Authored by Emily Cooke

Megan Miklos, owner and director of Open Arms Family Child Care in Clinton Maine, is excited about how 5-2-1-0 Goes to Child Care is helping her create an even healthier environment for the children she cares for. Below, she reports some of the ways she has been adopting the following four Let’s Go! Strategies into her program day:

#1. Provide healthy choices for snacks and celebrations; limit unhealthy choices.

#2. Provide water and low fat milk; limit or eliminate sugary beverages.

#3. Provide non-food rewards.

#8. Partner with and educate families in adopting and maintaining a lifestyle that supports healthy eating and active living.

As you read her report below, are you able to identify how she is working on each of these strategies?

“I am quite excited to put health and fitness into my program more. In a recent newsletter I mentioned for everyone to bring water bottles for drinking water and I have already had parents bring them in. I am also doing a chart with all the children’s names on it with a column for fruits and vegetables served at meals and snacks. When a child takes three bites of a fruit or veggie they get to put a sticker by their name and the fruit/veggie they tried or ate. So far it is working! The children that have never tried fruits and veggies before now are, which is exciting! I have been giving seconds of fruit to a child who never would put it in his mouth before. The chart is also an eye opener for parents to see what their children eat for fruits/veggies and I encourage them to go home and eat the same.”

Way to go Megan! You are a champion for children’s health. The little ones you care for (and their families) will benefit from the healthy habits you are teaching them for a lifetime!! Learn more about Open Arms on their Facebook page.

Indicates a Let’s Go! Priority Strategy.

I often joke with my patients that as soon as a magic potion is invented that will cure their disease they’ll be first on my list to receive it. Indeed, it is an encouraging time to be a physician because of the quickly expanding array of new medicines and treatments available for our patients. However, some of the best treatments, especially ones that can prevent disease, may be centuries old and right under our noses. What is surprising is that we are only now beginning to scientifically validate some of these simple approaches.

One magic potion is school recess.

In late December 2012 the American Academy of Pediatrics published a policy statement on the importance of recess. In the policy statement, a review of the most recent scientific evidence on the positive benefits of recess was presented. The bottom line? There is good evidence to support social, emotional, cognitive and health benefits of recess.

As an endocrinologist I would also argue that recess has important hormone health benefits, especially when it involves moderate physical activity: better sensitivity to insulin with subsequent reduction in diabetes risk, improved satiety (a better chance children will know when they’re full and not overeat), and a positive effect on growth, bone health and puberty.

The policy statement was prompted by reports that recess, distinct from physical education, is often at risk for being reduced or eliminated as classroom based academic goals expand. Concerns were also raised that withholding access to recess is sometimes used as punishment.

Imagine a medicine with no side effects that would improve your child’s growth, school performance, social skills, hormone levels, muscle development, and prevent diseases like obesity, diabetes and cancer. Would you give this medicine to your child? I would! Recess is an example of a magic potion and it is encouraging that the American Academy of Pediatrics is using its voice to advocate for its protection. This is another step in the right direction as we build healthy futures for our children.

This blog post is brought to you by Let’s Go! Healthcare, generously funded by Harvard Pilgrim Healthcare Foundation’s Growing Up Healthy Initiative.

A phys ed class that gives homework. Smoothie machines in cafeterias. Before school run/walk clubs. Breakfast in the classroom. Incorporating physical activity into daily lessons. School gardens. School is no longer just about science, language arts, arithmetic and social studies. It has become a place to educate children about wellness.

Some might say school is not the place for children to be learning seemingly non-academic lessons. But when you consider the average kid spends 2,000 hours every year in school, it makes our schools the perfect place to teach such lessons.

The topic of childhood obesity is a difficult one to avoid, and so are the negative impacts of the epidemic (Surgeon General Dr. David Satcher classified it as an epidemic 12 years ago). Fortunately, while it is still a serious concern, real progress has been made in this arena in the last decade. In part, that is because schools have access to programs like 5-2-1-0 Let’s Go! and Fuel Up to Play 60 – a program created by the National Dairy Council and the NFL. Both programs advocate eating right and being physically active 60 minutes a day and rely on a wealth of research and expertise to help schools lead children down the path to a healthier lifestyle. Best of all, they can be used in concert with one another, giving educators more resources from which they can draw.

