Childhood obesity rates have been climbing for the past 30 years, and by 2010, more than one-third of children and adolescents were overweight or obese in the U.S., according to the Centers for Disease Control. Because of this rise in obesity rates, many experts are predicting that this may be the first generation of children that will not live as long as their parents.
In the national ranking by state, Georgia has held the dishonor of coming in second only to Arkansas in rates of childhood obesity. In fact, childhood obesity has become so prevalent that it has been referred to as an epidemic.
The good news is that childhood obesity is also preventable. In order to call attention to this important issue, September has been named Childhood Obesity Awareness Month. Schools, organizations and individuals are asked to support the awareness effort with education, activities and distribution of information. The verdict is that from school lunches to snack machines and from family dinners to video games, childhood obesity does not have a sole culprit. This means that attacking the epidemic from all directions offers the best plan of action to elicit real change.
"We've probably seen some improvement or at least stabilization," says Dr. Stephanie Walsh, medical director of child wellness for Children's Healthcare of Atlanta. This does not mean that Georgia has reached the finish line, but it does mean that childhood obesity is a problem that can be solved. "It should be encouraging. If we all work together, we can change the way we've been living."
The Role of Schools
For many children, a great deal of eating, exercising and nutrition education takes place at school. Beginning with cafeteria lunches, schools have been making strides to offer healthier options that fall within the ever-changing guidelines of the USDA. "The USDA lunch regulations changed in school year 2012-2013 and included a New Meal Pattern," says Shani Hall MS, RD, LD, food and nutrition area supervisor with Cobb County School District. "These new regulations included calorie ranges for each school level that are in line with the 2010 'Dietary Guidelines for Americans,' mandating daily fruit and vegetable offerings (including an assortment of dark green, red-orange, legumes and starchy vegetables), offering more whole grains and phasing in sodium limits."
The USDA requirements are minimums, and school districts may provide more healthy choices. For example, according to Malcolm Quillen, school nutrition manager for DeKalb County, in addition to incorporating more fresh fruits and vegetables, schools offer only low-fat and fat-free milk. And while the federal government requires the inclusion of five daily components – protein, vegetable, fruit, grain and milk – schools may offer even more. In order to remain within the calorie requirements for each student, desserts have become rare, and even potentially questionable items have received a makeover. "While you may see bread or you may see pizza, most of these items are made with whole grain," says Quillen. However, even while schools work to offer healthier choices, school nutritionists and chefs often find that the students' palates could use a makeover as well.
Lower sodium limits will be required by the 2014-2015 school year, and these could also prove to be a trial for picky eaters. "This year our focus is testing and implementing recipes with more herbs and spices and fresh ingredients. Healthy food isn't nutritious until it's eaten, so we've always involved students in our menu planning process," says Brittany Slotten, MS, RD, LD, food and nutrition area supervisor with Cobb County School District. "We constantly collect feedback about our menus and test new products and recipes with students." Working with and educating students has earned the Cobb County School District awards from the USDA for creating healthier school environments through promotion of good nutrition and physical activity. The district served more than 80,000 pounds of Georgia Grown produce in school cafeterias during the 2012-2013 school year.
The Role of Local Health Organizations
Including local produce in school lunches is a great way meals can be healthier and provide opportunities for education. Georgia Organics started the first Farm to School program six years ago and has witnessed exponential growth. During the 2011-2012 school year, 14 school districts across the state purchased local produce for a total of three million meals. For 2012-2013, that number rose to 40 school districts, and Georgia Organics expects to have far exceeded its goal of five million meals that include locally grown foods.
Farm to School programs are multifaceted. They introduce farmers to school nutrition directors so that local fruits and vegetables can make their way into cafeterias, and they educate through gardening, in-class activities and taste testing of new produce in cafeterias. "Kids just don't have experiences eating fresh fruits and vegetables," says Emily Rose, Farm to School assistant with Georgia Organics. "Studies show that Farm to School programs increase fruit and vegetable consumption among children. Teaching kids about food helps them want to try new food."
