Under supervision from Nakia Bonds, 11-year-old Deriyon Davis cooks turkey burgers as part of the FIT-Together program at the Michigan City Elston YMCA. Staff photo by John J. Watkins
Under supervision from Nakia Bonds, 11-year-old Deriyon Davis cooks turkey burgers as part of the FIT-Together program at the Michigan City Elston YMCA. Staff photo by John J. Watkins
Indiana ranks in the paunchy midsection of the nation when it comes to childhood obesity.

One out of six Hoosier children ages 10 through 17 are formally classified as obese, ranking the state 24th in the country. Causes include familiar fat-producing culprits: generational genetics, easy access to processed food, lack of regular exercise and too much time staring into an electronic screen of some kind, state experts say.

“Children living in our society will likely have a predisposition to gain excess weight due to normal human biology," said Tamara Hannon, a professor of pediatrics at Indiana University. “Plus, Indiana ranks near the bottom for public health spending, and we have fewer resources to utilize.”

Hannon said environmental factors also promote genes related to obesity. Genetics contribute to 40-70% of obesity cases due to more than 50 genes strongly associated with the disease, according to a 2018 study conducted by the Obesity Medicine Association.

When food is scarce, humans are designed to store energy as fat on their bodies, allowing them to go long periods of time without eating. However, when this mechanism occurs in an environment where food is abundant, people are less likely to lose the extra fat. This happens with children as well, Hannon noted.

Children ages 2 to 4 who participate in the Indiana Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have a 13.5% obesity rate. In 2019, 138,611 Indiana residents participated in WIC, a program providing breastfeeding support, nutritious foods and health care referrals to women who are pregnant or with a child 5 or younger.

Although Type 2 diabetes isn’t overly prevalent in children, Hannon is beginning to see this condition more frequently in her patients. In 2001, 0.34 per every 1,000 children in Indiana were diagnosed with Type 2 diabetes. By 2017, the rate nearly doubled to 0.67 per every 1,000 children, she said. Hannon, a pediatric endocrinologist, reacted to this trend as it developed by founding the Youth Diabetes Prevention Program at Riley Children's Health at Indiana University Health in 2013.

“The clinic is meant to screen young people with multiple risk factors and educate them about the process,” she said. “There are some individuals who have multiple risk factors for diabetes, giving them a likelihood to develop it in their lifetime. Prevention resonates with me.”

Obesity rates are determined by using a body mass index, a calculation of how much a person weighs in relation to their height. If the calculation is at or above the 85th percentile for someone’s sex and weight, it qualifies as overweight. If it’s above the 90th percentile, it qualifies as obese, a multi-factorial disease that is too often mislabeled and unfairly judged.

Learning healthier habits

In August, a FIT-Together program was launched at Franciscan Health Michigan City. Children ages 8 to 14 in LaPorte County can join the eight-week fitness program with the goal of adopting the “seven C’s” of family resilience: competence, confidence, connection, character, contribution, coping and control.

The free program takes place twice per week, on Tuesdays and Thursdays, with three different components — healthy eating and cooking, fitness activities and coping skills.

“Overweight children have a 70% chance of becoming overweight adults,” said Nila Williams, community health improvement coordinator at the hospital campus.

One in three children are overweight, she noted, with contributing factors of watching too much TV and not getting outdoors enough.

“I understand not everyone can afford to eat healthy. It is expensive to buy all of these fruits and vegetables. But there are other options,” Williams said. “Even if it’s just walking a bit or moving around inside your house.”

The first 45 minutes of the FIT program involves physical training under the direction of Ron Gaston, a pastor from Temple Total Fitness. On Tuesdays, the second 45-minute segment is spent with personal chef Nakia Bonds from Kia Can Cook. On Thursdays, the second half of class is spent with Rebecca Saylor, a Franciscan Employee Assistance Program therapist.

“The kids and families are able to participate with cooking meals. The kids get to cut veggies, and they really enjoy that,” Williams said. “Every Thursday the families go home with a meal kit of what they cooked on Tuesday. It’s nice to hear parents say how proud they are to make the dishes as a family.”

There are currently 18 children enrolled in the FIT-Together program, in addition to family members who participate. One of those members is Charla McClain, of Michigan City, whose daughter and six nephews are enrolled, although none of them qualify as obese.

“When I heard about it, I thought it was a good idea to learn myself and keep the kids fit,” said McClain, noting that she is overweight. “The kids are learning good habits.”

McClain, whose family heard about the program at a back-to-school rally, said it is a way to keep children aware of their eating habits. The program may also prevent her young family members from gaining weight as they get older. Her 14-year-old nephew who attends the program now returns home wanting to prepare his own meals instead of asking for someone to do it for him.

Williams said, “We want parents to be involved because they’re learning as well. If we can have an impact on a few kids, maybe this thing will get bigger.”

Hopeful outlook from state experts

The Indiana Youth Risk Behavior Survey, conducted among high school students in selected schools across the state, shows the prevalence of obesity was 17.6% in 2021, up from 13.6% in 2015, according to Indiana Department of Health records.

However, the prevalence of high school students who reported being overweight fell from 17.3% in 2015 to 14.8% in 2021, data shows. This latest marker dishes up hope for public health officials.

ISDH’s Division of Nutrition and Physical Activity has taken different approaches to address childhood obesity, according to spokesperson Jennifer O’Malley.

The department has provided mini-grants to strengthen school wellness policies by adding more time for physical activity, updating vending options and offering healthier concessions, she said.

"We also have worked with partners to increase the number of schools that participate in Farm to School to help promote access to locally sourced food in schools,” O’Malley said.

Farm to School allows students to gain access to local homegrown food as well as provides educational opportunities, including school gardens, cooking lessons and farm field trips.

Walk to School and Bike to School days are promoted to help increase exercise outside of school. The state also provides funding to Playworks, an organization working to increase physical activity and to decrease bullying, she said.

Indiana Department of Education has partnered with the Fresh Fruit and Vegetable Program (FFVP), a federally assisted program that provides participating elementary schools with free fruits and vegetables during the school day. Elementary schools can qualify for this program if at least 50% of students receive free or reduced lunch.

In 2020, 568,773 Indiana residents participated in the Supplemental Nutrition Assistance Program (SNAP), with children representing nearly half of all participants, according to date from 2018.

Hannon said she’s hopeful that, as a society, childhood obesity rates will decrease over time.

“There are a number of things that can be done, not just one solution,” she said.

One major step on a national scale is the upcoming White House Conference on Hunger, Nutrition, and Health. On Sept. 28, the Biden administration will release a national strategy with actions that the federal government can take to address childhood obesity.

“Some studies show that rates aren’t increasing, and will begin to decrease over time," Hannon said. "In order for this to happen, it has to be a movement that includes multiple changes in society, not just medical treatments."

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