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Childhood Obesity Series

PART ONE: In the United States, one out of every three children is overweight. At one Flagstaff school, almost half of the children are considered overweight or obese. For the first time in many generations today's children will have shorter life spans than their parents because they're prone to high blood pressure, diabetes and heart disease. In the first part of the Changing America Desk childhood obesity series, Laurel Morales looks at the link between culture and obesity.

During recess at Killip Elementary School in Flagstaff the children don't look very sedentary. They play tag, climb on the jungle gym and shoot hoops. But community organizer Julio Quezada said they need more of this.

"When we interviewed a lot of the people in the community they all know they need to be living a healthier lifestyle. They all know they need to be exercising and eating healthy but there is barriers to that," Quezada says. "Parents working two jobs, convenience, money, health care insurance, recreational programs aren't free. You want to put your child in basketball it costs 100 dollars or so."

The children who attend this school are primarily from low income families, a third are from single parent homes. Many are Hispanic or Native American. Quezada says cultural differences play a role in the problem.

"Sometimes to have that chubbier child is endearing," Quezada said. "I know for the Hispanics its muy carinoso to have somebody that's my gordito or gordita."

All of the children at Killip were recently weighed and measured. Parents of children who were considered obese or overweight received a letter in the mail. Flagstaff school superintendent Barbara Hickman told a recent school board meeting she has received some angry phone calls about the letters.

"We are well, well aware that this is an emotional subject. It brings up something that are difficult sometimes. And parents can be offended how dare you say this you don't know everything about my child,'" Hickman said. "This is a screening test and parents have a choice what they want to do with these letters."

Parent George Pryer said a health care provider told his nine-year-old daughter Tiffane she was obese and it was very discouraging.

"They mentioned the word obese my daughter's beautiful. Obese wouldn't even come to my mind," Pryer said. "Just to see how a comment would affect her. It hurt my feelings."

The weigh-ins are part of a new community wide effort to combat childhood obesity. Local educators have recently partnered with health care providers, the city and the hospital to try to reverse the statistics.

One of the options northern Arizona parents have is a hospital-funded program called Fit Kids that takes a whole family approach.

Maria Montes has two daughters enrolled in the program in Sedona. She said one of the recommendations was to turn off the TV and play outside for 30 minutes every day. And Montes is learning how to cook healthier dishes.

As a result she said the girls' self esteem has improved and they don't get sick anymore.

North Country Health Care Pediatrician Nina Souders has made it her mission to help more families like this one. The majority of the patients she sees are on Medicaid.

"I have worked enough in Latin America and other developing realms to know skinny children are considered at risk," Souders said. "I have to combat that when I talk about the shape of their child. The way I put that in context in the clinic is I say, we are not living in Mexico and your child is not at risk for parasitic diseases. We're here and in this society this shape of child is the highest at risk.'"

Souders says Hispanics have a one in four risk of developing diabetes in their lifetime. All children in the US born in the year 2000 have a one in three risk of becoming diabetic.

"When you add those two statistics together and you see a child who's five and already overweight I try to bring up this child is at extreme risk of having diabetes," Souders said. "Almost all of my Mexican families have family members who have diabetes so they can tie those two things together."

Souders is relieved to have a program like Fit Kids to refer families to. But she said it isn't the whole solution because it's not a prevention program it's a treatment program. As a result, some of the problems, like early onset diabetes, are already taking effect.

PART TWO: First Lady Michelle Obama has launched a campaign to address the obesity epidemic among school children. But new research suggests the country needs a program that targets kids and mothers much earlier. In part two of the Changing America Desk childhood obesity series, Laurel Morales reports on one such effort on the Navajo Nation.

Aretina Chee unstraps her baby from a cradle board where she's been napping. The Chees live north of Winslow on the Navajo Reservation at one end of an eternal maze of dirt roads. Aretina just had her second baby three months ago and she's having trouble losing weight.

“I try everything I can,” she says. “I try doing my exercise. I see it not going down and so I just give up.”

Chee's faced with the dilemma that so many mothers face -- finding the time to take care of herself.

“In the evenings I have both of them,” Chee says. “One's crying one's running around. I'm trying to get dinner ready it is hard so I barely get in the time to get the shower sometimes.”

Three-month-old Ariana has lots of black hair, huge cheeks and wears clothes big enough for a baby twice her age. Mom's habits during and prior to pregnancy may have affected her baby's weight.

That's according to research published in the journal Pediatrics last spring.

Mona Patterson is the diabetes and pregnancy educator at Winslow Indian Health Care Center. She says poor eating habits and obesity can harm the baby.

“What we know now is the fetus will lay down an abnormal amount of fat cells during the pregnancy, which is what contributes to the baby being very large,” Patterson says.

And Patterson says this predisposes the child to obesity for the rest of his life. This is a potential problem for women like Diana Dixon. She was diagnosed with gestational diabetes in her third pregnancy.

“I kept telling my mom and my family when I get to 160 I'll lose weight. When I get to 170 I'll lose weight. When I get to 200 I'll start losing weight,” Dixon says. “But I never did I just kept going and going.”

She's now pregnant with twins and worried about their health so she's checking her blood sugar regularly and trying to improve her diet and exercise routine. A program at the Winslow Indian Health Care Center called Centering Pregnancy is helping her stay on track.

“Some still think that a 10 inch piece of fry bread with some mutton on it and some lettuce is the best meal in town,” says Beverly Earsing, a clinical dietician and a lactation consultant at IHCC. “You don't want to change their culture you want to appreciate where they've come from but you want them to move past some of these habits.”

Earsing says access and the cost of healthy food in remote areas like the Navajo Reservation can be a problem. And they face another challenge. In this matriarchal society Earsing says these pregnant women often hear advice from their own mothers and grandmothers.

“They say things like: ‘You need to get on the couch and take it easy slow down you're pregnant. You're eating for two make sure you have seconds and thirds every time you're eating.'”  

Earsing says correcting weight problems early in life is the key to breaking the generational cycle of obesity on the reservation. But there is a lot of work to do. The federal government says more than half of Native American women are overweight.