Childhood Obesity
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childhood obesity Kaiser Permanente

As Sharon Rowland's weight climbed to 210 pounds, she worried that her children would follow her example, especially her oldest girl.

"She likes to eat, and I was concerned about that," Rowland says of Kylah, now 12. "I also wondered if she was getting enough exercise."

It's a concern shared by parents across America as childhood obesity rates for children six to 19 have more than tripled since 1980, according to the Centers for Disease Control. Packing on the pounds in youth may cause a range of typically "middle age" health diseases to strike much earlier.

"Type 2 diabetes used to be called 'adult onset diabetes,'" says Wes Alles, director of Stanford Health Improvement Center in Palo Alto, CA. "But the name had to be changed because we were seeing younger and younger children with the condition." In fact, some experts have warned that this could be the first generation that won't outlive its parents.

Loss of self-esteem, eating disorders, depression, social isolation and learning problems are additional ills that can land at the doorstep of obese children.

Even without wading through knee-deep statistics on the subject, Rowland gleaned that it was important to monitor the diet of all four of her children, who, in addition to Kylah, include daughters Kennedy, 10, and Kamryn, 7, along with son Raymond, 4.

"It's hard as a single parent," she said, "but I knew that there were better ways to eat than the drive-thru at McDonalds." So when an administrator at her local Indianapolis YMCA approached her about taking part in the Healthy Family Home Program, she signed up.

Earlier this year, the Rowlands completed a four-month pilot study, which was also conducted simultaneously in Chicago, New York City, San Diego and Marshalltown, IA. More recently the Eli Lilly funded program went nationwide at 1700 YMCAs.

WORKING TOGETHER

In sessions with other families, the Rowlands learned to make healthier choices, scrutinize food labels and avoid the evil god of trans fats. Sharon Rowland lost 25 pounds, and found that the Healthy Family kit was easy to incorporate into her and her children's daily routine.

The opening pages of the colorful pamphlet provide tips for youth to take an active role, not only in planning and preparing meals, but also in choosing family activities. The booklet's second half addresses parental input, urging moms and dads to eat and play with their children, and to spend individual time with each kid, which may help reduce emotionally motivated eating.

Rowland finds that the lessons she learned during the program have given her children more hands-on decision-making skills, such as the ability to interpret nutrition labels and to leave fattier items right there on the supermarket shelves.

"Our family used go through boxes of Little Debbie Snack Cakes," Rowland recalls, "but after the trans fat discussion [at the Y], we went home and threw them all away. Now, when I tell them to go pick out something for a snack, nine times out of 10 they pick out something very healthy."

As the family's head chef, she changed up the menu, using recipes that trim the fat, switching to brown rice and whole grain spaghetti, substituting olive oil for butter, and baking instead of frying.

For exercise, the family bikes together. Sometimes the children zoom ahead on their heelys--shoes with little wheels on the bottom. Kylah, inspired by the historic Olympic performance of Michael Phelps, now swims three days a week; Kennedy and Kamryn often exercise before bed; and Raymond recently played his first season of flag football.

MODEL BEHAVIOR

Lauren R. Cislak, manager of communications for Eli Lilly, the pharmaceutical company, worked with the Y as well as with families to establish the program. Her development team delved into the lives of people such as the Rowlands and asked, "What are your special needs?" They also made gentle suggestions such as, "Take a nice walk around the block after dinner, crank up the music and dance together." The thinking, Cislak says, was for "families to set goals that are reasonable, win small victories, and move on to new achievements."

The fact that kids don't get fat by themselves is a key concept behind the Healthy Families program. "There is a context for behavior," says Alles. "It's reinforced through modeling of parents, their values and their sustained behavior." Maybe the family watches TV and eats ice cream together. Or perhaps a parent is on the computer, while a child plays a video game, each munching a high-fat snack.

"Our children are doing the same things we are, which translates to normal," he adds. If we over eat, they over eat. If we don't exercise, they may not either.

Alles suggests that parents model healthy eating habits and fitness routines in the same way that they teach children to look both ways before crossing a street, or warn them about unprotected sex. All represent life-sustaining choices.

Trina Wiggins, MD, a Las Vegas pediatrician, also finds it pointless to expect a child to be successful at losing weight if there's no family support.

"The mother or guardian purchases the food, so if they're not eating well or not working out, it's a moot point to talk to the kid."

Societal change over the past generation or so has helped to expand our waistlines, says Kristine Courtney, MD, director of Corporate Health Services at Eli Lilly. "We used to walk to school, now we take buses. Kids used to play outdoors, now free time is filled with video games." Wiggins agrees: "When I grew up," she says, "it was torture for me to be inside. I loved kickball, dodgeball and riding my bike."

Many wag the finger at technology for giving us entertainment that we can't put down, and for allowing us to take lazy short cuts.

"We've engineered physical activity out of our lives," Alles observes. "It's not only our passive use of escalators and elevators at the mall or in parking structures. We have created communities better suited for car transportation than for recreation." Expansion of roads and freeways often make walking to parks or finding dedicated bicycle lanes difficult or impossible.

At many schools, the daily physical education classes of Wiggins' day have been scaled back to every other day or even offered only as electives. Instead of a hot lunch from the cafeteria, the school may serve pizza, burgers and tacos from local fast food restaurants.

The young Rowland girls have learned to say "no thanks" to the fast stuff. Dissatisfied with the lunch choices at their schools, they bring their own. Kennedy and Kamryn also belong to an after school program called Girl Power, which stresses the importance of a healthy diet and exercise..... continued in ABILITY Magazine

ABILITY Magazine
Other articles in the Scott Hamilton issue include Senator Harkin — Updating the ADA; Headlines — Best Buddies, Diamonds in the Raw; Humor — Unfortunately, It’s All About Diet & Exercise; Best Practices — Microsoft; Managing Pain — Latest Techniques; DRLC — Good News For Vets; National Institutes of Health — Cool Research; Neil Romano — Assistant Secretary of Labor (Part 2); ABILITY's Crossword Puzzle; Events and Conferences...subscribe

More excerpts from the Scott Hamilton issue:

Scott Hamilton — Can’t Keep A Good Man Down

Logan — The Woman, The Magazine

Motorcycle Vets — Speeding Into The Danger Zone

Childhood Obesity — The Skinny on a Big, Fat Problem

Brain Tumors — From A to Z

Senator Harkin — Updating the ADA

Humor — Unfortunately, Itís All About Diet & Exercise

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