E-Health Info

Watching the waistline

Region program helps kids control their weight

June 13, 2007

SHELLEY BOETTCHER
Apple Magazine

Ghazal Hashemi is a typical young teenage girl.

The articulate, 13-year-old Calgarian loves to hang out with her friends. She likes to eat chocolate, and she enjoys listening to music. And over the past couple of years, she also has struggled with weight concerns.

“My family’s Persian and we like to eat a lot of rice and stew. We don’t usually have dessert, but when we do, it’s a lot,” she says. “I was getting just a little bit overweight.”

She’s not alone. These days, more North American teens and children than ever before are struggling with their weight. According to 2004 data from Statistics Canada, three per cent of children aged two to 17 were obese in 1978/79. By 2004, that number had almost tripled; it’s now about eight per cent, or roughly 500,000 children.

About 34 per cent of Canadian children aged two to 12 were overweight in 1994/95, according to Statistics Canada’s National Longitudinal Survey of Children and Youth. By 1998/99, 37 per cent of children aged two to 11 were overweight. In other words, one in every three children under the age of 12 has a problem with excess weight – and those numbers are increasing. A person is considered obese when his or her weight poses a serious risk to health. A person is considered overweight if they are heavier than they should be for their height and age.

Because children grow at different rates, it is often difficult to determine the “right weight” for a particular child. Health-care providers use growth charts to determine whether a child’s weight falls within a healthy range (see reference box on page 20 for more information on growth charts). While many Calgary kids certainly struggle with weight issues, childhood obesity is a global problem, says April Matsuno, Co-ordinator of the Prevention of Childhood Obesity Initiative for the Calgary Health Region. “It’s everywhere,” says Matsuno. “Experts believe the causes of the rapid rise in childhood obesity are related to our obesogenic environment. Obesogenic is a new buzzword that essentially means an environment that encourages us to eat more than we should and exercise less than we should.”

The evidence seems clear. Numerous studies have shown that today’s youth are less active than past generations. Instead of running around outside, they’re more likely to be inside watching television, playing video games or working on the computer.

It is recommended, for example, that children and youth be active for at least 90 minutes each day – running, climbing and swimming. But Canada’s Report Card on Physical Activity for Children and Youth, released earlier this year, says most kids fall short of that benchmark.

Moreover, the report says less than 20 per cent of Canadian children are meeting recommended guidelines of two hours or less screen time (television, computers) a day. More than 50 per cent of Canadian children are watching two to four hours of television and a third are spending two hours or more on leisure-related computer use, according to the report.

Then there are food portion sizes. Canadians eat out a lot, and we’re surrounded by fast food restaurants, which typically serve inexpensive foods that are high in calories and low in nutrients. Even regular restaurants serve much larger portions than typically served, say, 25 years ago. For example, the total calories in a meal consisting of a soft drink, fries and a burger in 1977 totalled 721. By 1996, the caloric intake jumped to 935, an increase of 214 calories due to larger portion sizes. Consider that the average nineyear-old boy who is not overly active requires a total of 1,500 calories a day, and it’s easy to see how things can get out of hand.

But the problem isn’t simply that fast-food restaurant portions have increased. A recent study by researchers at Rutgers, the state university of New Jersey, suggests that individuals have a distorted idea of what an appropriate portion or serving of food for one sitting looks like. The result is that most people will help themselves to larger helpings of food without realizing they are eating too much.

And it’s not just fries and burgers. The Rutgers study noted, for example, that typical portions of orange juice were more than 40 per cent larger today than they were 20 years ago. The additional daily consumption of juice produces 50 more calories, enough to add five extra pounds to a person over the course of one year.

“Our society wants the ‘bang for our buck’ and when portions are served to us that we think are small we feel short-changed,” says Jaime Schwartz, a researcher who helped conduct the study. “But we need to start ‘undistorting’ what we perceive to be a typical portion and begin to listen to our stomachs, not our eyes, to determine when to put the fork down.”

So what if a kid is chubby? They’ll just outgrow the problem, right? Maybe. Maybe not.

