1.  Increase the availability of fresh foods,  Develop a stable food supply in underserved communities, and  Improve the connection between urban and agricultural communities. The Food Trust, which hosts the Comprehensive School Nutrition Policy Task Force, was established in 1992 to: Comprehensive School Nutrition Policy Sandy Sherman, The Food Trust, Philadelphia, Pennsylvania

2. Comprehensive School Nutrition Policy Mission: To improve the health and well-being of youngsters who are at risk for poor nutritional status, including overweight status, by improving their diets through the adoption of a comprehensive school nutrition policy for the School District of Philadelphia. Funded by the Food Stamp Nutrition Education Program – PA Nutrition Education Plan

3.  Large numbers of children can be reached,  Costs to the family are minimal,  Program materials can be integrated into the ongoing curriculum, and  Peers, teachers, and administrators can support the adoption of a healthy lifestyle. Schools provide an ideal setting for the primary and secondary prevention of overweight:

4.  25 percent of the total calories for 6-11 year-olds and 33 percent for 12-19 year-olds come from meals and snacks consumed during the course of the school day. Modifying these meals and snacks is a significant environmental change to impact obesity and other diet related illnesses.  26 million students participate in the National School Lunch Program (NSLP) daily and rely on the schools to provide nutritious and healthy breakfasts, lunches, and snacks.

5. Goals: 1.Students in the pilot schools will improve their growth and weight gain profiles. 2.The ten pilot schools will successfully implement the school nutrition policy by:  Establishing School Health/Wellness Councils  Completing School Health Index and School Health Action Plan  Initiating social marketing,  Insuring that all foods meet the guidelines,  Integrating 50 hours of nutrition education,  Conducting 10 hours of teacher nutrition training, and  Involving family members and the community.

6. Extensive collaboration with the community:  Comprehensive School Nutrition Policy Task Force  Select Committee on Nutrition Standards  Research Team  Curriculum Committee  Community/Parent Committee  School-specific health/wellness councils

7. The Comprehensive School Nutrition Policy Task Force was formed in March 2000 to develop a nutrition policy for the School District of Philadelphia. Its goals are to change the school environment to:  Support healthy eating,  Increase physical activity, and  Decrease the prevalence of childhood obesity and its diet related diseases.

8. The Task Force is comprised of over 40 groups and individuals, including the:  School District of Philadelphia’s Food Services and Curriculum Divisions,  PA Departments of Health and Education  Philadelphia Department of Health,  Presbytery of Philadelphia,  Archdiocese of Philadelphia,  University of Pennsylvania’s Schools of Nursing and Medicine,  Thomas Jefferson University’s Community Prevention Program, and  School nurses, teachers, and parents.

9. School Health Team The School Health Index provides structure and direction to a school’s efforts to improve health programs.

10. Select Committee on Nutrition Standards The Committee developed standards for all foods sold and served in school meals programs. The standards are adapted from the CDC’s Guidelines to Promote Lifelong Healthy Eating and are more restrictive.

13. Increased Soda Consumption:  Soft drink consumption rates among children have doubled in the last decade.  Adolescents (aged 12-17) get 11 percent of their calories from soft drinks.

15. Snack Standards:  Total fat content must be less than or equal to 7 grams per serving  Saturated fat content must be less than or equal to 2 grams per serving  Sodium content must be less than or equal to 360 milligrams per serving  Sugar content must be less than or equal to 15 grams per serving  Candy will not be sold or served during the school day

16. Corner Store Campaign Students are buying an average of 600 calories in snacks and beverages on the way to and from school Schools can work with corner stores to promote healthy snacking Social marketing tools stimulate demand for healthier snacks

17. Social Marketing

18. Social Marketing Campaign The marketing campaign targets:  Breakfast  Lunch  Healthy beverages  Healthy snacks

19. After purchasing healthy beverages or snacks, students receive raffle tickets for prizes that reinforce healthy eating, physical activity, and learning, such as:  Bicycles,  Indoor basketball hoops,  Jump ropes, and  Calculators. The social marketing campaign is a healthy version of McDonald’s Happy Meals with prizes associated with the desired behavior.

22. All marketing materials have the logo imprinted to reinforce the message through frequent exposure.

23. Parent involvement Over 700 parents were directly reached through:  Home and school association meetings,  Exhibits at report card nights,  Parent education meetings and weekly nutrition workshops,  Newsletters sent home to all parents with children,  Elementary school fundraisers that promote and sell healthy foods, and  Messages from teachers encouraging families to bring healthy snacks to holiday parties.

24. The Weight and Eating Disorders Program at the University of Pennsylvania is working with The Food Trust to: Research and Evaluation evaluate the efficacy of the nutrition policy on 1,500 students in ten randomly selected and assigned schools in grades 4-8 comparing intervention and control students on changes, over a 2-year period, in the prevalence, incidence and remission of overweight. comparing the intervention and control students on measures of dietary intake, physical activity, sedentary behavior and body image.

25. Conclusions A School-based Nutrition Policy Approach has positive effects on reducing the incidence of becoming “at risk” but not “overweight” at 1 and 2 years. These effects are impressive given the relatively low dose of the intervention and the inattention to physical activity and sedentary behavior. Results may be, in part, attributable to a community- based rather than university-based intervention.