Denise M. Holston
 
Obesity is a growing health care problem in Louisiana and carries with it significant costs, both in dollars and quality of life. According to former U.S. Surgeon General Dr. Richard Carmona, "We may see the first generation that will be less healthy and have a shorter life expectancy than their parents." This statement was made as a result of the startling increase in childhood obesity rates over the past two decades.

Childhood obesity rates are of particular concern because children who are overweight or obese are 70 percent more likely to be overweight or obese as an adult. Being overweight or obese substantially increases a person’s risk for the development of nutrition-related chronic diseases such as cardiovascular disease, type 2 diabetes, some forms of cancer, stroke, sleep apnea, hypertension and osteoarthritis. Studies have also shown that being overweight or obese can affect school performance. For example, overweight children in one study had significantly lower math and reading test scores at the beginning of the school year than did their healthy-weight peers. These differences persisted into first grade.

In response to the epidemic increase in childhood obesity, the LSU AgCenter, in partnership with Blue Cross and Blue Shield of Louisiana Foundation, launched Smart Bodies in March 2005. Smart Bodies is a comprehensive nutrition education and physical activity program for elementary school children, kindergarten through fifth grade, which is integrated into core curriculum objectives. The program incorporates classroom activities with hands-on learning to teach children how to build strong bodies and active minds. Smart Bodies consists of three components:

Body Walk. Students explore nine organs of the human body in a 35-foot by 45-foot, interactive, walk-through exhibit. At each of the nine stations, children participate in activities focused on the effects that different foods have on each organ. They are given a take-home activity book to share with their families.

OrganWise Guys. These 10 characters help children understand physiology and healthy behaviors. Hardy Heart, Madame Muscle, Windy the Lungs, Peri Stolic the Intestines, Sir Rebrum the Brain, Peter Pancreas, the Kidney Brothers, Luigi Liver and Calci M. Bone are manifested as cartoons in books, games and videos and as dolls used in nutrition lessons. Participating schools receive a free kit with eight videos, dolls, books, games and puzzles.

Take 10! This classroom program is a grade-specific educational tool that encourages short bouts of physical activity integrated into academic learning objectives. Activities provided in all curricular materials are linked to the grade-level expectations of the Louisiana Department of Education.  

The goal of Smart Bodies was to reach 50 elementary schools each year for five years (2005-2009). Because of additional funding received beyond that provided by Blue Cross, the program has been able to reach more than 50 schools annually since it was launched. Since March 2005, more than 250 elementary schools have implemented the Smart Bodies program, and more than 125,000 children experienced the Body Walk. Seventy-five schools are expected to begin implementing the program during the 2008-2009 school year.

National Recognition
 In 2007, the Smart Bodies Program was recognized as a Program of Distinction by the National 4-H Headquarters.   

School Recruitment
LSU AgCenter extension agents recruit schools for the program and then conduct teacher training in the schools selected. Once the teachers have been trained, a school assembly is used to kick off the program and to build excitement and enthusiasm. Following the assembly, teachers begin using the Take 10! and OrganWise Guys curricular materials in the classrooms. At some point during the program, the Body Walk exhibit is taken to the school and set up by volunteers either in the gymnasium or cafeteria. After the Body Walk leaves, teachers continue to implement the program in the classroom. Smart Bodies newsletters are sent home to parents to emphasize physical activity and healthy eating.

Because of the popularity of the program, there is a waiting list of schools who want to implement the program. We are hopeful new moneys will allow the program to continue beyond 2009. The LSU AgCenter has recently purchased a second Body Walk that will be available to schools. Adding to the incentive to implement the program is a new federal mandate, effective in 2006, that requires school to have a wellness policy to receive federal funds. In addition, the Louisiana Legislature passed a law (Act No. 734) that requires children in grades K-6 to get at least 30 minutes of moderate to vigorous physical activity daily. The Take 10! has been a selling point because it provides the opportunity for students to be physically active during the school day without taking away from their academic learning time.

Research
Although each of the three components of Smart Bodies has been tested and evaluated separately in other states, the effectiveness of the three components together had not been tested. The purpose of the research project is to evaluate the effectiveness of Smart Bodies in promoting child wellness and preventing childhood obesity. A two-year investigation was conducted among elementary schools in East Baton Rouge Parish. Schools were stratified based on school enrollment, the number of students receiving free and reduced-price lunch, and state school performance score. After schools were clustered, they were pair-matched and then randomly assigned to a treatment (intervention) or control group. Only fourth- and fifth-grade students with parental consent were included in the research.

The primary goals of the research project were: (1) to increase consumption of fruits and vegetables served at school, (2) to increase nutrition and physical activity knowledge and willingness to participate in physical activity, (3) to increase parent awareness of their child’s weight status and (4) to decrease the number of students in the at risk for overweight or overweight categories. Analysis of the formal research data suggests that:

• Students participating in Smart Bodies significantly increased their knowledge about the health benefits of eating fruits and vegetables.
• Children who participated in the Smart Bodies program increased their knowledge about the effects and benefits of physical activity.

 During this project, we assessed activity levels on a small subsample of children by using accelerometers. The analysis of the pre-post test data revealed a trend suggesting that the children who experienced the Smart Bodies intervention had higher overall physical activity levels than those who did not. Additionally, there was clear evidence that children had higher activity counts during Take 10! than at lunch, during physical education lessons and during after school hours.

Body mass index (BMI) health reports were effective in increasing both school and parent awareness of children’s weight status. Parents of 40 children who had been randomly selected from each of two weight categories were mailed a BMI report and compared to parents who did not. After receiving the report, parents were 4.5 times more likely to accurately identify their child’s weight category.

The results of the research project suggest that, when implemented correctly, Smart Bodies is effective in teaching children about the importance of taking care of their bodies. If children learn how to adopt a healthy lifestyle, they will be less likely to experience the consequences associated with obesity later in life.

(This article was published in fall 2008 issue of Louisiana Agriculture.)