Exercising choices: living a healthy lifestyle can be a family affair–even in busy political families.

State Legislatures July 1, 2004 | Andrade, Jane Carroll Costas Rerras has a lot of self-discipline for an 11-year-old. He loves to run, and has placed first in his age group in several races in his home state of Virginia. He adheres to a schedule, does speed and distance work, and keeps a running log.

In a nation where more and more children are becoming severely overweight, Costas is in danger of becoming the exception to the rule: a kid who gets plenty of exercise.

But Costas doesn’t run because he worries about getting fat. He runs because he likes the exercise, and he’s competitive and determined. He leaves the worrying to his dad, Senator Nick Rerras.

“We live in a culture of sweets and fats and sugar,” Senator Rerras says.

That culture is of concern to legislators and public health officials across the country. According to the Centers for Disease Control and Prevention, the prevalence of obesity among American adults ages 20 and older stands at 30 percent. Among children and teens ages 6 to 19, 15 percent are overweight, triple what the proportion was in 1980. cdcgrowthchartsnow.net cdc growth charts

Like adults, children’s weight is measured according to their body mass index, or BMI, a number that shows body weight adjusted for height. While there is one formula for calculating adult BMI, measuring it in children is gender and age specific because children’s body fat varies greatly as they grow.

For this reason, the CDC does not use the term obese to describe children. Rather, they are classified as underweight, risk for overweight and overweight. Children are considered overweight when they have a BMI-for-age at or above the 95th percentile of the CDC growth charts, meaning compared to children of the same age and gender, 95 percent have a lower BMI.

CDC data also show that another 15 percent of children are at risk of becoming overweight (a BMI-for-age from the 85th to 95th percentile) and that overweight adolescents are at increased risk of becoming overweight adults.

All these extra pounds, of course, put children at a greater risk for contracting a host of chronic diseases, particularly Type II diabetes.

Former Surgeon General David Satcher says health problems resulting from obesity could reverse many of the gains made in the United States in recent decades. He called on states and communities to encourage healthier eating and more physical activity. States have taken heed, introducing approximately 600 bills this past session to address the problem.

ON THE HOME FRONT While policymakers grapple with the government’s role in the war on fat, many legislators put their sneakers where their mouth is at home.

Senator Rerras and his wife, Gall, watch what they feed Costas and their other two children, Nicholas, 16, and Helena, 14. And because he enjoys running and spending time with his kids, Rerras does both simultaneously.

“When the kids were younger, I would pick a course to run around the neighborhood, and they would get on their bikes and come with me,” he says. “When they got bigger, they started to run.” Today, although he’s “more of a computer kid” according to his dad, Nicholas occasionally runs with the dog and shoots hoops, Helena participates on her high school track and cross country teams, and Costas runs circles around all of them.

“I am, in fact, faster than my dad,” he says.

A FAMILY AFFAIR Other busy legislators also view exercise as a way to spend time with their children. Maryland Delegate Susan Aumann and her husband, Secretary of State Karl Aumann, take walks with their children, Lang, 13, and Catherine, 9. They walk the neighborhood during the week. On weekends, they hike near Loch Raven Reservoir.

“It’s pretty fun,” Lang says of the family excursions. “It’s nice being with my parents and talking and stuff.” Washington Representative Rodney Tom, who has run three marathons and climbed air five of his state’s volcanoes, tries to instill his love of healthy living in his children, Nicole, 9, and Dylan, 7. The family hikes together, and Dylan does Pilates with him.

“What I want to encourage in them is that exercise isn’t a chore,” he says. “One, it’s good for you. And two, it’s a lot of fun.” The kids particularly enjoy an annual tradition in which the Toms join about 20 other families to visit a national park where they hike for a few days.

Tom credits an elementary physical education teacher, who required his students to run two miles each day, with contributing to his self-discipline and love of the outdoors.

“That PE teacher made an impact on my life,” he says.

Tom now wants to change other kids’ lives. He introduced a bill this session requiring middle schools in his state to adopt physical education and fitness programs. He points to research showing that among children who engage ill aerobic exercise regularly for nine consecutive months, more than 70 percent go on to become active exercisers as adults.

