July 2010 Issue

Summer Camps With a Twist — Programs Help Kids Have Fun While Honing Healthful Habits
By Juliann Schaeffer
Today’s Dietitan
Vol. 12 No. 7 P. 36

Summer’s here, which means school is out for kids across America. However, if memories of neighborhood softball games or kickball in the park come to mind, you may want to snap yourself into present day.

According to a White House Task Force on Childhood Obesity report, roughly one in three children is either overweight or obese. And while there’s no one cause—or solution—to a crisis this massive and multifaceted, it’s hard to argue that a lack of exercise isn’t partly to blame. Video games, iPods, and TV have replaced bats and balls for many American youths, leading to a summer spent more indoors than any previous generation. Exercise is no longer a regular part of many children’s school-year schedules, let alone their summer routines.

While you may have spent a week or two of your childhood school-free months at a sports or scouts camp (likely focusing more on friendship than anything), weight-loss camps are fast becoming this generation’s summer camp trend. Whether you believe these camps to be a summer savior for children with bad lifestyle habits, a tool in the fight against obesity, or a symbol of America’s quick-fix mentality, these camps are gaining steam. Learn the basics as Today’s Dietitian profiles three such camps looking to reverse an overweight trajectory of today’s youths in the pretext of summer fun.

Summer Fun, With a Side of Weight Loss

Camp Shane
With locations in Ferndale, N.Y., and Mayer, Ariz., Camp Shane has been helping children get healthier since 1968 with its “one-of-a-kindest” weight-loss camp, according to David Ettenberg, camp founder/director for 42 years. Campers can choose among sessions lasting from three to nine weeks. Camp Shane’s mission is to transform children’s lives with self-esteem, fitness, and pure fun, all in a compassionate setting, and Ettenberg says losing weight isn’t the only goal of this family-owned and -operated summer camp.

“Our campers learn to eat properly by doing so and by being educated about what and why they are eating,” he says. “They learn to become fit by playing and participating in fun activities while learning how to do so safely and acquiring skills so that they can continue with their favorite fitness activities when they return home. Most of all, we promote self-esteem, good health, and teamwork, all of which combine to help a child change their attitude and lifestyle.”

Kids participate in six activities daily, ranging from aerobics and archery to wakeboarding and water sports, with more than 50 activities to choose from, “many focusing on disguised physical activities because they’re enjoyable,” says Ettenberg.

Campers, aged 7 to 17, are all weighed and measured at the camp’s commencement and all share a common menu of about 1,600 to 1,700 kcal per day. “The menu has been devised by registered dietitians and overseen by Dr. [Joanna] Dolgoff and meets the children’s nutritional needs. Also, children who have been determined to have food allergies or digestive issues are accommodated,” says Ziporah Janowski, Camp Shane’s co-owner/director.

“Nutritionists monitor the progress of each child on the menu and adjust the calories as necessary to provide the appropriate level for children needing more because they have reached their ideal weight or to ensure they are sufficiently fueled,” she continues.

Ettenberg says the plan is to serve healthful meals that kids actually enjoy: “Many children and teens have peculiar eating habits or eat a limited number of items. Since we are focusing on changing their habits, it is essential that we serve well-balanced, healthy meals that kids will be happy to eat when they return home. The same is true for snacks. Our meals include the foods children are eating now [but] excluding high-fat, high-calorie items … and served in the proper portion. Kids are surprised to learn that it is possible to eat healthy and enjoy the meal.”

What does that translate into? Chicken nuggets that are baked, not fried; pizza using whole wheat crust and low-fat cheese; BBQ chicken; baked potatoes with more nutritious toppings; and salads topped with fruit.

Between breaks from physical activities, children also partake in a mix of classes concerning nutrition, cooking, building self-esteem, and cognitive behavioral therapy (CBT) to give them the lifestyle tools necessary to sustain any weight loss after their return home.

