full potential update 2009

8/14/2019 Full Potential Update 2009

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FULL POTENTIAL2009:Actions on Obesity

An update to:FACTS ABOUT GROWING UP HEALTHY IN FRANKLIN COUNTY: 2008 Collaborative Childrens Health Repor


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Table of ContentsReaching Their Full Potential ................................ 1

Moving Forward ..................................................2

The Launch of Full Potential ................................. 3

Actions on Obesity: Community Update ..............4

Childrens Hunger Alliance ................................... 5

Columbus City Schools ........................................ 7

Danny Gwirtz Finds Self-confidence at

Healthier Weight ...............................................10

Columbus Public Health.......................................12

Ohio Action for Healthy Kids ................................ 14

OSU College of Education, Department of

Human Nutrition, OSU Extension .....................15

YMCA of Central Ohio .........................................16

Stambaugh Family Continues Weight Loss

Success .............................................................18

Nationwide Childrens Hospital ............................ 20

Critical Funders ....................................................26

Ohio Business Roundtable: Advocating for

Childrens Health ..............................................27

Recommendations for Addressing Pediatric

Obesity .............................................................28


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Page 1

Reaching Their Full PotentialCONTINUING THE CONVERSATION

ON PEDIATRIC OBESITY

In 2008, Nationwide Childrens Hospital was honored to

collaborate with 20 community partners to createFull

Potential: Facts About Growing Up Healthy in Franklin County, 2008

Collaborative Childrens Health Report. This inaugural report identified

10 critical indicators for our childrens health. Each issue was explored with insights from local experts and brought to life bythe stories of children and families affected. Pediatric obesity rose to the forefront in the report as the most significant obstacle

impeding the current and future ability of our children to reach their full potential.

The initial report clearly defined the need for interventions and the opportunity to partner. For 2009, we have again

collaborated with local resources to deliver this update report highlighting strategies within our community to reduce the

incidence of childhood obesity. Nationwide Childrens has actively joined this effort and we are excited to report on several

new initiatives. Most notable for us is the launch of our Healthy Neighborhoods, Healthy Families (HNHF) program.

Modeled after successful urban revitalization programs from across the country, HNHF presents a multi-pronged approach

to addressing barriers to health and well-being for the thousands of families surrounding our downtown campus. Combating

childhood obesity is a foundational element of our HNHF health platform, creating new partnerships with area neighborhood

associations, Columbus City Schools, Columbus Health Department and many others.

We are fortunate to have many community partners included in this report representing health care, education, social services,

government, business and foundations. All are reaching outside their own systems to work with other organizations to address

the obesity issue.

Collaboration is key, because, while obesity is a nationwide epidemic, its remedies will be discovered locally by organizations

working together to develop and test many new ideas. This is precisely what is happening in Franklin County now, as reflected

on these pages. During 2008, the organizations represented in this report were involved in a significant number of programs

that brought opportunities for making healthy changes to children and families in central Ohio.

In addition to the benefits these programs are creating in our community, they hold the potential to extend beyond the borders

of the state. A concerted effort is being made to report information and best practices nationwide, and what we do in Franklin

County may one day inform a national model for the prevention and treatment of childhood obesity.

Nationwide Childrens thanks our partners for their commitment and actions on obesity. Ours is a can do community,

supported by a wealth of institutional knowledge and expertise, as well as the capacity and desire to tap wide-ranging points

of view. Together, we can craft a better future for our children. Please read on to learn how Nationwide Childrens and our

community partners are working to combat childhood obesity.

Steve Allen, MD

Chief Executive Officer

Nationwide Childrens Hospital

Columbus, Ohio


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Page 2

Moving ForwardTO ADDRESS CHILDHOOD OBESITY

Columbus remains committed to creating safe and healthyenvironments for our residents, especially children, and so

we are proud to be part ofFull Potential 2009: Actions on Obesity.

While central Ohio has among the nations highest levels of childhood

obesity, diabetes and heart disease, we also understand the benefits of

early childhood prevention and wellness initiatives as critical components in helping our children fight these diseases.

Several promising initiatives have been launched or further developed since the 2008 Full Potential report, each

depending on the involvement and support of community partners. Healthy Neighborhoods, Healthy Families is

an exciting partnership between the City of Columbus and Nationwide Childrens Hospital to focus on neighborhood

revitalization in Columbus South Side.

In addition, my office created the Institute for Active Living with Columbus Public Health. The Institute shares a common

vision with Nationwide Childrens and we will work together, sharing data, expertise and people, to move forward.

Columbus Public Health initiatives, including Healthy Children, Healthy Weights and Healthy Places, demonstrate

results-oriented work to reduce childhood obesity. We can also be proud that Columbus City Schools now has all-water

vending in its middle and high schools.

I want to thank all our community partners for continuing to focus on broad-based measures to address the obesity epidemic.

Michael B. Coleman

Mayor

Columbus, Ohio


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Page 3

Nationwide Childrens Hospitals Full Potential

pediatric obesity initiative was launched at a

community breakfast at the Columbus Convention

Center on May 1, 2008.

That morning, we also released the reportFull

Potential: Facts About Growing Up Healthy in Franklin

County, 2008 Collaborative Childrens Health Report.

The report can be downloaded atwww.NationwideChildrens.org/FullPotential.

Hard copies may be requested online as well.

The report, developed in partnership with

Columbus Public Health and more than 20 other

community agencies, highlighted 10 indicators

presenting critical preventable health threats for

Franklin County children. A number of vital issues

affecting our communitys children were worthy

of focus. The following 10 threats, however, werecalled out in the 2008 report as particularly pressing:

- Infant Mortality

- Immunization

- Asthma

- Teen Smoking

- Teen Pregnancy

- Unintentional Injuries

- Adolescent Suicide

- Adolescent Homicide

- Access to Health Care

- Obesity

1 | Full Potential: Facts About Growing Up Healthy in Franklin County,2008 Collaborative Childrens Health Report

2 | Find out the facts about childhood obesity.

3 | Learn what leaders representing health care, business andgovernment have to say about the obesity issues implicationsand solutions.

The Launch of Full Potential

1

2

3


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Page 4

Overview of Key ProgramsDuring the past year, an exciting number and

variety of significant programs and initiatives

focused on pediatric obesity prevention or

management have been taking place in

Franklin County.

Overwhelmingly, our community recognizes

the magnitude of the obesity epidemic it

challenges our childrens ability to reach their

current and future potential, and it threatens

to overcome our health and human service

organizations, employers and other institutions.

Together, we can prevent this from happening.

The community response, as represented in this

report, demonstrates an encouraging resolve to

create effective evidence-based treatment and

prevention programs supported by committed

funding sources in an environment of continual

advocacy on behalf of children.

In the 2008 Full Potential report, we concluded the

discussion of pediatric obesity with a series of

recommendations* for families, schools, health

and social service organizations, communities and

society to effectively tip the scales in the

opposite direction on pediatric obesity.

