Kids and obesity
Percentage of U.S. children and adolescents who are overweight (2002): 20
Percentage of U.S. teens 12 to 19 who are overweight: 16
Percentage increase in that number from 1988 to 1994: 11
Percentage of U.S. children 6 to 11 who are overweight: 15
Percentage of U.S. children 2 to 5 who are overweight: 10
Percentage of schools that offered soft drinks in vending machines in 2000: 76.3
Percentage of schools that offered 100 percent fruit or vegetable juice in machines in 2000: 55.6
Percentage of children who get the daily recommended number of servings of fruits, vegetables and grains: 2
Percentage of high school students who are physically active for 20 minutes or more, five days a week, in PE classes: 19
Drop in percentage of daily enrollment in PE classes among high school students from 1991 to 1995: 19, from 44 to 25
Number of children who have cholesterol levels too high for good heart health (the optimum level is 170 or less): 1 in 3
Percentage of fifth-, seventh- and ninth-graders who did not meet California's physical fitness goals in 2001 testing: 75
Sources: Fifth Annual Report on Commercialism in the Schools, October 2002, by Arizona State University's Commercialism in Education Research Unit; Centers for Disease Control; National Institutes of Health; U.S. Department of Agriculture; Children's Healthy Heart Center, N.Y. Presbyterian Hospital.
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Racquel Hall used to be your typical burger-munching teen, scarfing down junk food at every opportunity. Her body showed it, too. In 2000, as she headed into ninth grade, the 5-foot-1-inch teen weighed 202 pounds.
Then Hall joined a popular school program called Ecotech, a specialized learning community focused on hands-on ecology, within University City High School in Philadelphia. There, Hall learned to grow, cook and sell fruits and vegetables harvested in the school's extensive outdoor and indoor gardens. She also discovered the joys of eating them.
Now 16, Hall packs 45 fewer pounds on her frame, prefers carrots to potato chips, and says she'll "never go back" to unhealthy living.
It's a great success story, but all too rare. Today's schools are filled with more obese and overweight children than ever, some at risk for - if not already suffering from - high cholesterol, Type-2 diabetes, high blood pressure and early cardiovascular disease.
Because most obese kids become obese adults, experts have recognized that stopping the problem early represents the best hope for success in saving both lives and health-care dollars. As a result, kids have been targeted by both government and nonprofit groups as the front line in the national fight against fat. And schools - which control kids' daily environments - have become the primary battleground.
Legislators at the federal and state levels have introduced bills to get rid of soda and junk food in schools. Federal funding for physical education programs has increased 20 percent this year, from $50 million in 2002 to $60 million. The U.S. Surgeon General has called for a return to daily gym classes and healthier food choices in schools. Numerous school-based programs have popped up around the country aimed at luring kids to eat better and exercise.
Still, millions of overweight kids continue to ride buses to schools where soda, candy bars and potato chips are served daily, and where they aren't expected to break a sweat in gym class more than two days a week, if that. Only one state - Illinois - requires daily PE for all students through 12th grade, but even many of those students evade gym class by cadging waivers to attend other classes. Meanwhile, cash-starved school districts have signed lucrative contracts with soda vending-machine companies.
Some people argue that schools can't be expected to reshape children who are molded by parents and society before they even get there.
"Schools don't operate in a vacuum," says Gail Woodward-Lopez, associate director at the Center for Weight and Health at the University of California at Berkeley. While Woodward-Lopez believes schools should provide healthier food and more activity, she notes that "if the community and parents aren't brought into the process, they can sabotage the efforts of the schools."
Dr. Christine Williams, a clinical pediatrics professor at Columbia University who treats obese children, says constant TV and super-sized meals at home contribute to the problem. Nonetheless, she says, "schools can do so much - kids spend most of the day there."
Williams had success working with preschoolers in the late 1990s through a Head Start program in New York called "Healthy Start." The program taught youngsters healthy eating habits so effectively that three years after graduating, they continued to have lower cholesterol levels.
