KENNEWICK -- As sixth-graders meandered into Ron Schuh's health class at Park Middle School this week, their attention immediately was drawn to a rack of exercise bars.
The students clustered around the rack -- some of them hefting the color-tipped bars to feel their weight -- before being hustled to their seats by Schuh so he could start the class.
The bars, which are free weights in bar form, were part of his "Walk the Talk Wednesday" -- a weekly lesson plan that incorporates some aspect of exercise and fitness into whatever students are learning at the time.
This week they were learning about healthy social skills, so Schuh paired students to learn how to build muscle endurance with the bars.
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"I think it's cool because then in (physical education) we will know what muscle we're working," said student Abigail Lopez.
The Wednesday lessons are part of Schuh's strategy to instill good, lifelong habits into the middle-schoolers, and to either prevent them from becoming a childhood obesity statistic or to help them stop being one.
But Schuh recognizes that one teacher, or even one school, can't tackle the issue of children's health and fitness alone.
"I'm a firm believer that to address this issue, it is going to take a real team effort -- not just a health class or a (physical education) class," Schuh said. "Everything is tied together."
Numerous Tri-Citians are working to tackle childhood obesity, its underlying causes and associated chronic illnesses using a variety of angles.
Every two years, students in sixth, eighth, 10th and 12th grades are asked questions on a variety of health topics.
Results from the state's 2010 Healthy Youth Survey show 23 percent to 29 percent of the Benton County students surveyed were considered obese or overweight.
That is a slightly higher number of obese and overweight middle- and high-schoolers than the state average.
Statistical reports for Franklin County from the 2010 survey were not available because the sample size of students who responded was too small to analyze, said officials from the Benton Franklin Health District.
The words "obese" and "overweight" are defined a little differently for children than for adults.
For adults, it's a straightforward measurement of the body mass index, or BMI -- basically a ratio of height vs. weight. If an adult has a body mass index from 25 to 29.9, he or she is considered overweight. A BMI of 30 or more is considered obese.
To determine if a child or teen is overweight or obese, doctors calculate a BMI, then see where that falls on the growth curve for the child's age, according to the Centers for Disease Control and Prevention.
Children whose BMIs are below the fifth percentile on the chart are underweight. Healthy weight is anywhere from the fifth percentile to the 85th percentile. Overweight children fall in the 85th to 95th percentile and obese children are those with BMIs in the 95th percentile or above.
When overweight and obese students were totaled, Benton County numbers show 29 percent of eighth-grade students, 23 percent of 10th grade and 26 percent of 12th grade fall into those two categories.
The state averages are 27 percent of eighth-graders, 24 percent of 10th-graders and 25 percent of 12th-graders.
Questions related to weight and obesity were not asked of sixth graders, according to the survey reports.
The survey indicates a stronger likelihood that obese children will perform poorly in school. Of the Benton County children surveyed, 36 percent of obese children scored Cs, Ds and Fs. Only 23 percent of non-obese children had grades in those ranges.
When officials compared 2008 survey results with last year's, they saw some increases in the number of children who are obese but some small improvements in those considered overweight.
Local people working to improve children's' health and fitness agree that it's important to teach children good habits when they are young.
Once they reach their teen years and chronic conditions such as type 2 diabetes start to appear, the trends can be difficult to reverse.
"One thing that becomes important and obvious is a lot of diseases people get later as adults start in childhood," said Dr. Matt Smith, a family practitioner in Kennewick. "Obesity by itself is a disease that begins in childhood."
Kennewick pediatrician Dr. Ronald Wojnas said the chronic diseases he sees in his practice primarily are diet driven, and he advises parents to avoid giving children any kind of milk other than skim and too much sugar. Sugar stresses the pancreas and can lead to type 2 diabetes.
But he sees palm oil, palm kernel oil and coconut oil in foods as the most insidious threat to children's' health.
The oils are used in a variety of foods -- Top Ramen, Flinstone Gummies vitamins, Pop-Tarts, candy bars and microwave popcorn to name a few. Wojnas has a display in his office showing parents some foods to avoid.
The problem with these oils is that they often are hydrogenated to increase their melting point to prevent foods from melting in warm climates.
Hydrogenation is a process of combining unsaturated fats with hydrogen to make them more saturated, so palm and coconut oils in foods tend to be high in cholesterol-raising saturated fats.
Wojnas is seeing children as young as age 4 with cholesterol levels above 225, and he said he believes this is a result of children consuming foods containing these oils. Anything above 200 is considered high, according to medical standards.
Most of the time, children's' cholesterol levels can be tackled with a better diet.
And that might be the only means, as no one seems to know whether it's safe to prescribe children cholesterol-lowering statin drugs.
"I have called Seattle Children's Hospital and sent them patients with cholesterol of 235 to 265," Wojnas said. "I'm asking if these kids should be put on a statin, but I'm not getting any answers."
While the cholesterol problem seems to be a surmountable one, Wojnas is much more pessimistic about tackling childhood obesity.
"Parents don't really cooperate with that," he said. "After about 6 to 8 years of age, it's too late. They don't respond. It is sort of sad."
Smith said that child obesity tends to be related to socioeconomic status -- poor children just don't have as much access to healthy foods, such as fresh fruits and vegetables, or low-income parents may simply not have the cooking know-how to make meals with fresh ingredients.
Smith is a member of the Food & Fitness Coalition, an initiative of the Benton Franklin Community Health Alliance, and said the group is trying to tackle the cooking skills issue by offering a healthy cooking demonstration at the Pasco Farmers Market on Oct. 22.
The coalition also is working with Washington State University students to compile a cookbook to hand out at food banks that would include recipes using ingredients commonly found at food banks.
School districts are working to tackle the nutrition piece of the issue by changing school menus to include healthier foods, and restricting access to sugary sodas and other less healthy offerings.
In the Kennewick School District, for example, the cafeterias stopped serving french fries even though they were a moneymaker, said district spokeswoman Lorraine Cooper. Brown rice was added as a side option instead.
The district also received a grant a few years ago to bring in a new physical education curriculum that focuses on lifetime fitness.
In Pasco, the school district has been training food service workers on a new federal program designed to get more fresh fruits and vegetables as snacks, said district spokeswoman Leslee Caul.
The district gets reimbursed from the U.S. Department of Agriculture's Fresh Fruits and Vegetables Program to offer free fruits and veggies to students throughout the school day, and separate from the lunch or breakfast menus.
The program now is operating in seven Pasco schools.
There also are numerous options for families to get kids moving, through programs at the YMCA or Boys & Girls Club of Benton and Franklin Counties, which offers a gym and weightlifting in its Teen Center in Pasco.
For families who can afford memberships, the Columbia Basin Racquet Club in Richland and Tri-City Court Club in Kennewick offer a variety of programs that let the whole family get moving.
Ryan Vogt, fitness director at the Court Club, said about 70 percent of the club's memberships are sold to families.
"What we're designed to do is family health," he said.
One service offered by the club, called Thin & Healthy's Total Solution, is designed to help overweight kids and adults learn to manage their health through diet and exercise.
The program is offered to children ages 8 and up, and allows them to work with a fitness coach to design a yearlong eating and exercise plan that involves not only the child, but their family.
"The child is not going to lose unless the parent is involved," Vogt said. "And most of the time when the child needs to lose (weight), the family is in that place too."
The challenge for everyone working on the issue of children's nutrition and fitness is getting the kids themselves to make good choices.
"It's like anything," Schuh said. "You may lead them to a salad, but they still pick the french fries."
* Michelle Dupler: 509-582-1543; firstname.lastname@example.org