The Pica Perspective

A Well-Balanced Approach to Children's Health

In my October 5th post, "A Simple Concept for Children's Health," I reported on a campaign that provided an easy, logical approach to creating awareness of the daily guidelines for nutrition and physical activity. Called "5-2-1-0," the initiative reminds families to eat at least 5 servings a day of fruits and vegetables, limit screen time to 2 hours or less a day, participate in at least 1 hour of moderate to vigorous physical activity per day, and restrict servings of soda and sugar-sweetened juices and fruit drinks to 0 per day.

It pleased me to learn of something that, for a change, proposed a balanced solution to a complex problem. (I'm a big fan of balance!)

Well, today I've come across another one. A new study, called Shape Up Somerville (Massachusetts), analyzed 1,178 children in 1st through 3rd grade, one-third of whom were assigned to a program that made changes to their lifestyle both in school and at home. Parents were provided with healthy recipes, as well as coupons for healthy food. They began feeding their children more whole grains, fruits and veggies, cut down on television viewing, and participated in such physical activities as walking.

These children were also encouraged to walk to school or to their bus stop. And once in school, teachers scheduled activity breaks, made physical education class more rigorous, and planned after-school activities that promoted  health.

Apparently the results were "compelling." Although there wasn't a massive weight loss (which would have been impractical, since the children are still growing), there was a significant decrease in body-mass index, which was sometimes great enough to put a child at risk for obesity on track to a healthy weight.

According to Christina D. Economos, the study's lead investigator, "What differentiates this study is we took the approach of changing multiple environments within a community."

What a novel idea! (Said facetiously.) For more information on the project, which Dr. Economos is working to spread beyond Somerville and Massachusetts, go to www.childreninbalance.org. 

Do Sports Build Character?

It's a given that parents only want the best for their children. And that's one of the reasons they enroll them in organized sports -- often at a very early age; they believe that sports participation builds "character."

People can go on and on, expounding on the many values children supposedly learn by taking part in competitive sports. It's been the conventional wisdom for longer than I've been alive. But the truth is, there's little research to support the theory. There is, however, evidence to the contrary.

Consider this: a 1995 poll of 198 Olympic or aspiring Olympic athletes, reported in Sports Illustrated, showed to what lengths individuals will go to win. Asked if they would take a banned, performance-enhancing substance that would both go undetected and enable them to win, 195 said they would; only three said no. And when asked if they would take such a substance if they wouldn't get caught, they would win every competition entered for five years, and then die from the substance's side effects, more than half of the athletes said yes!

But, you may be thinking, those were athletes whose lives had revolved around winning for many years; they're probably an exception to the rule.

Maybe, but the attitude had to begin sometime and grow from there, as this story indicates: a survey of 965 students at four middle schools in Massachusetts found that almost 3% of the children were using anabolic steroids to enhance their appearance and performance. From where do children as young as 10 learn such skewed priorities?

Other research shows that long-term participation in sports results in the display of less sportsmanship and more aggressive behavior -- and that even if athletes learn some prosocial behaviors on the field, they rarely transfer them to other areas of their lives. Studies have also demonstrated that competitive children are both less generous and less empathetic than others.

Most recently, the Josephson Institute of Ethics released a report on the impact of high school sports on the values and ethics of student athletes. Here's part of what it found:

• Boys who play baseball, football, and basketball are more likely to cheat on the field and in school.
• Nearly half of the baseball and football players saw nothing wrong with using a playbook stolen from a rival team.
• A high percentage of both male and female athletes thought it was okay for a coach to tell a player to fake an injury.
• About half of all baseball players thought it was okay for a coach to tell a pitcher to throw at the opposing batter.

Still, people continue to believe that sports participation builds character. But is that the kind of "character" we want our children to grow up with?

A Report Card on Schools & Children's Health

Here's what one reader had to say in response to my last blog about whether or not schools should be sending parents notification of their children's overweight/obesity:

"i think it would be hypocritical of schools to get involved by sending home notices if they are not also proving plenty of time for children to move during the day and providing fresh, healthy meals."

