1. A presentation for Missouri school board members Kari Thurman MPH student Walden University PUBH 6165 Dr. Heick January 2010 Improving Elementary School Nutrition

2. Improving the nutritional status of elementary students Focus on grades K through 5

3. Learning Objectives Identify problems with the nutritional status of our youth today. Explain why schools play an important part in nourishing our youth. Describe how schools can support healthy eating habits. Identify ways your school can go above and beyond the lunch program to instill good nutritional habits.

4. How Our Youth Weighs In Increase in obesity in 6 -11 year olds from 4% in the 1976 – 1980 NHANES survey to 17% in the 2003 – 2006 NHANES survey (CDC, 2009a) Obesity BMI Centers for Disease Control and Prevention. (2009, November 17). NHANES surveys 1976-1980 and 2003-2006. Retrieved January 21, 2010 from http://www.cdc.gov/obesity/childhood/prevalence.html Centers for Disease Control and Prevention. (2009, October 20). Defining childhood overweight and obesity. Retrieved January 21, 2010, from http://www.cdc.gov/obesity/childhood/defining.html

5. Health Consequences Type II diabetes mellitus High blood pressure High cholesterol Premature onset of puberty Sleep apnea (Gidding et al., 1996) Gidding, S. S., Leibel, R. L., Daniels, S., Rosenbaum, M., Van Horn, L., and Marx, G. R. (1996). Understanding obesity in youth. Circulation, 94, 3383-3387. Retrieved January 21, 2010, from http://circ.ahajournals.org/cgi/content/full/94/12/3383

6. Psychosocial Problems Social stigmatization Poor self-image (Gidding et al., 1996; Missouri Coordinated School Health Coalition [MCSHC], n.d.) Gidding, S. S., Leibel, R. L., Daniels, S., Rosenbaum, M., Van Horn, L., and Marx, G. R. (1996). Understanding obesity in youth. Circulation, 94, 3383-3387. Retrieved January 21, 2010, from http://circ.ahajournals.org/cgi/content/full/94/12/3383 Missouri Coordinated School Health Coalition. (n. d.). Promoting healthy weight in Missouri’s children. A guide for schools, families, and communities. Retrieved January 21, 2010, from http://www.healthykidsmo.org/resources/healthy_weight.pdf

7. Why Schools Need to Take Part The National Association of State Boards of Education (NASBE) has written: “Health and success in school are interrelated. Schools cannot achieve their primary mission of education if students and staff are not healthy and fit physically, mentally, and socially.” (Wechsler, McKenna, Lee, & Dietz, 2004, pg. 4) Wechsler, H., McKenna, M. L., Lee, S. M., and Dietz, W. H. (2004, December). The role of schools in preventing childhood obesity. The State Education Standard. Retrieved January 21, 2010, from http://www.cdc.gov/healthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf

8. Why Schools Need to Take Part Over 95% of young people are enrolled in schools (Wechsler, McKenna, Lee, & Dietz, 2004) Positive correlation between academic performance and good nutrition and physical activity (MCSHC, n. d.) Missouri Coordinated School Health Coalition. (n. d.). Promoting healthy weight in Missouri’s children: A guide for schools, families and communities. Retrieved January 21, 2010, from http://www.healthykidsmo.org/resources/healthy_weight.pdf Wechsler, H., McKenna, M. L., Lee, S. M., and Dietz, W. H. (2004, December). The role of schools in preventing childhood obesity. The State Education Standard. Retrieved January 21, 2010, from http://www.cdc.gov/healthyYouth/physicalactivity/pdf/roleofschools_obesity. pdf http://www.cdc.gov/healthyYouth/physicalactivity/pdf/roleofschools_obesity. pdf

9. Why Schools Need to Take Part School-based nutrition education can help students acquire knowledge, skills, and positive attitudes about healthy eating Schools can reinforce positive eating and give students a chance to practice healthy eating Schools can implement comprehensive nutrition policies that demonstrate a coordinated effort on school health (CDC, 2008) Centers for Disease Control and Prevention. (2008, November 19). Healthy youth! Nutrition: School health guidelines. Retrieved January 21, 2010, from http://www.cdc.gov/HealthyYouth/nutrition/guidelines/summary.htm

10. How Schools Can Support Healthy Eating Habits School food services should meet the Dietary Guidelines for Americans as well as exceed the minimum requirements for the National School Lunch and Breakfast Program standards (NSLP/SBP) Be sure that healthy and child appealing foods are available in meals, a la carte items, and classroom snacks (MCSHC, n. d.) Missouri Coordinated School Health Coalition. (n. d.). Promoting healthy weight in Missouri’s children: A guide for schools, families and communities. Retrieved January 21, 2010, from http://www.healthykidsmo.org/resources/healthy_weight.pdf

11. How Schools Can Support Healthy Eating Habits Mandatory fruit/vegetable side with lunch - children often choose on preference alone - repeated food exposure is often needed to get children to try new foods (Knowledge of Nutrition and Activities for Communities in Kansas [KNACK], 2008) Knowledge of Nutrition and Activities for Communities in Kansas. (2008, January 22). Shaping food preference and taste of young children. Retrieved January 21, 2010, from http://www.knackonline.org/news/2008/01/22/shaping-food-preference-and-thttp://www.knackonline.org/news/2008/01/22/shaping-food-preference-and-t aste-of-young-children/

