School-based Programming for Childhood Obesity Prevention and Control

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Child eating sandwich. Blend Images - Kidstock/Brand X Pictures/Getty Images

Children spend the majority of their waking weekday hours at school so it’s important for schools to be a part of the fight against childhood obesity. Otherwise, they could end up teaching kids the wrong lessons about taking care of their health or undermining the healthy eating and exercise habits parents are trying to instill in their kids. In a study tracking the weight and behavior of low-income kids from kindergarten up to 8th grade (in 2007), researchers found that girls who ate school breakfasts regularly had a .70 higher body mass index (BMI) score than their peers, while girls who regularly consumed school lunches had a .65 higher BMI.

By contrast, boys who participated in school sports had a BMI that was .55 lower than their peers.

Fortunately, new standards for school meals and recommendations for physical activity are starting to move things in the right direction. A recent review of the research on school-based interventions in the U.S. and abroad found that healthy interventions in schools are associated with positive changes in children’s BMI, physical activity levels, nutrition knowledge, and improvements in their eating behavior. The interventions vary considerably in content, which suggests that a one-size-fits-all approach isn’t necessary to make a positive impact. The most common strategies included offering instructional sessions, educational games (such as fruit and vegetable bingo), and cooking classes; providing school-based gardens and opportunities to sample healthy foods; improving the nutritional quality of school food options; and promoting more physical activity.

Fixing the School Food Scene

The Centers for Disease Control and Prevention recently issued guidelines to promote healthy eating and physical activity in schools, with the ultimate goal of preventing obesity and chronic diseases. These include:

  • Coordinating and evaluating healthy eating and physical activity policies and practices;
  • Creating an environment that provides access to healthy foods and physical activity opportunities and promoting a healthy body image among students and staff members;
  • Providing a good quality school meal program that complies with the Dietary Guidelines for Americans
  • Implementing a comprehensive physical education (PE) program as well as opportunities for kids to engage in physical activity outside of PE class;
  • Launching a health education program that promotes healthy eating and physical activity patterns; and
  • Providing counseling and other resources to students with health, mental health, and nutrition-related needs.

As far as school meals go, new nutrition standards from the USDA call for schools to ensure that kids are offered fruits and vegetables every day, more whole-grain-rich foods, and only fat-free or low-fat milk, as well as including less saturated fat, trans fats, sodium, and total calories in school-prepared foods. 

Making these changes can help the obesity-prevention effort.

 Research has found that kids who attend a school without school stores or snack bars are estimated to consume 22 to 26 fewer calories per day from sugar-sweetened beverages; elementary-school kids who attend schools that don’t offer French fries in meals consume 43 fewer calories per day, while high school students whose schools don’t offer sugar-sweetened beverages consume 41 fewer calories per day. All of these changes can add up to a reduction in overall calorie intake, which can assist with weight-control efforts. 

Getting More Physical at School

Programs that increase physical activity during the school day can also make a difference. A recent study found a 4.2 percent variation in BMI scores among primary school children from different schools and concluded that a significant proportion of this variation could be explained by differences in the physical education programs.

Adding more movement to the school day can have a positive ripple effect on kids’ activity levels and perhaps their weight. In a study involving 25 New York City public elementary schools, researchers compared the effects of the Recess Enhancement Program (REP), in which coaches guide kids through age-appropriate games to increase their physical activity, and the usual recess activities. The rate of vigorous physical activity was 52 percent higher in the REP schools—and kids continued to engage in more intense movement even when the coach wasn’t around, which suggests a lasting change.  

Increasing the rigor of PE classes can also help. In a study involving overweight middle-school kids, researchers at the University of Wisconsin assigned the kids to either lifestyle-focused, fitness-oriented, or standard gym classes for 9 months. At the end of the program, those in the fitness-oriented class lost more body fat and gained more cardiovascular fitness and a greater improvement in their fasting insulin levels than kids in the other groups did.

Ultimately, if schools can become allies with parents and physicians in the battle against childhood obesity, we’ll have a better chance of winning the war. If your child’s school hasn’t yet introduced healthier meals, nutrition education programs, greater physical activity, and other health-boosting activities, encourage your PTA to get involved in making it happen.  

Sources:

Briefel RR, Crepinsek MK, Cabili C, Wilson A, Gleason PM. School food environments and practices affect dietary behaviors of US public school children. Journal of the American Dietetic Association, February 2009 [Accessed online September 14, 2014]; 109(2 Suppl): S91-107.
Carrel AL, Clark RR, Peterson SE, Nemeth BA, Sullivan J, Allen DB. Improvement of fitness, body composition, and insulin sensitivity in overweight children in a school-based exercise program: a randomized, controlled study. Archives of Pediatrics & Adolescent Medicine, October 2005 [Accessed online September 14, 2014]; 159(10): 963-8.
Centers for Disease Control and Prevention. Nutrition, Physical Activity & Obesity: School Health Guidelines to Promote Healthy Eating and Physical Activity. Accessed online September 14, 2014.
Chin JJ, Ludwig D. Increasing children’s physical activity during school recess periods. American Journal of Public Health, July 2013 [Accessed online September 14, 2014]; 103(7): 1229-34.
Ickes MJ, McMullen J, Haider T, Manjo S. Global School-Based Childhood Obesity Interventions: A Review. International Journal of Environmental Research and Public Health, 2014 [Accessed online September 14, 2014]; 11(9): 8940-8961.
Pallan MJ, Adab P, Sitch AJ, Aveyard P. Are school physical activity characteristics associated with weight status in primary school children? A multilevel cross-sectional analysis of routine surveillance data. Archives of Disease in Childhood, February 2014 [Accessed online September 14, 2014]; 99(2): 135-41.
Story M, Nanney MS, Schwartz MB. Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q, March 2009 [Accessed online September 14, 2014]; 87(1): 71-100.
USDA, School Meals: Child Nutrition Programs. Accessed online September 14, 2014.
Vericker TC. Children’s school-related food and physical activity behavior are associated with body mass index. Journal of the Academy of Nutrition and Dietetics, February 2014 [Accessed online September 14, 2014]; 114(2): 250-6.

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