Kids in Motion Stay in Motion

It’s not exactly a news flash: children are experiencing serious health problems and a poor quality of life. More kids than ever suffer from the effects of poor nutrition and lack of exercise, and the child overweight/obesity rate has nearly tripled over the past 40 years (Alliance for a Healthier Generation 2006). At the start of 2008, most fitness professionals are aware of the issues and challenges of this epidemic, and many are looking for ways to turn the statistics around. Those numbers represent real children in desperate need of real help and guidance.

But what is the solution? Should we follow the recommendations of Oxford University researchers in Great Britain who recommend a “fat tax” of 17.5% on foods deemed to be unhealthy (Griffiths 2006)? Do we join the chorus of voices demanding that physical education (PE) be required daily in all schools? Do we get social services involved and remove severely obese children from their parents’ care, as almost happened to an 8-year-old boy in England (Templeton 2007)? Or do we follow in the footsteps of some of our colleagues, both corporate and individual, who are coming up with unique ways to improve the exercise and lifestyle patterns of our youth?

Big Companies, Big Plans

At Fitwize 4 Kids, aimed specifically at youth ages 6–15, parents are sent away while their children work out. “Although we involve the parents, since we do consider exercise to be a lifestyle issue, this is a club for kids,” says Warren Gendel, the founder and chief executive officer (CEO) of the Novato, California–based franchise. “We offer a variety of classes that are 45 minutes in length. We [emphasize] nutrition and self-esteem, and there are no mirrors or scales.” A former personal fitness trainer who wrote his university thesis on kids’ fitness, Gendel spent a number of years selling high-end fitness equipment before following his passion and starting Fitwize 4 Kids. He used his knowledge and background to fill Fitwize facilities with equipment that was specially designed for kids’ bodies and allows for multijoint, closed-kinetic-chain movements. As they progress, kids earn reward “bucks” that can be redeemed for iPods, baseballs and other youth-friendly prizes.

But Fitwize 4 Kids is about more than just exercise—there is also a registered dietitian who teaches nutrition workshops and leads roundtable discussions. “Our workshops are meant for kids, yet parents are encouraged to attend,” says Jasmin Ilkay, director of nutrition at Fitwize. “Our lessons, with titles such as ‘Snack Attack,’ ‘Are Food Companies Selling You Junk?’ and ‘How Food Is Used by the Body,’ are hands-on and activity-based.”

While Gendel created an entirely new business in order to serve kids, the YMCA of the Brandywine Valley in Chester County, Pennsylvania, took advantage of its established position to promote H.I.P. Kids, its Health Intervention Program for children 8 years and older who are at or above the 85th percentile of body mass index (BMI) for their age. Meredith Griffin, special projects coordinator for the YMCA, emphasizes that H.I.P. Kids is not a weight loss program. “It’s about a healthy lifestyle and the daily choices kids and their parents make,” she says.

During the 12-week program, kids have a weekly 1-hour session that incorporates physical activity and nutrition information. During a second weekly session, the children learn more about their bodies and how to select exercises. They also participate in a group discussion on a behavior modification topic. With an eye to the YMCA’s mission to build strong minds, bodies and spirits, the H.I.P. Kids program stresses character values, self-esteem and self-confidence so that participants feel they have control. “When kids are in an environment where they feel supported, they gain confidence in their abilities, which is particularly important when it comes to issues such as emotional eating, goal setting, positive self-talk and accountability,” states Griffin. The YMCA’s approach focuses on the cause-and-effect aspects of inactivity and obesity, while building on the organization’s history of defining “whole-body strength” as it relates to its mission statement. As a measure of its success, the H.I.P. Kids program is eligible for reimbursement through the local Blue Cross.

Involved Individuals

Whether their latest client is an asthmatic teen who can only lightly jog 20 feet, a 10-year-old who strength trains or a toddler who pretends to be a tadpole, many fitness professionals are working within their communities to positively impact children. In Dunwoody, Georgia, Karen Wells, director of The First Step, has been working with children since 1979. Her emphasis has been on creative exercise, with a focus on movement for young children. Rather than tell the kids that they’re exercising, Wells announces that the group is about to go on a mystery tour through a magic garden, where they’ll see a beautiful pond. From their vantage point on a fitness mat the children then become tadpoles, fish, flowers, rabbits and butterflies. They also practice making numbers and letters, combining exercise with reading readiness skills.

