Improvement of School Nutrition Audience: School Administrators Purpose of presentation: To inform school administrators of the importance of quality school nutrition and how they can improve their school’s current nutrition status. Learning objectives: Participants will understand the need for improved school nutrition based on the current epidemic of childhood and adolescent obesity. Participants will understand the contributing factors of obesity. Participants will understand ways that they can improve their meal offerings and school environment to do their part in fighting this epidemic. Welcome everyone and thank you for attending this presentation on school nutrition improvement. I’m Danielle Main and I am a graduate student in Walden University’s Master of Public Health program. Danielle Main, MPH Student Walden University

Topics to be Covered Childhood and Adolescent Obesity Contributing Factors What you can do to help In this presentation we will cover the current status of childhood and adolescent obesity, the factors that contribute to this epidemic, and how you as school administrators can help.

Childhood and Adolescent Obesity For children aged 2–5 years, prevalence increased from 5.0% to 12.4% For those aged 6–11 years, prevalence increased from 6.5% to 17.0% For those aged 12–19 years, prevalence increased from 5.0% to 17.6% The Centers for Disease Control and Prevention. (2009, November 17). NHANES Surveys (1976-1980 and 2003-2006). Retrieved on January 15, 2010 from http://www.cdc.gov/obesity/childhood/prevalence.html Politico. (2010, January 20). Michelle Obama calls for fight against child obesity. Retrieved on January 21, 2010 from http://www.politico.com/news/stories/0110/31744.html Obesity is a serious health concern for children and adolescents. Michelle Obama recently called childhood obesity an epidemic and an economic threat when she spoke at the U.S. Conference of Mayors winter meeting. Data from National Health and Nutrition Examination Survey (NHANES) (1976-1980 and 2003-2006) show that the prevalence of obesity has increased. For children aged 2-5 years, prevalence increased from 5.0% to 12.4%; for those aged 6-11 years, prevalence increased from 6.5% to 17.0%; and for those aged 12-19 years, prevalence increased from 5.0% to 17.6%. As defined by the CDC, obesity includes those with BMI ≥ 95th percentile.

Contributing factors The imbalance of calories consumed and calories used contributes to childhood obesity This imbalance can be caused by genetic, behavioral, and environmental factors Factors that we can control are behavioral and environmental factors The Centers for Disease Control and Prevention. (2009, October 20). Overweight and Obesity. Retrieved on January 15, 2010 from http://www.cdc.gov/obesity/childhood/causes.html Childhood obesity occurs when there is an imbalance between the calories a child consumes as food and beverages and the calories a child uses to support normal growth and development, metabolism, and physical activity. This imbalance can be caused by a number of factors, including genetic, behavioral, and environmental factors. Interactions between these factors is what causes obesity, not just one single factor. Factors that we can control are behavioral and environmental factors.

Behavioral Factors Excessive energy intake among children and teens Limited physical activity and increased sedentary behavior The Centers for Disease Control and Prevention. (2009, October 20). Overweight and Obesity. Retrieved on January 15, 2010 from http://www.cdc.gov/obesity/childhood/causes.html One behavioral factor of obesity that can be tackled is the amount of calories consumed by children and teens. Oversized portion sizes for food and beverages, frequent snacking on high calorie foods and consumption of sugar laden beverages are all thought to contribute to the excess calorie consumption among children and teens. In regards to consumption of drinks that are loaded with sugar, they are also high in calories and children often do not take into account the amount of calories in these beverages when considering calorie consumption. These types of calories are considered empty calories due to their lack of nutritional value. In addition to watching calorie consumption, increasing physical activity and limiting sedentary behavior are also crucial in the fight against childhood and adolescent obesity.

Environmental Factors Schools play a critical role in helping children and teens adopt healthy eating and physical activity behaviors. The Centers for Disease Control and Prevention. (2009, October 20). Overweight and Obesity. Retrieved on January 15, 2010 from http://www.cdc.gov/obesity/childhood/causes.html Due to the fact that most young people aged 5–17 years are enrolled in schools and the great deal of time that children spend at school each day, schools provide an ideal setting for teaching children and teens to adopt healthy eating and physical activity behaviors.

What can you do? Foster a healthy school environment Ensure safety School should be clean and well-maintained Positive psychosocial climate American Dietetic Association. (2003, April). Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association—Nutrition services: An essential component of comprehensive school health programs. Journal of the American Dietetic Association, 103(4), 505-514. Retrieved on January 15, 2010 from http://www.eatright.org/About/Content.aspx?id=8372&terms=school+nutrition Improvement of school nutrition is not based solely on children and adolescents consuming healthy foods and beverages. A school that is safe, clean, and well-maintained with a positive psychosocial climate and culture can foster school connectedness, which in turn boosts student and staff health as well as students’ educational achievement. When students feel comfortable and safe in school they are more likely to interact with staff about their health and dietary concerns.

