Friday, 30 August 2013

Schools tackling obesity and malnutrition

This blog, written by Wikichild co-ordinator Melinda Deleuze, is part of the Wikiprogress Series on Health and Child Well-being. Discussing what schools can do to tackle childhood obesity, the post also leads up to the Wikiprogress September spotlight on Education and skills.

Every time I return to the United States, one of the first things that strikes me is the number of overweight children I see in the airport. During the summer months, the focus has been on feeding hungry American children nutritious food. There are hundreds of programs run by churches, nonprofits and civic groups which receive USDA reimbursements for that purpose. In Arkansas alone, more than $97,000 in grant money was distributed. Now that school is back in session, the aim is not only to give children the nutrition they need, but also to tackle the widespread issue of childhood obesity. 

Child and adolescent obesity is exceedingly prevalent in the US, Canada and Greece. It is also on the rise in most developed countries and in Asia. Over the past 3 decades, childhood obesity rates in America have tripled. Today, nearly one in three children in America are overweight or obese. Approximately 12% of children ages 2 to 5 are obese and 18% of those ages 6 to 19 are considered obese. The figures are higher among African American and Hispanic populations, where nearly 40% of the children are overweight or obese. 

          Percent of overweight children*                            Percent of children who eat breakfast every day*
                11, 13 and 15 years old                                                        11, 13 and 15 years old
Obesity has many negative consequences, and last week the American Medical Association pronounced childhood obesity a disease. Obese children and adolescents are at greater risk for bone and joint problems, sleep apnoea, and social problems. Also, school children suffering from obesity are at higher risk of developing psychological problems. An obese child is at a higher risk of becoming an obese adult. Therefore, iIt is important to intervene earlier in life in order to combat and reverse adult weight issues that could cause severe health complications.

Schools play an essential role in tackling obesity among children and adolescents by establishing a healthier diet, increasing activity and educating about food and nutrition. In America, there are 32 million students who eat school lunches and 12 million who eat a school breakfast every school day. Ensuring that these meals are healthy and nutritious is part of the solution to childhood obesity, as well as improving children’s overall health and wellness. In January 2012, standards for school meals in US public schools were updated to the following criteria:  

• Ensure students are offered both fruits and vegetables every day of the week;
• Increase offerings of whole grain-rich foods;
• Offer only fat-free or low-fat milk;
• Limit calories based on the age of children being served to ensure proper portion size;
• Increase the focus on reducing the amounts of saturated fat, trans fats, added sugars, and sodium.

Schools are required to meet these standards in order to receive federal meal reimbursements. Fewer children ate school lunches after the standards began to take effect, especially those who paid full-price for their lunches; however, breakfast consumption at school increased. More schools provided grab-and-go breakfasts, breakfast in the classroom and second-chance breakfasts, as well as traditional breakfasts served in the cafeteria at no charge. Additionally, in July 2014, schools nationwide will be forced to remove junk food, soda and sugary snacks from their vending machines and menus. Some other recommendations in order to improve diets are encouraging parents to bring non-food treats for birthday celebrations and selling non-food options for fundraisers. 

     Percent of children who eat fruit daily*       Percent of children who exercise at least one hour daily*
                   11, 13 and 15 years old                                                        11, 13 and 15 years old

A school’s curriculum and efforts to increase physical activity can have a major impact on reducing obesity. What children eat at school is only part of the problem, because their amount of physical activity has a serious impact on their weight. Quality exercise can burn up just about anything a child ingests. Unfortunately, only 9 states require recess at the elementary level, while 41 states do not. Physical activity could be added to the classroom, for example by having students act out words, instead of sitting in chairs the entire lesson. Also, schools should not allow physical activity to be withheld (e.g. withholding recess) or used as punishment (e.g. making a student run laps). Another idea is to perform a “walkability assessment” to determine the environmental factors which deter students from walking to school, such as unsafe crossings and broken sidewalks. 

Schools can also use the classroom to teach children of all ages about eating nutritious, well-balanced meals. Gardens offer great opportunities to educate younger children about how healthy food is produced, while providing a fun and physical activity. Fruits and vegetables could also be used to teach shapes and colors. Teachers of older students could use fruits and vegetables from the garden when learning about weights and measurements. Also, adolescents should learn about counting calories, burning calories and daily nutritional value charts. Children who have a healthy association with food and who understand the benefits of a balanced diet will be at a lower risk for obesity.

Finally, if schools notified parents about their children’s state of health and informed them of ways they could help, then parents could reinforce good eating habits and encourage activity. Several programs have begun sharing students’ body mass index (BMI) scores, along with fitness test results, with parents. This height-to-weight information allows parents to continue conversations with their children and bring in a pediatrician if necessary. This program was piloted in Cambridge, Massachusetts, and obesity among 5 to 13 year old students decreased 6% in less than a decade. If schools decide to notify parents about their child’s BMI, they should respect the sensitivity and confidentiality of the information in order to avoid bullying and eating disorders.

Changes need to be made, in both the school and home settings, in order to improve the health of children. Early interventions are the best way to tackle obesity issues. There are several resources available to schools and parents to facilitate change and increase healthy habits:

Wikichild co-ordinator  

*These charts and data are from the UNICEF Report Card 11: Child well-being in rich countries

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