Louis.
Tanner teaches the Head to Toe program at the hospital, a 10-week nutritional program created six years ago to help treat children with type 2 diabetes, hypertension and other health problems. Tanner and a pediatric physical therapist conduct the classes, which include nutrition, education and fitness components.
Some changes are easy to make - like kicking the soda and juice habit and knocking off as much as 1,000 calories a day - but Tanner says increasing activity is the most difficult lifestyle change for her students. Many parents are afraid to allow their children to play outside because they don't know their neighbors, and with both parents working there's no one to supervise them, Tanner says.
"Another thing is, a lot of new subdivisions don't have sidewalks, and it's not safe to ride their bikes. And you have to cross a major intersection to get to a park where they can play," Tanner says. "Do you think kids can walk across an intersection like that? It's lucky to make a left turn if there's not an arrow."
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