On March 4, GENYOUth, the foundation behind Fuel Up to Play 60 released the Wellness Impact Report, highlighting the connection between learning and improved nutrition and physical activity. While some may argue that things like breakfast in the classroom or turning a spelling lesson into a physically active game, detract from learning, the exact opposite is true. It only enhances learning. “Brain-imaging studies show that the brains of aerobically fit children may exhibit superior executive-function control,” the Impact Report states.

It also goes on to say that “Serving school breakfast – especially through alternative options such as breakfast in the classroom or grab ‘n’ go – is possibly the easiest, most cost-effective and most directly helpful step schools can take to improve school and student wellness.”

If a child eats supper at 6 p.m., skips breakfast and then doesn’t get lunch until noon time, that’s 18 hours without a nutritious meal! When students are hungry, they don’t focus as well, there are more behavioral problems and performance decreases significantly. And it takes a toll on their bodies. Children who don’t eat right are sick more often, which means absences from school. In a recent Huffington Post Blog Dr. Satcher said 62 percent of teens go to school without breakfast, and “1 in 4 children live in a food-insecure household …” Breakfast at school seems a beneficial and simple solution.

And then there’s the physical activity aspect. On its web site, GENYOUth says 1/3 of the country’s elementary schools don’t offer daily recess for all their students, and more than 80 percent of kids don’t get 60 minutes of physical activity a day as recommended by the Physical Activity Guidelines for Americans. First Lady Michelle Obama recently launched Let’s Move! Active Schools. An official White House release about the campaign states that only 4 percent of elementary schools, 8 percent of middle schools and 2 percent of high schools offer daily physical education classes. Meanwhile, research shows that just 20 minutes of physical activity can improve academic performance.

This is why programs like Let’s Go! And Fuel Up to Play 60 are so important – they can help fill in those gaps.

The triathlon will be held on Sunday, September 8, 2013 at the University of Maine at Presque Isle’s campus, starting at Gentile Hall. The cost is $20 per child. Registration is required, and is currently open. After registering, participants will receive a pre-race packet with a course map, frequently asked questions sheet, policies and procedures, and more.

This event is capped at 100 youth athletes, so REGISTER TODAY!

Additional information can be found on the Youth Triathlon website and on the Triathlon Facebook page. Please direct any additional questions or concerns to Jonathan Kelley at redyyouthtriathlon@gmail.com.

TOWARDS ENDING CHILDHOOD OBESITY:
How doctors, toddlers, and schools can stop an epidemic.

Learn how to build capacity in your practice, in your community and for your patients. Take away material you can use the next day.

Join us on September 11th, 12th & 13th, and enjoy the beautiful Maine coastline. Bring your family along and make it a long, fun weekend to remember!!

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National Experts 

• Christopher F. Bolling, MD, FAAP - Program Chair, American Academy of Pediatrics, Provisional Section on Obesity
• Robert Lustig, MD -Pediatric Endocrinologist, UCSF Benioff Children’s Hospital
• Sandra G. Hassink, MD, FAAP – Director, Nemours Pediatric Obesity Initiative, A.I. Dupont Hospital for Children
• Charles Hillman, Ph.D – Associate Professor, College of Applied Health Sciences, University of Illinois at Urbana-Champaign
• David Ludwig, MD, Ph.D – Director, New Balance Foundation, Obesity Prevention Center, Boston Children’s Hospital
• Robin Hamre, MPH, RD – Senior Public Health Analyst,Centers for Disease Control and Prevention, Retired
  
• Stephen Pont, MD, MPH, FAAP – Medical Director, Texas Center for the Prevention and Treatment of Obesity
• Robert Schwartz, MD – Professor Emeritus of Pediatrics,Wake Forest School of Medicine
• Reginald Washington, MD, FAAP – Chief Medical Officer, Rocky Mountain Hospital for Children
• Judith Young, PhD – Professor, University of Illinois at Urbana-Champaign

