At the Batchelor Children’s Research Institute at the University of Miami, kids are riding a special stationary bike attached to a video game. To win the game, they must pedal faster and faster.
Then, they move onto dancing, jumping, kids yoga and other workout routines cleverly masquerading as “games.”
Later, the kids learn about healthy eating — and the dangers of sugary sodas and juices, whole milk and snacks like potato chips and cookies.
It’s all part of CRUNCHTIME (Children’s Rehabilitation Unit for Nutrition & Cardiac Health), a nine-month program the university began four years ago to help overweight or health-challenged children and adolescents get fit and healthy.
“We’ve seen kids lose a tremendous amount of weight,” said Dr.Tracie Miller, program director. “We’ve definitely had them become more active and engaged. We do a lot of education, with the children and the parents. Getting the parents onboard is key.”
According to the Centers for Disease Control, more than one-third of U.S. adults are obese. Obesity has been linked to heart disease, stroke, type 2 diabetes and certain types of cancer, making it one of the leading causes of preventable death.
Historically, obesity primarily affected adults. But in the last 20 years, that has changed: 15 to 25 percent of American children and adolescents are now obese. From 1980 to 2008, the prevalence of obesity in children ages 6 to 11 tripled from 6.5 percent to 19.6 percent. In teenagers, it has more than tripled, from 5 percent to 18.1 percent in the same time frame.
CRUNCHTIME is one of a growing number of programs aimed at helping reverse obesity at a young age and teaching children the importance of fitness and healthy eating so they develop good habits at an early age.
Open to kids from 5 to 18, the program begins with an in-depth, two-day physical assessment by pediatricians, nutritionists, psychologists and fitness experts. An exercise program and diet is tailor-made for the child, who returns twice a week for one-on-one fitness sessions at UM’s special pediatric gym and nutritional follow-up. The program also targets children with chronic illnesses such as diabetes or cardiac disease.
After three months, the child — and parent — take home what they have learned and are monitored for six additional months. And therein lies the challenge.
“During the initial three months, everybody improves,” said Gabriel Somarriba, one of the program’s two physical therapists. “The program is set up to have the patient increasingly take on responsibility for his or her own health. We have a lot less data after nine months. But we’ve learned that people are not as compliant when they are not monitored.”
In fact, at least one patient has returned to CRUNCHTIME for a second try.
Key to success is parent participation, say program organizers. If the parents don’t change their eating and fitness habits at home, the child will probably fall back into those bad habits, they say.
“It really only works when the parents decide to make these changes for themselves,” Somarriba said. “Essentially, the family has to buy into it.”
“You can’t isolate a child and say you have a weight problem and the rest of us don’t and we’re going to keep the cookies in the cupboard,” she said. “It’s much more successful when the parents buy in.”
South Miami Hospital is also combating adolescent obesity, but in a somewhat more dramatic way. The hospital is one of a small number to offer bariatric surgery to adolescents. The earliest a teen can have the procedure is at 14, when bone mass is considered mature enough.
Hundreds of teens have had the various surgeries — lap band, bariatric and sleeve — since the hospital first offered the surgery in 1998, said Dr. Anthony Gonzalez, head of South Miami Hospital’s Weight-Loss Surgery Program. Seventy-five percent of patients have been female.
Teens must pass a rigorous screening by doctors, psychologists and physiotherapists to become eligible for the procedures, and must be morbidly obese.
“We understand that obesity is a big problem in this country, not only for adults but for children, and it’s growing exponentially,” Gonzalez said. “We’re now seeing kids with high blood pressure, diabetes and sleep apnea. We’re seeing kids 100 to 200 pounds overweight.”
Gonzalez is the first to admit that bariatric surgery for youths is somewhat controversial. Some in the medical community have questioned whether children that age should be making decisions about surgery and whether such drastic measures are appropriate for a minor.
“A lot of hospitals probably don’t get involved in this because the amount of work it takes to create an adolescent program is tremendous,” he said.
Yet South Miami Hospital touts a higher degree of success for teen bariatric surgery over adult bariatric surgery.
“We’ve noticed that success and compliant rates in kids is better,” Gonzalez said. “You can teach a new dog a new trick rather than an old dog a new trick. It’s a behavioral problem, and it’s hard to teach a 40- or 50-year-old new behaviors.”
Memorial Hospital is getting into kids’ fitness, too, offering a boot camp for kids at its fitness center.
The program, held Saturdays from 10 to 11 a.m., is geared to any child that wants to get into shape, not just overweight children. The hospital also offers a weight management program for kids age 6 to 12 called Shapedown.
It is offered for two hours on Saturdays for 10 weeks. Shapedown teaches kids lifestyle changes but does not seek a quick fix or a “diet.”