SPECIALREPORT

Almost half the children in elementary schools are either overweight or

"We take 2 steps forward and 1.9 steps back. Progress is slow,'' said Dr. Ludwig. "Obesity rates don't need to go up. We could level off and we would still be set for an unprecedented disaster. medically obese, (30.3

percent children ages 6 to 11 are overweight and 15.3 percent are obese) according to the American Obesity Association.

The government has declared a war on childhood obesity.

Schools have declared a war - beginning to remove vending machines, requesting parents send in health snacks, encouraging physical activity.

But the numbers have not shrunk. Increasingly, local organizations are calling on families, schools, and communities to take ownership of the childhood obesity crisis and work together to fixit.

Local experts said this united-front approach is gaining momentum, in part because professionals have learned that lecturing families about healthy lifestyles or targeting children to modify their behaviors just doesn't work.

And, when the focus is taken off the child and put on families and communities, parents can get away from guilt or other emotional traps that often plague them when trying to help an overweight child.

"In some ways, we are still paralyzed on this issue,'' said Dr. David Ludwig, director of the Optical Weight for Life (OWL) Clinic at Children's Hospital in Boston. "But, we are not powerless and we can take action. We can hugely affect the future of this generation.''

Dr. Ludwig said a key step at the OWL Clinic is to help a family see that a change in lifestyle must happen not just for the overweight child but for the entire family. This concept and other healthy living strategies are the focus of Dr. Ludwig's first book, Ending the Food Fight, which is scheduled to be published next month. (See sidebar on page 11)

Childhood obesity has reached epidemic proportions - this generation has the highest percentage of overweight children in history. Reports vary, but it is estimated that at least 9 million children between the ages of 6 and 19 are overweight in the United States. In the last 25 years, the percentage of overweight children has doubled.

What is alarming is the potential health crisis that will soon be here, because of so many overweight children. Left unchecked, overweight children run the risk of Type 2 Diabetes, once an adult-onset disease, while they are still children, and heart disease or stroke as young adults.

"You can do prevention and behavior change for the individual, but then you need the programs to support it,'' said Janet Schwartz, chair of the Department of Consumer Science and Professor of Food and Nutrition at Framingham State College. "It takes the whole thing."

What we need to see, Schwartz added, is that "families are involved, school lunch programs support it, and then a program at school or after-school will develop it more.''

Several local organizations are now running childhood obesity programs that focus on this concept of giving the family ownership and empowering them to come up with ideas to get healthy. Further, some programs are now encouraging communities to collectively work on the childhood obesity crisis.

In some cases, these organizations are using grants recently received by Metrowest Community Health Care Foundation (MCHCF) to launch these programs. The Foundation is also the organization that sparked controversy earlier this year when it launched a provocative public awareness campaign on childhood obesity via billboards. (See sidebar on page 13)

For example, the Natick Service Council, a non-profit agency that provides a range of community services and referrals in Natick, will use a $50,000 grant from Foundation for a Bounce For Better Health program, said Rebecca Gallo, director of client services. The program will offer free classes at a local gym not just for children but for families of "anyone with children in their homes,'' Gallo said. The gym classes will include workouts on small trampolines, thus the "bounce" in the program's name. A second component will provide healthier foods and fresh produce at the Natick Food Pantry.

The Westborough Schools, another Foundation grant recipient, is rolling out a three-pronged plan, which supports the notion that a successful program to fight childhood obesity must involve the entire community.

"We wanted a strategy not only for our students, but for the Westborough community to highlight this issue,'' said Nancy Spitulnik, director of student services. "We wanted to see what the school could do in a united way with the community."

The program, funded via a $42,445 grant, will include an emphasis on healthy eating and "wellness'' to the current physical education program by the start of the next school year.

The second component is a communitywide health fair scheduled at Westborough High Saturday, March 3. Planned with the town's Board of Health, Senior Center, Community Education, and Recreation Department, it will provide information on healthy living, various medical screenings, children's activities, and adult activities like Tai Chi and aerobics.

The third piece is to open the High School's fitness center to the community. The center will be available to school staff before the start of school while middle school and high school students will have afternoon access. Residents of the community will have access in the early evening, at no charge during the grant's initial year.

"What we findis that everyone agrees we need to do more '' to fight childhood obesity, said Spitulnik. "This is helping people finda way to do it."

Another program hoping to unite family and community is underway at the YMCA of Greater Boston, which operates 15 locations. In the second-year of a three-year federal $500,000 Carol White Physical Education Program grant. The goal is to improve its after-school program.

Since its inception, the grant program has helped the YMCA of Greater Boston discover the more empowered children and families feel the more success the program will see.

"We have learned that you can't just change a program and expect the kids to get healthy,'' said John Hirliman, schoolaged child care health and wellness director at the YMCA of Greater Boston.

The key, Hirliman said, is to help families feel empowered and therefore motivated to participate.

For example, rather than hand out healthy snacks, the YMCA of Greater Boston at snack time offers a selection of fruits and allows the children to prepare the fruits. The children then have a taste test and vote on their favorite.

"We see a dramatic increase in their satisfaction levels," Hirliman added. "Now the kids are eating more healthy food and we aren't throwing away as much. They have more ownership in it."

Hirliman acknowledged that involving parents is not easy. Afterall, the reason children are in the after-school program is because their parents are typically working. However, the YMCA of Greater Boston recently created Total Healthy Habit Teams, which are groups made up of parents, children and staff who meet once a month to discuss healthrelated issues. The idea is to get families, with the help of staff, to generate their own activities. For example, one team recently created a healthy foods cookbook made up of recipes that family members contributed. Another test program offers parents with children in the program to workout for free at one of the YMCA of Greater Boston's fitness centers from 4-6 p.m.

Sharon McCollum, the WIC (Woman, Infants and Children) program director for the South Middlesex Opportunity Council, agrees that parents need to feel empowered. Through a $50,000 Foundation grant, her program will offer group discussions, facilitated by staff, in which parents can share information on meal preparation, recipe "makeovers'' and physical activity.

"In the past, we had good intentions, but it was more a fact-based lecture approach,'' said McCollum. "That, we find, doesn't really motivate people to change. It really needs to be a clientbased approach. You really need to

listen. They are really the experts on They are really the experts on

what happens in their lives."

Rose Cafasso is a freelance writer from Franklin.