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ST. LOUIS – About 140 second-graders at Hancock Place School in Lemay, Mo., are a study in motion – jumping rope, hopping on one foot, climbing stairs. The children aren’t competing in an obstacle course – they are participating in the Fit ‘n’ Fun Adventure, a program created by St. Louis Children’s Hospital to educate kids about the importance of exercising and eating healthy.
According to the American Academy of Pediatrics, the number of overweight and obese children has doubled in the past two decades. Currently, 15.3 percent of 6- to 11-year-olds and 15.5 percent of 12- to 19-year-olds are at or above the 95th percentile for body mass index (BMI).
Statistics like these and other evidence of the escalating problem of childhood obesity have prompted St. Louis Children’s Hospital physicians and staff to take action through two innovative programs – Fit ‘n’ Fun Adventure and Head to Toe.
Children participating in the Fit ‘n’ Fun Adventure, administered at their schools, learn the importance of exercise and healthy eating. Each child receives a magnet that is used on the "adventure board," which is similar to a game board, to track their daily movement and activity. Each day of the 20-day program, students receive a card that describes an achievable and fun activity they can do at home, such as dancing to a favorite song, walking up and down stairs five times, hopping 10 times on their left foot, etc.
Once they complete the activity, a parent or caregiver initials the card. The next day at school, the kids move their magnets along the adventure board. Students who complete all their activities for the week receive activity-based awards such as a jump rope, ball or hacky sack. At the end of the program, children in each classroom who complete all 20 activities receive completion awards.
"There are many programs that concentrate on nutrition, but often children don’t make decisions about what they eat," said Joanne Buttice, child health advocacy and outreach health educator at St. Louis Children’s Hospital. "We decided to focus on what children can control, and that’s movement."
In addition to the daily exercise activity, the cards also contain a nutrition fun fact and nutrition-related activities such as "eat a piece of fruit or a vegetable" or "drink three glasses of water." The aim is to make the activities simple, achievable and fun for the kids, as well as making the program easy for the teachers to administer.
"It takes about 15 to 20 days to form a habit, so the length of this program was chosen with long-term goal of encouraging kids to make exercise and movement routine," said Buttice. "We thought it was important to have parental involvement, as well, which is why caregivers must initial the activity card each day. The classroom teacher administers the program, but the physical education teacher, parents and coaches are involved, as well."
The Fit ‘n’ Fun Adventure is funded through the St. Louis Children’s Hospital Foundation and is being made available to kindergarten through fifth-grade students in several St. Louis-area schools.
The second education program focusing on healthy lifestyles created by St. Louis Children’s Hospital is called Head to Toe. Physicians may refer children and adolescents 8-17 years old who are beginning to have weight problems to this educational program. For an hour once a week for 10 weeks, participants learn about nutrition from a pediatric dietitian who addresses such topics as portion control, thinking of food as fuel for the body, and not measuring self-worth by how much someone weighs.
The program was created six years ago by a pediatric dietitian and pediatric physical therapist in response to weight issues they observed in their patients. The program’s philosophy is that children should be aware of their nutritional habits and should be well-informed and be able to take control of their health. It includes nutrition, education and fitness components.
A pediatric physical therapist or physical therapy assistant teaches children about target heart rates, what exercise is, the importance of movement and how to limit "screen time" – the amount of time spent playing video games, watching television or using a computer.
"Our goal is to help kids re-think how they’re living their lives and what habits they’ve developed in regard to nutrition and exercise," said Kelly Klasek, child health advocacy and outreach coordinator at St. Louis Children’s Hospital. "Although some participants lose weight, that’s not our ultimate objective. Rather, we want to stop the cycle of weight gain so that the children can maintain their weight while they continue to grow."
The Head to Toe curriculum follows guidelines established by the American Academy of Pediatrics, the American Dietetic Association and the American Academy of Physical Therapists. The classes currently are held at St. Louis Children’s Hospital and other local hospitals with the goal of expanding to other locations in the near future.
"We see a great opportunity to take the lead in developing and delivering programs to support kids’ awareness of eating well and exercising," said Klasek. "Both the Fit ‘n’ Fun Adventure and Head to Toe program emphasize the positives of a healthy lifestyle, rather than negatives that may harm children’s self-image and self esteem."
St. Louis Children's Hospital has provided specialized care for children for more than 120 years. Children's Hospital is affiliated with Washington University School of Medicine, ranked the second best medical school in the country by US News & World Report. In 2003, Child magazine ranked St. Louis Children's Hospital sixth on its list of the 10 Best children's hospitals in the country, and fourth in neonatology/neonatal intensive care unit (NICU). St. Louis Children's Hospital also is a member of BJC HealthCare.