While the organizations included in this report

did not set out specifically to meet theserecommendations, they have addressed many

of them through programs offered during the

past year. For each organization covered in

this report, we have called out the

recommendations addressed by their

programs, resources or advocacy**.

For the full list of recommendations from the

2008Full Potential report, see page 28.

* These recommendations were developed by physicians in the Nationwide Childrens

Hospital Center for Healthy Weight and Nutrition and incorporate several

recommendations from Healthy & Fit: A Community Action Plan for Franklin

County Children & Families, a publication of the Osteopathic Heritage Foundations

and Childrens Hunger Alliance.

**Effort has been made to include many significant organizations and programs in

this report; however, it is not an exhaustive list of all the organizations and programs

addressing the issue of childhood obesity in Franklin County.

Actions on Obesity: Community Update

Surveying the

bounty of food at

the Columbus Public

Health farmers market.

Photo courtesy of Columbus

Public Health.


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Page 5

Childrens Hunger AllianceThe mission of the Childrens Hunger

Alliance (CHA) is to break the cycle of

childhood hunger through education,

leadership, advocacy and service. As part

of their vision that all children will be well

nourished, healthy and thrive, CHA provides

and supports a variety of programs to help

combat obesity.

Early Care and Nutrition

The CARES (Children Are Ready for Education and

Success) program is a literacy, school readiness, nutrition

and physical activity initiative for Ohio children. This

program reaches almost 2,000 family child care providers

in Ohio through the USDAs Child and Adult Care

Food Program. The effectiveness of the program was

demonstrated in a 2007 random survey of providers that

found 86 percent plan learning activities from a CARES kit

at least once a month; 56 percent at least once per week.

Providers receive four CARES kits each year.

Afterschool Programs

CHA provides free, direct service nutrition education (Food

Folks curriculum) and physical activity (CATCH) curriculum

programs to afterschool programs that serve low-income

children, ages 5 through 18. CHA also sponsors the USDA

After School Meal Program to more than 70 afterschool

programs in Franklin County to ensure low-income children

are receiving a hot meal during the afterschool hours.

Of 2,009 children who participated in Food Folks, 81percent completing the pre- and post-test improved

their nutrition knowledge.

Of 1,844 children who participated in CATCH, 85

percent completing the pre- and post-test increased

their cardiovascular endurance.

In 2008, 78 sites actively participated in the USDA

food program resulting in 1,993 children receiving

nutritious food each month. CHA served 221,494

meals and snacks in 2008, bringing in an additional

$455,000 in USDA dollars to central Ohio.

Adult Nutrition Education

In 2008, CHA reached 358 low-income adults in Franklin

County with Nutrition Education Classes. These classes

use USDA curriculum to teach how to eat healthfully on a

budget, how to utilize available food resources and how to

feed your family.

School Breakfast Program

Eating a nutritious school breakfast gives children the energy

needed to do well in school. Studies show that kids who eat

breakfast are less likely to eat junk food. CHA works closely

with the Ohio Department of Education to help schools

access and implement School Breakfast Programs. The Food

Research and Action Center School Breakfast Report Card

indicates the following for central Ohio:

Columbus City Schools increased daily breakfastparticipation by 3,038.

Reynoldsburg City Schools increased daily breakfast

participation by 1,730.

South-Western City Schools increased breakfast

participation by 668.

Hamilton Local School District increased breakfast

participation by 1,028.

The beginnings of an award-winning community gar

Photo courtesy of Childrens Hunger Alliance.


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South Side Healthy Food Access and Nutrition

Education Program

CHA has helped to facilitate and lead community partnership programs to

improve access to healthy food in various Columbus neighborhoods, including

the South Side Healthy Food Access and Nutrition Education Program. This

program is a community-wide, multi-faceted initiative designed to increase

food access and promote healthy lifestyles and nutrition education among

South Side residents.

Utilizing multiple strategies, CHA, serving as the fiscal agent, partners

with key community organizations to achieve three goals: (1) provide

comprehensive nutrition education targeting for food stamp eligible adults;

(2) increase access to high-quality nutritious food to low-income residents and

their families; and (3) enhance leadership and increase community awareness

of healthy lifestyles and resources within the South Side Community.

Impact from this collaborative resulted in:

Quality nutrition education for South Side adults and seniors.

Establishment of a weekly farmers market that was one of the first in

Columbus to accept EBT food stamps and which served roughly 100

families per week in its first year.

Full conversion of four traditional food pantries to a choice model.

Planting a school-based community garden recognized by Franklin Park

Conservatory with an Education Garden of the Year award.

This project also made tremendous strides in creating partnerships and

alliances on the South Side committed to addressing food access issues that

can be factors in the prevalence of overweight/obesity.

To learn more:

www.childrenshungeralliance.org

614-341-7700

Childhood Obesity

Interventions:

Recommendations

Addressed

!Healthy lifestylebehaviors start early.

!Increase opportunitiesfor physical activity.

!Ensure all food anddrink choices are

healthy.

!Advocate and providelearning opportunities.

!Neighborhoodgroups are credible

advocates.


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Columbus City SchoolsRecognizing that students spend 25 to 30

percent of their day and get 35 to 50 percent

of their daily calories while at school, and

that students perform better when they are

healthy, through generous funding from the

Osteopathic Heritage Foundation, Columbus

City Schools (CCS) has developed andimplemented an effective and sustainable

wellness initiative based on the Coordinated

School Health Model to create the healthiest

school environment possible.

Components of the wellness initiative include the

following:

A district-level School Health Advisory Council to

guide the work of the wellness initiative.

School Health Services Committee that serves topromote and enhance a healthy and safe school

learning environment.

Physical Activity and Physical Education Committee

that serves to educate and encourage CCS students

to develop lifelong healthy physical activity

behaviors.

Nutrition Committee that serves to increase the

nutritional value of foods and beverages available to

students during the school day and educate students

on how to make healthy food choices.

Staff Wellness Committee that serves to create a

culture that values and supports the development

of lifelong health and fitness habits among CCS

personnel.

Communications Committee that serves to create

a district-wide wellness movement through increased

awareness and participation in the Wellness Initiative.

Highlights of the committee work include:

BMI Assessments

As part of their routine annual student screenings,

district school nurses conduct Body Mass Index (BMI)

screenings on every kindergarten, third-, fifth-, seventh- and

ninth-grade student. Each childs individual results are sent to

the parents explaining BMI and the hidden dangers of

being overweight or obese. All children identified with a

BMI in the 85th percentile or above are referred to their

primary care provider and additional community resourcesin efforts to prevent, monitor and treat obesity related

complications and encourage the adoption of healthier habits.

