“The surge in obesity in this country is nothing short of a public health crisis, and it’s threatening our children, it’s threatening our families, and more importantly it’s threatening the future of this nation.”
— First Lady Michelle Obama
By Lee Anna Sherman
When the doorbell chimes, the toddlers instantly forget about the movie flickering on the giant TV screen. Scrambling over the plush sofa and scooting past the coffee table, the five preschoolers at Cozy Corners family childcare home cluster curiously by the door to see who’s here.
These pintsized Albany residents have, after all, seen Beverly Hills Chihuahua before. What they haven’t seen are the mysterious high-tech gadgets Oregon State University doctoral student Kelly Rice starts unloading from her backpack soon after childcare provider Michelle Hoyt ushers her in.
“What are they, what are they?” the kids clamor, crowding around.
“They’re called accelerometers,” Rice tells the wide-eyed boys and girls, who range in age from 2 to 5. “They tell us how much activity you guys are getting while you’re here. Who wants to be first?”
“Me! Me!” Riley yells.
“OK, Riley, come on over here.” She wraps a black elastic belt around Riley’s waist and cinches up the Velcro. “We need to make it nice and snug because the last thing we need is a floppy accelerometer,” she tells him.
The matchbook-sized electronic monitor on his left hip will keep track of activity levels (sedentary, light, moderate, vigorous) by recording the frequency and magnitude of movement. Riley and his playmates will wear the accelerometers for a week during Phase One of an OSU study led by Associate Professor Stewart Trost. This initial activity data will form a baseline, along with each child’s body mass index (the ratio of height to weight, used to estimate the proportion of fat to lean tissue), for gauging progress at the study’s end.
Cozy Corners is one of 60 Oregon childcare homes in seven economically diverse counties along the I-5 corridor that are participating in the Healthy Home Child Care Project. Half of the homes will use the obesity-combating techniques devised by Trost and his team. The other half will serve as a “control” group for comparison, as well as receive training in food allergies.
The program’s premise: You don’t need fancy jungle gyms or pricey cuisine to make kids healthy and keep them that way. Rather, ordinary household items like card tables and couch cushions can get kids moving, and small changes like switching to skim milk can add up to big benefits.
“We’re making the intervention as simple as possible,” says Rice, who is coordinating the study. “We’re looking for really little things that can make a huge difference, things like giving kids balls and bats to play with, adding a couple of veggies to the lunch menu — teeny little steps.”
Essentially, the program will plug into kids’ innate love of running and jumping and introduce fun, fresh foods like fruit pizza to compete with the “bubblegum-flavored cereal” and “Hot Pockets” children see every day on TV, says Trost.
“Just like puppies and lambs and kittens, kids have a natural inclination to play,” he says. “Active play is inherent to normal development. Yet our studies have shown that kids in family childcare settings are getting only about five minutes of physical activity per hour, on average.”
Designer Diabetes Gear
The statistics are alarming. Nearly 30 percent of American kids are overweight or obese. Their parents are even heavier, with two-thirds tipping the scales at excessive numbers. If trends continue, fully 50 percent of kids born this year will end up with Type 2 diabetes in their lifetimes. Just imagine: Half of Americans soon could be tucking a diabetes testing meter (these days, they come in designer colors like “Tickled Pink” and “Purple Fusion”) into their purse or pocket along with their iPod and cell phone.
It was these startling trends — along with her pediatrician’s warnings about her own daughters’ marginal BMIs — that inspired First Lady Michelle Obama to plant an organic garden at the White House and to launch a national campaign to curb childhood obesity. She has gone so far as to demonstrate how easy exercise can be by hula-hooping on the South Lawn. The changes she made in her own household — a ban on weekday TV, smaller portions, low-fat milk, water bottles and apple slices in lunchboxes, grapes on the breakfast table, brightly colored veggies for dinner — she described to USA Today as “very minor stuff.” But the payoff was surprisingly big. “These small changes resulted in some really significant improvements,” Obama reported.
These are just the kinds of practical strategies Trost and his graduate students are using in their program, which is built around the theme “Journey to Healthy Child Care Home.” Kids will map their make-believe travels and send postcards to friends and family along the way. The program is funded by the National Institute for Food and Agriculture.
Participating childcare homes in Benton, Linn, Lane, Yamhill, Polk, Marion and Washington counties were identified through local “resource and referral” agencies (“R&Rs,” which train providers and help parents find quality facilities). Assistant Professor Kathy Gunter is leading the program design and will train OSU county Extension faculty to use it. They, in turn, will train the providers.
