Students in Lakota and Cincinnati Public schools are getting fruits and salads with school lunches instead of french fries and Tater Tots. Students at Mount Healthy High are lifting weights and measuring body fat as they learn physical fitness.

Local researchers are recruiting teens to find out if low-carb diets are a safe, effective way for youngsters to lose weight.

Across Greater Cincinnati and Northern Kentucky, families, schools and health officials are tackling childhood obesity by helping children and teens learn to make healthier choices. The action comes as the Institute of Medicine today releases recommendations aimed at helping the nation's children slim down. Nationally, 20 percent of kids are overweight or obese.

"It's an important focus," said Dr. Steve Daniels, pediatric cardiologist and medical director of Health Works, a weight- management program for children and teens at Cincinnati Children's Hospital Medical Center. "We have kids who are less active, and they are struggling with weight and developing health problems, some of which we used to think of as adult health problems, not pediatric."

Those problems include high blood pressure, high cholesterol and Type 2 diabetes, "which we used to call adult-onset diabetes," Daniels said.

Some of the issues examined:

• Vending machines and other foods that compete with school meals.

• The amount of time children and teens spend watching television and playing video games instead of being physically active.

• A plan to tackle child-targeted advertising of high-fat, high-sugar foods and drinks and sedentary recreation.

• Recommendations for revamping food packaging and portion sizes.

• Suggestions for parents to improve their children's eating and activity habits.

Cody Thomas, 9, wanted to be able to wear jeans to school instead of baggy sweats.

"A kid on the bus called me fat," he said.

Now that he's lost 22 pounds, the third-grader's jeans are baggy.

He's traded french fries for baby carrots and soda for water. He's signed up to play basketball, and he's logging plenty of miles on his bike every day.

Thomas and his parents, Richard and Vicki Thomas, have learned healthy habits through Cincinnati Children's Health Works. The program emphasizes how to make healthy food choices and get physically active, both at the center and at home.

Vicki Thomas said it took her months to realize that the problem wasn't only Cody's. She had to take responsibility for buying healthier, lower-calorie snacks and making dinner most nights instead of relying on fast food.

That's not always easy for the Thomases. Both parents work, and Richard Thomas changes shifts.

"The issue is busy lives and being in a hurry all the time and not actually sitting down to dinner as a family," Vicki Thomas said. "Doughnuts are convenient. Sitting down and eating breakfast was not convenient."

In the Lakota School District, all the snacks sold at the elementary schools must have 7 grams of fat or less, and all of the chips are baked. Vegetarian meals are regularly offered in the secondary schools.

"We're trying to be proactive," said Treva Whitlock, the district's director of child nutrition.

Meals offered at public schools have to follow federal guidelines as far as calories and foods recommended by the food pyramid, points out Renie Kelly, director of building operations/foods services for the Cincinnati Public Schools.

At Cincinnati Public, every school offers a fresh fruit of the week, dictated by what is in season. In addition, fresh broccoli, carrot sticks and celery have been added to the regular meal.

When possible, Kelly said, lower-fat or lower-sugar items are substituted, but those items can be costly.

At Mount Healthy High School, Jon Sheehan leads the P.E. Plus classes for students who are physically and mentally challenged, as well as students who haven't passed traditional gym classes because of weight issues.

The classes emphasize circuit training and healthy fitness habits rather than specific sports like flag football, Sheehan said. Students set goals and track criteria like body fat percentages. Sheehan also encourages students to be active on their own time.

"I tell them, you can't learn algebra just in the classroom; you have to do the homework. Well, it's the same with fitness," he said.

Researchers are signing up 70 teen-agers for a study on low-carb diets through Cincinnati Children's Hospital and the Cincinnati Pediatric Research Group.

The study is funded through a grant from the Robert C. Atkins Foundation, but teens won't follow the traditional Atkins diet, said Dr. Robert Siegel, the pediatrician leadingthe study. Siegel is the medical director for the research group and St. Luke Pediatric Centers.

During the study, teens will be limited to 50 or fewer grams of carbohydrates per day.

One of the advantages of the low-carb diet for teens is that they're not restricting calories, just the sources of those calories. And simple sugars and carbohydrates break down quickly in the body, triggering a hunger response, so by eliminating them, people tend to feel fewer hunger pangs, Siegel said.

Throughout the study, doctors will monitor participants' cholesterol levels and check other blood lipids. Teens will be asked to keep a journal of what they eat, and they and their parents will meet with a dietitian to learn smart food choices about carbohydrates and lean sources of protein, Siegel said.

E-mail pofarrell@enquirer.com