BMI Assessment Results 2007 - 2008 School Year

Kindergarten

Total number of students screened = 4,254

A total of 32% of kindergarten students screened

had a BMI > 85% (BMI 95% (+) =16% and BMI

85-94% = 16%)

A total of 1,396 kindergarten students were referred

to their primary care for assessment and treatment

related to increased BMI

Third Grade


A total of 42% of third-grade students screened

had a BMI > 85% (BMI 95% (+) = 25% and BMI

85-94% = 17%)

A total of 1,775 third-grade students were referred

to their primary care for assessment and treatment


Fifth Grade


A total of 44% of fifth-grade students screened

had a BMI > 85% (BMI 95% (+) = 26% and BMI

85-94% = 18%)

A total of 1,754 fifth-grade students were referred to

their primary care for assessment and treatment



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Acanthosis Nigricans Screenings

Acanthosis Nigricans is a skin marker for high levels of insulin in the blood that can help identify early

metabolic changes associated with increased weight. CCS and the Center for Healthy Weight and

Nutrition at Nationwide Childrens Hospital collaborate to conduct this screening. Assessments were

conducted during the 2007-2008 school year at three Columbus City School sites in grades 3, 5 and 7,

and follow-up services for identified students were offered by Nationwide Childrens.

Additional components of the Wellness Initiative implemented during 2008

(and continuing through the 2008-2009 school year) include:

Water only vending in all student accessible vending machines.

Improved nutritional standards in the Food Service Department: beverages, other than water,

are served in restricted serving sizes and include low fat milk and 100 percent juice only.

Fresh fruit/vegetable bars at all secondary schools.

Development of an enhanced health education curriculum.

Building-level School Health Committees.

Rates of Acanthosis Nigricans among 3rd, 5th and 7th Grade

Students in Target Zip Codes

3rd Grade

5th Grade

7th Grade

Percentage of studentsidentified as AN+ that have

a BMI > 85th percentile(70 of 177)

Percentage of studentsidentified as AN+ that have

a BMI > 95th percentile(55 of 72)

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

42.4%

31.8%

80%85.7%

65.2%63.6%


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Page 9

Childhood Obesity

Interventions:

Recommendations

Addressed

!Measure and intervene.!Increase opportunitiesfor physical activity.


healthy.

!Advocate and providelearning opportunities.

!Healthy lifestylebehaviors start early.

New food service equipment supports fr

fruit and vegetable bars. Photo courtesy of Un

Way of Central Ohio.

Other obesity related community-based programs in which CCS was a

partner include:

Happy Healthy Preschoolers (HHP)

CCS district school nurses conducted pre-kindergarten (ages 3-5 years) BMI

screenings and referred parents of identified children to the HHP program.

Among the 275 pre-kindergarten students in target zip codes who received

a BMI assessment, 65, or 23.6 percent had a BMI in the 85th percentile or

above. See page 23 for a program description.

Healthy Children, Healthy WeightsCCS implemented this program at eight Columbus City School

pre-kindergarten sites, in collaboration with Columbus Public Health.

See page 12 for a program description.

Fitness And Nutrition Club (F.A.N. Club)

Nationwide Childrens Hospital created this 90 minute physical activity and

nutrition education afterschool program, targeting third through fifth grade

students. It was launched at one elementary school site. See page 20 for

program description and results.

Childrens Hunger Alliance Partnership

CCS also worked with Childrens Hunger Alliance to install and maintain a

large community garden at one elementary site and provide adult nutrition

classes at four Columbus City School sites. See page 5 for descriptions of

these programs.

Managing and Preventing of Diabetes and Weight Gain Project

CCS received funding for the Managing and Preventing Diabetes and Weight

Gain Project (MAP) administered by the National Association of School

Nurses, with funding by the Centers for Disease Control and National

Diabetes Education Program. This program provides a CCS school nurse

part-time to serve as the districts MAP resource nurse to coordinate care for

over 180 diabetic students and provide education, training and resources for

school nurses, students and families.

To learn more:

www.columbus.k12.oh.us

614-365-8995


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Page 10

Danny Gwirtz was one of the

young people whose story

was featured in the inaugural

Full Potential report. He

shared how he began gaining

weight in second grade after his parents divorce

changed family eating habits, and explained how

this problem was compounded by unhealthy

school meals. Even the family physician failedto help by perpetuating the myth that children

grow out of their baby fat.

Eventually Dannys embarrassment from being

taunted and teased by classmates motivated him

to lose weight. His mom helped him enroll in

a weight program for children that taught him

about healthy eating and exercise.

Danny, now 15, has made significant progress in

his battle by eating healthier foods and exercising

frequently. Better choices are the key. Its the

simple things, like drinking more water, that

continue to make a difference, he says.

Danny Gwirtz FindsSelf-confidence atHealthier Weight


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Improved opportunities at school are helping

Danny make better choices. His school now

offers more healthy food selections, such as

bottled water, more fruits and baked versus friedfoods. Danny also has joined Bigger, Faster,

Stronger, an afterschool exercise program for

students. "I love the program because it keeps

me active and you have your friends for support

and encouragement."

Danny says he is always looking for new things

to keep him informed and fit. He is thinking

about taking a new nutrition and exercise class

being offered at his school. He also stays active

in school sports, playing football in the fall and

soccer in the spring.

While Danny believes his school has made

positive changes to help students deal with

obesity, he thinks more progress can be made

by providing even more healthy food options,nutrition classes and physical education activities.

He also stresses that eating well and staying

active dont end with the school day. At home,

Dannys family encourages his fit lifestyle by

preparing healthy dinners and supporting his

efforts to stay active.

It takes constant work, but Danny has succeededin making health and fitness part of his daily

routine. And, his self-esteem has improved now

that he is maintaining a healthier weight.

Mentally, I feel good about myself. No one

makes fun of me anymore.

Mentally, I feel good about myself.No one makes fun of me anymore.

Danny Gwirtz


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Page 12

Columbus Public HealthColumbus Public Health (CPH) is a leader

in improving the health and safety of

Columbus by monitoring community health

status, identifying and addressing public

health threats, enforcing laws that protect

the publics health, and providing services to

prevent and control disease. In keeping withthis mission, CPH has created or supports a

variety of obesity-related initiatives, including

those listed below.

Heart Health Network

The Heart Health Network (HHN) takes a population-

based approach to addressing the six main risk factors

of heart disease in the settings of community, schools,

worksites and health care. HHN is funded by the Centers

for Disease Control and Prevention and is administered

by the Ohio Department of Health.

In 2008:

HHN worked with community partners to pilot a

Veggie Mobile Market at four recreation centers, one

in each quadrant of the city, providing food stamp

access to fresh local produce.

The Heart Health Worksite Wellness Network

(HHWWN) hosted three networking luncheons

and a full day conference. They provided local

businesses with resources and information on

employee wellness, including the how-tos of

starting a worksite wellness team. HHWWNcurrently serves 80 local businesses.

Healthy Children, Healthy Weights

Healthy Children, Healthy Weights (HCHW) is an

evidence-based obesity prevention program that focuses

on improving the food and physical activity environments

of children ages 0 to 5 years in early learning centers and

at home. Over the last year, the program focused efforts

on centers in Columbus-area zip codes with the highest

prevalence of overweight/obesity. The program combines

training of adult caregivers in early learning centers (child

care centers and preschools), technical assistance to the

centers to improve nutrition and physical activity

practices at the center through menu development,

physical activity equipment and other resources, and

social marketing to influence parents behaviors at home.

