Terrill, a registered dietician and former president of the California Dietetic Association, is trying to lower those numbers by working with children who struggle with their weight.

"I feel like I am on a mission to impact lives," says Terrill, who has also taught classes at West Valley and De Anza colleges and has a radio spot on KEAR.

"Children's weight problems are becoming a serious epidemic. The health problems that will be seen in the next generation because of today's eating habits will be profound and will send health care costs through the roof," says Terrill. She explained that this is one of the reasons childhood obesity is an issue that all of society should be made aware of. Childhood obesity is on its way to becoming one of the most preventable causes of death in America. It will take a combination of parents, schools and community awareness to overcome it.

Terrill believes that overweight children become overweight adults with a shorter life span and heart disease. The rate of type II diabetes, which was once considered an adult disease, has surged in children and teens, according to recent studies by the American Dietetic Association.

Terrill has an excellent success rate with overweight children, who are usually eager to improve their self-image. Children that are overweight sometimes suffer from poor self-esteem and a lack of self-confidence. They struggle with being taunted by other children in regard to their weight.

"I have 11-year-old clients that become my biggest advocates for healthy eating," says Terrill proudly. "The kids usually want to lose weight, and they desire to change."

Her clients, typically between ages 10 and 13, are usually referred to her by pediatricians in the Los Gatos and Saratoga areas who recognize that a child may be at an unhealthy weight. "Many times parents are not aware that there is a serious problem until the pediatrician points it out," says Terrill.

Using added sensitivity, Terrill tries not to make children feel worse about their weight than they already do but instead focuses on eating right, not losing weight. If children are only moderately overweight, she works to create a diet that keeps them from gaining so that they gradually grow into a weight that is healthy for them.

Heavier children might require more emphasis on weight loss, but they still need nutrients and calories because they are still growing. Terrill strongly disagrees with the concept of a "diet," which is usually short-lived, but instead emphasizes a "food plan" that will hopefully become a way of life.

Photograph by George Sakkestad Pringles are part of Daves Avenue student Charlie Moyer's lunch.

Parents are the key to the entire program, and Terrill has found them to be very cooperative. Terrill works with the entire family because sometimes they just need help "trying to work healthier things into their schedule." It's easier for a child to lose weight if the entire family gets involved.

Involving the children in food-making decisions is an important part of getting them to eat healthier. If families take on a healthier eating style as a family project and include the children in the meal planning and preparation, it has longer-lasting effects. Terrill encourages children to do things such as helping make the salad for the dinner and choosing which vegetables they would like to have.

"Refusing all vegetables is not an option," says Terrill, "but letting children choose which vegetable to eat helps them feel part of the process and makes children more likely to eat them."

Along with exercise, she cites planning and portion control as two main keys to weight loss. With both parents working outside the home, it can be difficult to find time to prepare healthy meals, but it can be done with a minimal amount of effort. Planning meals ahead of time keeps families from grabbing fast food to save time and also keeps children from eating at the school cafeteria. Terrill also tries to suggest alternatives to fast food and calorie-laden snacks.

Portion size is the other key to weight loss. Because of the tendency of fast food restaurants to "super size" everything, Americans have begun to lose sight of what is an appropriate portion size. Terrill works with her clients in teaching them the correct amounts to eat.

Many people blame schools for the obesity crisis with children, saying fattening lunches and carbonated sodas are the culprits. Today's schools get a percentage of the profits from all of the soda they sell, which make for lucrative sales that are hard to turn away, especially with school budget cuts looming.

Although Terrill feels schools play a part in the obesity problem, she believes the main responsibility is with the parents and encourages them to pack healthier lunches so that kids don't have to turn to school vending machines. Letting children buy lunch at school once a week is a better alternative than buying every day, she says * it still gives them flexibility and also allows them some choices regarding their eating habits.

"Soda and vending machines are being banned at some schools, and that can only be a good thing," says Terrill, mentioning the recent school board decision in San Francisco to eliminate campus vending machines.

The surgeon general reports that, on average, adolescents get 11 percent of their daily calories from soft drinks. Not only are these beverages extremely high in calories and deficient in nutrients, some carbonated beverages can actually deplete calcium from the body, setting a child up for osteoporosis later on in life. Soft drink consumption in America has risen an astounding 500 percent in the last five years.