Wells wants to instill a lifelong love of movement, and so she has designed and led ballet, jazz, tap, modern dance, flexibility and yoga programs that take youth up to their teen years. “I started a sports camp for kids back in 1989, and now in 2007 there are more than 100 kids a week participating in the summer months,” says Wells. “Some of my ballet students go on to study dance in college. Even though I’ve now reached a ‘certain age,’ I still plan to teach for at least another decade.” Wells believes more than ever that today’s youth can and should “jump so high [they] can touch the sky.”

On the other side of the United States, personal fitness trainer Benjamin DeLuca, director of fitness at the Keystone Athletic Club in Poway, California, shares his viewpoint on what it takes to develop a successful children’s regimen. “It is important for children to respect themselves and find value in the time [they share with you]. I structure my programs with five major components—motivation, fun, education, progression and guidance. Times have changed from the days [when we sent] kids outside to play with friends. Nowadays the kids are less likely to come back covered in sweat and dirt than they are [to have] a sore thumb from playing video games.”

Less athletic children, according to DeLuca, have a very different motivation than their more athletic counterparts. “The [less fit youth] usually have very little experience with exercise and at first don’t really have a desire to improve,” he says. “The key is to educate them on the benefits of exercise and get them excited and made to feel accepted.” DeLuca tells the story of a former overweight, teenage client who was also asthmatic. “The first day I worked with him I had him lightly jog 20 feet. He was completely breathless and in need of his inhaler. After working with me 2–3 days per week for the entire summer, he’d lost 20 pounds and could run a mile without his inhaler. A year later I discovered he had made the baseball team and was starting at first base, and had plans to try out for football. I believe the introduction to exercise changed his high-school experience.”

Part of the reason why DeLuca has been so successful is that he tries to look at things from the child’s perspective. “Kids have fears and insecurities. I try to connect with them by simply letting them know I was once where they are and have also experienced fear and awkward discomfort. Sometimes I share an embarrassing story of my own.” Once the child is invested, DeLuca turns his attention to the parents. “[In addition to working on a biomechanically sound program with my young client] I find holding a parent-trainer meeting works well. It educates parents about making healthy dietary choices, as they are the ones who do the grocery shopping. When parents see the value in making time for their own health, it trickles down to their offspring.”

Cammy Dennis of Ocala, Florida, is currently the fitness director of On Top of the World Communities Inc., but she has held many titles, including being the creator of children’s programs and television workouts, co-developer and co-author of the “Kids in Motion” specialty certificate and co-author and presenter of the Kids in Motion DVD. Dennis is now a board member of the StartFit Foundation, whose aim is to help prevent and reverse childhood obesity by working within the community to teach healthy eating behaviors and promote regular physical activity. Working in tandem with police officers, exercise physiologists, registered dietitians, pediatricians and wellness directors, Dennis and her team coordinate countywide events with names such as Discovery Run, Pee Wee Olympics, Brick City Run, Zany Olympics and Safety Day. With a focus on prevention, StartFit designs events that include families, local businesses, schools and adult role models. Booths offer prizes and promote healthy activity and nutrition in appealing ways. Dennis and StartFit have come up with six motivational factors they believe hook kids on fitness: fun, success, variety, family support, peer participation and enthusiastic coaching instruction. In addition, they’ve listed four discouraging factors: boredom, feelings of failure, overemphasis on competition and overuse injuries.

In Augsburg, Germany, Carrie Ekins, MA, founder and director of Drums Alive™—Kids Beats, has hit (and pounded and whacked) upon a novel approach to fitness—drumming on stability balls! Ekins leads children through choreographed patterns that include whole-body opportunities for really letting loose with the drumsticks and hands on the ball. Whether sitting or standing, some overweight Drums Alive participants have commented that it’s a positive experience for them because they feel “sheltered” behind the balls and don’t see themselves shaking or jiggling as they might in a standard exercise class. And even during the seated portion of class, the students perceive themselves as getting a strenuous workout because they are more comfortable, which enables them to keep going for longer.

