Eating for Health and Performance

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Eating for Health and Performance

    Eating for Health and Academic Achievement

    By Julie Allington, Nutrition Education Consultant, Wisconsin Department of Public Instruction. Article published in the Wisconsin School News, March 2001.

    Promoting healthy behaviors among students is an important part of the fundamental mission of schools: to provide young people with the knowledge and skills they need to become healthy and productive adults. Improving student health can increase students’ capacity to learn, reduce absenteeism, and improve physical fitness and mental alertness.

    The quality of children’s diets is declining, while at the same time the emphasis on test scores and the concern about disciplinary problems in schools are increasing. Can the quality of children’s food intake affect their academic

    performance? Can it affect student behavior? Can commercialism in the school be detrimental to healthy eating? Would schools be prudent in creating a school environment that promotes healthy eating among students and staff?

Trends and Implications.

    ? Breakfast and Academic Achievement Many students start school with no breakfast or an inadequate breakfast. Qualitative surveys on breakfast consumption completed by Wisconsin students showed that approximately 10 percent of students at the elementary level, 25 percent in middle school and 30 percent of high school students started school without breakfast. (1) Many other students come to school with an inadequate breakfast.

    Studies show that omitting breakfast interferes with cognition and learning, an effect that is more pronounced in nutritionally at-risk children. A landmark study examined the effects of school breakfast on academic performance among 1,023 low-income third through fifth grade students. Results showed that children who participated in the study had significantly greater gains in overall standardized test scores, and showed improvements in math, reading and vocabulary scores. In addition, rates of absence and tardiness were reduced among participants. (2)

? Hunger and Behavioral Problems

    An estimated four million American children experience prolonged periodic food insufficiency and hunger each year, representing eight percent of the children under the age of 12 in this country.

    The Community Childhood Hunger Identification Project (CCHIP) study examined the relationship between hunger and psychosocial functions among low-income, school-aged children. Analysis showed that virtually all behavioral,

    emotional and academic problems were more prevalent in hungry children. Aggression and anxiety had the strongest degree of association with hunger. (3)

    The three-year Universal School Breakfast Program pilot study in six Minnesota elementary schools showed a general increase in composite math and reading scores, and improved student behavior, reduced morning trips to the nurse and increased student attendance and test scores. (4)

    ? Obesity and Health Risks and Low Self-Esteem Childhood obesity is recognized as a national epidemic. The prevalence of overweight among young people ages 6-17 years in the United States has more than doubled in the past 20 years, (5) and that trend is continuing. Over 4.7 million, or 11 percent of youths ages 6-17 years are seriously overweight. (6)

    As many as 30,000 children have Type 2 diabetes, a type of diabetes that was once almost entirely limited to adults. (7)

    It is well-known that overweight in adults increases the risk for cardiovascular disease and premature death. A recent study in Pediatrics reported that more than one fourth of children, ages 5-10, had one or more adverse cardiovascular disease risk factors. That number rose to nearly 61 percent among overweight children of the same age and to. Twenty-seven percent of overweight children had two or more risk factors. (8)

    The total costs of diseases associated with obesity have been estimated at almost $100 billion per year or approximately eight percent of the national health care budget. (9)

    ? Calcium Intake and Osteoporosis and Health Care Costs Only 30 percent of school children consume the recommended milk group servings on any given day (10) and only 19 percent of girls ages 9 to 19 meet the recommended intakes of calcium (11, 12). Between 1989-91 and 1994-95, among children aged 2-17, the average consumption of milk and milk products dropped by 6.2 percent while the average consumption of soft drinks rose by 41 percent.

    Osteoporosis is a growing concern. With almost half of an adult’s bone mass being formed during the teen years (13), the inadequate calcium intakes among children and adolescents is a serious trend. The focus of concern for children has been highlighted by a 1999 statement by the American Academy of Pediatrics Committee on Nutrition: “ it is reasonable to conclude that low calcium intakes may be an important risk factor for fractures in adolescents.” (14)

? Nutrient intake and Health Risks

Only two percent of children meet the recommendations of the Food Guide


    Less than 15 percent of school children eat the recommended servings of fruit.

? Physical Activity and Health Risks and Low Self-Esteem

    Nearly half of young people ages 12-21 do not engage in physical activity on

    regular basis.

