Home >  News and Events >  MUToday >  June 2010 - Issue 72 >  Taking on Childhood Obesity: A Conversation with Dr. Skye Donovan  

News and Events

Taking on Childhood Obesity: A Conversation with Dr. Skye Donovan

by Laurie Callahan

In February 2010, First Lady Michelle Obama launched the Let’s Move campaign to combat the growing problem of childhood obesity in the United States. The campaign takes a four-pronged approach, focusing on helping parents make healthy choices; encouraging schools to serve healthful foods; increasing children’s physical activity; and improving access to nutritious, affordable food for all Americans.

Kicking off this effort, Mrs. Obama stated, “The physical and emotional health of an entire generation and the economic health and security of our nation are at stake.” She added, “This isn’t the kind of problem that can be solved overnight, but with everyone working together, it can be solved. So, let’s move!”

Dr. Skye Donovan, Marymount University assistant professor of Physical Therapy, has been conducting research on obesity in children for the past seven years and is thrilled with the attention the First Lady is bringing to this issue. She notes, “According to the CDC’s National Center for Chronic Disease Prevention and Health Promotion, obesity among children ages 6 to 11 increased from 6.5% in 1980 to 19.6% in 2008. Among adolescents 12 to 19 years of age, the prevalence of obesity rose from 5% to 18.1%. This is an alarming trend and a real wake-up call.”

Dr. Donovan points out the health implications: “Children who are obese are at risk for cardiovascular disease, type 2 diabetes, and bone and joint problems, not to mention the social and psychological harm that can result from teasing and rejection by their peers.”

Currently, Dr. Donovan and Dr. Michelle Walters-Edwards, Marymount assistant professor of Exercise and Health Sciences, are conducting a study with children at the St. Charles School in Arlington. “We get them to do aerobic training to get the heart rate up, and they also do basic strengthening moves,” Dr. Donovan explains. “We focus on getting the kids to do activities that they think are fun, like relay races. We expose them to many different modes of exercise that require little or no equipment, so that they can do the activities anywhere.”

The two professors are also encouraging the campus community to be more active, by leading walking groups and offering free circuittraining for Marymount students, faculty, and staff.

Dr. Donovan recently sat down for a Q-and-A to talk about her research and ways to mitigate the childhood obesity epidemic.

Q: What are the principal causes of childhood obesity?

A: Genetics play a small role, in terms of a predisposition toward weight gain. But environment is actually what causes someone to become extremely overweight. And many factors come into play.

To start, there is a lack of nutritional awareness and a pattern of consuming too many calories. Many children today simply don’t have fresh, healthful food as part of their daily lives. Fast food restaurants are on every corner, fresh produce is expensive, and advertising often pushes unhealthy choices and can be misleading – for example, saying that a product has “no saturated fat,” while it still has a ton of sugar and calories.

Poor nutrition tends to be combined with insufficient exercise. A 2010 study by the Trust for America’s Health and the Robert Wood Johnson Foundation reports that fewer than one-third of all children ages 6 to 17 regularly engage in vigorous activity — defined as at least 20 minutes of physical activity that makes the child sweat and breathe hard. Several factors contribute to this situation. Parents who work full time may not feel that it’s safe for their children to play outdoors unsupervised. And children are moving less in school, as a result of cuts in funding for physical education programs. So the opportunities for exercise are diminished. And when exercise isn’t an enjoyable, integral part of a person’s daily routine, it begins to be perceived as a chore.

There are also psycho-social issues that contribute to exercise avoidance. Obese children are often stigmatized for their appearance, making them hesitant to join in physical activity with other children. And, being less flexible and more injury-prone because of excess weight, these children may find exercise painful.

Q: What can be done to effectively address these challenges?

A: Anything done in a school setting is good, because the students are a captive audience. There are fun ways to sneak in information about nutrition – for example, what constitutes a portion size or learning about the food groups. And school-based programs can incorporate physical activity at the same time. When healthy food choices and exercise are combined, we see weight loss.

Programs in schools have shown that children can make positive changes. Unfortunately, when the kids go on summer break, they often gain the weight back. Parents and the home environment, understandably, have a really, really strong influence. So parent education is huge. For lifestyle changes to stick, the whole family needs to be involved.

Also, efforts that take a multi-pronged approach, like the Let’s Move campaign, are showing some great benefits. The studies that I’ve been involved with include psychological counseling, plus consultation with a registered nutritionist and a physicalactivity person.

The hardest part is changing people’s mindset, and this is especially true with kids. Children think that they’re invincible. And many adults in this country don’t seem to acknowledge that obesity is a major health issue. The common mentality is, “I can always lose the weight.” Even diabetes is not always seen as truly serious; people think, “It just means my sugar is a little high. I can take these medications.”

So the research that Michelle Walters- Edwards and I are doing is not just about mitigation of an existing problem; it’s also about prevention. We show children how much fun it is to learn about nutrition and to make conscious choices at the grocery store. We encourage them to do enjoyable physical activity or just go outside and move around in the fresh air.

If we can reach children early, it can change their lives. Some really novel approaches are helping. For example, some teachers are having kids stand, rather than sit, during certain classes, because standing burns more calories and uses different muscles. Other teachers have children sit on exercise balls, rather than in chairs. And the Wii system is great; it’s being used in after-school programs in areas where there is less opportunity to play outdoors.