“Campers are taught several nutrition classes a week,” explains Janowski. “The object of the classes is to creatively introduce topics and involve as much class discussion as possible. Camp nutrition education is essential so that children can take what they have learned at camp and apply it at home. We want to give our campers the tools they need to make healthy choices on their own, all year long. It is not simply a matter of losing weight while at camp and then reverting to their old habits.”

Kids attending Camp Shane also attend a weekly cooking class during which they are taught to prepare a healthful meal and snack. “They prepare the meal from start to finish and learn that cooking and preparing your own meals is fun, easy, and the best way to follow a healthy lifestyle,” explains Janowski.

And to round out the educational aspects of camp is a strong guidance/behavioral modification program. “Guidance staff help campers understand their own feelings, identify their positive attributes, and feel good about and develop pride in themselves. This is accomplished through bunk discussions, rap sessions, journaling, and one-to-one conversations,” says Ettenberg.

Realizing that the real war on weight loss only begins when campers leave, Camp Shane sends its campers home with tools to help them stay on track. First, the camp has allied with Dolgoff, MD, a pediatrician and child obesity specialist who runs the Red Light, Green Light, Eat Right! child and adolescent weight-management practice. All campers not only receive a membership to Dolgoff’s online nutrition plan but also are encouraged to get in touch with her should questions arise.

Campers also receive an at-home booklet “with recipes, nutritional information, and guidance on how to continue the good habits they learned at camp. We send out monthly nutritional newsletters that are geared specifically for children, [and] our staff also stays in touch with the campers to provide support and encouragement throughout the year,” notes Janowski.

For these camp directors, summer camp is about kick-starting more healthful habits before it’s too late. “Children pick up habits at a young age that last a lifetime,” says Dolgoff. “If kids eat chicken nuggets and French fries as toddlers, they will continue to eat them as teenagers and adults. Further, obesity that starts in childhood causes a greater risk of early death than obesity that starts in adulthood. It is much easier to lose weight and sustain weight loss before puberty. For these reasons, it is important to help an overweight child as soon as possible.”

New Image Camps
With two locations, one in Pennsylvania (Camp Pocono Trails) and the other in Florida (Camp Vanguard), New Image Camps offers two- to seven-week camp sessions throughout the summer. Founded in 1991 by owner and camp director Tony Sparber and his wife, Dale, after Sparber fought his own battle with weight as a child, New Image Camps aims to provide the long-term tools necessary for campers to get healthy. Still, head dietitian Nicole Selinsky, RD/LD, says weight loss is only a by-product of this camp’s greater goals.

“New Image’s philosophy is very simple. From the moment the campers arrive, they are treated with respect and caring by our highly trained staff,” she says, noting the following principles in the camp’s philosophy:

• providing an environment where weight loss is an integral part of the summer camp experience;
• promoting health, wellness, integrity, and learning;
• building self-esteem and lasting friendships; and
• ensuring individualized attention that yields results.

Selinsky says the calorically sound meal plan at New Image gears the campers toward more steady rather than rapid weight loss. With meals based on the American Dietetic Association’s exchange list for weight management, all campers eat three meals per day, along with an afternoon and evening snack, averaging 1,600 to 1,800 kcal daily.

Selinsky says this menu and the broader camp experience are sufficient not only for children desiring to lose weight but also for those just looking for some summer excitement: “Camp is about having fun, trying new things, meeting new people, and feeling good about yourself. Not all of our campers are there to lose weight. Many come with a friend, a sibling, or because of the great programs we offer.”

As such, New Image can accommodate children with allergies as well as those campers of a healthy weight. “All campers follow the same meal plan, but it is adjusted for any camper with different needs: A camper with a food allergy will be offered a substitution for whatever menu item the allergy is for and it will be replaced with a comparable food item, or a camper who does not need to lose any weight will be put on a maintenance program where they are allowed to get extra portions of foods if need be,” she adds.

A typical breakfast could include an egg white omelet with cheese, skim milk, and an orange, while dinner might be steak teriyaki with rice and mixed vegetables, along with a salad bar, and fresh watermelon for dessert.

