When First Lady Michelle Obama learned her daughters were at risk of developing weight problems, childhood obesity became her top priority. Though Malia and Sasha appeared healthy and normal, their BMIs—Body Mass Indexes—were showing an upward curve, echoing patterns in children all over the U. S. Here in Hampton Roads, nearly one in five children is considered at risk for health problems related to weight. But childhood obesity and other nutrition-related illnesses do not have to become long-term realities. Tidewater area physicians, dieticians, teachers, and parents are working hard to keep our children healthy and correct trends that could affect their overall health for a lifetime.
“Childhood nutrition begins during pregnancy,” said Connie Smith, 53, registered dietician and director of Chesapeake’s Women, Infants and Children (W.I.C) program. “[It] really [begins] in the three months before they become pregnant—when women should begin to make positive changes like quitting smoking and paying attention to what they eat and drink.”
For more than 30 years, Connie has worked with families and children in hospitals and public health settings, counseling moms about prenatal nutrition and making wise choices for themselves and their young children’s diets. At this point in her career, Connie’s seeing stronger support for breastfeeding from physicians and researchers, and that makes her very happy.
“In the 80s, we still didn’t see many people nursing their babies, but current research is supporting the value of breast milk down to the cellular level,” she explained. But many women missed the chance to breastfeed because they hadn’t been taught by their mothers or other women. In addition, a two-day hospital stay after childbirth doesn’t allow enough time to establish nursing patterns, even with the help of lactation specialists.
Connie said things are changing. “After all the ‘how to’ training and videos and gizmos that women went through—with not very much attention to instincts—we are now looking at the mother-baby couple and how nursing works naturally,” Connie said. “Babies know what they need.”
If mothers can nurse for a whole year, as suggested in new guidelines from the American Academy of Pediatrics, Connie believes they are doing the best for the long-term health of their babies. If they can wait until the baby is six months old to introduce solids, so much the better. Breast milk protects babies against many infections and allergies, and research is also beginning to link nursing with decreased rates of juvenile diabetes and obesity.
Parents often ask Connie questions about their children’s picky eating habits. She says parents shouldn’t make a fuss if a child doesn’t like asparagus right now. She advises families to make the healthiest food available and remember that they have eighteen years to help their child make good choices.
“I think the concerns are there because most parents understand that nutrition is important, but they also need to be realistic about portion sizes. Even adults don’t get that yet,” Connie explained. “Do you know that the correct portion size of a serving of spaghetti for adults is about 1/2 cup? So for a 1 year old, that’s about 1 tablespoon.”
At 53, Connie’s own health reflects her knowledge of good nutrition and practices. She stays slim, avoids the cookie aisle in the grocery store, gardens, does yoga, plays acoustic music with her friends, and loves to go hiking. She and her 88-year-old father climbed Old Rag in the Virginia mountains on Mother’s Day. Five years away from retirement, Connie has learned that keeping nutritionally fit is not as hard as it seems.
“The more you know, the simpler it is,” she said. “Eating well is about variety, moderation, and portions—and eating many colors of food. And it’s about learning to cook, which I think is a vanishing art. Kids should be taught about making healthy food in high school. Mom’s not always going to be there to make your meals.”
PLANTING HEALTHY FOOD HABITS
In Virginia Beach, one group of schoolchildren is actively involved in planting healthy habits. At Cooke Elementary in Virginia Beach, an after-school club called Growing Green, comprised of students in grades 3-5, teaches children how food grows. Special Ed teacher Julie Laidlaw, Library/Media Assistant Carol Ann Guido, and a former parent at the school, Dana Sizemore, realized three years ago that many students had little connection with fresh foods and no understanding of the many steps involved from planting to harvest to foods they could see at the grocery store or in the cafeteria. Though they learned about the state of Virginia’s agricultural products as part of their SOLs, children had very little direct access to anything like agriculture.
Part of it stems from what Julie and Carol say is a “germophobic” environment because children today are not encouraged to get dirty. And some children at Cooke don’t have back yards. “Many of the children in our school have no contact with gardening or the outdoors. They don’t play in the mud. They don’t go out in the rain,” said Carol, who grew up in New Jersey, where many families had gardens, even in city neighborhoods.
They wrote a grant and received $1,000 dollars from the Virginia Beach Education Association. With the help of a local organic farmer, John Wilson, and Jane McNichol, a grandmother and professional landscaper gardener, the group started in the fall of 2007. Children and teachers nurtured plants at Wilson’s farm and greenhouse and transplanted them at school.
