Schools and the Prevention of Childhood Obesity

Transcription

1 EXHIBIT G Schools and the Prevention of Childhood Obesity Howell Wechsler, Ed.D., MPH Division of Adolescent and School Health National Center for Chronic Disease Prevention and Health Promotion January 2004 EXHIBIT G Committee Name OBESITY Document consists of 50 SLIDES. Entire document provided. Due to size limitations, pages provided. A copy of the complete document is available through the Research Library (775/ ) or library@lcb.state.nv.us. Meeting Date:

2 Government Agencies YOUTH

3 A Small Number of Calories unused calories/day = 3650 calories/year 3500 calories = 1 pound of extra weight/year... Makes a BIG difference

4 Why Schools? Most children and adolescents are enrolled in school Physical activity and nutrition programs have long been part of the school experience Research shows that well-designed, wellimplemented school programs can promote healthy behaviors Connections exist between physical activity, dietary behaviors, short-term health, and academic performance

5 In Arkansas, Schools to Score A Child's Weight The Wall Street Journal (20 August 2003) School children are used to getting grades in math, science and English. Now, Arkansas state officials want to score them on their weight. Alarmed at the growing number of overweight children in their state, state health experts have pressured lawmakers to do something about it. A law enacted in April calls for the state's 308 public schools to record their students' weights and heights and then send the results home.

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7 Michigan Consensus Paper: Six Safeguards Before Conducting Screenings Full implementation of safe and supportive learning environment recommendations Classroom instruction on healthy weight concept Parental permission system Referral system Staff training Respectful screening (no labeling, no comments on weight during measurement, privacy, confidentiality, respectful letter to parents, same procedures for all)

8 Guidelines for School Health Programs The guidelines contain: recommendations to help states, districts, and schools implement health programs and policies, based on an extensive review of published research

9 Priority Actions for Schools to Take to Promote Physical Activity and Healthy Eating Coordinated school health program and school health council Self-assessment and planning process (School Health Index) Quality health education Staff wellness programs Quality physical education Additional opportunities for physical activity (e.g., recess, after school, walk to school) Quality school meals Healthy school nutrition environment

10 Self-Assessment and Planning Process The School Health Index helps schools: Identify the strengths and weaknesses of their health promotion policies and programs Develop an action plan for improving student health Involve teachers, parents, students, and the community in improving school programs, policies, and services

11 Sample Changes Made As A Result of Using SHI Hired a PE specialist for the first time Increased time spent in PE Added healthy choices to vending machines Moved healthy choices to the front of the food line Incorporated health in School Improvement Plan

12 FHRTL Fit, Healthy, and Ready to Learn (FHRTL) provides schools with a guide to address broad policy issues, including policy development includes sample policies

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14 Percentage of U.S. High School Students Who Attended Physical Education Classes Daily, % Percent % 25% 27% 29% 32% Source: CDC, National Youth Risk Behavior Survey

15 Quality Physical Education emphasizes knowledge and skills for a lifetime of regular physical activity is based on national standards that define what students should know and be able to do provides many different physical activity choices

16 Quality Physical Education meets the needs of all students, especially those who are not athletically gifted keeps students active for most of class time is an enjoyable experience for students

17 Quality Physical Education Requires Adequate time (150 min/week for elementary; 225 min/week for secondary) Appropriately trained teachers Adequate facilities and supplies Reasonable class sizes

18 Curriculum Analysis Tools (CAT) Health Education Physical Education To help users select, develop, or assess curricula Question/Answer format with scoring rubric Based on national educational standards and CDC s school health guidelines Coming from CDC in 2004

19 Physical Activity Breaks

20 After School Physical Activity Programs

21 Promoting Walking and Biking to School Purpose Increase daily physical activity of children Improve pedestrian safety Educate and empower communities to work together to create safe routes to school International Walk to School Day

22 Strategies for Statewide Change Physical activity and coordinated school health requirements (Texas, North Carolina) Curriculum (Michigan) School report cards and accountability (South Carolina)

23 Texas Law: Physical Activity for All Students Every elementary school (K-6) must have physical activity a minimum of 30 min/day or 135 min/week All school districts must have a school health advisory council (SHAC) Composed of teachers, administrators, students, and various members of the community including business leaders Coordinated school health program Provides for coordination of health, physical, and nutrition education Emphasizes parental involvement

24 North Carolina State Board of Education: Healthy Active Children Policy Requires students in prek-8 to participate in physical activity as part of PE curriculum (ES: consider 150 min/week; MS: consider 225 min/week; minimum of every other day, throughout the school year) Appropriate amounts of recess not to be taken away as a form of punishment School health advisory council and coordinated school health program in each district Each district shall develop an action plan for policy implementation, in coordination with SHAC

25 Physically conditioned for life s demands Michigan s Exemplary Physical Education Curriculum The EPEC Physically Educated Person Safety equipped Motivated to be physically active Skilled in health- enhancing physical activities Prepared for citizenship

26 K-5 materials 6-12 materials Finished Modules In Progress Planned

27 South Carolina Physical Education Assessment Program Added to school report cards: % of students in each school who meet state PE standards Led to development and/or implementation of: Performance indicators and assessment materials Data collection Staff development Curricular changes Increased visibility and prestige for PE

28 State-Level Policy Options to Help Schools Promote Physical Activity Identify PE as a core academic subject Require specified amounts of time for PE and recess Require teacher certification in PE Support staff development in PE Establish state systems of accountability for student achievement of PE standards Provide support for extracurricular physical activity programs Provide support for coordinated school health

