Setting 2: Schools

Schools are identified as a key setting for public health strategies to prevent and decrease the prevalence of overweight and obesity. Most children spend a large portion of time in school. Schools provide many opportunities to engage children in healthy eating and physical activity and to reinforce healthy diet and physical activity messages. Public health approaches in schools should extend beyond health and physical education to include school policy, the school physical and social environment, and links between schools and families and communities. Schools and communities that are interested in reducing overweight among the young people they serve can consider options listed below. Decisions about which options to select should be made at the local level.

Communication

1. Build awareness among teachers, food service staff, coaches, nurses, and other school staff about the contribution of proper nutrition and physical activity to the maintenance of lifelong healthy weight.
2. Educate teachers, staff, and parents about the importance of school physical activity and nutrition programs and policies.
3. Educate parents, teachers, coaches, staff, and other adults in the community about the importance they hold as role models for children, and teach them how to be models for healthy eating and regular physical activity.
4. Educate students, teachers, staff, and parents about the importance of body size acceptance and the dangers of unhealthy weight control practices.
5. Develop sensitivity of staff to the problems encountered by the overweight child.

Action

1. Provide age-appropriate and culturally sensitive instruction in health education that helps students develop the knowledge, attitudes, skills, and behaviors to adopt, maintain, and enjoy healthy eating habits and a physically active lifestyle.
2. Ensure that meals offered through the school breakfast and lunch programs meet nutrition standards.
3. 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.
4. Provide food options that are low in fat, calories, and added sugars, such as fruits, vegetables, whole grains, and low-fat or nonfat dairy foods.
5. Ensure that healthy snacks and foods are provided in vending machines, school stores, and other venues within the school’s control.
6. Prohibit student access to vending machines, school stores, and other venues that compete with healthy school meals in elementary schools and restrict access in middle, junior, and high schools.
7. Provide an adequate amount of time for students to eat school meals, and schedule lunch periods at reasonable hours around midday.
8. Provide all children, from prekindergarten through grade 12, with quality daily physical education that helps develop the knowledge, attitudes, skills, behaviors, and confidence needed to be physically active for life.
9. Provide daily recess periods for elementary school students, featuring time for unstructured but supervised play.
10. Provide extracurricular physical activity programs, especially inclusive intramural programs and physical activity clubs.
11. Encourage the use of school facilities for physical activity programs offered by the school and/or community-based organizations outside of school hours.

Research and Evaluation

1. Conduct research on the relationship of healthy eating and physical activity to student health, learning, attendance, classroom behavior, violence, and other social outcomes.
2. Evaluate school-based behavioral health interventions for the prevention of overweight in children.
3. Develop an ongoing, systematic process to assess the school physical activity and nutrition environment, and plan, implement, and monitor improvements.
4. Conduct research to study the effect of school policies such as food services and physical activity curricula on overweight in children and adolescents.
5. Evaluate the financial and health impact of school contracts with vendors of high- calorie foods and beverages with minimal nutritional value.