It's an excellent point. So, I thought you'd like to see a "report card" of sorts -- findings from the Centers for Disease Control (CDC). The School Health Policies and Programs Study (SHPPS) 2006, conducted by CDC and published in the October 2007 issue of the Journal of School Health, is the largest and most comprehensive study of health policies and programs in the nation′s schools.

Here's the good news:

• States prohibiting schools from offering junk foods in vending machines increased from 8 percent in 2000 to 32 percent in 2006, and the percentage of school districts doing so increased from 4 percent to 30 percent.
• Schools selling water in vending machines or school stores increased from 30 percent in 2000 to 46 percent in 2006.
• States that required elementary schools to provide students with regularly scheduled recess increased from 4 percent in 2000 to 12 percent in 2006 and the percentage of school districts with this requirement increased from 46 percent to 57 percent.
• Schools with policies that prohibited all tobacco use in all school locations, including off-campus school-sponsored events, increased from 46 percent in 2000 to 64 percent in 2006.
• Schools that sold cookies, cake, or other high-fat baked goods in vending machines or school stores decreased from 38 percent in 2000 to 25 percent in 2006.
• Schools that offered salads a la carte increased from 53 percent in 2000 to 73 percent in 2006.
• The percentage of schools that offered deep fried potatoes (French fries) a la carte decreased from 40 percent to 19 percent.

Here are the areas that still need improvement:

• Seventy-seven percent of high schools still sell soda or fruit drinks that are not 100 percent juice, and 61 percent sell salty snacks not low in fat in their vending machines or school stores.
• Only 4 percent of elementary schools, 8 percent of middle schools, and 2 percent of high schools provided daily physical education or its equivalent for the entire school year for students in all grades.
• Overall, 22 percent of schools did not require students to take any physical education.
• Currently, 36 percent of schools still do not have policies prohibiting tobacco use in all locations at all times.

Should Schools Weigh in on Children's Weight?

The blogosphere has buzzed lately with the voices of parents who are appalled and sometimes outraged at the idea of the schools sending home notices regarding their children's weight. Here's part of a recent posting from MotherTalkers:

At least a dozen states have passed legislation requiring schools to start sending reports home if a child’s Body Mass Index (itself a controversial health-o-meter) indicates her or she is “overweight” or “at risk.” The latest state considering such action is New Jersey. Jeff Stier, the Associate Director of the American Council on Science and Health, wrote in the Huffington Post in June, “(I)f your child is obese, you probably know it already. A report card telling you so will only add to the stigma, without providing real approaches to addressing the problem.”

And the stigma is the real sore spot. Even the “real” approaches some states have tried have inspired some pissed-off parents to sound off. ABC News reported in January that a Wyoming school sent a letter to a twelve-year-old student’s parents, and invited their son to join the “Strong Kids’ Club.” The mother was livid that the school would call out only the heavier kids with an invite.

At the moment, the post has 28 comments on the issue; and from what I gathered, nobody thinks the schools should get involved.

Some things, most people feel, should be left to  parents and  parents alone. The problem, however, is that a great many parents are in denial about their children's weight. A Consumer Reports poll, reported in USA Today, found that, while 91% of the parents polled indicated being overweight or obese is a problem among children, more than 68% said their own children were at their ideal weight. And this was despite the fact that 36% of the kids had a BMI that put them into the overweight category.

Think it should be left to the pediatricians to inform parents? In one poll, only 36% of parents with heavy children reported that their physician recommended their child lose weight. The other 64% say their doctors didn't mention it at all. So, if they're in denial and their pediatricians aren't going to deal with the issue, from where is the necessary information to come?

Think a parent has to be completely clueless not to notice a child is overweight or obese? Apparently, it's easier than you'd imagine. Read author Jacquelyn Mitchard's article, in which she announces she was the "poster mom for denial."

Should the schools be involved? It's a heated -- and delicate -- issue. What do you think?

Playing with Blocks

If you've been reading this blog for a while, you know I'm a fan of simple, old-fashioned stuff for kids: free play and outdoor play as opposed to "playing" on the computer; finding creatures in the clouds as opposed to zoning out in front of DVDs; running and jumping as opposed to competitive, organized sports; play-based preschools as opposed to those that offer early academics. I think you sense the theme here...

Naturally, then, I was excited to come across a study this month indicating that playing with blocks may improve language development in toddlers! That's right: simple, old-fashioned block play. How about that?