THE SCHOOL CONNECTION Schools are popular targets for bills seeking to fight the obesity trend.

An Indiana hill sought to mandate physical education and remove vending machines in elementary schools.

“As schools have become more and more involved in achievement standards, they have replaced physical education activities with other types of classes,” says Indiana Senator Earline Rogers, one of the bill’s sponsors.

Along with a lack of PE, an increase in the availability of snack foods in schools has exacerbated the problem. The vending machine issue in particular has proved to be a painful dilemma in many states because budget-strapped schools find it hard to turn down the sometimes millions of dollars they receive from snack food vendors.

“School systems are really selling out to kids when they give in to these million-dollar contracts to put soda machines everywhere,” says Senator Rerras. “That is not right.” Rogers, a former educator, also worries about the omnipresence of junk food in schools.

“I see a big difference in how kids used to eat and the way they eat now,” she says. “There was a time when a lot of students brought lunches to school, lunches that were made at home.” Even when healthy choices are available in the cafeteria, many students don’t take advantage of them.

“Students have opted to replace milk with soft drinks,” she adds.

As if they don’t get enough salt and sugar and fat during school, many children eat on the run after school, which often means more salt and sugar and fat. In families where both parents work, it’s difficult to find time to prepare a home-cooked meal.

Delegate Aumann can relate to that problem. Her children’s grandparents step in to cook and help care for her children when the legislature is in session, “which is a blessing,” she says.

Senator Rogers also feels lucky that even though she worked while raising her children, they were not deprived of healthy foods.

“Because I was a teacher and my work schedule coincided with their school schedule, I was able to make certain that they are meals prepared at home,” she says. “I was always conscious that they had what we called three square meals a day.” “I refuse to take my kids to fast food places,” says Representative Tom. “I try to get them to eat what is good for them that also tastes good. I have this sports drink with no sugar, and I try substituting it for sweet drinks.” As children get older, health-conscious parents admit they lose some control over their kids’ culinary choices.

“I’ve tried to work with them the best I can in terms of being healthy,” says New Jersey Assemblyman Bob Morgan, M.D., of his son Richard, a freshman in college, and daughter, Alicia, a senior in high school. “Of course we’ve had mixed success–they are teenagers.” COUCH POTATO SYNDROME They may be eating on the run, but for too many children, that’s the only running they’re doing. Their tools of recreation–television, computers and video games–shoulder a lot of the blame for an increasingly sedentary lifestyle.

“I watch my grandchildren with their Game Boys and video games,” says Rogers, “and I tell them, ‘You must have the most physically active thumbs in the universe!'” In the Aumann household, the TV is off during the school week.

“I’m into video games, and I like watching my ESPN,” says Lang, but he understands the need to exercise, and keep his grades up and develop strong study habits.

“For the first two weeks, it was hard,” Lang says of the no-TV rule, “but you just get used to it. Even on weekends, you don’t watch that much. You go outside and play lacrosse or play with friends.” Television, video games and eating out are all part of a prosperous culture that offers many options. But there are downsides to those options.

A pediatrician who is active in children’s health issues, Dr. Morgan attributes part of the weight problem to affluence.

“Twenty years ago, we saw true malnutrition in children–calorie deficits,” Ire says. “We don’t see that any longer. By and large, we see problems with obesity–too much caloric intake.” Senator Rerras agrees.

“Sometimes in life, your strengths are your weaknesses and your weaknesses are your strengths,” he philosophizes. “No one’s going hungry–that’s a strength. The weakness is that we have so much you’ve got kids in line at school ordering nachos and cheese.” Another legislator-pediatrician, Dr. Bob Cannell, an Arizona senator, believes the best way to help children is for “the whole family to turn their lifestyle around.” “We have to carve out time for exercise,” he says.

Besides the obvious health issues, there are added benefits to exercising–and exercising self-discipline when it comes to food choices.

Gail Rerras has seen Costas’ discipline in running spill over into reading. He hadn’t been a big reader, she says, until he started subscribing to Runners World magazine a couple of years ago.

