An alarming study purports that the current generation of children may have shorter life expectancies than their parents for the first time in over two centuries. The rapid rise in childhood obesity in America may shorten children’s lifespan by two to five years (Olshansky et al., 2005). Almost one-third of children between the ages of two and nineteen years are overweight and 17 percent of those are classified as obese. The number of obese children has DOUBLED since 1980! Some studies suggest that this rate has tripled or even quadrupled. In addition, these statistics may be higher for some minority and low income children who are more likely to have overweight and obese parents due to living in communities with less access to fresh food, fewer recreation and park opportunities, and higher crime rates.

The unfortunate and yet challenging aspect of this problem is that overweight and obesity can be prevented for the most part through addressing the energy imbalance of expending energy through physical output equivalent to caloric intake. Camps have a role to play in addressing this growing health concern by encouraging young people (both campers and staff) to move more and eat healthier while at camp. Similar to other positive outcomes from camp, the experiences at camp can carry over into later life. Camp directors cannot assume that camps automatically address the obesity issue without reflecting on their programs.

In this article, we describe the nature of the problem and offer some ideas that camp staff might consider to encourage more physical activity and healthier eating at camp. The goal of camps for more than 150 years has been to provide opportunities for youth to experience healthy and safe outdoor environments. The ACA accreditation standards are specific about how formal practices can promote physical and mental health and safety. The focus on moving more and eating better is a natural exten¬sion of the goals of the camp movement.

Guidance for Camps

A focus in camps on moving more and healthy eating complements the recent national goals set by Healthy People 2020. These guidelines focus on the impact of social determinants such as camps on both physical and mental health:

• Preventing and/or reducing overweight and obesity through improved eating and physical activity behaviors
• Controlling total calorie intake to manage body weight
• Increasing physical activity and reducing time spent in sedentary behaviors

To this end, the ACA National Board of Directors adopted a public policy statement (September 1, 2011) about children and physical activity:

The American Camp Association (ACA) believes that all children need to be provided with a broad range of opportunities to be physically active. Physical activity produces fundamental physical, psychological, and social benefits — including an increase in life expectancy and a decrease in the risk of cardiovascular disease and obesity. For more than 150 years, camp programs have sought ways to create healthy communities for children by providing environments that offer frequent and varied opportunities for physical activity. ACA supports and promotes active living in camp communities and other environments that offer access to developing healthy lifelong habits and skills. Furthermore, ACA advocates on behalf of and in cooperation with children and community partners to mobilize resources that educate and facilitate physical activity.

Another example of ACA’s ongoing commitment to health is the Healthy Camp Study (funded by Markel Insurance Company). The focus of this five-year project was to identify injury and illness experiences of campers and staff. The idea was that camp leaders can shape camp experiences to promote wellness for campers AND staff. The results of this work to date have included identifying problems that can be prevented to assure that campers and staff are healthy while at camp. The next step of this project is to move these findings further to examine the future of camp health in concert with Healthy People 2020 (Erceg, 2011), and promote health when campers and staff return home.

The Centers for Disease Control and Prevention (CDC) recommends that children participate in at least sixty minutes of physical activity on most days of the week (see “Physical Activity Guidelines” sidebar). Suggestions for healthy eating have also been prescribed (see “Dietary Guidelines 2010” sidebar). All camp staff should be aware of these recommendations related to problems associated with obesity and strategies that promote health for all individuals associated with camp.

Prevalence of the Problem

Being overweight or obese can be a serious health concern for both adults and children. Overweight and obesity is generally defined as having excess body weight for a particular height measured by Body Mass Index (BMI). Children who are 10–20 percent over the appropriate weight for their height are considered to be overweight, and children who are more than 20 percent over their ideal weight are classified as obese. Calculations can be made to assess these definitions, but Figure 1 provides an illustration. We want to emphasize that fatness DOES NOT necessarily equate to lack of fitness. A child or adult can be overweight and physically fit. However, because of the difficulty in movement, most obese children and many overweight children and adults are not fit.