Most school-based programs reviewed two years ago by the Center for Weight and Health proved unable to significantly cut weight, especially in the long term. Newer programs are just beginning to be studied.
"There's probably no 'killer app' out there that's going to do it," says Michael Murphy, an associate professor of psychology at Harvard Medical School, who has studied the effectiveness of weight-loss programs.
Yet, as Hall's experience at Ecotech shows, solutions are emerging. Lacking a magic bullet, schools, health experts and communities have taken matters into their own hands. They have begun to create a wide range of innovative, grass-roots programs across the country that are beginning to eat away at myths about what kids will and won't do to get and stay healthy.
Myth No. 1: The PlayStation Generation won't play.
The fitness center at Madison Junior High School in Naperville, Ill., rivals an adult health club, with heart monitors, treadmills, stair-steppers, and even a rock-climbing wall.
The idea, says the center's physical education coordinator, Phil Lawler, is to promote a "paradigm shift" regarding gym class: Instead of teaching sports skills, the center focuses on health, wellness and lifestyle.
"So many are pointing the finger at poor nutrition, but a bigger factor is kids are just not physically active," says Lawler, who directs the PE4Life Institute, a national training center. "Physical education for every kid in school could be the solution to get control of health care."
In Naperville District 203's classes, taught daily to middle- and high-school students, all the kids move. Gone is the gym glass in which a few top jocks whiz balls while couch potatoes hug the sidelines. When students play football, for instance, they do it four-on-four, so everyone gets involved. While running laps, students are scored on their performances within their own heart zones, not on how well they compete against others.
Student cholesterol tests have improved every year since testing began in 1994. Fitness tests also show gains, Lawler says, with only 3 percent of Naperville ninth-graders considered overweight.
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In gym class at West Middle School in Downey, Calif., videogames aren't the enemy.
Children ride specially equipped exercycles hooked to videogames. Their fitness scores, including heart rate, are entered into customized computer game programs. The fitter they are, the more "power" is awarded to the characters in the game, which typically features bike races set in exotic locales, such as the surface of the moon.
"It's great," says Liz Javier, 13, an eighth-grader who has been in the Cyberobics program for three years. "Sometimes you don't even know you're working out because it's like playing video games." Yet, Javier says, she gets sweatier doing Cyberobics than she does running around outdoors in more traditional PE classes.
The program was developed by gym teacher Daniel Latham 10 years ago as a way to attract tech-oriented kids.
"Cyberobics links together the best of their world and the best of my world," says Latham. "It's the most popular class on this campus."
The students in the Spokane, Wash., school district start fitness awareness young, courtesy of a federally funded high-tech center that combines exercise and science.
Kindergarteners are taught the connection between aerobics and a healthy heart. By fourth grade, those lessons get put to use as students exercise wearing monitors that show their heart at work.
Once in middle school, students input their fitness data - which includes resting, active and recovery heart rate; blood pressure; body fat and mass; and exercise regime - into mini-computer labs that track their progress over a semester.
The lessons culminate in high school, when students get a taste of genetics by examining their family histories to determine predispositions for disease.
"Although high-school students still believe they are immortal, they are beginning to understand the connections to what they do now and their long-term health," says fitness coordinator Karen Cowan. "The biggest surprise they are showing is that there is a real connection between themselves and their families."
So far, results of the five-year-old program show participating students have stronger hearts and bodies, but only minimal reduction in body mass, Cowan says.
The centers had an unexpected benefit: Teachers and other school staffers are so taken with the facilities that they're filling them to capacity after school, a response Cowan calls "amazing."
Jerald Newberry, health information director at the National Education Association, says fitness for teachers, who spend long, sedentary hours in buildings with snack-filled vending machines, is such a concern that the professional group is working with Weight Watchers on customized pilot nutrition programs.