“Running helps me stay on top,” agrees Costas. “Maybe if I weren’t exercising, I wouldn’t be as determined to do my work and get good grades. I used to get medium grades, and I just got straight A’s.” WALKING FOR VOTES Drive through some neighborhoods, and you will see lots of children and adults running, walking, bicycling and rollerblading. In others, there won’t be anyone sharing the road with you except other cars. Sidewalks and bike lanes are the exception rather than the norm in many areas, making physical activity dangerous.

An avid exerciser, Nevada Senator Valerie Wiener is incorporating exercise into her campaign for the upcoming election. Sporting a pedometer and setting higher goals each day, Wiener hopes to walk her entire district.

“Health and safety are both important considerations when campaign-walking in my district,” she says. “I enjoy the fitness opportunities that walking provides. Many of my neighborhoods do not have sidewalks, however. Often this forces us to take some risks by walking in the street or on the shoulder.” A number of states are working to overcome the obstacles to safe walking. As of 2003, California, Delaware, Florida, Oregon and Texas have state laws encouraging safe routes to school. Delaware’s Livable Delaware initiative also takes a comprehensive approach by directing growth to areas of the state that have prepared for it through “infrastructure investment and thoughtful planning.” A 1995 law requires the state’s Department of Transportation to include sidewalks when any road in an urbanized area is widened, built or reconstructed, if officials decide there is a current or future need. Delaware is presently revising its law to add more pedestrian access and accommodations. cdcgrowthchartsnow.net cdc growth charts

–Leslie Robbins, NCSL WHAT’S YOUR CHILD’S BODY MASS INDEX?

In children and teens, body mass index (BMI) is used to determine if they are underweight, overweight or at risk for being overweight. Fatness varies by age and sex, this is why BMI for children is gender and age specific. To figure your children’s BMI take their weight in pounds, divide it by their height in inches, divide it again by their height in inches, then multiply it by 703. Health care professionals use the following percentile cutoff points to identify underweight and overweight in children:

Underweight: Under the 5th percentile At risk for overweight: Between the 85th and 95th percentile Overweight: Above the 95th percentile THERE OUGHTA BE A LAW In the past two decades, the number of overweight American children has doubled. The number of overweight adolescents has tripled. And chronic conditions like Type II diabetes are more and more common in children.

With these kinds of statistics, how bad will it be when they grow up? Legislators are trying to stop the trend now by raising awareness, promoting physical activity, providing diabetes screening, increasing the availability of healthier school vending choices and creating task forces to propose solutions. States have taken several approaches.

Raising awareness:

* California and Illinois require noninvasive screening of school children for diabetes risk and report the results to parents.

* Arkansas became the first state to require measurement of students’ body mass index and report that information to parents.

* Colorado legislators created “Walking Wednesday,” urging parents and children to walk to school together, and committed themselves to participate in Colorado on the Move, which has now expanded to America on the Move.

Nutrition and physical activity are “the big two” in responding to childhood obesity.

Tackling nutrition:

* California provides nutrition education materials to at-risk new parents and requires nutrition education in school health curriculum.

* Michigan is funding a comprehensive school health education curriculum.

* Washington state is developing a model policy on physical fitness and nutritious school foods to be available to school districts by January 2005. The districts will have six months to adopt policies.

* Illinois and Indiana are considering legislation that would establish school nutrition standards.

* Arkansas bans elementary students’ access to food and beverage vending machines, and Illinois is looking at a similar measure.

* California is replacing carbonated beverages in all elementary and middle schools July 1 with milk, water and juice. Studies in several districts indicate that revenues have increased.

Encouraging physical activity:

* Only Illinois currently requires daily physical education classes for K-12, but legislators in Indiana, Texas and Vermont considered it last session.

* Connecticut found a way to encourage physical activity, without raising budgets, by requiring at least 20 minutes of recess each day for grades K-5.

Studying the problem:

Finally, many states have enacted obesity task forces, commissions or studies, including Alabama, Arkansas, Florida (whose task force recently issued its report), Hawaii, Maine, Mississippi, Nevada, New Jersey, New Mexico, New York, Oklahoma, Tennessee, Texas, Rhode Island, Washington state and West Virginia.

–Amy Winterfeld, NCSL Jane Carroll Andrade is a former State Legislatures editor who now writes front her home in Evergreen, Colo.

Andrade, Jane Carroll