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Fall 2009Battling childhood obesity one person at a time Watch for liver abnormalities in obese children Stay safe while exercising at home NEW Kids at the Y makes changes to better meet the needs of busy families
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Battling childhood obesity one person at a timeBrian Fidlin, PsyD, director, NEW Kids™ ProgramAbout a year ago, the NEW (Nutrition, Exercise and Weight Management) Kids™ Program at Children's Hospital of Wisconsin was asked to join the National Association of Children's Hospitals and Related Institutions pediatric obesity focus group along with 15 other programs from across the nation. The agenda of our meetings usually focuses on a variety of issues related to pediatric obesity including adolescent bariatric surgery, reimbursement, hospital environment and political advocacy. In the next six months, we will be releasing our findings. As a member of this focus group, my time with colleagues has been invaluable not just for the structured, organized discussions, but also for the conversations that occur over a cup of coffee or during a layover at an airport. It is clear that many of us who work in the area of pediatric obesity are frustrated. Each year, we see children and families come to us heavier and more medically complicated. Combine this with the fact that no one has found the medication, procedure, counseling strategy or intervention that is appropriate, effective and produces dramatic results in large numbers of children. While this paints a discouraging picture, our group remains undeterred. If anything, we are optimistic. Challenges and opportunities abound when it comes to addressing pediatric obesity. Obesity is an immensely complex and difficult issue. Personally, I am doubtful that we are going to find some simple strategy that will work for large numbers of people. I believe it is through relationships that we forge with our individual patients where we are able to work together to initiate a change. Cutting down on those sweetened beverages or taking the dog out for a 15-minute walk each day is a great first step. Building on these healthy steps when someone is ready is where we will make a true difference. It often is through these types of small, simple changes and with support that a person can see that he or she can take on greater challenges. It is through these efforts that we may be able to combat the obesity epidemic one person at a time.
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Watch for liver abnormalities in obese childrenMichele Polfuss, APNP, Children's
Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis often are overlooked due to the "silent" symptoms associated with childhood obesity. Many health care professionals don't recognize these conditions until the disease progresses or cirrhosis develops, which can take years. Here are three stages of liver damage health care professionals should know about:
Not everyone will transition from nonalcoholic fatty liver disease. Even when nonalcoholic steatohepatitis occurs, there are different degrees of scarring and damage that occurs. If cirrhosis occurs, there is a potential need for a liver transplant. While the exact cause of nonalcoholic fatty liver disease progressing to nonalcoholic steatohepatitis is not known, potential factors that contribute to the development of nonalcoholic steatohepatitis include:
Mixed results have been found when identifying risk factors for nonalcoholic fatty liver disease. Potential risk factors include:
While there is no guarantee that nonalcoholic steatohepatitis may be reversed, current recommendations for treatment include losing weight, increasing physical activity, improving diet and avoiding alcohol and unnecessary medications. References Engiz, O, Berberoglu, M, Siklar, Z, Ocal, G (2009). Risk factors for non-alcoholic fatty liver disease in obese children. Hormone Research (72), 63-64. Feldstein, AE, Kay, MH Fatty liver sisease. Obtained from www.acg.gi.org 2009. Reinehr, T, Schmidt, C, Toschke, AM, Andler, W (2009). Lifestyle intervention in obese children with non-alcoholic fatty liver disease: 2 year follow up study. Archives of Disorders of the Child (94), 437-442.
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Stay safe while exercising at homeStacy Stolzman, MPT, Children's
Home can be a great place for adults and children to do physical activity together. However, according to the Consumer Product Safety Commission, more than 25,000 kids are injured by home exercise equipment every year. It is important to educate families about the safety needs regarding exercise equipment in their homes. Treadmills Treadmills are a top safety hazard. Children are fascinated by treadmills and want to imitate their parents by walking on them. On a moving treadmill, children can slip and fall, get clothing or hair caught in the belt, or sustain burns from a moving belt. To prevent treadmill injuries, kids younger than 10 should not use a treadmill. Children older than 10 should be monitored closely while using a treadmill. When not in use, the activation key should be placed out of reach. The treadmill unit should be unplugged. If possible, the room where the treadmill is located should be locked. Weight-lifting equipment Weight-lifting equipment also can put children at risk for injury through misuse. Until children are preteens, they should use only body weight or resistance bands for strength training. Many parents may want to weight lift with their children, but children do not have the understanding of their limits required for controlled weight training. This can lead to overuse syndromes or trauma injuries. A child also can get a hand caught in the pulleys of weight equipment. To prevent weight-lifting equipment injuries, place weights in a locked cabinet or room so children do not have access to them. Once a child has reached the preteen age, instruct him or her in proper weight training techniques. If a parent is not aware of these techniques, he or she should seek information through the school gym teacher, fitness instructor or athletic trainer. Keep in mind, children would much rather do a wheelbarrow race across the lawn than complete three sets of 10 push-ups. Other tips for safety In general, when a parent is exercising, he or she should not wear headphones in order to be more aware of his or her environment. This can help prevent children from sneaking up and getting hands caught in pedaling bicycles, treadmill belts or plates of weight-training equipment. Parents also should explain that exercise equipment is for adults only.
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All about whole grains
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NEW Kids at the Y makes changes to better meet the needs of busy families
Erin Ruenger, YMCA of Metropolitan MilwaukeeThe NEW Kids at the Y program teaches kids and families how to make better choices for a long and healthy life. Families work to identify and address issues that have led to their child's current level of health and chart a future that is healthy in spirit, mind and body. The NEW Kids at the Y program made some exciting changes to better meet the needs of families interested in joining. The program now consists of a new six-week format to better accommodate busy family schedules. In addition, participants will be able to direct the content of the program. Families have the opportunity to pick three or four topics that best meet their needs, and focus on those topics throughout the program. Topics to choose from include:
The cost of the NEW Kids at the Y program is $60 for YMCA members. Nonmembers pay just $75, which includes use of the Y facilities for the duration of the six-week program. In addition, financial assistance and payment schedules are available. For additional information, contact any of the four participating centers listed below. Rite-Hite Family YMCA Northside YMCA Southwest YMCA West Suburban YMCA
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