Sharon Sterchy has proved you don't need lots of money or high-tech equipment to get kids moving. In Aldine, Texas, a low-income Houston suburb, PE and wellness director Sterchy stretched the modest budget of $20,000 to revamp the program for 55,000 students.
Sterchy's students can be found kayaking in donated boats in the school pool, dancing, rollerblading and building campsites in the schoolyard.
Myth No. 2. Kids won't eat foods they know are good for them.
When nutritionist and consultant Dr. Antonia Demas began using the "ugh" foods from the federally subsidized school lunch program - lentils, brown rice and beans - many cafeteria cooks predicted kids wouldn't touch the results in a million years. Demas says they were wrong.
"When food is made in a way that's fun and sensory-based, kids will eat anything that's nutritious," says Demas, who heads up the nonprofit Food Studies Institute in Trumansburg, N.Y. "Schools say they can't serve healthy stuff because kids won't eat it, but they will if they're educated about it."
For elementary-school diners, Demas serves up ethnic cuisine, such as Brazilian black beans, Egyptian barley and peas, and red lentil curry. For tougher-to-please teens, Demas recommends a whole corn tortilla with beans and guacamole or a veggie pizza made with whole grains, accompanied by a salad, brown rice and fruit. "Always fruit and salad with every meal," she says.
Her program, "Food is Elementary," offered in more than 100 schools nationwide, uses games, songs, science experiments and other hands-on activities to teach kids that "healthy" isn't a bad word.
This spring, Demas worked with an alternative vocational high school in Lynn, Mass., to revamp the cafeteria menu. Soda and junk-food machines have been moved out and cooks are being trained to prepare food Demas' way.
Students were tested both before and after the four-month experiment to see what impact the diet had on their health. Results are expected this summer.
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Back in West Philadelphia, Racquel Hall's program, part of the local Urban Nutrition Initiative, turns city blocks into gardens to help teach students from inner-city schools - where up to 45 percent of kids are overweight - that healthy food can be good for them in unexpected ways.
The Urban Nutrition Initiative's method works by sharing community resources. Students from nearby University of Pennsylvania teach high-school students like Hall, while the teens pass on their knowledge to area elementary-school children.
"We don't hit the kids up front with how to eat healthy," says Martin Galvin, the Ecotech coordinator. "We try to weave it into our curriculum over a four-year span."
The younger children sell their produce at after-school stands. The older kids run a farmer's market and sell food to restaurants, learning real-world business skills as well as nutrition. Because their low-income neighborhood is under-served by supermarkets, the students' garden helps the community by providing much-needed fresh fruits and vegetables.
These culinary arts programs have roots in California's Edible Schoolyard program, created by famed chef Alice Waters, in San Francisco's King Elementary School. The program has spawned offshoots, funded by the nonprofit Center for Ecoliteracy, which is studying the results.
"It's amazing to see children come in at the beginning of sixth grade and say, 'I won't eat that,' or 'What is that?'" says Zenobia Barlow, Ecoliteracy's director. "Then, by the time they have prepared a fruit salad, they are licking pomegranate juice off the bottom of the bowl."
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Even the experts will admit that children, like adults, find it all too easy to slip back into unhealthy habits if that's what they find at home. Yet there is reason for optimism.
Lawler - who is seeking a grant to examine 10-year outcomes for his Naperville graduates - compares the fight for fitness education to the battle to reform other ingrained habits, from tobacco use to dental care. Just as smoking rates are falling and Americans brush every day, he says, so can daily exercise become routine - if government and community leaders get behind a strong national movement.
"I think the government should fund and push innovative programs like schoolyard gardens and multiple ways of increasing physical education requirements in schools," says Harvard's Michael Murphy. "Hopefully we can get a cadre of teachers and administrators working on this over the next ten years and we can begin to move the needle. But it's going to take a long time."
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Lorna Collier is a freelance writer who reports regularly on health and family issues for the Chicago Tribune's health and family section.
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