1. Washington Action For Healthy Kids
THE LEARNING CONNECTION: The Value of Improving Nutrition and Physical Activity in Our Schools
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Washington Action For Healthy Kids
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2. Overview of the Problem
The majority of American youth are sedentary and do not eat well.
These unhealthy practices lead to health and learning problems.
It is critical to bring to our attention that there are costs to poor nutrition and physical inactivity….costs on health and, importantly, costs to our schools.

3. The Facts
Only 2% of school-aged children consume the recommended number of servings from all food groups
More than 80 percent of children and adolescents eat too much total fat and 90 percent eat too much saturated fat
Fewer than one in four American children get 30 minutes or more of physical activity per day—and more than three in four get no more than 20 minutes of vigorous physical activity per week
9 million school-aged children and adolescents are overweight to a degree that directly affects their health (16% national average)

4. Schools Can Make A Difference
Some schools’ practices and policies can aggravate student’s health and can interfere with their readiness to learn
Evidence suggests that addressing student’s health can help schools to meet performance goals and alleviate financial constraints
Schools play a critical role in helping students and themselves by addressing nutrition and physical activity
By collaborating with many stakeholders, schools can take immediate action that will help to address these issues.
The nation's schools can play a critical role in combating problems associated with poor nutrition and inactive lifestyles. But schools cannot be expected to take steps to address these issues unless it is in their interest to do so. The purpose of this paper is to bring attention to the costs that poor nutrition and physical inactivity impose on our schools. There is mounting evidence that by taking action schools can help themselves in meeting performance goals and alleviating financial constraints.

5. Connection to Learning
Poor nutrition has a negative impact on learning
Undernourished children attain lower scores on standardized tests, are more irritable, have difficulty concentrating and have less ability to resist infection and may miss more school
Well nourished students who skip breakfast perform worse on tests and have poor concentration
Poor nutrition and hunger interfere with cognitive function and are associated with lower achievement
Well-nourished students tend to be better students, while poorly nourished children tend to have weaker academic performance and score lower on standardized achievement tests. Given that the majority of our nation’s youth have poor eating habits, this creates a tremendous challenge for meeting achievement outcomes. This link between nutrition and academic achievement exists for a variety of reasons. Inadequate consumption of key food groups deprives children of essential vitamins, minerals, fats, and proteins that are necessary for optimal cognitive function.[i],[ii]
[i] Nutrition and Cognitive Development in Children. Policy Statement. Medford, MA: Tufts University School of Nutrition; 1995.
[ii] Center on Hunger, Poverty, and Nutrition Policy. The Link Between Nutrition and Cognitive Development in Children. Policy Statement. Medford, MA: Tufts University School of Nutrition; 1995.

6. Connection to Learning
Being physically active has a positive impact
One study linked physical activity to stronger academic achievement, increased concentration, and improved math, reading, and writing scores.
Another study found that students participating in daily physical education exhibit better attendance, a more positive attitude toward school, and superior academic performance.
Physical activity among adolescents is consistently related to higher levels of self-esteem and lower levels of anxiety and stress—each of which has been associated with better academic performance.
Moderate physical activity has positive impact on immune function…this can help to prevent colds and flu.
A recent study found that California schools with high percentages of students who did not routinely engage in physical activity and healthy eating habits had smaller gains in test scores than did other schools.[i] Schools that offer intense physical activity programs have seen positive effects on academic performance and achievement (e.g., improved mathematics, reading, and writing test scores, less disruptive behavior), even when the added physical education time takes away from class time for academics.[ii] A recent national survey of 500 teachers and 800 parents conducted for The Robert Wood Johnson Foundation found that 90 percent of teachers and 86 percent of parents are convinced that physically active children are better able to learn.[iii]
[i] Hanson, TL and Austin, GA. (2003). Are Student Health Risks and Low Resilience Assets an Impediment to the Academic Progress of Schools? (California Healthy Kids Survey Factsheet 3). Los Alamitos, CA: WestEd.
[ii] Symons, CW. Bridging Student Health Risks and Academic Achievement through Comprehensive School Health Programs. Journal of School Health. August 1997;224.
[iii] The Robert Wood Johnson Foundation. Healthy Schools for Healthy Living. December 2003.

