With 30% of US adults and 16% of adolescents obese (a Body Mass Index of greater than 30) it is more important than ever for children and adults to engage in plenty of physical activity and eat healthy foods. For children, physical activity and nutrition are both linked to improved readiness to learn, better educational outcomes, and improved health. For adults, nutrition and physical activity are linked to improved physical and mental health and job related satisfaction. The serious health conditions that can result from a lack of physical activity and poor nutrition will seriously impact the quality of life as well as current and future health care costs.
ChildrenHealth consequences: According to the Centers for Disease Control and Prevention (CDC) the prevalence of obesity among children aged 6 to 11 more than doubled in the past 20 years, going from 6.5% in 1980 to 17% in 2006. The rate among adolescents aged 12 to 19 more than tripled, increasing from 5% to 17.6%. For these young people there are potentially serious health consequences. Almost two thirds have an additional risk factor for heart disease such as high blood pressure or high cholesterol. New research suggests that these children may have arteries that are as thick as those of the average 45 year old. Children who are obese are also at risk for bone and joint problems, sleep apnea, as well as psychological issues. And these problems go beyond childhood, since obese children are more likely to carry their weight problems into adulthood. Lack of physical activity and poor nutrition are the causes of most excessive weight and obesity in children. A caloric imbalance, combined with often eating foods that are of poor nutritional quality means that young people have additional health risks due lack of certain vitamins and minerals such as calcium It is important to note that concerns about childhood excessive weight and obesity (as well as the rarer problem of underweight) are more than concerns about “looks.” Within a fairly wide range of body sizes, that can change as they grow, children at the heaviest weights are at risk of serious and long term health problems. Additionally, all children need to consume healthy foods and get sufficient physical activity. Links to learning Both nutrition and physical activity have important links to learning. In the landmark report, The Learning Connection, Action for Healthy Kids reviewed the research and reported these important findings. Participation in school breakfast has been associated with increased academic test scores, improved daily attendance, better class participation, and reduced tardiness. Increased physical activity has been shown to be linked to improved cognitive functioning and improved mental wellbeing, both of which support learning. Additionally, their research has found no links between including physical education or physical activity in the school day and decreased test scores. However, emerging research has linked the problems of poor nutrition and lack of exercise to lower achievement. Nutrition Within the school environment there are many opportunities to promote good nutrition. These include the federal child nutrition programs such as School Breakfast, School Lunch (includes Afterschool Snacks, Fresh Fruit and Vegetable Program, and Summer Meals), and the Special Milk Program. All of these programs provide nutritionally balanced low-cost or free food to children each school day. The programs are administered by the United States Department of Agriculture (USDA) through state agencies (usually the state education agency). Foods served in the program must be in-line with the Dietary Guidelines for Americans (currently being updated by USDA. However, the decisions on what foods to serve are made at the local level by the school district. To ensure that children get the proper nutrients it is important that they eat whole grains (such as whole wheat or brown rice), low-fat or non-fat dairy, and fruits and vegetables. They should avoid as much as possible sugared or artificially sweetened beverages (flavored milk is an exception) and foods made with refined grains such as white bread and rice. One important thing that schools can do is promote breakfast programs. Many children who are eligible do not participate in school breakfasts. Breakfast in the classroom, “grab and go”, and other programs can help children start each school day ready to learn.