Kevin Skelly, principal of Saratoga High School, agrees that soda and snack vending machines are not the best thing for students and that Saratoga High School has considered eliminating them.

"It's a difficult issue," says Skelly. "Not only do the students and faculty enjoy having them but it creates revenue for the school." The school's budget reflects earnings of about $7,000 per year from the soda machines, money that is then used for extracurricular activities. Additional money is also generated from soft-drink sales in the cafeteria. In addition to soft drinks and snacks, the machines are stocked with sports drinks and bottled water so that students can make a somewhat healthier choice.

Saratoga High School stresses fitness with their students, who are required to take 20 units of physical education and pass a state fitness test. "Our students have always scored very well on the test. We don't have a significant problem with overweight children at our school," says Skelly.

At the elementary and junior high levels, Los Gatos Union School District chooses not to have snack machines and does not sell carbonated beverages on any of their campuses. Mary Ann Park, superintendent of the school district, explains, "We offer the students nutritional food, but that doesn't mean that they will eat it, and that doesn't mean that they still don't bring soft drinks from home."

Park states that all school lunches meet nutritional standards that are set at the state and federal levels and that the district also meets or exceeds state mandates for physical education. But she explains that there are no state requirements for teaching nutrition awareness in classrooms and that many times a child's eating habits are already in place by the time they begin school.

Photograph by George Sakkestad Conner Brossant grabs a handful of fried foods as he helps out in Los Gatos' Daves Avenue School cafeteria at lunchtime. School district superintendent Mary Ann Park says the school offers healthier options that students don't always choose to eat.

In agreement with the need for exercise and activity, Terrill is alarmed at the lack of exercise today's children are getting. She encourages parents to get children involved in sports at an early age so that exercise becomes a part of their lifestyle. "The amount of television that children watch today is phenomenal," says Terrill. Her fear is that when children spend hours playing video games or watching TV, it keeps them so sedentary that they do not burn calories and end up gaining weight. Limiting the amount they play video games and watch television is essential to healthy living, she says.

Family activities are a good way to get children away from the television. Bike riding, taking a walk after dinner or playing outdoor games such as basketball are all ways to get the entire family involved in calorie-burning activities.

Parental role models are the best defense against obesity. Experts agree that if kids see parents living a healthy lifestyle, they are more apt to follow in their parents' footsteps and mirror their behavior.

Dr. Majorie McCracken, a Los Gatos physician who specializes in pediatric gastroenterology and nutrition, agrees with this. McCracken stresses that in order for a child to gain control of their eating habits, the entire family, especially the parents, must become involved and also make a lifestyle change.

McCracken is also alarmed at the number of overweight children that she sees in her practice today. She cites a list of problems that overweight children can have, including asthma and lung problems, high blood pressure and a fatty liver, which "can be quite dangerous." She also explains that overweight children are "more inclined to suffer injuries during sports and athletics."

McCracken's hope is that "schools will get rid of the junk food." She is concerned that replacing soft drinks with juice is still giving children something that is "high in sugar with no nutritional content." She also hopes that schools will think about developing their physical education programs to a greater degree and allowing children to have physical education class every day. She would like to see schools put their money into this instead of competitive, after-school sports programs that do not benefit the entire school population.

Terrill believes that the nutritional crisis goes beyond just health problems and can have further-reaching effects—even causing problems with the defense of our country. She explains that during World War II the southern states had many malnourished adults that couldn't serve in the military, which is what began today's recommended daily allowance program.

She worries that excessive improper eating could have the same effect on the military. "In the future, people could become so over-nourished that the effects and health problems that come with it could keep them from serving in our military." Such a problem would force the military to spend money helping these people lose weight, or, if their health problems were too severe, to dismiss them altogether.

Photograph by George Sakkestad First grader Jacob Marr's lunch consists of a hamburger prepared by Daves Avenue cafeteria staff.

Terrill not only works with overweight children but also has adult clients that come to her for various reasons, including weight loss, gaining a healthier eating lifestyle and reducing elevated cholesterol. She also creates individual diets for people with allergies.

Terrill has spent most of her life promoting the importance of good nutrition and seeks to continue impacting people's lives in a positive way. "It makes me feel good to know I am helping people and that I am making a difference."

Dorothy Terrill, M.S., R.D., can by reached by phone at 408.741.1400 or by email at djterrill@earthlink.net.