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Are Our Kids Beating the Battle of the Bulge in Kentuckiana?
The bad news, according to a recent story from the Associated Press, is “the federal government will spend more than $1 billion this year on nutrition education,” but after they reviewed “dozens of scientific studies these programs almost never change the way kids eat.” So based on that piece of information – education may not be working. You can''t go a day without seeing or hearing a story about the fact that childhood obesity is on the rise. In fact, many agree that parental influence, not schools, are the greatest influence on our kids. If a child is overweight and the family makes weight loss a priority, the child is more successful in losing weight.
The AP reported a recent review of an eight-year program in the Los Angeles Unified School District showed that the children didn''t change what they ate as a result of the extensive nutrition education program but they “had a more positive attitude toward fruits and vegetables,” according to Dr. Mike Phelip, the UCLA researcher who headed up the evaluation.
According to the AP report, the USDA spent $696 million this year on childhood nutrition education in this country but doctors like Tom Robinson, director of the Center for Healthy Weight at Lucille Packard Children''s Hospital at Stamford University, feel that the money would be better spent on behavior programs rather than education. Behavior programs offer participants with interventions that include regular check-ups, family involvement, and scheduled exercise and nutrition education. The key is family involvement and scheduled exercise.
Forward Thinking Gets You Nowhere
When I first moved back to my hometown in 1989, I enlisted the help of exercise physiologist Judi Christopher to present a weight management program for kids in our community. It was apparent at that time that obesity was on the rise in our children and needed to be addressed. Judi and I decided to use the very successful weight management program from San Francisco called SHAPEDOWN® ( www.shapedown.com ) . I ordered all the educational manuals, promotional flyers, etc., which amounted to about $3,000 out of my own pocket. At the time, Humana Audubon Hospital agreed to lend us a room in the hospital to conduct the weekly nutrition education classes and fitness classes. The hospital at that time had a pediatric floor.
Pediatric obesity research has shown that family-based treatment is effective even at the 10-year follow-up. Research has indicated that treatments that don''t target the family have no long-term significant effects. The SHAPEDOWN program is family-based and targets weight, nutrition and activity in both child and parents. There are four program levels: Level 1 (6 to 8 years), Level 2 (9 or 10 years), Level 3 (11 or 12 years) and Level 4 (13 to 18 years). Each level is sensitive to the physical. emotional, cognitive and social needs of that age group. The SHAPEDOWN program incorporates into obesity treatment a broad range of family therapy and psychoeducational techniques to address underlying psychosocial correlates of the child or adolescent''s weight. Included are problem solving, assertive and emotionally expressive communication and parenting skills including limit-setting and nurturing techniques. In addition, cognitive therapy, stress management techniques and body image therapies are used. Together these techniques supplied children the necessary tools they needed to stop their excessive appetites for food and inactive pursuits.
Unfortunately, we only had a handful of participants. We could not get any health professionals, particularly the pediatricians, on board for referrals. After the poor response from the community at large, we decided to scrap the program.
So Fast Forward to 2007. Focusing on Behavior is the New Strategy
So, who is dealing with the childhood obesity challenge in Louisville today? Our community is doing a pitiful job at offering these types of programs. The Heuser Clinic ( www.heuserclinc.com ) and Fit Kids ( www.fitkidsbycatt.com ) are the only two programs that I am aware of that offer weight management classes for kids and their families . Fit Kids offers FREE educational classes for children and their parents. While these programs are both excellent, we have a lot of obese and overweight children in our community. Unfortunately, Kosair Children''s Hospital, the only children''s hospital in our area, does not offer any type of behavioral weight management programs. Unfortunately, these programs are not huge moneymakers.
Apparently, the Robert Wood Foundation ( www.rwjf.org ), a major funding foundation that is committed to improving the health and healthcare to all Americans, is focusing on behavioral programs, not just education, that can facilitate a real change in childhood obesity. The foundation provides funds even to our community for programming for health initiatives. The Foundation is committing $500 million over the next five years to fund programs that actually bring supermarkets into poor neighborhoods so healthy foods are more accessible (in Pennsylvania) and other behavioral programs.
Are Parents Facilitating Weight Gain in Their Children?
Parents are the gatekeepers of what food comes into the house, the portion sizes of the food served at home and how often the family eats out. In addition, they control the TV, the Internet and video game usage and also the amount of time the child is active or inactive. Latch key kids are more prone to be inactive and eat more food when they are left alone to fend for themselves. Armed with video games, the TV and Internet, plus total access to the food in the refrigerator and the cupboard, these children tend to become overweight and sedentary.
Breaking the Childhood Obesity Cycle
The Mayor''s Healthy Hometown Movement is working hard to engage families to get more active by developing activities that are fun, like the Mayor''s Hike and Bikes. When our mayor and his family practice what they preach (see the July-August issue of Kentuckiana Healthy Woman Magazine which features Madeline and Jerry Abramson''s approach to health), it''s refreshing and provides our community with great role models.
Programs like Girls on the Run, the Fit 4 Me Program offered through Women4Women, Get Healthy.KY.Gov and an assortment of programs, offered at schools like TEAM Assumption and TEAM Mercy, are trying to encourage children to become more active. Junior League, through its Be Fit, Be Fine umbrella, is taking on the obesity issue by promoting active lifestyles as well. They have organized a new family fun run/walk called Run Wild 2-Mile Family Fun at the Louisville Zoo, taking place on Sept. 29 from 8:30a.m.-1:00 p.m. However, if the childhood obesity cycle is to be broken, parents need to lead the charge.
Barbara Day, M.S., R.D., C.N., is the publisher and nutrition editor of Kentuckiana HealthFitness and Kentuckiana Healthy Woman. She is the former sports nutrition consultant to the University of Louisville Athletic Department and the United States Navy SEALs. She is the author of “Fast Facts on Fast Food For Fast People” (ISBN 0-9631538-6-2) and “High Energy Eating Sports Nutrition Workbook for Active People” (ISBN 0-9631538-5-4). In addition, Barbara has a private practice specializing in sports nutrition and has a weekly health and fitness radio show on WKJK 1080 AM. She serves on the advisory board of the Mayor''s Healthy Hometown Movement Advisory Committee. She is a member of PE4Life, Coalition for a Healthy and Active America, the American Dietetic Association, NAWBO and Greater Louisville, Inc. She is a runner, cyclist, hiker and grandmother.