1. Supporting Student Success: Exploring Evidence of Critical Links between Health and Learning Focus on Nutrition and Physical Activity A Presentation to the Mississippi State Board of Education Jackson, Mississippi May 19, 2005 Harvard School of Public Health Partnerships for Children’s Health

2. What We’ll Do Today Gain a greater understanding of: 1) The obesity epidemic in America, and current issues in nutrition and physical activity that affect students in Mississippi

3. What We’ll Do Today Gain a greater understanding of: 2) Evidence demonstrating connections to learning and economic costs to our schools

4. Obesity Trends Among U.S. Adults between 1990 and 2003 Definitions:  Obesity: having a very high amount of body fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher.  BMI is a measure of an adult’s weight in relation to his or her height (the adult’s weight in kilograms divided by the square of his or her height in meters).

5. Obesity Trends Among U.S. Adults between 1990 and 2003  The data shown in the following maps were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS).  Each year, state health departments use standard procedures to collect data through a series of monthly telephone interviews with U.S. adults.

6. Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%

7. Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

8. Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24%

9. Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

10. “Overweight and obesity… have reached epidemic proportions in the United States…Left unabated, overweight and obesity may soon cause as much preventable disease and death as cigarette smoking.” “Overweight and obesity… have reached epidemic proportions in the United States…Left unabated, overweight and obesity may soon cause as much preventable disease and death as cigarette smoking.” - David Satcher, M.D., Ph.D. - David Satcher, M.D., Ph.D.

11. Diet and inactivity are cross-cutting risk factors, contributing significantly to four out of the six leading causes of death. 1. Heart Disease 710,760 2. Cancer553,091 3. Stroke167,661 4. Chronic Lower Respiratory Diseases 122,009 5. Accidents97,900 6. Diabetes69,301 7. Pneumonia and Influenza65,313 8. Alzheimer’s Disease49,558 9. Nephritis37,251 10. Septicemia31,224 11. Suicide29,350 12. Chronic Liver Disease/Cirrhosis 26,552 13. High Blood Pressure18,073 14. Homicide16,765 15. Pneumonitis16,636 Leading Causes of Death, United States National Center for Health Statistics, CDC/HHS. “Deaths, Percent of Total Deaths, and Death Rates for the 15 Leading Causes of Death in 5-Year Age Groups, by Race and Sex: United States, 2000.” Hyattsville, MD: CDC, 2002.

12. Obesity is Associated with an Increased Risk of:  Premature death  Type 2 diabetes  Heart disease  Stroke  Hypertension  High blood cholesterol  Gallbladder disease  Osteoarthritis  Sleep apnea  Asthma  Cancer (endometrial, gallbladder, colon, kidney, and post-menopausal breast)  Complications of pregnancy  Psychological difficulties due to social stigmatization

13. Ages 12-19 Ages 6-11 5 4 14 13 Overweight Children and Adolescents* *>95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts. **1963-1970 data are from 1963-1965 for children 6-11 years of age and from 1966-1970 for adolescents 12-17 years of age. National Center for Health Statistics.

14. Nine million school- aged children and adolescents are overweight to a degree that directly affects their health

15. High School Students Who Reported Unhealthy Dietary Behaviors CDC Youth Risk Behavior Survey, 2003; Mississippi YRBS, 2004 (2003 data). *Ate <5 servings of fruits and vegetables per day during the 7 days preceding the survey. **Drank <3 glasses of milk per day during the 7 days preceding the survey. ***During the 30 days preceding the survey. 78 83 5 80 0 10 20 30 40 50 60 70 80 90 Insufficient Consumption of Fruits and Vegetables* Insufficient Consumption of Milk** Used Laxatives or Vomited to Lose Weight Percent United States Mississippi 89

16. Beverage Intake Among Adolescents Aged 11-18, 1965-1996 Cavadini C et al. Arch Dis Child 2000;83:18-24 (based on USDA surveys). 0 200 400 600 800 1000 1200 1400 1600 1965197719891996 Per capita grams consumed per day BoysGirls (Soft drinks, diet soft drinks, and fruit drinks)

17. High School Students Who Reported Insufficient Physical Activity CDC Youth Risk Behavior Survey, 2003; Mississippi YRBS, 2004 (2003 data). *Vigorous physical activity on <3 of the 7 days preceding the survey. **Neither vigorous or moderate physical activity on any of the 7 days preceding the survey. 33 10 47 15 0 10 20 30 40 50 60 70 80 90 Insufficient Vigorous Physical Activity* No Physical Activity During the Past Week** Percent United States Mississippi

18. High School Students Who Reported Insufficient Physical Activity CDC Youth Risk Behavior Survey, 2003; Mississippi YRBS, 2004 (2003 data). 45 72 38 69 54 0 10 20 30 40 50 60 70 80 90 Not Enrolled in PE ClassDid Not Attend PE Daily Watched TV 3 or More Hours Per Day (on an average school day) Percent 77 United States Mississippi

19. Health Education Requirements by Grade 33 39 41 42 44 27 22 20 10 9 3 2 K1st2nd3rd4th5th6th7th8th9th10th11th12th 0 10 20 30 40 50 Percent of schools CDC School Health Policies and Programs Study, 2000.

20. Physical Education Requirements by Grade 40 51 52 50 32 26 25 13 10 6 5 K1st2nd3rd4th5th6th7th8th9th10th11th12th 0 10 20 30 40 50 60 Percent of schools CDC School Health Policies and Programs Study, 2000.

21. The No Child Left Behind Act The No Child Left Behind Act  Does not specifically mention school health, though the word “health” appears over 100 times

22. Kids have to be healthy to learn, and they have to learn how to be healthy.

23. Tools to Assist Schools Action for Healthy Kids www.actionforhealthykids.org Action for Healthy Kids is about creating health-promoting schools that support sound nutrition and physical activity as part of a total learning environment.

24. About AFHK www.actionforhealthykids.org Our mission: 1.Enhance the learning potential of all children 2. Slow the rate of increase in overweight and obesity 3. Increase efforts that lead to the prevention of overweight and obesity among youth

25. About AFHK www.actionforhealthykids.org Who we are: Over 4000 state team members in 50 states and the District of Columbia A Partner Steering Committee of 47 leading national health and education organizations, including NSBA A diverse and distinguished board of directors