AMY WHEELER used to eat a lot of popcorn with butter. Now she eats popcorn "with a little salt."
Matthew Layman has discovered peas, broccoli and cauliflower. Although they're just "OK," he eats them "sometimes."
Craig Widdowson has cut his fried chicken consumption drastically. And he thinks he's eating less candy.
Lauren Kuta eats French fries only once a week.
Amy Harper still eats cheese, "but not a lot," and she's added apples, brussels sprouts and spinach to her diet.
These fourth-graders at Grange Elementary School in Dundalk are not dieting. Nor are they being punished.
They are learning how to eat well and how what they eat now can affect how they feel years from today.
They are part of a three-year nutrition-education program that is reaching into 12 elementary schools around Francis Scott Key Medical Center with practical information about foods and exercises that are good for their hearts and those that are not so. The program also tracks the youngsters' height, weight, blood pressure and cholesterol levels, as well as their consumption of fatty foods and overall knowledge of heart-healthy living.
The Food Re-education for Elementary School Health -- FRESH -- program is preventive medicine prescribed years in advance. If applied properly and repeatedly, it will help these youngsters avoid heart disease.
"These are children of our patients or people who will become patients," says Kerry Stewart, director of the FRESH program and the hospital's cardiac rehabilitation and prevention programs.
Lifestyle factors -- smoking cigarettes, poor eating habits, lack of exercise -- make many of the adults who live in the neighborhoods around the hospital at "high risk for heart disease," so it is particularly important to reach their children, who are still forming eating and exercise habits, he says. The children are a normal group of 9- and 10-year-olds, chosen
because their schools are part of the community the hospital serves.
"We're trying to teach kids that there are a lot of choices . . . to develop healthy habits in areas of nutrition and exercise," explains Stewart, who is also an assistant professor at Johns Hopkins School of Medicine.
FRESH began in September 1989 with 700 third-graders in a dozen public and parochial schools in the city and county.
Dietitians and educators from the hospital go into their classrooms four times each school year to talk about the heart and how eating and exercise affect it. They use games, demonstrations -- putting a potato chip on a paper towel to show how much grease comes out -- and art projects to reinforce the information.
The program also publishes a newsletter, FRESH Ideas, to share eating tips, exercise suggestions and even recipes with parents, says Sheryl Gray, a registered dietitian who works full-time with health educator Jill Adler on FRESH. More than 2,000 copies of each newsletter were distributed this year.
The program includes teacher workshops, family activities, PTC cooking demonstrations for parents and a "heart-healthy" tour of a local grocery store for adults.
Involving parents is essential to the program, Gray says, as parents are still the children's primary role models. The parents also choose and prepare most of the food the children eat.
The first-year lessons focused on the workings of the heart, the details of heart disease and the connection between diet and health, says Gray. This year the information became more practical as students learned to read food labels, to calculate the percentage of fat in a food, to eliminate some of the fat from their favorite fast-food meals and to add fruits and vegetables to their diets.
"We're teaching skills to identify foods high in fat and to make choices of foods low in fat," says Gray.
She takes a realistic approach to changing young eating habits. "I don't tell them not to go to fast-food restaurants. Maybe twice a week is OK. I don't tell them they should never have potato chips, but they need to cut back. We're not depriving them."
She also takes a cautious approach to how effective the program is. "I know that the children are learning what we are teaching; I don't know how much they are practicing it," she says.
But many of the results have been positive.
The youngsters are enthusiastic: "I love it," says Amber Wheeler, 9. "It really tells me how I'm doing with my heart, how healthy I am and what I can do to be healthier."
The group's overall cholesterol and blood-pressure levels fell last school year -- this year's assessments are still being made -- and the children's knowledge of food rose, says Stewart. (About 450 of the 700 children participate in the cholesterol screening, which requires that blood be taken twice a year; children must have a parent's written permission for this.)
The overall average cholesterol level dropped from 162 to 153. Normal cholesterol for children of this age is 160-164, Stewart says. The average blood pressure dropped from 108/67 to 103/65. Both of these decreases are "statistically significant," he adds.
During the same time, the youngsters reported that their consumption of high-fat foods fell 13 percent; high-sodium foods fell 11 percent, and high-sugar foods fell by 7 percent. Consumption was determined by asking the children how often they ate each of 51 foods on a standardized survey.
The assessment also tested the children's knowledge of heart health. The number of correct answers increased by 19 percent from September to May, Stewart says.
Although Gray says parent involvement has been disappointing, many of the children at Grange thought their parents' eating and buying habits had changed.
"My mom used to buy lots of nacho chips," says Sabrina Hensley, 10. "Now, she only buys two bags. She buys lots of apples and fruits."
"We don't go to fast-food restaurants as much," adds Matthew Layman, 10.
Wheeler is particularly proud; she's taking at least some of the credit for getting her mother to lose weight. "She doesn't like being on a diet," says Wheeler, "but it's helped."
FRESH has helped Craig Widdowson, too. His cholesterol level dropped nearly 40 points last school year, and he's lost 10 pounds, he says. Widdowson, 10, doesn't eat just because he's bored anymore and he limits his corn curls to Friday nights.
Other schools in the FRESH program are: Bear Creek, Berkshire, Charlesmont, Colgate, Dundalk, Logan, Norwood, Holabird, John Ruhrah, Our Lady of Fatima and Our Lady of Pompeii.
FRESH ideas for a healthy diet
HERE ARE some FRESH ideas for cutting fat from your diet, whatever your age:
* Spread sandwiches with mustard instead of mayonnaise.
* Top baked potatoes with plain, non-fat yogurt instead of sour cream.
* Add lettuce, tomatoes and other vegetables, instead of sauces, to sandwiches for moisture.
* Replace high-fat snacks with lower-fat goodies: apple rings dusted with cinnamon; frozen grapes, pineapple and melon chunks; rice cakes; popcorn without butter.
* Instead of potato chips, try snacking on graham crackers, pretzels or fig bars.
* For lunch, make turkey or chicken sandwiches instead of eating cold cuts or hot dogs.
* Limit meals at fast-food restaurants to two per week.
* At fast-food restaurants, order a "small fry" instead of a larger serving.
* Be wary of salad bars; all ingredients are not low in fat, especially mixed salads made with mayonnaise.
* When ordering a salad in a restaurant, ask for the dressing on the side.
* Enjoy dinner rolls, but forget the butter.
* Eat meatless tacos or tacos with chicken or ground turkey instead of beef.
* Avoid fried or heavily battered foods.
* Drink skim or 2 percent milk instead of whole milk.
* Learn to read food labels, so you can determine the amount of fat in foods.
-- Mary Maushard