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Nebraska school district lowers obesity rate

Fellowship Story Showcase

Nebraska school district lowers obesity rate

Picture of Kate Long

West Virginia is among the top five on just about every national chronic disease list. The state leads the nation in diabetes and obesity, according to the Gallup Healthways poll.

Surveys show that many West Virginians do not realize obesity is a leading cause of many chronic diseases. Many also feel those diseases are hereditary, and there is nothing a person can do to prevent them.

The state's children raise major red flags for the future. West Virginia University screens thousands of schoolchildren every year. In 2010-11, they found that 24 percent of fifth-graders have high blood pressure, 26 percent have high cholesterol, and 29 percent are obese. Eighteen percent of kindergartners and 23 percent of second-graders are obese.

There has been little public discussion of this problem. "The Shape We're In" project aims to stir up that discussion. Written and photographed by Annenberg fellow Kate Long, it will be divided into three parts in The Charleston Gazette, the state's largest newspaper:

• Children at risk
• Programs that work
• Communities making a difference

Some segments will be accompanied by West Virginia Public Radio pieces.

Part 1: "This is a public health emergency"

Part 2: A growing problem

Part 3: Putting the pieces together

Part 4: Health officials say W.Va. can reverse its chronic disease numbers

Part 5: W.Va. man: diabetes programs work

Part 6: "Get kids moving"

Part 7: Daily activity affordable, Department of Education says

Part 8: Wood researchers: Active kids do better academically

Part 9: Rocking the gym at 7:30 a.m.

Part 10: Nebraska school district lowers obesity rate

Part 11: What happened?

Part 12: 'Everyday heroes' saving own lives

Part 13: W.Va. ranks first in heart attack, diabetes, eight other categories

Part 14: Success from scratch

Part 15: Great Kanawha food fight

Part 16: Better focus

Part 17: W. Va. slammed with sugar

Part 18: Glenda and Jill vs. diabetes

Part 19: This is how bad diabetes can be

Part 20: Recognize diabetes before it's too late

Part 21: Logan hardest hit by diabetes

Part 22: Even if your relatives had diabetes, you don't have to

Part 23: Body and spirit

Part 24: American Diabetes Association is MIA in W.Va.

Part 25: Young people contending with diabetes

Can W.Va. do the same?
The Charleston Gazette
Monday, February 20, 2012

CHARLESTON, W.Va. -- In 2005, almost four out of 10 kids in the Kearney, Neb., schools were obese or overweight. "It was time to do something about it," said Cari Franzen, Kearney Schools wellness coordinator.

Five years later, Kearney had chopped the obesity rate of their grade school kids by a stunning 13 percent. Eighty six kids dropped from obese or overweight to normal.

Franzen couldn't believe it when she first saw the numbers. "I knew we'd gotten the students more active, but when I saw those BMI numbers, it was like wow!"

"We aimed to cut the obesity rate by 2 percent," she said. "We thought 2 percent would be a challenge, because, nationwide, childhood obesity is rising or staying the same. Nobody is lowering it. We never dreamed of 13."

No other school system has done that, said Ginny Ehrlich, CEO of the Alliance for a Healthier Generation. "What Kearney has done is unique and a great example for the rest of the country," she said.

Two Kearney grade schools pulled off especially dramatic drops. Low-income Emerson Elementary started with 44.8 percent of students obese or overweight and ended with 35.2 percent. A second school dropped from 36.5 percent to 26.4 percent, a 27.7 percent drop.

Mary Weikle's eyes widened when she heard the Kearney numbers. "How'd they do that?" she said.

Weikle is point person for West Virginia state Schools Superintendent Jorea Marple's new campaign to get students moving. "West Virginia is at the beginning stages of what they did," Weikle said. "We can learn from what they did."

A smaller state such as West Virginia definitely could tackle a program like Kearney's, said Kate Heelen, professor of exercise science at the University of Nebraska-Kearney. "It's not rocket science. It's really just making smarter choices. But in a smaller state, you have more chance of getting buy-in."

How'd they do that?

"We basically rethought the school day to find ways to get the kids moving," Franzen said.

First, they applied for and got a $900,000 federal Physical Education Program grant.  But $900,000 is not a lot of money to change a school system, especially divided into three years. 

So they teamed up with the education and exercise science staff at Nebraska-Kearney, looking for the nation's best, proven-to-work strategies. "They helped us plan ways to get the most bang out of the bucks." Here's what they did:

  • They adopted a new physical education program, Spark, that promotes lifelong fitness and enjoyment of exercise, rather than athletic competition. "It gives you a research-based roadmap, with activities and tips," Franzen said. They trained their P.E. teachers to use it.
  • They scheduled physical education class every other day and had physical activity sessions on the non-P.E. days.
  • They wove short bursts of physical activity through the classroom day, using the "Take Ten" program that shows teachers how to connect physical movement to subject areas. Some schools used the free "Jammin Minutes" program that provides ideas for quick minutes of physical activity.
  • They structured their recesses. Instead of standing around the playground, all students now play group physical activity games. "The kids really enjoy that," Franzen said. Some grade schools run or walk laps at lunch, she said.
  • Every school joined the Healthy Schools Network online, sponsored by the Alliance for a Healthier Generation. "They give you a checklist so each school can inventory and say, 'OK, where are we in these areas and where can we improve?' Then they send back a nice roadmap of things that school can do to create a more healthy environment.'"
  • They encouraged teachers and staff to tackle their own physical fitness, offering incentives. "It was voluntary, but we made it clear we expected them to be role models."
  • They started a middle-school Fitness, Fun and Games class, focused on activities children could do all their lives.
  • In high school, "we opened the gym at lunch to anybody who wanted to shoot baskets, play volleyball or do other activities."
  • They bought each school inexpensive play equipment such as jump ropes, balls, rubber fitness station mats, scooter boards, as well as video exercise DVDs.
  • They revamped their food service to reduce processed food.
  • They involved the community, including family fun nights.

