Sunday, September 26, 2004

Join the roundtable discussion: The region's looming health crisis

By Krista Ramsey Enquirer staff

The region's looming health crisis
Meet the panel
What you can do now
Fight back with small actions
Editorial: We can battle this crisis together
Take the pledge

When it comes to nutrition and physical fitness, Greater Cincinnati and Northern Kentucky children are being endangered by their own habits - habits that compromise their health and shortchange their futures.

These children are besieged on all sides by lifestyle shifts, neighborhood changes and marketing campaigns that have led them to eat more and exercise less. Those habits will cost Americans billions of dollars in health care costs over the next few decades.

Today's kids are fatter, weaker, more poorly nourished and more sedentary than American kids were even a generation ago. Raised in a super-sized world, most have no notion of normal portion sizes and no memory of playing outside until they fell into bed exhausted.

Childhood is becoming a hothouse for dangerous habits that lead to spikes in the nation's top adult killers - heart disease, high blood pressure, high cholesterol and diabetes.

That's the jolting wake-up call sounded recently when the Enquirer met with a panel of local leaders in health, public policy and education. Their discussion helped shape "Healthy Children, Healthy Future," a five-part Enquirer Editorial Board project that addresses the alarming spike in childhood obesity and "lifestyle diseases" - such as Type II diabetes and cardiovascular disease - and the drift away from physical activity and overall well-being.

The scope of these problems is nothing short of a national and local disaster, and we're sounding the alarm. But our most important message is that this disaster doesn't have to happen. Small personal changes, modest improvements in public policy and good thinking by families, educators and community groups can prevent, reverse or reduce these health threats.

Over the next three months, we'll ask readers to begin changes to curb these dangerous trends, and we'll advocate for simple ways policymakers, businesses and schools can help fight this threat.

Our message is simple: Kids' health, and lives, are at risk. It's time to take action. "We're raising the first generation of people who may very well live less long than their parents," said Dr. William Hacker, acting public health commissioner for Kentucky and a pediatrician. "This issue has tremendous long-term economic impact. We in Kentucky are looking at it, not only for personal impact, but in terms of how a state can endure it and succeed."

A recent study by the Centers for Disease Control and Prevention reported that in 1998, Ohio spent $3.3 billion on obesity costs alone, and Kentucky $1.2 billion. This year, estimated national cost for obesity-related illness is $117 billion - and rapidly rising.

Our panel used professional expertise and personal observation to outline a problem that has sharply escalated over two decades, grown to an epidemic today and is drastically changing the everyday life of the average American child.

• Pat Weiland, an 18-year veteran physical education teacher at Blessed Sacrament School in Fort Mitchell, has seen the school's number of Presidential Fitness Award winners plummet. "The kids' upper body strength and flexibility are unbelievably poor," she says.

• Dr. Camille Graham, a community pediatrician and president of staff at Children's Hospital Medical Center, sees generations of health problems ahead. "In my practice, only about 10 percent of my patients eat breakfast," she says. "They say they don't have time. And lunch is chips and pop or chips and juice. Now, what is that generation going to be like when they have children? What is their concept going to be of what healthy breakfast is, or a healthy lunch?"

• Dr. Michael Farrell, chief of staff at Children's, watched Type II diabetes, once known as adult-onset diabetes, go from being unheard of as a pediatric diagnosis during his medical training in the 1970s to outpace juvenile diabetes diagnoses at Children's today. "The issue's very simple: We eat more than we burn up. But the next level down is very complex. What's driving these behaviors?"

That's a pressing concern. Now, one-fifth of all Kentucky kids ages 2 to 5 are seriously overweight (see Body Mass Index chart at left), as are 15 percent of Ohio children ages 6 to 19.

Nationally and locally, the percentage of overweight children has tripled over the last 15 years, leading top obesity researcher Dr. Stephen Daniels, a cardiologist at Children's, to label it an epidemic and to warn: "I don't think anybody sees any real signs of it slowing down."

But it's not just overweight children who are at risk. Poor nutrition threatens everything from children's immune systems to their dental health. Poor fitness habits put children at risk of inadequate bone development, compromised cardiovascular health and a lifetime of sedentary habits.

The causes of this crisis are almost endless, an unholy alignment of overabundant and oversized foods, disappearing play spaces, kid-savvy food marketing and an energy-efficient society that produces too much food and requires too little physical effort.

But the most significant cause, our experts say, is the fast-paced, high-stress family life that pulls children away from movement and pushes them toward fast, high-fat, low-nutrition foods.

Roundtable members lamented the rise in highly organized and "elite" sports programs at the cost of old-fashioned, exhaustive backyard play.

"Parents often misguidedly think that's the only kind of activity their kids can get involved in," says Keith King, a University of Cincinnati assistant professor of health promotion and education. "But the Centers for Disease Control recommends kids be involved in vigorous physical activity at least three to five times per week, 20 minutes per session, making sure they're sweating and breathing hard. They just need to be moving - they don't have to be moving on a football field or basketball court."

The challenge is "figuring out how to get kids back to the concept of playing games and being active and enjoying every minute of it - that being active is more fun than instant messaging on the computer or playing video games," Daniels said.

Families can't rise to that challenge alone. Our experts were in wide agreement that children need more time in physical fitness classes at school, more recreational opportunities in their communities and safer neighborhoods to be active in.

They want to see more action like the "Get Healthy, Kentucky" program, which drew 1,200 residents this summer to statewide forums to address the obesity problem. "I look enviously across the river all the time and use Kentucky as a model for some of its public health policies," said Lauren Niemes, executive director of the Greater Cincinnati Nutrition Council. "On our side of the river, we need to work on that upper level of legislation so funds are designated to these health issues. It all boils down to money - and we're selling out on our kids' health."

In terms of nutrition, our experts worried over hurried fast-food meals in the back of the minivan, poor nutritional choices at school, and Saturday morning TV ads and kid-level grocery store choices that push kids to sugary snacks and all-day eating. "Once kids hit the sugar line (the school cafeteria line) at lunch, their inattentiveness is terrible," said Jamie Gindele, a Blue Ash mother whose son has juvenile diabetes.

Panel member Maureen Kenner, a pediatric nurse and clinic manager of the Boone County Health Center, understands both the causes for the current health dilemma and the modest - if nevertheless challenging - steps that will help solve it.

"I'm out there counseling people on healthy eating, but my family is not always practicing it. I work, my husband works fulltime, my kids have homework until 8 or 9 at night, and nobody has enough energy on Saturday or Sunday to do much of anything," Kenner said.

But her family's solution is what experts say may be the best way to win the war on inertia and overweight - simple steps, steadily taken. The Kenner family is making sure they get "five a day" servings of fruits and vegetables, and fit exercise into every empty 30 minutes they can find.

For families, those are exactly the kind of modest, truly effective steps we are recommending. We also call on policymakers, communities and schools to make kids' wellness a top priority and incorporate it into their planning and budgeting.

The region's looming health crisis
Meet the panel
What you can do now
Fight back with small actions
Take the pledge
We can battle this crisis together
You can help boost Ky. college grad rates
Ky. test scores don't tell whole story
Letters to the editor