Keeping Kids Fit

Childhood obesity has reached epidemic levels. What’s a parent to do?

Posted December 14, 2009 by Jill P. Capuzzo

Photo by Michael Mahovlich/First Light/Corbis.

Samantha Ryan and Amanda Needleman look like perfectly fit 12-year-olds with lithe limbs, firm stomachs, and just a hint of the curves that await them in adolescence. Still, the two seventh-graders from Marlboro are not taking any chances. Each Thursday evening they report to the Training Studio in Morganville where they are put through push-ups, jumping jacks, rope pulls, and ball slams. Both girls hope to make their middle school cheerleading squad think this weekly preteen fitness class will make them stronger and more agile.

“Afterwards my muscles are sore, so I know it’s working,” Needleman says. “And it’s fun.”
Ryan has an additional goal in mind. She’s thinking about next summer. “I want to be able to fit into a bikini,” she says.

Another adolescent, Matt Pena, spent a recent Sunday working out at the Mount Laurel YMCA, looking to trade his soft middle for some muscle—at least enough to make next year’s football team. The 13-year-old Cinnaminson boy started by racing against his 20-year-old sister, Elvira, on side-by-side treadmills, then moved on to the abdominal-crunch and arm-curl machines.

“It’s good because they have a lot of different equipment, so you can work out different parts of your body,” says Pena of the Y. He and his family try to get there twice a week.

With continued effort, these kids will not join the ranks of increasingly unfit youth—or, worse, become a statistic in what is being called a childhood obesity epidemic. According to a 2007 National Survey of Children’s Health, 15.4 percent of New Jersey children ages 10 to 17 are considered obese, and another 15.6 percent are overweight. The outlook for the toddler set may even be bleaker—especially in low-income families, where 18.2 percent of 2- to 5-year-olds in New Jersey are obese, the worst rate of any state.
As a side effect, pediatricians nationwide are seeing children as young as 8 with type 2 diabetes, which is directly linked with obesity. For the first time in this country’s history, medical experts are predicting that the current generation of children will live shorter, less healthy lives than their parents.

Not all the news is bad. Recent studies show childhood obesity leveling off, but the rate still far exceeds what most medical experts find acceptable.

“We’ve made good inroads in some areas; in others we are flunking,” says Dr. Margaret Fisher, vice president elect of the American Academy of Pediatrics’ New Jersey chapter and chairman of pediatrics at the Children’s Hospital at Monmouth Medical Center.

Fisher, a keynote speaker at last spring’s childhood obesity conference in New Jersey, attributes the plateau in rates to increased awareness. Pointing to a host of societal conditions—including school physical education programs that don’t mandate physical activity, lower-income neighborhoods where access to healthy foods is limited, and overprotective parents who do not allow their children outside to play—she says New Jerseyans still have a long way to go before the problem is adequately addressed.
What can a parent do?

Dr. Michael Segarra, president of the New Jersey chapter of the American Academy of Pediatrics, says the key is catching kids early and teaching them good eating habits and the value of exercise. While he discourages parents from fixating on the weight of their babies, the North Brunswick pediatrician suggests what he calls a daily 5-2-1-0 regimen for children 3 and over: five servings of fruits and vegetables a day, no more than two hours of TV or computer time, one hour of exercise, and zero sweetened beverages.

Like many other pediatricians, Segarra uses the Body Mass Index, which calculates a person’s height-to-weight ratio, as an early diagnostic tool to determine if a child is heading for trouble. For children, the range of normal BMI is far greater than for adults (several organizations have BMI calculators on the web, including the Centers for Disease Control at cdc.gov). But kids ages 2 to 19 with a BMI between the 85th and 94th percentile are considered overweight, and those with a BMI of 95 or more are considered obese.

If weight loss is the goal, the recipe is simple: Kids need to eat less and exercise more. Fisher recommends 30 to 60 minutes of physical activity a day. She says it is unlikely that this will happen in school, where the state-mandated 150 minutes a week of physical education may include health classes. Instead, the Long Branch pediatrician suggests kids walk or ride their bikes to friends’ homes or after-school activities rather than being driven. She also recommends more casual play, like pick-up basketball or touch football.
“Organized play is not as vigorous,” Fisher says. “You look at something like T-ball, with all the coaches and rules. It moves at a pace that is mortifying.”

Segarra tries to leave it up to his patients to select their own form of exercise. “I tell them, ‘You pick the activity, and then do it. If you don’ t like it, you’re not going to stick with it.’”

Recognizing an untapped market, fitness centers are creating exercise programs geared toward young people. A good program will steer kids away from activities that could be potentially harmful to their growing bodies. Training Studio co-owner Mike Hanley says boys in their early teens should be discouraged from bodybuilder regimens like single-repetition maximum-weight lifting.

“Their bodies are not mature enough to handle this kind of strain,” says Hanley, who focuses on core-strength and agility exercises. “We try to train them how to move their bodies in proper ways so they use more muscle but don’t get hurt.”

Susan Sheeley, fitness director at the Madison YMCA, says young people “should pretty much do what we do—at least 30 minutes of cardio each day. We want our kids to be active but also to have fun.” She is an advocate of organized sports like soccer and lacrosse, as well as classes like yoga and dance. “They need to have fun,” Sheeley says, “and being with peers helps build self esteem, and they’re so much happier.”

The Madison Y offers cycling and interval-training classes just for teens. They also teach a ten-week course on the proper use of weight-training equipment. Teens under 16 are not allowed to use the free weights here—at many other clubs the minimum age is 14—but Sheeley thinks that the use of light weights and resistance equipment can benefit young people. “As long as they’re properly trained and supervised, I think it’s okay,” she says. “You don’t want kids lifting super-heavy weights, but light weights and muscle training is good for them.”

The Hackensack University Medical Center’s fitness center recently began a program for teenagers, allowing them to work out on the center’s equipment and giving them “alternatives if they don’t have a lot of equipment at home,” says manager Jim Miastkowski. “We teach them the basic principles, and try to keep it interesting so they want to keep it up.”

In the public sector, numerous government agencies and organizations that deal with kids throughout the state are trying to build youth-fitness awareness.

In October, the governor’s office launched a student fitness challenge and website, encouraging kids between the ages of 6 and 17 to track their daily intake of food, and the time they spend in front of the TV or computer. Dr. Michael Lamaccia, chairman of pediatrics at St. Joseph’s Children’s Hospital in Paterson, has created an after-school program for 300 children that has expanded to include the whole family.
“The longer these kids are allowed to be overweight, the higher the incidence that they’ll be overweight as adults,” he says. “We need to break that cycle early.”

4-H is introducing a “Get Moving, Get Healthy” initiative in each of its 762 clubs throughout the state, while the NJ YMCA State Alliance has launched a pilot program at a dozen area Ys offering free membership to 7th graders.

“This is the age when you lose them,” says Alliance executive director Gary Graham. “They’re consuming more hollow calories, experiencing more screen time, and just dealing with the idiosyncrasies of kids as they get older.”

As a side benefit, some youth, like Pena, are bringing their family members along to work out as well.
“Kids become the change agent in the household,” says Graham. “First with exercise, and then with diet. It’s really amazing.”

Jill P. Capuzzo is a frequent contributor to New Jersey Monthly.

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