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Illinois School Board Journal
July/August 2002

Good nutrition establishes foundation for excellence

by Deborah Rees

Deborah Rees is a registered, licensed dietician who supervises the Illinois Nutrition Education and Training Program

Research shows a clear link between nutrition and a child's ability to do well in school. Undernourished children earn lower test scores and have difficulty concentrating. Even short-term hunger, like skipping breakfast, can negatively impact school performance. Participation in school breakfast programs has been shown to improve test scores and math grades as well as reduce absence, tardiness and behavior problems.

But while it's clear that good nutrition is vital to academic success, recent statistics show many of our children are flunking health.

• Only 2 percent of children meet the recommendations of the Food Guide Pyramid -- the standard for a healthy diet.
• Four out of five children don't consume the minimum recommended amount of five fruits and vegetables daily.
• Two out of three children consume more than the recommended amount of fat.
• Four out of five children don't consume enough calcium.
• Nearly 50 percent of 12- to 21-year-olds doesn't engage in enough physical activity.

The consequences of poor eating habits and an inactive lifestyle are troubling. A December report in The Journal of the American Medical Association concludes that being overweight is now the most common health problem facing children today. Data from the most recent National Health and Nutrition Examination survey indicates that 13-14 percent of children and adolescents are overweight -- a three-fold increase since the 1960s. Another 14 percent are at risk of being overweight. Particularly hard hit are African American and Hispanic children with overweight increasing more than 120 percent between 1986 and 1998 in these ethnic groups.

Children's health and education are being compromised by these trends. Risk factors for heart disease, like high blood lipids and hypertension, are occurring with increased frequency in overweight children. Health professionals are concerned that Type 2 diabetes, once limited to adults, is now showing up in children as young as 14.

Overweight adolescents also have a 70 percent chance of becoming overweight or obese adults with greater risk for chronic disease problems later in life. But perhaps the most immediate consequence of being overweight is social discrimination, poor self-esteem and depression -- all significant barriers to education.

Schools play an important role in children's lives and can do more than any other institution to promote lifetime health. Children spend much of their time in the school setting and are impacted by the school environment, for better or worse. The Surgeon General recently released a "call to action" encouraging schools to join a nationwide effort to prevent overweight and obesity.

"Public health approaches in schools should extend beyond health and physical education," said former Surgeon General Dr. David Satcher, "to include school policy, the school physical and social environment and links between schools and families and communities."

Schools can take the following action steps to ensure children's health and academic success:

• Provide a quality nutrition education and physical education program that helps students develop the knowledge, attitudes, skills and behaviors to adopt, maintain and enjoy healthy eating habits and a physically active lifestyle.
• Ensure that school meal programs meet nutrition standards.
• Adopt policies ensuring that all foods and beverages available on school campuses and at school events contribute toward eating patterns that are consistent with the Dietary Guidelines for Americans. (See "Study finds high-fat snacks, high-sugar beverages common.")
• Prohibit access to vending machines, school stores and other venues that compete with healthy school meals.
• Ensure that an adequate amount of time is provided for students to eat school meals.
• Ensure fund-raising efforts support healthy eating.

Focus groups recently conducted with Illinois Association of School Boards members identified potential barriers to improving the school nutrition environment. One often-cited barrier was that students don't seem to eat school meals. Many factors may be responsible.

Student attention on recess instead of eating, lack of choices, inadequate or uninviting cafeteria space, not enough time to eat, lack of student input in menu planning and even incorrect serving sizes all can play a role in plate waste. Many districts and school food service programs are implementing innovative ideas like these to help shape a quality food service program that encourages student participation and minimizes plate waste:

• Washington Communication Academy (a magnet school) in Rockford found that simply moving recess before lunch meant less food ended up in the garbage.
• Many districts boost participation in meal programs by increasing choices through the addition of food bars, redesigning cafeterias to resemble a food court or by simply offering a choice of entrees. A National Food Service Management survey found that overall satisfaction with meals was higher in schools that offered choices.
• More than one district has tapped student talent to paint a mural in the cafeteria -- a cost-effective way to make the cafeteria more inviting.
• Districts employ various methods to ensure enough time for students to eat, including adding service lines and designing the serving area to provide many access points instead of one.
• Quality school food programs make it a point to involve kids in menu planning. Regular surveys, taste testing, student nutrition action councils and suggestion boxes are all ways to ensure that meals reflect student preferences.

According to Fit, Healthy and Ready to Learn, a school health policy guide, policies governing food service programs should clearly lay out the results expected by policymakers. Policies provide the foundation for a quality food service program. Sample policy language is available in this key resource and can be adapted to reflect local needs.

