June 19, 2018
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Battling childhood obesity in Maine

By Meg Haskell, BDN Staff

ORONO, Maine — Girl Scout Cookies season has presented a manageable challenge this spring for 11-year-old Haley Reynolds. Haley, who has been overweight most of her life, has lost 15 pounds since September — almost 10 percent of her starting weight — and she is determined to keep it off.

Haley is an avid Girl Scout, her mother is a troop leader, and cookie season signals a stockpile of delectable goodies in the family’s Orrington home.

“Oh, yeah — there are cookies all over the house right now,” Haley said cheerfully during a recent interview. “It is very tempting for me to just grab a box … I’m very addicted to them.” But with the help of a special program for overweight youngsters, Haley has learned to just say no to the fatty, sugary treats — at least most of the time.

Haley is one of about 60 children between the ages of 4 and 19 who are pioneering the new WOW program — the Way to Optimal Weight — at the University of Maine. WOW takes an integrated approach to promoting healthful eating habits and physical activity, not only for the youngsters who are the official clients of the program, but for their families as well.

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Children enrolled in the WOW program, which is housed in the Cutler Health Center on campus and administered by Eastern Maine Medical Center in Bangor, undergo a comprehensive medical evaluation, receive psychological support as needed and get age-appropriate nutritional guidance.

“We used to say you can’t overfeed a 2-year-old,” said Dr. Valerie O’Hara, medical director of the program. “But now we know you absolutely can.”

The WOW program draws on the simple diet and activity recommendations of the “5-2-1-0” model, developed in Massachusetts and in wide use now in Portland-area schools and community centers. The model is also being used in a growing number of schools in Bangor and the northern part of Maine.

The 5-2-1-0 model distills reams of public health recommendations into just four succinct guidelines for improving health:

• Eat fruits and vegetables at least five times on most days.

• Limit nonschool-related screen time (computers, television) to two hours or less daily.

• Get one hour or more of moderate to vigorous exercise every day.

• Consume no sugar-sweetened drinks.

Importantly, children in the WOW program also have easy access to the nearby University of Maine Student Recreation and Fitness Center and the one-on-one services of a professional personal trainer.

Trainer Sarah Livingstone, who works directly with all WOW program youngsters, said it is not enough simply to tell children they should be more active.

“Children need to understand that exercise can be fun, that it isn’t necessarily a chore,” she said. Many overweight and obese youngsters have had so little exposure to physical exercise, she said, that they can’t identify a single activity at the well-equipped rec center that seems interesting — not swimming against the swirling current of the “vortex pool,” not smashing through a fast game of racket ball, not shooting a few baskets, not pedaling a stationary bike, not even playing a gentle round of pingpong.

Livingstone’s job is to help them choose an activity and find the fun in it. This typically includes keeping kids’ expectations reasonable, downplaying competitive components, and keeping up a stream of chatty conversation during the 30-minute sessions.

“We start slow,” she said. “We want there to be lots of success.”

Since November, Haley Reynolds has found a number of rec center activities she enjoys. Swimming in the facility’s comfortably warm leisure pool is her current favorite.

In addition, she has ramped up her participation in dance lessons — she is taking classes in jazz, ballet, tap and hip-hop at a studio near her home in Orrington.

Haley’s parents said their daughter has been more physically active even in her unstructured time since she started with the WOW program.

“She’s always running around with her friends,” Kimm Reynolds said.

“She is outside a lot more now,” said Haley’s father, Jeff Reynolds.

Kimm and Jeff Reynolds, who also have struggled with their weight, said their own lifestyles have become healthier since Haley agreed to take part in the WOW program. Their diets have improved, and they’ve purchased a family membership to the rec center.

High cost of child obesity

Public health officials discuss obesity using the term “body mass index” — a proportion of weight to height. Obesity is defined as having a body mass index of more than 30. People with a BMI between 25 and 30 are considered overweight.

Maine ranks 39th among states in the percentage of overweight or obese youths and 35th in the percentage of overweight or obese adults, according to a new report by Trust for America’s Health and the Robert Wood Johnson Foundation.