Because they couldn’t plant food on the school grounds, The Growing Green Club partnered with students at the Vocational Technical School to design and built five waist-high planters, filled with a mixture of compost and organic soil. The kids watered, weeded, and watched. At the end of the first growing season, the club had a bountiful banquet, featuring fresh salads and their own potatoes and dill. The kids savored their harvest with a delight usually reserved for sweet treats, and the project has inspired the teachers, too.
“I’ve always liked to garden, but I don’t think I’ve been as good as I’m getting,” said Julie Laidlaw, a Minnesota native who grew up with raw milk and plenty of fresh food. “I’ve learned little bits of information from lots of different people, and I don’t think my horizons would have been expanded without this gardening group."
Carol Ann Guido says she’s trying to introduce new concepts every year—like composting at school and creating a worm bin. “We fed the worms vegetable scraps, and the next day it was gone. Of course it came time to take the compost out, so we dumped the bucket out and gave the kids rubber gloves and told them to pull out the worms. You would have thought you had given them gold. They loved it,” Carol recalled. As the Cooke Elementary Growing Green Club finishes this school year, the students are looking forward to savoring their homegrown salad bar banquet.
A HEALTHY LIFESTYLE
What happens when children don’t have access to healthy foods and their family meals are full of over-processed, fatty, and fast food offerings? They are at risk for serious diseases like juvenile diabetes and cardio vascular problems. At the Children’s Hospital of the King’s Daughters, Dr. Dominque Williams is the pediatric director of a special program called “A Healthy You,” which offers children and families a new lease on health.
“I feel strongly about the impact that nutrition has on every area of our lives, and it is sometimes underestimated,” said Dr. Williams, whose undergraduate degree is in nutrition. She and the Healthy You team—a registered dietician, a physical therapist, and a licensed clinical social worker—receive referrals from pediatricians, seeing kids who need to revamp their relationships with food.
“We have to be sensitive to the fact that not every community has access to fresh foods in their neighborhoods,” she continued. “If we can get families to switch from canned food to frozen, that’s an improvement.”
Dr. Williams says children and families have to “buy in” to the program, encouraging the patient to choose which professional to work with first. As the lab results come in and parents see improvement, the family food culture often changes, too.
“The biggest misconception about children and obesity is that you can see it,” Dr. Williams said. “You can’t always. What physicians need to do is to look for the height and weight pattern over time. In A Healthy You, we often see children who are over the age of five and have a height/weight ratio greater than the 85th percentile, and these patterns can be seen in children as young as two.”
SETTING TEEN GIRLS STRAIGHT
Pop culture’s promotion of fast food attracts another population: teens. And girls have a particularly difficult time because the messages they get about staying slim conflict with the lack of food value in commercial food items. At Bon Secours In Motion Physical Therapy and Sports Performance Center in Virginia Beach, Registered Dietician Brooke Mercedes sets up nutritional assessments for teens with a range of challenges: girls with eating disorders, teen athletes, and those with obesity issues. Brooke is a regular on area TV public affairs and news programs because of her unique experience with kids and their nutritional needs. She loves her patients and develops close, caring relationships with them.
“I think our society is just too image oriented,” Brooke said. “Then you send a kid to school where they are offered French fries every day, and that’s the biggest challenge with our girls.”
Brooke is concerned that this is the first generation of American kids who may not outlive their parents, though they are pushed to excel in academics and testing. She mourns that schools don’t require nutrition classes that would help them thrive.
Regular exercise is the partner of excellent food choices, says Brooke, who quoted the American Academy of Pediatrics guideline that all kids should exercise a minimum of 150 minutes a week and up to 300 minutes for weight loss.
No matter what their schedules, teens need to have lunch. "When I have young ladies who come in here with eating disorders, and they don’t eat lunch, I encourage them to eat every 3 to 4 hours,” Brooke said. “But in some schools you are not allowed to bring any food into a classroom.”
Teen girls often get out of balance with their attitudes towards carbohydrates. She says she often hears girls say carbs make you fat. “Especially for students who are athletes, carbs are not the enemy,” she said. “They’re the energy source. It’s the portions and the type that matters.”
“We often just eat to eat,” Brooke said. “We just don’t know how to stop.” She’s working on another, longer version of Nutrition Camp and stays faithful to her mission to guide teens in healthy eating plans.
Kathleen Fogarty is a frequent contributor to Tidewater Women. She lives on a farm in Virginia Beach.