If parents and children don’t learn about the importance of portion control and exercise, if they don’t embrace a healthy lifestyle, children will be at risk for weight-related health problems: high blood pressure, cardiovascular disease, Type 2 diabetes, skin problems, osteoarthritis, gall bladder disease and even certain types of cancer.

The Calgary Health Region recognizes the problem and is working, in conjunction with various partners, to educate children and families to help prevent obesity, and to help kids who are already showing signs of weight concerns.

You won’t hear health educators talking about dieting, though, notes Matsuno. “Our society marginalizes obese and overweight people, and it can really have an effect on their self-esteem,” she says. “We have to be really careful about how we address the problems. We don’t want to create eating disorders (such as anorexia). “If we focus on good habits, the weight will take care of itself.”

That’s where initiatives such as the Calgary Health Region’s Make it Happen program come into the picture. A year ago, after a recommendation from her family doctor, Ghazal and her mother, Parinaz Hashemi, signed up for Make It Happen, geared toward kids aged six to 12. Once a week for eight weeks, the pair went to the classes and learned more about the importance of active living and healthy food choices. In addition to hands-on discussion about nutrition, the kids played racquetball, swam, skated and played basketball. (Parents and children attend the Make It Happen program together. Teens 13 to 17 years of age can attend the U of C’s Teen Leap Program.)

Time is also spent each week addressing self-esteem. Some components of the Make It Happen program, including physical education and nutrition information, are offered through a partnership with TrymGym, a weight management program at the University of Calgary.

Liz Young, Co-ordinator of TrymGym, says some of the kids who attend these classes have been teased about their weight. “This is a good place for them to come to, to talk about how they feel. Our goal is to help make them feel better about themselves,” she says. In response to what she’d learned in the class, Parinaz posted a copy of Canada’s Food Guide to Healthy Eating on the family’s fridge door. She started cooking brown rice, instead of white, and she now buys and serves more fruit and vegetables, as well as brown bread. She reads labels now, too, to check the fat and calorie content in packaged products.

In the process of trying to cook better for her only daughter, Parinaz lost about 10 pounds without even trying, she says with a laugh. “But it’s not about the weight,” she says. “I feel healthier and I’m so glad. . . They tried to teach us practical stuff. I really liked it.”

It hasn’t all been easy. Ghazal Hashemi says she learned a lot through Make It Happen, and she does her best to incorporate her new-found knowledge into her daily life. But she admits that she usually has so much homework, she isn’t always as active as she’d like to be. She’s in Grade 8 at a French immersion school in southwest Calgary.

She studies hard and dreams of becoming an orthodontist or a scientist one day.

Despite her hectic schedule, she tries to go out with a friend a few times a week for a long walk or run, and she walks to and from school every day.

Plus, this fall, her school will start offering physical education classes every day, an increase from just a couple of times a week last year. Ghazal says she almost always takes her lunch – a meat, lettuce and cheese sandwich on brown bread – to school, instead of heading to the cafeteria for a high-calorie meal. She eats more fruit than she did before, and she drinks water instead of juice. “Before I didn’t know how much I should eat, so I overate,” says Ghazal. “But I learned what to eat, how many fruits and how many servings of grain a day. I’m not a big junk food fan, but I used to love to eat a lot of rice and chocolate.”

Step by step, Ghazal continues to be responsible for her choices, and to establish healthier habits. And that’s what it’s all about, say experts. We and our children need to eat more vegetables and less french fries. We need to pour out the pop and drink water. And we need to get moving. “This isn’t about fancy gym memberships and expensive equipment,” says Kay Watson-Jarvis, Manager of the Region’s outpatient programs in child health. “This is about kids playing. People walking together. It’s about building those behaviours, getting those behaviours normalized as part of everyday life.”

Shelley Boettcher is a Calgary writer. This article originally appeared in the November 2006 issue of Apple magazine.