What can you do? Promote healthy eating habits in health education Focus should be on changing unhealthy behaviors Developmentally appropriate concepts Family involvement Environment should reinforce what is being taught American Dietetic Association. (2003, April). Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association—Nutrition services: An essential component of comprehensive school health programs. Journal of the American Dietetic Association, 103(4), 505-514. Retrieved on January 15, 2010 from http://www.eatright.org/About/Content.aspx?id=8372&terms=school+nutrition Incorporation of nutrition education into the curriculum from preschool through twelfth grade can significantly increase students’ health knowledge and improves eating and physical activity behaviors. However, less than one-third of schools provide thorough coverage of nutrition education that is needed to influence students’ motivation, attitudes, and eating behaviors. Nutrition education programs should focus on changing specific behaviors rather than on learning general facts about nutrition. Concepts should be developmentally appropriate at each grade level and adequate time should be focused on behaviors and skill building. An effective education program should also link to the child’s family, as research has shown that parental involvement helps to initiate changes in children’s dietary patterns. The school meal programs and food-related policies should also reinforce what is being taught in the classroom.

What can you do? Increase availability of healthy food choices School environment should also foster a healthy atmosphere American Dietetic Association. (2003, April). Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association—Nutrition services: An essential component of comprehensive school health programs. Journal of the American Dietetic Association, 103(4), 505-514. Retrieved on January 15, 2010 from http://www.eatright.org/About/Content.aspx?id=8372&terms=school+nutrition Meal standards and children's’ access to healthy foods improves health status and academic performance. School breakfast must provide one-fourth, and lunch programs must provide one-third, of the recommended daily allowance (RDA) for calories, protein, calcium, iron, vitamin A, and vitamin C for the applicable age or grade groups. Less than 30% of calories must come from fat. It is crucial that in addition to providing healthy meal options in the cafeteria that the school environment also foster a healthy atmosphere with healthy food and beverage options. Snack bars, school stores, and vending machines that promote sales of food and beverages of low nutrient density will contradict healthy school meal efforts and nutrition education. School policies that reinforce students’ healthful dietary behaviors must be developed and enforced. Food and beverages sold or served on school grounds or at school-sponsored events need to meet nutritional standards and guidelines set by the school/district/state.

Summary Childhood and adolescent obesity is surging Be an advocate for healthier options Increase nutrition education Foster a healthy environment Childhood and adolescent obesity has climbed at an alarming rate. Due to the significant amount of time that children and adolescents spend in schools your role as school administrators is crucial in the fight against obesity. By being an advocate for healthier school meal, snack and beverage options you can help reverse this trend. Increasing the amount of time allotted for nutrition education and fostering an environment that reflects what is being learned is critical.

Resources The Centers for Disease Control and Prevention-Coordinated School Health Program http://www.cdc.gov/HealthyYouth/CSHP/ American Dietetic Association http://www.eatright.org/ School Nutrition Association http://www.schoolnutrition.org/ Here is a list of additional resources to aid in the development of a healthier school nutrition program. The Centers for Disease Control and Prevention has information on a coordinated school health program (CSHP) model that has eight interactive components. The components help schools tackle school and health problems by providing the framework for a comprehensive school program that includes families and the community. The American Dietetic Association is a great resource for nutritional information. The School Nutrition Association website provides information on developing a school nutrition program, teaching students about nutrition, and planning healthy meals.

References American Dietetic Association. (2003, April). Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association—Nutrition services: An essential component of comprehensive school health programs. Journal of the American Dietetic Association, 103(4), 505-514. Retrieved on January 15, 2010 from http://www.eatright.org/About/Content.aspx?id=8372&terms=school+nutrition Politico. (2010, January 20). Michelle Obama calls for fight against child obesity. Retrieved on January 21, 2010 from http://www.politico.com/news/stories/0110/31744.html The Centers for Disease Control and Prevention. (2009, October 20). Overweight and Obesity. Retrieved on January 15, 2010 from http://www.cdc.gov/obesity/childhood/causes.html The Centers for Disease Control and Prevention. (2009, November 17). NHANES Surveys (1976-1980 and 2003-2006). Retrieved on January 15, 2010 from http://www.cdc.gov/obesity/childhood/prevalence.html Again, thank you all so much for your time. I am available for any questions or comments that you may have.