Childhood Obesity: What Can Schools Do?: Childhood Obesity: What Can Schools Do? Nutrition, Physical Activity and Academic Success


Objectives: Objectives Participants will be able to: 1. Verbalize the impact of nutrition and physical activity on academic achievement. 2. Discuss several ways schools can provide an environment that is conducive to healthful eating behaviors and regular physical activity. 3. Help implement policies in their school district that address physical activity and nutrition.


Utah AFHK Core Team Members: Utah AFHK Core Team Members Utah PTA Utah School Nutrition Association Utah Office of Education Utah Department of Health American Heart Association, Western States Affiliate Intermountain Pediatric Society Utah School Nurse Association Dairy Council of Utah/Nevada Utah School Boards Association Jordan District School Board Utah State School Board Utah Dietetic Association Primary Children’s Medical Center BYU Health Sciences-Physical Education University of Utah College of Health Utahns Against Hunger


David Satcher, MD, PhD,United States Surgeon General (1998-2001): David Satcher, MD, PhD, United States Surgeon General (1998-2001) “In schools the focus needs to be on creating an environment that fosters lifelong habits of good nutrition and increased physical activity.”


Slide6: Why a School-Based Initiative?


Obese and Overweight Kids in Utah: Obese and Overweight Kids in Utah Fill 124 elementary schools - 2,067 classrooms


“Change The Conversation”: “Change The Conversation” “It’s not just an obesity epidemic. It’s an epidemic of physical inactivity and poor nutrition.” Mark Fenton, UNC Pedestrian and Bicycle Center


Potential Health Consequences: Potential Health Consequences Elevated Lipids and Cholesterol Hypertension Type II Diabetes Apnea Liver Abnormalities Orthopedic Problems Depression Poor Peer Interaction


Economic Consequences of Obesity: Economic Consequences of Obesity National costs attributed to overweight and obesity: -9.1% of total US medical expenditures -$78.5 billion dollars (1998) Approximately half of the costs were paid by Medicaid and Medicare Utah’s portion of this cost was $393 million dollars -$62 million paid by Medicare -$71 million paid by Medicaid Finkelstein, EA, Fiebelkorn, IC, Wang, G. National medical spending attributable to overweight and obesity: How much, and who’s paying? Health Affairs 2003;W3;219–226. Finkelstein, EA, Fiebelkorn, IC, Wang, G. State-level estimates of annual medical expenditures attributable to obesity. Obesity Research 2004;12(1):18–24.


Link Between Achievement and Good Health: Link Between Achievement and Good Health By improving: Academic success Attendance Behavior Energy levels Participation Test scores By reducing: Absences Anxiety Apathy Depression Fatigue Infections Irritability


Link Between Achievement and Good Health: Link Between Achievement and Good Health Over 200 studies linking physical activity with cognitive functioning Studies link increased time in physical education with improved test scores in math, reading and writing Reduces anxiety and stress in teens Fitnessgram showed direct correlation with test scores Good health and nourishment enhance performance on cognitive testing Improved tests scores are a result of school breakfast program


Cost of Poor Nutrition and Physical Activity: Cost of Poor Nutrition and Physical Activity Money associated with absenteeism Staff time and money Health care costs for staff ADA accommodations Money taken away from school meal programs


School is Kids’ “work” and social world: School is Kids’ “work” and social world Need consistency between educational messages and “real life” messages in the school Growing commercial trends compete with healthy options


Creating Change and Solutions: Creating Change and Solutions Community Home School


Making ChangeCreating Policy: Making Change Creating Policy


What’s Happening in Utah?: What’s Happening in Utah? Gold Medal School Program Nutrition Policies in Wasatch, Tooele and Nebo Districts Legislative Resolution (HJR-11) Federal Child Nutrition Reauthorization Act- Wellness Policy Sample Policies Awareness Activities


Slide18: Shaping Utah’s Future Utah Department of Health


An Incentive Approach: An Incentive Approach Promoting Physical Activity Healthy Nutrition Tobacco Free Lifestyle


How Does GMS Work?: How Does GMS Work? Infrastructure Criteria School Recruitment Mentors Training Awards Cost


GMS Infrastructure: GMS Infrastructure


Criteria Developed: Criteria Developed Bronze Silver Gold Platinum


Policy CriteriaExamples: Policy Criteria Examples Each student gets at least 90 minutes of structured physical activity per week Food is not used as reward or punishment for students


Environment CriteriaExamples: Establish a Gold Medal Mile Provide competitive and non-competitive physical activity programs accessible to all students Environment Criteria Examples


Reaches the Intended Audience: Reaches the Intended Audience Between 2001 and 2005: 203 schools have participated in GMS and 114 of these schools have reached Gold level Over 103,000 students reached More than 2,700 teachers involved in a faculty wellness program More than 5 million Gold Medal Miles walked by students


Changes Schools: Changes Schools Between 2001 and 2005: Almost 1,300 individual school policies or environmental supports have been implemented or strengthened to promote healthy choices


Physical Activity Policy2001 and 2005: Physical Activity Policy 2001 and 2005 Percent of GMS with a Policy for 90 Minutes of Structured Physical Activity Per Week GMS with Physical Activity Policy by Year Percent


Nutrition Policy/Supports2002-2004: Nutrition Policy/Supports 2002-2004 Nutrition Policy and Supports by Year Percent


Wellness Policy : Goals for Nutrition & Physical Activity Nutrition Guidelines Involve parents, students, SFS, school board representative, school administrator, public Wellness Policy


Slide30: 2. Food as a reward is discouraged and shall be used on a limited basis. 4. Seventy (70) percent of the contents of vending machines accessible to students shall be water, milk, 100% fruit juices, and items that meet the nutritional standards established by the Food Service Department.