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Watching the waistline

Region program helps kids control their weight

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	E-Health Info Watching the waistline Region program helps kids control their weight June 13, 2007 SHELLEY BOETTCHER Apple Magazine Ghazal Hashemi is a typical young teenage girl. The articulate, 13-year-old Calgarian loves to hang out with her friends. She likes to eat chocolate, and she enjoys listening to music. And over the past couple of years, she also has struggled with weight concerns. “My family’s Persian and we like to eat a lot of rice and stew. We don’t usually have dessert, but when we do, it’s a lot,” she says. “I was getting just a little bit overweight.” She’s not alone. These days, more North American teens and children than ever before are struggling with their weight. According to 2004 data from Statistics Canada, three per cent of children aged two to 17 were obese in 1978/79. By 2004, that number had almost tripled; it’s now about eight per cent, or roughly 500,000 children. About 34 per cent of Canadian children aged two to 12 were overweight in 1994/95, according to Statistics Canada’s National Longitudinal Survey of Children and Youth. By 1998/99, 37 per cent of children aged two to 11 were overweight. In other words, one in every three children under the age of 12 has a problem with excess weight – and those numbers are increasing. A person is considered obese when his or her weight poses a serious risk to health. A person is considered overweight if they are heavier than they should be for their height and age. Because children grow at different rates, it is often difficult to determine the “right weight” for a particular child. Health-care providers use growth charts to determine whether a child’s weight falls within a healthy range (see reference box on page 20 for more information on growth charts). While many Calgary kids certainly struggle with weight issues, childhood obesity is a global problem, says April Matsuno, Co-ordinator of the Prevention of Childhood Obesity Initiative for the Calgary Health Region. “It’s everywhere,” says Matsuno. “Experts believe the causes of the rapid rise in childhood obesity are related to our obesogenic environment. Obesogenic is a new buzzword that essentially means an environment that encourages us to eat more than we should and exercise less than we should.” The evidence seems clear. Numerous studies have shown that today’s youth are less active than past generations. Instead of running around outside, they’re more likely to be inside watching television, playing video games or working on the computer. It is recommended, for example, that children and youth be active for at least 90 minutes each day – running, climbing and swimming. But Canada’s Report Card on Physical Activity for Children and Youth, released earlier this year, says most kids fall short of that benchmark. Moreover, the report says less than 20 per cent of Canadian children are meeting recommended guidelines of two hours or less screen time (television, computers) a day. More than 50 per cent of Canadian children are watching two to four hours of television and a third are spending two hours or more on leisure-related computer use, according to the report. Then there are food portion sizes. Canadians eat out a lot, and we’re surrounded by fast food restaurants, which typically serve inexpensive foods that are high in calories and low in nutrients. Even regular restaurants serve much larger portions than typically served, say, 25 years ago. For example, the total calories in a meal consisting of a soft drink, fries and a burger in 1977 totalled 721. By 1996, the caloric intake jumped to 935, an increase of 214 calories due to larger portion sizes. Consider that the average nineyear-old boy who is not overly active requires a total of 1,500 calories a day, and it’s easy to see how things can get out of hand. But the problem isn’t simply that fast-food restaurant portions have increased. A recent study by researchers at Rutgers, the state university of New Jersey, suggests that individuals have a distorted idea of what an appropriate portion or serving of food for one sitting looks like. The result is that most people will help themselves to larger helpings of food without realizing they are eating too much. And it’s not just fries and burgers. The Rutgers study noted, for example, that typical portions of orange juice were more than 40 per cent larger today than they were 20 years ago. The additional daily consumption of juice produces 50 more calories, enough to add five extra pounds to a person over the course of one year. “Our society wants the ‘bang for our buck’ and when portions are served to us that we think are small we feel short-changed,” says Jaime Schwartz, a researcher who helped conduct the study. “But we need to start ‘undistorting’ what we perceive to be a typical portion and begin to listen to our stomachs, not our eyes, to determine when to put the fork down.” So what if a kid is chubby? They’ll just outgrow the problem, right? Maybe. Maybe not. If parents and