Helping School boards Enact Policies that Support Healthy Eating

The primary responsibility of schools is to foster academic achievement. Schools can do this by providing a high-quality instructional program, but also by paying attention to student health. There is substantial research that shows a clear connection between nutrition, physical activity and learning. Healthy, well-nourished children are more prepared to learn, more likely to attend school and class, and able to take advantage of educational opportunities. Inadequate nutrition during childhood can have a detrimental effect on children’s cognitive development and productivity in adulthood. (1)

Research also shows a direct relationship between breakfast and educational achievement. Studies have repeatedly demonstrated that breakfast at school not only enhances learning, but also reduces tardiness and improves daily attendance.(2)

Physical activity can also have a positive impact on student achievement. Schools that offer intense physical activity programs see positive effects on academic achievement, including increased concentration, improved mathematics, reading and writing test scores, and reduced disruptive behavior, even when time for physical education classes reduces the time for academics. (3) In California, higher achievement was associated with higher levels of fitness for fifth-, seventh- and ninth graders. (4)

One of the ways to prevent chronic diseases is to establish policies and programs that encourage children and adolescents to develop and sustain healthy eating and physical activity habits that they can maintain throughout their lives.

Poor diet and inadequate physical activity are the second leading cause of death in the United States and together account for at least 300,000 deaths annually; only tobacco use contributes to more deaths. (5) The general health of our students is at risk, in part, due to poor nutrition.

Continuing increases in the number of overweight children and adolescents is of public concern. Among children and teens ages 6-19, 15 percent (almost 9 million) are overweight according to the 1999-2000 data, triple what the proportion was in 1980.(6) An increase in Type 2 diabetes among children has paralleled the rising rates of obesity. (7). A recent study showed that consumption of sugar-sweetened beverages, such as soda and fruit-flavored drinks, is associated with obesity in children.(8)

Schools should provide education and an environment that gives students the skills, opportunities and encouragement they need to adopt healthy lifestyles. This requires more than educating youth on the importance of eating healthy foods and being physically active. Students cannot practice what they learn if they are offered mostly foods and beverages high in fat and sugar, and little opportunity to be physically active.

School-based programs such as the California Project LEAN (Leaders Encouraging Activity and Nutrition) Food on the Run program and CATCH (A Coordinated Approach to Child Health) have shown positive behavior change in students despite the prevalence of high fat and sugary foods offered outside of school.

Schools cannot meet all of the nutrition-related needs of student alone. However, because the relationship between health, nutrition, physical activity and learning is so strong, and because young people spend so much of their time at school or at school-related activities, schools can be a vital part of the solution.

A comprehensive school nutrition and physical activity program can help students attain full academic potential and optimal health by providing the skills, social support and environmental reinforcement necessary to adopt lifelong, healthy eating and physical activity behaviors. By adopting policies, school board members ensure that the health of students is a top priority.

To provide a comprehensive nutrition and physical activity program, districts should consider the following steps. These recommendations have been adapted from the Surgeon General’s

Prescription for Change, Centers for Disease Control and Prevention, and the United States

Department of Agriculture’s Changing the Scene.

1. Emphasize proper nutrition and physical activity as a priority.

• Establish a vision and goals for the district’s child nutrition and physical education programs.
• Adopt policies that ensure all foods and beverages available on campuses and at school events contribute toward eating patterns that are consistent with the school food standards in state and federal law. In California, school food standards have been developed and incorporated in SB 19 (Escutia, Chapter 913, Statutes of 2001). Extend the more rigorous nutrient standards that are typical at the elementary schools so that they apply to middle and high schools.
• Retain well-trained food service professionals who reinforce student’s adoption of healthy eating habits.

• Ensure that nutrition and physical education policies are implemented and evaluated annually.

2. Ensure quality school meals.

• Involve students in the selection, tasting and marketing of healthy foods and beverages that appeal to students.
• Provide more options, such as fruits, vegetables, whole grains and dairy foods, that are low in fat and added sugars.
• Offer a variety of healthy choices that appeal to students, including cultural and ethnic favorites.
• Commit all schools to participate in available child nutrition programs, including breakfast, lunch, after school snacks, child care and summer food service.

3. Monitor competitive food sales.

• Restrict student access to unhealthy foods in vending machines, school stores, and other venues that compete with healthy school meals in all grades, pre-kindergarten through grade 12.
• Ensure that healthy snacks and beverages are provided in vending machines, school stores and other venues within the district’s control. These options should be available at the same cost or less than unhealthy alternatives.