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30 School Lunches Are Now Significantly Lower in Fat % of Calories Target: 30% or less Target: less than 10% SY SY Total Fat Saturated Fat Source: School Nutrition Dietary Assessment Study-II (School Year )

31 Certification and Training of Food Service Coordinators Certification for district-level food service directors: 18% of states offer and 6% require District food service directors: 60% are certified, 40% have undergraduate degrees School food service managers: 52% are certified, 14% have undergraduate degrees Source: CDC, School Health Policies and Programs Study 2000

32 Time to Eat 20% of schools usually give students <20 minutes to eat lunch once seated 26% of schools serve lunch before 11 am 13% serve lunch after 1:00 pm Source: CDC, School Health Policies and Programs Study 2000

33 Innovative Approaches to Promoting Consumption of Fruits and Vegetables Salad bars Prepackaged salads Gardening programs Farmer s markets DoDFresh Program Taste tests, promotions Free distribution USDA / NCI in 2004

34 USDA s Competitive Foods Regulations Prohibits sale of FMNV (foods of minimal nutritional value)--i.e., soda, water ices, chewing gum, and certain candies--in food service area during meal periods. FMNV does not include many popular snacks high in fat, added sugar, or sodium (e.g., potato chips, chocolate candy bars, donuts, juice drinks). States, districts and schools can impose additional restrictions on the sale of all foods at any time throughout the school.

35 Types of Foods Available in School Vending Machines or Stores* Soft drinks, sports drinks, fruit drinks: 76% of schools High-fat salty snacks: 64% High-fat baked goods: 63% 100% fruit juice: 55% Low-fat salty snacks: 53% Bottled water: 49% Chocolate candy: 47% Fruits or vegetables: 18% *Among the 61% of schools with a vending machine or store

36 Strategies for Change Adopt nutrition standards Negotiate vending contracts that promote health Limit access to foods and beverages Offer more healthful products Use marketing techniques to promote healthier choices

37 Adopt Nutrition Standards West Virginia prohibits the following at school: Chewing gum, flavored ice bars, candy Food or drinks containing 40% or more, by weight, of sugar or other sweeteners Juice or juice products containing less than 20% real juice Foods with >8 grams of fat per 1 oz. serving Soft drinks in elementary and middle schools

38 Adopt Nutrition Standards Maine: Administrative order from the Education Department bans soft drinks and candy from vending machines in all public schools during the school day. Texas: Department of Agriculture prohibits In elementary schools: FMNV throughout the school day In middle schools: FMNV during meal periods and carbonated beverage with volumes greater than 12 ounces throughout the school day

39 Adopt Nutrition Standards Old Orchard Beach, ME Removed all soft drinks and replaced with milk, water, juice Removed candy, high-fat snacks and replaced with trail mix, pretzels, granola bars, and cereal/fruit snack mixes Maintained contracts with vendors, agreed to purchase only healthful snacks Maintained vending revenue

40 Negotiate Vending Contracts that Promote Health Fayette County, Lexington KY Negotiated vending contract to increase revenues and healthy options Higher commission for healthful items Advantageous pricing for healthful items RFP gave points for promoting nutrition Parent working in the food industry assisted with the RFP

41 Limit Access to Foods and Beverages Alabama: No sales of FMNV during meal service anywhere on campus. Nebraska: No competitive foods anywhere on campus from ½ hour before until ½ hour after breakfast and lunch. New Jersey: No sales of FMNV anywhere on campus until the end of the last lunch period. Arkansas: No sales of foods and beverages through vending machines in elementary schools. Louisiana: No a la carte sales in schools.

42 Offer More Healthful Products Quad Cities, IA/IL: Sell milk, cheese, and yogurt through vending machines in 17 middle and high schools Central Middle School, Whitefish, MT: Replaced soft drinks and candy with milk, bagels, baked chips, fruit, homemade pretzels, pudding, salads, sandwiches, string cheese, and yogurt

43 Use Marketing Techniques to Promote Healthier Choices Vista, CA Child Nutrition Services Took over all school food options and began by conducting market research with consumers. Replaced candy and chips with crackers, pretzels, granola bars, peanuts, dried apricots, etc. Replaced soft drink machines with new beverage units selling milk, 100% juice, smoothies, water, sports drinks, and soft drinks.

44 Soda, Pepsi or Coke Sports Drink Iced Tea Water Fruit Drink, 10% juice Price $1.25

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46 Use Marketing Techniques to Promote Healthier Choices Vista, CA: Results of Changes School district commissions and bonuses were more than twice as much as it received before CNS took over the vending operation. Capital investments will be recouped in 30 months. Some of the new revenue is being used to convert cafeterias to fitness and nutrition centers.

47 Students are most likely to make the healthy choice... When it s the easy choice!

48 State-Level Policy Options to Help Schools Promote Healthy Eating Require certification and continuing education for child nutrition staff Establish guidelines for meal schedules Support promotion of fruits and vegetables, nutrition education, and coordinated school health Set nutrition standards for foods and beverages Limit student access to foods and beverages Promote inclusion of nutritional concerns in vending contracts Provide technical assistance to help schools offer and market more healthy choices

49 Components of a Coordinated School Health Program Health Education Family and Community Involvement Physical Education Health Services Health Promotion for Staff Healthy School Environment Nutrition Services Counseling, Psychological and Social Services

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