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7 Schools
Pages 237-284

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From page 237...
... The school environment has the potential to affect national obesity prevention efforts both because of the population reach and the amount of time that students spend at school each day. Children obtain about onethirdi of their total daily energy requirement from school lunch (USDA, 2004a)
From page 238...
... FOOD AND BEVERAGES IN SCHOOLS The school food environment has undergone a rapid transition from a fairly simple to a highly complex environment, particularly in high schools. Traditionally, school cafeterias offered only the U.S.
From page 239...
... Foods and Beverages Sold to Schools Federal School Meal Programs The National School Lunch Program (NSLP) was established in 1946 to "safeguard the health and well-being of the Nation's children and to encourage the domestic consumption of nutritious agricultural commodities and other food" (7CFR210.1)
From page 240...
... can be served to students as part of their school meals. The target goals for the NSLP and SBP are that no more than 30 percent of calories should come from fat and less than 10 percent of calories from saturated fat (USDA, 2004b)
From page 241...
... This includes "a la carte" foods and beverages offered by the school food service; items sold from vending machines located inside or outside the school cafeteria; foods and beverages sold anywhere in the school as part of fundraising efforts by student, faculty, or parent groups; items served in the classroom for snacks and rewards; and foods and beverages made available during after-school activities. As discussed below, competitive foods from these various sources are typically lower in nutritional quality than those offered as part of the school meal programs.
From page 242...
... . Local schools and school districts are also implementing their own restrictions on competitive foods (GAO, 2004)
From page 243...
... . Because students' food choices are influenced by the total food environment, the simple availability of healthful foods such as fruits and vegetables may not be sufficient to prompt the choice of these targeted items when other food items of high palatability (often high-fat or high-sugar items)
From page 244...
... New policies are needed, both to ensure that the foods available at schools are consistent with current nutritional guidelines and to support the goal of preventing excess energy intake among students and helping students achieve energy balance at a healthy weight. School-Based Diet try Intervention Studies School-based interventions to improve food choices and dietary quality among students have been designed primarily as multifaceted interventions that include one or more of the following components: · Changes in food service and the food environment (e.g., food availability, preparation methods, price)
From page 245...
... Both the CATCH and Pathways interventions show the feasibility of making positive changes in the school food environment, but also the challenges still to be faced in designing primary obesity prevention interventions in schools. As pointed out by the researchers in the Pathways study, restriction of energy intake is not an option in schools because there are students who are below the fifth BMI percentile, additionally, the school meals programs have to meet minimum mandatory levels for calorie content (Caballero et al., 2003)
From page 246...
... .CATCH schools received school food service modifications and food senvice personnel training, physical education (PE) interventions and leacher training, and classroom curricula that addressed eating behaviors, physical activity, and smoking (Luepker et al., 1996)
From page 247...
... Outcomes assessed included changes in student BMI and physical activity levels Stanford Adolescent Heart Health Program—Designed to reduce cardiovascular disease nsk factors in high school students, the into Vention consisted of 20 50minute classroom sessions on physical activity, nutrition, smoking, and stress (Killen et al., 1988)
From page 248...
... Next Steps As discussed above, several large-scale school-based intervention studies demonstrate that changes in the school food environment can impact students' dietary choices and improve the nutrient quality of their diets while at school. Schools, school districts, and state educationaJ agencies need to ensure that ad meads served or sold in schools are in compliance with the Dietary Guidelines for Americans.
From page 249...
... Current nutritional standards are extremely limited for regulating competitive foods sold in schools, and many schools are selling high-calorie, energy-dense food and beverage items, often in competition with school meal programs. To ensure that foods and beverages sold or served to students in school are healthful, USDA, with independent scientific advice, should establish nutritional standards for all food and beverage items served or sold m schools.
From page 250...
... Funding and Sales of School Meals and Competitive Foods School Meal Funding School nutrition programs are financially self-supporting and must generate sufficient revenues to pay for food-service staff, food purchases, and equipment. Schools that participate in the NSLP receive a fixed amount of reimbursement for each school meal served.
From page 251...
... Schools and school districts should consider adopting policies to discourage the sale of foods and beverages and instead encourage other types of fundraising activities, such as walkathons or fun runs. Pricing strategies may also be an effective means of promoting the sales of healthful foods, while discouraging sales of high-fat or energy-dense foods and beverages.