12. How Schools Can Support Healthy Eating Habits Discourage food rewards in classrooms Provide adequate time to eat meals in a safe, pleasant environment Link with professionals (CDC, 2008) Centers for Disease Control and Prevention. (2008, November 19). Healthy youth! Nutrition: School health guidelines. Retrieved January 21, 2010, from http://www.cdc.gov/HealthyYouth/nutrition/guidelines/summary.htm Missouri Coordinated School Health Coalition. (n. d.). Promoting healthy weight in Missouri’s children: A guide for schools, families and communities. Retrieved January 21, 2010, from http://www.healthykidsmo.org/resources/healthy_weight.pdf

13. Going Above and Beyond Yearly BMI measurements by school nurse (Schantz, 2007) School garden (Food and Agriculture Organization of the United Nations [FAO], 2008) Centers for Disease Control and Prevention. (2008, November 19). Healthy youth! Nutrition: School health guidelines. Retrieved January 21, 2010, from http://www.cdc.gov/HealthyYouth/nutrition/guidelines/summary.htm Food and Agriculture Organization of the United Nations. (2008). School gardens: Education and nutrition go together. Retrieved January 21, 2010, from http://www.fao.org/newsroom/en/news/2005/104116/index.html Schantz, S. (2007, July). Child and adolescent obesity, BMI and the school nurse role. NASN Newsletter. Retrieved January 21, 2010 from http://www.nasn.org/Portals/0/education/scope_article.pdfhttp://www.nasn.org/Portals/0/education/scope_article.pdf

14. Role of School Board Members Support the procurement of healthy food choices Support nutritional education Encourage collaboration among nutritional services staff with health and physical education staff (O’Toole, Anderson, Miller, & Guthrie, 2007) O’Toole, T. P., Anderson, S., Miller, C., and Guthrie, J. (2007, October). Nutrition services and foods and beverages available at school: Results from the school health policies and programs study 2006. Journal of School Health, 77(8), 500 – 521.

15. Learning Objectives Revisited Identify problems with the nutritional status of our youth today. Explain why schools play an important part in nourishing our youth. Describe how schools can support healthy eating habits. Identify ways your school can go above and beyond the lunch program to instill good nutritional habits.

16. Questions?

17. Additional Resources USDA’s Team Nutrition: http://www.fns.usda.gov/tn/http://www.fns.usda.gov/tn/ U.S. Department of Health and Human Services on childhood obesity: http://www.dhss.mo.gov/Obesity/Childhood.htmlhttp://www.dhss.mo.gov/Obesity/Childhood.html National School Lunch Program: http://www.fns.usda.gov/cnd/lunch/AboutLunch/NSLPFactshe et.pdf http://www.fns.usda.gov/cnd/lunch/AboutLunch/NSLPFactshe et.pdf School Nutrition Association: http://www.schoolnutrition.org/http://www.schoolnutrition.org/

19. References Centers for Disease Control and Prevention. (2008, November 19). Healthy youth! Nutrition: School health guidelines. Retrieved January 21, 2010, from http://www.cdc.gov/HealthyYouth/nutrition/guidelines/summary.htm Centers for Disease Control and Prevention. (2009, November 17). NHANES surveys (1976-1980 and 2003-2006). Retrieved January 21, 2010, from http://www.cdc.gov/obesity/childhood/prevalence.htmlhttp://www.cdc.gov/obesity/childhood/prevalence.html Centers for Disease Control and Prevention. (2009, October 20). Defining childhood overweight and obesity. Retrieved January 21, 2010, from http://www.cdc.gov/obesity/childhood/defining.htmlhttp://www.cdc.gov/obesity/childhood/defining.html Food and Agriculture Organization of the United Nations. (2008). School gardens: Education and nutrition go together. Retrieved January 21, 2010, from http://www.fao.org/newsroom/en/news/2005/104116/index.html

20. References Gidding, S. S., Leibel, R. L., Daniels, S., Rosenbaum, M., Van Horn, L., and Marx, G. R. (1996). Understanding obesity in youth. Circulation, 94, 3383-3387. Retrieved January 21, 2010, from http://circ.ahajournals.org/cgi/content/full/94/12/3383 Knowledge of Nutrition and Activities for Communities in Kansas. (2008, January 22). Shaping food preference and taste of young children. Retrieved January 21, 2010, from http://www.knackonline.org/news/2008/01/22/shaping-food-preference-and- taste-of-young-children/http://www.knackonline.org/news/2008/01/22/shaping-food-preference-and- taste-of-young-children/ Missouri Coordinated School Health Coalition. (n. d.). Promoting healthy weight in Missouri’s children: A guide for schools, families and communities. Retrieved January 21, 2010, from http://www.healthykidsmo.org/resources/healthy_weight.pdf

21. References O’Toole, T. P., Anderson, S., Miller, C., and Guthrie, J. (2007, October). Nutrition services and foods and beverages available at school: Results from the school health policies and programs study 2006. Journal of School Health, 77(8), 500 – 521. Schantz, S. (2007, July). Child and adolescent obesity, BMI and the school nurse role. NASN Newsletter. Retrieved January 21, 2010 from http://www.nasn.org/Portals/0/education/scope_article.pdf Wechsler, H., McKenna, M. L., Lee, S. M., and Dietz, W. H. (2004, December). The role of schools in preventing childhood obesity. The State Education Standard. Retrieved January 21, 2010, from http://www.cdc.gov/healthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf http://www.cdc.gov/healthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf