Health Status U.S. Youth Obesity Obesity Major health threat in U.S. Major health threat in U.S. Since 1980, obesity rates: Since 1980, obesity rates: Doubled among children Doubled among children Tripled among adolescents Tripled among adolescents Crucial period for weight gain Crucial period for weight gain 90% obese adolescents stay obese into adulthood 90% obese adolescents stay obese into adulthood 1/3rd of children obese or overweight 1/3rd of children obese or overweight 2/3rds adults obese or overweight 2/3rds adults obese or overweight

Health Implications Obesity Epidemic Obese youth at increased risk : High blood pressure & cholesterol, type II diabetes High blood pressure & cholesterol, type II diabetes Long-term health problems Long-term health problems Exclusion from peer groups, depression, stress, poor body image & low self-esteem Exclusion from peer groups, depression, stress, poor body image & low self-esteem Interventions that promote healthy eating & physical activity in childhood crucial for health & wellness Interventions that promote healthy eating & physical activity in childhood crucial for health & wellness

Diet & Physical Activity U.S. Youth ↑ calories and ↓ physical activity = weight gain ↑ calories and ↓ physical activity = weight gain Diet Diet Children consume inadequate amount nutritious foods – eg, fruits & vegetables Children consume inadequate amount nutritious foods – eg, fruits & vegetables Half of children aged 2-18 y consume less than one serving fruit/day Half of children aged 2-18 y consume less than one serving fruit/day Consume excess of nutrient-poor foods – eg, potato chips, cookies, sugary foods Consume excess of nutrient-poor foods – eg, potato chips, cookies, sugary foods Physical Activity Physical Activity Activity levels have declined, but sedentary activities (eg, video games) increased Few children meet recommended activity levels (60 min/day)

2010 Dietary Guidelines for Americans Due to obesity epidemic, strong emphasis on: Due to obesity epidemic, strong emphasis on: 1) reducing calorie intake 1) reducing calorie intake 2) increasing physical activity 2) increasing physical activity Guidelines recommend: Guidelines recommend: Eat more fruit, vegetables, whole grains, low-fat dairy products Eat more fruit, vegetables, whole grains, low-fat dairy products Eat less sugar, sodium, refined grains, fatty foods Eat less sugar, sodium, refined grains, fatty foods Balance calories with more physical activity Balance calories with more physical activity

Ways to Intervene: Wellness Policies Schools identified as important partner in health promotion Schools identified as important partner in health promotion Schools in unique position to intervene Schools in unique position to intervene Can reach almost all children & adolescents Can reach almost all children & adolescents Provide opportunities to practice healthy habits Provide opportunities to practice healthy habits Children eat > 1 meal at school + snacks Children eat > 1 meal at school + snacks Teachers serve as role models Teachers serve as role models And, after training can provide nutrition instruction And, after training can provide nutrition instruction Studies show school-based health programs can improve eating & exercise behaviors of youth & advance academic performance Studies show school-based health programs can improve eating & exercise behaviors of youth & advance academic performance

School Wellness Programs CDC, ADA, SNA recommend a comprehensive program that provides: CDC, ADA, SNA recommend a comprehensive program that provides: students with knowledge & skills of healthy habits based on 2010 Dietary Guidelines for Americans students with knowledge & skills of healthy habits based on 2010 Dietary Guidelines for Americans consistent access to healthy foods & opportunities for regular physical activity consistent access to healthy foods & opportunities for regular physical activity healthy school environment that supports positive health behaviors healthy school environment that supports positive health behaviors family involvement to promote reinforcement of healthy behaviors in the home family involvement to promote reinforcement of healthy behaviors in the home

CDC & ADA Key Recommendations: Nutrition Policy Content Adequate time for nutrition education preschool-12 th Adequate time for nutrition education preschool-12 th Healthy foods available & consistent with dietary guidelines : Healthy foods available & consistent with dietary guidelines : E.g., cafeteria meals, vending machines, classroom snacks/parties, fundraising E.g., cafeteria meals, vending machines, classroom snacks/parties, fundraising Recommended food use guidelines for classroom Recommended food use guidelines for classroom Discourage using food for rewarding students Discourage using food for rewarding students E.g., candy as reward reinforce preference for low-nutrition food & contradict what taught in nutrition education E.g., candy as reward reinforce preference for low-nutrition food & contradict what taught in nutrition education Support for healthy school meals Support for healthy school meals Educate parents about value healthy school & home meals Educate parents about value healthy school & home meals Students given adequate time to eat (at least 20 min. after served meal) Students given adequate time to eat (at least 20 min. after served meal) Consider recess before meals (improved nutrient consumption & less plate waste) Consider recess before meals (improved nutrient consumption & less plate waste)

CDC Recommendations: Physical Activity Policy Content Schools should require daily physical education in grades K-12 Schools should require daily physical education in grades K-12 Provide school time (e.g., recess) for unstructured physical activity Provide school time (e.g., recess) for unstructured physical activity Discourage use of physical activity as punishment or withholding to catch up on schoolwork Discourage use of physical activity as punishment or withholding to catch up on schoolwork Help students develop knowledge, attitudes & skills to adopt & maintain physically active lifestyle Help students develop knowledge, attitudes & skills to adopt & maintain physically active lifestyle Encourage parents to support children’s participation in activity Encourage parents to support children’s participation in activity

Current Constructive Classroom Rewards in Use at ASH Stickers Stickers Marble/fish party Marble/fish party School supplies School supplies Oriental trading prizes Oriental trading prizes Posters of teen idols Posters of teen idols Geo lanterns Geo lanterns Classroom privileges Classroom privileges Puzzle games Puzzle games Gold star/pins Gold star/pins Extra recess Extra recess Friday – last 5 minutes dance party Caught-being-good coupons Scrapbook embellishments Costume jewelry Select seat Lunch with teacher

Wellness Policy – Newburgh, NY Snacks Snacks Only nutritious food served at school events (eg, fruits, vegetables, low-fat dairy, water & whole-grains items) Only nutritious food served at school events (eg, fruits, vegetables, low-fat dairy, water & whole-grains items) Rewards Rewards Discourages use of food (eg, candy/treats) as rewards Discourages use of food (eg, candy/treats) as rewards School celebrations/birthday parties School celebrations/birthday parties Parties include at least 1 serving of nutritious foods & encouraged to offer physical activity Parties include at least 1 serving of nutritious foods & encouraged to offer physical activity Fundraising Fundraising Encouraged to feature healthy food choices & non- food items Encouraged to feature healthy food choices & non- food items

Break-Out Session