Childhood obesity and its implications for cardiovascular disease, diabetes, and cancer have been highlighted for over a decade. The statistics, however, remain compelling. Most startling is that 85 percent of obese children remain obese as adults, unless something changes drasti¬cally in their lives. Camp could potentially be a positive intervention, which at best can help children experience the joy of move¬ment and opportunities for healthy eating. At the least, camp experiences should not contribute further to the problem by reinforcing sedentary behavior or mimicking poor eating habits.

The implications of the obesity epidemic on the economy are staggering. The medical cost associated with overweight and obesity involves direct and indirect costs. The estimated $300 billion yearly total cost in the United States and Canada is the result primarily of the increased need for medical care. Health care costs in the United States equal about 16 percent of the Gross National Product, and are expected to grow due in part to the risks associated with obesity.

In addition to the physical health risks, obese children are frequently teased and often experience discrimination. Psychological effects can include feelings of embarrassment and low self-esteem. Bullying issues might be more common for these children because of their vulnerability due to feelings of inadequacy. Further, physical play is often more difficult for obese children because they may lack the speed and stamina needed. Children who are not active may become inept and never develop lifelong physical activity skills. In addition, these children may also be less likely to participate in school and community sports and other forms of physical activity.

Researchers have found that summer is a time when children may be less likely to be physically active and more likely to gain weight (Carrel, Clark, Peterson, Eickhoff, & Allen, 2007; von Hippel, Powell, Douglas, & Rowland, 2007). Many young people are not involved with structured opportunities like school physical education programs and recess or school lunch programs. They may be sedentary and have less healthy diets. Structured summer opportunities such as youth camps can provide opportunities for children to be physically active (Jago & Baranowski, 2004), and to experience healthy eating practices that could become long term habits. However, the benefits of camp do not just happen without intentional and purposeful plans to instill healthier lifestyles in children and staff.

Challenges in Society

Given the prevalence of childhood obesity, camps are not the cure for the problem. However, camp staff can assure that they are not unconsciously reinforcing and reproducing less than desirable health practices at camp. Reflecting on the causes of obesity in society may illuminate alternative opportunities for staff to consider.

One issue of concern is the decrease in children’s opportunities to participate in recess and structured physical educa¬tion classes in schools. Schools have been under increased pressure regarding test scores (i.e., No Child Left Behind) and this academic focus, although important, has compromised some ways children were traditionally active. Unfortunately, the lost physical activity in schools generally is not redressed outside schools. Although some children participate in afterschool programs, the structured focus is often more on doing homework than providing exercise and sports opportunities. Free time available in these programs is often unstructured and although some children, more likely boys, choose to play team sports, many children just sit around waiting for the program to be over. The snacks served in these programs may not be the healthiest, either.

Competitive sports may be important for some children, but not all children want to be elite athletes. Further, at some point in early adolescence, many young people drop out of sports because they are not skilled enough to participate in interscholastic opportunities. This problem may be exacerbated among children who have been chronically overweight and have never developed sport skills.

Many of the environments in which children find themselves, unfortunately, do not encourage physical activity. Children’s after school time frequently is spent on screen-based activities — television, playing computer games, video games, and listening quietly to music. These activities have merit, but optimum health requires daily physical activity. The energy balance aspect of overweight and obesity is a controllable activity. Although genetics, emotional stability, and hormone levels must be considered, camp programs have great potential for addressing caloric intake–physical activity relationships.

Challenges in Promoting Physical Activity at Camps

Similar to the potential in schools, camps can establish safe and supportive environments with policies and practices to support healthy behaviors. Camps offer a variety of formats. Type of camp (day or resident), session length, a camp’s physical layout and features, populations served, and program offerings vary. Nevertheless, the challenge to keep kids moving and eating healthy is consistent regardless of format. Importantly, camp staff members will also need to assess the camp program and operations to use the opportunities that abound.

Although research is minimal, children at camp appear to be getting the recom¬mended amount of physical activity, which is greater than what children generally get in the summer time. Hickerson (2009) found that resident campers took an average of almost 17,000 pedometer-recorded steps daily while day campers took about 12,000 steps during their camp day (i.e., usually about eight hours). These step numbers exceeded the recommendations for youth.