Although they do a lot of good, Farm to School programs sometimes come with implementation challenges. For a large school district like DeKalb County, the trick is finding enough local product to supply the entire district with the same thing. Many small farmers simply do not produce enough. To solve this problem, Rose has seen districts split menus so that half of the district gets the item one week, and the other half gets it the next week. In another situation, groups of local farmers pooled their kale to have enough to cover an entire large school district.
This October, Georgia Organics sponsors the Lettuce Try It campaign to encourage schools to serve local Georgia lettuce – something the state produces plenty of, but mostly exports.
For some older students, vending machines offer a third option to school lunches and a packed lunch from home, and unfortunately these machines are outside the purview of the county nutritionists. Moreover, the machines do not currently have USDA requirements to meet, but this might be changing. "The USDA recently proposed a Competitive Foods Policy that would ensure that only healthy options be sold in vending machines in schools. If this policy is adopted, then changes could occur as early as 2015," Hall says.
The Role of Parents
Even with the improvements to school lunches, some parents and students still decide to brown bag it. "We tend to pack our kids' lunches a lot," says Michelle Bowers, parent of daughters ages 7 and 9 and chair of the Health & Wellness Committee at Atlanta Neighborhood Charter School. "My younger daughter has severe food allergies, so it's a necessity for her." With her older daughter, Bowers uses the school lunch menu as an opportunity to discuss food choices and allows her to choose a couple of school meals a week and take lunch from home on other days. "When she comes home, we talk about what she ate and what she didn't eat."
While children spend most of their weekdays in school, there are many hours outside the cafeteria where healthy choices need to be made. "There's no surprise, we need to engage in healthy behaviors," Dr. Walsh says. "Start with small changes and things that will bring a positive change into your life." There are four simple rules every family can follow: Fill half your plate with fruits and vegetables, drink more water and limit sugary drinks, limit screen time to one hour per day and get active for at least 60 minutes per day. Dr. Walsh also recommends creating habits like putting out a plate of raw vegetables each night before dinner so that pre-meal snacking is filled with high nutritional value.
Since childhood obesity has so many contributing factors, these solutions like Farm to Table programs and healthy examples of food and fitness at home must work in conjunction to reverse the problem. "I would love for [the cause of obesity] to be one thing because then we could go and fix that," she says. "It's sort of the perfect storm. We have a lot of food. We have a lot of access to food." From parties at school to snacks after soccer games, much of our lives have become centered on food. This availability of food has been accompanied by a reduction in PE classes and recess. The second main component to tackling childhood obesity is to get the kids moving again.
"If we were able to figure out 'energy in and energy out,' we would solve the obesity issue," says Vanetta Keyes, founder and executive director, Center Helping Obesity In Children End Successfully, Inc. (CHOICES). At CHOICES, parents are encouraged to set the standard. "We want parents to be an example," says Keyes. "You cannot ask your child to go walk because they are overweight, and you stay home and open a pint of ice cream. In order for children to change, they've got to see the adults in their lives as role models. They need to know that someone is there as their cheerleader."
Parent Myia Clay turned to CHOICES several years ago to help her teenage daughter, knowing that the 8th grader's activity level was causing a weight problem. "We wanted to find something that she could be a part of to encourage her to lose weight," says Clay, who appreciated the program enough that she still volunteers with CHOICES. "We increased her activities a bit. It was helpful allowing her to come to herself as an individual and say, 'This is what I need to do.'"
With many temptations readily available, the battle against childhood obesity will not be won overnight, but as awareness increases and schools and organizations join the fight, parents can find the support they need.
