2. Improving the School Nutrition Environment in South Central Pennsylvania By Sophia I. Allen A Tool for Educators and Parents

3. Purpose To increase awareness of the adverse health status of children and adolescents in the United States and provide possible solutions to decrease the adverse health outcomes by improving the school nutrition environment in South Central Pennsylvania.

4. Learning Outcomes  Provide improvement checklist for school nutrition environment  Provide suggestions for parents in relation to school nutrition  Provide a list of resources for further reading

5. United States Statistics  70% of obese children had at least one cardiovascular disease risk  39% of obese children had two or more cardiovascular risk factors  Percent of adolescents age 12-19 years who are overweight: 18% (2005-2006)  Percent of children age 6-11 years who are overweight: 15% (2005-2006)  Percent of children age 2-5 years who are overweight: 11% (2005-2006)  Consumption of the recommended fruit and vegetable servings for adolescents significantly decreased by 2.5% from 23.9% to 21.4% during 1999-2007  Consumption of the recommended milk servings for adolescents significantly decreased by 3.9% from 18% to 14.1% during 1999- 2007  Physical activity for female students decreased by 2.2% from 2005 to 2007 and were less active than male students by 18.1% in 2007. Source: http://www.cdc.gov/obesity/childhood/consequences.html Source: National Youth Risk Behavior Surveys, 2005 & 2007

6. United States Statistics  Life expectancy for a child today may be shortened by two to five years due to obesity-related problems. 1 Source: Schafft, Jensen, & Hinrichs, 2009

7. Selected Health Conditions and Risk Factors: United States, 1988 - 2006 Source: CDC/NCHS, National Health and Nutrition Examination Survey 1 Overweight is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile BMI cutoff points from the 2000 CDC Growth Charts: United States

8. Percentage of High School Students Who Ate Fruits and Vegetables Five or More Times/Day,* 1999 – 2007 Source: National Youth Risk Behavior Surveys, 1999 – 2007 * 100% fruit juices, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables during the 7 days before the survey. 1 Decreased 1999-2007, p <.05

9. Percentage of High School Students Who Drank Three or More Glasses/Day of Milk,* 1999 – 2007 Source: National Youth Risk Behavior Surveys, 1999 – 2007 * During the 7 days before the survey. 1 Decreased 1999-2007, p <.05

10. Source: National Youth Risk Behavior Surveys, 2005 & 2007

11. Percentage of schools that always offered fruits or non-fried vegetables in vending machines or school stores, and during celebrations when foods and beverages are offered 2% - 7% 8% - 12% 13% - 14% 15% - 25% No Data Source: School Health Profiles, 2008 PA, 20%

12. Percentage of schools that provided parents and families with health information to increase parent and family knowledge of physical activity 30% - 36% 37% - 41% 42% - 46% 47% - 56% No Data Source: School Health Profiles, 2008 PA, 45.7%

13. Improvement Checklist for School Nutrition Environment  Component 1: A Commitment to Nutrition and Physical Activity  Component 2: Quality School Meals  Component 3: Other Healthy Food Options  Component 4: Pleasant Eating Experience  Component 5: Nutrition Education  Component 6: Marketing Resource: http://www.fns.usda.gov/tn/Healthy/kit.html

14. Component 1: A Commitment to Nutrition and Physical Activity  Nutrition and physical activity are part of each school day  Policies are in place and enforced  School foodservice is on the team  School health councils give support Resource: http://www.fns.usda.gov/tn/Healthy/kit.html

15. Component 2: Quality School Meals  School meal programs are available  Healthy, appealing choices are available  Food safety is a priority  Menus meet nutrition standards Resource: http://www.fns.usda.gov/tn/Healthy/kit.html

16. Component 3: Other Healthy Food Options  All foods and beverages available at school make a positive contribution to healthy choices  Parents make healthy options available  Food is not used for fund-raising  Food is not used as a reward or punishment  Access to vending machines is limited Resource: http://www.fns.usda.gov/tn/Healthy/kit.html

17. Component 4: Pleasant Eating Experience  Meals scheduled at appropriate times  Students have time to eat and socialize  Adequate serving and seating areas.  Dining room décor is attractive  Creative methods are used to keep noise levels appropriate  Drinking fountains are available  Hand washing equipment and supplies are available Resource: http://www.fns.usda.gov/tn/Healthy/kit.html

