JaQuan Allen, 6, plays video tennis at his home in Hampton. A patient at the Healthy You clinic operated by Children's Hospital of the King's Daughters, JaQuan has agreed to get more exercise and eat a healthier diet.
JaQuan and his mother, Lakita Allen, talk about the types of food they eat during the day at the Healthy You clinic in Norfolk.
JaQuan Allen, 6 and his mother, Lakita Allen, look over the display of food models while waiting to talk with Mary Jo Haney, a registered dietitian at CHKD's Healthy You clinic. Haney uses the food to teach such things as portion control and serving sizes.
JaQuan Allen get some exercise in front of his home in Hampton riding his bike.
Summary: Healthy You clinic teaches families how to eat, drink and play away the pounds
Lakita Allen, a bus driver for Hampton schools, knows that her son, JaQuan, 6, a rising first-grader at Tyler Elementary, eats too much of the wrong foods. She's also concerned about his asthma, for which he takes medication. She estimates he gained between 30 and 40 pounds over the last year. At 95 pounds and 50 1/4 inches, he has a BMI of 26.2 and measures above the 90th percentile for weight for his age. He's frequently out of breath and often complains of being hungry. JaQuan is an only child and when he pitches a fit, Allen tends to give in. She knows what he should be doing, but she needs help implementing a healthier lifestyle for him.
His doctor referred him to the Healthy You clinic at Children's Hospital of the King's Daughters in Norfolk. The clinic has regional reach and is the only multidisciplinary health team in the area devoted to the issue of weight management for children.
At the Healthy You clinic
In the waiting room at the Norfolk clinic JaQuan gazes into the vending machine: It's stuffed with the cookies and processed foods he loves. A second vending machine is loaded with sugar- and caffeine-laden sodas. He stands transfixed in front of them. Inside the clinic, he'll be getting a message that these are foods he should avoid.
As a first-time visitor, JaQuan is assessed by four specialists: a doctor, physical therapist, nutritionist and social worker. Babs Benson, a registered nurse and the clinic's coordinator, then develops an action plan based on the family's priorities. The Allens will be asked to agree to one or two manageable goals until their follow-up visit a month later. As an example, Benson says they might agree to reduce JaQuan's "screen time," time in front of the television or computer, start regular exercise - even a few minutes a day - and reduce the number of sodas he drinks or switch to diet sodas. JaQuan will then visit monthly to assess his progress.
JaQuan fits the mold for clinic visitors. He is both tall and overweight for his age, a common combination. "That makes it easier for the family to be in denial," says Benson. "They'll often blame the thyroid or genetics."
Other common factors include a love for video games (X-Box 360), high-fat foods (pepperoni and sausage pizza) and quantities of sugary drinks (Kool-Aid). Also, the family eats out several times a week, often at pizza parlors or buffets, such as Golden Corral, and at school he'll pick lunches such as mac and cheese, pizza, chicken nuggets and french fries. JaQuan does like the plantains that his father cooks, and he's been active in baseball and football at the community center this summer. However, he reports, some exercises hurt him.
Nutritionist Mary Jo Haney quizzes the mother and son about his eating habits. Allen says JaQuan eats when he gets bored, he gobbles, and he doesn't like to eat the right things; he won't eat vegetables or fresh fruit, just the juice from fruit cups. He loves bread and she'll supply a pack of cookies and chips along with his sandwich at lunch or opt for the convenience of packaged Lunchables. An hour after dinner, he'll say he's hungry and will eat again as well as drinking as many as three or four cups of Kool-Aid. Allen concedes it's her fault that she gives in when he whines.
Haney tells Allen how to know if he's hungry. "Offer him strawberries, which he's had before. He'll eat them if he's hungry." (JaQuan makes a face, saying they're sour. That's Haney's cue to tell him that fresh foods taste better at different times of year, when they're in season.) "If he wants something particular, then he's not hungry," she adds.
JaQuan does a double-take when Haney holds up some fake mac-and-cheese (a favorite of his) in her hand and says that half of that is an appropriate portion; he inquires what the grapes are, though names them when prompted. Asked if he'll try to eat slower, he says he eats fast so he can get more food.
Then JaQuan moves on to the physical therapist. Tina Dolenti takes his resting heart rate (96) and has him do a 3-minute step test, which brings the heart rate up (133), not a huge increase. She puts him through a battery of exercises, urging him to follow through and be persistent. He scores in an acceptable range on flexibility and range of motion, but his endurance is below par. The push-ups give him some problems and so does balancing with his eyes closed. He admits that he wants to give up football. Dolenti encourages him to stick with it; if you practice these exercises at home, then you'll be able to keep up with the others, she urges, and practices will be easier.
Dolenti wants to encourage regular, unstructured exercise as part of his day. She inquires whether he has a bike and if there are other children his age in the neighborhood. He has a bike but doesn't like to ride it. Dolenti suggests that Allen offer a healthy reward, such as time at the park or bowling, if he'll ride his bike for a few minutes each day. Allen and JaQuan settle for a new X-Box game.
FOUR WEEKS LATER AT HOME IN HAMPTON
At 10 a.m. JaQuan is sitting on the sofa in the living room watching "Phineas and Ferb." He's absorbed in the program but answers questions readily when asked. What did he have for breakfast? "I didn't have any yet," he says. Allen reminds him gently that he did eat. "Remember?" she asks, reminding him that she offered him a choice between a packaged honey bun and peanut butter crackers. He chose the crackers after he pointed out that there were 440 calories in the bun, she says proudly. He washed it down with chocolate milk. He has started to like peanut butter, he says, and now will happily eat a peanut butter and jelly sandwich for lunch.
He proudly shows off a new game, "New Super Mario Bros. Wii," which sits on top of a neatly stacked pile. It's not one of the active Wii games, but he has those too. He and his mother play a game of Wii tennis to demonstrate, swinging their arms fiercely in several long rallies. JaQuan sinks back to the sofa, but complies when asked to show how Wii baseball works. He's not as adept and Allen tells him not to worry; but with encouragement he persists and after hitting several foul balls he starts scoring runs and getting caught up in the game.
One child's struggle with obesity
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