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Translated, those figures mean that during the past 25 years the number of children with a body mass index (BMI) of 30 (the marker for obesity) has doubled and more than tripled for teens. So bad is the obesity problem that some scientists anticipate a spike in heart disease, diabetes, high blood pressure and cancer.

“We know if kids remain this way they are going to lose quality later in life,” says Ken Germano, founder of Operation FitKids, a 15-year-old nonprofit organization dedicated to improving the health and fitness of America's youth. “We know that if you don't teach and help kids understand the benefits of exercise, obese teens become obese adults.”

The plumping of America's youth can be traced to several factors, from families where both parents work to the popularity of caloric-rich fast foods. Add to that recipe a dramatic decrease in PE classes and the result is what the American Obesity Association calls “the most inactive generation in history.”

“We have to wage war on inactivity,” says Germano, who is also president of the American Council on Exercise. “We've always had food and beverage. But when there is no physical activity, then it becomes a problem.”

Solving America's obesity problem, experts say, will require everyone — parents, schools, health clubs and equipment manufacturers — working together. It will also mean changing the traditional concept of physical education from a team-sports orientation to an individual-based program about learning to live a healthy lifestyle.

“The focus should not be on sports but on physical fitness and lifetime fitness,” says Dr. Kenneth Reed, director of PE4Life's Center for Advancement of Physical Education. “We think that daily, quality physical education is the most effective and efficient solution for attacking physical inactivity. It's a whole new concept, and that is why we say quality physical education.”

Testing, Testing

It's no coincidence that in the past quarter century as obesity rates have risen, PE class time has declined. Facing tighter budgets, schools save money by cutting PE programs and eliminating intramural sports. More recently, the No Child Left Behind Act has put more demands on academic performance and has further reduced PE time, says Reed. In its 2000 Youth Behavioral Risk Factor Surveillance System study, the CDC found that while 56 percent of high school students were enrolled in PE classes, only 29 percent attended them daily. Seventy-five percent of American children don't even get 20 minutes of physical activity a day, Reed says.

“What gets tested gets taught,” he says. “We like to say that it's a three D world and that data drives decisions.”

And since there are no academic standards or national testing, physical education loses out. PE4Life wants to change that. Founded four years ago, the organization's goal is to make quality physical education part of education requirements. To that end, PE4Life has been the driving force behind the federally funded Physical Education Programs (PEP) grants. This year there should be $70 million in grant money, Reed says.

For the past four years Congress has increased its PEP money allocation. This year's money will be doled out in grants to 300 school districts and community-based organizations that submitted applications. The funds can be used for equipment, teacher training, education and staffing. The idea is to give kids the tools to lead a healthy lifestyle.

“I think just by the fact that schools sponsor athletics they have a responsibility to offer the same benefits to the whole student body through physical education and intramurals,” Reed says. “We think the main role of the school is to prepare these kids for adult life.”

For the past 15 years Germano and Operation FitKids have been preaching the same sermon. The single biggest obstacle to physical fitness for kids, Germano has found, is money.

“You do what you can do,” he says. “It really comes down to a matter of dollars and cents.”

Since its founding, Operation FitKids has provided more than $6 million in donated equipment, educational materials, staff training and mentoring to schools and youth facilities across the nation. Today, there are 25 FitKids programs in San Diego and New York.

“The schools for sure have a responsibility, and teachers have a responsibility,” Germano says. “But it depends on what their commitment is to a quality and exemplar education. Is it about athletics or physical education for all the students?”

Germano quickly adds that some PE programs are flourishing because of dedicated teachers. But while schools are a lynch pin in physical fitness, learning to live a healthy lifestyle starts at home. He suggests having families walk the dog together, hike together and swim at the beach together.

“You have to take responsibility for yourself first, and then it has to come from the parents,” he says. “Let's go ice skating, roller blading or do yard work together. Housework burns tremendous calories.”

What makes Germano do a slow burn is the lack of industry involvement in the fight against childhood obesity. From his vantage point, manufacturers seem unwilling to support programs, while club owners seem to ignore their social responsibility.

“When you look at the fitness industry, what the heck are we giving back?” he says. “I'm appalled by the lack of support for these types of initiatives. For me, educating young children about technology and products demonstrates that they will be consumers down the road. But this is about doing it because we need to do it.”