The relative ranking looks pretty good, but officials agree that every state is suffering from alarming rates of youths who are overweight or obese. Public health experts say the combination of poor dietary choices and insufficient physical exercise are fueling an obesity trend that could result in the current generation of American youngsters being the first ever to have a shorter life expectancy than that of their parents. Children who are overweight or obese very often remain overweight or obese as adults.

In Maine, the annual economic cost of childhood obesity and its many complications runs upward of $2 billion, according to a recent report based on 2003 data.

There is growing evidence that the propensity to become overweight or obese as a child has its origins in the very earliest stages of life. An expectant mother’s eating and exercise habits and clinical conditions such as diabetes can have a profound effect on her baby’s weight and the size and number of fat cells in her infant’s body.

Family and community attitudes toward diet and activity also affect weight and health. This environmental influence continues from infancy into toddlerhood, the preschool years and beyond.

Overweight youngsters start their lives with some serious strikes against them — not only the pervasive social stigma and self-consciousness that come with a weight problem, but a complex of related medical maladies that can linger and worsen throughout their lives. High blood pressure, liver disease, heart disease, gallbladder disease and Type 2 diabetes all can get started in childhood as a result of chronic poor diet, being overweight and insufficient physical exercise.

According to a recent report from the Robert Wood Johnson Foundation, as many as one-third of all American children eventually will suffer from diabetes if current trends continue with the rate closer to half of children from Latino and African-American families.

Obesity in Maine

In Maine, about 30 percent of children and teens are overweight or obese, according to data from the Maine Center for Disease Control and Prevention. The numbers in Maine are in line with national statistics, according to Maine CDC’s director, Dr. Dora Anne Mills, but among New England states, Maine’s rates typically are the highest.

That’s partly because there is a strong correlation between poverty and obesity, Mills said. Maine’s lower-than-average household income means more families scramble to put food on their tables and in their bellies. It would be logical to think that low-income people eat less food and that gaining weight shouldn’t be a problem, but Mills said the opposite is true.

“In general, healthy foods are more expensive,” Mills said, with heavily processed, prepackaged foods typically costing less than lean meats and fresh produce.

Whether people are paying their grocery bills out of their own pockets or using low-income assistance programs such as food stamps, she said, their dollars go further for foods that are high in sugars, fats and calories.

Another factor driving Maine’s obesity rates is its population patterns with many people living in rural areas without sidewalks or safe walking trails and far from daily destinations such as workplaces, schools and shopping centers. The state’s long, cold winters also deter many people from including physical activity in their routines.

But strong-arming youngsters into short-term diet-and-exercise regimens is not the answer, Mills said. Instead, children, families and whole communities must embrace lifestyle changes that make healthful eating and physical activity enjoyable and sustainable lifetime habits.

Mills said she is encouraged by the Obama administration’s commitment to addressing childhood obesity, referring to the introduction earlier this year of the national Let’s Move program aimed at reversing the obesity trend in children. In Maine, she said, there are many public and private programs with the same mission.

The 5-2-1-0 model in use at the WOW program and in other settings provides a useful tool for children and families, Mills said. But public health policy must provide a much more expansive framework for combating the epidemic of obesity in children, she added. Maine has adopted some important strategies, Mills said, such as developing “walkable” communities and housing developments, eliminating soda and junk foods from school vending machines, supporting farm-to-school food purchasing programs, and passing a law — which will take effect next year — requiring chain restaurants to post the caloric content of foods on their menus.

But in order for states to succeed in driving down obesity, she said, federal agencies such as the U.S. Department of Agriculture, the Food and Drug Administration and the U.S. Centers for Disease Control and Prevention must be brought into alignment. For example, she said, the USDA’s food stamp program, now formally re-named the Supplemental Nutrition Assistance Program, could be strengthened by providing incentives to purchase more healthful foods in compliance with CDC dietary recommendations.

“The solutions are starting to be worked out,” Mills said, “but it will take time.”

For more information about the WOW program, call 581-4039.

On the Web: http://healthyamericans.org


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