Upland, Pa. - With so many conveniences available at their fingertips - such as fast food, the Internet and hand-held video games - it’s not surprising that physicians are seeing more and more children who are clinically overweight or obese.

“A day does not go by where I do not see at least one significantly overweight child,” says Richard Kaplan, M.D., chairman of the Department of Pediatrics at Delaware County Memorial Hospital. “This includes children of all ages. The causes are multi-factorial, both genetic and environmental. We live in a very sedentary society. Kids do not get enough exercise. Children, and adults for that matter, spend far too much time watching TV, playing video games and on the computer. The days of kids going outside to play all day are long gone.”

Physicians and schools are now using the Body Mass Index (BMI) to determine if a child is considered overweight. “The clinical definition of overweight is above 85 percent of the national standard,” says Gerald Kolski, M.D., chairman of the Department of Pediatrics at Crozer-Chester Medical Center. “Those who are over 95 percent of the national standard are considered significantly overweight.”

It’s a known fact that children who are considered “obese” are at higher risk for Type 2 diabetes. “In addition,” says Karen Rockwell, R.N., B.S.N., CDE, program coordinator for the Crozer-Keystone Center for Diabetes at Springfield Hospital, “obese children have a higher incidence of orthopedic problems, kidney problems, and high blood pressure and cholesterol - which are risk factors for heart disease. There also are social issues, because children who are ‘different’ are teased, which does nothing for their self-esteem.”

Rockwell says that although the Center for Diabetes has not counseled many obese children who have Type 2 diabetes, they are definitely out there. Her advice to parents of obese children is to work in tandem with the child’s pediatrician and a registered dietitian (RD). The RD will take into account the child’s medical history and environmental factors to construct a plan to help them lose weight and to continue to get the nutrients they need to grow.

Physicians and staff at Crozer-Keystone Health System have taken on the fight against childhood obesity. And from the looks of things, progress is being made.

Asthma Camp

For example, Kolski has been involved with an American Lung Association-approved Asthma Camp for the past 12 years and has run a separate camp the last seven years at the Healthplex® Sports Club. “Asthmatics have a difficult time exercising,” he says, “and as a result, they tend to gain weight. It’s a vicious cycle.” Kids who participate in the Asthma Camps learn how to manage their asthma symptoms while engaging in exercise.

School Programs

The health system is even taking the message into Delaware County schools. “Crozer-Keystone is partnering with five elementary schools to help administrators set up health councils to address health issues in children,” says Gwendolyn Smith, chief operating officer of Springfield Hospital and CKHS vice president. “We want to help schools develop policies that will incorporate healthy eating and exercise habits at an early age.”

Rockwell says she also takes the message about diabetes out to the schools. “We go to health fairs and give interactive presentations to teach them about the correlation between diabetes and obesity,” she says.

Ches Penn After-School Wellness Program

Smith also points to the overwhelming success experienced by the Ches Penn After-School Wellness Program at Community Hospital, a collaborative effort among medical director Rekha Yagnik, M.D.; Iesha White, program coordinator and a social worker with the Crozer Pediatric Residency Program; the Crozer-Keystone Wellness Center; the Penn State Cooperative Extension; and staff from the Healthplex® Sports Club.

The Ches Penn After-School Wellness Program was held in the Fall of 2004, from Monday through Thursday at the Mini-Healthplex® facility at Community Hospital. Targeted toward children who reside in Chester, the program “had several components weaved throughout its fabric that promoted physical activity, nutrition education, mentoring, and ultimately behavioral changes that would facilitate an overall healthy lifestyle for our families,” White says. “It was a wonderful experience. We had a total of nine participants, and all completed the program. We were happy to see subtle improvements with the children’s weight management. All of the children and their families began to understand the importance of healthy living and the need to incorporate physical activity into their daily routine.”

White says that the team is looking to hold the program again and to expand on its offerings.

Healthplex® Sports Club Programs

Other ways Crozer-Keystone is fighting childhood obesity can be found at the Healthplex® Sports Club. The club offers a range of children’s fitness programs, as well as specialized sports programs in basketball, volleyball, karate and more. The club also offers the Summer Sports and Games Camp (a 10-week, full- or half-day experience that includes arts and crafts, fitness activities, racquet sports, swimming and more) and specialty camps for tennis, cheerleading, basketball and volleyball.

Crozer-Keystone is also a sponsor of Healthy Hoops, an innovative community-based program designed to educate children suffering from asthma, obesity or cardiovascular disease about the importance of exercise and nutrition. Hundreds of Chester and Philadelphia children are participating in the program, which is organized by Keystone Mercy Health Plan and cosponsored by AstraZeneca.

For more information on fitness programs at the Healthplex® Sports Club, call (610) 328-8869; for the Ches Penn After-School Wellness Program, call White at (610) 497-7208. To find a Crozer-Keystone pediatrician who’s right for you, call 1-800-CK-HEALTH (1-800-254-3258).

Additional Information

Proper nutrition and exercise are keys to keeping kids off the couch and living healthy. Drs. Kaplan and Kolski offer the following tips to help kids to eat right and become more physically active:

• Teach your children healthy eating habits by offering them more fruits and vegetables. Limit snacks that are high in fat, and pay careful attention to portion size. For example, one snack that kids love is celery with peanut butter and raisins.
• Use skim milk instead of whole milk for all family members over two years old, and try to use butter sparingly.
• Offer water instead of beverages that contain a lot of sugar, such as soda.
• Try to serve meals at the same time every day. The whole family should eat together at the dinner table (do not eat in front of the television).
• Limit the time children spend watching TV, using the computer or playing videogames to a total of two hours a day.
• Send children outside to play every day.
• Plan family activities, such as a daily walk. Spend weekends taking bike rides, hiking, going to the zoo or just walking around historic Philadelphia.
• Ask kids to help out with household or yard chores.