18. Component 5: Nutrition Education  Available in pre-K through grade 12  Focuses on skill development  Integrated into core curriculum  Dining room and classroom are linked  School is a Team Nutrition School Resource: http://www.fns.usda.gov/tn/Healthy/kit.html

19. Component 6: Marketing  Healthy eating and physical activity are actively promoted  Students receive positive, motivating messages  Schools promote healthy food choices Resource: http://www.fns.usda.gov/tn/Healthy/kit.html

20. Parents Role in School Nutrition Improvement  Support the school meal program and have children participate  Insist schools provide appropriate nutrition education and physical activity in the curriculum  Provide healthy snacks for school parties and special events  Volunteer to help on the school health council  Identify ways to raise money for the school other than selling food  Reinforce healthy living at home by being physically active and providing healthy food choices  Work to build support for shared local/state/federal funding for the school meal program Source: http://teamnutrition.usda.gov/Resources/support.pdf

21. Eat Well and Stay Healthy! Visit www.mypyramid.gov for additional information on personalized eating plans and interactive tools to help plan and assess food choices.www.mypyramid.gov GRAINS VEGETABLESFRUITS OILS MILK MEAT & BEANS

22. Conclusion  This presentation discussed the importance of increasing positive health outcomes for children and adolescents in the United States.  Suggestions were provided to schools and parents to improve the nutrition environment in the educational setting.  A list of resources provided for further reading will help to expand upon the topics discussed and present the basis for further learning and research.  To be successful, students, parents, educators, and community leaders will need to collaborate and develop a multidisciplinary approach to solve this public health problem.

23. List of Sources for Further Reading Centers for Disease Control and Prevention (2009a). Recommended community strategies and measurements to prevent obesity in the United States. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm Centers for Disease Control and Prevention (2009b). Nutrition for everyone. Retrieved from http://www.cdc.gov/nutrition/everyone/ Centers for Disease Control and Prevention (2009). Recommended community strategies and measurements to prevent obesity in the United States. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm Pennsylvania Department of Education. (2009). School nutrition incentive program. Retrieved from http://www.pde.state.pa.us/food_nutrition/cwp/view.asp?a=5&q=125996 Pennsylvania State University. (2009). Project PA, 2009. Retrieved from http://nutrition.hhdev.psu.edu/projectpa/2007Style/index.html United States Department of Agriculture. (2009a). Dietary guidelines for Americans. Retrieved from http://www.cnpp.usda.gov/DietaryGuidelines.htm United States Department of Agriculture. (2009b). HealthierUS school challenge: Recognizing excellence in nutrition and physical activity. Retrieved from http://teamnutrition.usda.gov/HealthierUS/index.html United States Department of Agriculture. (2009c). Mypyramid.gov. Retrieved from http://www.mypyramid.gov/

24. References Centers for Disease Control and Prevention. (2009). Overweight and obesity: Consequences. Retrieved from http://www.cdc.gov/obesity/childhood/consequences.html Centers for Disease Control and Prevention. (2009). National Center for Health Statistics: Overweight and obesity. Retrieved from http://www.cdc.gov/nchs/fastats/overwt.htm Centers for Disease Control and Prevention. (2008). School Health Profile: Pennsylvania. Retrieved from http://cdc.gov/healthyyouth/profiles/pdf/facts/pa_selected_profiles.pdf Centers for Disease Control and Prevention. (2007). Youth risk behavior surveillance system (YRBSS): 2007. Retrieved from http://www.cdc.gov/healthyyouth/yrbs/slides/index.htm Centers for Disease Control and Prevention. (2005). Youth risk behavior surveillance system (YRBSS): 2007. Retrieved from http://www.cdc.gov/healthyyouth/yrbs/slides/index.htm Schafft, K. A., Jensen, E. B., & Hinrichs, C. C. (2009). Food deserts and overweight schoolchildren: Evidence from Pennsylvania. Rural Sociology, 74(2), 153-177. United States Department of Agriculture. (2000). Improving the school nutrition environment. Retrieved from http://www.fns.usda.gov/tn/Healthy/kit.html United States Department of Agriculture. (2000). Changing the scene. Retrieved from http://teamnutrition.usda.gov/Resources/support.pdf