With childhood obesity rates continuing to skyrocket, everybody - parents, school administrators, government officials - is scrambling to find a solution. School programs and meals are often a main target for change because kids spend so much time there, and also because it's the place that parents send their kids to learn stuff, including health and nutrition.
In one recent Pennsylvania initiative, health officials were becoming increasingly alarmed at the growing rate of type 2 diabetes among children. Once rare before adulthood, type 2 diabetes (the type linked to unhealthy lifestyle factors such as poor diet and lack of exercise) has been rising steadily in children. Blacks and Hispanics are at particularly high risk; the government now projects that half of all babies born in those minority groups will develop diabetes later in life.
So researchers at seven major universities in PA set out to improve the health of kids before they became a statistic. They targeted schools that enrolled high percentages of poor and minority students. The plan was to intervene early, before diabetes develops - and at a young enough age to learn new habits that could prevent or reduce obesity, a major risk factor for the disease.
They began the interventions in 21 schools in the fall of 2006, when the students were in sixth grade; another 21 schools were designated as controls. A total of 4,603 students completed the study in June 2009, at the end of eighth grade. The results of the study were published last week online in the New England Journal of Medicine.
Analysis showed that there were significantly greater reductions in several diabetes risk factors - body-mass index scores, average insulin levels, and the percentage of students with the largest waists - at the intervention schools vs. the controls.
And it's no wonder, the initiative took a comprehensive look at the role of health and nutrition in schools, making changes in everything from the lunchroom to gym classes to summer programs. Here's a look at what they did:
- Change school meal programs, snack bars, vending machines, fund-raisers, and classroom parties
- Lower average fat content of food served in school.
- Provide at least two fruit/vegetable servings in lunch programs and one at breakfast.
- Limit all desserts and snacks to 200 calories or less.
- Eliminate milk greater than 1 percent fat, all drinks with added sugar, and nearly all 100 percent fruit juice.
- Provide at least two servings of grain-based foods or legumes, with at least 2 grams of fiber per serving, in lunch programs, and one serving at breakfast.
- Increase physical activity levels in gym
- Providing at least 225 minutes of physical education class over every two-week period.
- Ensuring 150 minutes of moderate-to-vigorous activity (at least 130 heartbeats per minute) over two weeks.
- Using strategies in gym class to better manage administrative time, reduce inactivity, and increase activity through motivational techniques, equipment, exercises, and games.
- Support the nutrition and phys-ed goals
- Classroom instruction on related topics
- Self-learning materials for students during breaks.
- Newsletters to families with recipes and support tips.
- Posters in English and Spanish.
- Public address announcements.
- Creative messaging, such as a healthy Jeopardy! game.