When it comes to kids, parents have plenty to worry about--sex, drinking, drugs, grades, peer pressure. Add to those another concern: children are gaining weight. In the United States, too much TV, poor eating habits, and lack of exercise mean that 17 percent of kids ages 6-19 are overweight or obese, and consequently at risk for type 2 diabetes, heart disease, and other debilitating chronic diseases.

Supporters of the Harvard School of Public Health hope to change how America's kids live, eat, and play, particularly in impoverished urban areas. In February, Harvard College alumna Penny Pritzker '81 and her husband, Bryan Traubert--the parents of two healthy, active adolescents--pledged $5 million to launch the rigorous scientific evaluation of an after-school exercise and nutrition program developed by HSPH researchers and piloted, since 2004, at YMCAs around the country. The Y is the single largest provider of after-school care for public school students in the United States. YMCAs serve nearly 400,000 school-age children each year, many of them from urban, low-income, and minority populations, in which obesity rates are rising fastest.

HEAVY TOLL

For children, poor nutrition and physical inactivity have weighty consequences.

34
Percentage of U.S. children who are overweight or obese

17
Percentage of children in the U.S. who are obese

2.3- to 3.3-fold
Increase in childhood obesity in the U.S., past 25 years

30
Percentage of children who eat fast food on a given day

10-fold
Estimated increase in prevalence of childhood diabetes, last 20 years

500
Percent increase in soft drink consumption per capita, 1950s to today

60
Percentage increase in children's obesity risk from one additional soft drink per day

167
Number of calories per day added to children's diets for every one-hour increase in TV viewing

49
Percentage of every U.S. food dollar spent on food eaten outside the home (includes take-out items)

44.5
Average number of hours per week that kids ages 8–12 spend in the recreational use of TV, videos, music, video games, computers, movies, and print media

* Whether a person is overweight or obese is determined by the ratio of weight to height, or the body-mass index (BMI). A healthy weight is one that equates to a BMI of less than 25. From 25 to 29.9, a person is considered overweight; and a person with a BMI of 30 or more is considered obese.

Sources: Centers for Disease Control and Prevention, Journal of the American Medical Association, Pediatrics, U.S. Department of Agriculture, Lancet, Archives of Pediatrics and Adolescent Medicine, Tufts University/Friedman School of Nutrition Science and Policy, Kaiser Family Foundation

Pritzker and Traubert's gift will also create student scholarships and a junior professorship in obesity-prevention oriented, fitness-promoting research at HSPH. Collectively, the couple's efforts are known as the Donald and Sue Pritzker Nutrition and Fitness Initiative, in honor of Pritzker's parents.
The initiative's co-directors are HSPH's Steve Gortmaker, professor of the practice of health sociology in the Department of Society, Human Development, and Health, and Frank Hu, associate professor in the departments of Nutrition and Epidemiology.

HSPH's researchers aim to measure the impact on health of YMCA after-school programs by documenting physical, behavioral, and biological changes in kids over time. Changes in height and weight, energy expenditure and heart rate, blood pressure, food intake, diabetes risk factors, and other data will be recorded. Within approximately three years, the researchers will compare results in youngsters from participating YMCAs with results in a control group.

The YMCA is ideally positioned to bring about healthful changes in kids' and families' lives, according to project leader Jean Wiecha, a senior research scientist in the Department of Society, Human Development, and Health at HSPH. "The YMCAs have both the will and the infrastructure to make important changes that reach millions of people," she says, adding that the organization's reach is broad. About 9,000 YMCAs serve more than 20 million Americans in approximately 10,000 communities across the country.

HSPH's research team, which includes Gortmaker and Hu, will enroll 2,000 children from grades K-6 at YMCAs in up to 20 U.S. cities. The team will test a set of behavior-changing principles and activities derived from their successful middle-school curriculum Planet Health. Used by more than 100 Massachusetts schools, Planet Health has been proven to decrease obesity and eating disorders among girls. The obesity effect among girls appears to be due mainly to a reduction in television viewing, which was also noted in boys. Planet Health stresses four simple messages: reduce television viewing, increase fruit and vegetable intake, reduce intake of unhealthy fat, and increase physical activity.

Developed with a grant from the National Institutes of Health, Planet Health was updated and retooled for the Y with a generous gift from another set of philanthropic-minded parents: Mary Finnegan and her husband, Paul, AB '75, MBA '82, a member of the HSPH Leadership Council. In choosing to fund this effort, the couple cited the School's "impressive ability to leverage its expertise for maximum impact" in the fight against childhood obesity.

The hope is that children and families who volunteer for the new YMCA research study will embrace healthier habits: Eat more fruits and vegetables, and less saturated and trans fats. Drink fewer sugar-sweetened drinks. Turn off the TV. And experience the joy of movement while burning calories.

Force for Change
The YMCA after-school evaluation by HSPH researchers is just one part of an ambitious YMCA organizational improvement effort led by Activate America, a project of YMCA of the USA. As one member of a team of leaders, Wiecha has been chairing this effort since 2004.

Fitness has always been part of the YMCA's credo--the sport of basketball was invented and popularized through YMCAs by the late James Naismith, a staff training director. The organization aims to "take it up a notch" by becoming "a force to combat the epidemic of obesity in the United States," according to Lynne Vaughan, director of the Gulick Collaborative, an organizational improvement effort focused on fitness and health, and named for a visionary Y director who championed physical health as vital to total well-being.
Says Kenneth Gladish, president and chief executive officer of YMCA of the USA: "For decades, YMCAs have been building kids strong in spirit, mind, and body. Our YMCA Activate America initiative is taking this commitment to a whole new level by incorporating and modeling health habits in all facets of our after-school programs." The aim, Gladish says, is "to make real change in the lives of children in America's most under-resourced neighborhoods, where the compounding effects of poverty on our children's health are most devastating."

The gift from Pritzker, who for Harvard College co-chairs 25th Class Reunion Giving, and Traubert, a member of HSPH's Visiting Committee, will enable HSPH to seed the emerging field of obesity research with talented scholars. In addition to allocating $1 million of the total to scholarships over five years, the couple directed $1.5 million to a junior professorship, which will pass from one outstanding young faculty member to another, every three years. Recruited at the assistant and associate levels in disciplines from nutrition to social and behavioral sciences to biostatistics to laboratory science, these rising stars will work to slow and reverse the global rise in children's weight and a constellation of disorders known as the metabolic syndrome. (This syndrome, characterized by overweight and elevated blood pressure, blood sugars, and blood fats, carries a heightened risk of type 2 diabetes and cardiovascular disease.)

Says HSPH Dean Barry Bloom: "The childhood obesity problem in the U.S. is a growing epidemic, particularly among minorities and the socio-economically disadvantaged, whom YMCAs serve in significant numbers. We at Harvard are enormously gratified by our generous supporters' strong commitment to partnering with us in this effort."

Karin Kiewra is editor of the Review and associate director of Development Communications at HSPH.

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