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Published in Print: July 12, 2006, as Recipes for Life

Recipes for Life

Students in Eagle Pass, Texas, go to summer camp to learn how to eat better, play harder, and make smarter decisions about their health.

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While stringing plastic beads during arts and crafts time at a school-based summer camp for overweight children, 11-year-old Francisco Oca lists some of the reasons he was once “real fat.”

He drank a lot of soda. He ate large amounts of his mother’s Mexican cooking, which he loves. About twice a week, he ate hamburgers and french fries from McDonald’s.

But now, he says proudly, when he’s thirsty he drinks water, juice, or milk instead of his favorite soft drink: Dr Pepper. He’s cut back on fast food. And he’s found he even likes vegetables, such as broccoli, carrots, and onions.

Francisco improved his eating habits after he and his mom joined the weekly Get FIT evening program at Sam Houston Elementary School, one of four elementary schools in the Eagle Pass Independent School District that took part in a nine-week intervention program for overweight children this past school year.

The FIT in the program name stands for Families in Training.

Francisco had been losing some of his extra weight as he grew taller and ate less food after his doctor advised him to cut back, he says, but the evening program taught him about nutrition and exercise. That instruction helped him lose 5 more pounds, bringing his weight down to 95 pounds.

Now, during the already-sweltering hot days of June here in southern Texas, Get FIT summer camp is giving Francisco tools to continue on his path to a fit lifestyle. “When I saw people mocking me, I said, ‘I need to lose weight,’ ” Francisco recalls. “It’s healthy. I like this program.”


Francisco, who will be in 5th grade this fall, is one of 130 children who spent most of last month dancing, kickboxing, doing yoga, swimming, playing volleyball, enjoying water fights, and otherwise playing hard to try to trim down.

The children are served healthy snacks and lunches, and are taught about nutrition. Parents are invited one evening a week to attend nutrition and parenting classes while their children watch movies and munch on popcorn in the gym. The camp targets children who are significantly overweight, but their brothers and sisters can also attend even if they are slim.

School district officials in this small but sprawling city right next to the U.S.-Mexican border have good reason to help sponsor the program.

The proportion of overweight 6- to 12-year-olds at the four elementary schools in Eagle Pass participating in the Get FIT program is nearly twice the national average. In those schools, 34.2 percent of children in that age group are overweight, according to classifications of the federal Centers for Disease Control and Prevention, compared with the national average of 18.8 percent of children ages 6 to 11, according to Child Trends, a nonprofit research group.

Click to hear audio interview:'Francisco Oca'
Listen to an interview with Assistant Editor Mary Ann Zehr and Francisco Oca: MP3 file (4:31)

One-fourth of Mexican-American boys in the 6-to-11 group nationwide are overweight, compared with 18.5 percent of non-Hispanic white boys and 17.5 percent of non-Hispanic black boys, according to Child Trends. A lower percentage of the nation’s Mexican-American girls are overweight than Mexican-American boys that age. Still, 19 percent of Mexican-American girls ages 6 to 11 are overweight.

Most of the 14,000 students in the Eagle Pass schools are of Mexican heritage and come from low-income families. Many of their parents work in construction, truck driving, and home health care, or run small businesses. Some parents supplement their income with food stamps from the federal government, local educators say.

Jesús E. Sánchez, a Mexican-American and the superintendent of schools for Eagle Pass, surmises that a combination of rich Mexican food and the availability of food stamps, which some families use to buy high-fat snacks, has contributed to a high rate of obesity here.

“One [factor] has to do with the diet we have—tortillas, the beans, and the rice,” said Mr. Sánchez, who grew up working hard in the fields alongside his migrant parents when he wasn’t in school. “If you don’t exercise, you aren’t going to burn it.”

Tere Verastegui, the mother of Jessie, a 7-year-old Get FIT camper, listed some of the high-calorie Mexican foods her family loves: enchiladas, tacos, flautas, and mole. “Any time you want to put on weight, come over to my house,” she said warmly.

She’s glad that Jessie is picking up tips for healthy eating. “ ‘I didn’t know we can eat celery with peanut butter,’ ” she said Jessie told her, after being introduced to the snack at camp.


Eagle Pass is spending about $5,000 to provide Sam Houston Elementary as the site for the camp and to bus children to and from home each day. Mr. Sánchez said the school system wouldn’t have been able to carry out such a program without a partnership with other institutions.