Similar to other studies, boys, non-minorities, and individuals with normal (i.e., a BMI below the 85th percentile) weights were more likely to be physically active while at day camp. However, day campers were more likely to be active if their peers AND their counselors also had a high step count. Hickerson also found that larger and more facilities were directly related to more day camper steps, likely because more opportunities were available in these camps for formal as well as informal movement. However, with purposeful programs, children can be active in small spaces.

In resident camps, similar activity findings were uncovered. Boys, non-minorities, and children of normal weight were more likely to be physically active. High peer group step counts were directly related to an individual’s activity. However, in resident camps, more physical activity facilities, larger camp acreage, longer walking distances between programming areas, low camper-staff ratio, and intentional physical activity programming were directly related to greater resident camp physical activity. Hickerson concluded that the design of the social, physical, and organizational environments can impact campers’ physical activity. Therefore, to encourage physical activity requires intentional efforts regardless of the organizational or physical camp environment. Yet, much more is still to be learned about opportunities at camp.

Camps and Positive Youth Development

The focus of positive youth development in camps is to develop healthy and happy adults. Camp experiences typically focus on the whole child, including their physical health. However, camps are not places where weight loss should be encouraged (i.e., unless it is a specialized camp focusing on weight loss). Further, becoming physically fit is not a goal that can be accom¬plished in a short period of time. If a child is in a weight loss program, he or she should be supervised by a physician with an emphasis on developing lifelong habits, not just short-term endeavors. Weight lost during a diet may be quickly regained if the motivation to change eating and physical activity habits does not occur at the same time. Camps are not places to institute a “Biggest Loser” program, like the television show on NBC. However, camps can be places to ensure that children AND staff eat healthily and do not gain weight by addressing the recommended dietary and physical activity guidelines.

Overweight and obese children will come to camp. Counselors must let overweight and obese children know that they are appreciated and loved regardless of their size. They do not need to be told about their size — they know! Counselors can provide support, acceptance, and encouragement. Further, staff should be modeling healthy eating and physical activity. Inclusion is the key to working with all children who come to camp. They should not be separated from their camp buddies for any reason related to size. Staff as well as parents should also keep in mind that as some children mature, getting taller and keeping weight stable may change their shape.

Counselors serve as in loco parentis (i.e., in place of the parent). Children look to adults as role models, and staff members are those adults/role models at camp. Although camp staffers have not been studied relative to their health conditions and camp, research shows that when both parents are physically active, children are SIX times more likely to be active. If a parent over-consumes high fat foods, a child is TWICE as likely to be overweight, and if both parents eat high fat foods, a child is three to six times more likely to be overweight (Understanding Childhood Obesity, 1999). A correlation between these statistics and what happens at camp cannot be made. However, just as parents can set an example, counselors can be significant role models. Staff should be encouraged to be active alongside children and practice good eating habits that can be mirrored by children.

Although camps aim to address youth development in many ways, camps should always be just plain fun. People continue to do things they find enjoyable. Therefore, the types of physical activities (i.e., focusing on more than just sports) and the ways that food is shared and presented can be a foundation for fun and potentially lifelong interests and habits.

Misconceptions abound about how boring exercise and good nutrition can be. Sometimes when children and adults think about exercise they think about calisthenics and/or exerting their bodies so hard that they can hardly breathe. Further, nutrition may be associated with only foods that are “good for you” like spinach or liver. Because fun is used as the motivator for positive youth development and almost everything done at camp, being physically active and eating nutritionally must be made FUN!

Possibilities for More Physical Activity in Camps

According to Hickerson and Henderson (2010), the physical structure of a camp and the intentional programming of physical activities can influence active participation. They offered several recommendations:

• Females, minorities, and overweight children are often less active than their counterparts. Therefore, programming activities that target the interests of these individuals may encourage them to be more physically active during the camp week.
• Precamp training sessions and incentives to encourage physically active counselors may result in more physically active campers.
• Outdoor environments provide space for physical activity programs and walking. Heat is an issue during the summer months, and, thus, natural or built shade areas and water consumption are essential.
• Physical activity is only one output that can occur in summer camps. Although it is important, it should be balanced with other activities.

