Keeping the Whole Child Healthy and Safe. Marge Scherer

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are facilitating changes at the state, district, and school levels to improve student health. Collaborating in teams as part of the Action for Healthy Kids initiative, they are creating and distributing nutritional guidelines, educating policymakers, helping to develop school wellness policies, instituting changes in vending and other noncafeteria food sales, creating school health councils, and improving health education. The teams are successful because they are inclusive and grassroots, representing administrators, teachers, health professionals, community leaders, parents, and students.

      The Arizona Action for Healthy Kids team worked in cooperation with the Arizona Department of Education and USDA Team Nutrition to create and implement a model healthy school policy in eight pilot schools (see "Arizona Healthy School Environment Model Policy"). The policy addresses food-service operation, nutrition education, food choices at school, physical education, and a healthy school environment. To facilitate implementation, each pilot school received $5,000–$10,000 as part of a USDA Team Nutrition grant. Among other improvements, participating schools replaced low- or no-nutrient foods with more healthful items, such as water, juice, low-fat milk, fruits, and vegetables.

       Arizona Healthy School Environment Model Policy

      Following are some guidelines for physical activity adapted from the Arizona Healthy School Environment Model Policy, modeled after the National Association of State Boards of Education (NASBE) sample policy.

      Recommendations for Physical Activity

       Offer physical education courses in an environment in which students learn, practice, and are assessed on developmentally appropriate motor skills, social skills, and knowledge.

       Provide students with at least 60 minutes of physical activity on all or most days of the week.

       Discourage extended periods of inactivity (periods of two or more hours).

       Provide at least 150 minutes each week of physical education classes for elementary school students and at least 225 minutes each week for middle and high school students for the entire school year.

       Ensure that students are moderately to vigorously active in physical education classes for at least 50 percent of the time.

      Encouraging Lifetime Physical Activity

       Provide daily recess periods of at least 20 minutes for all elementary school students.

       Provide physical activity breaks during classroom hours.

       Encourage parents and community members to institute programs that support physical activity, such as a walk-to-school program.

      The complete model policy is available at www.actionforhealthykids.org. Reprinted with permission.

      The pilot study found no negative impacts on vending machine or cafeteria sales once healthier options were offered. In fact, sales in some schools increased with the more healthful selections. The Healthy Food Sales and Schools Act, which has been introduced in the Arizona legislature, proposes that all schools be required to implement nutrition standards on the basis of those recommended in the initial Healthy School Environment Model Policy created by Arizona Action for Healthy Kids. A bill addressing physical education standards has also been introduced.

      Several states have worked to create and disseminate nutritional standards for schools. In Idaho, the Action for Healthy Kids team developed "Idaho Recommendations for Promoting a Healthy School Nutrition Environment." The guidelines recommend that all foods and beverages available on school campuses and at school events meet USDA dietary guidelines. The state superintendent of public instruction and the state board of education endorsed the team's recommendations and distributed them to school district leaders throughout the state. Sixteen of Delaware's 19 school districts agreed to adopt health standards, beginning with the 2004–2005 school year. In Massachusetts, statewide distribution of nutritional guidelines will affect 1 million students.

      Students themselves are concerned about these issues. In a 2002 poll conducted by Action for Healthy Kids, 81 percent of the 1,308 student leaders surveyed believed that schools should make eating healthy a priority, and 72 percent believed that schools should make physical activity more of a priority. In Massachusetts, the Action for Healthy Kids team is working in collaboration with the Department of Education student advisory group to educate student governments on creating nutrition and physical activity policies.

      The team approach can often open doors for especially committed individuals, providing support and resources that wouldn't otherwise be available. For example, a minigrant provided by the Minnesota Action for Healthy Kids team enabled a physical education teacher to enhance her school's physical education program by weaving more activity into students' daily lives. Jo Zimmel started using pedometers at Garlough Elementary School in West St. Paul, Minnesota, to obtain a baseline measure of kids' activity levels while at school. She developed strategies to increase activity during school hours and taught kids as well as teachers how to find time for extra movement each day. At the conclusion of the program, Zimmel will evaluate the students' progress, using the pedometers to measure their post-activity levels.

      Schools need not act alone to tackle the issues of good nutrition and physical activity. They can encourage community partners to sponsor an extracurricular fitness program or draw on grandparents to help start a walking club. Schools will benefit as both achievement scores and attendance improve. Students will benefit as they perform and behave better in school and experience more energy and fewer illnesses. Schools not only need to teach good eating habits and healthy levels of physical activity, but they also need to model and reinforce these habits every day throughout the building.

       Aims of Education

      Education … is a process of living and not a preparation for future living.

       —John Dewey

      What Schools Can Do

      Schools can take a number of steps to promote student health.

      Form a school health advisory council. Principals, superintendents, and board members do not have to change schools on their own. Instead, they need to engage a group of volunteers—including parents, students, medical professionals, business professionals, school administrators, youth group leaders, and law enforcement officials—to help conceive and implement nutrition education and physical activity programs that make sense for the local school community.

      Develop a comprehensive wellness policy. With the 2004 passage of the Child Nutrition Reauthorization Act, all schools that participate in federal school meal programs will need to develop a local wellness policy. This road map needs to include guidelines for all foods and beverages sold in school as well as guidelines for teaching students how to make good decisions about what they eat. The policy must include goals for increasing students' physical activity and school strategies for promoting student wellness. Policies should include recommendations for staff training on developing nutrition education curriculums and for new approaches in physical education. In addition, policies should address program implementation, monitoring, and evaluation.

      Integrate physical activity and nutrition education into the regular school day. Teachers can start classes with fun calisthenics or dancing and can incorporate nutrition information and physical activity into reading, writing,

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