Are Carroll’s Kids too Fat?

When Jason was a baby, his chubby apple cheeks and round little tummy were welcome signs to his parents that he was happy, healthy and thriving.

Fast-forward 10 years.

Little Jason has grown – and how! Thanks to television, computer games, fast food and a plethora of readily available sodas and other high-calorie treats, he is growing rounder faster than he is growing tall.

Jason is not a real child, but a composite of an increasing number of children and adolescents – not just in Carroll County, but around the country – who are overweight and unfit and likely to remain so.
Consider these facts: A recent study showed that many young children are too heavy for standard car-safety seats. More than a quarter of a million U.S. children ages 1 to 6 are heavier than the weight limits for standard car-safety seats, and most are 3-year-olds who weigh more than 40 pounds. Manufacturers are starting to make heftier models to accommodate them.

Another study reported that 58 percent of Maryland’s children and teens do not exercise regularly.

Even more stunning are statistics gathered by the Centers for Disease Control that show childhood obesity is growing nationally at an alarming rate. In 1970 4.2 percent of children (ages 6 to 11) and 4.6 percent of adolescents (ages 12 to 19) were categorized as obese by the CDC. By 2004, those numbers have more than quadrupled in children (18.8 percent) and almost quadrupled in adolescents (17.4 percent).

In total, CDC found that about one-third of U.S. children are now or are at risk of becoming overweight; that’s about 25 million kids.

Neither the state nor the county keeps statistics on obesity in children within their jurisdictions, according to John Hammond, a spokesman for the Maryland Department of Health and Mental Hygiene. But he added it is a good bet that Maryland and Carroll County children reflect the national statistics.

“I don’t know that what I am seeing is an epidemic – although nationally epidemiologists call it that,” said Dr. Robert Wack, director of pediatrics at Carroll Hospital Center. “But the children I see here are generally a bit heavier and less conditioned than they should be. And we are definitely seeing an increase in Type 2 Diabetes in kids – the type of diabetes that typically is called adult onset and generally occurs as people age.”

Health problems directly attributable to overweight are not common in the patients Dr. Wack sees. “Overweight kids who are asthmatic typically have a harder time with their disease than those who are a normal weight,” Dr. Wack said. “But kids are remarkably resilient and even obese children bounce back from injury or disease better than obese adults.”

He noted that a significant proportion of his patients at the hospital come in with orthopedic and other types of injuries and accidents that result from being “active sports kids.” Dr. Wack added, however, that although inactive, overweight kids may spare themselves the broken bones, twisted ankles, bumps or bruises of their more active neighbors, they are setting themselves up for a variety of ills later in life.

As they grow into adulthood, obese kids who fail to control their weight and achieve a reasonable level of fitness may experience early onset of a panoply of ills, including joint problems, arthritis, heart problems, sleep apnea, stroke, gallbladder disease and even some types of cancer.

Modern life in America is replete with fast food, high-calorie holiday celebrations and sweets-filled vending machines. And then there are the engaging computer games, television shows, and omnipresent minivans that ferry them from place to place, conspiring to keep children and adolescents from walking, playing and moving.

In addition, there are subtle societal influences at work that may keep kids sedentary. “When I was a kid we came home from school, did our homework and we were out the door, playing until dinner time,” Dr. Wack said. “We were on our bikes; we were running all over the neighborhood. Now, with the heightened awareness of child abuse, abductions and pedophilia, parents are afraid to let their kids go to the park or ride around the neighborhood the way we did.”

But parents and children are not without allies in this juvenile battle of the bulge. The county school system, the YMCA and a variety of recreational programs aim to help fight the growing epidemic of obesity in the young.

Take, for example, the county’s school cafeterias.

“Our school lunches have to meet federal nutritional standards,” said Eulalia Muschik, supervisor of food services for Carroll County Public Schools. “That includes a two-ounce portion of protein, three quarters of a cup of fruits and vegetables, a serving of bread and a serving of milk.”

In addition, her food services staff “pushes” children to eat fruits and vegetables and makes in-season produce readily accessible to students at all levels. No sodas or sugary drinks are available to students during school hours and even popular fast-food type items are prepared in school kitchens as healthfully as possible.

“Our chicken nuggets are baked, so they aren’t as fatty as the ones served at McDonald’s that are deep fried,” Muschik said. “When fresh fruit isn’t available we offer fruit canned in light syrup or its own juice. And salad is offered at almost every school every day.”

Still, like the proverbial horse to water, you can lead a student to salad, but you cannot make him eat. And although the school cafeteria operation is part of the public school system, the bottom line is the bottom line.

“People don’t understand that the money we take in must cover the cost of the food and the salaries of our workers who prepare and serve it,” Muschik explained. “We have to offer food kids like, that they will buy and eat. And to their credit, the kids seem to be catching on to nutrition. We’ve seen increases in our sales of fruits and veggies; not as much as we’d like, but we still see some improvement.”

And Carroll County Public Schools still works to keep its students moving. Unlike some school districts that have abandoned recess and physical education in a fever to meet the “No Child Left Behind” testing requirements, Carroll still has 90 minutes of recess per week for elementary and middle school children and a physical education requirement for high school students.

“With all the emphasis on math and reading scores, there is a real tendency for schools systems to push aside physical education and recess,” said Linda Kephart, assistant supervisor of health and extracurricular activities for Carroll County Public Schools. “But the reality is that the more healthy, active and physically-fit children are, the better they will do academically.”

Unlike many school systems, Carroll has an established curriculum for physical education, she said. With a full program of physical education, the one area in which the county is lacking is a swimming program. “We don’t offer swimming because none of our schools has a swimming pool.”