Physical activity among adolescents is consistently related to higher levels of

    self-esteem and lower levels of anxiety and stress.

Guidelines and recommendations to reverse these trends

? Dietary Guidelines for Americans 2000

    The Dietary Guidelines for Americans 2000 (15) have three main messages: Aim

    for fitness, Build a healthy base and Choose sensibly the ABC’s of good health.

    These guidelines incorporate the latest scientific research and knowledge to

    promote health and reduce the risk of chronic diseases such as heart disease,

    certain types of cancer, diabetes, stroke and osteoporosis. Good diets can also

    reduce major risk factors for chronic disease, such as obesity, high blood

    pressure, and high blood cholesterol.

Guidelines for each of the three messages promote healthy eating patterns and

    taking action for good health:

    A - Aim for Fitness…

     Aim for a healthy weight.

     Be physically active each day.

    B - Build a Healthy Base…

     Let the Pyramid guide your food choices

     Choose a variety of grains daily, especially whole grains

     Choose a variety of fruits and vegetables daily

     Keep food safe to eat

    C - Choose Sensibly…

    Choose a diet that is low in saturated fat and cholesterol and moderate in

    total fat.

    Choose beverages and food to moderate your intake of sugars.

    Choose and prepare foods with less salt.

    If you drink alcoholic beverages, do so in moderation.

? Guidelines for School Health Programs to Promote Lifelong Healthy

    Eating (6)

The Centers for Disease Control and Prevention (CDC) has developed seven

    recommendations for improving the eating behaviors of children and adolescents,

    based on the available scientific literature, national nutrition policy documents,

    and current practice. These recommendations ensure a quality nutrition program

    within the context of the comprehensive school health program framework (see

    article by John Benson, Wisconsin State Superintendent, in this issue of School


    1. Adopt a coordinated school nutrition policy that promotes healthy eating

    through classroom lessons and a supportive school environment.

    2. Implement nutrition education from preschool through secondary school

    as part of a sequential, comprehensive school health education

    curriculum designed to help students adopt healthy eating behaviors.

    3. Provide nutrition education through developmentally appropriate,

    culturally relevant, fun, participatory activities that involve social learning


    4. Coordinate school food service with nutrition education and with other

    components of the comprehensive school health program to reinforce

    messages on healthy eating.

    5. Provide staff involved in nutrition education with adequate preservice and

    ongoing in-service training that focuses on teaching strategies for

    behavioral change.

    6. Involve family members and the community in supporting and reinforcing

    nutrition education.

    7. Regularly evaluate the effectiveness of the school health program in

    promoting healthy eating, and change the program as appropriate to

    increase its effectiveness.

Tools and Resources to Make It Happen

Local school systems need to assess the nutrition needs and issues particular to

    their communities, and they need to work with key school and community-based

    constituents, including students, to develop the most effective and relevant

    nutrition education plans for their communities. What resources are available to

    help Wisconsin schools and communities in these efforts?

? School Health Index for Physical Activity and Healthy Eating: A Self-

    Assessment and Planning Guide (16, 17)

    The School Health Index is a self-assessment and planning guide developed by

    the Centers for Disease Control and Prevention (CDC) that will enable you to:

    1) Identify the strengths and weakness of your school’s health promotion

    policies and programs.

2) Develop an action plan for improving student health, and

    3) Involve teachers, parents, students, and the community in improving school


    This tool can help your school assess its physical activity and nutrition policies and programs based on national standards and guidelines, and it can be used as a part of your School Improvement Plan. It is available at,

    http://www.cdc.goc/nccdphp/dnpa .

    ? School and Community Health and Safety Councils

    In order to ensure the health and academic success of our youth, all community members and institutions must be engaged in coordinated youth development, health promotion, and risk prevention efforts. Families, schools, health and social services professionals, justice personnel, community-based organizations, media, and others must work in concert to help guide our young on a successful life course.

    In order for each of these various entities to reach its goals, they need to develop successful relationships and partnerships that are the foundations of effective collaboration. One cutting edge strategy to accomplish this is to form and implement a School and Community Health and Safety Council (SCHSC).

    A SCHSC is an advisory group representing various segments of the school and community. The SCHSC provides support for student achievement by facilitating communication, coordination, and monitoring of youth health and safety activities in your community and school. It makes recommendations to the school district on health and safety policies, programs, and activities that impact school.