Lead researcher for the study was Dimitri Christakis, MD, MPH, of the Seattle Children's Hospital Research Institute and the University of Washington. He's the same gentleman who was part of the "DVD study" showing that baby DVDs may hinder, rather than help, language development. Now he's found that distributing blocks was associated with significantly higher language scores in the sample of middle- and low-income children. On average, children who received blocks scored 15% higher on their language assessment than those who did not.

Said Christakis: "Playing together remains the best way parents can help foster their young children's development. Our findings point to a pragmatic and fun way to improve language acquisition. Though many toy manufacturers claim their products improve children's cognitive abilities, few such claims are substantiated by research."

Of course, once upon a time, blocks were an essential part of every preschool and young child's home. I'm curious: Are they still, or have they gone the way of the dinosaurs? Let me know!

How Important is IQ?

In preparation for my interview with David Perlmutter for "Body, Mind and Child" this morning, I read his book, Raise a Smarter Child by Kindergarten. The subtitle is Build a Better Brain and Increase IQ by up to 30 Points. The premise and the promise are brilliant and, as you can imagine, the book is selling quite well. After all, parents have become convinced that they should want smarter children and that they can do something about it!

The book is actually quite good, and there are many, many points on which Dr. Perlmutter and I agree. For example, he has plenty to say about the importance of play and physical activity in children's lives. I gotta love him for that! But I also have some concerns.

First, I debate whether or not parents really need to help "create" their children's brains. After all, parents in the past never attempted such a thing; and a lot of our brains turned out just fine. He writes, "Your child's future depends on how well you do that job." That's a lot of pressure to put on parents! And while he prescribes many wonderful activities, it all seems so calculated! Also, what if parents turn these wonderful play activities into drills, believing that, if a little can improve a child's brain, a lot can create an Einstein?

But it may be the premise and the promise of a higher IQ that bothers me most of all. According to a number of experts, IQ is not indicative of how well a child will do as an adult. Writes Daniel Goleman, author of Emotional Intelligence: Why It Can Matter More Than IQ,"IQ contributes only about 20% to the factors that determine life success." And developmental psychologist Howard Gardner has said, "The vast majority of one's ultimate niche in society is determined by non-IQ factors."

Would I recommend the book? Sure. As I said, there's a lot of good stuff in there. But I also recommend that you read it with your critical-thinking skills in full operational mode!

Helicopter Parents

"Extreme parenting." "Hyperparenting." "Helicopter parents." These are just some of the uncomplimentary terms being assigned to some of today's parents and their parenting styles. The last one refers to parents' tendency to "hover." They all imply an inability on parents' part to lighten up and let go.

Stacy DeBroff of Mom Central and a regular contributor to the Today Show did a segment on helicopter parenting on the show last week. To view the piece and read an excellent article by Stacy, click here.

The topic strikes a chord with me because I came across so many unbelievable stories while researching my book, A Running Start. There was the story of the 24-year-old car salesman who didn't get his annual bonus because of his poor performance. His parents arrived at the company's regional headquarters and sat outside the CEO's office, refusing to leave until the CEO would meet with them! Then there was the 22-year-old pharmaceutical employee who didn't get the promotion he wanted because, according to his boss, he needed to first work on his weaknesses. Because he was a Harvard graduate who'd excelled at everything he'd ever done, he was devastated. His parents were sure they could find a way to fix it, as they had fixed everything for him in the past. His mother called the Human Resources Department the next day seventeen times, demanding a mediation session with her, her son, his boss, and a representative from Human Resources.

Chances are pretty good that these two young men, who haven't been allowed to work out conflicts on their own and to fend for themselves, have not and will not learn independence and resilience. On the other hand, kids trusted to take responsibility -- even if that means some failure and mistakes -- gain the courage to make decisions and the gumption to get back up again when life knocks them down! And life will occasionally knock you down...