Camps can always have equipment/toys available for children to engage in sponta¬neous play. For example, outdoor activities might include balls of various sizes, kites, a sand box, sprinklers, and jump ropes. Indoor spaces might also have equipment such as a boom box with music, hula hoops, jump ropes, or a mini trampoline. During precamp training, staff may want to discuss the purposeful ways to encourage campers to be active during planned activities as well as other times in the day. Campers likely will have other suggestions for free play. Rather than standing around waiting for the next activity, children can be encouraged to be active.

Staff should consider how they can keep themselves active as role models while at camp. Sometimes getting around in a large acreage camp may take time, but the trade-offs in terms of being physically active as well as being role models can be valuable. Staff should consider for themselves how they will ensure their wellness while at camp. During their time off, they may seek accessible opportunities to be physically active. Physical activity can be as refreshing to the mind as it is to the body.

Resources exist for active games and sports. A list of resources follows at the end of this article. Some easy examples include:

• Intentionally emphasize physical activity each day by programming a free-time active hour as well as a rest hour.
• Encourage campers to walk around the world, across the state, or to some destination by using pedometers and having campers convert the steps to miles. Walking teams or walking buddies can be encouraged at camp. Note: Pedometers may need to be purchased but are relatively low cost — or perhaps these devices could be donated.
• Try new activities at camp (e.g., pickle ball, geocaching) that will be fun and get people moving. Campers may be able to continue these activities at home.
• Get campers involved in a road race or community walk.
• Do not emphasize winning or being the best. Always focus on making physical activities FUN.

Possibilities for Better Eating at Camps

The other half of the energy balance equation includes healthy eating for campers. Empowering campers and staff with improved nutrition literacy and possibly gardening and cooking skills can heighten their enjoyment of preparing and consuming healthy foods. Reaching these goals will not be easy given the ubiquity of sugar and fast foods in campers’ lives. Nevertheless, many options and opportunities exist at camp.

Menus and food service influence the eating patterns of children. Camp staff, however, should be careful to guide campers and not dictate their choices. Most people eat too fast and even when they are not necessarily hungry. Use meal time as an opportunity to “slow down” from the busy camp pace. Children are anxious to get on to the next activity, but meals do not need to be rushed. Eating a healthy breakfast is the best way to start the day and can be a habit that is reinforced.

Many camps have the “big” meal (i.e., dinner) in the evening, when children are likely to be sedentary the rest of the eve¬ning. Consider the old agricultural model of having the big meal at mid-day as a way for refueling for the rest of the day and then offering a lighter supper at night.

Food does not have to be boring or the same old stuff. For example, adding healthy garnishes or toppings options such as fresh herbs, cheeses, fruits, and vegetables allows campers and camp staff to try new tastes and develop an individual palette. Tasting parties can be fun (i.e., campers and staff choose foods they have never tasted, purchase and/or prepare the food, and have a party to try the new foods). Food can also be presented in a fun way such as encouraging campers to use fruit to put “art” on their pancakes before they eat them.

Examining food labels with interesting facts such as where it came from (especially if it is local), how it was made/prepared, its nutritional value, and good things to pair with it can add to the complexity and value of children and camp staff’s experience during meal times. Meal times can be a way to educate, excite, and entice campers about food — not just a time to refuel and get on to the next activity. Meals can be fun, rewarding, and a place to share common likes and interests. Asking campers which foods they enjoyed most, food trivia, and having them compost their food instead of throwing it away can lead to a “dining experience” and not just “gobble and go” at camp.

Avoid using food as a reward, or as a punishment. Rather than giving ice cream to the winners, some other reward might be considered, such as giving an extra fifteen minutes of swim time. Children also should be encouraged to drink water often. Beverages with added sugar such as fruit juice drinks, soft drinks, and sports drinks should be limited. Healthy snacks should be available when people are hungry — fresh fruit, fat-free or low-fat milk, vegetables, lean proteins such as nuts or eggs, and whole grain cereals. Campers might also be involved in selecting the healthy snacks that camp will provide. People tend to eat what is available to them, not necessarily what is good for them. Having healthy snacks and meal options will encourage healthier eating habits while at camp and, hopefully, in the future.