Just this June, USA TODAY reported on a National Institutes of Health-funded study for the American Diabetes Association that found that changes in school programs, from reducing fatty foods and adding fruits and vegetables to increasing physical education classes, can lower obesity and the risk of type 2 diabetes. The study followed 4,600 middle-school children from 6th through 8th grades and documented that overweight or obese kids in schools with intervention programs were 21% less likely to be obese by the end of 8th grade. But, sadly, only five states now require physical education in every grade, K through 12, and only 19 states require some form of student assessment in physical education. So there is clearly more to be done!

Q: What are the hardest challenges to overcome?

A: The fact is, it’s not easy to lose weight. Everyone wants a magic pill, but the only thing that really works is lifestyle change. In my experience, the hardest thing for people to overcome is the feeling that they’re giving something up. They think, “I can’t have this anymore.”

When I give nutrition classes, I say, “Yes, you’re making a change, and that may seem daunting. But you don’t have to give up all the things that you love. You just have to have them in moderation, and you need to establish some new habits.”

For example, you can reinvent a favorite dish in a way that’s just a little bit more calorie-conscious; there are plenty of cookbooks and websites out there that show you how. You can avoid fast food and mindless snacking in front of the TV. I believe that eating more consciously is key; if you pay attention to serving sizes, eat slowly and really savor your food, and stop eating when you begin to feel full, it can make a big difference. And, of course, exercise is the other essential component. If you decide to eat that cake, you’re going to need to exercise a little more that day!

Unfortunately, people think that exercise is too hard, and they don’t have enough time to do it. The key is finding something that you enjoy. There are lots of choices out there, and it’s important to make the commitment to yourself. Putting in 20 minutes of exercise a day will come back so many fold in terms of feeling good and having less sick time. Exercise also clears the mind, making room for brilliant ideas to surface!

Q: What elements of the Let’s Move campaign especially excite you?

A: This effort has the potential to make a tremendous difference in the lives of our children and to move us toward becoming a healthier nation. The Let’s Move strategy focuses on prevention, in addition to intervention. It highlights the importance of good nutrition and exercise in maintaining health. It shines a spotlight on access, too, not just education. Education is wonderful, but if you have to pay more for good food and maybe travel five miles by bus to get fresh produce, it makes healthy eating nearly impossible.

Improving the food in schools is of paramount importance. One of the populations at highest risk for obesity is children from low-income families. These kids are able to eat in school for free or at a greatly reduced price. So it’s obvious that providing healthy food in schools is essential. But this is an ambitious goal because fresh, nutritious food is expensive and often not favored initially by kids. Still, providing only healthy foods – no junk food – in schools sends a critical message: Good health is essential to growth and learning. Plus, the availability of fresh fruits and vegetables in school exposes children to these foods, which they may then introduce to other family members.

Having kids involved in menu preparation and the growing and cooking processes would be an innovative way to combine learning with food consumption. Schools need to get creative in order to reach the children. They could hold math class in the cafeteria to measure out ingredients, or science class in the school garden to talk about the biology of the plants that provide the vegetables that will be served for lunch.

One thing I like about the Let’s Move campaign is that it emphasizes simple, incremental changes. It shows people that they don’t have to change everything at once. We need to encourage small, manageable steps that people can accomplish easily, like going on a 15-minute family walk after dinner, taking the stairs rather than the elevator, or eating a vegetable once a day.

Let’s Move also has a great familyoriented, interactive website that includes a contract family members can sign and online tools to help with setting goals and tracking progress.

My research and teaching aligns closely with the Let’s Move strategy. I believe that education is key to lifestyle change. I advise people to follow the U.S. Department of Agriculture guidelines for a healthy diet and stay away from fad diets and other gimmicks. My work also focuses on the simple task of getting children moving. Fitness goals can be achieved in public parks and on public sidewalks, using only the most basic of equipment.

Q: Can you leave us with some tips for a healthier lifestyle?

A: The key is being less sedentary. Just moving around more during the day is better than setting a goal of running 20 minutes every day. It’s important to set realistic goals. Simple activities like parking a little farther from your office so you have to walk more, getting up from your desk every 20 minutes to move around, and taking the stairs can easily become part of your daily routine.

We also need to set a good example for our children. The American College of Sports Medicine recommends at least 30 minutes of moderate to vigorous exercise three to five times a week. So incorporating physical activity into your family’s leisure time is important. Go for walks or jogs, take a swim, ride bikes, throw a ball with your kid. And don’t be afraid to try something new, like taking an exercise or dance class. You might enjoy it, and I guarantee that more exercise will make you feel better and help you stay healthier in the long run.

“Going green” can also be a huge help in increasing physical activity levels. Walk or bike to your local store or farmer’s market. Work in the garden, cut the grass, rake leaves.

In terms of food advice, fresh is best. If there is a farmer’s market in your area, check it out; you can often get fresh produce at very reasonable prices. And try out new foods. Decrease your salt intake and add spices as you cook; you can change things up and make your diet healthier. Cooking together as a family can be fun, too, and it provides an opportunity to teach kids about the importance of good nutrition.

I think that is the biggest key: If we can make healthy eating and exercise a shared endeavor – in our schools and in our homes – we will be successful in reducing obesity in both children and adults. The more people you get involved, the bigger your support group. When you are doing things together, you encourage one another and have a greater chance of success.

Finally, I’d like to mention that there are great websites available to help you create a personal healthy lifestyle program. In addition to www.letsmove.gov, they include www.mypyramid.gov, www.cdc.gov/healthyliving, www.americanheart.org, and www.colormehealthy.com.