Childhood obesity discussion by Del. School Nurses Assn.
By JEFF MONTGOMERY, The News Journal Posted Saturday, March 3, 2007 at 9:00 pm
Delaware school nurses gather in Dewey Beach for a conference on childhood obesity today. Dr. Karyl Rattay addresses the crowd.
Delaware school nurses gather in Dewey Beach for a conference on childhood obesity today. Dr. Karyl Rattay addresses the crowd. The News Journal/Scott Nathan
Small steps and big commitments are needed to reverse steady and frightening increases in childhood obesity across the state and nation, Delaware’s school nurses were told Saturday.
The comments came mid-way through Delaware School Nurse Association’s seventh annual winter conference in Dewey Beach, devoted almost entirely to mobilizing for a statewide effort to help children and family’s adopt healthier food, fitness and lifestyle choices.
Behind the push are warnings that 20 percent or more of children in most states are overweight, with levels moving above 30 percent in a few. The rate has jumped dramatically since 1985, when only four states reported obesity above 15 percent, and none at 20.
“It’s hard to look at that and not gasp,” said Dr. Karyl Rattay, a senior program and policy analyst in with the Center for Children’s Health Innovation, part of Nemours Health and Prevention Services.
Anne Biddle, nurse at Newark Charter School and an association officer, said that DSNA focused this year’s conference on obesity largely because nurses struggle daily to help children confronted with health and social problems related to excessive weight.
“We see so may complications -- Type 2 diabetes, knee and joint problems, asthma,” Biddle said. “It really has become an epidemic.”
Similar concerns have given rise to childhood health and weight campaigns across the country, with varying results. Arkansas legislators recently overhauled a law passed in 2003 that required school reporting of “body mass index.”
Critics said the practice stigmatized overweight children, without giving them support needed to improve their health habits.
In Delaware, lawmakers last year passed a measure that eventually could lead to statewide fitness evaluations and physical activity goals for elementary, middle school and high school students.
Also approved were measures creating statewide heath advisory and physical education and activity policies.
Delaware’s approach would assess body mass index, but also other aspects of student health, with a goal of providing opportunities for 150 minutes of physical activity weekly.
Pilot projects already are under way, along with attempts to involve family members in the effort.
“It’s a whole community focus,” said Beth Mattey, school nurse at Mount Pleasant High School, one of the pilot sites for the state’s fitness program.
“The nurses are going to be doing the BMIs and measuring them accurately, because that’s very important, and then we’re going to provide the referral to the families, offering information on what they can do and providing education.” said Mattey, who also is a Delaware representative to the National Association of School Nurses.
Mary Gavin, medical editor for the Nemours Center for Children’s Health, said that schools should avoid approaches with blunt report cards that simply brand students as overweight.
Parents and families also should be encouraged to chip away at the problem, working up from an approach that starts with physical activity for a few minutes daily while also replacing high-sugar drinks and foods with healthier choices.
“You need to give them a small thing,” to start with Gavin said.
Rattay said Nemours has adopted an approach dubbed “5-2-1-Almost None,” shorthand for five servings of fruits and vegetables, two hours or less of screen time daily, one hour or more of physical activity and almost no sugar-sweetened beverages.
Delaware’s Medicaid Program will step up its emphasis on childhood fitness and nutrition this year, potentially reaching 80,000 children across the state.
A push also is on to expand opportunities for physical activity across the state, starting with such basic strategies as assuring the availability of safe sidewalks and walk-to-school routes in communities.
Without action, Rattay said, the country could face a health crisis.
“Overweight children, especially overweight adolescents, are much more likely to be overweight adults,” Rattay said, with a greater risk of developing diabetes and other health problems that could lead to disabilities and early death.
“It’s going to happen if we don’t get this turned around,” Rattay said.
Childhood Obesity 
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