Ekins has documented many positive results that help children with their life management skills, including increased confidence, perseverance, concentration and social competence and decreased aggression and stress—all of which are necessary skills for overweight children who are trying to make long-term changes to the way they make decisions, set goals and perceive their place in the social hierarchy. Ekins is an enthusiastic believer in the power of rhythmic drumming to “heal the mind, body and soul.”

University Programming & Research

In January 2006, Thomas Nesser, PhD, was awarded a 4-year Promising Scholar grant by Indiana State University in Terre Haute, where he is an assistant professor in the department of physical education. Nesser, who also serves on the National Strength and Conditioning Association’s education committee, is seeking solutions to improve children’s fitness levels. Given to fund “An Evaluation of the Effectiveness of a Community-Based Childhood Obesity Treatment Program on Improving Physical Activity and Dietary Patterns of Child and Parent Participants,” this grant has enabled Nesser to focus on the prevention and treatment of childhood weight concerns through the Healthy Choices for Life program. This program seeks to improve children’s nutrition choices, increase their physical activity and enhance their self-esteem.

In addition to working with children and their parents, Nesser involves his university students, both as future PE instructors and as mentors. For example, during Indiana State’s annual PE Field Day, local elementary-school students come to campus and participate in activity stations designed and led by the university students. Nesser’s students also act as mentors for the children enrolled in the grant program and accompany their young charges during bike rides, walks and games. Although results have been mixed so far, Nesser has seen specific improvements. “Some children have lost weight, some have maintained and a few gained weight,” he says. “Compliance has been low, but for the most part feedback from the children is positive.”

Nesser expects compliance and participation to climb and childhood obesity rates to decline, especially if parents, educators and other community members demand the re-establishment of daily PE in schools. “I challenge my undergraduate and graduate students to be part of the solution,” he says. To this end, Nesser suggests that every PE class should include resistance training, enjoyment and maximal movement—no standing around.

With a few more years left to complete his research, Nesser emphasizes the importance of the child-parent collaboration. “Maintaining a healthy weight is more than random dieting; it’s about lifestyle. The habits practiced by the parents are often passed on to the child. Our program tries to break these bad habits. [Part of my goal with the grant] is to help parents take responsibility for their child’s obesity and future health issues. Although obesity is in the headlines, I don’t think the concern has truly hit home.”

Technology: Talking Kids’ Language

Although it’s hard for many adults to wrap their minds around the idea that fitness and video technology can be complementary, just as many people believe that video/computer games can be the “portkey” for getting kids to connect fitness with fun. While a lot of publicity surrounds Nintendo’s new Wii Fit™, an exercise game that uses a balance board controller manipulated with the feet, several companies have been emphasizing the fitness-technology connection for a while.

At the 2007 IDEA World Fitness Convention™, the XaviX® booth was always busy. Kids (and adults) ran, jumped, ducked, hopped and danced on a J-MAT®, which is a type of pad that is hooked up to a variety of interactive video games. The choices ranged from a 10-second running-in-place challenge to a 32-minute “Step Lively” cardio workout. However, the most popular seemed to be the 5-minute Jackie Chan obstacle course (complete with ninjas) that had kids happily sweating as they tried to beat their own records. The booth also featured interactive sports, including tennis, golf, boxing and others. Perhaps part of the appeal was that kids viewed the programs as games rather than exercise, which seemed to be the byproduct.

