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Alarms on youth obesity in Mass.

School study finds 1 in 3 overweight; sharp disparities linked to income

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By Stephen Smith
Globe Staff / September 9, 2010

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More than one-third of Massachusetts students evaluated during the 2008-2009 school year were overweight or obese, according to a report released yesterday that revealed stark differences in how the obesity epidemic has touched cities and towns.

The study, which reflects weight and height measurements for about 110,000 students, for the first time provides data on separate school districts and underscores the role of poverty and affluence in determining weight.

Lawrence, one of the state’s poorest cities, had the highest rate of students with excessive weight, about 47 percent. Arlington, a wealthier suburban community with a longstanding commitment to nutrition and exercise campaigns, had the lowest level, about 10 percent.

“Impoverished, and especially inner-city communities, are almost optimally designed to promote obesity, depriving children of access to high-nutrition, lower-calorie foods like fruits and vegetables and beans,’’ said Dr. David Ludwig, director of the Optimal Weight for Life program at Children’s Hospital Boston. “And at the same time, those communities make physical activity either inconvenient or dangerous.’’

The state Department of Public Health report contained results of nurses’ measurements of students in the first, fourth, seventh, and 10th grades in 80 school districts. About 34 percent of these children exceeded recommended guidelines for healthy growth, consistent with earlier, less rigorous studies based on families answering surveys.

Public health authorities and pediatricians were alarmed by the wide weight variations discovered among cities and towns, some just miles apart.

“The statistic that impressed me the most is a fivefold difference from community to community. That is huge,’’ said Dr. Alan Woodward, a member of the state Public Health Council and former president of the Massachusetts Medical Society.

Massachusetts last year joined a growing roster of states mandating that public school districts calculate the body mass index for every student.

By the end of this academic year, every school must complete at least one round of screenings, with reports sent home to parents. But select districts have been collecting the data for several years, and the findings released yesterday provide a window into those schools and a benchmark for the future.

Known by the acronym BMI, the measurement is a widely used standard that plugs height and weight into a formula to determine the appropriateness of someone’s size. For children, the BMI calculation is more complex than for adults because their scores take into account expected growth patterns.

The BMI scores of children are converted to a percentile score showing how they compare with what is considered optimal for children of the same age and gender.

A child who scores in the 85th to 95th percentile — meaning their BMI is significantly higher than what is recommended — is considered overweight. Youngsters above the 95th percentile are regarded as obese.

The new study, which represents 38 percent of students statewide in the tested grades, found that 16.9 percent of children were overweight and 17.3 percent were obese. The Massachusetts obesity rate mirrors national studies, which have found that 17 percent of 2- to 19-year-olds are obese.

Weighing too much as a child can set a youngster up for a lifetime of health problems, including heart disease, specialists said.

And the consequences of the childhood obesity epidemic — more than two decades in the making — already appear evident in a city such as Lawrence. State figures show premature deaths and hospitalizations due to cardiovascular disease are substantially higher there than statewide averages. In Arlington, by contrast, they are substantially lower.

“While this is a statement about what we currently know about kids, communities would be well advised to consider it as a snapshot of what their community is going to look like unless they are able to plan for a different trajectory,’’ said Dr. Lauren Smith, medical director of the Department of Public Health.

“If you are a city or town where 40 or 50 percent of your 10th-graders are overweight or obese, you can reasonably predict that same proportion of adults — or more — will be overweight or obese in the future,’’ Smith said.

The result of excessive consumption of sugary soft drinks and high-calorie foods and a lack of exercise are evident in the halls of schools in Lawrence, Fitchburg, and Boston — among the districts with the heaviest students.

“It saddens me and yet motivates me to do more to increase the educational and nutritional offerings, the physical education offerings,’’ said Pamela Rivers, nurse leader for the Fitchburg schools.

At her Boston school, Naia Wilson watches students forgo cafeteria meals in favor of remnants from the previous night’s dinner.

“Oftentimes, it’s filled with carbs or fatty meat,’’ said Wilson, headmaster of the New Mission High School in Roxbury. “It’s not a well-balanced meal.’’

To help change behaviors, a teacher with a particular flair for whipping up tasty salads started bringing samples to school gatherings — instead of cakes, cookies, and chips. And New Mission began offering students an elective: walking. Teachers and students go for strolls to help youngsters develop exercise habits.

In Lawrence, a pilot program begins this year in one middle school that will introduce students to rowing machines. And, perhaps as soon as October, a local rowing group plans to open its doors to children — and their parents.

“Everything starts at home, whether it’s education, whether it’s wellness,’’ said Kathleen DeFillippo, health and nursing services coordinator for the Lawrence schools. “We want to see if a few families enjoy it and then they can spread the word.’’

In many respects, those districts are following the lead of Arlington, which has emphasized healthy eating and exercise for years. The lessons start in kindergarten and continue in middle school with the 5-2-1 program — eat five vegetables a day, restrict TV and computer use to two hours a day, and exercise for one hour. In high school, a fitness room is open free of charge to students and staff.

Parents of middle and high school students can even see exactly what their children are eating every day. There’s no more cash in the cafeteria. Instead, families add money online, and children punch in their ID code when they get food, which, in turn, records their every order, said Cindy Bouvier, director of wellness and counseling at the Arlington public schools.

Liz DiNolfo, president of the townwide Parent Teacher Organization in Arlington, has two daughters in the public schools there. Many children, she said, live no farther than 2 miles from their school and get there on foot. There are recreation centers for playing, and an array of locally owned restaurants for healthy eating.

Just the other night, she found herself at a sushi restaurant with her fifth-grade daughter.

“She had a seaweed salad and miso soup,’’ DiNolfo said. “And I thought, ‘This wasn’t the kind of food I grew up on.’ ’’

Stephen Smith can be reached at stsmith@globe.com.

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