The problem is large
More than four out of 10 fifth graders in Catawba County school districts are either overweight or obese, according to data provided by the Catawba County Health Department. Of those four, more than two are obese.
“This is troubling,” said Michelle Rimer, Director of the Solmaz Institute at Lenoir-Rhyne University. “We know that overweight and obese children are 80 percent more likely to become overweight/obese adults. This leads to increased risk for cardiovascular events, type 2 diabetes, cancer and an overall decreased quality of life.”
Brittany Maxfield, a senior at Bunker Hill High School, fell into that obese category, and was referred by her doctor to the services provided through the institute. She is proactively addressing areas of her life in terms of healthy diet education and practices and regular exercise. She is, however, a very small percentage of a figuratively and literally large problem in America.
BMI and what it means
The health department conducts an annual measurement of BMI, body mass index, on all fifth graders in the three Catawba County school districts. BMI is a number that results from a formula that uses height and weight. Depending on age, a child’s BMI is plotted on a scale that shows how the number compares to normal ranges.
“A score can indicate a child’s height and weight ratio being within normal ranges, or too low – or, in what we look at, too high,” said Rimer.
Normal BMI percentiles fall within 5 percent and 84 percent. If the BMI falls within 85 and 94 percent, that child is considered overweight, and at risk for being obese. If BMI is 94 percent or above, the child is considered to be obese.
Ancel Keys of the University of Minnesota developed the body mass index in the early 1970s after measuring height, weight and body fat of more than 7,400 subjects, according to livestrong.com. A formula he developed proved to be the most accurate measurement of body fat. Researchers found a correlation between BMI and obesity-related diseases, said the article.
Over the years, BMI indicators have changed. Early on, for example, overweight BMI changed from 25.0 percentile to 29.9.
BMI is not without its detractors. Vondell Clark, medical director for Healthy House at Catawba Valley Medical Center and a family practice physician, questions the use of BMI across the board.
“By the BMI indicators, nearly every ball player in the NBA or the NFL is obese,” he said.
He also believes environment is a key proponent of health when considering BMI. For example, a member of the Aleuts, who live in an extremely cold environment, have more body fat typically than someone who lives in Northern Africa. Switch environments between the two and survival would be a challenge, according to Clark.
Still, BMI is the standard in predicting the danger of, or diagnosis for obesity.
What’s being done locally about the obesity problem?
Addressing obesity is one of the top four health issues identified by the county, according to Kelly Schermerhorn, Public Information Officer with Catawba County Public Health.
Taking the BMI measurements of fifth graders each year enables public health to see what the trends are with regard to obesity. Statewide, the obesity measurements have leveled out, but those figures are compiled only from WIC clinics throughout the state.
WIC is the Women, Infant and Children federal program that focuses on low-income pregnant women and their children. The data is skewed to that group and is not as representative as the county’s fifth graders’ measurements.
A unique LRU institute
The Solmaz Institute has established an interdisciplinary approach to the health aspects of weight – specifically obesity – among adolescents. The institute is located at Lenoir-Rhyne University, and is the only of its kind in the nation, according to Rimer.
Gungor Solmaz, a successful businessman in the textile industry, established the Solmaz Institute for Obesity with a gift of $3 million, according to information from the institute. A native of Turkey, Solmaz wanted to do something positive for his adopted country.
According to Rimer, Solmaz was struck by the negative affects that overweight employees had on his business. Those included increased sick days, higher insurance costs and loss of productivity. It also affected quality of life for the employees. The intent of the institute was not to create a “weight-loss factory,” but an interdisciplinary program to train its clients how to modify their lives.
“It’s been shown that interdisciplinary training leads to better patient care,” she said, referring to a student team approach through the institute. According to Rimer, students from a variety of disciplines, including nursing, occupational therapy, and health and science, form teams assigned to each student.
Brittany Maxfield goes to the Solmaz Institute once a week to work with LRU students in a plan developed for her that includes diet and exercise.
Richard Joe is a senior in the Registered Dietician program at LRU and is doing his dietetic internship program through the institute. He works with clients like Brittany.
“For the hour, we divide it up into 30 minutes of an educational component and 30 minutes of exercise – usually something fun,” he said.
He and Maxfield work out to a Michael Jackson interactive dance video, flinging arms and twisting and moving about in response to the Jackson screen icon.
“It’s really educated me since I’ve been here,” Maxfield said. “I’ve learned a lot about nutrition and the right portions – I feel better and have more energy now that I’m eating healthier.”
Joe attributes the increased energy due to the fact Maxfield is not skipping breakfast, and has added fruits and vegetables to her diet.
“A lot of people don’t eat breakfast,” Joe said, “and are tired during the day as a result. Then they go home and overeat, which again makes them feel tired.”
It is a practice that is counterproductive, according to Joe. People think when they skip a meal or two, which decreases the calories, it should result in weight loss. It works just the opposite, said Joe.
Maxfield commented that her new regimens are having an affect at home.
“My grandmother eats healthier as a result of what I’m doing,” she said.
