1. Alice Hildenbrand, Ph.D. student
School Nutrition
Alice Hildenbrand, Ph.D. student
Walden University
PUBH
Dr. Joanne flowers
Fall, 2009

2. Introduction
Children ages 5-18 spend the majority of their time in the school setting.
Children on the average spend seven to eight hours a day five days a week in the school environment. Because children spend the majority of their week in school it has a major impact on their diet (Center for Disease Control and Prevention (CDC), 2009). Based on this information the school is an ideal setting to change unhealthy eating patterns and establish life-long eating behaviors (CDC, 2008a).
Schools that have improved standards and policies for foods and beverages provided from outside sources have demonstrated improvement in school nutrition (CDC, 2009).

3. A child’s school performance is affected by their nutritional intake.
Hunger has been linked to behavior problems and poor academic achievement.
Insufficient food intake and hunger are related to poor behavior and low academic achievement (CDC, 2008, Florence, Asbridge, & Veugelers,2008). Data indicates that breakfast positively influences the students academic achievement (Florence, et al, 2008). Florence, Asbridge, & Veugelers (2008) research data indicated that 875 out of 5,200 (19.1%) 5th grade students failed 1 or both of the literacy components in the study. The study indicated that students who reported eating a diet containing fruits and vegetables were significantly less likely to fail the literary assessment (Florence, et al, 2008).
Of 1,200 schools completing the “State of School Nutrition 2009 Survey” 77% indicated that funding for food and food preparation is a challenge for improving school nutrition (School Nutrition Association (SNA), 2009). For the school to provide a nutritious meal the school will spend approximately $2.92 per student (SNA, 2009). The Federal government reimburses $2.57 per student meal (SNA, 2009). This difference has influenced the School Nutrition Association to seek an increase of $0.35 per student meal in order to provide the schools with adequate funding to deliver healthy, nutritious meals (SNA, 2009).

4. National Health and Nutrition Exanimation Survey (NAHNES)
NHANES result from ( and )
Prevalence of obesity in the United States
Ages
increase
2-5 5%
12.4%
7.4%
6-11
6.5%
17.0%
10.5%
12-19
17.6%
12.6%
The identified goal for Healthy People was the reduction in the number of children who are overweight or obese (CDC, 2009). A factor that contributes to this is the school environment (CDC, 2009a). In the school environment students select foods and beverages with little nutritional value if other appealing nutritious foods are not offered (CDC, 2009a).
The CDC (2009a) has indicated that the school environment is ideal for educating children on the benefits and methods to achieve a healthy eating behaviors. Since implementing healthy food programs some states have indicated a decrease in the percentage of children who are overweight or obese. In 2008, the Indiana State health Department reported that the Youth Risk Behavior Survey indicated that in 2005, 15% of the students were overweight by 2007, there was a decrease of 1.2 % with only 13.8% of the students overweight or obese (Indiana State Department of Health (ISDH), 2008).

5. What Children Eat and Don’t Eat.
Less than 40% meet dietary guidelines for saturated fat.
80% Do NOT eat fruits and vegetables at a minimum of 5 times per day.
39% Do eat fiber, dried beans, peas, fruits, vegetables, and whole grain.
80% of female children do not take in enough calcium.
Statistics are from the CDC, 2008b.
Many children do not eat the daily recommended nutrients required for a healthy diet (CDC, 2009). This has lead to a trend of increasing number of children who are overweight or obese (CDC, 2009).
Young females consume 36% less milk today than in any other time in the past years (CDC, 2008b). The lack of milk in their diet could result in deterioration of the bones (CDC, 2008b). This deterioration could result in bones that are easily fractured or Osteoporosis (CDC, 2008b).
On the average adolescents consume anywhere from 11oz to 19oz of soft drinks daily (CDC, 2008b).

6. Negative Weight Loss Methods
11.8% Do NOT eat to lose weight.
4.3% vomit or take laxatives
5.9% take diet pills, powders, and liquids without being under a physicians care.
Many high school students make unhealthy choices to lose weight that could affect their health (CDC, 2008b).

7. What Some Schools are Doing
Between schools in 34 states were
Did not sell soft drinks
Sold only fruit drinks that were 100% fruit juice.
64% of the schools by 2008 did not sell candy or salty snacks
Adding nutritional selections on the menu.
The Center for Disease Control and Prevention (2009) indicate that schools play a major role in influencing a child’s diet.
Wechsler, McKenna, Lee, and Dietz (2009) research indicated an increase in the number of school districts are offering fat-free or low fat milk (99%), fresh fruits and vegetables (98.8%), whole grains (96.3%), salad bars (91.1%), yogurt products (87.9%), vegetarian meals (63.9%), and local grown fruits and vegetables (37%).

8. 10 Strategies for School Nutrition
1. Develop a Coordinated School Health Program which includes:
Health education
Physical education
Health services
Nutrition services
Counseling, psychological, and social services
Health school environment
Staff health promotion
Family & Community participation.
The National Association of State Boards of Education (NASBE) identified ten key strategies that can improve school nutrition for all children (Wechsler, et al, 2004).
Before beginning any school nutrition program it would be beneficial to include a selected number of students, their families, faculty, and other members of the community to encourage their participation with planning and implementing the program (Wechsler, et al, 2004).