Physical activity In 2008, the United States Department of Health and Human Services issued the first ever Physical Activity Guidelines for Americans. Because physical activity is so important to children’s health and learning, the guidelines call for children ages 6-17 to do at least 60 minutes or more of daily physical activity, including:
While it is important for the school day to contain time for activity through recess and in the classroom, before and after school are also critical. The Safe Routes to School Program is one way for school districts and communities to provide safe ways for kids to walk or bike to school. The guidelines also note that it is important to encourage young people to participate in physical activities that are appropriate for their age, that are enjoyable, and that offer variety. Physical education is one important way for children to get physical activity in school while learning skills that can help them be active for life. The National Association for Sport and Physical Education (2004) describes a quality physical education program that includes:
Hydration and access to water Hydration is important to children’s health. it support overall wellness and brain functioning. Water, rather than sugared or artificially sweetened beverages, should be the drink of choice in addition to low-fat and not-fat dairy (or a nutritionally equivalent substitute) for children over the age of two. Children should have access to clean, safe drinking water throughout the day (at home and at school) and when active, teachers, coaches, and parents should ensure that water is available. BMI Screening and Surveillance Body Mass Index (BMI) is the ratio of height to weight and is a popular screening measure because of its correlation with body fat levels. As concern about childhood obesity has grown, interest in school based BMI screening has grown. In 2007 the CDC published guidance on BMI screening and surveillance in schools. In screening programs, BMI is used to assess the status of individual students to identify those at risk and to provide parents and families with information and resources to help them take appropriate action. In surveillance programs, BMI is used to assess the status of a specific population to understand the number and percentage at risk. Surveillance data is usually anonymous. Some states and local districts have begun school-based screening programs in the past few years due to concerns over childhood obesity (Note-the American Academy of Pediatrics recommends that, regardless of what schools do, BMI should be conducted annually and plotted for tracking as part of a normal health exam in their medial home). BMI screening in schools has been controversial. Some have expressed concern that such programs might stigmatize some children or that they distract or take resources from other prevention activities. Because BMI screening meets some, but not all, of the criteria established by the AAP for school-based screening, CDC does not make a recommendation for or against school-based BMI screening. CDC notes, “Schools that initiate a BMI measurement program should have in place a safe and supportive environment for students of all body sizes and a comprehensive set of science-based strategies to promote physical activity and healthy eating.” If a school or school district decides to implement a screening program the following safeguards should be put in place:
Policies There are many laws and policies that cover nutrition and physical activity in schools. These include USDA regulations for school nutrition programs, state curriculum and assessment standards for physical education and nutrition education (as part of health education), state laws and policies on nutrition standards and physical activity, and local policies. Since the 2006 school year all local school districts that participate in the federal school meal programs are required to have a Local Wellness Policy. Local Wellness Policies are required to address five key areas; although the federal government did not set requirements on how districts were to address these areas:
While there is no single collection point for these local wellness policies, all districts should make them available to staff and families. Adults
Health consequences Adults, like children, need activity and good nutrition for their health. According to the CDC, data from the most recent NHANES survey1 shows that among adult men the prevalence of obesity was 33.3% and among adult women, the prevalence was 35.3% in 2006. At the state level, in 2007, only Colorado had adult obesity levels at below 20%. While people in a wide range of sizes can be healthy, adults who are obese are more likely to experience serious health problems including:
A healthy weight can reduce these risks significantly. Costs The health problems associated with excessive weight and obesity are a major cost factor for the health system. The National Institutes of Health estimates the total annual costs at $117 billion. This includes $61 billion in direct costs and $56 billion in indirect costs. However, the cost goes beyond this. NIH also estimates that lost work days cost about $39 billion. While data does not exist for the costs to schools, educator absences are a concern and as in other sectors, excessive weight and obesity are significant factors. Healthy Eight CDC notes that the key to achieving and maintaining a healthy weight is “not a diet but a lifestyle.” This means finding a balance between the “calories in”, and the “calories out.” To maintain weight, the calories in and out should balance each other. When the calories in are greater than the calories out, weight gain occurs. When the calories out are greater than the calories in, weight loss occurs. Tracking what you eat and your physical activity can help you make adjustments. Some simple ideas for making healthy food choices
Like kids, adults need to be physically active. The 2008 physical activity guidelines for Americans say that:
School Employee Wellness School Employee Wellness Programs are one important strategy for helping promote good nutrition and physical activity for the adults in schools. These programs provide opportunities for school employees to improve their health status, practice healthy behaviors, and serve as role models for the students in their schools. Employee wellness programs can also help to support the overall goals of creating safe and healthful workplaces that are free from hazards. They should be part of a comprehensive approach that includes contracts and policies, joint labor-management committees and health insurance coverage that promotes prevention and treatment. Research has shown that employee wellness programs can reduce occupational injuries, sick leave, and health care costs. Employee wellness programs can be part of a contract, offered through insurance, and/or included in local wellness policies. Examples of things that an employee wellness program might cover include:
Regardless of what the program includes it is important that participation in these programs is completely voluntary and not considered as part of employee evaluation or compensation decisions. healthy communities In addition to a healthy workplace, the neighborhood or community where people live and work should be a healthy one. Some things that make up a healthy community are:
Many communities are “food deserts” where people experience geographical and financial problems in accessing healthy food. This may be because there are no grocery stores, or because food is too expensive. The Food Trust is a national organization working to bring healthy food and jobs to food deserts, and is one resource to consider if you live in such a community.
Healthy Associations NEA state and local associations can do a lot to create an association culture that promotes healthy choices. This includes providing healthy food choices at meetings and creating opportunities for physical activity breaks. Additionally, by working to include school employee wellness in contracts and policies, state and local associations can help members be healthier and to be better educators. Resources from NEA HIN and its partners School Employee Wellness Guide HIN Organizing for a Safe and Healthy schools Creating a Healthy Meeting (TBD) Creating a Healthy Association (TBD) Additional resources |