Programs promote fitness via lifestyle.

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Two programs developed by Children's Healthcare of Atlanta successfully promote healthier lifestyles in children, and one of the programs specifically targets prevention of type 2 diabetes.

Fit Kids is a program for overweight children aged 6-12 years and their families. Since 1996, more than 700 families have participated, with an overall class completion rate of 96%, and a high level of success as measured by 2-year follow-up surveys. TIPPs is a newer program that incorporates exercise and nutrition education in an after-school diabetes prevention program for those aged 10-18 years who are overweight and at risk for developing type 2 diabetes.

The goal of the Fit Kids program is to address the escalating problem of obesity in the community by providing a comprehensive approach that engages the family, the community, and the medical community, and by providing children and families with the resources they need to overcome obesity, Dr. Seema Csukas, director of child health promotion for Children's Healthcare of Atlanta, a nonprofit pediatric health care system, said in an interview.

"The program was designed to address this struggle we are all having on how to deal with the obesity epidemic," she said.

Fit Kids involves weekly 90-minute classes for up to 12 families. Instructors help parents and children improve activity levels and nutrition with a focus on lifestyle rather than dieting, and they help families identify barriers to lifestyle changes. Other topics addressed during the 6-week program include body image, role modeling on the part of the parents, and hunger-fullness regulation. Each session includes 45 minutes of exercise.

Pre- and post-tests to assess changes in knowledge and behavior are completed by parents and children, and weekly goal sheets are completed to track completion of weekly family activities, consumption of fruits and vegetables, amount of sedentary screen time, number of family meals served, and number of sweetened beverages served. The 2-year follow-up surveys indicate that 97% of participating families serve fruits and vegetables with meals, 67% have increased physical activity levels, 58% have reduced screen time, and 98% offer milk or water with meals and snacks.

"What's nice about the program is that it's not about losing weight--it's about just doing things that are healthy and making good choices about what to eat," Dr. Csukas said, adding that Fit Kids is good not only for the child, but for the whole family in terms of a lifestyle makeover.

Also, the physical activity aspect of the program isn't just about traditional exercise, but about walking, dancing, and just moving around. "It takes something that might seem overwhelming and makes it easier," she said.

Similarly, TIPPs also focuses on a lifestyle makeover, she said.

TIPPs participants undergo baseline labs, height and weight measurements, and fitness testing, and they complete an eating habit questionnaire. On the basis of the findings, individualized exercise and nutrition plans are developed. Participation requires twice weekly 45-minute exercise sessions.

The TIPPs program includes nutritional consultations and food demonstrations to model healthy eating, and also focuses on self-esteem issues.

The ultimate goal is to prevent the onset of type 2 diabetes.

At 12 weeks, participants are reassessed, and healthy lifestyle goals are redefined.

In 2005-2006, 65% of participants completed the 12-week program. Of those, 78% decreased or stabilized body mass index, 61% decreased total cholesterol, 61% decreased LDL cholesterol, 54% increased HDL cholesterol, and 57% normalized or decreased fasting insulin.

The Fit Kid and TIPPs programs were among those honored recently with an Innovation in Prevention Award by the U.S. Department of Health and Human Services.

The Innovation in Prevention Awards--part of President Bush's HealthierUS initiative and HHS' continuing focus on preventive health--recognize organizations that provide novel and creative chronic disease prevention and health promotion programs. Children's Healthcare of Atlanta received the initiative's Health Care Delivery System Award for the two programs.

In granting the Innovation in Prevention Awards, HHS hopes to increase public awareness and promote duplication of successful strategies like those developed by Children's Healthcare of Atlanta, according to an HHS statement.

BY SHARON WORCESTER

Southeast Bureau

DATA WATCH Percentages of Overweight U.S. Youth are Increasing Age 2003-2004 1999-2000 2-5 years 10.3% 13.9% 6-11 years 15.1% 18.8% 12-19 years 14.8% 17.4% Source: Centers for Disease Control and Prevention Note: Table made from bar graph.