Class helps kids set goals for weight loss

Visual lessons, hands-on instruction educate

To help children struggling with a weight problem learn how much fat is in their favorite lunch; instructors at WHAM, a wellness, health, action, and motivation class at Arkansas Children's Hospital in Little Rock; weigh out caulk on a gram scale and put it in small take-out boxes. On the top of each box is a picture and name of the food item, such as a taco salad from Taco Bell.

The exercise triggers a lesson on how to make good choices when eating out, explains Bethany Spillman, MS, RD, LD, a pediatric clinical dietitian at Arkansas Children's Hospital and one of the class instructors.

This one-day free class is open to all overweight and obese children ages 6-18 in Arkansas and a family member. The class is one way the hospital is addressing childhood obesity. The hospital also has an obesity clinic for children in the 97th body mass index (BMI) percentile in children of the same age and sex. Families attending the class receive information about the clinic.

The key areas of education in WHAM include nutrition, physical activity, motivation, and goal setting. The overall goals of the program are for all children to eat at least five servings of fruits and vegetables each day; consume no more than 12 ounces of a sweetened drink per day; increase meals prepared and eaten at home to greater than five a week; increase physical activity to at least 30 minutes a day; and decrease screen time to less than two hours a day, which includes television, video games, and computers.

At the end of the class the instructor, who is a registered dietitian, helps participants set realistic, achievable goals. In a recent WHAM class, one child agreed to monitor portions, eat at the table, and wait 20 minutes before getting seconds. Another child wrote that he would eat healthier snacks and watch the nutrition facts. Also wrote that he would try to work out 30-60 minutes every day.

Families have the option to schedule 15-minute follow-up sessions with a registered dietitian every two weeks at the hospital to go over the goals and address what they are struggling with. There is a fee for the sessions.

Children can also participate in a free support program. An eight-week program run by the physical therapist from the obesity clinic called Champions Club focuses on activities, nutrition, goal setting, and working on challenges. The class is held on Thursdays in the fall and spring.

Lessons in the WHAM class are a mixture of computerized graphic presentations and activities. Usually 2-10 families attend, so the teaching is casual with lots of questions. Also families have an hour of activity at the recreation center, which is part of the obesity clinic. Children are taught how to use a resistance band, and they take it home. The exercise session begins with warm up walking/jogging around a track and stretching. Strengthening exercises with the band are conducted as well as simple calisthenics and aerobic movement exercises. The focus is on simple exercises, without a lot of equipment, that can be done at home.

They also receive handouts on the nutritional topics discussed and food and activity tracking sheets. When children come into the class they fill out a food and activity recall sheet for the day and also track how much time they have spent in front of a TV or computer screen. [For a copy of a food and activity tracking form and family meal tracking form, see the online issue of Patient Education Management. For assistance, contact customer service at (800) 688-2421 or customerservice@ahcmedia.com.] The main educational material used is found on web sites and is free to the general public. The web sites include information from the United States Department of Agriculture "MyPyramid.gov, Steps to a Healthier You" (www.mypyramid.gov), and information on "Portion Distortion" from the U.S. Department of Health and Human Services, National Institutes of Health (hp2010.nhlbihin.net/PORTION). A booklet named "We Can Parent" is also distributed, which provides information for parents about helping children lose weight. The material is produced by the Department of Health and Human Services.

Such activities can be enlightening. Families and children need education, says Spillman. Many are surprised by nutritional facts such as salads can be higher in fat than a hamburger when dressing is added.

Source/Resource

For more information about WHAM contact:

Bethany Spillman, MS, RD, LD, Pediatric Clinical Dietitian, Arkansas Children's Hospital, One Children's Way, Little Rock, AR 72202-3591. E-mail: spillmanbd@archildrens.org.

• We Can! educational materials can be downloaded from the program web site at: http://www.nhlbi.nih.gov. In the "Public" section, select "Heart and Vascular Diseases," "Obesity and physical Activity, and "We Can! – A Way to Enhance Children's Activity and Nutrition."