As part of its commitment to health and fitness, XaviX also offers a Lifestyle Manager system that tracks weight trends, body measurements and vital indicators. The system provides stretching and exercise examples as well. “Our company was founded with a shared vision of contributing to society by creating innovative, new-generation products that utilize technology to deliver enrichment, enjoyment and social interaction,” says Peter Newman, U.S. general manager for XaviX programs, from his office in San Diego. “We are working with universities around the world to study the impact our products have on battling inactivity, and from there to see if this increased activity helps fight obesity, hypertension, coronary heart disease, type 2 diabetes and so on.” So far, in a soon-to-be-published study conducted by researchers at California State University at San Bernardino, children were shown to have a very positive predicted caloric expenditure per week playing the J-MAT games versus watching cartoons (Brandt, Haddock & Wilkin 2006).

HOPSports™, a multimedia PE system, uses technology in a different manner. Used in schools, Boys & Girls Clubs, YMCAs and other settings with large juvenile populations, the multiscreen format provides fitness lesson plans that meet state and national standards while integrating nutrition, fun facts, anatomy instruction, career counseling and other educational information for students in kindergarten through grade 12. Entire classes of children participate simultaneously, following on-screen directions given by a variety of famous athletes and Olympians. Kids are still doing push-ups, ladder and balance work, fitness ball drills and other standard calisthenics moves, but it’s set up in a fun way. As one eighth-grader from a participating school in Marina del Rey, California, commented, “They should keep HOPSports in PE because it teaches me how to do things like balance or simple exercises. It is really helping me get stronger muscles, and it’s cool.”

“HOPSports merges training for physical fitness with technology, which mirrors the way today’s youth access information,” says Tom Root, CEO of the Valencia, California, company. Plans for the future include expanding the library to include dance and sport-specific content, and moving into facilities that have been traditionally adult-focused. HOPSports has also forged important affiliations with organizations like the National Association for Sport & Physical Education, the Chicago Bulls foundation (CharitaBulls) and the California Association for Health, Physical Education, Recreation, & Dance. In 2006 HOPSports ran a 6-week test with 187 participants in conjunction with the Chicago Bulls and Polar. The results included an average weight loss of 2 pounds per participant; strength and flexibility improvements of 10% and 5% respectively, and a 10% decrease in total scores for BMI. As Root enthusiastically states, “We are exciting an inactive generation to become active.”

The Doctor Is In(novative)

Twenty years ago, Naomi Neufeld, MD, FACE, of Los Angeles, saw the oncoming weight epidemic as she treated a growing number of children with no underlying medical problems except their weight. Her reaction was to create a family program called KidShape®. Now licensed in more than 30 U.S. locations, and in several languages, KidShape has a well-defined curriculum that reflects input from physicians, dietitians, mental health professionals, physical activity instructors and other experts. The program is divided into three parts: the families attend nutrition classes, participate in facilitated group discussions about changing bad habits, and exercise with a certified instructor. There is also a three-part, at-home component that involves exercise, eating-habit modifications and food journaling. This plan follows what Neufeld lists as the four critical aspects of pediatric obesity treatment: nutrition education based on the USDA Food Guide, physical activity, family/parental involvement and support, and help with the children’s psychological issues, with an emphasis on behavior modification and self-esteem.

As a medical professional, Neufeld is committed to measurable outcomes, and has done extensive research on the KidShape program. According to Christiane Wert Rivard, MPH, RD, program director for KidShape, “We are dealing with a growing and particularly difficult problem, namely the prevention and/or reversal of childhood obesity. We have seen students significantly decrease their fat and sweets consumption and increase their fruit and vegetable consumption after attending our classes. Additionally, they are more active and the hours they spend doing sedentary activities, such as watching television, have decreased. Our experience confirms what experts have long held to be true—successful treatment is more likely when we help children and their families together to establish good habits before bad habits are firmly entrenched.”

The people and programs reviewed in this article are making a difference in unique and creative ways. Nothing they’re doing is earthshattering, and yet all have the potential to change the world for our children. Everything they’re doing, the rest of the fitness industry can do. We all have something in common with these innovators—passion, commitment, imagination and knowledge.

SIDEBAR: Tips for Starting Your Own Kids’ Fitness Program

Here are some practical tips to help guide you as you contemplate working with children.

