CORINTH, Maine — Students in Ms. Chase’s fourth-grade class at Morison Memorial School in Corinth know the 5-2-1-0 Let’s Go! song by heart. They sing it every morning at their desks. Hum along — you’ll recognize the tune.
If you’re healthy and you know it, go for five! (clap, clap)
Five fruits and veggies every day will help you thrive! (clap, clap)
They give you energy to go
And vitamins to grow.
If you’re healthy and you know it, go for five! (clap, clap)
Developed and funded by a coalition of public and private groups in southern Maine, the 5-2-1-0 Let’s Go! program and its catchy theme song are coming soon to a school near you, if they’re not already there. More of an attitude adjustment than a specific curriculum, the program is reinforced with friendly messages to parents, healthy snack options and nonfood rewards for students, and incentives for increased physical activity both in and out of the classroom.
With ideas and free materials for workplaces, day care settings, medical offices and other sites, the Let’s Go! program recently was selected as one of seven partners to help develop the federal Prevention Center for Healthy Weight within the U.S. Department of Health and Human Services.
The 5-2-1-0 message is aimed at combating obesity and reinforcing healthy behavior in children, families and communities. Participation means you and the children in your life will learn the benefits of consuming five servings of fruits and vegetables daily; that two hours is the maximum recreational “screen time” children should spend with their televisions and computers; that one hour is the recommended amount of daily physical activity for just about everyone; and that zero is the number of sugar-sweetened beverages that kids — and the rest of us, incidentally — should drink.
Child obesity on the rise
Nationwide, according to the U.S. Centers for Disease Control and Prevention, childhood obesity has more than tripled over the past 30 years. The prevalence among children aged 6 to 11 years increased from 6.5 percent in 1980 to 19.6 percent in 2008. The prevalence among adolescents aged 12 to 19 years increased from 5 percent to 18.1 percent during the same time period.
Numbers in Maine are generally in line with national statistics, but among New England states, Maine’s rates of obesity typically are the highest. Obesity in youngsters exists across the social-economic spectrum, but higher rates are found in populations afflicted with poverty, social isolation and low educational attainment. Individuals who are overweight or obese as children are likely to be overweight or obese as adults.
In addition to the personal costs of obesity — poor physical health and low self-esteem are among the most pervasive complications — obesity exacts a high price from society. Chronic medical conditions related to obesity, including diabetes, heart disease and certain types of cancers, account for most of the money spent on health care in the United States, as well as fueling high rates of disability and unemployment.
Growing evidence shows that obesity in adults has its roots in early childhood, when attitudes and behavior related to diet and activity become established. That’s why public health experts are focusing on school-based programs such as 5-2-1-0 Lets Go! as essential to reversing the obesity trend.
While 5-2-1-0 Let’s Go! offers materials tailored for a variety of settings, the school-based component is the most visible.
Lee Averill at Eastern Maine Healthcare Systems in Brewer coordinates the 5-2-1-0 Let’s Go! program for the northern half of Maine. It is making inroads in schools from Waterville to northern Aroostook County and from Calais to Jackman.
“The highest rate of success is in schools with a strong team committed to teaching healthy choices,” Averill said. That means, ideally, that everyone from the superintendent to the janitorial staff is on board with the message, she said, although finding that kind of consistency is rare.
But Morison Memorial School is moving in the right direction.
One recent day, for example, the kids in Mrs. Blanchard’s fourth-grade class were revved up for the next big snowfall, ready to buckle on some of the 24 pairs of snowshoes the school recently purchased with a $1,500 grant from the 5-2-1-0 program.
The “1” in 5-2-1-0 stands for one hour of physical exercise every day, said one of Mrs. Blanchard’s students. Some of that activity takes place each school day, when the children head outside at recess to burn off energy on the swings and slides and along the nature trail that loops around the edges of the playground.
“When we go around the walking trail in the winter, the snowshoes will help us,” the student explained.
Until there is sufficient snowpack, Mrs. Blanchard’s students are taking part in a walking challenge that exercises their math skills as they check off half-mile laps on the walking trail. Those who complete the challenge will be rewarded with extra free time in the school gym or nonfood prizes such as backpacks or tote bags.
