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Arkansas Works to Fight Child Obesity

June 15, 2004 at 12:00 AM EDT
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GWEN IFILL: Obesity in America. A new report out today in the Journal of the American Medical Association declares the numbers of obese and overweight Americans “alarming.” Researchers at the Centers for Disease Control raised particular concerns about obesity among children.

In recent weeks, health correspondent Susan Dentzer has been looking at just that issue in one state that’s taking action. Our health unit is a partnership with the Henry J. Kaiser Family Foundation.

TEACHER: Everyone jump up. Show me a food pyramid.

SUSAN DENTZER: In this elementary school gym class in Arkadelphia, Arkansas, the emphasis is on fitness and eating right.

TEACHER: And over here we have … meats! Muscle, protein. Calcium.

SUSAN DENTZER: The class is just one example of how schools in Arkadelphia, and all across Arkansas, are tackling the rising rate of obesity in kids.

TEACHER: Excellent.

SUSAN DENTZER: Nationwide, it’s an epidemic. Over the past two decades, rates of obesity and overweight have doubled in children and tripled in adolescents. Nine million kids, like some of these Arkadelphia High School students, are now deemed at risk of developing obesity-related chronic diseases ranging from diabetes to high blood pressure.

Arkansas has now become the first state to launch a systematic attack on the problem, and with good reason. Recently, the state released results of a groundbreaking study showing that a hefty 40 percent of Arkansas schoolchildren are overweight or obese. Mike Huckabee is Arkansas’ Republican governor.

GOV. MIKE HUCKABEE: In Arkansas, we have a crisis. That crisis is that we eat too much. We eat too much of the kinds of food that only create an obesity crisis.

SUSAN DENTZER: Huckabee, who’s 48, should know. After ballooning to nearly 300 pounds, he’s shed more than 100 of them in the past year. In a state where more than three out of five adults are also overweight or obese, he says major changes are needed.

GOV. MIKE HUCKABEE: Health care costs are soaring in states like Arkansas. We have larger-than-desired issues of diabetes. We have huge problems with heart attack, stroke, all of which are preventable diseases in the cases when they’re obesity-related.

SUSAN DENTZER: Arkansas’ lawmakers were especially alarmed by exploding Medicaid outlays, driven in part by obesity-related chronic illness. So last year, they enacted a law aimed at combating obesity by targeting children first.

WOMAN: I’m going to bring this down onto your head, and when I do, I want you to take a deep breath and hold it.

SUSAN DENTZER: The new law is called Act 1220. A key piece of it is a plan to assess the so-called “Body Mass Index” of every school-age child in Arkansas. BMI is an indicator of whether a person is underweight, normal weight, overweight, or obese. Arkadelphia, about an hour southwest of Little Rock, volunteered to be the first of the state’s 306 school districts to undergo the assessments. Tony Prothro is Arkadelphia’s school superintendent.

TONY PROTHRO: We started with kindergarten, first grade, and worked our way up through to the high school. Our main concern was to make sure that no students would be a source of ridicule, and that it would not be an embarrassment to them in undergoing the process or in the receiving of the reports.

SUSAN DENTZER: No additional funds were appropriated to carry out the new law, so money was donated by nonprofit groups to buy these scales. Prisoners in the state’s corrections system turned out these stadiometers, devices for measuring height. Pediatrician Joe Thompson directs the Arkansas Center for Health Improvement, which coordinated the BMI assessments for the state. He says the Arkadelphia results, which were sent to local families in April, were grim.

JOE THOMPSON: Nationally, about 15 percent of boys and about 15 percent of girls are overweight, or in that highest classification of BMIs. Unfortunately, we’ve got 22 percent, 18 percent, of the boys and girls, respectively, in Arkadelphia that are in the heaviest classification from a BMI perspective.

SUSAN DENTZER: In other words, those kids weren’t just overweight, but obese. Add in children whose BMIs signaled they were merely overweight, and the tally in both categories was a whopping 36 percent of girls and 39 percent of boys.

TEACHER: Okay, if you’re done…

SUSAN DENTZER: Arkadelphia High School junior Camille Johnson is an honor student. She exercises regularly as a member of the cheerleading squad. But at 5’4″ and 166 pounds, she had a BMI of 28.6. That suggested she was overweight, or as the state’s gentler rating system put it, “at risk of overweight.”

And in fact, Arkansas’ new data shows that a whopping 46 percent of African American schoolgirls like Johnson are overweight or obese. This so-called “child health report” was mailed home to Johnson’s mother. Johnson herself told us she resented the report.