“It’s a train-the-trainers, capacity-building approach,” says Trost. “Our goal is to translate research into practice in a sustainable, community-based way.”
With these kinds of novel approaches, Trost has rocketed to prominence in his field. “Stewart has rapidly become one of world’s foremost researchers of issues related to physical activity in children and youth,” notes Professor Russell Pate of the University of South Carolina. “He has developed an international reputation for his work on measurement and promotion of physical activity in kids.”
Getting Switched On
When he was fresh out of Oregon State University with a bachelor’s degree in exercise physiology, young Stewart Trost took a job in his native Australia as a corporate fitness director. It didn’t take him long to notice that the sparkling new gym — fully equipped and conveniently located at the Brisbane headquarters of Australian Mutual Providence Society, the country’s largest insurance firm — was vastly underused. There was a pattern to the laxness. Each year just after January 1, employees spurred by New Year’s determination would join an aerobic dance class or hit the weight room, only to drift away within a few weeks or months. What was tripping up these good intentions?, wondered Trost, a lifelong athlete who had attended OSU on a track scholarship.
He came back to his alma mater to find out.
“It’s a really tough task to try and sell exercise to a sedentary adult,” he discovered as he dug into the literature as a master’s student. “By that time, exercise is viewed as drudgery. Look at Biggest Loser. On that show, weight-loss regimens are treated like basic training in the military.”
Messages should emphasize health, not weight, says Stewart Trost. Overweight and obese kids have lower self-esteem and at are increased risk for Type-2 diabetes.
When Trost headed to the University of South Carolina for his Ph.D. in the mid-1990s, the nation’s obesity problem was “just coming into the crosshairs” of public awareness, he says. The time, he realized, was primed for serious action. He returned to Corvallis once more — this time as a professor in the Department of Exercise and Nutrition Sciences — steeled by the conviction that solutions must take root in childhood. But today’s fight against fat is gummed up with hurdles unimaginable just a couple of decades ago. Cable TV peddles hundreds of programs and millions of junk-food commercials to children. Videogames hook kids hard with eye-popping graphics and mesmerizing sounds. Moms and dads work longer hours to pay the bills, leaving their offspring alone after school with unfettered access to chips and soda. Stranger danger lurks, making romps in the woods risky. And schools, pressured to raise test scores in reading and math, have dropped PE and curtailed recess.
Trost knows we can’t go back to the ‘50s and ‘60s. But he’s waging a sustained research campaign to find a way forward for children’s health, partnering not only with childcare workers but also with doctors.
“We have to work closely with health-care providers,” he says. “By looking at the child’s BMI, the physician knows immediately when the child is obese.” Girded by knowledge of the medical risks of obesity, doctors can bring up children’s diet and exercise choices more easily than can teachers or even parents. Trost sees the primary-care physician’s office as the ideal forum for productive conversations about maintaining a healthy lifestyle.
Toward that end, he’s working with Portland-area physicians to engage patients in brief motivational interviews — basically, lifestyle negotiations — that can begin an ongoing dialog and let the patient set the agenda based on his or her readiness for the message.
Schools, too, must play a pivotal role. With the Robert Woods Johnson Foundation’s “Active Living Research” program, for instance, Trost is crafting a policy statement challenging the trend of cutting PE to boost instructional time. “There’s not a single study that shows academic performance increases when you reduce time for physical activity,” he notes. “On the other hand, there are a number of studies showing improved academic performance with increased activity during the school day. We also know there’s a positive link between activity breaks and time on task in the classroom. When kids get activity breaks, they’re more attentive in class, which facilitates better learning.”
The evidence of benefit to brain power is compelling. “Aerobic exercise improves cognitive function,” says Trost. Experiments ranging from sophisticated animal-based studies to functional MRIs on humans show that “exercise turns on the factors that promote greater cerebral blood flow and the growth of new brain cells,” he says.
By playing harder and eating smarter, kids can not only learn better at school but also lay the foundation for vitality and longevity. Trost’s message is this: You don’t have to take up mountaineering, compete in a decathlon, or eat only bean curd and baby spinach to prevent chronic disease and optimize health. In fact, the preventives are right in plain sight.
“Kids don’t need a $150 inflated castle in the backyard,” he says. “An obstacle course with lawn furniture or a fort fashioned from a blanket thrown over a card table can encourage both imagination and physical activity.”
To support Stewart Trost’s research in child health, contact the OSU Foundation, 800-354-7281.