One Town Gets Children to Live a Healthy Lifestyle

Sari Harrar


"The school cafeteria had given kids -- even kindergartners -- whole fruit at lunch, and Ben was so excited he brought his home to share with his brother, his dad, and me. He called it 'The Family Fruit,'" recalls Ben's mother, Anna Huckabee Tull. Her son, who used to eat few fruits, and only after his mom had peeled and sliced them for him, was suddenly thrilled to have an entire apple. "Ever since, he's arrived home with fruit almost daily. And he started eating things I never thought he'd try, like tangerines and pears. I was blown away."

That was just the beginning. Thanks to Shape Up Somerville -- a groundbreaking antiobesity program in Somerville, MA, spearheaded by public schools, local government, and Tufts University -- the Tull family not only eats more healthily, they've begun biking around town for fun. And Ben, now in third grade, has started packing his own healthy snacks to earn extra points in a classroom good-eating competition. "We had wanted to be health-conscious, but Ben's led the way for the whole family," says Tull, 43.

Five years ago, when Somerville launched the battle for its children's health, the odds against the city of 77,000 seemed insurmountable. Almost 45 percent of its first, second, and third graders were overweight -- 50 percent higher than the national average. The high-speed commuter traffic thundering through on its way to nearby Boston and the lack of open space (95 percent of Somerville's four square miles is developed) meant that kids had few opportunities for physical activity. Most ate far fewer than the recommended five to nine servings of fruits and vegetables a day. The unofficial Somerville High School lunch? Cool Ranch Doritos and blue Gatorade.

But the Shape Up Somerville program worked. Kids got closer to their ideal weights, grew healthier, and actually enjoyed it. During the first year, 2003-04, students in grades 1, 2, and 3 gained, on average, about one pound less as they grew than children in other comparable towns. The shift sounds small, but to the scientists, it's remarkable. When the best news about kids' obesity we've had in 25 years was May's report from the Centers for Disease Control and Prevention that skyrocketing rates may have leveled off, Somerville bucked the national trends -- within the program's first school year of operation. And while the study focused on younger elementary schoolkids, the wholesale changes the town made likely benefited every child in the system, right up through high school.

The program never used the words "fat," "diet," or "weight loss" with the children. "Strong, powerful, and healthy. That's what the kids told us they want to be," says the study's principal investigator, Christina Economos, Ph.D., the Friedman School at Tufts University New Balance chair in childhood nutrition. "So those were the words we used and that parents can use, too, when they talk about healthy food and activity." Besides, this really isn't just about weight. "Exercise keeps bones and muscles strong and helps kids focus in school," she explains. "Nutrients like calcium, fiber, and all the vitamins, minerals, and antioxidants in fruit and vegetables protect against a wide range of diseases." Developing a strong, powerful, healthy sense of self could even discourage a child from drug and alcohol abuse in adolescence, research in teens suggests. And when a child reaches the teen years at a healthy weight, he's less likely to be overweight in adulthood, which in turn lowers his risk of type 2 diabetes, heart disease, and even some kinds of cancer as he gets older.

Shape Up Somerville's not-so-secret weapon: the three simple principles by which its kids now live.

* Consume fewer fatty snacks and sugary soft drinks.
* Eat more fruits, vegetables, whole grains, and low-fat dairy.
* Get more physical activity.

But the genius of the program lies in how the town got its kids to embrace the kinds of healthy behavior that most children wouldn't agree to even on Mother's Day. Read on for how you can make these transformations just as appealing and permanent at your house.

Step One: Jettison (Most of) the Junk

Supersweet soft drinks. Cookies. Greasy potato chips. Cupcakes at fund-raisers and class parties. School-day snacking in Somerville, as in many towns across America, meant sugar, saturated and trans fats, and oversize portions. "But we changed all that," says superintendent of schools Tony Pierantozzi. The new snack norm: baked chips on the older kids' à la carte menu; a small cookie or pudding as dessert only occasionally in the elementary schools. And the district scaled back the number of party days to limit kids' sugar intake.

The program also persuaded 21 local restaurants to offer healthier choices -- low-fat milk, side dishes of fruits and vegetables, and smaller portions -- and designated the participants as Shape Up Somerville-approved eateries. "Our favorite Chinese restaurant was on the list," says Somerville parent Susan Kamin, 48: "It's good to know you can get healthy takeout from a place where your family already likes to eat."

Taking a stand against the toxic food environment in which kids (and adults) live is crucial. "The empty calories in snack foods and soft drinks mount fast," Economos says. "There might be 300 calories in a large soda. But a 50-pound second grader uses just 30 calories when he walks a mile. Burning it all off is nearly impossible."

