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A Big Fat Problem
A Gym of Their Own

by Jeff Worley

Photo of Chris Holian and Cody StoneCody Stone was the first participant enrolled in UK's PEP program, which began in February 2003 at the Seaton Center. The children and teens typically work out three times a week, using special kid-sized equipment, with the guidance of trainers like Chris Holian.

Not so long ago, common wisdom said that kids shouldn't pump iron. This was also the long-stated policy of the American Academy of Pediatrics (AAP). Kids just weren't developed enough and could be easily injured by this type of activity, the reasoning went. They needed to wait until muscle and bone developed.

Now, that's changed. Three years ago, the AAP revised its policy, stating that if proper techniques are used and precautions taken, preadolescents can benefit from strength training. This reversal was music to Jody Clasey's ears, especially since she already knew a little about kids and strength training.

"What we have in place at UK now in the newly developed Pediatric Exercise Physiology (PEP) Lab located in the Seaton Center are special kid-sized exercise machines. We have the gold standard in this equipment," says Clasey, an unabashed cheerleader for exercise. She comes across as the type of woman who, if she were your morning jogging partner and you tried to beg off, would pull you out of bed anyway and make you go running with her.

"Using these smaller machines, the preadolescents in our program can do leg presses, leg curls, bicep curls, lat pull-downs, bench presses, shoulder presses, and a seated row. Sits ups are also a part of the regimen," says Clasey, who teaches undergraduate and graduate courses in exercise physiology.

"Children aren't just small versions of adults—they're physiologically and metabolically unique." This equipment was purchased over two years ago with funding provided by the Building Interdisciplinary Research Centers in Women's Health fellowship program and UK large-equipment grants.

These aren't just any kids who show up in the PEP lab to huff and puff for three one-hour sessions a week for 10 weeks. The children Clasey works with in this study are all 7 to 11 years old and have a body mass index greater than the 95th percentile based on age- and sex-specific norms. According to a screening requirement, none of the children can show any signs of puberty. In Clasey's program, diet is being monitored but no diet is prescribed—only programmed exercise.

The children in this study don't have far to go if they need help or advice. The training ratio is no greater than one instructor to two children, though Clasey says, happily, that often the children get one-on-one supervision: "We make sure the kids are going through proper breathing technique and proper lifting technique when they're being tested or during training." Other key experts assisting with this study include Kent Adams, associate professor of health promotion, physical education and sports studies at the University of Louisville, and UK grad student Chris Holian.

All children recruited for the study first undergo a physical examination performed by a pediatrician and a body composition analysis involving underwater weighing, total body water analysis and bone scans to measure the relative compositions of muscle, fat, water, and bone in their body. "We need these measurements, and we've done everything we can to make them kid-friendly," Clasey says. "Rather than taking blood samples for the total body water analysis, for example, we just have the kids breathe through a tube submerged in methanol and dry ice that freezes the moisture in the breath. We can get plasma concentrations that way without having any needle sticks involved." Among other things, these measurements allow Clasey to track changes in the children's body composition.

Photo of Jody ClaseyJody Clasey, an associate professor of kinesiology and health promotion, hopes to expand UK's PEP lab so even more overweight kids can slim down through this exercise program.

Though this study isn't complete and she and her staff haven't crunched the final numbers, Clasey says physical changes in the obese kids are noticeable.

"Truthfully, I'm amazed at the body composition changes. Even though one child has gained eight pounds while he's been in the study, he went from a husky 14 pant size to a regular size 11. Another child had completed the intervention study and been away from us for several months. When we called him back for another study, I expected to recruit him as an obese child, but now he fits the lean criteria. I said to his mother, 'What have you been doing?' She said, 'Your program jump-started my whole family. We now grocery-shop together, the children read product labels, and we eat dinner together. Exercise has become a part of our daily routine.'"

Clasey knows that this program works. The PEP lab currently has several ongoing studies involving both lean and obese children, and she's excited about its potential in the years to come. The hobgoblin is funding for the lab. There are, she says, some efforts under way to seek endowment funding so that the lab can continue and grow.

To spread awareness of what the lab offers, Clasey leapt at the chance recently to meet with the governor's wife, Glenna Fletcher, who has made a commitment to support efforts to combat childhood obesity. "Mrs. Fletcher has publicly stated her concerns about obesity in general and the related health problems and health-care costs associated with obesity [Glenna Fletcher is a registered nurse and has devoted much of her time to encouraging and promoting healthier life styles for all Kentuckians], so we wanted to tell her about our efforts at UK." Fletcher met with Clasey and several faculty members from the College of Education and, according to Clasey, it was a fruitful meeting.

"We discussed our past, current and future plans to fight childhood obesity. She was very interested in helping to facilitate efforts across the state to combat obesity by expanding our knowledge and providing resources to assist both children and adults. Perhaps, with the first lady's help and support from others, that can become a reality," Clasey says.

In the meantime, she is pleased with recent news that she has become a HERO.

In September, the Louisville Science Center announced that Clasey has been chosen as one of its KY-HEROS (Kentucky Health Education Rural Outreach Scientists). As a result, her collaborative research into health issues associated with childhood obesity will be transformed into an educational exhibit at the Louisville Science Center for the next two years. The HEROS program is funded by a Science Education Partnership Award from the National Institutes of Health.

Clasey will be one of four Kentucky scientists whose work will be featured at the science center. Kent Adams, a frequent collaborator with Clasey on a number of research initiatives concerning children's physical development and obesity, will also participate in this program.

"I'm pleased that the work Kent and I have been doing regarding prevention and intervention strategies related to childhood obesity is receiving attention and will increase awareness. It's an honor to be able to represent UK in this way and bring some focus to the research programs ongoing in our state," Clasey commented.

Anyone in the Lexington area interested in information on Clasey's studies should call the UK PEP lab at 859/257-4867 or 859/257-1597.

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