Pediatrician-Led Program Helps Kids Get Moving, Eat Healthier Foods

“It gives me so much joy to know how to eat better. I am happy and my son is happy. Thank you.”

“I liked the topic about portions. I am very happy because I learned a lot. I am very grateful to the program.”

“It helps me a lot because I can vary my kids’ meals.”

“They are very productive and educational meetings.”

An exercise session in Dover


These are just a few examples of the feedback that Zufall Health pediatrician Amy Kotler, M.D., has received from parents of ÁNDALE participants. ÁNDALE, the holistic and culturally responsive program that Kotler developed for Hispanic/Latino children aged 7 to 11 with obesity, has made a significant difference in Zufall patients’ and families’ lives.

ÁNDALE is Spanish for “Let’s get moving!” and an acronym for “Actividad, Nutricion, y Divertido para Latinos” (Activity, Nutrition, and Fun for Latinos). The program, which has enrolled 144 unique participants since its launch in 2013, aims to address disparities in obesity among Zufall pediatric patients and support their healthy growth and development.

“Childhood obesity is an epidemic that disproportionately affects Zufall Health’s patients,” says Kotler.

Nationally, Hispanic/Latino children have a higher prevalence of obesity than any other racial/ethnic group. Many of Kotler’s patients come from low-income homes, and research in The Cureus Journal of Medical Science shows an inverse relationship between household income and pediatric weight.

Children with obesity are more prone to conditions such as depression, anxiety, or attention-deficit hyperactivity disorder. They also face an increased risk of developing chronic disease later in life, like type 2 diabetes, liver disease, and high blood pressure, according to Kotler.


Culturally appropriate food recommendations presented in ÁNDALE have included traditional Hispanic meal elements that fit the one-fourth grains, one-fourth protein, and one-half vegetables MyPlate model from the USDA.


ÁNDALE operates in six-month cohorts with twice-weekly fitness classes for children and monthly nutrition education sessions for parents. The aerobic exercise component, provided in English, takes place in Zufall’s Dover headquarters or, when the weather permits, in a nearby park. Nutrition sessions, presented in Spanish, teach parents about the physical and mental health benefits of nutritious diets for their children using culturally appropriate examples. These sessions also periodically include lessons about kids’ self-esteem and parenting from Zufall behavioral health staff. All nutrition meetings conclude with the distribution of fresh produce for families.

Although the initial funding for ÁNDALE came from an American Academy of Pediatrics Community Access to Child Health (CATCH) grant, the program is currently carried out by Public Health AmeriCorps members. AmeriCorps volunteers play a critical role in executing the program each year, overseen by both Kotler and AmeriCorps Program Manager Jenniffer Amaya. A designated AmeriCorps member engages new participants, prepares healthy snacks, leads fitness classes, and administers program surveys.

“Our AmeriCorps members strive to make it enjoyable for the kids and show them that exercise is more than a chore. We emphasize that exercise makes us feel better, gives us more energy, and helps us perform better in school,” says Amaya.

“For the kids, this is about exercise and nutrition, not about stigmatizing weight. And I see their enthusiasm as they return year after year,” says Kotler, who in 2017 received the Population Health Hero Award from Governor Chris Christie for her work with ÁNDALE.

The next ÁNDALE cohort is expected to begin in December 2023. Families whose children receive care in Dover can discuss eligibility with their pediatrician.

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