3 areas of education for Healthy Kids/Weight

Focus: Nutrition, exercise and behavior

Healthy Kids, Healthy Weight is a clinical research program at University Hospitals Rainbow Babies & Children's Hospital in Cleveland, OH. The program is open to children ages 4-18 with a body mass index (BMI) above the 85th percentile in children of the same age and sex.

Children older than age 7 participate in a 12-week family-based program. At least one parent must attend, but other family members can participate, such as the grandmother, if the child spends a lot of time in another household. Children are divided into two groups, ages 7-13 and ages 14 and above.

They learn about nutrition and exercise with the aid of lots of games. For example, one nutrition game is called "Food Label Frenzy." Children are divided into two teams, and each has a set of food labels. There is a buzzer on a table in the middle of the room. Questions are called out and the team with the correct answer sends out a runner with the label to hit the buzzer. Questions include: a food that is a good source of vitamin A, a food that is a good source of fiber, a food that is high in total fat, a food that is high in sodium, a food that is more than 500 calories a serving, a food that has more than three servings per container, and a food that is high in cholesterol. There also is a behavioral component addressing body image, teasing, emotional eating, binge eating, setting goals, monitoring food intake, and sleep duration.

During the exercise portion, children are exposed to different activities. Younger children participate in playground games such as relay races and versions of tag. Sometimes floor aerobics, dance, or yoga is included. The exercise session for older children is more of a group fitness workout with such exercise techniques as kickboxing, interval training, step aerobics, circuit training, and yoga. They play games as well. Both groups do strength training with weight-bearing exercises such as push-ups, squats, crunches, and lunges. Also, they use weights that are appropriate to their age and fitness level. With strength training the exercise physiologist focuses on form to make sure the children do the exercises correctly.

Families attend the education portion for 12 weeks, and they come to one class a week. They meet once a month for the remainder of the year.

A manual is followed for the education portion, since the program is a research project to gather knowledge about childhood obesity. An exercise physiologist, registered dietitian, behavioral specialist, and psychology assistant teach, explains Carolyn Landis, PhD, a clinical psychologist who has participated in the program for four years. It has been operational for six years.

The hospital funds the program except for the medical evaluation and labs at the time of enrollment, which is billed to insurance. At the time of the physical exam, the family meets with the dietitian, psychologist, and exercise physiologist.

A group of physicians created the program based on literature and other existing programs at the time, says Landis.