9. 3. Review school’s current health policies and program.
2. Find a Coordinator
3. Review school’s current health policies and program.
4. Improve current policies for school nutrition and physical activities
The school leaders should select an individual to coordinate, manage, and review current health policies, and the nutrition program (Wechsler, et al, 2004).
The coordinator and other members of team collaborate to identify the schools policies strengths and sections that need improvement (Wechsler, et al, 2004).
Schools should improve the quality of the school’s nutrition program, but the schools should increase the amount of time that students participate in physical exercise (Wechsler, et al, 2003). Physical activity and nutrition go hand in hand to promote health and well-being (Wechsler, et al, 2003).

10. 6. Improve current health education courses.
5. Develop and implement a health promotion program for staff and students.
6. Improve current health education courses.
7. Improve physical education courses.
All courses taught at the schools can incorporate health and nutrition into the course content and homework assignments (Eliassen & Wilson, 2007). For example, the students in math class could be asked to calculate the percentage of fruit and vegetables that should be included in the average daily diet (Eliassen & Wilson, 2007).
Words that should be avoided when educating students or staff include any words with negative connotation such as good, bad, healthy, and unhealthy (Eliassen & Wilson, 2007). Instead educators should utilize words that contain “Do” messages (Eliassen & Wilson, 2007).
The schools can incorporate interactive guides and tools to support and reinforce health and nutrition education in the classroom (United States Department of Agriculture (USDA), 2009).

11. 9.Improve the quality of school meals.
8. Provide opportunities for student to participate in physical activities.
9.Improve the quality of school meals.
10. Select foods and beverages that are appealing healthy that are offered outside school meals.
Wechsler, McKenna, Lee, and Dietz (2004) suggest the “American Association for the Child’s Right to Play” ( or “Brain Breaks” ( as resources to include physical activity to the school day.
In the planning of meals schools include foods and beverages that are not only nutritious but that will be appealing to the students (Wechsler, 2003).
The dietary planners can utilize the food pyramid ( to support selection of foods for the school nutrition program (USDA, 2009).

12. Quality School Nutrition
Can be achieved through collaboration of selected members from the following groups:
School superintendent
School board members
Parent Teacher Association
Student participation
Teachers
Health professionals
Food Service Director
Through collaboration efforts these groups can address needs, issues, and concerns of establishing a school nutrition program (Wechsler, et al, 2004). The interested parties can then develop a plan based on needs of the school community (Wechsler, et al, 2004).
After the plan has been established, the schools can implement their plan of action (Wechsler, et al, 2004). At the end of a specific period of time, the members can evaluate if the school nutrition plan achieved their established goals (Wechsler, et al, 2004).

13. Benefits of Quality School Nutrition Program
Improved and establish healthy eating behaviors.
Improved health and well-being.
Improved behavior in the classroom.
Improved academic learning.
Through school nutrition programs, the schools can help establish healthy eating behaviors that the students will utilize throughout their life (Florence, et al, 2008). By helping them to establish health eating habits the schools can help prevent short and long term health problems such as diabetes, hypertension, and heart disease (Florence, et al, 2008).
Another benefit of having a school nutrition program is that it will improve student learning (Florence, et al, 2008). Improved academic performance can provide them with the opportunity to further their education (Florence, et al, 2008). An education will enable them to seek employment that will benefit them economically and socially (Florence, et al, 2008).

14. References
Center for Disease Control and Prevention .(2008a). NHANES Surveys ( and 2003-
2006). Retrieved September 16, 2009 from
Center for Disease Control and Prevention. (2008b). Nutrition and the health of young people.
Retrieved September 16, 2009 from
Center for Disease Control and Prevention. (2009a). Contributing factors. Retrieved September
16, 2009 from
Center for Disease Control and Prevention (2009b). Press Release. Retrieved October 14, 2009
from
Eliassen, E. K. & Wilson, M. W. (2007). Selecting appropriate elementary school nutrition
education resources. American Journal of health Studies, 22 (4), Retrieved
September 28, 2009 from ProQuest Health and Medical Complete Databases.
Florence, M. D., Asbridge, M., & Veugelers, P. J. (2008). Diet quality and academic
performance. The Journal of School Health, 78 (4), Retrieved September 16, 2009
from ProQuest Health and Medical Complete Databases.

15. Indiana State Department of Health. (2008). 2007 YRBS News Release
Indiana State Department of Health. (2008) YRBS News Release. Retrieved October 1,
2009 from
School Nutrition Association (2009). SNA Press releases. Retrieved October 1, 2009 from
Wechsler, H., McKenna, M.L., Lee, S. M., & Dietz, W.H. (2004). The role of schools in
preventing : Childhood obesity. National Association of State Boards of Education.
United States Department of Agriculture. (2009). Myprymarid.gov. Retrieved October 22,
2009 from