Teaching Kids to Eat Right and Get Moving
Much of the latest research on childhood obesity is focused on prevention and intervention: breaking children of their bond to television, guiding them toward more physical activity and improving their eating habits.
Effects of television: In landmark studies in the 1980s and ‘90s, Dr. William H. Dietz, head of the nutrition and physical activity division at the federal Centers for Disease Control and Prevention, collaborated with Steve Gortmaker at the Harvard School of Public Health on research that found television to be a major cause of children’s overeating. In part, they said, it’s because commercials encourage consumption of fatty, calorie-packed foods.
Gortmaker continues to study the effects of television. He developed an interdisciplinary curriculum called Planet Health that uses math, arts, science and physical education classes for lessons about reducing television time, eating fresh produce and reducing saturated fat. According to a study that compared five schools using the test program with five that didn’t, students at participating schools improved their diets, ate more produce and watched less TV. Boys and girls without the program gained weight during the study period.
Gortmaker said about half the children in his studies--many from low-income households--had TV sets in their bedrooms. Kids without bedroom sets watched about an hour less a day.
Further, in a small study that appeared in the Oct. 27 issue of the Journal of the American Medical Assn., Dr. Thomas N. Robinson of Stanford University found that a curriculum that encouraged less TV watching led third- and fourth-graders to cut their TV and video hours by a third, and gain an average of two fewer pounds than students without the curriculum. Children who curbed their TV watching also reduced the number of meals they ate in front of the set.
Parental involvement: Leonard Epstein, a psychologist at the University at Buffalo in New York, has found ways to curb TV viewing by establishing contracts with kids’ parents. When the kids watched less TV, they were rewarded with zoo trips or other time with Mom or Dad. Epstein found the children filled their newly free hours with more active pursuits and easily met the current recommendations of getting at least a half-hour of exercise a day. In two studies, the second of which will soon be published in the Archives of Pediatric and Adolescent Medicine, he found “decreased sedentary behavior is at least as good as, or better than, a traditional exercise program.” Furthermore, freeing up a small amount of time produced the same weight losses as freeing up a lot of time.
Epstein also has 10-year follow-up data showing that small intervals of moderate daily activities such as walking or playing can be as beneficial as high-intensity aerobics or calisthenics.
Changes in the schools: Robinson, of Stanford, has been working for years on a three-pronged approach to obesity that targets physical education classes, classroom work and school lunches. He has been working with kids in the San Francisco Bay Area to replace television, video and computer time with physical activities. Some participating schools have substituted physical education programs for 8-to 10-year-olds with dance classes, and have shown improvements in body fat and fitness compared with children of the same age group in conventional programs.
Robinson also has worked with school officials to alter cafeteria offerings. He has encouraged a switch to nonfat milk, the addition of nonfat chocolate milk, and the placement of salad, fruit and vegetable bars at the front of the line so that students fill their plates with the healthiest selections.
He has also had success with a classroom curriculum that stresses the benefits of reducing pollution by eating locally grown fruits and vegetables that don’t have to be hauled long distances by polluting vehicles.
Assessing the risks: Michael Goran, a visiting professor at USC’s Institute for Prevention Research, has spent years trying to determine the risk factors for obesity in children and how they’re influenced by diet and physical activity. He is developing a CD-ROM that will teach children in third through fifth grades about physical activity and nutrition. “This is a good window of opportunity to try and change things before puberty, when it might be too late,” he said.
On the physiological side, Goran has just begun a study of Los Angeles children to identify some of the metabolic differences that seem to put some kids at risk for obesity, and place black and Latino children at higher risk for diabetes. He is examining body fat, rating overall fitness and measuring children’s ability to regulate sugar intake--to help determine future diabetes risk.
