Fighting obesity: what schools can do.

The latest estimates from the Centers for Disease Control and Prevention indicate that the percentage of children who are overweight has more than doubled since 1980. Among adolescents, the rates have more than tripled.

This trend does not bode well for the future health of today's schoolchildren. Those who are overweight are more likely to be overweight or obese as adults, increasing their risk of type II diabetes, hypertension, heart disease, stroke, some cancers and other serious medical conditions.

Additionally, researchers are exploring the relationship between students' physical activity/fitness and academic performance. A widely publicized 2004 study by the California Department of Education found students who do better on achievement tests are also more physically fit than their peers who do not score as well. Other studies suggest physical activity yields short-term benefits in helping students focus and concentrate.

Survey results recently published in the American Journal of Health Behavior show public support for childhood obesity prevention is increasing. Yet schools alone cannot solve the "obesity epidemic." Research shows obesity to be a complex issue with genetic, nutritional and environmental causes. However, research also indicates school polities and practices--if well designed and well executed--can have a positive effect on students' nutritional choices and physical activity.

Develop a comprehensive approach The CDC reviewed scientific evidence and identified 10 school-based strategies (see box) that are most likely to improve young people's health-related behaviors.

Promote knowledge and skills Providing factual information is an essential part of an effective school health education program. However, research indicates student behaviors are more likely to be affected when students also learn the necessary skills for putting factual information to use.

Offer healthful food Oversized portions and the increased consumption of sugar-sweetened drinks have been linked to rising obesity rates. Schools can support healthful choices by restricting the sales of food and beverages that are high in fat and sugar. Emerging evidence shows schools can offer more healthy foods in their vending machines without losing revenue.

Require regular exercise The National Institute of Medicine recommends school-age children get at least a half-hour of physical activity a day. However, nearly a third of the nation's elementary schools do not regularly have recess. Only a third of the nation's teens exercise for more than 20 minutes at least three days a week.

Don't focus on weight loss For children and teens who are overweight, experts do not generally recommend weight loss as a goal. Instead, the goal is to reduce the rate of weight gain as normal growth and development occurs. The CDC recommends that school-age children not be placed on a weight-reduction diet without the consultation of a healthcare provider.

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10 BEST SCHOOL-BASED STRATEGIES

The CDC reviewed the research and identified these school-based strategies as "most likely to improve key health behaviors" among young people:

1. Address physical activity and nutrition through a coordinated school health program.

2. Designate a school health coordinator and maintain an active school health council.

3. Assess the school's health policies and programs and develop a plan for improvements.

4. Strengthen the school's nutrition and physical activity policies.

5. Implement a high-quality health promotion program for school staff.

6. Implement a high-quality course of study in health education.

7. Implement a high-quality course of study in physical education.

8. Increase opportunities for students to engage in physical activity.

9. Implement a quality school meals program.

10. Ensure that students have appealing, healthy choices in foods and beverages offered outside of the school meals program.

Source: CDC, www.cdc.gov

OVERWEIGHT, OBESITY ON THE RISE

17% of U.S. children (ages 2-19) are classified as overweight--at or above the 95th percentile of the sex-specific body mass index (BMI) for age growth charts

32% of us adults are obese (have a BMI of 30 or higher)

Source: Ogden et al., JAMA, 2006