Maxfield plans to go to N.C. State in their pre-veterinarian program. Asked if she is concerned about being in Raleigh and getting off-track with her program, she responded confidently, “Not at all.”
Catalino “Junior” Campuzano, 9, attends St. Stephens Elementary School. While he goes to play basketball with Greg Kirk, Zach Howell and Demetrius Green, all seniors in LRU’s Health and Exercise Science program, his mother works with Michelle Rimer and student interns. With the help of an interpreter, they go over Campuzano’s progress and explain to his mother what her roles are.
“I like that they let me choose what I want to play. I like to play soccer and basketball,” the 9-year-old said. “I lost weight – five pounds.”
“Each client has a different goal,” Rimer said. “They like interacting with college students.”
The program has been operational for a year, and the average age of clients benefitting from the program is 13.
Clients normally self-refer themselves, and family practice physicians or pediatricians may also suggest the program to their patients. In the rare case, cardiologists refer patients who are children or adolescents, according to Rimer. Clients also come through Healthy House.
There is no charge for services through the institute, according to Rimer.
“Mr. Solmaz wanted to make sure no one was left out due to ability to pay,” Rimer said.
In 2008 Catawba Valley Medical Center opened the doors of Healthy House, a facility and program dedicated to preventing and treating childhood obesity. The program was launched after the hospital was awarded two three-year grants totaling nearly $825,000 for the initiative, according to the hospital website
It is the first of its kind in the region and is located on the medical center campus in a house once owned by a physician, according to Lynn Winkler, Wellness Coordinator for the program.
“My part of the program is to teach children and families healthy lifestyles,” she said. “Through things like cooking classes, we try to tweak habits that are difficult to break.”
Designed for ages 3 to 12, the program requires that parents, guardians and family members participate. That requirement is essential if the child is going to receive reinforcement at home, according to Winkler. The program is free of charge, and clients are referred by a variety of sources.
The facility includes a kitchen that opens to a larger room. Stocked in its cabinet are a variety of spices, canned beans and other ingredients used to demonstrate to parents how to prepare healthier meals.
There is no delusion about the steep climb that every family struggling with weight issues faces.
“We are bombarded with social and ecological messages that are contrary to healthy habits and healthy eating,” said Clark. He pointed to federal government’s concerns regarding obesity coming out of the White House through First Lady Michelle Obama versus legislative actions that subsidize corn – not the healthiest of foods.
“We have developed an incredible delivery system of salt, sugar and fat to Americans,” said Clark. “Our models used to fight obesity include the clinical model -- eat less, exercise more; the public health model, which is obesenogenic (his word) -- all-concerned with obesity; and the personal responsibility model – which asks us to do the impossible.”
In turn, Healthy House has adopted a philosophy of small and incremental successes. Such as a family switching from whole milk to 1 percent milk, according to Winkler.
“Rather than deprivation, we emphasize what is enjoyable,” Winkler said. “We do this in a way that is fun, from food to exercise.”
Myra McDonough, activity specialist with the program, takes all clients and their family to a play area outside the building. She teaches a game called “Go Fish,” based on the children’s card game. Dividing into two teams – children v. adults – she quickly explains the game, which involves running and jumping and various other movements. Exercise, but also fun.
“Habits drive our behavior, and we’re on cruise control with regard to that,” Winkler said. “We have to be very sensitive to that for the future.”
The schools and other programs
School districts in the county are very aware and involved with both nutrition and exercise among students – especially in the elementary grades.
Programs like Mileage Club, Girls on the Run, and Eat Smart, Move More are geared to encouraging more and better exercise for students.
While school lunches do include pizza and corn dogs, Winkler is confident the various districts are approaching nutrition very seriously. Children nutrition programs are self-supporting.
“Our child nutrition directors in our area are working to provide nutritious meals based on USDA guidelines, the Healthy Hunger-Free Kids Acts, and their operating budget,” Winkler said. “For many children the meal they receive at school is the most nutritious meal of the day.”
The following have been provided by Hickory Public Schools regarding programs currently in place with regard to childhood nutrition:
1. School lunch program – with the changes brought on by the Healthy Hunger-Free Kids Act of 2010, school meals have become a key factor in targeting childhood obesity concerns. They offer more fruits and vegetables (in a wide variety) and more whole grains, all emphasized in the Dietary Guidelines for Americans.
2. The Fresh Fruit and Vegetable Program at Southwest and Longview introduces fruits and vegetables to children who may not receive a wide variety at home. This is a grant through USDA for low-income elementary schools to receive fruits and vegetables in the classroom as “snack” 2-3 times per week, with at least one time per week receiving a vegetable. The purpose of the program is to encourage and introduce healthy snacking habits at a young age.
3. Healthy Schools Recognition program through Eat Smart, Move More Catawba County/Catawba County Public Health. Currently only Hickory High is recognized. However, HPS superintendent Walter Hart has made it part of the strategic plan for all HPS schools to earn this award.
For more info: Contact the Solmaz Institute @ 828-328-7473; Health House @ 828-326-3415.