Fighting for fitness

Fifteen years ago, Patty Cornell’s fifth-graders could swing from the uneven bars, toe the balance beam and handle other gymnastic feats with ease.

Now, Cornell doesn’t offer that gymnastics unit; most of her students don’t have enough upper-body strength, she said.

“They have little awareness about the size of their bodies, no balance or position control, as far as gymnastics goes,” Cornell said.

She has taught physical education for nearly 20 years, the past three at Paxton Keeley Elementary School.

Cornell said she has seen an increase in overweight children during her tenure as a physical education teacher. So has Sandra Gray, a Paxton Keeley nurse.

Statistics support the observations of both.

During the 2000-01 school year, school nurses trained by the Missouri Department of Health and Senior Services weighed and measured 17,000 students statewide, a sample that represented 1.5 percent of the school-age population. More than one in five, 21.5 percent, was found to be overweight, according to measurements of their body mass index-for-age as calculated by the state health department.

By contrast, only 4.2 percent of children 6 to 11 were overweight in 1963-65, according to a similar nationwide study the National Center for Health Statistics, part of the federal Centers for Disease Control, conducted.

A majority of Missouri public schools are weighing and measuring children, but for most of these children who are found to be overweight, schools offer no help.

A newly released survey by the state health department revealed that 72 percent of Missouri schools collect annual height and weight measurement information. From those measurements, BMI-for-age is calculated.

A far lower number of schools respond to the results. Only one-quarter of schools follow up with children found to be overweight.

The survey did not seek to find why schools do not respond to the data. Rita Arni, a child nutrition program manager, said there could be a number of reasons schools do not do anything with the data they gather.

For researchers and others interested in helping children eat healthier and be more active, the data proves frustrating.

“Whose responsibility is it to follow up with this?” said Ann Cohen, a nutrition specialist. “Three-fourths of schools are taking no action.”

Lack of action was one factor prompting Cohen and Steve Ball, members of the Missouri Extension Network, to start a program called Jump Into Action.

The program is a team-taught nutrition and physical education program that seeks to change behaviors to reduce the risks of Type Two diabetes in fifth-grade students.

Cohen, a nutrition expert, and Ball, a fitness specialist, are well aware of the rise in overweight children.

Both note how difficult it is to determine or address the causes of those troubling increases.

“It is multifactorial,” Cohen said.

She cited parents, schools, economics and advertisers such as the soft drink industry as among the factors.

Ball agreed, noting that there is no single, isolated cause.

“It’s really kids are exposed to a toxic environment,” he said. “They’re bombarded with ads. A lot of time in the schools there are vending machines with things kids shouldn’t be eating. Parents are also partially to blame. So, it’s really society as a whole.”

Gray said she has noticed children seem to spend less time outside and more time inside playing with computer or video games. Also, she has seen an increase in fast food intake and the amount of time families spend eating at restaurants.

Such behavior can have debilitating health consequences, including diabetes.

“Obesity carries with it a lot of different associated health problems,” Ball said. “Type Two diabetes and diabetes on the whole is on the rapid increase.”

In November 2003, Cohen and Ball received a $668,181, three-year grant from the Missouri Foundation for Health to implement the Jump Into Action program in schools. The program is in place in the 25 Missouri counties within the foundation’s financing area with the highest instance of adult diabetes, including Boone County.

Children who have at least one diabetic parent have a higher risk of developing Type Two diabetes. Being overweight can tip the balance in favor of development of the disease, as can inactivity, Cohen said.

The program, which is in its first year, will reach 30,000 to 40,000 students over three years, organizers hope. It targets fifth-graders, students who remain in one classroom for the school day.

“Fifth-graders are at that age where they are starting to make independent decisions and understand cause-effect relationships,” Ball said. “It’s also, I believe, an age where we can reach them.”

Gray said noted that as students become heavier and progress into middle school or junior high, they become bombarded by a bevy of social problems.

“Always, I think, there are peer concerns, peer pressure,” she said. “When kids are overweight you worry about their self-esteem and the acceptance by their friends. But you also worry about what it’s doing to them health-wise.”

Jump Into Action uses a combination of classroom lessons and pedometers to help students become more aware of their choices when it comes to nutrition and physical activity. The program has five goals, Cohen said.

They are: Increase fruit and vegetable consumption to five or more servings a day; decrease consumption of sugar-added beverages; decrease the amount of time sitting in front of a computer or television screen to two hours or less, increase the consumption of milk, yogurt and cheese to four servings; and increase physical activity to at least 60 minutes.

The activity part of the program relies on the use of pedometers, which measure the number of steps students take per day. Physical education teachers such as Cornell use the pedometers for six to eight weeks in class.

Students record their number of steps and activity time at the end of each class, setting individual goals along the way. After that period, the pedometers are moved into the classroom, where kids put them on upon arriving at school and wear them all day. Then, if schools permit, the children are allowed to take the pedometers home.

Ball said he thinks that pedometers are preferable to standard fitness testing, such as testing a student on a one-mile run, to see whether children have improved their fitness or activity levels.

He hopes that gym teachers will modify their activities based on the results from the pedometers, adding activities that increase the amount of steps children take.

Cornell said she has always tried engage students in active games.

“When we work on overhand throwing, for softball, I have them throw the ball as hard as they can and then run to go get it before throwing again,” Cornell said. “It’s called aerobic throwing.”

The program is free for schools in the identified counties. Other schools can implement the program but must cover the cost of the program. Costs include pedometers, student activity books, teachers’ guide, instruction materials, assessment and evaluation, training, support and family newsletters. Cohen said the first year will cost schools $180, $60 in subsequent years.

Participating schools are expected to foster cooperation between teachers, school nurses, physical education teachers and parents.

“We know from research that a team approach is most effective,” Cohen said.

At Paxton Keeley, Gray and Cornell met with fifth-grade teachers before deciding to implement the program.

“We just wanted to give our students an opportunity to be more active and to learn about healthy eating and exercise habits,” Gray said.

Paxton Keeley students seem to enjoy the program. Kelsey Nietzel, 11, knew about pedometers because her mother uses the device. She said she runs in class more to accumulate more steps.

Zermin Dzananovic, 12, called the pedometers “cool,” noting that he once recorded 10,000 steps. He and his friends compete to see who can get more steps.

As far as the nutrition lessons, Zermin said he has learned to step away from eating junk food when it’s available.

“I just stop eating it,” he said.