Understandably, many school board members also express concern over the cost of improving the school nutrition environment in an already strapped education budget. While many positive changes require little more than a firm commitment, lack of funding can hamper implementation of a coordinated school health program that promotes increased physical activity and healthy eating.

Grant funding can assist schools in making positive strides. Savvy districts are tapping into grants to provide much-needed money and more funding is likely on its way with as many as 12 bills currently being taken up by Congress that address the obesity epidemic.

The Centers for Disease Control and Prevention currently maintains a Healthy Youth Funding Database at www2.cdc.gov/nccdphp/shpfp that can help districts locate funds to promote student health.

While most focus group participants agreed that nutrition is important, many admitted that nutrition would likely take a back seat to most other board issues. Even though schools have long been involved in drug prevention and anti-smoking efforts, nutrition education has not fared as well. Yet in terms of health risks, deaths due to lack of physical activity and poor dietary habits are second only to those caused by tobacco in the U.S.

Not surprisingly, several focus group participants voiced valid concerns that funds from vendors (particularly soda contracts) support education and student activities. While soda contracts can literally mean thousands of dollars in revenue for districts, more and more districts are coming under fire from those who believe that children's health should not be sold at any price.

Healthy vending options, like milk in resealable plastic bottles, bottled water or 100 percent fruit juice, are being considered by schools seeking to give students healthier alternatives to soda. In a national pilot program conducted by the dairy industry last year in 70 middle and high schools around the country, average weekly sales were 280 units per milk machine. Several districts in Wisconsin and at least 10 schools in northern Illinois are vending milk with excellent results. Jerry Stegman, vice president of Triple S Vending in Naperville, notes that two large high schools in Naperville currently average 400 to 500 units of milk a week.

Pricing can steer students to more healthful choices, too. Last fall, North High School in Minneapolis replaced all but one of its soda machines with 10 water and two juice machines. Pricing the soda at $1.25 and water at 75 cents resulted in water outselling pop in the fall, compared to the same period the year before.

An emerging trend nationwide to eliminate foods with low nutritional value in schools is sure to grow. Recent legislation in California and Texas is aimed at eliminating soda and junk foods from schools. According to a USDA Web site, at least eight states have policies restricting sale of foods of minimal nutrition value in schools that go beyond USDA regulations. Many other states are weighing guidelines and restrictions in the wake of the current obesity epidemic.

In the Midwest, Ohio requires public school districts to pass and enforce a local food for sale policy, while Wisconsin provides districts with guidance on establishing competitive food policies. Other states, like Illinois, allow local districts to address this issue as they see fit.

To their credit, many local school districts across the nation are adopting initiatives to improve the school environment. Oakland's school district, with 55,000 students, is one of the largest in California to enact a system-wide ban on junk food. Four schools in Philadelphia accepted an offer of $10,000 for school supplies in exchange for devoting 1,500 school hours to nutrition education. Nutrition education is being integrated into various subject areas and includes activities like using food labels to teach math skills or stories with nutrition themes to hone reading skills. The offer came from a Philadelphia task force galvanized by a recent attempt by Coca Cola to strike a $43 million deal with the district.

When surveyed about what would be needed for national school health guidelines to be implemented, school health practitioners responded that a solid foundation of policy is critically needed. Without commitment at the highest level of school leadership, implementing a well-coordinated school health program is difficult. Resources are available to assist districts in establishing effective policies that should reap short-term benefits for student learning and long-term benefits for public health.

Illinois Nutrition Education and Training (NET) Program is partnering with IASB to provide policymakers with key information on children's health trends, their impact on education and how schools can initiate positive change in the school environment. Changing the Scene: Improving the School Nutrition Environment, a presentation funded by a U.S. Department of Agriculture grant, can be scheduled for IASB division, district or school meetings by calling Illinois NET at 1-800-466-7998. Illinois NET is a non-profit program promoting child achievement through improved nutritional status and health.

While establishing good policy is not enough to ensure a healthy school nutrition environment, policymakers certainly play a pivotal role in laying the foundation. Policies are valuable for providing leadership, commitment, support and direction. Nutrition policies should establish the district's purpose and goals as well as lay a framework for nutrition education, physical education, the food service program and other food choices at school.

Several resources can help schools develop sound nutrition policies. Fit, Healthy and Ready to Learn provides national data and recommended policy language on physical activity, healthy eating and tobacco. Another good resource is USDA's Changing the Scene -- a guide to local action that can help districts assess their current nutrition environment and implement a plan for improvement. The Centers for Disease Control and Prevention provides guidelines for school health programs and assessment tools, as well. Additional technical assistance, resources and presentations are available through the Illinois NET program at 1-800-466-7998.