News

Ben Eaton runs a lot in order to stay fit. He limits his consumption of junk food to a couple of bites a week. And he figures high self-esteem is a key to lifelong happiness.

Sounds like Ben has been indoctrinated by Men's Health magazine. But Ben is 12 years old - and along with his peers at West Sechelt Elementary on British Columbia's Sunshine Coast, learned all those strategies for leading a long, healthy life ... from other kids.

"Sometimes your teacher can be quite boring and ranting on," says Ben, who is in Grade 7 at the school of 195 students. "I think for little kids, learning is better from someone that's older, but not like an adult."

Finding an effective way to combat the epidemic of childhood obesity in North America has stumped doctors, educators and parents for years. But a pilot study at West Sechelt - led by a team of B.C. researchers and published this week in the prestigious journal Pediatrics - has showed unusual success in improving children's health.

The program involved students in Grades 4 to 7 teaching younger "buddies" the importance of good nutrition, exercise and self-esteem. Within one school year, researchers from BC Children's Hospital found that students had made major strides in their health knowledge - and gained less weight than a control group from another school.

Fuelled by West Sechelt's success, the Healthy Buddies program has spread to dozens of schools across British Columbia, Alberta and Ontario. Last month, the World Health Organization took notice and is taking steps to implement the program across the Arabic-speaking world.

It's a success story the original participants couldn't have dreamed of in 2002, when it began with a frustrated doctor, an elementary school and a question: Can kids teaching kids have a measurable impact on their health?

"I certainly couldn't have imagined this," said Valerie Ryden, a physical education teacher who helped design and implement Healthy Buddies. "But at the same time, we realized that something really special was happening."

The inspiration for the program came from Suzanne Stock, an endocrinologist at BC Children's Hospital. Frustrated by the high number of obese children referred to her clinic, she wondered if there was a way to combat the problem through education.

Dr. Stock teamed up with Ms. Ryden, who was hired for her expertise in educational programming. To design their program, they decided to try something that has been gaining recognition among educators in recent years for its effectiveness: peer teaching. "We thought maybe if the older kids partner with the younger kids, maybe we'd have an impact," said Jean-Pierre Chanoine, a pediatric endocrinologist and researcher involved in the study. "But would it work? We didn't know."

For their guinea pig, the researchers turned to Sechelt, a town of about 8,500 on the B.C. coast. The town's school superintendent had shown interest in finding ways to promote healthy living among students. West Sechelt Elementary was selected for its manageable number of classes. Another school, located about 30 minutes away, would act as a control group.

Beginning in September, 2002, West Sechelt students in Grades 4 through 7 were taught lessons in nutrition, and the importance of exercise and positive self-esteem.

Then, for two or three hours a week, the students were paired up with students in kindergarten to Grade 3 and, with Ms. Ryden acting as a facilitator, they passed on those lessons to their younger buddies. Once a week, the pairs would head to the playground to do organized physical activities.

As the year went on, school faculty members began to realize that they were on to something.

"The [older buddies] would talk to me like we were in the staff room," Ms. Ryden recalls. "They would say, 'It went really well today, she's really catching on.' "

Once the school principal, Carolyn Spence, was caught holding a bag of Cheezies. "That's a bad orange. You're not supposed to eat that," Ms. Spence remembers being told by a child. "I'm like, damn. I got nailed."

Researchers and teachers also began noticing changes that none of them had expected. The program seemed to be putting a dent in a problem that can be just as detrimental to a child as obesity, and just as difficult to fix: bullying.

Sometimes, in the hallways, a bemused teacher would spot six-year-olds gazing in awe at their older buddy. Other days, they'd notice buddies - young and old - playing together at recess.

"They would look out for us on the playground and stuff like that," said Ben, who was in Grade 2 when the Healthy Buddies pilot project began.

"Usually I would stand around, not knowing what to do," added his 12-year-old classmate, Cassidy Robinson. Her older buddy, Stephanie, "was always explaining things to me so I would know what to do."

In June, the students were assessed using fitness, knowledge and self-esteem indexes that had been applied in September, including a nine-minute run, and measures of body mass index (BMI) and blood pressure.