Elementary Schools: Elementary Schools No competitive foods during school meals. If schools have vending, they must contain only water, 100% fruit juice, non-fat or low-fat milk and fresh, dried or canned fruits and vegetables.


Competitive Foods- Secondary Schools: Competitive Foods- Secondary Schools The following beverages may be sold or served: water, 100% fruit juice, non-fat and low-fat milk The following beverages may not be sold or served: soft drinks, sports drinks, punches, teas and other beverages containing less than 100% fruit juice. Fruits and vegetables should be offered for sale at any location on the school site where foods are sold (including fresh, cooked, dried, juice, or canned).


Competitive Foods, cont.: Competitive Foods, cont. All snacks, sweets, or side dishes sold or served on school sites outside of the federal school meal programs shall meet all of the following standards: have 30% or less of its total calories from fat, Have 10% or less of its total calories from saturated plus trans fat, have 35% or less of its weight from sugars, excluding sugars occurring naturally in fruits, vegetables, and dairy ingredients.


Physical Education Policy Recommendations: Physical Education Policy Recommendations Elementary Implement the Physical Education Core Curriculum (Utah State Office of Education) in each elementary school. Aim for daily physical education instruction and activity for each elementary school child, with a goal of 150 minutes per week. Include at least two recess periods with active play each day. Restrict the use of recess as a reward or withholding recess as a punishment. Establish and promote safe routes for walking to and from school. Establish recess as an important time of day for children and teachers and not a time for remediation. Alter school schedules to allow for recess before lunch.


Physical Education Policy Recommendations: Physical Education Policy Recommendations Secondary Implement the Physical Education Core Curriculum (Utah State Office of Education) in each secondary school. Prioritize instruction that emphasizes activities, knowledge and skills for life-long physical fitness. Include and promote intramural sports and fitness activities that emphasize involvement of all students in addition to formal athletic programs. Establish and promote safe routes for walking and biking to school.


Nutrition Policy Recommendations: Nutrition Policy Recommendations Implement the Nutrition Core Curriculum (Utah State Office of Education) at each school. Limit food used for celebrations and rewards to less than once per month in each classroom. Achieve or exceed the federal standards for the school breakfast and lunch programs. Allow at least 10 minutes for breakfast and 20 minutes for lunch (once a student is seated). Assure adequate facilities for each student to eat sitting down in the cafeteria.


Nutrition Policy Recommendations: Nutrition Policy Recommendations No competitive foods sold during meal times. Establish guidelines for competitive food sales (vending, school stores, etc.) that promote healthy eating. See accompanying document “Recommendations for Competitive Food Standards in Utah”. Incorporate pricing that encourages the consumption of healthy foods in a la carte lines, vending and school stores. Include fruits, vegetables, salad bars, whole grain products and low-fat dairy and protein products while restricting the frequency of breaded and fried items as a la carte options in secondary schools.


Wellness Policy Recommendations: Wellness Policy Recommendations Establish a wellness committee at the school district level that includes school administrators, food service administrators, school board members, health and physical education teachers, other teachers, parents and students. Wellness committee to write, implement and evaluate physical activity and nutrition policies using accompanying materials in order to comply with the Child Nutrition Reauthorization Act which requires wellness policies to be in place in each district that receives school meal funding by Fall 2006. Encourage schools to use the Utah Gold Medal School Program (http://www.hearthighway.org), which provides guidelines, resources and incentives to schools that makes changes in physical activity and nutrition.


Wellness Policy Recommendations: Wellness Policy Recommendations Encourage schools to use the Healthier US program, which helps make healthy changes to school breakfast and lunch. www.fns.usda.gov/tn/HealthierUS/index.htm) Restrict fund-raising activities that rely on the sales of unhealthy foods and encourage those that incorporate physical activity. Promote wellness recommendations to staff, teachers, administrators and parents so they can serve as role models for health. Include a yearly evaluation of the wellness policies, identifying implementation rates, results and plans for additional recommendations.


What Kids Want: What Kids Want “I want to play like the other kids” “I want to be treated like the other kids” “I don’t want to be fat”


What Can You Do?: What Can You Do? “There is no limit to what we can achieve when we combine with the right people. Together we really can make a difference in the health of our nation's children.” Call to Action David Satcher, MD, PhD


Resources: Resources AFHK- Utah Competitive Food Standards Policy Guidelines Displays Listserv Fact Sheets Research backgrounders Presentations NASBE Sample Policies CDC School Health Index


More Resources: More Resources Institute of Medicine Report: Preventing Childhood Obesity: Health in the Balance, 2005 American Heart Association: Child Obesity Facts and Figures, 2005 American School Nutrition Association, sample policies Hearthighway.org- UDOH links to school health information and Gold Medal Schools


Contact Information: Contact Information Julie Metos, Utah-AFHK Chair julie.metos@hsc.utah.edu Sarah Rigby, Gold Medal Schools, Utah Department of Health srigby@utah.gov