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Increasingly Obese US Youngsters Face Health Risks - 2004-01-21

Doctors say America's children are facing a major health crisis, and it's one that doesn't have to exist. Twenty percent of American children are overweight. That puts them at risk for diabetes, heart disease, and even stroke... problems that used to affect only adults. Experts blame a whole host of factors, ranging from fast food and the Internet, to the surprising lack of sidewalks and parks in many of the housing developments built over the last 20 years. Whatever the causes, educators and nurses in one small, Pennsylvania town are determined to do something about childhood obesity. But as VOA's Maura Farrelly reports, their efforts haven't exactly been met with enthusiasm by parents.

Lisa Lechmanick remembers vividly the day she got what she calls two "fat letters" from officials in the East Penn School District in Emmaus, Pennsylvania. "I just kind of put the letters away, didn't show them to my children," she recalls. "Weight issues, for one of my children, it was a huge issue, and I just felt that wasn't necessary for them to see."

Ms. Lechmanick's reaction was actually pretty restrained compared to that of many parents who received letters in 2001, telling them their children were overweight and should be taken to a doctor. George Ziolkowski, director of Pupil Personnel Services for the East Penn School District, says most of the recipients were outraged.

"The primary attack was, 'This is none of your business. You're in the business of education, that's reading, writing, and arithmetic. This is none of your business. Stay out of this,'" said Mr. Ziolkowski. "Well, health education IS our business. People who are fit are better learners. The Greeks knew this 2,000 years ago. I mean, you know, 'healthy body, healthy mind.' It all comes together."

Mr. Ziolkowski says many parents just don't recognize that their children are overweight. Some are blinded by love. Others are overweight themselves, so their perspective on what's healthy is a bit skewed. Either way, parents don't like to hear that their kids are fat, because they see it as a criticism of their parenting skills. But Ann Johnson, one of the school nurses who helped to design the District's Body Mass Index measurement program, says that conclusion is just plain wrong.

"We're all in this boat together," she said. "We're not dealing with individual parental decisions on what they chose to feed their children, or what they chose to involve their children in as far as activity. It's cultural. It is something that we are all dealing with, the food choices we have, the lifestyle we live. So it's not a criticism of parents as much as it is a byproduct of our entire culture."

Ms. Johnson says schools routinely screen children for health problems like scoliosis, a curvature of the spine, and streptococcus, a highly contagious infection that, if untreated, could lead to arthritis and kidney problems. So it made sense, she said, for school officials to also start screening for the leading cause of diabetes and heart disease in children.

"We were seeing six year olds with type 2 diabetes. We were seeing high school football players with hypertension. We were seeing children being put on medication to control cholesterol levels," said Ms. Johnson. "And we kind of put all our information together and realized that the information that we were reading in the research coming out about obesity in children, that we were actually seeing this in our own school district."

The Body Mass Index measurement program in East Penn School District has evolved quite a bit since it was first introduced three years ago, and the changes have been a response to parental complaints. All parents are now given their children's measurements, whether or not there's a problem. And since anorexia nervosa has been seen in girls as young as eight or nine, parents of underweight, not just overweight children, are told a health issue could be developing.

Long before the letters are written, though, parents are given the option of not participating in the program. This year, the parents of roughly 300 children, in a district with more than 7,000 students, chose not to receive letters. For her part, Lisa Lechmanik says she has a better understanding now of why the school district is interested in her children's weight. And she says her kids have become a bit more aware of what they're eating ... and how much.

"I don't eliminate everything from my house and only have fruit," said Ms. Lechmanik. "I mean, I have the bad stuff in my house. Everybody does. However, my children know they don't just go and eat it. They ask me. I mean, I have an 18-year-old and a 13-year-old, and they still will ask, 'Mom, can I have this?' And pointing out to them also the difference between making a choice, 'Well, no, you can't have that now. Now would be a better time to have some fruit.'"

It's not clear yet whether the program has had an impact on the obesity rate in East Penn School District. Nurse Ann Johnson says she thinks that won't be known for another couple years, at least. But state education officials have noticed what's happening in Emmaus, Pennsylvania. They've taken steps to expand the East Penn program to nine other school districts throughout the state. And if it makes a difference there, the so-called "fat letters" could become standard in all 501 Pennsylvania school districts.