1. “Make it fun and interesting. Keeping a child entertained is a challenge, and I’m always working on that secret combination of education and activity.”
   —Thomas Nesser, PhD, assistant professor at Indiana State University, Terre Haute

2. “Start a program in a facility that already houses kids—schools, churches or temples, recreation or daycare centers, clubs and fitness centers.”
   —Karen Wells, director of The First Step, Dunwoody, Georgia

3. “Assess the ability level of your client or group and do the right progressions. If you are working with deconditioned overweight kids, any exercise will be hard, so keep it simple and fun. Don’t overwork them—make it a positive experience.”
   —Benjamin DeLuca, director of fitness at Keystone Athletic Club, Poway, California

4. “Let the kids and parents know in advance that they will reach a point, probably around the 3-month mark, where the kids might want to drop out. Get a commitment that they will overcome this hurdle and stick with it, as the kids do get reinvested within a week or two.”
   —Warren Gendel, founder and CEO of Fitwize 4 Kids, Novato, California

5. “Especially with younger kids, you need to make exercise ‘play based.’ Kids need to learn to move, and they need to move to learn. For example, in order to teach the skills for making healthy food choices, I have the kids play a relay game where they select empty food containers that represent different types of choices. The containers are scattered around the room, and [the kids] have to run and put the containers into boxes marked ‘Go,’ ‘Slow’ and ‘Whoa.’”
   —Cammy Dennis, fitness director of On Top of the World Communities Inc., Ocala, Florida

6. “We recommend that parents educate themselves on sound nutrition. Also, start out with small amounts of activity and increase it as time goes by. And be careful about sending negative messages—if we have kids do push-ups or laps as punishment, that will counteract the message that movement is fun and healthy.”
   —Tom Root, CEO of HOPSports, Valencia, California

7. “Incorporate technology, as this is a medium kids relate to. Provide the ability to track results. Kids are smart and catch on quickly, so speak up to them; tell them what they’re doing and why, and how it impacts their lives. Kids are familiar with the adage ‘Do as I say and not as I do,’ so get involved and be a role model.”
   —Peter Newman, general manager of XaviX, San Diego

8. “[Overweight] kids already know they are bigger than other kids and are probably teased, so use a positive and instructive approach. With so many confusing messages out there, be consistent and provide real information and guidance. Watch how you talk about exercise—if you complain, they will too. Avoid comparisons, as there will always be a loser. Appeal to schools and municipalities to increase opportunities, whether it’s more recess in school or accessible parks and trails in the community.”
   —Meredith Griffin, special projects coordinator at the YMCA of the Brandywine Valley in Chester County, Pennsylvania

9. “Include the whole family. Not only will everyone lose weight and feel better, but being active as a family strengthens relationships and provides a positive support system. Provide follow-up support as needed, whether by mailings, meetings or message boards.”
   —Naomi Neufeld, MD, FACE, founder and medical director of KidShape, Los Angeles

Alexandra Williams, MA, has two fit children who are allowed 1 hour of television/computer time a day and are forced to go outside and play, with complete disregard for the weather.

References
Alliance for a Healthier Generation. 2007. Facts and Figures: Health consequences. www.healthiergeneration.org/about.aspx?id=316; retrieved Nov. 15, 2007.
Brandt, A.M., Haddock, L.D., & Wilkin, H.S. 2006. The use of interactive video games for exercise in children. California State University, San Bernardino. Unpublished study.
Griffiths, P. 2007. “Fat tax” could save 3,200 lives each year. Reuters, July 12.
Templeton, S-K. 2007. Fat boy may be put in care. TimesOnline, Feb. 25.
Resources

Alliance for a Healthier Generation, www.ideafit.com/kids
American Council for Fitness & Nutrition, www.acfn.org
Drums Alive, www.drums-alive.com
Fitwize 4 Kids, www.fitwize4kids.com
HOPSports, www.hopsports.com
KidShape Foundation, www.kidshape.com
Life Fitness Academy Circuit Series, www.lifefitness.com
SSD Company Limited, www.shinsedai.co.jp/index_e.html
Start Fit Foundation, www.startfit.org
XaviX, www.xavix.com