The Get FIT program was designed by Peggy M. Visio, a dietitian and adjunct professor at the University of Texas Health Science Center at San Antonio, who now directs the program.

Weight Data

The percentage of young people who are overweight varies by gender and by race and ethnicity. In the 6-to-11 age range, Mexican-American boys and African-American girls are the heaviest groups.

*Click image to see the full chart.

Click to enlarge: Weight Data

NOTE: ** Data for Mexican-Americans are for 1982-1984.

"Overweight" is defined as a body-mass index (BMI) at or above the sex-and-age-specific 95th percentile BMI cutoff points, according to the U.S. Centers for Disease Control and Prevention.

At the request of the Methodist Healthcare Ministries of South Texas Inc., Ms. Visio submitted a proposal to Methodist Healthcare for a nutrition education program in Eagle Pass. The nonprofit organization has financed Get FIT with a three-year grant of $437,000.Ms. Visio also helped recruit graduate students from the physician’s-assistant program at the Health Science Center and doctoral candidates in nutrition from the University of Texas at Austin to staff the summer camp.

In addition, she hired a physical education teacher, a school counselor, a school nurse, and two cafeteria managers from Eagle Pass to help run the camp. Some of them had participated in the Get FIT evening programs. Ms. Visio hopes those Eagle Pass staff members can continue the district’s nutrition education if support from Methodist Healthcare Ministries ends.

Ms. Visio believes that schools’ emphasis on academic achievement needs to be coupled with a focus on health if the United States is to combat the rise of child obesity and its possible side effects, such as diabetes and cardiovascular disease.

She may get some help toward that goal from the federal government.

Get FIT may be just the kind of program districts will turn to as they decide how to meet the Child Nutrition Act’s requirement that school districts craft wellness policies, said Ms. Visio. The 2004 legislation requires school districts to include goals for nutrition education and ways to increase the physical activity of students in all grades. It went into effect July 1 but lacks penalties for school districts that miss the deadline. ("Schools Respond to Federal ‘Wellness’ Requirement," June 14, 2006.)


The Get FIT camp doesn’t use a heavy-handed approach to teach fitness and healthy eating.

First and foremost, the camp gives children a chance to get out of the house and be active. An air-conditioned school gym is a valuable resource here, where outdoor temperatures hit 108 degrees in June.

“There aren’t too many activities in the summer for these children,” said Maria De Hoyos, a nurse for Rosita Valley Literacy Academy and a member of the camp staff. Ms. De Hoyos said children are often left in the care of older siblings during the summer while their parents work.

She believes families of Mexican heritage north of the border struggle more with obesity than those south of the border. It’s easier to get fresh food cheaply in Mexico than in the United States, she noted. Also, she said, in the United States both parents typically work outside the home, while in Mexico, most mothers are full-time homemakers and less likely to rely on fast food.

Many children said Get FIT was their first summer-camp experience. A few said that though their parents forced them to join, they were having fun.

Components of the Get FIT Initiative

EVENING PROGRAM

For nine weeks during the school year, children and parents attend classes once a week on nutrition, exercise, and positive parenting. A child is eligible only if accompanied by an adult family member. After watching a short video on the topic of the week, the parents and children split up for about an hour of class and then rejoin each other for 30 minutes of walking. They are weighed weekly and earn points for attendance, walking, and losing weight. The points can be traded for small prizes for the children at the end of the nine weeks.

WALKING CLUB

Parents and children who graduate from the evening program can join a Saturday-morning walking club in which they earn points for the miles they walk. The points can be traded for large prizes for the children, such as a bicycle or nonmotorized scooter.

SUMMER CAMP

Children who graduate from the evening program can attend a free, monthlong day camp during the summer. They are served healthy snacks and lunches, learn about nutritious eating, and play hard. Parents are invited to attend a nutrition and parenting class one evening per week during the camp. To help attract the parents, a prize is raffled off for children at each meeting.

WEIGHING IN

A child must weigh in the 95th percentile or above for his or her age to qualify for the Get FIT program in Texas’ Eagle Pass school district. For example, a 10-year-old boy who weighs just over 100 pounds is at the 95th percentile for his age group and is likely significantly overweight. A 10-year-old boy who weighs 70 pounds is at the 50th percentile, and thus has an average weight for boys his age.