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Local Experts

• Victoria Rogers, MD – Director, Let’s Go!, Barbara Bush Children’s Hospital at Maine Medical Center    
• Jonathan Fanburg, MD, MPH – Maine Medical Partners
• Michael Dedekian, MD – Director, Countdown to a Healthy ME Program, Maine Medical Partners

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WHEN
September 12 & 13, 2013

 WHERE
MaineHealth Conference Center
110 Free Street, Portland, Maine

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September 11th – Special Pre-conference Training Seminar
Motivational Interviewing: Building on What You Know About Making Behavior Change Happen

Featured trainers:

• Robert Schwartz, MD – Professor, Wake Forest School of Medicine
• Robin Hamre, MPH, RD – Centers for Disease Control and Prevention, Retired

 ________________________________________

$150 – Motivational Interviewing Training
$250 – Let’s Go! Conference
$350 – Both Conference and Motivational Interviewing Training

Space is Limited – Register Now!! 

Let’s Go! and Healthy Kids Out of School, an initiative of ChildObesity180 in collaboration with Tufts University, share the common goal of making a positive contribution to kids’ lives, so they are equipped with the skills and confidence to become happy and productive adults. With millions of children participating, out-of-school-time programs can play a key role in promoting healthy eating and physical activity habits.

Let’s Go!’s 5-2-1-0 Goes After School and Healthy Kids Out of School share a common set of principles around healthy eating and physical activity so that children will hear consistent, healthy messages, across out-of-school-time programs:

• Choose water instead of sugar-sweetened beverages.
• Increase physical activity.
• Increase healthy eating by choosing fruits and vegetables.

Realizing that making these kinds of changes can sometimes be challenging, Healthy Kids Out of School recently launched the Healthy Kids Hub website to help leaders adopt these principles. The Hub provides hundreds of free and low-cost resources including those created and used by Let’s Go!. Visitors to the Hub can browse through resources on their own, or take a brief survey to get a customized list of resources that are specific to their program needs.

Join us in supporting this great work and the efforts of out-of-school-time leaders from around the country in making healthy environments for kids by taking the pledge to adopt these principles. Anyone who takes the pledge by May 8, 2013 will be entered into a random drawing to win one of 100 $50 gift cards.

Learn more about the initiative and get your customized list of resources at www.HealthyKidsHub.org.

It was wonderful (finally!) to hear President Obama put the rapidly warming earth at the top of his second term agenda in his inaugural speech: “we will respond to the threat of climate change, knowing that the failure to do so would betray our children and future generations.”

But if you live in New England, you didn’t need the President to tell you that something is desperately wrong with our weather. We had a winter without snow followed by ferocious storms – Nemo right after Sandy – and plant and animal habitats unable to support traditional species.

As we all try to redouble our efforts to lead sustainable lives, or at least lesson our use of carbon-based fuels, it’s encouraging to know that Let’s Go’s message of 5210 is a roadmap to planet health as well as family health:

5 fresh fruits and vegetables a day can cut down overall meat consumption which reduces pollution from animals – an important source of climate warming. And even better, if the produce is grown and harvested locally less carbon fuel is used to transport it to market.

2 hours or less of recreational screen time helps to minimize the use of electricity, most of which is generated now from burning fuel that adds to pollution.

1 hour of physical activity – especially if it’s walking or biking instead of driving cars is another key pollution reducer.

And last but far from least, 0 sugared drinks and more water – cuts down on all of the processes to refine the sugar and manufacture the drinks, not to mention the energy used to make the containers and the landfills they pack each year.

Clearly, this isn’t all we can or should do to reverse climate change, but it’s a great start and its easier knowing that there’s a double win for every step we take to eat better and move more. We all want the New England we love – from forests and mountains to our iconic coasts – to be preserved for our great grandchildren. Let’s Go’s 5210 message can help us do that while keeping us all healthy enough to enjoy them.