Students also are encouraged to spend time reading about healthy foods and activities, selecting books from a special 5-2-1-0 rack donated by a local business. The books include nonfiction titles as well as old favorites such as “Blueberries for Sal,” by Robert McCloskey. At home, Mrs. Blanchard’s students are asked to chart the time they spend reading as well as recreational time in front of a computer or television.
Next door in Mrs. Dearborn’s room, students were anticipating morning snack time, when they would be able to purchase relatively healthy edibles from the 5-2-1-0 snack cart. Approved treats include packages of raisins, pretzel sticks, fat-free pudding, crackers, low-fat yogurt and string cheese, each selling for 50 cents — another math challenge.
The 5-2-1-0 Let’s Go! literature encourages children to consume just one such snack during the school day instead of less-healthy “a la carte” items often provided in school cafeterias. Although a la carte foods must contain a minimal amount of at least one important nutrient, many are clearly off-the-scale bad for kids, including greasy chips, over-sweetened juice drinks and sugary desserts such as whoopie pies and ice cream cups.
Physical education teacher Brian Clark said 5-2-1-0 Let’s Go! provides cross-curriculum consistency to his once-a-week message to kids that vigorous activity is not only healthy but also fun.
“Activity doesn’t just mean doing exercises; any kind of physical playing and running around is good,” he said. “Having the teachers and the school nurse all speaking the same language is a huge benefit.”
School nurse Sue Parker says staff commitment is the glue that holds 5-2-1-0 Let’s Go! together. At Morison, the professional staff already was dedicated to instilling healthy behavior in students; adopting 5-2-1-0 last fall was just a way to get everyone on the same page, she said.
“I believe children are like little sponges, absorbing everything they see,” she said. “When we role-model for them, they want to learn.”
School, Parker said, is an essential environment where children can learn about enjoying healthy foods, the pleasures of an active lifestyle and the importance of keeping television and computer time in its place.
“We’re hoping that because we talk about this daily, it supports changes at home,” she said. Information about 5-2-1-0 also goes directly to parents, helping to change the culture within families and the greater community, Parker said.
Jennifer Wain, whose son Brandon is in Mrs. Blanchard’s class, has refrained this year from contributing her usual classroom party treats of cookies and cupcakes.
“At Halloween, I brought in ants on a log,” she said in a phone interview, referring to the whimsical confection consisting of celery, peanut butter and raisins. For the recent Christmas party, Wain brought fruit-and-cheese kebobs.
“The kids all liked it,” she said. “I think it’s great.”
But does it work?
The support of parents like Wain shows that 5-2-0-1, Let’s Go! is making incremental change in Corinth, Parker said.
But measuring the long-term value of preventive public health programs is a bigger challenge. Success in this case would mean that, over time, fewer Corinth youngsters go on to develop obesity and its attendant disorders of diabetes and heart disease.
In southern Maine, where 5-2-1-0 Let’s Go! has been used in area schools since 2004, the rising trend of obesity in children and teens is showing some moderation.
“But it’s hard to pin a leveling-off in obesity rates on any one thing,” said Dr. Victoria Rogers, a Portland pediatrician. Rogers, who practices at the Barbara Bush Children’s Hospital at Maine Medical Center, is the statewide director of 5-2-1-0 Let’s Go! There are so many efforts under way to promote healthier lifestyles and reverse obesity trends in adults and children that teasing out the effect of any one program will likely not be possible, she said.
For now, the program measures success by the number of participating schools that adopt policies that support healthy student behavior.
These include strategies to incorporate physical activity into classroom time, replace fatty and sugary cafeteria foods with healthier snack choices, promote water and nonfat milk as beverages, and encourage children to offset screen time with reading or more active pursuits.
In addition, evaluators survey parents to determine if the 5-2-1-0 Let’s Go! message is familiar and if their children seem to understand the goals of the program.
According to the program’s 2010 annual report, all 54 participating schools in the Portland area have adopted meaningful policies to support the health of their students and a significant number of parents surveyed are able to identify the four types of healthy behavior highlighted by the program materials.
But how long will it take to see a true reversal in obesity trends? Lee Averill at EMHS said there’s no quick fix to the problem, which has emerged over time as the unintended consequence of complex social factors, including the prevalence of fast food outlets, the emergence of television and computer technologies and urban sprawl that discourages walking and bicycling as routine modes of transportation.
“It’s going to take a generation,” Averill said. “First we have to start raising kids who will become parents who raise their kids to make healthy choices.”