"I did it because you were so mean to me," Dr. Tracy Macpherson recalled one of her 11-year-old patients telling her, explaining why he lost more than 50 pounds.

However, the pediatrician said she wasn't being mean to him, just honest.

She and others on staff at The Pediatric Clinic in Orangeburg have seen children come to their office with hip and foot pain, increased blood sugar levels, asthma, dysmetabolic syndrome, and the list goes on and on.

The culprit? Childhood obesity, a problem that Macpherson said is the number one health crisis facing youth today.

Macpherson said the young boy told her he lost the weight because he didn't want to stick himself to check his blood sugar level every day if he became diabetic.

"He was upset because he had to get lab work" to check for problems that could be associated with obesity, she said. But that was all the motivation he needed to turn his lifestyle around, Macpherson said.

Children's weight is sometimes simply "off the charts."

A person with a body mass index at or above the 95th percentile is obese; those with BMIs between the 85th and 95th percentiles are considered overweight.

With children, Macpherson said they are a little more "polite" -- those between the 85th and 95th percentiles are at risk for becoming overweight, while anyone with a BMI at or above the 95th percentile is overweight.

Children taking part in the "Highway to Healthy Lifestyles Clinic" housed at The Pediatric Clinic in Orangeburg have been packing on the pounds from fast food, sweet snacks and a sedentary life in front of the television, computer and video games.

"We're seeing adult onset, insulin-dependent diabetes in kids," Macpherson said. When she started practicing medicine 20 years ago, it was simply unheard of, but Macpherson said she recently diagnosed a 7-year-old with the condition.

"The one thing about being overweight or obese is there is not one body part that's not affected by it," she said. "You name the organ -- obesity can affect it."

There is only one other risk factor that's as damaging to the body, Macpherson said -- smoking.

"You want them to be healthy," she said of children who are obese or overweight. "These are lifestyle changes we're talking about."



Eat right ...

We heard it all the time when we were kids: An apple a day keeps the doctor away. Eat only as many calories as your body can burn. But how much of that information has really stuck in our adult brains, and how much is really getting through to our children?

"It's good to offer a lot of different textures, shapes and colors" when it comes to getting kids to eat more healthy foods, said Heather Forsythe, registered dietitian and clinical nutrition manager at the Regional Medical Center.

An example would be pairing crackers with peanut butter. "It's important to have that (variety) so that they're interested in it," Forsythe said.

Also, buy fresh fruits and vegetables. If fresh is not available, frozen is the next best option. However, if parents must purchase canned foods, Forsythe said choose those packed in their own juice.

Vegetables are always healthy, but the darker the color, the more nutritious they are, she said.

"Baked sweet potato fries with a little brown sugar or cinnamon" are a great alternative to french fries, Forsythe said. And if you want your kids to eat more broccoli, just add a little low-fat cheese.

Finger foods, including baby carrots and cherry tomatoes, are a big hit with young kids, she said, but white bread and flour-based products are a no-no. Forsythe said incorporating whole grains, oatmeal and rolled oats into a diet can help tremendously.

If popcorn is a special favorite, try it air popped, she said.

Cutting out sugary drinks is a huge step in the right direction, Macpherson said, as well as getting rid of fast food and prepackaged items.

Forsythe said it's not about putting restrictions on a child's diet.

"But it's the parents' responsibility to make sure healthy food is accessible," she said. "You have to watch what you eat and how much. How could a 5-year-old be responsible if they're not the one who shops?"

Calcium-rich foods do not have to be "whole" to be wholesome. Forsythe said 2 percent, 1 percent and even skim milk products pack just as many vitamins and nutrients as their fattier counterparts.

"They don't need the whole milk," she said. "It just adds fat."

The entire family should be involved in changing eating habits, she said, with children playing an active role in healthy grocery shopping.

"Good eating habits should be sought across the board," Forsythe said.