4. Provide an environment conducive to good health.

• Allow an adequate amount of time and space for students to eat school meals, and schedule lunch periods at reasonable hours around midday. Make sure that lunch lines are not too long and students have plenty of time to eat their food and socialize in a safe, comfortable and inviting place.
• Encourage safe access to physical activity facilities during and after school.
• Ensure that drinking fountains are operable, clean and convenient for students to access throughout the school day.

5. Support nutrition education and physical education.

• Offer nutrition education and daily physical activity in all grades, pre-kindergarten through grade 12. Enforce mandated physical education requirements.

• Focus on skill development so students are able to learn and adopt healthy eating and physical activity behaviors.

• Offer nutrition education in the school dining area and in the classroom with coordination between food service staff and teachers.

6. Promote healthy eating and physical activity.

• Discourage the use of unhealthy foods (e.g. soda, candy or high-fat foods) as an incentive or reward in the classroom, and instead encourage non-food alternatives (e.g. inexpensive stickers, pencils, erasers).
• Serve healthy foods such as smoothies or salads for class parties.

• Use a variety of strategies to actively promote healthy eating and physical activity to students, parents, teachers, administrators and the community.
• Conduct promotional campaigns in the cafeteria and on campus that encourage healthy eating and do not promote less nutritious food choices.
• Discourage the promotion and advertising of unhealthy foods and beverages.

• Explore revenue-generating alternatives.

• Continually seek other sources of revenue for schools so food service programs, booster clubs, student clubs and parent-teacher associations do not have to support their activities through the sale of unhealthy foods in vending machines, snack bars, student stores and other food outlets.
• Explore how some districts are able to be less reliant on the sale of unhealthy foods and beverages.

• Assess the district’s nutrition and physical activity program.

• Visit your school cafeteria for breakfast and lunch and spend time with students and staff to learn what students are eating and drinking.
• Involve students, parents, school staff, administrators, nutritionists and community leaders in assessing the school’s eating and physical activity environment. Develop a shared vision and an action plan to achieve it.

• Review successful school-based models.
• Identify other resources to develop sound policies for physical education and physical activity, and other components of comprehensive school health program.

Many school districts are meeting the challenge. They are offering healthy foods that students like while remaining financially sound. For example, Vista Unified School District strived to become the first "junk food free" district in the San Diego, California area. Vista’s Child Nutrition Services (CNS) program took over responsibility for managing vending machine contracts and introduced new, healthier products, such as fresh fruit, nuts, dried fruit, lower fat ice cream bars, and fruit bars. Sodas are still offered, but only in limited quantities. The program has met with unqualified success. The students are eating better and during the first year, the school generated $200,000 more in sales than in the previous year – which translated into nearly $15,000 in commissions for the school versus $9,000 the previous year.

Other California districts are taking similar steps to improve the nutritional quality of food sold to students. Capistrano Unified School District passed a resolution banning soda from vending machines during the entire school day, and also improved the quality of vended snacks. Los Angeles Unified School District has banned the sale of all soda and sugary drinks from all campuses before, during and until one-half hour after the end of the school day. Oakland Unified School District adopted one of the strictest policies on soft drinks and junk food in the nation. Unlike some school regulations that allow sales of unhealthy foods and beverages after school, Oakland has completely banned caffeinated drinks and some high-sugar sports drinks, candy, and all similar products. The policy expands nutritional standards to apply to all foods served on campus and extends the policy to middle and high schools, and important change since more rigorous nutritional standards typically exist at the elementary level.

Folsom Cordova Unified School district has revamped its entire food service operation. As a result, healthier school meals are available, point of sale locations have been increased to reduce the amount of time students must stand in line to receive food, and the district has eliminated the practice of requiring students who are eligible for free or reduced-prices lunches from standing in separate lines by allowing all students to punch ID numbers into a computerized keypad to pay for their lunch. The district is serving a substantially greater number of meals to students, and even more importantly, a district that was losing $200,000 annually on its food service program now has a $400,000 reserve and an annual budget that has gone from $1.75 million in 1995 to $3.5 million in 2002 due to increased revenues.

These districts all had to overcome a variety of challenges in the quest to improve nutritional standards for their students. These obstacles included concern from school officials that the changes would lose money for the schools, opposition from students who fought to keep sodas on campus, and the sheer effort that can be required to adopt and enact procedures necessary to comply with initiatives that support healthy eating.