    The Wisconsin Departments of Public Instruction and Health and Family Services have developed Tools for Comprehensive School Health Programs:

    Starting a School Community Health and Safety Council. (18) This resource

    offers recommended first steps in organizing and gaining support for health and safety councils and is available at


? Team Nutrition Training Project

    Wisconsin Department of Public Instruction was awarded a Team Nutrition Training grant to help school board members, administrators, teachers, pupil services staff and parents internalize the Dietary Guidelines for Americans 2000. School food service staff will be supporters and collaborators in these efforts.

    Free workshops with trained facilitators will be available from March through December, 2001 both onsite at local school districts and regionally. In addition,

articles in professional journals, conference sessions and exhibits, nutrition fact

    sheets and a Team Nutrition website will be featured throughout the grant period. More information is available at

We encourage school administrators, school board members, teachers and pupil

    services staff, and parents to actively seek information and resources on the

    importance of nutrition and physical activity to children’s health and academic

    performance and to support decisions that positively affect children’s health.

Contact for more information on any of the topics or resources: Julie Allington,

    Nutrition Education Consultant, Department of Public Instruction, 125 S.

    Webster St., PO Box 7841, 608-267-9120, fax: 608-267-0363, email:


(1) Wisconsin Good Breakfast for Good Learning Campaign. Unpublished

    surveys on breakfast consumption by Wisconsin school children. 1998.

(2) Meyres AF, Sampson AE, Weitzman M, Rogers BL, and Kayne H. School

    Breakfast Program and School Performance. American Journal of Diseases

    of Children. 1989; 143:1234-39

(3) Kleinman RE, Murphy JM, Little M, Pagano M, Wehler CA, Regal K, and

    Jellinek MS. Hunger in Children in the United States: Potential Behavioral

    and Emotional Correlates. Pediatrics. 1998; 101(1):E3.

(4) Minnesota Department of Children Families and Learning. School Breakfast

    Programs Energizing the Classroom. Minnesota Department of Children

    Family and Learning, 1998. Roseville, MN.

(5) National Center for Health Statistics. Health, United States, 2000. With

    Adolescent health chartbook. Online at

    (6) Centers for Disease Control and Prevention. Guidelines for school health

    programs to promote lifelong healthy eating. MMWR 1996;45(No. RR-9).

(7) Centers for Disease Control and Prevention. Adolescent and School Health.

    Promoting better health for young people through physical activity and

    sports. Online at: http/

(8) Freedman, DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of

    overweight to cardiovascular risk factors among children and adolescents:

    the Bogalusa heart study. Pediatrics 1999; 103:1175-82.

(9) Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in

    the United state. Obesity Research 1998; 6(2):97-106.

(10) Gleason, P, Suitor, C. Changes in Children’s Diets: 1989-91 to 1994-96.

    U.S. Department of Agriculture, Food and Nutrition Service, 2000. In press.

    (11) Healthy people 2010: Understanding and Improving Health. Conference

    Edition. Washington, DC: U.S. Department of health and Human Services

    or at Accessed February 15, 2000.

(12) Department of Health and Human Services. National Center for Health

    Statistics. The Third National Health and Nutrition Examination Survey

    1988-1994. Hyattsville, MD, 1994.

(13) Duyff, R.L. The American Dietetic Association’s Complete Food and

    Nutrition Guide. Chronimed Publishing, Minneapolis, MN. 1996.

    (14) American Academy of Pediatrics Committee on Nutrition. Calcium

    Requirements of Infants, Children and Adolescents. Pediatrics. 1999.

(15) US Departments of Agriculture and Health and Human Services. Dietary

    Guidelines for Americans 2000. Fifth edition. Home and Garden Bulletin No.


(16) Centers for Disease Control and Prevention. School Health Index for

    Physical Activity and healthy Eating: A Self-Assessment and Planning

    Guide. Middle school/high school version. Atlanta, Georgia. 2000

(17) Centers for Disease Control and Prevention. School Health Index for

    Physical Activity and healthy Eating: A Self-Assessment and Planning

    Guide. Elementary school version. Atlanta, Georgia. 2000

    (18) The Wisconsin Departments of Public Instruction. Tools for Comprehensive

    School Health Programs: Starting a School Community Health and Safety

    Council. 2000

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