The results were impressive. Compared with the students at Langdale Elementary School in Gibsons, which acted as a control group, both older and younger students at West Sechelt showed a greater improvement in their knowledge and attitudes about healthy living, according to the research published in Pediatrics.

As expected, the children's BMI and weight increased over the course of the school year because they were growing. But the weight and BMI of the West Sechelt students in Grades 4 to 7 increased less than those of the Langdale students. The West Sechelt students also had a smaller increase in systolic blood pressure (when the heart contracts; diastolic blood pressure is taken when the heart is relaxed).

There was no significant difference between the two schools in the nine-minute run. However, the researchers point out with a chuckle that Langdale elementary did happened to launch a running program that year. "We were quite happy, of course, because it seemed that we could make a difference," said Dr. Chanoine, who works at BC Children's Hospital. "But we also wanted to make sure that we could reproduce that."

Finding effective strategies to combat childhood obesity has been baffling and frustrating for researchers for years. While alarm over the obesity epidemic among North American children has been growing since the late 1990s, proven methods of prevention or changing bad eating and exercise behaviours have eluded educators.

One of the main reasons is that scientists still aren't sure why children become obese, says Tom Baranowski, a psychologist and professor of pediatrics at Baylor University's medical school in Houston, Tex., who has been researching obesity-prevention programs for children since the early 1980s.

"We've done all kinds of stuff, and there are little flickers of promise in some of them, but none are overwhelmingly successful," he said. "When you start analyzing what's going on, what you find is that we really don't know what the behaviours are that lead to the obesity."

What children put in their mouths is often controlled by their parents, he says. Genetics may also play a role. So when it comes to changing those behaviours through educational programs, it's hard to know where to begin. "There are lots of people who are very, very interested in the problem," Dr. Baranowski said. "We're all hoping that one of us is going to hit it on the head."

Since 2003, 44 more schools across British Columbia have started the Healthy Buddies program using a grant from the province. At the end of this school year, the researchers will begin assessing students from half of those schools, looking for the same changes observed at West Sechelt.

Meanwhile, word of the program's success has spread across the country. Last month, an Alberta school launched the program, as well as the Ontario-based children's charity project Variety Village, which provides thousands of children with educational programming each week.

Also last month, the program was presented to 85 delegates representing 22 countries at a conference hosted by the World Health Organization. After seeing Healthy Buddies presented at another international health-education conference in Vancouver, a WHO official based in Cairo had invited a program official to give a presentation at a WHO conference in Damascus.

"It was really well received," said David Barnum, a former B.C. elementary school teacher who along with Ms. Ryden now oversees Healthy Buddies programming. After the presentation, WHO officials agreed to fund the translation of the Healthy Buddies program into Arabic. If all goes according to plan, the program will be distributed to countries across the Middle East, South Asia and the eastern Mediterranean.

Back at West Sechelt Elementary, the program is running on a smaller scale because the school no longer has the same resources it had during the pilot study - namely, a full-time Healthy Buddies teacher, Ms. Ryden.

It has been years since some of the students, such as Ben and Cassidy, began learning how to stay healthy from their older peers.

"I'm a big buddy now," says Ben, who has a buddy in Grade 1. "I try to set a good example."

Get with the program

Healthy Buddies is divided into three elements: nutrition, physical activity and self-esteem. Older and younger students pair off to complete various activities:

Go Move!

Students rotate through eight stations in circuit-training exercise. The older children lead their buddies through a 20-minute workout, including a warm-up and a cool-down.

Older students present skits about their favourite physical activities. The skits show how they move, why they love it and how it keeps them healthy.

Go Fuel!

Students are given a variety of food images to sort into three groups: unhealthy, sometimes nutritious and very nutritious.

In a bingo-type game, each student receives a card showing images that represent the food groups. A student calls out different foods while others match the item to the groups on their cards.

Go Feel Good!

Students write down their goals for healthy living on paper cutouts of their feet. The message: Goals are achieved by taking one step at a time.

In a dimly lit room, students lie on mats listening to music, while a teacher leads them through visualization exercises. They are asked to imagine themselves doing something positive.

Hayley Mick