Princess Health and Clinton County coalition works to change the health lifestyle of its children, in an effort to change the local health culture. Princessiccia

Princess Health and Clinton County coalition works to change the health lifestyle of its children, in an effort to change the local health culture. Princessiccia

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By Melissa Patrick

Kentucky Health News

Public officials and local leaders in a small, rural county in Southern Kentucky that ranks near the bottom of in the County Health Rankings for the state have formed a coalition to improve the health of its community, with a focus on its children.

Clinton County (Wikipedia map)

Clinton County ranked 102nd out of 120 Kentucky counties in the 2016 County Health Rankings. �We recognize that. We saw that in our kids,� Lora Brewington, chief compliance officer of Cumberland Family Medical Center Inc., told Kentucky Educational Television in a report to be aired soon about the coalition.�And if we don�t change something now, we�re going to be going to the funeral home for kids a lot younger.�

So, with the help of the Foundation for a Healthy Kentucky, they formed the Clinton County Healthy Hometown Coalition to implement a multi-faceted public health program for the community's citizens, that focuses on its children.

�The coalition came together [according to] Aristotle�s thinking, that the whole is greater than the sum of its parts,� Brewington told KET. �We have a lot of great groups, that do a lot of great things, but if everyone is going for the same goal, and the resources are not combined, you�re not going to accomplish anything. And once we get everybody together and on the same page, by combining resources, we�ve been able to do some great things.�

Paula Little, assistant superintendent and supervisor of instruction for Clinton County schools, told KET that the coalition recognized most of the county's health issues stemmed from obesity, and decided to focus their efforts on the children in the community to change their culture.

"So we feel like if we can start young and start with our children and teach them healthy habits and healthy lifestyles that when they grow up they won't be faced with obesity and all of those chronic diseases that go with it," Little said.

Many of the coalition�s activities are school-based. Teachers have incorporated physical activity into the school day as well as during their morning routines and after-school day-care programs.

The coalition has worked with the schools to improve nutrition. Fruits and vegetables are now served every day with every meal. The schools also began offering supper to students during the school year and has since served over 6,400 meals. The program began last October.

Recognizing that an estimated 38 percent of Clinton County's children live in low-income families, the coalition launched a summer food program that delivers breakfast and lunch in a retrofitted school bus called the Bus Stop Caf� to areas in the county with high student populations.

The Healthy Hometown Coalition has also implemented school-based health clinics, which provides for the healthcare needs of students through a public-private partnership while they are at school. The clinics are run by the Cumberland Family Medical Center. In addition to providing clinical care, the clinics provide body mass index assessments and provide nutrition and obesity counseling.

�It�s about accessibility,� Brewington said. �It�s about the kid who has a cough and needs to see a doctor, but the parent can�t take off from work. ...It's about having healthcare right there where the child is the majority of the time."

Not mentioned in the KET report is that Clinton County schools implemented a comprehensive smoke-free policy last year that will go into effect in July. The policy will ban smoking on school property both during school hours and during school sponsored events, and also includes electronic cigarettes and all vapor products.

The coalition is working to change the culture of its community so that a healthy lifestyle becomes the norm, and not the exception.

�When you�re attempting to change a culture, and change the way people live, that�s a very long process,� Little said. �And it has to be something that�s consistent, that�s ongoing, and it has to be a message that children hear everywhere they go in the community.�

A full-time coordinator, April Speck, manages the various coalition programs and writes a weekly health column in the Clinton County News that often celebrates individual success stories. The coalition also sponsors community events, and has built a new playground.

�What makes me feel good about it is that I know there�s a real need here,� Speck told KET. �There�s a lot of kids who have childhood obesity... And just seeing them start to make changes in what they are doing, how much they are eating, their water intake, I know that we�re making an improvement.�

Princess Health and McDonald's stops sending to schools man who says he lost much weight eating only at McDonald's, including Big Macs and fries. Princessiccia

Princess Health and McDonald's stops sending to schools man who says he lost much weight eating only at McDonald's, including Big Macs and fries. Princessiccia

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Photo via flickriver.com

McDonald�s has stopped "giving nutrition advice to students in schools, pulling back on a program that critics said was a subtle form of fast-food marketing that could imperil kids� health and understanding of nutrition," Roberto Ferdman reports for The Washington Post.

The company had been sending to schools "a middle-aged teacher from Iowa who came to fame after claiming to have lost almost 60 pounds eating only McDonald�s," including Big Macs and french fries, Ferdman writes.

"McDonald�s said in a statement this week that Cisna stopped those visits last fall, after a Washington Post article highlighted how McDonald�s used its relationship with local schools and teachers� associations to get its message in front of students. . . . McDonald�s had long defended the practice, saying that Cisna�s presentation was about choice, not about eating McDonald�s. But critics argued it amounted to little more than a veiled attempt to woo customers at a young and impressionable age."