Macpherson said chips and sodas should be viewed as treats as opposed to a part of a child's everyday diet. Once a week, they can cheat, she said.

"What you want kids to start thinking about is, 'Yes, I can start making healthy choices,'" Macpherson said. "It's about making healthy choices on a day-to-day basis, and then you can still have your treats."

Eating dinner or snacks in front of the television is a big no-no, said John Lukowski, director of rehabilitation services/HealthPlex at the Regional Medical Center. He said food commercials contribute to the need to eat.

"It's like we're being conditioned to eat in front of the TV, whether it's a snack or a meal," Lukowski said.

Web sites such as www.mypyramid.gov promote healthy eating habits and outline nutritional requirements for individuals.



And exercise

Maintaining an active lifestyle is also important in curbing childhood obesity, Forsythe said.

She said children should have at least 60 minutes of activity per day, whether it's skating, jogging, biking, swimming -- any physical movement counts.

Instead of a standard birthday party, for example, Forsythe recommends planning an activity party, where partygoers participate in an outdoor Olympics-type course. Home gyms -- using canned food for weights and stairs in the place of a stair climber -- are also ideal.

Give children activity gifts, including basketballs, squirt guns, Frisbees, hula hoops, etc., to encourage active play. Forsythe said involving children in dance or extracurricular sports will give them the physical activity they need each day as well.

"A lot of kids are so sedentary, they're not getting any physical activity when they aren't in class," Macpherson said.

But parents should start out slow. Macpherson suggests beginning with 30 minutes of physical activity a day and working up to the recommended hour.

As part of the "Highway to Healthy Lifestyles" program at The Pediatric Clinic, Workout Wednesdays allow children to get active in a group environment once a week, Macpherson said. She said the choices for activities are endless; they have rarely repeated one, as participants take part in tag, jump rope, hiking, basketball and, what Macpherson calls the most popular, "Dance Dance Revolution."

"All of our regulars have lost weight," she said. "But it's not the Wednesday night workout. It's the commitment.

"All you can do is plant the seed. You have to be honest, but you have to be nurturing, supportive ... giving them the right foods and giving them an opportunity to exercise, be active."

Lukowski said he's a big believer in getting kids outdoors to get them active.

"They'll find something to do," he said. "Go to a friend's house, they can ride bikes, play sports, stickball. There are a lot of things kids will do when you get them outside."

He said the activity does not have to be done in one block of time, but can be spread throughout the course of a day.

"I think parental activity is the big thing," Lukowski said. "It's probably not a bad idea for parents to take part in the activities. Children kind of fall in the shadow of their parents. If a child is having a hard time, parents have to take a little interest. Lead by example."

He said setting a limit on TV and computer time is the key -- no more than two hours of the activities, combined, for everyone in the house.

"You can get your kids involved in that," he said. "If they spend one-and-a-half hours on the computer, they can only watch TV for 30 minutes."

Macpherson said adjustments in behavior are needed for children to be successful. Do they eat because they're bored? Hungry? Watching TV? For emotional fulfillment?

"That is where behavior modification comes in," she said. "Behavior modification is a big part of the treatment. It's a lot easier to make these changes when they're younger."

Younger kids tend to get bullied for being larger than their peers, she said.

"That does have an impact on their self-esteem," Macpherson said. "It's not about them being fat. It's about them choosing to be healthy. And kids do want to be healthy."

Body mass index should be monitored in children as young as 2, Macpherson said. Preschool, she said, is a prime time for intervention so young kids know how to make smart choices for themselves.

Macpherson said parents can't expect to change their child's lifestyle overnight but instead should take it one step at a time.

"It's making a commitment to a lifestyle," she said. "It's choices you're going to start making now and stick to."

wjeffcoat@timesanddemocrat.com or by telephone at 803-533-5546. Discuss this and other stories online at TheTandD.com.

T&D Features Editor Wendy Jeffcoat Crider can be reached by e-mail at

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