From page 252...
... Experimental research is needed to examine the effects of school-based interventions and policy changes on students' dietary intake and eating behaviors. For example, changes in food availability and access to both healthful and less healthful foods, pricing of foods and beverages sold through competitive food sources and pricing of the school meals, promotional programs to support healthful food choices, and corporate-sponsored in-school food and beverage marketing activities need to be evaluated to determrne therr effects on students' diet and eating behaviors.
From page 253...
... . But although more than three-fourths of the states and school districts responding to the SHPPS survey required that PE be taught, the nature and duration of the classes varied widely in practice (Burgeson et al., 2001)
From page 254...
... , but for the grades after elementary school the percentages steadily decreased (Figure 7-1 and Figure 7-2) There have also been concerns about the nature and duration of physical activity levels during PE classes.
From page 255...
... Recess is generally defined as unstructured time for physical activity during the school day. The Centers for Disease Control and Prevention's (CDC's)
From page 256...
... that tested the effectiveness of a cardiovascular health promotion program in 96 elementary schools. Students in CATCH intervention schools participated in significantly more moderate-to-vigorous physical activity during PE classes than did students in control schools, but significant improvements in physical fitness levels or body weight were not observed (Luepker et al., 1996)
From page 257...
... Physical education classes of 75 or more minutes are not feasible within most current school days; however, the impact of this intervention on students' BMI encourages the development of approaches for increasing physical activity that can realistically be implemented. The other PE intervention that has demonstrated significant effects on body weight was the Stanford Dance for Health intervention, which substituted popular and aerobic dance classes (40 to 50 minutes, three times per week, over 12 weeks)
From page 258...
... Research has shown that physical activity levels often decrease for middle- and high school students, especially among girls (Sallis, 1993; Pate et al., 1994; Trost et al., 2002)
From page 259...
... An expansion of physical activity opportunities available through the school may result in benefits not only for students' health and well-being but also may potentially foster the formation of a lifelong practice of daily physical activity. Schools should ensure that all children and youth participate in a mimmum of 30 minutes of moderate to vigorous physical activity during the school day.
From page 260...
... · Schools should offer a broad array of after-school programs, such as interscholastic sports, intramural sports, clubs, and lessons, that together meet the physical activity needs and interests of all students. · Schools and child development centers should support and encourage physical activity opportunities for teachers and staff for their own wellbeing and because they are important role models for their students.
From page 261...
... , which are followed by most states and school districts, also emphasize the importance of teaching students behavioral skills—such as effective decisionmaking and goal-setting—thereby making healthful behaviors more likely. National data show that 69 percent of states require health education curricula to include instruction on nutrition and dietary behaviors, and 62 percent require the inclusion of physical activity and fitness (Kann et al., 2001)
From page 262...
... . Behavioral Nutrition and Physical Activity Cunlicula As described below, research findings support the effectiveness of behavior-oriented curricula—based on self-monitoring, goal-setting, feedback about behavior change efforts, incentives, and reinforcement methods—in promoting healthful food choices and physical activity.
From page 263...
... and environmental intervention targets (e.g., school meals, PE classes)
From page 264...
... Number of television hours declined for both genders in the intervention schools as compared with controls and for girls in the intervention schools there was an increase in fruit and vegetable consumption. The positive results of Stanford SMART and Planet Health suggest that obesity prevention efforts should involve reductions in sedentary television viewing time (see Chapter 8)
From page 265...
... Given the limited resources in many schools and their varied priorities regarding the nature and duration of nutrition, health, and physical education classes and curricula, it is critically important for innovative approaches to be developed and evaluated to address obesity prevention in the schools. These approaches should involve evidence-based curricula that teach effective decision-making skills in the areas of diet and physical activity.
From page 266...
... receive a proportion of the sales; some of the contracts include incentives for increased sales such as equipment, supplies, or cash awards. Advertising by soft drink companies is allowed in the school building at 37.6 percent of the schools with contracts; advertising is allowed on school grounds at 27.7 percent; and advertising on school buses is allowed by only 2.2 percent (Wechsler et al., 2001)
From page 267...
... do not generally understand that difference between information and advertising. Because public schools are institutions supported by taxpayer dollars, there are issues regarding whether it is appropriate for public schools to be a site for corporate or commercial advertising and marketing of products to children.
