Bert and Ernie jump rope and munch apples and carrots, and Cookie Monster has his namesake treat once a week, not every day. Can a Muppets mini-makeover improve kids' health, too?
A three-year experiment in
Already, a test run in a
"What we created, I believe, is a culture" of healthy eating to fight a "toxic environment" of junk food and too little exercise, said Dr. Valentin Fuster, a cardiologist at
Six years ago, he started working with Sesame Workshop, producers of television's
"At that age they pay attention to everything" and habits can be changed, he said.
The need is clear: A third of
"The focus is younger and younger" to try to prevent this, said Dr. Stephen Daniels, a University of
"While Cookie Monster is an engaging figure, we felt there was an opportunity there to really model healthy eating," said Jorge Baxter, regional director for
The new message is that certain things like cookies are "something you can eat sometimes, but there are some foods that you can eat all the time," like vegetables, he said. The healthy messages have been gradually incorporated into the television show, and its producers even made a doctor Muppet — Dr. Ruster (pronounced "Rooster") — in Fuster's image for the preschool project.
It launched in
It involved 1,216 children and 928 parents from 14 preschools. Some were given the program and others served as a comparison group.
Kids had training on healthy habits and how the body works for an hour a day for five months using Sesame Workshop-produced videos, a board game (the "heart game"), songs, posters and activities.
Parents were involved through take-home assignments and workshops that focused on overcoming barriers to good food and exercise. For example, in areas with poor access to parks or play spaces, parents were coached to encourage kids to use stairs instead of elevators and to walk instead of taking a bus.
Children's weight and exercise habits were measured at the start and 1 1/2 and 3 years later.
Although many moved or dropped out by the time the study ended, researchers documented a significant increase in knowledge, attitude and health habit scores among kids in the program versus the comparison group.
The proportion of children at a healthy weight increased from 62 percent at the start to 75 percent at three years for those in the program. Ironically, in
"A lot of the kids are from low-income families, shelters," and many have poor access to healthy foods, said Rachael Lynch, director of educational services for an Episcopal Social Services preschool, The Learning Center, in
Her preschool tested the
"They love it. The kids relate, I can't stress it enough," to the
The program had kids work in a nearby community garden one day a week to learn about growing vegetables. They had a "mystery food box" to reach inside, feel and guess the contents, then use what they found to make a healthy snack such as smoothies, fruit salads, microwaved baked apples and apple dip.
Children took home a "weekend update" to list and draw pictures of what they ate. Parents were asked to sign it to encourage an adult focus on healthy meals.
Kateshia Strowder said the program had a big impact on her and her daughter, Jahmeice.
"We'd be in the grocery store and she would name every vegetable. It's amazing. Brussels sprouts — she likes it. Cabbage — she likes it," Strowder said. "I'm not a vegetable eater, to be honest. But I had to learn to do those things for her."
Donte Payne said the same for his son, Bryson, a 4-year-old who also was in the Harlem program.
"It made him more interested in eating more healthy things," Payne said. "He became very interested in salads. He loves salad now."
In Colombia, the program is now expanding to about 20,000 children, and in Spain, a project is starting in Madrid. In New York, a foundation Fuster runs at Mount Sinai will sponsor the U.S. launch, aided by private donors.
Dr. Jaime Cespedes, a pediatric and heart specialist who helped lead the project in Colombia believes it will succeed wherever it is tried.
"Sesame knows kids, knows media and how to communicate the messages," he said. "When you get the kids to deliver the message to the family, change will come."