The decision to forgo offering swimming in county schools was primarily a financial one. “Swimming pools are expensive to build, maintain and manage,” she said.

Privately, Kephart has worked for several years for the Westminster Swim Team’s Stingray Learn to Swim program, which uses McDaniel College’s pool. It is well subscribed, she said, adding that the annual enrollment for children ranges around 250. It is just one example of programs aimed at getting kids fit.

County schools are not the only places where children and teens can find motivation to move. There are a variety of recreational sports leagues, and the local YMCA is willing and able to encourage kids to get away from the computer screen and onto the playing field.

In April, the Carroll County YMCA held a Healthy Kids Day, providing a variety of activities as well as information for parents on how to keep their kids mobile, fit and well-nourished.

But the Y’s activities go well beyond this one-day program. The Y offers a variety of activities, from sports to activity- filled summer camp,
to keep youngsters moving.

“We have seen an increase in enrollment in our swim lessons and the parking lot is overflowing with parents bringing their kids for our spring soccer program,” said Jeff Sprinkle, executive director of the Carroll County Y. “I think parents have become more aware of the problem of childhood obesity. They want their children to be fit and active and they are making a real effort to get them involved in sports programs.”

He notes that unlike some of the many Recreation League programs around the county, the Y’s plans emphasize kids having fun and being active rather than competition.

“Our objective is to keep kids moving and make sure that they are having fun. We want all kids to feel that they can participate and have fun; not just those who are athletically gifted,” he explained. “We try to downplay the more competitive aspects of sports because that often leads kids to think that they can’t join in because they aren’t good enough,” Sprinkle said.

He added that parents seem to be increasingly aware that keeping their children fit and moving is essential from the earliest age. “Parents seem to be much more aware that it is important for their children to be active and to participate, whether or not they are gifted athletes,” he said.

“With most of our parents it is the fun aspect of sports that they seem to feel is important more than the competitive and we really stress that, although we still have the occasional parent who confesses to video taping another team’s games so that the team their kid plays on can have an edge when they compete,” Sprinkle said. “We really discourage that.”

He said that the Y has a number of summer programs that range from conventional camping to soccer with the Baltimore Blast members, golf, football skills camp and a fitness camp that stresses cardiovascular well-being in addition to the importance of healthy eating.

So despite all of the bad news, there are a variety of resources out there for children and the parents to learn good eating and exercise habits. It simply takes some time and research to make sure that children eat and exercise their way to fitness.

Helping Your Child to a Healthy Diet

What does it take to keep your child fit and healthy?

The first step is a healthful diet. And according to Alison Manger-Wiekel, a registered dietitian at the Carroll Hospital Center, the secret is in planning well-rounded meals, getting kids involved in the process and controlling the size of portions.

“First and foremost, healthy eating isn’t a kid’s issue, it is a family issue,” said Manger-Wiekel.

The dietitian believes that all foods can be part of a balanced and nourishing diet. But the basics come first–fruits, vegetables and protein are the building blocks of a diet that controls weight and provides the nutrients for good health.

And she notes that one of the biggest problems with children’s diets is controlling portion size. In a “Super-Size Me” culture, people no longer know what a “portion” really is.

“Generally a proper portion of protein is the size of a standard deck of playing cards,” she explained, adding that vegetables and fruit portions–10 a day–should be a half cup in size. A main course portion of starch–like spaghetti–should be about the size of a tennis ball.

Never missing an opportunity to market, today’s fast-food outlets continue to skew consumers’ ideas of portion size. Today they offer packaged meals for older kids. In the case of McDonald’s, old Ronald has moved beyond the traditional Happy Meal to a Mighty Meal–with larger portions and a spiffier prize.

“Lots of little kids want the larger meal because they want the different toy that comes with it or because they think it is a more grown up kind of meal,” she said, adding that it is consumed completely by pint-sized people who need only a fraction of the calories it contains.

A working mother of four children, Manger-Wiekel understands how hard it is to make sure that children maintain a diet that supports good health. “It takes some planning and some effort–it isn’t always easy,” she said.

She offers a few tips for parents intent on helping their kids control calories and eat healthfully.

Plan and do as much ahead as possible. For example, find time on a weekend to make and freeze one or two nutritious casseroles that can be popped into the oven and served to the family at the end of a busy day.

Pack school lunches before bedtime and get the kids involved. “Kids should help make their lunches. Make it a family affair. At night they can decide what they want for lunch the next day and parents can make sure their lunches are healthy and well-balanced,” she said, adding that making lunches the night before eliminates the last minute scramble that leads to bad food choices in a frantic morning.

Make prepackaged foods like Lunchables a special treat–not an everyday occurrence. Many of these prepackaged foods are full of preservatives, salt and high-fat food. “Read the labels and try to steer you kids toward healthier choices.”

Sit down at home together for as many meals as possible. When people eat on the fly they often are not conscious of what and how much they are eating. Restaurant portions are often several times the size of a normal portion–and kids and adults tend to be members of the “clean plate club.”

Eliminate sugary drinks. “I want my kids to drink skim milk or water, not soda that has no nutritional value and a lot of calories,” she said. “If they absolutely must drink soda, I encourage them to drink diet soda.”

Finally, remember that a healthy diet can include all kinds of foods–in moderation.

“When fat-free cookies came out people thought they could eat the whole package because they were Ôhealthy cookies,’” she said. “But just because you take the fat out doesn’t mean you take the calories out.”

So go ahead. Let your kids have a cookie or maybe even two now and again–not the entire package. But if you can get them to eat an apple or an orange instead–all the better.

¥ Patricia A. Rouzer