New Image also includes nutrition education on its list of must-haves, and every camper attends one nutrition and one cooking class per week, with lesson plans designed to teach kids how to eat and cook more healthfully so as to incorporate this new knowledge into their everyday lives.

“These lessons range from label reading and following the Food Guide Pyramid to how to avoid stress eating and dining out. In the cooking classes, they cook something new each week. We focus on healthy recipes that are kid friendly and can easily be duplicated at home,” says Selinsky.

New Image treats physical activity as another integral part of children’s new healthy habits. Swimming, aerobics, calisthenics, tennis, volleyball, basketball, dance, yoga, golf, and waterfront activities such as skiing and kayaking are just some of the activities available to campers, who participate in up to five outdoor activities per day.

The camp also offers self-esteem classes to all attendees “to work on the campers from the inside out. Weight gain or loss is directly linked to how someone mentally feels about themselves. Therefore, higher self-esteem and quality friendships yield better choices, which leads to a healthier lifestyle,” says Selinsky.

To help kids upon their return home, Selinsky has created a take-home maintenance book for every camper that is filled with meal plans, tips on how to continue achieving health and fitness goals, and nutritious recipes to make at home. “Along with this book is an e-mail address directly linked to me so they have access to speak to an RD at any time throughout the off-season. I answer nutrition and fitness questions all year long from the campers and parents to help them stay on track,” she says.

While realizing that any diet can be a short-term fix, she says the tools learned at camp, along with the take-home booklet of tips and tricks, are meant to guide campers toward lifelong behavior modification to aid in their journey toward a sustained healthful lifestyle.

Wellspring Camps
Wellspring Camps, with eight locations across the United States, including California, Texas, Wisconsin, and Pennsylvania, has a scientific approach to diet and activity management that it believes aids campers in adopting healthier behaviors for the long haul.

Shauna Johnson, leading nutritionist of Wellspring, says that while weight loss may happen in the short term, behavior change for the long term is the ultimate camp goal. “Every Wellspring program works toward instilling lifelong healthy habits. We know from scientific studies, our scientific advisory board, and decades of experience and expertise that the changes in habits we work to have our participants develop will lead to initial and long-term weight-loss success. This is why cognitive behavioral therapy is critical to what Wellspring does. The goal of CBT is to change the way people think and act—in our case, dealing with diet, activity, frustration, stress, and goal-setting.”

Johnson says Wellspring can accommodate a variety of campers—from children who are 20 lbs overweight to those who would be categorized as super morbidly obese. She describes the camp’s meal plan as very low fat and low calorie while still meeting all dietary needs and guidelines. It focuses on balanced meals that are nutrient dense and sustainable so that campers will make these meals at home. “In a sense, we’re changing the individual’s eating patterns in a way that he or she likes and will follow in the long term. We do not leave out the foods that an individual likes, but we make it healthier,” she says, such as brownies with applesauce instead of butter for a dessert.

Daily menus, developed by RDs, include three meals and two snacks. Although a typical day of controlled foods will include roughly 1,200 calories, 10 g of fat, 50 g of protein, and 30 g of fiber, campers are allowed unlimited access to an uncontrolled foods section of fruits and vegetables, which can add to these totals. “At Wellspring, there is no caloric goal. If campers are hungry, they will have as much uncontrolled food as they like until they are satisfied. All Wellspring asks is that they self-monitor everything so that it can be processed and discussed with their behavioral coach,” says Johnson, noting that the uncontrolled foods section allows the campers to practice portion control while using foods that are virtually fat free and low in calories.

Johnson says Wellspring prides itself on giving campers not only basic nutrition education about topics such as macronutrients and portion size but also real-world nutritional education—information on how to combat the dietary dilemmas campers will come in contact with when they’re outside camp perimeters. How to order more nutritious choices in restaurants as well as knowledge of using food labels in grocery stores are two examples of this real-world education.