According to the Kaiser Family Foundation, kids ages 8–18 now spend, on average, a whopping 7.5 hours in front of a screen for entertainment each day, 4.5 of which are spent watching TV. Over a year, that adds up to 114 full days watching a screen for fun. That’s just the time they spend in front of a screen for entertainment. It doesn’t include the time they spend on the computer at school for educational purposes or at home for homework.

The Centers for Disease Control and Prevention (CDC) recommends children get at least 60 minutes of physical activity each day. You know… the “1” in 5-2-1-0. That doesn’t have to mean joining a sports team. Walking the dog, riding a bike around the block, and dancing in the living room all count as physical activity.

CDC created an interactive infographic to inform parents about how much screen time kids are experiencing on average each day. This infographic also offers physical activity ideas and tips for parents on limiting entertainment screen time. You can also check out Let’s Go!’s Parent Resource Page for more tips and information on reducing screen time and increasing physical activity. Try sitting down with your kids and using these resources to make a family fun plan for Screen Free Week.

Cutting back on recreational screen time for our kids, we can make more room for active, quality family time – and help keep our kids happy and healthy!

Did you know that both 5-2-1-0 and the Let’s Go! multi-setting model have spread across the country? In 2012 Let’s Go! provided some degree of technical assistance to over 120 sites in 36 states! Some organizations and sites have adopted the 5-2-1-0 message, while other organizations are implementing the Let’s Go! model in multiple settings.

Interestingly, over the years as organizations adopted the 5-2-1-0 message, many of them elected to innovate the mnemonic to include messages such as the benefits of eating breakfast, getting enough sleep, breast feeding, and dairy consumption. Examples include:

521 Almost None                      Nemours

54321 Go!®                                 Consortium to Lower Obesity in Chicago Children (CLOCC)

BB 210                                           National Initiative for Children’s Healthcare Quality (NICHQ)

75210                                             Seattle Children’s Hospital

5321 Almost None                    Eat Smart, Move More, Weigh Less, North Carolina

95210                                             Northern Virginia Healthy Kids Coalition (NVHKC)

Let’s Go! offers free access to our Toolkits and resources. Organizations and individuals may print and use any of our online resources. Organizations who prefer to purchase hard copy materials may order many of our resources at www.letsgotoolkits.com.

Karen Schebaum is a manager at the Kids CO-OP, Barbara Bush Children’s Hospital at Maine Medical Center – Home Office for Let’s Go!. 

Authored by Emily Cooke

Dawn Gauthier owns Ponderosa Playland Child Care in St. George, Maine and this is her first year on board with 5-2-1-0 Goes to Child Care. She shared with us how 5-2-1-0 Goes to Child Care and her Let’s Go! contact, Adrienne Gallant, have been making a big difference in her program where she serves 15 children between the ages of 2 and 6.

“I went to our local food program training in October and Adrienne was there talking about Let’s Go!. The program sounded so interesting and easy to do that I wanted to sign up right away.”

Dawn reported how at this training, Adrienne talked about fruit juice and that it’s not necessary for good nutrition. Adrienne taught how there are many easy ways to get your daily fruit servings from whole fruits instead that include the healthy fiber which juice doesn’t have.

“So from that point on, I immediately took juice out of our daily routine. The kids don’t miss it and at this point they know why we never have juice. Every afternoon we have a fresh fruit or vegetable as part of our snack. I already feel better about this.”

Dawn has also been working on promoting healthy celebrations.

“We also only do healthy celebrations and I am putting this in my handbook as a policy. I had a mom ask if she could bring cupcakes for her son’s birthday. I told her we had joined Let’s Go! and cupcakes were no longer allowed and she said she would do something healthy instead!”

Dawn is a shining example of how to implement the Priority Strategies #1 – Provide healthy choices for snacks and celebrations; limit unhealthy choices, and #2 – Provide water and low fat milk; limit or eliminate sugary beverages.

A big high-five to Dawn and Ponderosa Playland from Let’s Go! for hitting it out of the park this year!! Check out their Facebook Page!