7. A More Tenuous Link
Evidence of a direct effect of weight on achievement is less conclusive, however emerging research shows an association.
A 2003 JAMA study found that severely overweight children and adolescents were 4 times more likely than healthy children and adolescents to report “impaired school functioning”
A 2004 study of 11,192 kindergartners found that overweight children had significantly lower math and reading test scores at the beginning of the year than did their non-overweight peers, and that these lower scores continued into first grade.
i] National Institute Health Care Management (NIHCM) Foundation. Obesity in Young Children: Impact and Intervention. Research Brief. August 2004.
[ii] Data A, Sturm R, Magnabosco JL. Childhood Overweight and Academic Performance: National Study of Kindergartners and First-Graders. Obesity Research 2004; 12:58-68.

8. Overweight and Learning
Associations between weight problems and achievement do not imply causation, as there are a number of relating factors
Underlying cause of overweight -- poor nutrition and inactivity -- affect learning
Being overweight can impact a student’s health and leads to increased absenteeism
Overweight children face more psychological problems and studies show these student’s may be victims of bullying or be bullies…this can interfere with readiness to learn
While the evidence on the direct effect of weight on academic achievement is less conclusive, there is little doubt that overweight students face additional barriers to learning that likely lead to poorer academic achievement.
Being overweight can trigger or exacerbate a variety of chronic medical conditions in school-aged children, including, asthma, joint problems, Type II diabetes, high blood pressure, high cholesterol, depression/anxiety, and sleep apnea.[i],[ii],[iii] Sixty percent of overweight children have at least one risk factor for heart disease.[iv] These weight-related medical conditions undoubtedly cause students to miss class time, either through absences or visits to the nurse's office. In fact, some of these conditions appear to be significant sources of absenteeism. Several studies support the link between psychological and social problems faced by overweight students and academic achievement. For example, a 2004 study found a strong association between being overweight in kindergarten and behavior problems such as anxiety, loneliness, low self-esteem, sadness, anger, arguing, and fighting.[i]
[i] NIHCM Foundation 2004.
[i] Must A, Spadano J, Coakley E, Field A, Colditz G, Dietz W. The disease burden associated with overweight and obesity. JAMA October 1999; 282(16):
[ii] NIHCM Foundation 2004.
[iii] USDHHS 2001.
[iv] Freedman 1999.
[v] CCSSO 2004.

9. Economic Strains on Schools
Comprehensive analysis to evaluate the impact of poor nutrition, inactivity and increasing number of overweight students on school’s ability to manage within its budget has not been conducted.
However, there are subtle and indirect ways that these factors are taking an economic toll on our schools
Reduced state funding
Indirect/hidden costs

10. Reduced State Funding
In nine states, that collectively serve more than one-third of all students in the U.S., state funding for schools is determined by the number of students that show up for school – average daily attendance.
In these states, a single-day absence by one student can cost a school district between $9 - $20 dollars.
This adds up quickly – to estimate the potential cost of poor nutrition, inactivity and weight problems might pose on these districts, The Finance Project made projections based on percent of American children that are overweight to a degree that affects their health (16%)
Absenteeism
9 states – CA, ID, IL, KY, MS, MO, TN, TX – funding based on average daily attendance…In other words, public education dollars in these states are determined not by how many students are enrolled, but by how many actually show up at school. Student absenteeism can therefore have a negative impact on a school's bottom line.
One study found that severely overweight students miss, on average (using the median estimate), one day per month or nine days per year, with absenteeism rates being six times higher among overweight students than among their non-overweight peers.
While more research is needed, one can use these figures to develop a preliminary estimate of the potential impact of poor nutrition, physical inactivity, and weight problems on attendance, and thus on school funding in these states.
The Finance Project, a nonprofit policy research and technical assistance group, demonstrate just how significant a problem absenteeism can be for school budgets. These data suggest that a single-day absence by one student in these states costs a school district anywhere between $9 and $20. While these figures may seem small, they add up quickly.