Here's an anecdote from my book, given to me by the mother of a 6-year-old:

"I was talking with my pediatrician about an ABC News report I saw about a mom with two sons in college. This mother sent her sons to-do e-mails, checked their grades, their bank account balances, and even used their personal passwords to check their student e-mail. One of her sons was in a college two hours away, and she drove there twice a month to clean his dorm, do his dishes, and pick up his laundry! My pediatrician told me that as long as her husband lived under his mother's roof, her mother-in-law had picked up his dirty clothes from the floor where he dropped them every day -- and that he had expected her to do the same thing for him when they got married. She told me that had cured her of any temptation to become a parent who did everything for her child, and she gave me some wonderful advice: She told me to raise an adult, not a child."

A Simple Concept for Children's Health

So much of what comes across my computer -- in the way of Google and New York Times alerts, and even e-mails from distraught parents and teachers -- is bad news. Or disturbing, discouraging, or all of the above.

I read that recess and physical education are being cut. That children are overweight, obese, and suffering from symptoms formerly seen in adults only. That French fries are the number-one vegetable and viewing television the number-one "activity." It's even frustrating to learn that banning cupcakes is considered a solution to what's ailing our children! (See my last post.)

But today I came across a great story about a school program that makes sense  -- and a campaign that's as simple as it is logical. And it's all happening right here in my state of New Hampshire!

At the Greenland Central School, a kindergarten-through-eighth-grade school, "exercising more and eating well are front and center" in this year's curriculum.  Says Beth Sommers, the school's curriculum integration and extended learning coordinator, "Our goal here at the Greenland Central School is to support a healthy school environment." Then she uttered one of my favorite sentiments: "The idea is everything in moderation."

The initiative is being implemented in a variety of ways -- even through music and theatrical productions -- which I really appreciate, because it ensures that more children will get the message. And once they get it, it's more likely to stick.

The campaign is called "5-2-1-0 Healthy NH," and it's a statewide public education campaign intended to bring awareness to the daily guidelines for nutrition and physical activity. Its message is simple and clear and represents some of the most important steps families can take to prevent childhood obesity. Here's its message:

5 Fruits and vegetables…more matters!  Eat at least 5 servings a day.  Limit 100% fruit juice. 
2  Cut screen time to 2 hours or less a day.
1  Participate in at least one hour of moderate to vigorous physical activity every day.
0  Restrict soda and sugar-sweetened sports and fruit drinks.  Instead, drink water and 3-4 servings/day of fat-free/skim or 1% milk.

As I said: simple and logical. The initiative also involves resources, including doctors, teachers, and free, reprintable materials. If you're looking for ideas to take to your child's school, 5-2-1-0 might be just the thing!

The Cupcake Controversy

Typically, I don't address children's nutritional issues (energy in). Although I do give nutritional issues a good deal of thought, my specialty is physical activity (energy out). Obviously, though, the two go hand in hand; and when I began reading blogs dedicated to the "cupcake controversy," I thought I'd weigh in. (Pun intended!)

It seems that, due to concerns about childhood obesity and diabetes, some New York state school districts have banned cupcakes from children's birthday celebrations. Appalled at the notion, Assemblyman Michael Benjamin of the Bronx wants to make the cupcake the official state children's snack. He says: "Making the cupcake the official state children's snack is my way of saying, 'Let's put some brakes on what's happening to the cupcake.' The way the American eagle is the official national bird and it's illegal to harm one -- my thought is, you make the cupcake something similar and leave the cupcake alone."

I certainly understand the desire to combat the childhood obesity crisis. As such, we need to draw some lines. But the cupcake at children's birthday celebrations? Isn't this going a tad far? And do we really need to anoint it the state snack?

Interestingly enough, the biggest difficulty with the energy in/energy out equation may not be with the number of calories consumed but with the number of calories burned! Studies both here and abroad have indicated this is true. The Framingham Children's Study, for example, found that preschool children with low levels of physical activity gained significantly more subcutaneous (beneath the skin) fat than did more active children. More specifically, in the United Kingdom, while the proportion of overweight or obese children remained the same between 1974 and 1984, there was a marked increase in the following decade. The research, reported in the British Medical Journal, determined the change was due not to increased energy (caloric) intake but rather to a decrease in energy output.

Studies in the United States have made the same determination. An increase in childhood obesity of 20% over the last decade (at least one in five American children is currently overweight) has occurred despite a decrease in overall fat consumption and little change in caloric intake.

Anyway, what do you think? Do we ban the cupcake or leave it alone?