Einstein-Montefiore research tackles childhood obesity in the Bronx

The National Institutes of Health has awarded Albert Einstein College of Medicine of Yeshiva University $1.22 million to combat childhood obesity in the Bronx. Working with Montefiore Medical Center, The University Hospital and Academic Medical Center for Einstein, a team of researchers will build upon their earlier work using education-based audio CDs in the classroom to encourage physical activity and promote positive lifestyle habits.

The prevalence of pediatric obesity has tripled in the past three decades and inner-city minority children have been disproportionally affected. In the South Bronx, nearly one in three children enrolled in the Head Start program, which provides educational services for three- to five-year-olds from low-income households, is obese. Almost half are overweight or obese.¹

"After 20 years of medical practice in the South Bronx, I have come to appreciate the enormity, complexity and morbidity of the epidemic," said Philip Ozuah, M.D., Ph.D., chair of pediatrics at Einstein and Montefiore and principle investigator of the study. "The impact of obesity on children and their health is devastating and demands to be addressed."

Physical inactivity is one of the contributing factors to this widespread problem. Although the World Health Organization has identified physical activity in schools as an essential strategy to prevent childhood obesity, many schools - especially in low-income areas - lack facilities to implement the recommendation.

To address this reality, Dr. Ozuah and his team created a series of 10-minute audio CDs designed to encourage aerobic activity. Developed in conjunction with the New York City Department of Education and local schools, the education-based CDs coincide with the curriculum of each grade level. The activities are led by a teacher in a standard classroom setting and are meant to be a supplement to physical education classes and recess.

"Through his innovative approach to confronting childhood obesity, Dr. Ozuah offers the type of leadership we need to fight the epidemic and its consequences, including the appearance of type 2 diabetes among children and adolescents," said Allen M. Spiegel, M.D., the Marilyn and Stanley M. Katz Dean at Einstein and former director of the National Institute of Diabetes and Digestive and Kidney Diseases. "Type 2 diabetes is no longer a disease diagnosed only in adults. Children are now facing the dire complications associated with lifelong exposure to type 2 diabetes, including heart disease, kidney disease, blindness and lower-limb amputations. We face enormous human and economic costs if we do nothing."

"This novel strategy to increasing physical activity in children is the outgrowth of Montefiore's school-health program," said Steven M. Safyer, M.D., president and CEO of Montefiore Medical Center. "As one of the largest programs in the country, Montefiore's school-health program has a legacy of success in developing novel ways of improving the health and well-being of urban school-aged children."

The series of CDs, called CHAM JAM (Children's Hospital at Montefiore Joining Academics in Movement), contain educational material and music that encourage dance, movement and exercise. To keep the activities fresh and to offer variety, new versions are regularly developed and distributed.

Building upon this promising pilot program, Einstein-Montefiore researchers will use this new grant to quadruple the reach of the CD series, from 4,000 to 16,000 students enrolled in kindergarten through third grade in Bronx schools. Through this new randomized group, researchers will evaluate the frequency of CD use, physical activity level during playback, and overall physical fitness of the students over the course of two years.

"We have received consistently positive feedback from the schools we're working with and our preliminary results are very promising," said Dr. Ozuah. "We believe that this program, if validated by further research, has the potential to transform school-based health policies across the country in terms of increasing physical activity in inner-city children, particularly in resource-poor neighborhoods."

Researchers have already begun to identify additional schools to participate in the program and will begin distributing the new CDs in the coming weeks. This new phase of the study will run through August 2011.