11. Costs of the Status Quo
Current practices and policies include selling and promoting low-nutrient, high-calorie foods in an attempt to generate revenue
Some school practices and policies have cut back on physical education, recess and other physical activity opportunities to increase classroom time as a way to boost achievement
These strategies are not proven to meet those objectives and, unknowingly, are counterproductive
One of the primary reasons that schools cut back on physical activity and physical education programs is more classroom time, which is thought to lead to higher test scores and grades. Yet there are little or no data to support this theory. In fact, a growing body of evidence suggests that opposite is true. In other words, allotting to little time to physical education may undermine the goal of better performance, while adding time for physical activity may support improved academic performance.

12. Nutrition Practices Today
Research shows that selling competitive foods can drive students to these foods and beverages and away from the school meal programs
Schools can help their budgets via reimbursements from participating in school lunch and breakfast programs
If students are not participating, dollars from reimbursement decrease
Finances could improve by increasing participation in these programs
And, studies do indicate children that consumer school meal program have better nutrient consumption
Selling Competitive foods may not help (and could even hurt) school’s finances.
Students who purchase competitive foods do not eat school meals, and as a result government funding for school meal programs declines. Individual schools and school districts are finding that they can improve the healthfulness of food and beverage offerings without losing revenues. Some, in fact have seen gains.
Students at schools that limit competitive foods participate in the school meal programs and eat more nutritious foods. Better nutrition equates to better achievement outcomes.

13. Physical Activity Practices
The National Association for Sport and Physical Education’s recommends elementary schools offer 225 minutes of physical education per week and that secondary schools offer 150 minutes per week
However, just 8 percent of elementary schools, 6.4 percent of middle/junior high schools, and 5.8 percent of senior high schools provide daily physical education.
Increasingly, schools have reported cutting back or not increasing programs to meet these recommendations in order to give more class time to reading and math
While 48 states have laws requiring public schools to teach physical education, those laws are rarely enforced.
Student participation in physical education appears to be declining overall, with the rate of activity varying greatly by gender and generally declining with age. According to the CDC, 42 percent of high school students had physical education every day for at least one semester in By 1999, that figure had dropped to 29 percent and has remained steady through the last published CDC report in 2003.[i] The CDC estimates that one in four children do not attend any physical education classes, and that less than half of all schools offer intramural activities and only 14 percent of these schools offer transportation home.[ii]
[i] CDC 2003.
[ii] CDC 2003.
[i] U.S. Centers for Disease Control and Prevention. School Health Policies and Programs Study; 2000

14. The Bottom Line
It is in school’s own interest to address these issues discussed.
Solutions lie in partnerships and collaborations
AFHK is dedicated to improving children’s health and their readiness to learn through better nutrition and physical activity in schools
Private public partnership with thousands of volunteers on state teams and over 40 national organizations representing education, health, fitness and nutrition

15. Our Vision
Schools provide an environment that fosters the development of lifelong habits of good nutrition and physical activity for all children
Our aim is to:
Enhance the learning potential of all children,
Slow the rate of increase in overweight and obesity,
Increase efforts that lead to the prevention of overweight and obesity among youth.
Create health-promoting schools that support sound nutrition and physical activity as a result of state & national initiatives
Educate key audiences about nutrition and physical activity patterns that improve children’s health and learning
Lead at the national level to create public-private partnerships that sustain action focused on improving of children’s health