In 2008, HCHW served 46 child care centers and

preschools, training 500 adults and impacting over 2,800

children. Results demonstrate increased knowledge and

self-efficacy on the part of center staff to make changes

that impact the food and physical activity environment

in which young children spend significant time. Through

technical assistance visits, documented changes include:

Reduced frequency of serving juice and sugar

sweetened beverages,

More nutritious snack offerings, and

Increase structured, teacher- or peer-led, physical

activity throughout the day.

Happy Healthy Preschoolers

CPH provided expert advice, materials and support to the

development of this program. See page 23 for program

description.

Healthy Places

Healthy Places is a key component of the Citys focus on

community design with active living in mind. Columbus

Public Healths Safe Places Program has created walking

maps for 18 Columbus neighborhoods, eight of them in

2008. The City of Columbus passed legislation onComplete Streets, a partnership between the Mayor

Coleman Administration (Public Service, Development,

Utilities, and Technology) and the bicycle community.

The legislation supports the Citys plan to expand its

current network of 87 miles of bike trails, bike routes and

bike lanes by adding 31 miles of off-street trails and 58

miles of on-street bike lanes and bike routes.


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Page 13

Farmers Markets

Three farmers markets, held at CPH at 240 Parsons Avenue, drew more

than 11,000 residents who were able to purchase reasonably priced, fresh

local produce. The markets have the capability to accept Women, Infants

and Children (WIC) Farmers Market Vouchers, Senior Farmers Market

Vouchers, and, new in 2008, customers could use their food stamp dollars

to purchase fresh fruits and vegetables.

The Institute for Active Living

Mayor Coleman created The Institute for Active Living (IAL) within CPH

in July 2008 to help Columbus residents build an active and healthier

community. IAL works to lower the incidence of childhood obesity and

diabetes by developing strategies and initiatives and assisting community

partners with their implementation. IAL was launched with Mayor

Colemans annual bicycle event, which raised awareness about the

importance of children maintaining a healthy weight and taking steps to

prevent diabetes. A new initiative, City Green Bikes, was also launched to

enhance workplace wellness for city employees and to serve as an example

for other workplaces. Bicycles donated by the Police Impound Lot and tuned

up by the Fleet Division, have been located at various city offices to allow

employees to bike from place to place around the city. In addition, IAL

created a City Department Advisory Committee that meets monthly to look

at ways in which all departments can operate using an active living lens.

To learn more:

www.publichealth.columbus.gov

614-645-7417

Childhood Obesity

Interventions:

Recommendations

Addressed

! Increase opportunities forphysical activity.

! Ensure all food and drink

choices are healthy.

! Advocate and provide

learning opportunities.

! Healthy lifestyle behaviors

start early.

!Implement a comprehensive

community plan.

! Support the recommendationsof the Ohio Activity Plan.

! Employers must get in on

the action.

1| Choosing healthy nutrition for mother and child. Photo courtesy of Columbus Public Health.

2| Cooking up a nutritious dish. Photo courtesy of United Way of Central Ohio.

3| Purchasing fresh fruits and vegetables with WIC vouchers. Photo courtesy of Columbus Public Health.

31 2


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Page 14

Ohio Action for Healthy KidsOhio Action for Healthy Kids (AFHK) represents a consortium

of education and health professionals dedicated to improving

the health and educational performance of Ohios children by

promoting healthy school environments that offer sound

nutrition and adequate opportunities for physical activity.

In central Ohio in 2008, the Zone 8-Ohio AFHK regional team

provided conferences, workshops, mini grants, monthly newsletters

and technical assistance to advance school wellness policies.

2008 Healthy Schools, Healthy Kids Conference

The Zone 8-Ohio AFHK annual conference reached more than 180 participants.

The conference is designed to help local schools strengthen wellness policies

and program activities that support nutrition and physical activity.

Mini-Grants to Local Schools

The Zone 8-Ohio AFHK team allocated funding to help local schools

implement nutrition and physical activity programs. Four schools initiated

wellness activities that included breakfast initiatives, nutrition education and

increasing physical activity opportunities.

Game-On Funding Recipients

Game-On is a National AFHK program that challenges youth and their

families to incorporate healthy nutrition and physical activity into their

daily lives. Several central Ohio schools were selected this year as

Game-On recipients.

Snackwise Nutrition Rating System

On the recommendation of AFHK, several local schools have implemented

Nationwide Childrens Hospitals Snackwise online rating program to

provide healthier, nutrient rich snacks in vending and a la carte areas.

Setting up for the Fruit and Veggie Challenge.

Photo courtesy of Ohio Action for Healthy Kids.

To learn more:

http://www.ohioactionforhealthykids.org/

zone_teams/zone8.htm

614-341-7700 x216

Childhood Obesity

Interventions:

Recommendations

Addressed

! Increase opportunitiesfor physical activity.

!Ensure all food and drink


!Advocate and provide



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Page 15

Access to fresh produce is vital to prope

nutrition. Photo courtesy of Columbus Public Health

OSU College of Education, Departmentof Human Nutrition, OSU ExtensionThe mission of the OSU College of Education, Department of

Human Nutrition, OSU Extension at The Ohio State University

is to generate, disseminate, and apply knowledge in the areas of

human nutrition and dietetics to improve the quality of life for

individuals, families and associated organizational systems. Faculty

and students are at the fore of research that will lead to evidence-

based solutions to pediatric obesity.

Food Fit

Food Fit is a 14-week behavior change program that is designed to teach

children the skills needed to execute food behaviors associated with

prevention of childhood obesity (AMA Expert Committee Guidelines.

Pediatrics. 2008; 120: S164-S192). Two Food Fit studies were conducted in

2008, in a total of seven low-income sites with a total of 179 participants.

In the first study, 12 dietetic interns from the Department of Human Nutrition

delivered and evaluated Food Fit in six YMCA-sponsored afterschool

programs for children in grades 3 through 5. Statistically significant changesin childrens nutrition skills and dietary behaviors were found. Results

regarding changes in BMI and changes in numbers of servings within major

food groups and macro and micronutrient intake were being evaluated when

this report went to print.

In the second study, Food Fit is being delivered and evaluated with two new age

groups: grades kindergarden through 2 and 5 through 7. In addition to examining

skills attained and impact on self efficacy, the study is evaluating anthropometrics

and dietary behaviors that will include a review of the differences in dietary intake

noted during weekdays as compared to days during the weekend.

YMCA-OSU Snack ProgramUnder the direction of a faculty member and Director of the Dietetic

Internship in the Department of Human Nutrition, a dietetic intern developed

an afterschool, four-week cycle snack menu that: 1) complied with federally

funded Child and Adult Care Food Program (CACFP) regulations, 2) improved

nutrient density and nutrition quality of the snack program, and 3) did NOT

increase costs for the program.

To learn more:

http://ehe.osu.edu/hn/

614-292-4485

Childhood Obesity

Interventions:

Recommendations

Addressed

!Measure and intervene.!Increase opportunitiesfor physical activity.


healthy.