Princess Health and New license plate would promote outdoor recreation, support environmental education programs; 900 buyers needed to start.Princessiccia

Princess Health and New license plate would promote outdoor recreation, support environmental education programs; 900 buyers needed to start.Princessiccia

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A new "Let's Go Outside" license plate is being offered to give Kentucky motorists the opportunity to promote the health and environmental benefits of outdoor recreation.

First Lady Jane Beshear unveiled the license plate June 10. She said that encouraging children to play outside will help improve their health and noted that "Kentucky has one of the highest childhood obesity rates in the nation," reports to The Lane Report.

Proceeds from the specialty plate will support the work of the Kentucky Environmental Education Council, including coordinating the Kentucky Green and Healthy Schools program and certifying professional environmental educators.

�Kentuckians have said in surveys that children not spending enough time outside is a major concern,� KEEC Executive Director Elizabeth Schmitz said. �One of our goals is to encourage children to embrace the outdoors and to teach them the importance of a clean environment for our health and preservation."

The Kentucky Environmental Education Council needs 900 applications, each accompanied by a $25 donation, before any plates will be manufactured.

Submitting the application does not obligate you to purchase the plate, but your donation will be credited toward the purchase of a plate once they are in production. If not enough applications are received, your $25 will be considered a tax-deductible donation.

A link to download the application is available at www.keec.ky.gov/LetsGoOutside.

Princess Health and Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children.Princessiccia

Princess Health and Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children.Princessiccia

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The University of Kentucky recently partnered with over 100 fourth and fifth grade students in two Clay County schools to study the relationship between circadian rhythms and weight in children.

Sydney Sester, a fifth grade student at Manchester Elementary School, said in a UK news release that in addition to learning more about science and helping others by contributing to research, participating in the study showed her the importance of maintaining a healthy weight and eating well.

"It made me want to be more responsible with food and be patient with what I eat and only eat when I'm hungry," she said.

The project, "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children," also known as the Clay County Clock Study, is led by Dr. Jody Clasey, associate professor of kinesiology and health promotion, and Dr. Karyn Esser, professor of physiology.

The research team says it hopes to learn about the relationship between circadian rhythms, eating, and activity behaviors and the incidence of overweight and obesity in children.

And while the team is in the process of analyzing the data, Esser told a group at the 10th annual Center for Clinical and Translational Science conference in March that early data show 33 percent of the students in the study are considered obese, their initial blood pressure measurements are on the high end of normal, and the students are less active on weekends and nights than during the school week.

The data was gathered through electronic devices that the students wore for seven days to measure activity, heart rate and skin temperature. The students also kept a daily journal to record their sleep and eating activities each day.

Previous studies have shown that disrupting an adult's circadian rhythm is associated with increased risk for metabolic disease, which is a combination of chronic health conditions that puts a person at a higher risk of heart disease and diabetes. Similar research with children has been limited.

Esser noted that "Clay County and many of the counties in Appalachia have a much higher rate of these chronic diseases."

She also said that while it is known that light exposure affects the body clock, recent findings show that the time that we do activities, like exercising and eating, also contribute to circadian health, and that this is also likely true in children.

This research "could not only influence an individual, but school start times, activity intervention, just so many different areas from personal practice or behavioral choices to public policy, all for the metabolic or physiological good of the individual or collective body," Clasey said.

Princess Health andSchool nutritionists' lobbying group, freshly funded by grocery makers, wants more funding and flexibility with school-lunch rules.Princessiccia

Princess Health andSchool nutritionists' lobbying group, freshly funded by grocery makers, wants more funding and flexibility with school-lunch rules.Princessiccia

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School nutrition officials want more flexibility with new school lunch rules to cut down on the waste of unwanted food, Spencer Chase reports for Agri-Pulse, a Washington newsletter. Julia Bauscher, president of the School Nutrition Association, told the House Education and Workforce Committee that the organization supports the rules, but needs more funding to enforce them  and more flexbility to serve foods students will eat. (USDA graphic)

"SNA is requesting 35 cents more in federal funding for each lunch and breakfast that is served in the school lunch program, up from the additional six cents the government provided when the new standards were put in place," Chase writes. Bauscher told the committee, �That will help school food authorities afford the foods that we must serve, but unfortunately that won't make students consume it.�

Bauscher, who said SNA wants Congress "to soften the bill's target levels for more whole grains and less sodium in school meals," said that "in many cases, the new requirements have forced school lunch programs outside of budgetary constraints, forcing them to ask school districts to make up the difference. According to SNA, school districts will absorb $1.2 billion in new food and labor costs in 2010," Agri-Pulse reports. SNA has drawn major funding from some food manufacturers.

Chase writes that 51 percent of students qualify for free or reduced lunches, the first time the number has topped 50 percent in at least 50 years.

