Growing girth

When Christina McGee wanted a snack after dinner Thursday, she ate an apple. And then another.

And while she nibbles on fresh fruit instead of potato chips or snack cakes, the Cape Girardeau kindergartner is already conscious of her body size.

"She's already worried about her weight and says she's getting fat so she's got to run," said her father, James McGee.

And while it's good that Christina chooses healthy foods for snacks and thinks about exercise, an obsession with weight shouldn't be foremost on her mind.

But it's at the forefront for health officials in Missouri -- and across the country -- who are worried about an obesity epidemic among children.

In the past 20 years, the number of overweight Missouri schoolchildren has more than doubled. One-third of the students enrolled in Missouri public schools in 2003 were overweight.

That growing girth on children has many health officials alarmed because the statistics show that Missouri's percentage of overweight children exceeds the national average.

In Missouri, 32 percent of children in grades 6 to 8 are overweight or at risk for being overweight. At the high school level, the figure is 27 percent.

Part of the problem is that society is setting children up at a young age to be overweight, says Dr. Gary Bucher, a physician practicing in Phoenix and a Southeast Missouri native.

Bucher says America is doing worse today at educating children and young adults about how to eat right. He blames in part the dietary guidelines that parents, schools and educators use to teach children about healthy eating habits.

The current guidelines don't explain that people need foods low in fat and whole grains, in addition to plenty of fruits, vegetables and dairy products, he said. New food pyramid guidelines are expected in January.

"People think if they're eating from the pyramid they're OK," Bucher said. "People think they're healthy, but they're eating the wrong types of foods."

Schools take some of the blame, too. While schools follow dietary guidelines, much of what they serve in the cafeteria has been processed and is loaded with sugar and calories that children don't need, he said.

A complex problem

The problem of obesity is complex, and particularly complicated when addressing weight in children.

Children need nutrients for their growing bodies, but what they don't need are excess calories. Most snack foods are high in calories and low in nutrients. Children have to be taught to choose foods for themselves that are higher in nutrients but low in fat and wasted calories.

"With the youngest kids it's more an awareness and just teaching them to keep trying those vegetables they don't like," said Raina Childers, a registered dietitian.

What sorts of fruits and vegetables children eat depends on what they've been exposed to, she said. "Parents are such role models in what they offer or keep in the house as healthy foods."

And teaching children about exercise and good nutrition often means teaching their parents, she said.

During an after-school "Fun on Friday" program at Franklin Elementary School, Childers spoke about how many servings of vegetables are necessary and what size those servings should be.

She asked each child to hold out a hand and look at the palm -- that is the guide for the amount of vegetables to eat. But children aren't the only one who needs those fruits and vegetables. She encourages children to talk to their parents about what they eat too.

Jessica Coomer, 9, said her mother cooks vegetables every night with the family's dinner. It's not always something she likes, but she tries to eat some vegetables. "It's not really too hard to do," she said.

30 minutes a day

But Chris Martin and his friend, Michael Johnson, said getting exercise is harder than watching what they eat. Martin said they like to play video games.

A decreased amount of physical activity is partly to blame for the obesity epidemic in America. "We all want to raise healthy children, but we need to demonstrate a healthy lifestyle," said Lisa Talamini, a registered dietitian and program development coordinator for Jenny Craig Inc.

As a general guide, parents need to make sure their child gets 30 minutes of brisk activity each day, said Eileen Sievers, a wellness nurse at Saint Francis Medical Center. "You don't always know what's happening at school, and if they got 30 minutes of activity at school and more at home that's all the better."

James McGee makes exercise part of his family's day. He bikes to his job and walks home with daughter Christina after school. "That's just always the way we were," he said. For his family, it's not a matter of trying to add exercise, it's part of their life.

Social norms have to change in order for children and adults to add exercise to their daily lifestyle, said Ross Brownson, a professor of epidemiology at St. Louis University's School of Public Health. "Some of it's about the access people have to physical activity."

Schools can help create safe routes for students and parents who bike or walk to school or open gyms for exercise. Communities need parks in neighborhoods so people can use them.

"We have to work on intervention issues because fat kids become fat adults," Brownson said.

To help combat that, staff from Main Street Fitness in Jackson visit Franklin School each Friday to teach children about good nutrition and exercise. A similar program called "Way to Go Kids" runs for eight weeks and starts Wednesday at Orchard Elementary in Jackson.

Neither program is just for children who have weight problems or who are at risk of being overweight. "There isn't a kid who doesn't need to hear this," said Debbie Leoni with Main Street.

Changing as a family

Parents can eliminate fried foods and foods high in fat for healthier family meals, Sievers said. Even at restaurants there are a lot of healthier options on the menu, she said.

Making the change to better eating as a family is a sure way to reach success, Sievers said. "It's defeating when you think of it as a diet or weight-loss plan but not if you think of it as an eating plan for life and focus on healthful eating because it benefits all of us."

And getting parents involved is a sure way to effect change, Bucher said.

"It might start with a group of parents who want to make sure their children are eating well at school," he said.

Preventing children from becoming overweight or obese is much easier than trying to change eating habits for teenagers or adults, Leoni said.

Most of what children like to eat is ingrained in them by age 6 and if they like to watch television and don't move around, "it's hard to break those habits."

Talamini said if the nation doesn't address its childhood obesity problem, there will be a health crisis when today's children turn 30 and begin having heart and kidney disease associated with obesity or diabetes.

"The largest challenge is the way we live," Brownson said.

ljohnston@semissourian.com

335-6611, extension 126