Clearly though, some in the fitness industry are getting the message. Take, for instance, Lady of America and Ladies Workout Express fitness centers. For the second year running, clubs across the nation have opened their doors to teenage girls at no charge.

“The program was conceived because of reports on childhood obesity,” says Scott Breault, spokesman for the franchise health club company. “We felt like the one excuse we heard was that teens can't afford a fitness membership. So we took that excuse right out of the game.”

The company suggested that its franchisees present the free summer workouts to local school districts to get middle school and high school teens on board. “That was definitely part of the plan to get teens involved through the school system,” he says. “We just wanted to instill a healthy lifestyle at an early age.”

Last year the program drew 35,000 girls. Next year, Breault says, the company is launching its FitTeen program at Workout Express sites for men and women. “We will be doing this for quite some time,” he says. “We found that if given the opportunity to take part in a fitness program and be around their friends, teens are more likely to get involved. The easier we make it for them, the more participation we are going to get.”

For younger children in kindergarten through sixth grade, Ohio-based FitWorks is joining forces this fall with the American Diabetes Association (ADA) to launch School Walk and FitSchools programs. SchoolWalk is the ADA's national, one-day, fundraising and educational event.

“We decided we could do something very positive for our community and also with a non-profit organization and help them raise awareness about diabetes,” says Mike Cross, FitWorks' director of marketing. “We feel we are providing a solution. We felt the missing piece was the solution for getting active.”

The FitSchool program kicks into gear after SchoolWalk. It is an ongoing program involving exercise and health education for students and their families both at school and inside FitWorks clubs. Currently, 15 elementary schools are signed up, but the program is open to all Cleveland-area elementary schools. FitWorks' Regional Program Director Kathy Fisher has developed an in-school exercise program and chart for the children to use. “I think with kids the key is to keep it fun and get down to the kid's level,” says Fisher, who intends to visit every participating school several times. “I just want to get them excited about exercise and movement and just add some music and make it fun, getting them away from the video games and hoping they pass it along to their families and make fitness a family event.”

Fisher's routine is broken into one- and two-minute segments of hip hop, kick boxing, marching in place and other simple movements. The idea, she says, is getting their little hearts pumping.

“They can do that in after-school fitness assembly, or one day a week they can come into the club,” Cross says. “They can take the chart home and do it on their own alone. They have a road map on what to do if they want to do it.”

Parents are invited to work out with their children at the club. If parents sign up for full memberships, all the better, but that's not the reason for the program, Cross says. “I think if you are a moral and ethical individual, then yes, you have a responsibility [to your community]. With our resources, how can we help? Even if it is something minimum, what can we do to give back? We are doing it because it is the right thing to do to be more active,” she says.

Also looking to give back, USA Track & Field teamed with American Sports Medicine on a health initiative called Be a Champion. The program promotes fitness, fair play and the benefits of physical activity. Starting this month, U.S. track and field athletes will appear in school assemblies to deliver health promotion messages and to encourage kids to take a pledge to be more active.

Even with the new programs, no one expects the childhood obesity problem to go away anytime soon. In fact, some experts expect things to get worse before getting better.

“There will be a tipping point,” Reed says. “Then there will be enough pressure on legislators and school officials that things like physical fitness and cognitive health will be tested in schools. All of a sudden physical education programs will start coming back.”

Obesity by the Slice

Prevalence of Obese Children at the 95th percentile of Body Mass Index (BMI)
YEARS Ages 6 to 11 Ages 12 to 19
1966 to 1980 7% 5%
1988 to 1994 11% 11%
1999 to 2000 15.3% 15.5%

“Donut” Ignore The Problem

Increase in Obesity Prevalence Among U.S. Children and Adolescents ages 6 to 19
Boys ages
6 to 11
Girls ages
6 to 11
Boys ages
12 to 19
Girls ages
12 to 19
1971 to 1974 4.3% 3.6% 6.1% 6.2%
1988 to 1994 11.6% 11% 11.3% 9.7%
1999 to 2000 16% 14.5% 15.5% 15.5%
Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Ogden et. al. JAMA. 2002;288: 1728-1732.
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