From page 268...
... The problem of rn-school advertising is complex and warrants a thorough and complete separate examination. Part of the difficulty in addressing issues regarding food and beverage advertising in schools is the issue of distinguishing advertising and promotion of healthful foods and beverages themselves from the companies or brands that may be associated with several different food or beverage products, some of which may be healthful and some less so.
From page 269...
... . Similarly, the survey found that physical fitness tests were required by approximately 20 percent of states or school districts.5 Some states have developed their own fitness test, while others use the President's Challenge or the Fitnessgram (Burgeson et al., 2001)
From page 270...
... For example, CATCH collected weight, height, blood pressure, skinfold thickness, aerobic fitness, dietary intake, and physical activity data on 4,019 students in 96 schools in third grade and again in fifth grade (Luepker et al., 1996)
From page 271...
... . Community health nurses are an important part of this effort, because they are first certified in height and weight research measurements at Arkansas Children's Hospital and subsequently train school nurses and other school personnel (ACHI, 2004)
From page 272...
... The committee urges CDC and other relevant federal, state, and local agencies to develop guidelines that assist schools in developing protocols that are not only reliable and useful, but that sensitively collect and communicate this information. AFTER-SCHOOL PROGRAMS AND SCHOOLS AS COMMUNITY CENTERS Organized after-school programs, both public and private, are daily opportunities for engaging many children and youth in physical activity and promoting healthy food choices.
From page 273...
... Furthermore, communities with limited recreational facilities would benefit from access to school facilities during nonschool hours. After-school programs should encourage and enable daily physical activity, provide healthful nurnrional choices, and provide students with the information to foster a better understanding of energy balmce.
From page 274...
... Pilot results for after-school obesity prevention programs in low-income African-American communities are already showing promise in this regard (Beech et al., 2003; Robinson et al., 2003) , though further research and evaluation is needed.
From page 275...
... If data are collected on a representative sample of students, the results should be publicly reported only in the aggregate. Research is needed to determine optimum ways to assess the impacts of school programs, policies, and environments on obesity prevention.
From page 276...
... It is also important to develop and implement curricula that will encourage students to move beyond an awareness of energy balance to the routine incorporation of good nutrition and physical activity into their daily lives. There are numerous innovative programs and changes relevant to obesity prevention that are being implemented in schools throughout the country, and it is important to adequately evaluate these efforts to determine whether they should be continued, expanded, or refined.
From page 277...
... To implement this recommendation: USDA, state, and local authorities, and schools should: · Develop and implement nutritional standards for all competitive foods and beverages sold or served in schools · Ensure that all school meals meet the Dietary Guidelines for Alnericans · Develop, implement, mud evaluate pilot programs to extend school meal funding in schools with a large percentage of children at high risk of obesity State and local education authorities and schools should: · Ensure that all children and youth participate in a minimum of 30 minutes of moderate to vigorous physical activity during the school day · Expand opportunities for physical activity through physical education classes; intramural and interscholastic SpOl'tS programs and other physical activity clubs, programs, and lessons; after-school use of school facilities; use of schools as community centers; and waling- and biking-to-school programs · Enhance health curricula to devote adequate attention to nut~ition, physical activity, reducing sedentary behaviors, and energy balmce, and to include a behavioral skills focus · Develop, implement, mud enforce school policies to create schools that are advertising-free to the greatest possible extent · involve school health services m obesity prevention efforts · Conduct annual assessments of each student's weight, height, and gender- and age-specific BMI percentile and make this infolmation available to parents · Perform periodic assessments of each school's polices md practices related to nutrition, physical activity, and obesity prevention
From page 278...
... 2003. Child- and patent-ta geted interventions: The Memphis GEMS pilot study.
From page 279...
... 2003. Childhood obesity: Do patents tecogroze this health tisk?
From page 280...
... Prev Med 37(6)
From page 281...
... Prev Med 28(2)
From page 282...
... Heal thy Fetms Heal thy Kids: Eveluenng the Burners end Opportunities for Fetm-to-School Programs. Venice, CA: Commt nity Food Set vice C oa ition (CFSC)
From page 283...
... AmJ Prev Med 24(3)
From page 284...
... Prev Med 24(1)


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