You are what you eat
Two major reports cite the role of schools in tackling childhood obesity

Combating the alarming rise of obesity among American children requires an approach as “comprehensive and ambitious” as national anti-smoking efforts. That’s the conclusion of a new report from the National Academy of Sciences’ Institute of Medicine.

“We must act now, and we must do this as a nation,” says Jeffrey Koplan of Emory University, who chaired the committee of 19 experts in child health, nutrition, fitness and public health that prepared the report. “Obesity may be a personal issue, but at the same time, families, communities and corporations all are adversely affected by obesity and all bear responsibility for changing social norms to better promote healthier lifestyles.”

With that comprehensive approach in mind, the report outlines specific steps that schools, parents, community organizations, state and local governments, as well as the food, beverage and entertainment industries, can take to help kids stay healthy. The specific recommendations for schools focus on the availability of snack foods in schools and the amount of physical activity students engage in.

“New policies are urgently needed to ensure that all foods and beverages available at schools are consistent with nutrition guidelines,” the report says. That means restricting the use of vending machines full of sodas and high-calorie, low-nutrient snacks or at least offering more nutritional foods that meet standards for fat and sugar content. The report acknowledges that “competitive foods”—for example, the items sold in vending machines or at bake sales—are indeed a source of money, but schools should also develop other fundraising activities, such as walkathons.

To counter the trend of decreasing physical activity among school-age children, the report calls on schools to provide opportunities for students to engage in “at least 30 minutes of moderate to vigorous physical activity daily.” In addition to daily PE classes, schools should expand opportunities to include intramural sports, activity clubs, walking and biking to school, and other programs. The report also suggests that school health services should measure each student’s weight, height and body mass index annually, and provide the results to students and families.

Academic and dollar costs

Another recent report addresses how poor nutrition, inactivity and weight problems among children are harming student achievement and possibly costing schools millions of dollars each year. Action for Healthy Kids is a public-private partnership of more than 40 national organizations and government agencies, including the AFT. While the report’s conclusions about what it calls the “costs in achievement” have been described before—smaller gains in test scores for students who don’t eat well or exercise; lower test scores, increased absenteeism and lower energy levels among students who don’t get adequate nutrients; and stronger academic achievement, as well as better attendance and attitudes toward school, for students who participate in daily physical education—the “cost in dollars” is a more unusual analysis.

In states that use daily attendance to help determine state funding, for example, a one-day absence can cost a district from $9 to $20. The report goes on to calculate that if health problems related to poor nutrition and inactivity kept children out of school just one day per month, it would cost a district like New York City about $28 million each year, while Chicago could lose $9 million.

The report also discusses “hidden costs,” including extra staff time and attention devoted to students with academic and behavior problems caused by poor nutrition and inactivity, and costs related to administering medications associated with those problems. Likewise with employees: Problems stemming from weight as well as poor nutrition and lack of exercise can lead to rising healthcare costs, absenteeism and lower productivity.

Many of the recommendations from Action for Healthy Kids, such as increasing the availability of healthful foods and offering more physical activity programs, mirror those from the Institute of Medicine.

More information on the two reports is available online at www.actionforhealthykids.org and www.iom.edu.