Lorena Ramos, 14, is a patient at the Healthy Hearts clinic at Children's Hospital Oakland. Credit: Gabriela Quirós.

One in six kids in the United States is obese, a condition that doubles their risk of heart disease. Castro Valley teenager Lorena Ramos has been overweight since she was a small child. Now, with the help of her mother and the Healthy Hearts clinic at Children’s Hospital Oakland, she’s fighting to exercise, eat healthily and drop weight. Will she succeed? Watch our story to find out.

The staff at the Healthy Hearts clinic had useful advice for parents. Here's a list I came up with.

7 Things I Learned About How to Help Your Kid Keep a Healthy Weight:

1. Serve appropriate portions.

“Half of your plate should be fruits and/or vegetables, a quarter of your plate is your protein, and the remaining quarter is your whole grains – things like rice or pasta,” said Dr. Lydia Tinajero-Deck, co-director of the Healthy Hearts clinic.

The portion of whole grains should be about the size of a fist, she said. This can sometimes be surprising for kids and parents used to covering their plate with rice or pasta and placing the protein or veggies on top. A serving of meat should be about the size of the palm of a hand.

2. Try to have some meatless meals.

Marin County cardiologist Dean Ornish found in the mid-80s that a low-fat vegetarian diet, together with stress management and exercise, could reverse heart disease. But during our interview, he repeated over and over again that it’s not all or nothing – you don’t have to go vegan to be healthy.

Watch this 5-minute video for more heart-health tips from Dr. Ornish:

3. If you and your family go vegetarian, make sure you don’t eat too much cheese.

“A lot of times, especially with our teen girls on a vegetarian diet, there’s a compensation with extra cheese,” said Dr. June Tester, co-director of the Healthy Hearts clinic, “and they end up actually, ironically, introducing a lot more saturated fat.”

4. Lobby for more and better physical education in schools, healthier school lunches and summer programs for kids.

“I wish for kids to play for an hour every day at school. It will help them academically as well as help their little bodies not gain so much weight,” said Dr. Tinajero-Deck. “And we can feed kids a lot better in schools. Oh, my goodness, we can do so much better.”

After Dr. Tinajero-Deck suggested to a group of dietitians at the Oakland Unified School District that milk or water were better choices than juice for breakfast, they went ahead and modified their menu.

5. Give your kid the gift of movement.

“Jumping rope 5 to 10 minutes, four days a week, is great exercise,” said Tess Barbieri, the exercise physiologist at the Healthy Hearts clinic. “You get a lot of bang for your buck.” She also recommends things as simple as bouncing a ball back and forth, or tossing bean bags and skipping to retrieve them.

6. Help your child find their life-long exercise.

Some kids like to ride a bike or rollerblade; others prefer to go on a walk with their friends. The important thing is to get moving and to make moving a habit.

“You really have to teach kids at a young age that movement is just a part of their lives,” said Dr. Tinajero-Deck.

7. Find someone for your kid to exercise with.

Sometimes kids won’t exercise with a parent. Or parents don’t have time (imagine that!).

“Try to figure out who’s going to be that motivator for your kid,” said Dr. Tinajero-Deck. “Maybe a best friend.”

You can also find out more about obesity prevention in a related post from KQED's State of Health blog, Lessons Learned from the War on Smoking, Applied to Obesity.

Lorena Ramos, 14, struggles to lose weight.

The show opens with the 14-minute story Childhood Obesity: Kids Fight Back. One in six kids in the United States is obese, a condition that doubles their risk of heart disease. Castro Valley teenager Lorena Ramos, 14, has been overweight since she was a small child. Now, with the help of her mother and the Healthy Hearts clinic at Children’s Hospital Oakland, she’s fighting to exercise, eat healthily and drop weight. Will she succeed?

A heart patient is treated at John Muir Medical Center in Concord.

Rushing to Save Heart Attack Patients tells the story of Arlene Skuba, who survived a heart attack at 72, after doctors at the John Muir Medical Center in Concord rapidly unclogged her arteries. Just 30 years ago, doctors could only watch patients as they suffered their heart attacks. As many as 20 percent of them ended up dying. Now, by opening their blocked arteries while their heart attacks are underway, they save all but 5 percent of those who make it to a hospital.

After being injected with three genes, the hearts of mice who had suffered a heart attack pumped blood normally. All photos by Gabriela Quirós.

The special report’s final 4-minute story, New Hope for Heart Repair, takes us into the future, to a time when a single injection of three genes might be able to repair damaged hearts and give heart attack survivors their quality of life back. We visit the Gladstone Institutes, in San Francisco, and watch as researchers repair tiny mice hearts using the next generation of cell reprogramming.

You can watch each of the three stories individually, as well, by following the links below:

Lifestyle factors that influence your risk of vascular disease including high blood pressure, obesity, diabetes and smoking also increase your risk of developing dementia, according to a new study from UC Davis.

Researchers from UC Davis looked at data from the Framingham Offspring Cohort Study, a prospective cohort study beginning in 1978. They tracked participants for markers of vascular disease, which are known to be associated with diet and lifestyle choices.