children don’t learn about the importance of portion control and exercise, if they don’t embrace a healthy lifestyle, children will be at risk for weight-related health problems: high blood pressure, cardiovascular disease, Type 2 diabetes, skin problems, osteoarthritis, gall bladder disease and even certain types of cancer. The Calgary Health Region recognizes the problem and is working, in conjunction with various partners, to educate children and families to help prevent obesity, and to help kids who are already showing signs of weight concerns. You won’t hear health educators talking about dieting, though, notes Matsuno. “Our society marginalizes obese and overweight people, and it can really have an effect on their self-esteem,” she says. “We have to be really careful about how we address the problems. We don’t want to create eating disorders (such as anorexia). “If we focus on good habits, the weight will take care of itself.” That’s where initiatives such as the Calgary Health Region’s Make it Happen program come into the picture. A year ago, after a recommendation from her family doctor, Ghazal and her mother, Parinaz Hashemi, signed up for Make It Happen, geared toward kids aged six to 12. Once a week for eight weeks, the pair went to the classes and learned more about the importance of active living and healthy food choices. In addition to hands-on discussion about nutrition, the kids played racquetball, swam, skated and played basketball. (Parents and children attend the Make It Happen program together. Teens 13 to 17 years of age can attend the U of C’s Teen Leap Program.) Time is also spent each week addressing self-esteem. Some components of the Make It Happen program, including physical education and nutrition information, are offered through a partnership with TrymGym, a weight management program at the University of Calgary. Liz Young, Co-ordinator of TrymGym, says some of the kids who attend these classes have been teased about their weight. “This is a good place for them to come to, to talk about how they feel. Our goal is to help make them feel better about themselves,” she says. In response to what she’d learned in the class, Parinaz posted a copy of Canada’s Food Guide to Healthy Eating on the family’s fridge door. She started cooking brown rice, instead of white, and she now buys and serves more fruit and vegetables, as well as brown bread. She reads labels now, too, to check the fat and calorie content in packaged products. In the process of trying to cook better for her only daughter, Parinaz lost about 10 pounds without even trying, she says with a laugh. “But it’s not about the weight,” she says. “I feel healthier and I’m so glad. . . They tried to teach us practical stuff. I really liked it.” It hasn’t all been easy. Ghazal Hashemi says she learned a lot through Make It Happen, and she does her best to incorporate her new-found knowledge into her daily life. But she admits that she usually has so much homework, she isn’t always as active as she’d like to be. She’s in Grade 8 at a French immersion school in southwest Calgary. She studies hard and dreams of becoming an orthodontist or a scientist one day. Despite her hectic schedule, she tries to go out with a friend a few times a week for a long walk or run, and she walks to and from school every day. Plus, this fall, her school will start offering physical education classes every day, an increase from just a couple of times a week last year. Ghazal says she almost always takes her lunch – a meat, lettuce and cheese sandwich on brown bread – to school, instead of heading to the cafeteria for a high-calorie meal. She eats more fruit than she did before, and she drinks water instead of juice. “Before I didn’t know how much I should eat, so I overate,” says Ghazal. “But I learned what to eat, how many fruits and how many servings of grain a day. I’m not a big junk food fan, but I used to love to eat a lot of rice and chocolate.” Step by step, Ghazal continues to be responsible for her choices, and to establish healthier habits. And that’s what it’s all about, say experts. We and our children need to eat more vegetables and less french fries. We need to pour out the pop and drink water. And we need to get moving. “This isn’t about fancy gym memberships and expensive equipment,” says Kay Watson-Jarvis, Manager of the Region’s outpatient programs in child health. “This is about kids playing. People walking together. It’s about building those behaviours, getting those behaviours normalized as part of everyday life.” Shelley Boettcher is a Calgary writer. This article originally appeared in the November 2006 issue of Apple magazine.	FYI Childhood obesity strategy April Matsuno (403) 826-7630 Make It Happen Program For children between 6-12 who have weight issues Mary Waterman (403) 955-7435 Tina Freitas (403) 955-7440 TrymGym Offers programs for children between 13 - 17 to gain control of their weight. Liz Young (403) 220-4374 www.ucalgary.ca/trymgym Go2 Calgary Encourages people to engage in at least 30 minutes of physical activity throughout the week www.go2calgary.com
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