A couple thousand Flagstaff parents will soon receive letters from the school district stating their elementary-school children are overweight or at risk of becoming so.
This is arguably the most serious step Flagstaff Unified School District has ever taken to counter obesity beyond the schoolhouse. It's happening because Flagstaff's medical community is warning of life-shortening consequences for part of a generation if nothing changes.
Although Coconino County's adults have the lowest rate of obesity in the state and the prevalence of adult obesity here is among the lowest in the country (17 percent as of 2007), the same does not seem to hold true for the community's children.
That's according to physicians and nurses here, who are reporting obesity-related diabetes in children as young as age 4.
"These are serious, serious problems going on inside of these children now, and we have to do drastic things to make them better," pediatrician Nina Souders told FUSD's board Tuesday.
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HALF WITH WEIGHT PROBLEMS
The school district's top nurse estimates that about 50 percent of FUSD's elementary school students will be classified as either overweight or bordering on overweight, almost 50 percent will be classified as having a healthy weight, and a few percent will be underweight when the district finishes measuring.
At Killip Elementary, for example, 42 percent of the students measured this fall were deemed overweight based on a height/weight index, called the body mass index.
Just as they now receive exams to detect sight or spine problems, all of FUSD's elementary school students will be weighed and measured this fall with help from Flagstaff Medical Center's Fit Kids staff and North Country HealthCare.
The nonprofits then plan to target education and more to the schools with more students having severe weight problems.
The letters to be sent to elementary school students' parents in cases where students are underweight, overweight, or marginally overweight provide graphs showing a range of weights for a given age and height, noting unhealthy weights at either end.
UP TO THE PARENTS
They recommend good nutrition, exercise, and a visit with the child's physician, but it's entirely up to the parents to make any such decision, said FUSD Superintendent Barbara Hickman.
She's expecting some displeased phone calls.
"This is an emotional subject," Hickman said to the board. "It brings up difficult issues and parents can be a little bit offended sometimes."
But in a time when physicians are warning that today's kids could eventually die of cirrhosis from fatty livers, or suffer from long-term high cholesterol, unwanted weight for life, or cardiovascular problems, Hickman says the district must raise the issue.
"Given the effect this has on the long-term health of our kids, once we know about it, we have to say something," she said to the board.
LACK OF INCOME AND TIME
In her practice at North Country HealthCare, Souders treats patients in their mid-20s who are on multiple medications for blood pressure and diabetes due to weight.
Some of these patients' children are on track to be worse off, she said, gaining weight younger and more irreversibly.
Income and time are partly to blame, Souders said, with family members working multiple jobs, going for inexpensive, nutrient-poor food that is quick to prepare, and taking whatever they can get from food assistance agencies.
One counterpoint to that has been a state food-assistance program for women, infants and children (WIC) that last fall reduced the amount of milk, cheese and juice recipients could buy and added more whole grains, soy and fresh produce for the first time.
Some 400 of the children battling weight problems who have opted, with their families, to go for health counseling and fitness at FMC's Fit Kids are getting blood drawn to measure health. That procedure is somewhat new in pediatrics, said Richard Henn, director of education programs at FMC.
What's surprising is how bad some of the results have been, Henn told FUSD's board.
"If I was to hand those numbers of those lab results to a group of physicians, they would think we were running a geriatric clinic for people with cardiovascular disease," Henn said.
WHAT ABOUT MORE EXERCISE?
FUSD Governing Board member Chris Bavasi asked whether more physical education time might be budgeted into the school week for exercise. But he received an answer that it would be unlikely, given other academic requirements, unless the school day were to grow longer.
Elementary, middle and high school students here receive physical education, but it's not required daily.
Nutrition is built into other health classes that also cover a range of other topics like bullying or sexual health, Hickman said.
Next up could be weigh-ins at local middle schools. High schools could be next, but it's uncertain.
Long ago, a student's height and weight used to be mailed home with a report card, but that hasn't been the case for years at FUSD.
The letter goes beyond those numbers by outlining what these heights and weights mean in the greater context of the population.
But there are some specific shortcomings: Body mass index measurements might say a muscular athlete or a tall African-American student is obese when one is not, or that an Asian student is of a healthy weight in some cases when the student weighs more than is healthy.
"It's not an exact science," said Marilyn Grudniewski, the district's top nurse.
Cyndy Cole can be reached at 913-8607 or at firstname.lastname@example.org.