Try This at Home

Make your house a healthy-snack zone. "Talk with your kids about why it's important to eat mostly healthy food and save sweets and fatty food for treats, then set limits together," Economos advises. Here's how:

* Don't demonize dessert: "It's part of the variety you should have in your diet," says Mary Joan McLarney, Somerville's public schools food-service director. "But we keep portion sizes for sweets small and only offer them once a week." Try reducing everyone's serving sizes at home -- and endorse the idea by being visibly satisfied with your own helping. By doing so, you'll help equip your kids to make healthier choices even when you're not there.
* Prep healthy grab-and-go foods: Place them strategically in the fridge and cabinets for supereasy munching options. A few Somerville-tested ideas: low-fat yogurt; veggies with a little low-fat salad dressing; applesauce; a handful of whole wheat pretzels, sunflower seeds, and baby carrots; even easy-to-prepare low-fat turkey or taco roll-ups, made with low-fat cheese.
* Stop stocking sugary drinks: A single can or bottle of soda, sweetened tea, or fruit punch can pack 200 to 300 calories. Make water, herbal unsweetened iced tea, and fat-free or 1 percent milk your household's default drinks. You'll cut hundreds of useless calories out of your child's day almost effortlessly.
* Know when to bend the rules: Surprisingly, kids can still buy chocolate milk at lunch in Somerville's schools. "Many children don't get the three servings of dairy products they need each day during these crucial bone-building years," says McLarney. At 150 calories, an eight-ounce carton of chocolate milk has about 40 more calories than plain low-fat. She judged the compromise worthwhile -- and you might, too, especially if you stick with one serving a day and cut back on other treats.
* Send fruit or favors for school fetes: Take a stand against high-calorie party fare by providing grapes or nonfood treats like colored pencils, fun erasers, or cartoon-character stickers. The kids will adjust: Most Somerville students aren't even aware that their party fun food is unusually healthy.


Step Two: Make Healthy Food Its Own Reward

The mouthwatering aroma of tomato sauce filled the kitchen at the West Somerville Neighborhood School one morning last spring as the staff prepared for lunch. Cafeteria employee Linda Russell chopped mountains of fresh green peppers, tomatoes, onions, and cucumbers for salad. Ripe apples and oranges were heaped next to the cafeteria line. When the lunch bell rang, students loaded their trays with salad, fruit, milk, and low-fat pizza or turkey sandwiches on whole wheat bread -- without a word of complaint.

Those healthy lunches had a rocky start, though. In 2003, when the district halted sales of the chips, cookies, fruit punch, and sports drinks that were popular with students, snack revenues plummeted by about 50 percent, McLarney admits. "If you were a kid with $1.80 in your pocket, would you buy a Powerade and chips or a sandwich and a salad?" she asks rhetorically. "But sales are better than ever now -- with an even higher percentage of kids buying food from the cafeteria."

The school district's secret to finding healthy foods kids love is simple: Ask them. Students taste-tested dozens of recipes. When steamed broccoli got a universal thumbs-down, the food-services team rolled out new variations. "We now serve lightly steamed broccoli with lemon zest, garlic, and a little olive oil and Parmesan cheese," McLarney says. "We wanted to create a buzz about vegetables." The kids aren't shy about praising what whets their appetites, even when it surprises them. At a recent taste test, Samantha Fitzgerald, now a third grader at the West Somerville Neighborhood School, never expected to like the bean, cheese, and broccoli wrap sandwich: "But it was so good, I ate seven pieces!"

Try This at Home

Get kids to eat between five and nine servings of fruit and vegetables a day, plus several servings of whole grains. Here's how:

* Detox your kitchen: "You're the policy maker in your own house, so be proactive," says Economos, who's also the mother of a 5-year-old and an 8-year-old. "Decide to stock mostly healthy foods and snacks so you don't have to say no all the time." And let your kids eat their fill -- as long as it's of fresh fruit.
* Tempt their taste buds: It's OK to add a little healthy fat (such as low-fat cheese, low-fat salad dressing, or olive oil) or the crunch of a baked, whole-grain chip to "sell" a healthy food to your family. McLarney's staff developed a vegetarian chili that they could barely give away, she says. "Finally, we melted a dab of low-fat mozzarella on top and served it with low-fat, whole-grain baked tortilla chips. Today, it's a popular item."
* Enlist kids to help in the kitchen: "The elementary schoolers shucked hundreds of ears of local corn one morning, then ate it at lunch. They still talk about it," McLarney says. Helping with food prep gives kids a sense of pride about their product, and may make them more partial to the results. Learning kitchen skills also helps prepare kids for a future of healthy cooking.
* Conduct your own taste tests: Offer your child just a nibble of a new food, instead of forcing her to eat a whole serving. If the healthy food isn't a hit, just change the preparation or presentation and offer it again. Better still: Test-drive a new food when your child has friends over. "If one kid is enthusiastic, everyone wants to try it," McLarney notes. Letting kids decide for themselves gives them a sense of control -- and the thrill of discovery.
* Grow your own (or visit a vegetable garden): "Seeing food grow, and then actually eating it, is exciting for kids," says McLarney. Schools in Somerville now grow herbs, tomatoes, and peppers in raised garden beds on tiny swaths of school property that were once pavement, and she uses the crops that are produced in the students' lunches, making a point of playing up the many fresh, "homegrown" ingredients.


Step Three: Up Your Children's Activity

The Somerville YMCA faced challenges from Shape Up Somerville that have stymied many parents: finding innovative places for active play, and getting everybody -- not just athletic, competitive kids -- moving.

