Kids' Health Blog

This is a post by Dr. Julie Boman, a pediatrician at Children’s Hospitals and Clinics of Minnesota.

The fact that September is National Childhood Obesity Awareness Month means that childhood obesity is well accepted as an epidemic in our country. Children’s Hospitals and Clinics of Minnesota recently released a white paper that examined the issue of childhood obesity. The assessment revealed a startling conclusion from an obesity expert with the World Health Organization that “the die is cast by the age of five,” referring to the prenatal and early childhood determinants of a child’s likelihood of becoming obese.

The frustration is that we know the causes and even the solutions, but the pathway to success is far from clear.  We know that getting kids to exercise more, eat healthier and avoid too much screen time are part of the equation. However, when we add in the factors of underlying health disparities, food deserts, the need for family-based interventions or acceptance of healthier prenatal and early childhood practices, the answers quickly become far more complicated.

For me, the complicated nature of the problem simply means that we need more creativity and flexibility in how we tackle the problem. As someone who has devoted her career to the health interests of children, I can’t stand by and watch more children come into Children’s clinic with conditions that, 20 years ago, were almost exclusively associated with adults: Type 2 diabetes, high blood pressure, elevated cholesterol, and liver disease.

That’s why earlier this year, in partnership with the Minnesota Chapter of the American Academy of Pediatrics and supported by Children’s, I spearheaded an initiative focused on providing support and resources to the Minneapolis Latino community to foster healthier eating and more physical activity. Called Vida Sana Minneapolis, the initiative is built on several guiding principles that we believe are critical to the success of the program:

• Community-based: Engaging community partners in the planning and implementation of the program.
• Family-based: Understanding the powerful influence family dynamics have on a child, particularly if the goal is to prevent problems in the first few years of a child’s life.
• Culturally-appropriate: We can’t assume a one-size fits all approach.
• Responsive. Letting families shape a program that they need rather than imposing a program on them.

Initially supported by a grant from the National Initiative for Children’s Healthcare Quality, we’ve built a coalition of 15 different private and public organizations that have a vested interest and desire to promote healthy lifestyles with the Latino community. The response so far is inspiring. At our kick-off event in July, attendance far exceeded expectations with more than 200 people participating in a mini health fair that included health screenings and education on nutrition and physical activity. More importantly, we’ve seen a sustained interest from Latino families and other community interests. After just two months of weekly evening events that include Zumba classes and activities for children, we’re already expanding our programming to include nutrition classes for families, Zumba and yoga for kids and are considering an additional night of Zumba for adults.

The growth doesn’t stop there. Thanks to a newly-formed partnership between Children’s and HealthPartners focused on childhood obesity, the Vida Sana project will continue to build by broadening our reach, more active recruitment within the community and incorporating elements such as BMI screenings and physician engagement. Vida Sana continues to gain interest from potential partners and others interested in highlighting how we’ve approached the program. As proud as we are of that growth, this program alone won’t solve the problem.

The bottom line is, when it comes to the issue of childhood obesity, we can’t afford to wait for the perfect solution. By building on the lessons learned from previous efforts and being flexible to allow for real-time learning and adjustment, programs like Vida Sana can make a difference. Yes, the problem is severe but, as the last several months working on this project have shown me, there’s also reason to be optimistic for one fundamental reason: parents want their children to be healthy. There is no greater motivation; our job is to empower them to make the choices that will achieve that goal.

For more information about Vida Sana, contact Dr. Julie Boman at julie.boman@childrensmn.org. For more information about Children’s childhood obesity efforts, contact Anna Youngerman at anna.youngerman@childrensmn.org.

Healthy eating choices begin in infancy, and children continue to learn about healthy lifestyles as they grow and watch their adult role models. Julie Boman, MD, a pediatrician at Children’s of Minnesota, joins Good Enough Moms hosts Marti and Erin Erickson to discuss how physicians monitor your child’s growth and weight and to offer practical tips on how the “5-2-1-0” daily guidelines for nutrition and physical activity can improve the health of your family.