Camps can encourage healthy eating through cooking classes and involvement in food preparation. For example, cabin groups could be rotated through the kitchen for at least one meal, allowing them to plan and prepare for the rest of the camp. Not only could they develop cooking skills, but they could also learn budgeting, sourcing, familiarity with food vendors, and nutritional requirements. Camp cooks and chefs could be encouraged to work with campers to create balanced meals that are tasty, nutritious, and easy to prepare at home. This approach will provide camp¬ers with take-home knowledge that may encourage their families to eat better, or at least be aware of the food they are purchas¬ing and consuming.

Pizza ovens are also on the rise. Camps can learn from schools that have built ovens in close proximity to their school/camp gardens. Campers can then make pizzas or flatbreads using fresh-from-the-garden ingredients. While making the pizzas, discussions can ensue about where food is grown, other ways to prepare it, and what food does to bodies and the environment.

A movement that has begun over the past decade is the “farm-to-school” program. Why not consider a “farm-to-camp” program? The focus of these programs is on bringing local fruits, vegetables, meats, and other animal products to camps. These programs might include farm visits, cooking demonstrations, camp gardens, and composting sites. The outcomes in schools have been successful in changing eating habits and increasing awareness about local foods and food production. Several camps have been successful in initiating such programs:

• Farm and Wilderness Camp invites campers to experience life on the farm while participating in traditional camp activities such as hiking, canoeing, and sing-alongs. Campers care for livestock, assist with garden operations (both on site and around the area), explore the interconnectedness and diversity of life at camp, and learn about the nutritional value of farm foods versus processed foods. Campers better their understanding of the efforts required to produce their food and maintain a healthy planet. (www.farmandwilderness.org/Our-Farm-Forests/The-FW-Farm)
• Gwynn Valley campers participate in farm work including planting, harvesting, weeding, milking cows and goats, and collecting eggs. These activities promote responsibility, independence, and awareness of food source and production. Lessons in veterinary science, horticulture, botany, and other topics are paired with farm-based activities. At Gwynn Valley, 70 percent of the camp food comes from its on-site farm. (www.gwynnvalley.com)
• The Green River Preserve teaches composting and waste reduction through the “Ort-Report.” After meals, campers place leftover food scraps in an “ort bucket” to be weighed. Teams are formed by cabin or table, and the team that reduces its waste the most by the end of camp wins. Campers learn about sustainability, the “waste trail” (i.e., where leftover food goes), and leave camp with a greater sense of human impacts on the environment. (www.greenriverpreserve.org)

Make a Commitment

The old adage “if you are not part of the solution, you are part of the problem” may apply to camp roles in addressing obesity and providing healthy camp experiences through nutritious eating and ample opportunities for physical activity. Many strategies exist. The mandate is to make a commitment for camp to become a place that encourages wellness and healthy living. Camp can be an alternative to the sedentary and high caloric world in which many children and adults live. Staff can be influential role models regarding physical activity and eating habits.

Camp staff members have little control over campers once they return home. However, while at camp, the program and operations can focus on keeping children as healthy as possible. Memorable camp experiences change lives, and these changes carry over into the future. Policies and systems can be encouraged within camps and across the camp community to prevent and reduce obesity. Identifying good ideas and best practices can facilitate the adoption of these practices now and for the future.

References
Carrel, A. L., Clark, R., Peterson, S., Eickhoff, J., & Allen, D.B. (2007). School-based fitness changes are lost during summer vacation. Archives of Pediatrics and Adolescent Medicine, 161(6), 561–564.

Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., & Dietz, W. (2009). Annual medical spending attributable to obesity: Payer- and service-specific estimates. Health Affairs, 28(5), w822–w831).

Erceg, L. E. (2011, June). Healthy camp people 2020. Association for Camp Nurses Newsletter.Healthy People 2020. Retrieved from http://healthypeople.gov/2020/default.aspx

Hickerson, B. D. (2009). Individual, social, physical environmental, and organizational correlates of children’s summer camp‐based physical activity. PhD Dissertation, North Carolina State University.

