The 3- and 4-year olds at Kids Kollege preschool in Miami Springs showed off their nutrition smarts to some special guests this week – UM President Donna E. Shalala and two other former Cabinet secretaries – who watched the youngsters talk, sing and dance about the function of their hearts, kidneys, brains, bones, and yes, even their intestines.
“If you want to keep it movin’, then you have to have a plan. You can start by eating fiber, fruits and vegetables and bran,” the youngsters sang along with “Hardy Heart” and the “Kidney Brothers,” three cuddly characters in the innovative “Organ Wise Guys” curriculum the Miller School of Medicine is testing in 27 Miami-Dade preschools for the U.S. Department of Agriculture.
Followed by a three-stop tour of UM nutrition and fitness programs and an evening public forum on the importance of nutrition education and physical activity, Wednesday’s preschool visit officially kicked off the Bipartisan Policy Center’s new Nutrition and Physical Activity Initiative aimed at combating obesity in a nation where more than one-third of adults and 17 percent of children are obese.
Co-chaired by President Shalala, the longest serving secretary of the U.S. Department of Health and Human Services (HHS), former Secretaries of Agriculture Dan Glickman and Ann M. Veneman, and former HHS Secretary Mike Leavitt, the initiative was launched in March to promote and build national consensus for the best nutrition and physical activity policies and programs. Leavitt was unable to attend the first of the many forums and site visits to be held across the country, but Veneman and Glickman got a whirlwind tour of many University initiatives.
They were, for example, impressed that third-year Miller School students learn about patient advocacy and community involvement during their primary care clerkships, especially when they learn how to teach children the importance of good nutrition, staying fit, managing stress and avoiding tobacco for the Fit to Play program UHealth sponsors at local parks.
“The fact that this is being taught here, the fact that these folks may become patient advocates…is really very important and it hasn’t been emphasized in medical education in forever,’’ Glickman said.
In addition to sitting in on the class taught by Donna Wiener, director of the primary care clerkship, the co-chairs and policy center staff visited the Patti and Allan Herbert Wellness Center and the Hecht-Stanford Residential Dining Hall on the Coral Gables campus, where they were introduced to the University’s food service vendor and the panoply of initiatives, benefits and policies aimed at promoting good nutrition and physical activity.
Among them: the stress-reducing, brain-boosting and “waist-less” themes promoted in campus dining halls, the free Walking Canes and ‘Canes Biggest Loser programs, rebates offered to active Wellness Center members, the Mini Canes Recreational Sports Camp for kids aged 6 to 12, and the L.I.F.E. program aimed at improving strength, balance and agility in the 65-plus crowd.
“From 6-year-olds to 88-year-olds, we pretty much have it covered,’’ said exercise physiologist Tony Musto, associate director, fitness programs, at the Herbert Wellness Center.
Glickman agreed: “Sounds like what you do here is way ahead of the game.’’
That said, it was clear from the evening forum, which included Veneman’s sobering overview of obesity in America and two panel discussions, just how far away the goal posts are. As preventive cardiologist Arthur Agatston, assistant professor of medicine and author of The South Beach Diet, warned, the nation, with its fast foods and sedentary lifestyles facilitated by technology, has “reached a tipping point.’’
“We’re developing belly fat that we never had before, and with this belly fat, we are releasing every day what’s really a chemical bath of inflammatory cytokines,” Agatston said. “We’ve known for quite some time that it’s affected the heart. We now realize it’s causing every chronic disease—cancer, arthritis, Alzheimer’s, macular degeneration.”
Other panelists, who included the former Bush and Clinton administration cabinet members and Miller School researchers and physicians, agreed acute care medicine alone will not reverse that terrible trend. Better nutrition and preventive strategies touting healthier eating habits and exercise are essential, and must start early in life, when poor eating habits begin.
“Obese children are likely to become obese adults,” Veneman said, “and we also know that high obesity rates correspond to higher incidence of diabetes.”
One key strategy, Miller School Dean Pascal Goldschmidt, said, is getting more medical schools to adopt preventive medicine and nutrition education in their curriculum and urging health care providers to focus not only on medical procedures, but the benefits of healthy behavior.
“We’re also trying to personalize this intervention—diet and exercise—in a way that will fit individuals the best,” Dean Goldschmidt said. “We’re very interested in trying to explain the genetics of why one individual responds better to one form [of exercise] than another.”
Other panelists included Sylvia Daunert, chair of biochemistry and molecular biology, Arlette Perry, chair of kinesiology and sport sciences; Evadnie Rampersaud, research assistant professor of human genetics; Tracie Miller, professor of pediatrics and director of clinical pediatric research; and Natalie Geary, director of executive medicine. They all agreed with President Shalala, who told the audience of mostly students, faculty and staff at the Newman Alumni Center, “It’s imperative that we find a way to help people make healthier choices so that we can reduce obesity and obesity-related diseases and the many associated health care costs.”
For youngsters, one way may be the USDA-endorsed Organ Wise Guys curriculum, which uses high-energy activities and fun characters – Peri Stolic, Calci M. Bone, and Sir Rebrum, to name a few – to teach children why healthy food choices are so important. Already found in elementary schools in 48 states, the program’s effectiveness for preschoolers, particularly low-income ethnic minorities who, in many cases, have never tasted a fresh fruit or vegetable, is now being tested by Miller School researchers with a three-year, $1 million USDA grant.
“The children are learning about nutrition as they develop their language skills,’’ explained Sarah Messiah, Ph.D., research assistant professor of pediatrics and director of research for the Healthy Caregivers-Healthy Children project at Kids Kollege and 26 other area preschools. “They’re learning to eat right and take care of their bodies, a skill set we hope they will carry for the rest of their lives.’’
Though Messiah and fellow investigators Ruby Natale, assistant professor of clinical pediatrics and Danielle Hollar, voluntary assistant professor of pediatrics, won’t start measuring the program’s impact until next year, the curriculum already has triggered one tangible change at Kids Kollege. There wasn’t a sugar-laden fruit juice or cookie in sight – only cups of water and trays of raw carrots, broccoli, plums, kiwis, oranges and pears – which the kids gobbled up shortly after singing “Keep It Movin,” the song about the intestines, for the initiative co-chairs.
“Impressive kids,” President Shalala said, summing up the pervasive feeling at the school visit. “I have pre-med students who don’t know that much about the body.’’