In Capistrano, those pushing the ban on sodas and junk food found more support than they originally expected, and they also speculate that a closed campus made the switch easier to enforce. In Los Angeles, proponents of the ban made a concerted effort to stress that the central issue was health, not economics, and they worked with health advocates and district students to amass data and statistics supporting the ban. In Oakland, a small but vocal group of parents, community leaders, and health advocates raised concerns, and their outcry led to the creation of an official task force, the Nutrition Advisory Board (NAB). NAB is charged with implementing the ban on soft drinks and junk food, with the input of the community and staff. In Folsom Cordova, it took the concerted effort of a new food service director determined to do what it takes to steer nutrition programs through the changes in philosophy necessary to radically overhaul food delivery mechanisms to maintain nutritional integrity and fiscal viability. These examples all prove one thing: the ingredient required for success is the recognition of the vital importance of good nutrition for students, and a vocal determination to change practices and procedures to achieve it.

Information in this article has been adapted from The Healthy Food Policy Resource Guide developed by the California School Boards Association and California Project LEAN (Leaders Encouraging Activity and Nutrition). Copies are available for $20 each. To order a copy, contact CSBA at (866) 266-3382 or send an email to policy@csba.org. Visit www.csba.org and www.Californiaprojectlean.org for more information on children’s health and nutrition-related policy development.

(1) Tufts University, Center on Hunger, Poverty, and Nutrition Policy, Statement on the Link Between Nutrition and Cognitive Development in Children, Tufts University, Medford, MA, 1994.

(2) Meyers, A.F., et al., "School breakfast program and school performance, "American Journal of Diseases of Children, 1989, 143:1234-1239.

(3) Symons, C.W., Cinelli B., James, T.C., and Groff, P., "Bridging student health risks and academic achievement through comprehensive school health programs," Journal of School Health 1997, 67(6):220-227. See also Kolbe, L.J., Green, L., Foreyt, J., et al, "Appropriate functions of health education in schools: improving health and cognitive performance," In: Krairweer, N., Arasteli, J., Cataldo, M., eds. Child Health Behavior: A Behavioral Pediatrics Perspective, New York, NY John Wiley, 1986.

(4) California Department of Education, The Relationship Between Physical Fitness and Academic Achievement, 2001, PFT/SAT-9 Study, Sacramento, CA, 2002.

(5) McGinnis, J.M., and Foege, W.H., "Actual causes of death in the United States," JAMA, 1993, 270:2207-2212.

(6) Centers for Disease Control and Prevention (CDC), National Health and Nutrition Examination Survey (NHANES). Obesity Still on the Rise, Press Release, October 8, 2002.

(7) Rosenbaum, A.L., Joe, J.R., and Winter, W.R., "Emerging epidemic of type 2 diabetes in youth," Diabetes Care, 1999; 2292:345-54. and American Diabetic Association, "Type 2 Diabetes in Children and Adolescents," Diabetes, March 2000, 23(3):381-389.

(8) Ludwig, D.S., Peterson, K.E., Gortmaker, S., "Relationship between consumption of sugar-sweetened drinks and childhood obesity: A prospective, observational analysis," Lancet, 2001, 357:505-508.

Victoria Berends is Marketing Manager of California Project LEAN, a program to promote healthy eating and physical activity among adolescents as a way to improve chronic disease. She can be reached at Vberends@dhs.ca.gov.

Martin Gonzalez is the Assistant Executive Director for Policy Services at the California School Boards Association. He can be reached at mgonzalez@csba.org

For Additional Information:

Action for Healthy Kids

More information on this topic can be found through Action for Healthy Kids (AFHK), a nationwide initiative dedicated to improving the health and educational performance of children through better nutrition and physical activity in schools. This effort represents a response to our nation's epidemic of overweight, sedentary, and undernourished children and adolescents. Healthy schools produce healthy students -- and healthy students are better able to learn and achieve their true potential. An outgrowth of the 2002 Healthy Schools Summit, AFHK is composed of 51 State Teams and a national coordinating and resource group. AFHK fosters sharing and collaboration among diverse stakeholders to encourage and facilitate meaningful change in schools. Guidance and direction is provided by more than 30 national organizations and government agencies representing education, health, physical activity and nutrition.

For more information about Action for Healthy Kids and how you can become involved visit www.actionforhealthykids.org .

To obtain more specific information regarding physical education and healthy eating policies contact NSBA’s School Health Programs Department at schoolhealth@nsba.org or 703-838-6722 or visit us at www.nsba.org/schoolhealth.