Hickerson, B. D., & Henderson, K. A. (2010). Children’s summer camp-based physical activity.Camping Magazine, 83(3). 20, 22–23.

Jago, R., & Baranowski, T. (2004). Noncurricular approaches for increasing physical activity in youth: A review. Preventive Medicine, 39(1), 157–163.

Olshansky, S. J., Passaro, D. J., Hershow, R. C., Layden, J., Carnes, B. A., Brody, J., et al. (2005). A potential decline in life expectancy in the United States in the 21st century. New England Journal of Medicine, 352, 1138–1145.

Smith, J. C. (1999). Understanding childhood obesity. University of Mississippi Press.

Von Hippel, P.T., Powell, B., Downey, D.B., & Rowland, N.J. (2007). The effect of school on overweight children in childhood: Gain in Body Mass Index during the school year and during summer vacation. American Journal of Public Health, 97(4), 696–702.

Karla Henderson, PhD, is a professor in the Department of Parks, Recreation, and Tourism Management at North Carolina State University. She currently chairs ACA’s Committee on the Advancement of Research and Evaluation (CARE) and is a member of the Active Living Research National Advisory Committee of the Robert Wood Johnson Foundation.

Amy Saltmarsh is a master’s student in parks, recreation, and tourism management at North Carolina State University. She holds a bachelor’s degree in sociology from Appalachian State University. Amy has worked as a farmer, teacher, and camp counselor. Her career goal is to operate a summer camp that teaches children about farming, gardening, and healthy eating.

Web Resources

• Action for Healthy Kids provides programs and information for family, school, and community partnerships to improve nutrition and increase physical activity. (www.actionforhealthykids.org)
• America on the Move is an online community to promote healthy lifestyles for individuals and groups. (http://aom.americaonthemove.org/site/c.krLXJ3PJKuG/b.1524889/)
• American Heart Association offers tips about exercise for children. (www.americanheart.org/presenter.jhtml?identifier=3007589)
• Camp Resource includes art projects, games, skits, songs, stories, icebreakers, ropes course activities, team-building activities, field trips, articles, and suggestions for theme days. (www.ultimatecampresource.com)
• CDC’s Guide to Community Preventive Services: Physical Activity has reviews of literature on the most effective physical activity programming practices. (www.thecommunityguide.org/pa/)
• CDC’s Recommendations and Reports: Guidelines for School and Community Programs to Promote Lifelong Physical Activity among Young People provides comprehensive guidelines for physical activity programs in communities and schools, including specific population preferences for physical activity. (www.cdc.gov/mmwr/preview/mmwrhtml/00046823.htm)
• Disabled Sports USA has detailed information about making various sports accessible for people with disabilities. (www.dsusa.org)
• Games Kids Play has an index of games, including ball games and mental games. (www.gameskidsplay.net)
• Group Games includes a database of group games sorted by type or age. (www.group-games.com)
• Mr. Gym lists and provides directions for games including cooperative, small space, and dance/rhythmic activities. (www.mrgym.com)
• National Center on Physical Activity and Disability includes information about disabilities and creating inclusive physical activity opportunities for people with disabilities. (www.ncpad.org)
• PE Central features a database with a broad range of physical activity lesson plans and activity ideas. (www.pecentral.org)
• President’s Challenge Physical Activity and Fitness Awards Program includes activity logs and ideas to get active for various ages and ability levels. (www.presidentschallenge.org)
• SPARK — Sports, Play and Active Recreation for Kids is a school-based program to promote physical activity. (www.sparkpe.org)
• Take10! offers a set of lessons available for purchase for elementary school teachers to integrate ten-minute intervals of physical activity into the school day. (www.take10.net)
• US Department of Health and Human Services’ Small Step (Adult & Teen) provides diet and exercise advice, obesity statistics, activity log, graphs to monitor performance, and other resources. (www.smallstep.gov/index.htm)
• Wilderdom, a Project in Natural Living and Transformation offers suggestions for group activities, outdoor education, experiential learning, quotes, a bookstore, and youth development. (www.wilderdom.com)

Originally published in the 2012 March/April Camping Magazine.