The Get FIT staff members also calculate each child’s body-mass index, or BMI, which takes both the child’s height and weight into account and is a more accurate measure of whether he or she is overweight. While an adult with a BMI of 30 or above is considered obese by the federal Centers for Disease Control and Prevention, the cutoff figure for teenagers and younger children varies by age.

The CDC provides a BMI calculator and links to information about how to tell if a child is overweight on its Web site at www.cdc.gov/nccdphp/dnpa/bmi/ index.htm.

That is the case with Monica Luna, 11, a Get FIT camper who is going into 7th grade and lost 8 pounds in the Get FIT evening program.

Speaking above the din of children splashing and shouting in the pool and rock-and-roll music on the public address system, she talks about the practical tips she’s learned at camp, such as how to make healthy pizzas with whole-wheat pita bread. She’s also tried kickboxing, which she describes as cool.

The camp’s staff members try to get participants to take small steps.

Their efforts to get children to eat vegetables on pizza, which is made with whole-wheat pita bread, sauce, and low-fat cheese, is only moderately successful. In one group of 10 children during lunch, five pick off the vegetables.

The Get FIT program tries to involve parents, Ms. Visio said, because “we look at child obesity as a family problem. Child obesity is not the child’s fault.”

Quite a few parents of Get FIT campers are also overweight.

The heaviest camper, a 9-year-old who weighs 205 pounds, is at least 130 pounds overweight for his height and age, Ms. Visio said. His mother is one of several parents who were too heavy to be weighed accurately on Ms. Visio’s scales, she added, which are accurate for people weighing up to 330 pounds.

In the evening programs held in the 2005-06 school year, parents were weighed weekly along with their children. Parents and children earned points for attending the evening program, losing weight, or walking, which could be traded for prizes for children, such as a Get FIT T-shirt or a pedometer.

Similar incentives are offered at the camp. At a meeting for parents, Get FIT leaders raffle off a child’s nonmotorized scooter to one of the families.

“After this, it’s going to be your job to keep your children going for the rest of the summer,” Ms. Visio told parents.

She likes to teach parents through questions. For instance, she asks how many parents buy skim milk instead of whole milk, or eat four servings of vegetables each day, which nutritionists recommend for teenagers and adults.

A heavy child herself, Ms. Visio slimmed down in high school through Weight Watchers, and developed a passion for learning about and teaching nutrition.

When discussing food portion sizes, she asks parents to make a fist and explains a child’s stomach is about the same size. Telling them to open their fists, she adds that the amount of food they should put on a child’s plate at every meal shouldn’t cover more than the space of an open hand.

Maria de Jesus Macias, the mother of campers Pedro, 12, and Kenya, 11, is struck by that illustration. “Maybe I let them eat too much,” she said.

Both Pedro and Kenya lost some extra pounds last fall in the Get FIT program at Henry B. Gonzalez Elementary School. But in the months that followed, they gained the weight back.

In the weekly evening pilot programs, the overweight children lost an average of 4 pounds, according to Ms. Visio. By contrast, overweight children from Eagle Pass in a control group who didn’t participate in the intervention program gained an average of 4 pounds in the same period. According to school nurses, Ms. Visio said, school records show that overweight school children in grades K-6 in four participating elementary schools in Eagle Pass gain about 15 pounds every year, a statistic she feels underscores the need for intervention.

Ms. Macias said it has been particularly hard to get her son, Pedro, who is in the school program for gifted and talented students and prefers books over exercise, to be active. But the Get FIT camp is giving her new ideas. For one, she’s learning that she shouldn’t just tell her children to go to the park and play, but that she should join them.

Ms. Visio and Ms. De Hoyos, the school nurse, believe nutrition education can turn families around.

It certainly made a difference for Francisco Oca, who is proud of how he’s applied what he learned and notes that his mother supported him along the way.

He relates how he can now run with his cousins without getting short of breath. At Get FIT summer camp, he kicks high and punches the air hard during regular kickboxing workouts. During an hour-long dance activity, he tries out eye-catching break-dance moves with his shoulders, arms, and hips.

“I’m learning how to have fun and lose weight at the same time,” Francisco says.

Vol. 25, Issue 42, Pages 38-41

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