Princess Health andResearchers discuss physical activity as a way of maintaining or improving health; daily walking is still the best exercise .Princessiccia

Princess Health andResearchers discuss physical activity as a way of maintaining or improving health; daily walking is still the best exercise .Princessiccia

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By Melissa Patrick
Kentucky Health News

Obesity worsens the damage that arthritis does to joints, but simply telling patients to go home and diet and exercise is not working, and health care providers must proactively monitor their patients and help them find affordable solutions to succeed. And daily walking is still the best exercise.

Those were examples of research findings discussed at the 10th annual Center for Clinical and Translational Science conference sponsored by the University of Kentucky on March 25. More than 700 researchers, students, policymakers and guests discussed research with a focus on physical activity across the lifespan.

Stephen Messier, professor and director of a biomechanics laboratory at Wake Forest University, said obesity has a significant effect on joint health, particularly osteoarthritis, which he said is quite painful. He called for closer attention to obese patients with arthritis.

He said a study found that a combination of diet and exercise over an extended period of time offers the best results for less pain and less disability. He said that a separate study found those who lost 10 percent of their body weight had the most "significant outcomes" related to function, which included walking speed.

The conference featured 31 oral presentations and 270 poster presentations, addressing a vast array of topics including physical inactivity in children, physical inactivity in chronic disease and biomedical informatics.

"The conference was designed to raise awareness of the science behind the benefits of exercise and the dangers of physical inactivity," Charlotte Petterson, professor and associate dean of research in the College of Health Sciences, who chaired this year's conference, said in a UK press release.

The keynote speaker, Duke University medicine professor William E. Kraus, encouraged walking as a proven and simple activity that can improve health and actually extend life. "Fitness always trumps fatness," he said, noting that a "culture of convenience" and conditions of built environments, such as absence of sidewalks, deter people from physical activity.

Research on fourth and fifth graders in two Clay County schools, while in the early stages of analysis, found that obesity and inactivity begins early.

Karyn Esser, professor of physiology at the UK College of Medicine, said her research was examining the circadian rhythms and physical activities of students because changes in natural circadian rhythms "can create pre-cursors to disease" in just seven days, even in healthy young people. She said her study is intended to help schools improve students' health by adjusting meal times and offering physical activities to best coincide with circadian rhythms.

The data for Esser's study was gathered through electronic devices that the 136 students wore for seven days to measure activity, heart rate and skin temperature. The students also kept a daily journal to record their activities. So far, Esser said, the data show 33 percent of the students are considered obese, their initial blood pressure measurements are on the high end of normal, and the students are less active on weekends and nights than during the school week.

Another UK study found that students who are more active during the school day do better in mathematics.

Alicia Fedewa and Heather Erwin of the College of Education said they found that increased physical activity levels "significantly improved" math scores and slightly improved reading scores of the students who got an extra 20 minutes of movement on each school day. They recommended two short 15-minute recesses per day, rather than one long one. They also said that classroom "energizers" and stability balls also help students with these behaviors.

The researchers said many studies show that students who participate in recess and physical education during the school day are more focused and less fidgety, show less listlessness, and have better overall classroom behavior. They said more controlled studies need to be conducted, but said most studies to date have found that fit kids have less anxiety and better overall well-being. Also, a regimen of consistent physical activity is best for kids with attention deficit hyperactivity disorder (ADHD).

Princess Health and Princess Health andSome school districts reject federal offer of free lunch for all students, saying schools would lose money on the deal.Princessiccia

Princess Health and Princess Health andSome school districts reject federal offer of free lunch for all students, saying schools would lose money on the deal.Princessiccia

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Some school districts are rejecting a federal program that would provide free meals to all students in districts with a certain percentage of students in poverty, Jared Nelson reports for The Times Leader in Princeton, after the Caldwell County Schools decided against joining the Community Eligibility Program.

�Right now, we are not at the economically feasible point to do that. We would lose money,� District Food Service Director Will Brown told Nelson.

Nelson writes, "The district�s food service program is largely self-sufficient, earning income based on students and teachers who pay full-price for meals, and federal reimbursement for those meals and those provided to students qualifying for free or reduced-rate lunches."

If everyone gets a free lunch, �You are losing all of your students on full paid status,� Brown said. �You�re losing that revenue.� He said the number of qualifying students is �not high enough to do that.�

In other words, Nelson writes, "Having a percentage sufficient to qualify ... is different from having a percentage that would make the program viable locally. . . . Brown said other districts have signed on to the CEP program in prior years and been adversely affected. . . . The revenue earned each year allows the food services department to be able to use its own funds to cover the costs of most repairs, new equipment, and other expenses required during the school year and in the summer.

The program "is expanding nationwide this year, after being tested in 11 states, including Kentucky," Nelson notes. Qualifications are based on students in households in the Supplemental Nutrition Assistance Program (food stamps), the Kentucky Transitional Assistance Program, certain Medicaid recipients and foster children. (Read more; subscription required)