Step One: Pull everything from your kitchen pantry and inspect the ingredient labels closely. Look for glucose, sucrose, high-fructose corn syrup, any kind of sugar. Now, for a reality check, consider that about 4.2 grams of sugar equals one teaspoon.

Step Two: Open the fridge and calculate the sugar load in sweetened beverages such as sodas or sports drinks. Visualize the 10 teaspoons of sugar in some 12-ounce sugary drinks.

Step Three: Congratulate yourself. You now know almost as much as a 5-year-old. That is, a 5-year-old being schooled in healthy eating in a new, innovative pediatric weight management program for kids aged 5 to 18 at Kaiser Permanente Medical Center, south Sacramento, facilities in Elk Grove.

The program echoes heightening community and nationwide concern over the obesity epidemic in the United States.

In California, about 17 percent of youths aged 6 to 19 are obese, according to the California Department of Public Health. That same figure holds true at the community level in the south Sacramento region.

Obesity can lead to type 2 diabetes, a growing chronic ailment once known as adult-onset but now increasingly seen in youths who lack access to healthy food and activity choices. Diabetes can cause heart disease, strokes, amputations and, when advanced, can bring on early death. Latino, African American and other ethnic communities often see higher rates of obesity, along with other social and health inequities, the state Department of Public Health says.

Already, some of the youths enrolled in the Elk Grove program are prediabetic, with higher than normal blood pressure and high lipids levels, said Dr. John Struthers, a pediatrician who helped develop the program.

Though the program is free, it's in high demand and competitive. Families are screened before being allowed to participate.

Every 10 weeks, 20 new participants are added to the 20-week program, but not before parents sign contracts, agreeing to support their child, attend the sessions and provide healthy meal choices.

Family involvement key

Making the program a family affair is one of the benefits that Tiffany Romano, 16, a participant since late April, most enjoys.

"I like how the family is involved and how we do activities," said Tiffany. "We have family meetings, take family walks and learn about food together."

When Tiffany attends weekly sessions, her father, Bryant Romano, is there to back her up. At age 50, her father said he's been watching his health, too, and he's shed 48 pounds while accompanying his daughter.

"I think the key to this program is understanding foods and supporting our children," Romano said. "As parents, we've got to first lead by example, so we're doing this together as a family."

The most surprising fact that Tiffany has learned so far, she says, is the extent to which sugar exists in processed foods, and that "low-fat" processed foods often have sugar added to fool the taste buds. Her father said having kids learn to translate grams into teaspoons of sugar is invaluable in helping them identify high-caloric foods.

In keeping with Dr. Struthers' philosophy to "try not to talk about losing weight but being healthy," Tiffany said her goal is "to be healthy and more active." She rises at 5 a.m., works out, plays basketball and flag football, and has stuck to a regimen of chicken breasts, broccoli, protein drinks and salads.

Modest changes valuable

According to the Centers for Disease Control and Prevention, making modest behavior changes such as improving food choices and upping physical activity to at least 150 minutes per week is enough to help participants lose 5 to 7 percent of their body weight. And that's enough to reduce the risk of developing type 2 diabetes by 58 percent in people at high risk.

Last week, Struthers and his team had the youths taste-test fruits and vegetables such as jicama, edamame, blueberries, cherry tomatoes and yellow bell pepper, and compare them to white bread, red fruit snacks, cheese puffs and blue fruit snacks.

Nutritionist Janet Belcher told the kids that red fruit snacks have an artificial dye that amounts to a chemical.

"Has anybody ever seen a Red Lake #5 tree?" Belcher asked the group, identifying the fruit snack dye.

One of the key components of the program is a reward of sorts that the kids have to earn by coming to each session on time and demonstrating their commitment. It's a money-clip-sized wireless physical activity tracker they wear, or pocket, to track calories spent walking, climbing stairs, running, even dancing.

Called a Fitbit, the device automatically uploads data from up to 15 feet away to a base station connected to a computer.

The information then goes to a website that shows the day's activity in a piechart that represents the last 24 hours – and how much of it was spent being lightly active, fairly active, very active or sedentary.

The device appeals to the kids because it syncs to cellphones they use to input what they ate and information about their activities. Then they, or their parents, can go online to check progress.

Romano, Tiffany's father, said this is a high point. "It's great because I could see online the program working. Accountability is key."

And he also appreciates that Kaiser's program focuses on prevention by helping youths read ingredient labels.

"All in all, I think everybody should learn to read labels like they taught the kids," Romano said. "Just by sitting in the sessions, I now understand what's in the food I put in my mouth."

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