Listen to the podcast

I read about an upcoming lecture at the Walker Art Center in Minneapolis that involves a discussion by a developmental psychologist who has worked with the Lego Corporation about the therapeutic benefits of play in childhood. It makes me think that we should do a better job in general of creating treatments for kids who don’t have to seem so much like “therapy” or “medicine,” but rather that seem like fun.

Toy and media companies like Nintendo, Sony, Microsoft and Apple have certainly figured out how get kids to play with their products, but few of them have designed products with therapeutic benefits.  Helping kids to get healthy, physically fit and lose weight is a good example of a challenging area where we could use some multimedia, fun treatments. Although the American Academy of Pediatrics and other groups have come up with some excellent information about the prevention, assessment and treatment of obesity, it all seems a bit “dry” to me in terms of actual day-to-day practice.

Also, beyond physical activity and nutrition changes, addressing the mood, self-esteem and stress issues that often plaque overweight kids is of critical importance. I struggle with finding ways to help kids and teens feel motivated, interested and excited enough to want to follow through and change. There is hope — a relatively low-tech approach that was successful in helping kids lose weight in a recent study involved simply having overweight kids read a fictional story about another kid who was struggling with obesity.

Products like Nintendo’s Wii Fit are a good start. It would be pretty amazing if more toy companies turned some attention to creating “therapeutic toys” — toys and activities with a defined therapeutic benefit (stress management, weight loss, physical fitness, better sleep, etc.) that are designed so well that the kids don’t even need to know about the therapeutic benefit. Clinicians would love this.

A few products and companies are trying to get there, but the road has been slow. Many kids experience “emotional overeating” because of stress. Here some products that begin to address exercise and stress for kids:

• Wild Divine makes computer games for stress management. Overweight kids need to get active, but need engaging and time-efficient tools.
• Me Moves is a new product that makes a cool product combining music and tai-chi like movements for kids, soon to be available as an iTouch application.
• Yoga Kids has some fun practice books and DVD’s for kids to learn Yoga at home.
• Some kids with obesity have related issues with sleep. A Minnesota  company, The Shrunks, also makes some fun kits including plush toys and colorful gadgets to help kids sleep better.
• Local resources for kids and families to coach them on healthy lifestyles include the LiveWell Fitness Center at Abbot Northwestern Hospital in Minneapolis and the IEMPHIT group for kids in St. Paul as well as our Physical Therapy team here at Children’s.

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Recently, I saw a 7-year-old patient who weighed more than I do. The family did not understand that their child was overweight. They all ate potato chips during our visit at 10 a.m.

I am certain that this patient will be a 300 lb adult with hypertension, type 2 diabetes mellitus, and early coronary artery disease, who will be hospitalized numerous times as an adult and be an over-consumer of health care.

By 7 years old, this child’s path has nearly been set.  This patient has developed all the wrong eating patterns, is eating the wrong foods, and is drinking the wrong beverages.  Food has a different meaning for this child than it does for other children.  She has the wrong priority for exercise, the wrong life balance.

Yes, I have failed this child, despite numerous attempts.  The time to intervene is as eating starts, right at the initiation of solids, right when families are using food as a reward, right when children will eat whatever parents will give them. Right then is the time to get it right.

Looking for ways to teach your kids about healthy eating? Here are some kid-friendly recipes from our new ChowKids Cookbook from chef Brenda Langton of Spoonriver. How have you taught your kids about eating right? Be one of the first three readers to share your idea or kid-friendly recipe below, and we’ll send you your very own copy of the ChowKids Cookbook! (Update: We loved the responses we got, and we have a few more cookbooks to give away. Share your recipes/ideas and you could win one!)

Gigi Chawla, MD, is the Chief of Staff at Children’s Hospitals and Clinics of Minnesota. Read more about her here.