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Children's Hospital teaches healthy lifestyle

by Michael Baker
Public Relations
South Carolina, like the rest of the nation, has an obesity problem and the problem appears to be swelling. The state’s incidence of cardiovascular disease consistently ranks in the nation’s top two, and a pervasive quick-fix attitude isn’t helping. 

Instead of focusing on traditionally effective preventative methods founded on lifestyle education, many people turn to non-supervised options like fad diets and unproven supplements to combat weight problems on their own.

But not at MUSC’s Children’s Hospital.

The new Heart Health program puts a modern spin on the “Give a man a fish ...” adage, using education to help obese children and their families develop healthy eating and exercise habits.

Children and adolescents (ages 2 to 21) who enroll in the family-oriented, educational program learn tools to prevent cardiovascular health problems by making better choices and living healthier lives.

Phil Saul, M.D., director of pediatric cardiology, spoke enthusiastically about Heart Health’s inception.

“The enormity of heart disease, especially in South Carolina, is much bigger than what we previously focused on,” he said. “MUSC’s Children's Hospital needed a cardiovascular risk prevention program directed at children for a long time, and now we have one.”

Program coordinator and MUSC clinical dietitian Debbie Petitpain echoed Saul’s sentiments.

“The number of overweight children has increased exponentially every decade,” she said. “Ideally, we’d like to prevent these kids from getting to that point, but the reality is that many children are already there.”

Melissa Henshaw, M.D., assistant professor of pediatrics and medical director of Heart Health, agrees that the need for such a program became increasingly apparent.

“Physicians see these types of cardiovascular health problems in adults all the time,” she explained, “but increasing amounts of evidence signify that this isn’t just an adult problem. The roots of cardiovascular disease begin in childhood.”

Thus, MUSC initiated Heart Health. Henshaw directs the program in conjunction with the Children’s Hospital’s metabolic syndrome clinic, where she works with pediatric patients who also suffer from hypertension, insulin resistance, and/or dyslipidemia (abnormal cholesterol levels). Petitpain delivers Heart Health to participating patients.

Heart Health expands upon the clinic’s work, initiating an educational program that can be personally adapted to each child.

Based on a similar program—Committed to Kids, which began at Louisiana State University—Heart Health encourages children to learn about their health problems and take steps to remedy them.

Unlike its parent program, however, Heart Health works with each patient individually. The personal attention allows Petitpain to understand the unique nature of each patient’s concerns.

“With adults and weight management, what works for one person might not work for others,” she said. “There’s no reason to think it’s any different with children.”

At the beginning of the program, Petitpain distributes a book, Trim Kids, that serves as the patient’s educational guide.

“For the next six months, the book is like their health bible,” she said. “It provides reference materials and helps them record their progress, tracking their diet and exercise habits. Self-monitoring can be very effective.”

In addition to distributing the book, she collaborates with each patient to determine a set of goals and possible strategies to achieve them. She believes that having a plan of action is crucial to the patient’s success.

“It’s important for us not only to set goals, but to create a plan to reach them,” she said. “A lot of the children know how healthy they want to be, but they don’t know how to get there.”

The program includes 12 sessions—children typically schedule a meeting every two weeks for six months, although scheduling is flexible. At each session, Petitpain meets with the child and his/her family to review the child’s progress and to set new goals.

She also brings a new educational tool to each session for the child to take home. These include a pedometer to count steps during exercise and measuring cups to control portion sizes during meals.

The reading material, tools, and personalized sessions are designed to reinforce the attitude that improved cardiovascular health and weight management require lifestyle changes.

“We’re trying to encourage healthy lifestyle habits,” Petitpain said, noting that weight loss isn’t necessarily the goal for everyone in the program. “If these kids make permanent positive changes, they’ll be metabolically healthier regardless of whether or not they lose weight.”

Henshaw agreed, hoping that the program encourages the children to analyze the choices they make. 

“Heart Health is about lifestyle education,” Henshaw said. “Some patients aren’t interested in making an important lifestyle change, but then something happens and the light bulb goes on. That’s what we want to accomplish with the program.”

But the responsibility for such changes falls on everyone. Petitpain pointed out that children don’t shop for, choose, or cook the majority of the food they eat. Therefore, healthy habits need to be gleaned from their parents. With this in mind, Petitpain directs much of the information to the parents during the bi-monthly sessions.

Further solidifying the program's family-oriented stance, she often refers interested parents to the 12 Months to a Healthier Heart program. The free program, taught mainly by MUSC dietitians, brings health-conscious adults together once a month to discuss healthy lifestyle skills. The participants receive important information such as how to read a nutrition label, exercise tips, healthy cooking demonstrations, and even a guide to heart-healthy restaurants in Charleston.

Petitpain hopes that the parents’ participation in the adult program inspires them to set healthy examples for their children in Heart Health.

“Many of the parents are also overweight,” she said, “but by educating the adults, we can teach them to be positive role models for their kids.”

Between the extensive educational materials and personalized care, Heart Health might seem like an expensive program to enter. Petitpain recognized the potential concern, saying that “while a program like Heart Health is fantastic, money is always a hurdle for both the patient and the provider.”

Fortunately, the program lessens both parties’ financial burdens through efficient planning and outside philanthropy.

“The out-of-pocket cost is a $120 fee for the materials we provide,” Petitpain asserted. The patient’s insurance is charged a facility fee for Petitpain’s sessions and a physician's fee for time spent with Henshaw. 

Heart Health also provides a financial counselor, when necessary, to organize payment plans for participating families.

The program also received a $2,400 donation from Sodexho, a food and facilities management services company. The money will provide scholarships for families who can’t afford the materials fee.

With finances and materials in place, Heart Health began accepting patients in June. Currently, enrollment is open to patients within the metabolic syndrome clinic, and Petitpain hopes that with future success comes expansion. 

In the meantime, Heart Health remains dedicated to providing personalized, realistic treatment options for children with cardiovascular health problems. There are no gimmicks or deceptive quick-fixes. Just integrated, preventive education for children and their families who are determined to change their lifestyles for the better.
 

Friday, June 18, 2004
Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.