By Keith Ferrell

The success of an ongoing childhood fitness and weight-loss program sponsored by five NIH institutes is spreading across the United States. Here's how you can get involved in We Can!—Ways to Enhance Children's Activity and Nutrition.

"The heart of We Can! is empowering parents to see that they can do this for their children," says Anita Courtney, the state of Kentucky's coordinator for the We Can! obesity-prevention program. "Of all the things that we parents do to try to help our children, this gift of teaching them healthy behaviors as a part of life is the best gift we can give our kids."

To help counter the current epidemic of childhood obesity in the United States, five NIH institutes joined together in 2005 to start and promote an obesity-prevention program "We Can!"—"Ways to Enhance Children's Activity and Nutrition." Today, the program has grown to include 369 We Can! community sites in 43 states, is supported by dozens of national and state health care organizations, and such corporate partners as Alltel, Delphi, Mutual of Omaha, Univision Communications, Wal-Mart, and others. They key to its success, according to Courtney, is to get parents and community leaders actively involved in influencing children's eating and exercise decisions in new ways.

Courtney has already trained more than 200 Kentucky parents and community volunteers through the program's four 90-minute instructional sessions.

We Can! is unique among existing youth obesity-prevention initiatives because it focuses its activities and education on parents and caregivers—the primary group influencing children and adolescents. Joining in this effort with the National Institute of Child Health and Human Development (NICHD) are the National Heart, Lung, and Blood Institute (NHLBI), the National Cancer Institute (NCI), and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The program, which is aimed at families and entire communities, is an outstanding example of how NIH research is being translated into significant beneficial results for the American public, notes Karen Donato, coordinator of the NHLBI Obesity Education Initiative. (See accompanying article, "Obesity Research: A New Approach.")

We Can! focuses on three important behaviors: improved food choices, increased physical activity, and reduced recreational screen time.

Fighting the obesity battle properly requires not only a collective effort to alter and improve children's nutritional habits and exercise patterns, but also work to learn more about the causes of childhood obesity in the first place. We Can! community sites include schools, YMCAs, parks and recreation departments, worksites, and hospitals. The new We Can! City program helps mayors and policy makers to mobilize community members. South Bend, Ind., Gary Ind., and Roswell, Ga. were the first three We Can! cities.

The percentage of children and teens who are overweight has more than doubled in the past 30 years. A total of 17 percent of American children ages 2 to 19 are overweight or at risk of becoming overweight. Like adults, overweight children and adolescents are at risk for a variety of health consequences, including type 2 diabetes, high blood pressure, high blood cholesterol, cardiovascular disease, and asthma. Those facts are changing the way that researchers are approaching obesity itself, as well as its causes and treatment.

"We're reaching the point where we're shifting away from traditional behavior-modification approaches to childhood and adolescent obesity," says Terry Huang, M.D., Program Director of Pediatric Obesity and Metabolic Syndromes at NICHD. "Those approaches did not yield very good success rates."

The new approach pursued by Dr. Huang and his colleagues calls for a dramatic re-examination of the causes of childhood and adolescent obesity, one that takes into account far more than physiological factors.

"We're broadening our approach to the epidemic," he says, "looking at a far wider range of factors in order to have a better chance of getting closer to a viable solution to the problem. We're now considering both the social and physical environments that contribute to the obesity epidemic."

Obesity in Context

"The ways in which we as a society have constructed our social and physical environments doesn't easily enable the behavioral changes that may be necessary to achieve victories against obesity," he says. "In other words, you can't just encourage kids to take responsibility when the context of their lives actually works against them taking that responsibility."

Understanding that context requires parents to look closely at all of the activities their kids are involved in—school, after-school time, and leisure time.

"How we get around, how we spend our time, what is considered important—all of these factors can have a bearing on a child's or adolescent's nutrition and exercise," Dr. Huang says.

Walk, Don't Ride

For example, the habit of hopping in the car to give children a ride to a destination just a short distance away plays a role in creating a context in which the child thinks of riding rather than walking as the primary—or only—means of transportation, no matter how short the distance. The car is just one of countless factors, such as the constant presence of soft drinks, fast foods, and convenience foods rather than fresh fruits, juices, and vegetables.

Other factors include the amount of time spent with video games and other electronic media, and the amount of time spent indoors rather than outside. All of these play a role in creating a social context that not only encourages obesity, but also may work against solving the childhood and adolescent obesity epidemic.

"If we want to turn the obesity trend around," Dr. Huang says, "we'll need to address some of these more fundamental issues involving our way of life, our policies, our society. And to accomplish that, we'll need to address these issues as a society, on all levels."

Summer 2007 Issue: Volume 2 Number 3 Pages 26 - 27