Tool kit battles child obesity
Parents and professionals helped develop the material, with focus on local food and activities
When Alicia Kagawa shops and cooks for her family, she pictures a 4-ounce steak the size of a deck of cards and a salad the diameter of a CD.
She learned about portion control as part of a focus group of parents who tested draft materials for a Hawaii pediatric Weight Management Toolkit.
"It was really great, very informative," Kagawa said. "It had a lot of nutritional facts in there and a lot of visual guides," with pictures relating portions of food to certain objects, she said.
A team of professionals developed the tool kit with HMSA Foundation funding to battle Hawaii's childhood obesity epidemic, said Dr. Galen Chock, president of the Hawaii chapter of the American Academy of Pediatrics.
About one-fourth of some 10,000 isle children entering kindergarten in 2002-2003 were classified as overweight in a state Department of Health survey, Chock said.
"It's a large number and they were only kindergartners," he pointed out. "They can't quite get to fast-food places on their own, and they're not quite into couch-potato activities yet."
He said the tool kit is designed to give pediatricians, family doctors and others who care for children "a concrete, hands-on tool they can use when they've identified a child who is overweight."
There are so many variables involved with an overweight child that "it's difficult to find out what is the problem," Chock said.
He said the tool kit provides doctors with data to give them a feeling for what the child is like; worksheets to fill out assessing the child's medical history, activity and nutrition; behavioral tip sheets to review with a parent and child; and pages that parents are asked to fill out with information about the child.
Behavioral changes are suggested in five areas: reducing sugar-sweetened drinks, reducing sedentary activities, developing a strategy to deal with fast foods, encouraging more physical activity and alternatives to white rice.
"Our impression was many local kids eat too much white rice," Chock said.
The tool kit will be presented at a seminar Thursday to more than 150 physicians, nurse practitioners, public health nurses, dietitians and state Health and Education department personnel.
The event, "Pediatrics Island Style: A Hawaii Approach to Pediatric Weight Management," will be from 1 to 5:30 p.m. at the Hilton Hawaiian Village.
Development of the tool kit began at the end of 2003, with focus on local foods and activities to make it culturally relevant, Chock said. Three focus groups of parents with overweight children reviewed the material in July.
The tool kit provides healthy choices of meats, vegetables, starches and drinks, and the information is "color-coordinated" for easy identification, Kagawa said, such as green paper for vegetables and yellow for starches.
"The obesity problem is so big, we need something like this for kids out there," she said. "I come from a family that has that problem."
She said everything on the table at family gatherings is a starch -- such as bread, rice, noodles and corn. She is trying to add more green vegetables and salads to their diet.
The Mililani family also has stepped up exercise, Kagawa said. She walks every day with a pedometer and, coupled with healthier eating, has lost 10 to 15 pounds.
She also teaches hula one day a week.
"Every little step counts," she said.