CAMILLE JOHNSON: I believe that it probably offended most people to say they’re overweight, or they just didn’t care — just threw the paper down and said, “oh, whatever. That’s not how I feel.” I try to be active, and, you know, do exercise and different things like that, but it’s just my body. I can’t do anything about it, you know?

GLORIA JOHNSON: Not much cornbread, huh?

CAMILLE JOHNSON: No.

SUSAN DENTZER: But her mother, Gloria, who says she’s also overweight, told us she welcomed the assessment. She told us she and Camille had poor eating habits that they needed to change.

GLORIA JOHNSON: I always keep a box of … what are they? Hot tamales and…

STUDENT: Mike and Ikes.

GLORIA JOHNSON: Mike and Ikes. I go to Wal-Mart and get the big box. And of course I have them in bed, and I just … popcorn. I eat a bag of popcorn every night. I’m sitting up in bed with my popcorn and a glass of water or either a Coke.

MAN: Green.

CHILD: Green?

MAN: Yeah.

CHILD: I think I’m going to use orange.

SUSAN DENTZER: Jason Hughes says he was angry at first when his 5-year-old daughter, Ashtynn, was labeled “at risk of overweight.” But he now says the notice prompted positive changes.

JASON HUGHES: We don’t go to McDonald’s as often. We don’t eat out as often. We eat at home more. I’m drinking Diet Coke instead of Coke, you know? Just a few lifestyle changes that — and I think that’s great. It raised awareness that we were doing some things wrong as parents.

DR. WESLEY KLUCK: Big breaths.

SUSAN DENTZER: The child health reports encouraged families of overweight or underweight children to consult their doctors for help. One was local pediatrician Wesley Kluck.

DR. WESLEY KLUCK: The usual question is, “tell me what diet to put my child on.” And of course, we don’t believe in putting children on diets because they need to have a good, well-balanced intake of calories and nutrition. My suggestions are, number one is to make the meal a healthy time, to make it a normal calorie intake, to avoid the excess of calories in snack time. And also there’s suggestions on a plan of exercise activity that can be carried out summer, winter, fall, spring — all seasons.

SUSAN DENTZER: Kluck says that in more than two-thirds of cases of overweight kids, the parents are also overweight too, so the whole family is advised to make lifestyle changes. Kluck says it isn’t easy.

DR. WESLEY KLUCK: Behavior change for weight loss may be one of the hardest human experiences possible. I believe that your brain is hardwired for hunger. When you have that hunger experience, it is very hard to fight back.

SUSAN DENTZER: To encourage healthy eating when kids are hungry, Act 1220 also ordered other changes. Vending machines were removed or declared off-limits to students at elementary schools. Their use may soon be restricted at high schools as well.

STUDENT: Oh, Ding-Dongs!

SUSAN DENTZER: Schools are also required under Act 1220 to review the nutritional content of school meals. Detri Brech, a Ph.D. nutritionist at Ouachita Baptist University, walked us through the lunch line at Arkadelphia’s Perritt Primary School.

DETRI BRECH: Well, the menus range between 25 percent and 32 percent fat, and the menu today with the pepperoni pizza is going to be a little bit above 30 percent, about 32 percent for the total meal.

SUSAN DENTZER: Brech told us the lunch could be improved.

DETRI BRECH: Could be a leaner protein source. The pudding is a little high in sugar. I would serve a whole-grain bread with turkey and a low-fat cheese, like mozzarella cheese, still keeping the salad, and the oranges for the Vitamin C. And they’re going to have low-fat milk to drink.

SUSAN DENTZER: Physical education in all grades is also under review. In Arkadelphia, high school students now get just one class of P.E. per week, and for only one semester during their entire four years. A new state child health advisory committee now says middle and high school students should get three hours and 45 minutes of P.E. each week. But Perritt Elementary P.E. teacher Mary Taylor told us it’s unclear whether the state can afford to follow through. What would it take?

MARY TAYLOR: Money. Have it, but you know, move it from the bottom to the top. Make it a priority. But you know, Arkansas, with –money’s not there right now, you know. So that’s our biggest concern.

SUSAN DENTZER: Child health reports with BMI assessments of the rest of Arkansas’ 450,000 school kids are to be mailed home to families this summer. Later this month, Governor Huckabee is expected to announce special measures to attack childhood obesity in hardest-hit parts of the state.