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Page 16

YMCA of Central OhioThe YMCA of Central Ohio has a long tradition of

providing innovative and family focused fitness programming

at all branches and program sites. Youth of all ages choose

from a wide variety of programs to challenge skill levels,

build confidence and have fun.

Youth Sports and Physical Activity Programs

The YMCA offers a series of youth sports and physical activity programs targeting

children and youth ages 6 through 16. The programs provide opportunities for

children of all abilities to participate, to learn and to have fun while being

physically active. The programs include activities such as basketball, soccer, martial

arts, gymnastics, dance, swim lessons, swim teams, teen conditioning and more.

From programs that required tracking, 87 percent of participants achieved 60

minutes of physical activity at least five days per week.

Y Kids Are Fit

The Y Kids Are Fit curriculum has been implemented in more than 40 before

and afterschool child care sites in Franklin County. The program is designed

to increase youths strength, flexibility and endurance. The curriculum includes

health and nutrition lessons, as well as fitness activities that on-site Y-Club staff

can implement with youth.

733 youth participated for more than eight months during the school year.

96 percent of participants improved in at least one of the fitness test areas.

82 percent of participants improved in at least two of the fitness test areas.

44 percent of participants improved in all three of the fitness test areas.

Fitness tests included a shuttle run (endurance), curl ups (strength), and sit and

reach (flexibility).

Summer Day and Resident Camp

The YMCA of Central Ohio offered youth from all over central Ohio the

opportunity for camp fun and activity. More than 3,800 youths participated in

active camp programs such as youth sports, horseback riding, dance and more.

Nutritious Meals

The YMCA of Central Ohio served more than 62,000 free nutritious meals in

their child care, camp and early education programs.

Childhood Obesity

Interventions:

Recommendations

Addressed

!Increase opportunities

for physical activity.

!Ensure all food and

drink choices are healthy.



!Healthy lifestyle

behaviors start early.


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Page 17

Partnerships

The YMCA of Central Ohio and The Ohio State Universitys College of Human Nutrition

partnered to provide fitness and nutrition programming in seven of the YMCAs afterschool

programs. The YMCA afterschool staff provide the Y Kids Are Fit curriculum and activities, and

OSU graduate students provide a 14-week Food Fit nutrition program to enhance the Y Kids are

Fit program.

The YMCA of Central Ohio collaborated with Nationwide Childrens Hospitals Center for

Healthy Weight and Nutritions New U and New U Jr. programs to offer free 6-month

memberships to their graduates.

The Ohio State Universitys Department of Human Nutrition recreated the daily afterschool

snack menu. See page 15 for additional information.

To learn more:

www.ymcacolumbus.org

614-224-1142

Fitness is fun!Photo courtesy of YMCA of Central Ohio


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Small steps have added up to big

progress for the Stambaugh

family in their efforts to lose weight.

Since they came forward to tell

their story during the Full Potential

breakfast in 2008, theyve continued exercising

the winning strategy that has helped them shed a

combined weight of nearly 300 pounds over the

past two years.

I believe the small, gradual changes are what its

about, says mom, Dianna Stambaugh. Big, fast

changes are scary and make it more likely you

will fail.

Being successful is terribly important to Dianna,

who once weighed 317 pounds and has lost nearly

125 of them. Before she started losing weight,

Dianna was afraid that obesity related health

problems would prevent her from seeing her

children grow up. She feared for her familys

health as well. Now, she, husband Lawrence, and

their children Nicole and David all are feeling

healthier and happier.

Stambaugh Family Continues

Weight Loss Success

The Stambaugh family celebrates their success with Eddie

George, former OSU Buckeye and NFL running back,

during the 2008 Full Potential breakfast event.


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Page 19

Their strategy of making small changes has

involved taking a variety of steps to ensure they

eat healthy foods and stay active.

The family limits the amount of fast food they eat

in favor of healthy meals. Its not that we cant

have it, but we have learned not to overindulge.

Dont get out of control. They also have learned

that eating in moderation, reducing sugar intake,

reading labels, measuring food portions and

counting calories gives them control over what

they eat, which helps the family achieve their

weight-loss goals.

In addition to the dietary measures theyve taken,

the Stambaughs have incorporated regular

exercise into their routines. According to

Lawrence, what works best for them is to exercise

consistently, so the family goes to the gym at least

three times a week.

Another key to losing weight is staying focused.

Family members post before-and-after pictures of

themselves throughout their home. Seeing the

progress were making really keeps us motivated,

says Dianna. Plus, it helps that we feel better.

Dianna also has noticed that her complexion is

clearer and she looks much younger.

Dianna is inspiring others with her story. Each

week, Dianna mentors women dealing with

weight issues through a program offered at her

local fitness center. Its been great to share my

story with others and hopefully inspire them to

stay focused on their weight-loss goals.

Its been great to share my story with others

and hopefully inspire them to stay focused ontheir weight-loss goals.

Dianna Stambaugh


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Nationwide Childrens HospitalNationwide Childrens Hospital currently

addresses childhood obesity through medical

services, community programs, policy initiatives

and employee wellness programs. These include:

Center for Healthy Weight and Nutrition Initiatives

The Center for Healthy Weight and Nutrition (CHWN)

at Nationwide Childrens Hospital offers families acomprehensive approach to weight management,

providing programs for both the prevention and

treatment of overweight children.

In 2008, an Expert Committee of physicians within the

American Medical Association provided specific, stepwise

guidance for healthcare providers on treating obesity.

Prevention, early identification through use of Body Mass

Index (BMI) and education and counseling in practice are

the cornerstones. The CHWN continues to develop new

resources to help make such interventions as effective as

possible here in central Ohio. Since the lastFull Potentialreport, the CHWN has added:

The New U Jr. program, a weight management

program for kids ages 6 to 11 years and their families

The Healthy Happy Preschoolers program, in

collaboration with the community and funded by

United Way of Central Ohio and the Central

Benefits Foundation (see page 23)

Website materials at www.NationwideChildrens.org/

HealthyWeight:

A video on bariatric surgery

Resources for physicians to implement the new Expert

Committee recommendations in their practices

Parent information on how to work with the

nine core evidence-based obesity prevention and

treatment messages

These activities complement the full-service medical and surgical

programs for pediatric obesity patients and their families.

Primary Care

Nationwide Childrens offers community-based physician

services to help keep children healthy with regular physical

exams, vision, hearing and general development checks,

and immunizations against childhood diseases. There are 10

Primary Care Centers in Franklin County, including one on

the hospitals main campus. There were more than 137,000

patient visits to the Primary Care Network in 2008.

In 2008, an electronic health record system was rolled out to

all of the Primary Care Centers. The system calculates and

graphs the Body Mass Index (BMI) for all patients, 2 years

and older, seen during well child/adolescent visits. Our

Primary Care Network providers can now more easily

identify children with unhealthy weights, monitor their

care and make appropriate referrals to the Center for

Healthy Weight and Nutrition or other community resources.