The Y's smart solution: "If you don't let kids know it's exercise, they'll participate," says Joe Pinto, YMCA youth-services director. His staff helped organize an after-school "just for fun" league in which teams played games like bombardment (a gentler version of dodgeball) and, later, soccer and basketball. "Even the nonathletic kids started to enjoy the competition after a while," he says. And with no room for a playground, the younger kids played jumping games indoors, building up eventually to a friendly broad jump competition with their parents. The effects have reached beyond kids' physiques. "My son is more independent now, and he's more interested in whether whatever he's doing is healthy and will help him grow stronger," says mom Sirleia Lartey, who attended the jumping meet with her son Kelven Polite, age 8.

Try This at Home

Follow the 1-to-2 rule: Kids need at least one hour of physical activity every day, and no more than two hours of screen time -- watching TV, playing video games, or using the computer recreationally. Here's how to fill that offscreen hour:

* Expand your idea of exercise: If your kid's not interested in high-stress team sports, find an activity that fits his personality and interests, such as swimming, horseback riding, skateboarding, or simply a lower-key sports program (call directors of town and local leagues to judge the level of play). And don't be surprised if increased confidence makes your kid more comfortable with competition. "Some kids from the YMCA program were inspired to try out for the varsity high school sports teams," Pinto says.
* Make it easy: Gather outdoor sports and play equipment like balls, racquets, skates, skateboards, and sidewalk chalk for hopscotch in one handy location. The Tull family now makes a point of keeping their bicycles tuned and tires pumped, so they're ready to ride whenever the urge strikes them. And scope out nearby parks, biking and hiking trails, and playgrounds ahead of time, so you'll have ideas ready for Saturday afternoons or for a quick outing after dinner.
* Use the great indoors: A hopscotch mat, a CD player, and some danceable tunes -- even a roll of painter's tape -- can turn a cold, rainy afternoon into a fun movement marathon, especially for a group of youngsters. Try the Somerville YMCA jumping game: Tape a starting line on the floor, then have each player leap from a standing position; mark their landing spots with tape labels to see who gets farthest. Jumping burns calories and boosts heart rates, and the impact helps build strong, healthy bones in growing children, says Economos.
* Work out together: Susan Kamin exercises with her son Charlie, 11, to fitness videos several times a week. "We try different videos, some for adults and kids, others that just look like they'd be fun to do," she says. "It's good for both of us."


Shape Up Your Hometown

What made such a stunning difference in Somerville, says Economos, was "a lot of people making smart, small changes." But Somerville's not the only city whose citizens have banded together for the common good. Neighbors nationwide have made thoughtful improvements that benefited their communities -- and you can, too.

* Revive Walking to School

This Community Made It Happen: Fairfax, CA. Deirdra Rogers organized one of the nation's first Safe Routes to School programs at the town's Manor School. In two years, the number of pupils who walked or biked to the elementary school rose from 21 percent to 38 percent.

What You Can Do: After scoping out an appropriate route, start a "walk to school day" once a week in your neighborhood. If you live farther than walking distance from school, drive partway and then walk the remainder with your child. For information on starting your own local program to develop good walking routes to your local schools, visit saferoutesinfo.org.

* Upgrade School Food

This Community Made It Happen: Upper Adams School District, PA. Three years ago, phys ed teachers Jane Little and Deborah Yargar-Reed asked their elementary school principals for the OK to suggest some healthy changes to the food-services director. The result: Menus now include baked potato chips and fresh fruit in place of sweet desserts. The cafeteria transitioned kids from white to whole wheat bread by replacing just one slice in a sandwich with wheat.

What You Can Do: Recent federal nutrition guidelines may already have brought more fruit, veggies, and whole grains to your local school breakfast and lunch menus. But these healthy meals may face competition from high-calorie drinks and snacks still sold in or near many schools. Organize a Just One More campaign at your kid's school: For this program, started at the Sparta (NJ) Middle School, children make healthy pledges, including a promise to eat one more serving of fruit or veggies a day. Or consider approaching your district's food-services director and school board about spearheading a drive to switch to healthier school snacks. For ideas, check the Alliance for a Healthier Generation Web site, healthiergeneration.org.

* Blaze New Trails

This Community Made It Happen: Moses Lake, WA. Volunteers here worked with local officials to plan more trails and better access to the existing paths in the lakefront town -- with more work slated for the future.

What You Can Do: Sign up to build trails in a park near you, so there will be more places for kids' exploration. Or offer to map out bike lanes or bike trails in your town -- approach your town's parks-and-recreation board to see where your help is needed most. Bonus: You'll get exercise yourself while helping to keep others healthy.

Other Resources to Improve Kids' Health

* Snacks from Shape Up Somerville: A list of healthy grab-and-go munchies and snacking tips from Somerville Public Schools Food Service Department.
* Find Out What's Happening In Your State: Action for Healthy Kids, a nonprofit organization dedicated to improving nutrition and physical activity by focusing on changes in schools, tracks progress on these issues nationwide.

Additional reporting by Kate Schmier


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