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Program Helps Hispanic Children Learn to Stay Fit

Posted on: Monday, 25 October 2004, 14:00 CDT

Oct. 23--Rosa Molina used to give a predictable response when her mom offered a steaming bowl of broccoli at the dinner table: "ewww" or "ugh," followed by a recoil in disgust.

So innate was this disgust for the vegetable, in fact, Rosa had never tried it. Then a teacher suggested that broccoli wasn't so bad, and it was healthy, too. So Rosa tried it and no longer passes on broccoli at home. She's also taken up gymnastics to get fit.

"These were pretty easy decisions," said Rosa, a fifth-grader with a very slight weight problem who attends Schmalz Elementary in west Houston. "I want to live a long life."

This is one, arguably rare, success story amid an almost overwhelming rise in childhood obesity rates, especially for Hispanics. By the time Rosa reaches the 11th grade, she and other Hispanic girls are more than three times as likely to be overweight as Anglo girls in Texas to be overweight. The Hispanic boys in her class won't be any better off.

The success comes in prevention, like getting Rosa to develop a taste for broccoli and exercise now, before she has to suffer under major weight-loss programs. It's not an easy sell when kids are bombarded with ads for fast food and the latest video games.

But in a state where Hispanics will become the plurality population by 2015 or 2020, and a majority by 2050, the societal and economic consequences of ignoring the problem and creating an ever-larger, more-diabetic Texas are dire.

Because epidemiologists and health officials recognized the full scope of the obesity problem only in the past half-decade, researchers are now beginning to ask why Hispanics seem to be more prone to gain weight and become diabetic.

"This, clearly, is an understudied area of science," said Texas Health Commissioner Eduardo Sanchez. "But I think we should be investing in things that can make a difference even as we try to figure out why this problem exists. If we spend all of our time trying to figure this out, we may lose out on our opportunity to intervene."

The program that led Rosa to try broccoli, Community Access To Child Health, or CATCH, is one of many such interventions. It is distinguishable from other programs, however, in one quantifiable way -- it works.

The CATCH program combines increased activity in gym class, lessons for cafeteria workers to make leaner, healthier meals and classroom instruction for students on how to eat better and lead more active lives.

A study that followed 900 El Paso students, to be published later this year, found that boys and girls enrolled in the CATCH program maintained healthy weights, while many of their peers did not.

At the beginning of the two-year study, 30 percent of the third-grade girls in CATCH were overweight or at risk of becoming overweight, according to national standards. By the fifth grade, that figure rose to 32 percent. In contrast, during the same time period, the percentage of their peers in El Paso schools who were overweight or at risk jumped from 26 percent to 39 percent.

The findings were similar for boys. The percentage of boys enrolled in CATCH with weight problems rose slightly between third and fifth grades, from 40 percent to 41 percent, while for boys not enrolled in the program it rose from 40 percent to 49 percent.

"The program increased their physical activity to recommended levels and gave them better food choices," said the study's lead author, Karen Coleman, an assistant professor in the Graduate School of Public Health at San Diego State University.

"This will lead to their being more active as adolescents and adults and thus able to maintain a healthy weight."

Researchers know both genetics and behavior play a role in obesity.

But because human genes haven't changed much in the past four decades -- and Americans have continued to get fatter -- researchers believe environmental factors such as diet, exercise and socioeconomic status have driven recent increases.

To begin answering questions about Hispanic health disparities, the National Institutes of Health awarded a $7.5 million grant last year to the University of Texas School of Public Health at Houston and UT-Brownsville. The grant, the first NIH funding ever received by the Brownsville school, will focus on the threats from obesity, cardiovascular disease, diabetes and cancer in the lower Rio Grande Valley.

Scientists in Houston and Brownsville are finding they need to be creative when identifying fixes.

"We can't just ask people to eat more fruits and vegetables when they're on a tight food budget," said Steven Kelder, a UT-Houston researcher involved in the project. "It's much cheaper and quicker for them to go to a fast-food restaurant."

At Baylor College of Medicine, researchers have collected DNA from about 1,000 overweight Hispanic children in the Houston area to see whether they can identify genes that make people more susceptible to becoming overweight.

Many of these children already have developed serious complications, such as high blood pressure or blood sugar levels that could lead to Type II diabetes, said Nancy Butte, a Baylor professor involved in the study.

"It's really quite alarming," she said.

Researchers also are studying the diet and physical activity of the children, and have found a high intake of sweetened drinks such as Kool-Aid, soda and Tampico fruit punch, a top-selling brand that parents may not realize isn't juice at all, Butte said. Such sugar-sweetened beverages have been linked to diabetes and obesity in adults.

Another Baylor professor, Theresa Nicklas, is studying the eating and exercise habits of children enrolled in Head Start, a program for preschool children in low-income families. Her study is a year or two away from producing results.

But already, she's found a link between overweight parents and children. In her study, Nicklas said 90 percent of the children who are at risk of being overweight, or already are, have a mother who is overweight.

This suggests that any intervention must include messages for parents, including the message that their children emulate them, researchers said.

"We need to change lifestyles during preschool," Nicklas said. "This is the time when children are developing their lifelong habits."

Few, if any programs, begin that early. Some components of CATCH start in kindergarten, but the bulk of the program, including classroom education and increases in physical activity, doesn't begin until the third grade.

CATCH is not new. First tried in 1991, researchers at UT-Houston and three other institutions conceived the program to control heart disease, before they recognized obesity as a major health problem.

Although the program successfully reduced the fat content in school lunches and increased physical activity, it was only recently seen as a tool to fight obesity.

Now about 1,500 schools, or one-third of the state's elementary schools, have implemented some form of the program, Kelder said.

Sanchez and other health researchers say success requires a comprehensive set of programs -- from public service announcements during Saturday morning cartoons to a subsidized discount on lowfat milk.

As parents become aware of the problem of childhood obesity, they must also realize there is no quick fix, said Deanna Hoelscher, who directs the human nutrition center at the University of Texas School of Public Health at Houston.

The cultural trends that have led to the problem -- video games, TV and junk food among them -- have developed over decades, she said.

It will take combined efforts by schools, government and parents to reverse these trends. Rosa said her mother, Alma, suggested she try gymnastics -- along with broccoli -- when she was younger. Encouragement from a teacher helped Rosa overcome her fears.

"I was always scared of gymnastics because I thought you had to be very flexible to do flips," Rosa said. "Now I am becoming flexible, and it's good for my body."

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Source: Houston Chronicle

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