Fitness and Nutrition Club (F.A.N. Club)

The F.A.N. Club curriculum is based on a social cognition

model, combining fitness training and nutrition programs,

for high risk and obese youth administered over 30 weeks

in an afterschool format. In June 2008, the program was

launched at Livingston Elementary School, near the

hospital campus.

By the beginning of the winter semester 2008, 11

participants completed the most recent post

assessment and had, as a group:

Increased their aerobic endurance by 42 percent.

Increased their strength.

Average number of push-ups increased 139percent (an increase of an average of 6

push-ups per student).

Average number of sit-ups increased 115

percent (an increase of an average of 11

sit-ups per student).

Increased their overall flexibility and maintained

their BMI.


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By February 2009, the F.A.N. Club included 54 children

at Livingston Elementary School and Lincoln Park

Elementary School. In March 2009, 20 participants

completed at least one post assessment and had, as a group,

improved their overall fitness and decreased their BMI.

March 2009 F.A.N. Club Results

The F.A.N. Club now has 30 participants at Livingston

Elementary School and an additional 37 at Lincoln Park

Elementary School.

Snackwise

Developed by doctors and nutritionists in the Center for

Healthy Weight and Nutrition at Nationwide Childrens

Hospital, Snackwise is a research-based online snack

rating system that calculates nutrient density in snack foods.

Snackwise is designed for use by any organization or

individual interested in making healthier snack choices.

This online tool uses a scientific formula based on the

current Dietary Guidelines for Americans, considering 11

weighted nutrition parameters, to measure the nutrient

richness of snack foods straight out of the kitchen pantry or

off of grocery shelves. Then, using an easy-to-understand,

color-coded system, the calculator assigns the snack food

one of three colors, indicating the nutritional quality of the

snack. Visit www.Snackwise.org for more information.

Education Collaboration with YMCA

The Education Institute and the Department of Clinical

Nutrition Services at Nationwide Childrens Hospital

conduct the Healthy Lifestyles Weight Management

program in collaboration with the YMCA. This four-

week program, held at rotating YMCA sites, is a primer

in healthy eating and activity, and sessions are held for

both parents/caregivers and children. Participants receive

six months of follow-up newsletters and a three month

YMCA membership after program completion.

Healthy Neighborhoods, Healthy Families

This initiative was announced in 2008 as a community

collaboration dedicated to taking action in Columbus

South Side to help create/improve affordable housing,

health and wellness services, educational opportunities,

safe and accessible neighborhoods, and workforce and

economic development.

While additional partners are expected to join this

collaborative effort, current partners include:

City of Columbus

Community Development For All People

Columbus Public Health

Columbus City Schools

Home Again


0

20%

40%

60%

80%

100%

BMI Percentile

Body Mass Index

71% 68%

0

2

4

6

8

10

12

14

16

18

20

Fitness

Push-ups(total number)

Sit-ups(total number)

Aerobic Endurance(pacer laps)

Pre Assessment Post Assessment

6

12

9

17

10.28

14.61


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Page 22

Nationwide Childrens Hospital will provide support for Healthy Neighborhoods,

Healthy Families. The health and wellness services and safe and accessible

neighborhoods components in particular will provide focused programs to

address obesity.

Executive Leadership in the Ohio Business Roundtable Child Obesity

Prevention Collaborative

The Ohio Business Roundtable is a leadership group of the chief executive

officers of the states largest corporations. The Roundtable has adopted the

prevention of childhood obesity as one of its main goals related to the health

of Ohio workers and their families. Dr. Steve Allen, CEO of Nationwide

Childrens Hospital, provides the executive leadership for the Collaborative

convened by the Roundtable to advocate for more effective statewide policies

on fitness and nutrition for children and adolescents.

Employee Wellness

Each year, insured spouses and employees of Nationwide Childrens Hospital

complete an annual Health Risk Assessment. Recent trends indicate a 9 percent

increase in the number of low-risk employees/spouses, and a 7 percent decrease in

the number of moderate-risk employees/spouses.

In 2008, employees participating in the Weight Watchers at Work program

surpassed the goal of losing 2,008 pounds by losing 2,011.6 pounds. As a

wellness incentive, the hospital supplements a portion of the Weight Watchers

program fee.

In 2008, Nationwide Childrens hosted two farmers markets to encourage

employees to eat more fruits and vegetables and make produce shopping moreconvenient. The markets were also open to the community. Additionally, at

no cost, employees are able to meet one-on-one with a licensed dietitian or

attend monthly nutrition education workshops.

All employees have the opportunity to join the on-site, 24/7-access fitness

center and attend free group fitness classes including yoga, toning, aerobics

and boot camp. At no cost, employees can meet with a certified exercise

specialist to receive individual fitness assessments and exercise plans.

Childhood Obesity

Interventions:

Recommendations

Addressed

!Measure and intervene.

!Healthy lifestyle behaviors

start early.

! Increase opportunities for

physical activity.

!Ensure all food and drink




!Employers must get in

on the action.

Keeping active after school as part of

the F.A.N. Club. Photo courtesy of Nationwide

Childrens Hospital.


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Page 23

Happy Healthy Preschoolers

is an intensive six-week, community based

program whose aim is to remodel the

familys daily habits toward ones that

promote health and fitness. It provides

an initial intervention offered to families

at the first signs of overweight in their

child or for children deemed high-risk.

The long-term goal is to offer the program

throughout central Franklin County in easily

accessible sites: child care facilities, faith

centers, health care facilities and recreation

centers. The programs curriculum and

materials were developed using the

American Medical Associations Expert

Committee on Obesity core evidence-based

messages. Piloted in 2008, the program will

collect and evaluate data to improve

program delivery and effectiveness.

Happy Healthy Preschoolers brings together

a broad coalition to provide this unique

community based model of intervention.

Central Benefits Health Care Foundation

Lead funder for the program.

United Way of Central Ohio

Fiscal agent for the project.


Center for Healthy Weight and Nutrition

Program development, implementation,

supervision and management.

The Ohio State University College of

Public Health (OSU-CPH)

Evaluation support, design and

implementation assistance.

YMCA of Central Ohio

Assists in securing program sites and

supporting implementation of the program.

Columbus Public Health (CPH)

Assists in securing program sites and

supporting the implementation.

Contributes expert advice and materials.

Columbus City Schools (CCS)Supports implementation of the program

through data collection and participant

referral and recruitment.

Happy Healthy PreschoolersA Partnership in Early Intervention


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Page 24

Supporting Our Community Partners

Its clear that pediatric obesity is a complex

epidemic disease that affects all segments of

society. However, it is especially prevalent and

destructive in low-income, urban communities,

such as those in which Nationwide ChildrensHospitals main campus and primary care

centers are located.

Columbus City Schools

Because we have a unique passion and responsibility to

improve quality of life for these neighbors, in 2009 we

will continue to partner with Columbus City Schools and

other local leadership organizations to develop a scalable,

efficient and accountable program to increase fitness,

improve nutrition, identify children at risk, coordinate

referrals and communication, and measure outcomes for

elementary-aged children in high-risk schools.