Starting in 1999, researchers started measuring vascular disease in the brain including brain volume and white matter hyperintensities, and also conducting cognitive tests such as verbal and spatial memory and decision making.

Participants with higher blood pressure developed cognitive problems and hyperintensities more quickly. Obesity was highly correlated with increased cognitive decline on executive tasks. Diabetes was associated with decreased volume in a region of the brain called the hippocampus, which is responsible for memory formation. Smokers had a more rapid increase in hyperintensities.

Thus poor lifestyle choices that lead to vascular problems and obesity may also contribute to decline in cognitive health.

Given today's environment, it is surprising that there are still thin people around.

The origins of this epidemic are pretty easy to spot– lots of food and less opportunity for exercise. And yet, not everyone in the U.S. is overweight. So why is one person fat and the next thin?

One big reason is genetics. A number of twin, family and adoption studies have found that somewhere between 45-60% of body mass index (BMI) comes from the genes we inherit. In other words, some people are more likely to be sucked into a Super-Sized meal because of their genes.

So how might genes affect someone’s chances of succumbing to the mountain of food now available? Lots of ways.

Some people burn energy more slowly than other people. These folks need to eat less to maintain their weight. Not an easy thing to do!

Some people take longer to realize they are full. Others get hungrier more quickly after eating. Still others need more sweets and fat to get enjoyment from their food.

The last example was <a href="http://psycnet.apa.org/index.cfm?fa=main.showContent&id=2007-13974-007&view=fulltext&format=html
">addressed by a study last year. One of the reasons people eat is that they get a hit of dopamine when they do. The dopamine makes us feel good and once we get it, we feel less inclined to keep eating.

The study found that people with a certain version of the DRD2 gene needed more food to get enough dopamine to stop eating. So they ate more on average.

There are more and more studies finding gene variations just like this one. Finding these gene variations might be useful in creating new medicines to help people eat less by decreasing hunger, burning calories faster, etc.

Knowing about these gene variations might also help doctors identify who is at a greater risk for obesity. These folks can get early help in maintaining their optimal body weight.

Now none of this is an excuse for getting fat (although I wish it was). For the most part, genes that affect our BMI make maintaining a healthy weight harder, not impossible.

But what it also means is that the thin should be a bit nicer to the overweight. Recognize that it might be easier for the thin person to not overeat.

This is not to take away from the thin person's accomplishment. In a world awash in high calorie foods and with work and play involving a lot of sitting, it takes will power not to become overweight. Just remember that it is easier for some people to be thin.

http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/index.htm

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I'm the third from left to right.

Every year, during the decade or so that I was a Girl Guide in Costa Rica, my fellow guides and I would trek up the steep hill, usually carrying our own sleeping bags and supplies. Once we got to the top, we chopped up wood with machetes and cooked over open fires. We woke up at the crack of dawn and showered in icy-cold water. During the rainy season, we got very wet. During the dry season, we got sunburned.

Camping took precedence over almost everything else. The day I graduated from high school I was in the middle of an international camping trip with girl guides from around the world. My parents drove up the hill, put some ointment on my sunburned ears and whizzed me over to the theater to pick up my diploma. Then they drove me back up the hill to finish the event.

My childhood home in Costa Rica, with the
campground ridge in the backgroundOur trips were always full of that sense of adventure you can only experience as a kid when you're out in nature and away from your parents. We ran up and down the mountains, crawled in muddy pits, climbed trees and cut ourselves with our machetes. By the end of our trips we were always completely worn out. Once, I sat on my bed and fell asleep with my backpack still on my back.

But all this happiness came to a crashing halt. On Aug. 20, 1988, when I was 16, a young couple my age was murdered in a coffee field on the road to the campground. My sister and I were supposed to go camping a few days later. But my parents wouldn't hear of it, no matter how much we begged. And who could blame them? The way he had killed his 14 victims was so cruel that it was impossible to incorporate his methods into his moniker, à la The Boston Strangler. So the press simply called him el psicópata, The Psychopath. Fear of el psicópata marked my adolescence and early adult life.

What was near-miraculous was that in time I was allowed to go camping again at Campo Escuela Iztarú. This photo of me is proof, I guess, although it doesn't make any sense, because my parents were so fearful of everything when it came to their daughters. Perhaps they let me go because they both had good memories of the time they spent outdoors, my mother as a little girl camping all summer long in New England and my father as a teenager pedaling up and down Costa Rica's mountains to make it to the Pacific coast by sundown. I'm so grateful to them for overcoming their fears (or not – I'm sure they had many sleepless nights). Those fleeting moments of freedom and that sense that anything is possible that I felt when I was camping are so much a part of me that I can't even really consider them memories. So thank you, Mummy and Daddy, for letting go and letting us go up the mountain.

Watch the "Nature Deficit Disorder" TV Story online, as well as find additional links and resources. Also, please share your own photos of childhood nature experiences in our Flickr Photo Pool.

Gabriela Quirós is a Segment Producer for KQED-TV, and is the producer for this story.

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