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Schools can promote physical activity, implement nutrition
programs to combat obesity epidemic
Since obesity among our nation's children is a multifactorial problem, it makes sense that a solution cannot rely on only one or two interventions.
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Many are working on strategies that can be implemented by primary care professionals who are in positions to identify and educate overweight individuals or those at risk and provide (or direct them to) management. There also have been calls to implement solutions through public health venues because broad-scale education is necessary to change the nutritional "environment" as well as increase opportunities for physical activity.
All of these strategies are necessary. In fact, it likely will be the cumulative effect of many small changes in children's and adults' environments that will be necessary to confront the obesity epidemic.
It is in this context that the role of schools should be looked on as one of many essential forums.
How schools contribute to problem
Some in the educational sector argue that obesity prevention and management are medical, not educational issues; that obesity is something parents must address, not educators. They also contend that the schools' role is minuscule compared to societal problems that predispose children to obesity, such as the role of advertising, the costs and availability of healthy foods, the perception that neighborhoods are inadequately safe to foster physical activity, and the pervasiveness of sedentary distractions for children, most notably television.
To clarify schools' potential role in the solution, it is worthwhile to explain the probable contributions schools make to the prevalence of obesity.
The Centers for Disease Control and Prevention's (CDC's) School Health Policies and Programs Study (SHPPS) in 2000 found that half of all school districts have a soft drink contract. Of these, nearly 80% receive a specified percentage of the sales receipts. Almost two-thirds of schools are given incentives once sales achieve a specified amount.
One-third of schools allow soft drink advertising in their buildings, and between 56% and 93% of schools (depending on elementary or secondary) allow students to purchase such beverages in vending machines, school stores, canteens or snack bars. It is difficult to avoid the contribution of schools to the 41% increase per capita in soft drink consumption in the first five years of the 1990s.
Although soft drinks may be the biggest culprit, their consumption in schools is not the sole problem.
U.S. Department of Agriculture guidelines discourage sales of "foods of minimal nutritional value" and foods at the tip of the Food Guide Pyramid (typically snack foods with added sugars and/or fats, far beyond what is found in foods in their natural state). Yet, 70% of schools allow students to buy these items during the lunch period.
Insufficient vigorous physical activity is the most significant risk factor for having a high body mass index in adolescent boys and girls. Yet, only 6% to 8% of schools provide daily physical education or its equivalent to their student populations (SHPPS data from the CDC), despite recommendations to do so by numerous professional organizations, including the Academy.
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Reversing the obesity trend
The first step schools can take to combat the obesity epidemic is to implement programs that have been shown through research to work or to be promising. For example, physical education should be optimally aerobic with students spending minimal time standing idly waiting for their turn. Physical education curricula and staff development programs have been designed to do just this (see resource box).
Similar progress in "what works" has been made for school nutrition programs. A coordinated school health program will provide healthier choices for foods, price them competitively and display them prominently. Healthy offerings in school cafeterias, vending machines, snack bars, and at celebratory and fund-raising events have been shown to be preferably purchased and consumed when they are in forms that are most acceptable to the cultural preferences of the student population, when families are involved in their promotion and when they are enhanced by complementary classroom nutrition educational curricula. Staff development curricula on nutrition also are available.
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Schools are excellent focal points in the community for other societal changes related to the prevention and management of obesity. There are excellent models throughout the nation in which schools have joined with community partners to arrange for safer bicycle and walking routes to and from school and after-school programs that promote physical activity. Schools have hosted community gardens, kept their playgrounds open on weekends and hosted media events to advertise their healthy programs.
Schools can set an excellent example on the importance of selecting a healthier diet and engaging in physical activity not only for students and families but also for corporations, small businesses and even health professionals.