Nationwide Childrens is fortunate to have a consistent

source of BMI data through the Columbus City Schools,

one of the few school systems in the nation to measure

BMI regularly. The challenge is how to analyze and use

this data, to evaluate which interventions are working,

and to refer at-risk children into them.

In 2009, Nationwide Childrens will introduce three

programs designed to make childhood obesity

interventions more effective:

School Nurse Advocacy Program (SNAP)We will provide an annual training and continuing

education program, an ongoing learning collaborative

and facilitated referral program for school nurses

managing obese or morbidly obese children in the

Columbus City Schools. Training will cover new

information on prevention and management of

pediatric obesity, measurement and database

education, communication strategies and motivational

interviewing for interaction with parents, and referral

mechanisms.

Data Analysis, Reporting and Training Program

(DART)

To support Columbus City Schools collection and

reporting of child height, weight and body mass

index, we will conduct training in the use of automated

entry programs that enable secure and encrypted data

storage, management and reporting. In addition, we

will conduct school, census tract and zip code trend

analysis of the data collected.

Fitness and Nutrition Club (F.A.N. Club)

Over the next three years, Nationwide Childrens

hopes to expand community collaborations and grow

the F.A.N. Club to serve a total of 500 children or

more per year in 20 Columbus City Schools locations.

McConnell Heart Health Center

We look forward to a new partnership with the

McConnell Heart Health Center, which has requested

that the Center for Healthy Weight and Nutritioncollaborate with them for the 2009 Wolfe Symposium

Creating Health Through the Prevention and Treatment

of Obesity Within Our Community. This will be a

service program targeting 9 to 13 year-olds in the Boys

and Girls Club of Columbus, Milo-Grogan location.

Nationwide Childrens Hospital as an Employer:

Leading By Example

Additional Coverage for Employee Dependent

Children

Nationwide Childrens Hospital is one of the first Ohio

employers to participate in the Alliance For A HealthierGenerations childhood obesity health care initiative, a

collaborative effort with national medical associations,

leading insurers and employers to offer comprehensive

health benefits to children for the prevention, assessment

and treatment of childhood obesity. Nationwide

Childrens will provide eligible children ages 3 to 18

with access to at least four follow-up visits with their

primary care provider and four visits with a registered

dietitian per year. The new health benefits will be

offered to those children at or above the 85th

New Initiatives: 2009 and Beyond


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Page 25

percentile for Body Mass Index (BMI). As a member

of the Alliance, Nationwide Childrens will also participate

in a first-time evaluation of this new benefit program.

The goal is for more than 6.2 million children nationally

to have access to this health care benefit within the next

three years. The benefits are in line with the American

Medical Associations Expert Committee Recommendations

on the Assessment, Prevention and Treatment of Child

and Adolescent Overweight and Obesity. For more

information, visit www.HealthierGeneration.org.

Healthy Food Choices

Nationwide Childrens is working to meet our responsibility

to provide the same healthy choices for employees,

patients and their families that we advocate for the greater

community. In 2008, we instituted several nutritional

practices as a foundation for additional changes in 2009:

Lite mayonnaise is used in all recipes that call for

mayonnaise.

Neither butter nor margarine is added to any

vegetables in the cafeteria.

Salmon patties, veggie burgers and turkey burgers are

available in the food court and cafeteria.

A yogurt and fruit bar was added during breakfast in

the cafeteria, using lite yogurt.

Nutritional information for items in the cafeteria is

posted daily.

Subway was added as a food vendor in the food

court, offering healthy choices and limiting the

drink sizes available.

All hospital vending machines follow the Snackwise

system, and the color-coded designation is posted for

each snack.

In 2009, fried foods will be eliminated in the

cafeterias and replaced with healthier, baked versions.

Also in 2009, healthy options from Mark Pis will be

added in the food court.

Employee Health and Wellness

Nationwide Childrens will also implement a variety of

programs and policies to improve the health and fitness

of our employees, including:

Expanding our comprehensive employee wellness

program.

The hospitals gift shop has coordinated with the

Center for Healthy Weight and Nutrition to reduce

portion sizes on all snack foods and introduce several

new nutrient-dense options.

Expand farmers markets to increase frequency.

Build upon the Diabetic Counseling program to

include an exercise program and support group.

To learn more:

www.NationwideChildrens.org

614-722-2000

Making nutritious food choices after sc

as part of the F.A.N. Club. Photo courtesy o

Nationwide Childrens Hospital.


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Central Ohio is fortunate to have several

philanthropic organizations that provide

financial support for community-based

programs promoting physical activity and

good nutrition. Several of these vital resources

are listed below along with the obesity related

programs they helped support during 2008.

Columbus Medical Association FoundationSt. Stephens House SNS All Stars Health, nutrition

and physical activity project.

Union County Health Department Healthflix video

contest supporting the Physical Activity category entry

for PSAs to be developed.

Childrens Hunger Alliance Health promotion on the

South Side. This program aims to train four adult health

advocates who will then be deployed throughout the

community to provide nutrition and physical activity

education to other community members. There is also a

youth component that is being developed that will engage

the youth at Southside Settlement House to educate their

peers on healthy food choices and physical activity.

Osteopathic Heritage Foundations

Columbus City Schools To advance the district-wide

wellness initiative, including nutrition improvements and

infrastructure support. See page 7 for program description.

The Columbus Foundation

Ohio State University Research Foundation

Supported the Food Fit program serving children at

risk of obesity. See page 15 for program description.

United Way of Central Ohio, Inc. Two grants to

support the Health Funders Collaborative to improve

the health of Franklin County residents by reducing the

incidence of overweight and obesity.


Current investment in nutrition and fitness-related

programming in central Ohio exceeds $2 million,

supporting nearly 20 programs per year that engage

people in healthy nutrition and physical activity. This

investment also aims to improve the nutrition and

physical activity environment to help people more easily

eat healthy food and be more physically active. Following are

several programs currently supported by the organization.

South Side Healthy Food Access and Nutrition Education

Program See page 6 for program description.

Healthy Children, Healthy Weights See page 12 for

program description.

Healthy & Fit Partnership Initiative designed to change

the cafeteria environment in three Westside schools:

Westmoor Middle, West High School, and Hilltonia

Middle. Supported by a funding partnership including

the Abbott Fund and United Way of Central Ohio, the

program resulted in:

Fruit and vegetable expenditures 24 percent higher in

target schools.

Between 27 percent and 41 percent of students

selecting healthy food options, surpassing the

expected benchmark of 19 percent.

Happy Healthy Preschoolers Funding partnership

including the Central Benefits Health Care Foundation,

United Way of Central Ohio, and Nationwide Childrens

Hospital. See page 23 for program description.

Critical Funders

Page 26


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Page 27

Learning to make healthy snack choices.

Photo courtesy of United Way of Central Ohio.

To learn more:

Columbus Medical Association

Foundation

www.goodhealthcolumbus.org

614-240-7410

Osteopathic Heritage Foundations

www.osteopathicheritage.org614-737-4370

The Columbus Foundation

www.columbusfoundation.org

614-251-4000


www.liveunitedcentralohio.org

614-228-8700

Ohio Business

Roundtable:Advocatingfor Childrens Health

Last year, the Ohio Business Roundtable launched a

major initiative that seeks to identify and implement

short- and long-term strategies to address Ohiosgrowing childhood obesity epidemic. The initiative

is led by Dr. Steve Allen, CEO of Nationwide

Childrens Hospital (on behalf of all childrens

hospitals across the state) and Toby Cosgrove,

CEO of the Cleveland Clinic.

Key partners include Ohio Action for Healthy Kids,

American Heart Association, Cardinal Health

Foundation, Childrens Hunger Alliance,Nationwide Better Health, Ohio Department of

Health, Ohio Childrens Hospital Association and

Ohio Hospital Association.

The initial focus of the initiative will be major state

legislation addressing school nutrition, physical

education and BMI/fitnessgram screening assessment

standards that the Ohio Business Roundtable is

preparing and expects to release during the first half

of 2009. The initiative will also consider actions

employers can take to address childhood obesity

among their employees and their dependents.


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For the FamilyEat a quality diet.

Follow the U.S. Dietary Guidelines. Incorporate five servings of fruits and

vegetables per day, try to use whole grains when possible. Include low-fat

(skim, 1%, or 2%) dairy products, and concentrate on low-fat protein sources

(lean meats, fish, beans and nuts). Limit consumption of juice, soft drinks,

fast food, and fried foods. Being aware of correct portion size is also helpful.Portion sizes vary with age; for adolescents and adults, one-half cup generally

represents one serving of pasta or rice and 4 ounces (the size of the palm of

your hand) represents a serving of meat or protein. Remember that the amount

of caloriesespecially in sugars and fatsthat can safely be consumed each

day depends on the persons activity level.

Be better consumers.

Learn to read a food label and look for products with less than 30 percent of

calories coming from fats, and seek out food with high percentages of vitamins

and minerals. Reading the nutrition information panel will help identify empty

caloriesthose with high calories but no vitamins or minerals. Eliminating

empty calories helps ensure that every food and drink contributes to a quality

daily diet.

Processed foods tend to be less healthful and should be avoided. You can

identify processed foods as those containing multiple ingredients that are

difficult to pronounce and possibly unfamiliar to you. Healthful foods tend to

contain ingredients that are known to you. Shopping more around the outside

edges of the grocery store (fruits, vegetables, meat, freezer, dairy sections) and

less in the inside aisles (packaged foods) will promote a more nutritionally

balanced diet.

Two helpful web sites: www.nutrition.gov and www.snackwise.org

Recommendations for Addressing

Pediatric Obesity

2008 FULL POTENTIAL REPORT EXCERPT


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Eat together as a family.

Restart the tradition of a family dinner together without the TV.

Cut sweet drinks.

Substitute sweet drinks and juices with water or other drinks with

no calories.

Know your childs Body Mass Index (BMI).

The American Academy of Pediatrics recommends using BMI to

screen for overweight children beginning at age 2 and through

age 19. Discuss your childs BMI with your family doctor.

Stay away from fast food.

Eat fast food rarely. When you do, pick the restaurant and your

food carefully. Look up the nutrition information (available at

the counter) to know how many calories youre eating. Stick to

non-supersized portions. Downsize your selections using the

junior menu. Add fruit or a baked potato rather than fries. Add

vegetables and fruits at every opportunity. Avoid non-diet sodas

and desserts.

For SchoolsMeasure and intervene.

Increase school based BMI screening connected with

the medical practices to form a seamless system of early

identification and intervention.

Increase opportunities for physical activity.

Ensure daily recess in all elementary and middle schools.

Implement Take 10! This program encourages taking two

10-minute breaks in the school day for moderate to vigorous

activity in the classroom.


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Page 30

Ensure all food and drink choices are healthy.

School nutrition standards should be established for all non-USDA

food in schools, including vended, a la carte, school store and

fundraisers.

Advocate and provide learning opportunities.

Schools should incorporate healthy eating and physical activity

behaviors into their lessons. Afterschool programs will provide nutritiousfood choices and a safe environment for learning and physical activity.

Parents, school agencies and schools should advocate, support and

implement programs which provide a healthier environment.

For Other OrganizationsHealthy lifestyle behaviors start early.

Meals and snacks at child care centers should comply with the USDA

guidelines. Child care providers need to be trained on best practices in

nutrition and physical activity for the young child.

Faith-based organizations can reach out to families.

Faith-based organizations are a trusted source of support for families.

They offer an excellent venue for screening, educational and health

promotion programs.

Health care providers need to screen all children

for obesity.

Along with screening children using body mass index, they shouldcounsel families on strategies to prevent childhood obesity. Health

care providers should receive training on evidenced-based obesity

management guidelines. In addition, they must be involved in basic,

translational and clinical research programs that advance our knowledge

on causes, prevention and treatment of childhood obesity.


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For CommunitiesNeighborhood groups are credible advocates.

Along with working toward safe sidewalks, parks, and neighborhood

physical activity programs, neighborhood groups can work in

collaboration with stores and local farmers to increase availability

of fresh fruits and vegetables.

Food industry can help improve food choices.The food industry should offer a variety of healthy food options

and provide information on nutrient quality, e.g., require

restaurants to list calorie content of food items.

Employers must get in on the action.

Businesses should support employee activity through corporate

steps challenges, Eco-bucks programs, walking and cycling clubs

during lunch hour, and other programs that get people moving.

For SocietyEngage the media to increase awareness about

obesity and co-morbid conditions.

Assist with health promotion messages on healthy lifestyle

behaviors.

Implement a comprehensive community plan.

Community leaders, business leaders, hospitals, government and

other stakeholders need a coalition to develop and implementa Columbus community plan to promote optimal nutrition and

daily activities.


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Support the recommendations of the Ohio Activity

Plan.

This recently enacted program of the Ohio Parks and Recreation

Department will include communities working on creating a built

environment that entices its citizens outside using parks,

walkways, bike and roller-blade paths, and skateboard parks.

Building downtown grottos that showcase sculpture, fountains

and parkland to draw workers and visitors out onto the streets is

also advocated.

Advocate for local, state and federal government

polices.

Enact policies that create and improve resources for physical

activity in schools, workplaces and neighborhoods. Advocate for

legislation that supports reimbursement for obesity-related office

visits; improve access to nutritious food choices for children who

are affected by food insecurity; and promote diversification of

healthy and culturally appropriate food options in the Women,

Infant and Child (WIC) program.

Support legislation to improve the built environment in

communities, such as safe sidewalks. There must be uniform

access to green spaces, parks and recreation centers in all

communities.

Note: Recommendations were developed by physicians at the Center for Healthy Weight and

Nutrition at Nationwide Childrens Hospital and incorporate several recommendations from areport Healthy & Fit: A Community Action Plan for Franklin County Children & Families by

the Osteopathic Heritage Foundations and Childrens Hunger Alliance.


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700 Childrens Drive

Columbus, Ohio 43205

www.NationwideChildrens.org/FullPotential

full potential update 2009

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