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Health Report Cards Used to Fight Obesity

Posted on: Tuesday, 12 August 2003, 06:00 CDT

By LINDSEY TANNER

CHICAGO (AP) -- A school program that sends home health report cards with student weight and fitness information has helped get parents of overweight children involved in trying to address the problem, a study found.

While the program studied at Boston-area schools did not change some unhealthful behaviors, the researchers say their results show health report cards might be a promising tool in the battle against the nation's childhood obesity epidemic.

"Parents who received health and fitness report cards were almost twice as likely to know or acknowledge that their child was actually overweight than those parents who did not get a report card," said Robert McGowan, physical education program leader at Cambridge Public Schools.

They also "were over twice as likely to plan weight-control activities for their overweight child," said McGowan, a study co-author.

The report appears in August's edition of Archives of Pediatrics & Adolescent Medicine, the journal's first-ever issue devoted exclusively to obesity research.

August's Archives, published Monday, aims to get more doctors involved in obesity prevention, treatment and research, said journal editor Dr. Frederick Rivara, a Seattle pediatrician.

"It is the first time we've done it because it's pretty clear to everyone now that obesity is a huge national epidemic," he said. "We really need to think about interventions during childhood and adolescence not only to prevent childhood obesity but also to prevent adult obesity."

In other studies published in this month's journal:

-- Researchers found that nearly 30 percent of overweight adolescents may have metabolic syndrome, a cluster of symptoms that can lead to diabetes and heart disease. Symptoms include abdominal obesity, elevated blood pressure and unhealthful levels of insulin and cholesterol. Nearly 1 million teens may be affected, researchers at the University of Rochester said.

-- Adolescents teased about their weight face an increased risk of developing depression and suicidal tendencies, according to a University of Minnesota study of Minneapolis-area middle schools and high schools.

The reports come a week after the American Academy of Pediatrics urged doctors to routinely measure all youngsters' body-mass index in its first policy dealing solely with identifying and preventing childhood obesity.

There isn't "a single answer to the dilemma we're facing," said Dr. Karen Hacker, who participated in the Boston-area study.

"It's going to have to take place in schools and families and pediatricians' offices ... if we're really going to address this," said Hacker, executive director of the Institute for Community Health in Cambridge.

The study involved 1,396 students at four Cambridge elementary schools in 2001-02. Health report cards were sent at the end of the school year to 481 parents, including those with normal-weight children.

Afterward, 42 percent of parents of overweight kids reported initiating or planning physical activities, 25 percent planned medical help, and 19 percent planned dieting activities. Among parents of overweight children who didn't get cards, 13 percent or fewer reported doing any of those activities.

The school also sent home tips for daily healthy living, including less television and more physical activity and fruits and vegetables. However, parents' efforts to follow those recommendations didn't differ significantly among the groups.

The researchers said repeating the mailings and more follow-up contact with at-risk families might improve the response rate. They also are tracking whether participating children end up losing weight.

While some overweight children were uncomfortable with the report-card program, most parents responded favorably and the program has been expanded to include all 12 of Cambridge's elementary schools, McGowan said.

An Archives editorial said that doctors should offer a "behavioral prescription" to encourage exercise and healthful eating and that physicians need to know that fighting obesity in children is not futile.

The prescription should encourage breast-feeding, which has been linked with a decreased obesity risk in children; limiting sugar-sweetened soft drinks; curbing television-watching; and increasing outdoor activity, said editorial author Dr. Robert Whitaker of Princeton University's Center for Health and Wellbeing.

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