Putting as much emphasis on physical activity as nutrition, Wellspring lets its campers experience a wide variety of activities during their stay, including kayaking, hiking, swimming, and ropes courses. Between activities, students also participate in therapy sessions with a behavioral coach as well as group sessions with other campers.

And to round out the weight-loss approach, Wellspring also offers campers cooking classes in which they learn to make healthier versions of foods they learned to love at home. “We don’t want our campers to feel as though healthy eating is boring, redundant, or simply not possible. … Empowering our campers is important and necessary in the long term,” Johnson says.

“Our program is not focused on weight loss; it is about learning the tools,” she adds. “Yes, we know it is important to our participants’ physical and emotional health to lose weight, but our goal is to change the behaviors, and we know weight loss will follow.”

After sessions are over, campers have access to an after-care site that offers emotional support and where campers can share their real-world experiences—both good and bad. They’re also set up with an account on www.myselfmonitoring.com, where they can log and track daily fat and calorie intake and detail their daily thoughts. In addition, Johnson says all staff members are available via e-mail for added support and questions.

Long-Term Answer or Quick Fix?
Are summer camps of any kind a viable solution to the childhood obesity epidemic? No surprise here: There are both avid proponents and critics of the “summer camps equal healthier kids” equation.

One such critic, Deborah Rhea, MEd, EdD, an associate professor at Texas Christian University, is wary that the short-term premise embedded in summer camps sends the wrong message to children who are overweight and obese. “Camps are short term, meaning they’re anywhere from two weeks to 12 weeks. But behavior change takes time and it takes comprehensive change, not just going to a camp,” she says.

While she believes comprehensive weight-loss camps that incorporate long-term learning tools can help change children’s unhealthy habits, she cautions against summer boot camps—purely physical activity camps, which are also gaining popularity, that try to whip kids back into shape in a short period of time without giving any nutritional guidance.

Rhea recommends a more multifaceted approach to attacking childhood obesity and believes the answer lies in a place in which children spend much more of their time: school. She says that if all schools (elementary, middle, and high schools) were to increase the weekly time given to physical education and activity, then that would send the right message to children—that physical activity matters.

“Inactivity is more harmful than the obesity at this point. If we can get kids to understand that through the education and the movement in the gym setting, and we’re doing that every year of their life K through 12, then that’s why I say that schools are a better place because they’re going daily to schools,” Rhea adds.

Rhea compares the idea of weight-loss camps to a mentality with which too many Americans have gotten too comfortable: “It’s ‘how can I do this in a short period of time and then be OK again?’” she says. “Well, it doesn’t work that way. There are two premises that have to happen: eat less and be more active. And I don’t know how else we can say that, but the problem is that we come out with more and more [short-term solutions] and think that we’re going to change and we’re not.”

However, research published in a recent issue of Pediatrics may give some credence to weight-loss camps. In following 10- to 18-year-olds at Camp Jump Start, the study found that the camp improved participants’ weight, body mass index, physical fitness, and blood pressure. The Saint Louis University researchers plan to follow the children to determine how many sustain these weight losses from summer camp.

Personal beliefs aside, Janowski notes that the U.S. Preventive Services Task Force recently reported that obesity programs can be effective and are recommended for children aged 6 to 18 who are overweight. While she can attest to the success weight-loss camps can provide, she also realizes that children need resources once they return home to maintain any weight loss from camp: “Many hundreds of kids have lost weight at Camp Shane and maintained that weight loss afterwards. This is proof that the program can be successful. The critical element that is the key to long-term success is having the parents participate in the process and make changes at home so that the whole family is eating healthy and exercising.”

A Tool, Not a Solution
Are weight-loss camps a solution on their own to the massive childhood obesity problem? Probably not. But with camps such as these offering nutrition education and cooking classes, along with behavior therapy and other tools aimed at long-term change, they may just be a valid tool to kick-starting kids on the path to more healthful lifestyle habits.

— Juliann Schaeffer is an editorial assistant at Today’s Dietitian.