16. Actions Schools Can Take
Form a school health advisory council
Develop a comprehensive wellness policy
Integrate physical activity and nutrition into the school day
Incorporate nutrition and physical activity into after school programs
Encourage staff to model healthy lifestyles
1. Form a school health advisory council. Principals, superintendents, and board members do not have to change schools on their own. Instead, they need to engage a group of volunteers—including parents, students, medical professionals, business professionals, school administrators, youth group leaders, and law enforcement officials—to help conceive and implement nutrition education and physical activity programs that make sense for the local school community.
2. Develop a comprehensive wellness policy. With the recent passing of the Child Nutrition Reauthorization, all schools that participate in federal school meal programs will need to develop a local wellness policy that includes goals for nutrition education, physical activity, and other activities that promote student wellness. This “road map” needs to include guidelines for all foods and beverages sold on school campus as well as for teaching students how to make good decisions about what they eat. The policy should also address staff training needs.
3. Integrate physical activity and nutrition education into the regular school day. Teachers can start classes with fun calisthenics or dancing and can incorporate nutrition information and physical activity into reading, writing, math, science, and other assignments. For more information, visit the What’s Working database of programs at
4. Incorporate nutrition education and physical activity into after-school programs. Students who stay on campus after classes let out can do more than finish homework, play board games, and watch television. Time should be set aside for physical activities that engage students in fun and innovative ways to get them moving and to increase their physical skills. In addition, after-school programs should provide access to healthy snacks and hands-on opportunities to learn about food and nutrition.
5. Encourage staff to model healthy lifestyles. A wellness program for faculty and staff can enhance school effectiveness by strengthening morale, reducing absenteeism, and cutting insurance costs. By exercising regularly and eating healthy foods, staff can also set a powerful example for students.

17.
“We must understand this important truth: that improving children’s health likely improves school performance. It may even help a school’s bottom line.
This quote is from Dr. David Satcher, Former U.S. Surgeon General and Founding Chair of Action for Healthy Kids sums up the the major point of “The Learning Connection”. Improving children’s health will lead to improved performance and help school’s bottom line.

18. Actions School Districts Can Take
Develop a comprehensive wellness policy for schools in your district
Develop a district level school health advisory council
Keep nutrition and physical activity on the agenda at your local, district, and state school boards
Contact your AFHK State Team or visit our website for resources and to learn more
These are just a few examples of activities that can be done at the school district level.

19. Actions Individuals Can Take Now!!!!
Join your AFHK State Team!!!!
Be an advocate for better nutrition and physical activity in your local school.
Spread the Word!!!!! Don’t keep this information to yourself. Share this information and encourage others to get involved.
If you haven’t already, now is a great time to Join your AFHK state team.
You can go to our website to join the team.
You can also find a copy of the Learning Connection on our Website and there are other things that you can do.
Most importantly, get involved with this issue. Either at the state, district or the local level.

20. Schools Must Be Part of the Solution
Why are schools so important?
Children and teens spend 2,000 hours each year at school
Feeding programs are already in place
Schools are a great equalizer –all children have equal access to information about nutrition and physical activity
Schools have an opportunity to create the type of environment that students are being taught in the classroom
Schools are in a unique position to play a critical role in preventing and decreasing problems associated with poor nutrition and inactive lifestyles. Schools cannot, however be expected to take steps to address these issues unless it is in their interest to do so.

21. AFHK Approach
Establish
State and
National coalition
Private-public
partnerships
Produce programs
and projects for
state teams to
help schools
adopt CTC goals
Assess actions
Determine what
works, under
what conditions
Identify models
Communicate
Findings & tools
Stimulate more
schools to change
Recognize
successes
This will result in
children developing
Positive eating
and activity
patterns
Healthy schools, healthy children and healthy communities

22. Focus on “Commitment to Change”
Serves as framework for planning & action
Collaboration of multi-discipline group essential for success
Details specific actions necessary to create healthy schools that promote sound nutrition & physical activity
Increasing health, physical & nutrition education
Increasing physical activity (recess, PE, after school)
Ensuring health promoting foods are available throughout the school environment
CTC = AFHK’s guiding document, “Commitment to Change” – goals from Surgeon General’s report, school section