They did not make schools participate, but all eventually did. "We got buy-in," Franzen said. "That's harder than ordering people to participate, but it makes you more successful. We started with the most willing schools. Then other schools wanted to do it too."

Emerson School joined immediately, fourth-grade teacher Chris Weis said. "Once we heard how bad our children's numbers were, the teachers all said, 'What can we do differently to address this?'"

"The kids have been so open and willing to participate," she said. "They grasp onto what you give them. It's a matter of exposing them to some different lifestyle choices."

Two grade schools that increased their BMI started late, Franzen said. The other seven schools lowered their BMI.

The grant is running out, but the program does not depend on it, she said. "We planned it to be sustainable." Otherwise, she said, the system could gain the weight back, like a person who goes off a diet.

The drop in BMI numbers is getting attention, Franzen said, but "I think the most important thing is, we've established a culture of physical fitness in our district. We've got a lot of fit kids who have formed healthy habits that will last a lifetime."

Eighty six children dropped from the obese or overweight category to healthy weight.

"They are growing in height, so of course, they gained weight," Franzen said. "But -- and this is an important point -- they didn't gain as much. They gained five pounds instead of 15.

"So the BMI didn't drop because children lost weight. It dropped because they did not gain as much unnecessary weight."

Could W.Va. counties do it?

To get those results, West Virginia kids would need equivalent physical activity time, Mary Weikle said. "You have to have 20 consecutive minutes to get cardiovascular benefit," she said. "We're not there. You've got to intentionally have that time," she said, whether it's in physical education class or less formal physical activity sessions.

"If we get to five days a week, we'll start reaping benefits." For now, they're aiming for 15 more minutes of activity per day. "That's not enough to change the numbers," Weikle said, "but we're starting. We're getting people comfortable with the idea."

It could require legislative change, she said. "We at least need to meet the national guidelines from [the National Association of Sport and Physical Education]. From that point, individual schools could design a daily program based on their facility and staffing."

West Virginia has already done a few things Kearney did, she noted:

  • Junk food is banned from school vending machines.
  • Soda pop sales are outlawed in 54 of  55 school systems, Wyoming County being the only exception.
  • West Virginia has started to get processed food out of school meals with a six-county pilot project.
  • Like Kearney, West Virginia braved the cupcake moms and replaced cupcakes at school parties with salsa and healthy snacks.

Kearney kids face many challenges that West Virginia kids face. More than 60 percent qualify for free and reduced-price school lunch, compared with West Virginia's 52 percent. Kearney's per capita income is $23,071, compared with West Virginia's $16,477.

In 2007, 63 percent of Kearney kids spent between one and three hours a day surfing the net and texting. Thirty-one percent of West Virginia kids watch three or more hours of television a day, not including the Web and texting.

Thirty-six percent of Kearney children were obese or overweight in 2006. Today, 47 percent of West Virginia fifth-graders are in the same boat, 29 percent obese and another 18 percent overweight. 

Seventy-five percent of Kearney students did not eat green salad more than three times a week. Eighty percent of West Virginia kids say they do not eat five servings of fruits and vegetables a day.

In 2005, 62 percent of the Kearney kids had zero phys ed per week. In 2009, 67 percent of West Virginia high school students had no PE in an average week.

Nebraska legislators worry about the rising cost of health care, as do West Virginia legislators.

Can W.Va. change the future?

Can a whole state like West Virginia lower its future heart disease and diabetes rates by getting kids more active? 

There are 772 West Virginia public schools, with 283,000 students. State Superintendent Jorea Marple is signaling local schools that more physical activity is expected, but it is not policy, so far.

The local level is where it happens, said Ginny Ehrlich of the Alliance for a Healthier Generation. The Alliance, sponsored by the American Heart Association, works with 14,000 schools nationwide to promote physical activity, including more than 130 West Virginia schools.

"It's really important to have that state support and policy," she said. "Then each school needs to create their own magic. Each needs to customize their plans in a way that suits their students."

It will be clear that the state is serious when they put measures of physical fitness in places that count, she said. At this point, there is no measure of fitness on West Virginia's state, county or school report cards that determine whether school systems get accredited.

Melanie Purkey, director of the Office of Healthy Schools, said her staff is in conversation about that subject with the state's education information system staff. "We're talking about fitness data sets that might be included on the report card."

"What gets measured gets done," Ehrlich said. "If the state sets the bar -- as West Virginia has a history of doing around foods and beverages -- schools will find innovative ways to meet those guidelines."

Meanwhile, in Kearney, Neb., grant funds are running out. Franzen is scheduled to be laid off at the end of this school year.

The coordinator, the person who kept stirring the pot, will be gone. "I hope we've set it up to sustain itself," she said.  "We'll see."

Kearney Schools have been bombarded with requests for information. They expect to release a detailed report this spring.