Paving the way for healthy and active kids
Center Helping Obesity In Children End Successfully, Inc. (CHOICES)
Each year CHOICES, based in Kennesaw and downtown Atlanta, hosts two expos to bring health education into underserved communities. Those are the areas that need more after-school programs and subsidized activity offerings. At its new location, CHOICES will have a teaching kitchen where they will be able to train representatives who can take healthy practices into more communities. They also offer Camp Diva, a summer camp for overweight girls, and Sisters in the LITE, a 12-week program that teaches girls and women how to sustain a healthy weight by making lifestyle changes. www.choicesforkids.org
Children's Healthcare of Atlanta's Strong4Life program combines a fun camp, parent involvement and healthy education for kids struggling with their weight. Families must attend Family Welcome Weekends in the spring and in the fall, while children attend a one-week summer camp where campers participate in traditional camp activities like rock climbing and swimming while also gaining the support of other children struggling with the same issues. www.strong4life.com
Kaiser Permanente Fit Kids Programs
Kaiser Permanente offers a variety of programs to help get kids to eat healthy, control their weight and stay active.
Snack Facts for KP Kids – This is a one-session hands-on class where kids and families learn together how to prepare delicious meals and nutritious snacks that even picky eaters will enjoy.
Operation Zero Weight Management – This is a program for children ages 9 to 17 that gives them six sessions with a dietitian, chef and fitness specialist and learn about healthy eating, exercise, the relationship between being overweight and diabetes, and reading food labels.
KP Fit Kids & Fire Up Your Feet – To encourage exercise, Kaiser Permanente hosts KP Fit Kids, six-week classes featuring fun, games and lots of high-energy movement. The new Fire Up Your Feet programs encourage families, students and schools to work together to get active by tracking activity during a Challenge Period and earning awards for schools. Even better, most of the offerings are free, but registration is required. www.kp.org
Active Schools Acceleration Project (ASAP)
ASAP is an entrepreneurial non-profit focused on increasing quality physical activity in schools. The organization will provide $1,000 to 1,000 schools ($1 million total) across the country to help implement one of three innovative movement programs. Any school in the nation can apply for the funding, and seven Atlanta-area schools were awarded monies for the 2013-2014 school year. www.activeschoolsasap.org
Launched by Governor Nathan Deal, this initiative addresses childhood obesity by providing digital resources at GeorgiaSHAPE.org. The resources include a fitness directory where people can enter their zip code and a list of nearby fitness programs will be provided. Georgia SHAPE also wants to combat childhood obesity at the very earliest by promoting breastfeeding. www.georgiashape.org
The Recess Rocks
This national initiative offers a low-cost way for schools and other organizations to integrate physical exercise into kids' days with things like "Subject Switchins" and "Hallway Grooves" to get kids moving in a fun way. Recess Rocks provides a free toolkit to implement their positive program in any area. www.recessrocks.com
This after-school program combats childhood obesity in Georgia on the local level by encouraging physical activity and healthier eating habits for Georgia's kids. This initiative is led by the Resurgens Charitable Foundation, whose mission, among others, is to address childhood obesity. Some of PowerUP!'s other partners are the YMCA of Metropolitan Atlanta, fitAtlanta Magazine, and the Georgia Department of Education. www.powerupgeorgia.org
Voices for Healthy Kids
The national advocacy initiative Voices for Healthy Kids aims to address childhood obesity in the hardest hit communities by improving the nutritional quality of snack foods and beverages in schools, protecting children from marketing of unhealthy products, and increasing access to affordable healthy foods, safe parks and playgrounds. The Robert Wood Johnson Foundation and the American Heart Association are behind this effort, hoping to reverse the childhood obesity trend by 2015. www.voicesforhealthykids.org
Active Schools Acceleration Project – www.activeschoolsasap.org
Camp Strong4Life - www.strong4life.com
Dr. Stephanie Walsh – Children's Healthcare of Atlanta, www.choa.org
Vanetta Keyes – CHOICES, Inc., www.choicesforkids.org
Emily Rose – Georgia Organics, www.georgiaorganics.org
Georgia SHAPE – www.georgiashape.org
Kaiser Permanente – www.kp.org
PowerUp! - www.powerupgeorgia.org
The Recess Rocks – www.recessrocks.com
Voices for Healthy Kids – www.voicesforhealthykids.org