Healthy children ready to learn: recognizing the strong connection between health and learning, school leaders are playing a key role in creating healthy school environments that meet or exceed new state and federal standards.

Education leaders throughout California are playing a key role in creating healthy school environments for the 6 million students in the state's public schools. Recognizing the strong connection between health and learning, they have made significant changes to the nutrition environment in their schools.

This article looks at how these leaders--many of whom have implemented or exceeded current nutrition standards for all food and beverages sold on campus --are making necessary changes happen. Their leadership approaches are especially relevant because new federal and state nutrition policies will begin taking effect in 2006, meaning that all school districts in the state will be required to make similar changes.

Leadership is vital when undertaking significant changes. As in all areas, leadership in nutrition and student wellness may not always be the easy path to take. Changing the food and beverages sold or served on campus often involves key challenges--including fiscal concerns about food service programs and food sales by other school groups. But visionary leaders know how to meet these challenges head-on.

New policies promote healthy school nutrition environments

Development of new food policies at the state and federal levels is on the upswing, and for good reason. California has the second highest rate of overweight children in the nation, a health issue attributed to poor diet and physical inactivity. A growing number of California children remain at risk for Type 2 diabetes, hypertension, heart disease, cancer and psychological problems.

Both State Superintendent of Public Instruction Jack O'Connell and the governor have made improving school nutrition a top priority. In January 2005, O'Connell became the first SSPI in California history to make improving student health and nutrition one of his top three educational priorities. Simultaneously, O'Connell released the California Department of Education's White Paper on health, nutrition and physical education, "Healthy Children Ready to Learn" (www.cde.ca.gov/eo/in/se). The document establishes four goals, including implementing nutrition standards for all food and beverages sold on campus and supporting instructional programs that provide students with the knowledge to maintain healthy lifestyles.

At his Summit on Health, Nutrition and Obesity held in September 2005, the governor signed SB 12 and SB 965, landmark legislation making California's standards for food and beverages sold at schools the most rigorous in the nation. He also signed SB 281, providing 71 percent more in state funds for school breakfast programs to support fruit and vegetable purchases.

These and other forward-thinking state policies emphasize the importance of a healthy school environment. Such an environment incorporates a commitment to nutrition and physical activity, pleasant eating experiences, adequate facilities, quality school meals and other healthy food and beverage options. It also emphasizes nutrition education, and "markets" healthy nutrition to students, parents and the community at large.

Educational leaders know that we cannot attempt to educate only a child's mind--we must focus on the whole child. For us to be successful, we must recognize that a healthy mind requires a healthy body. As educational leaders, it is our responsibility to ensure that our campuses reflect a healthy environment so that our children are ready to learn.

Food and beverages served on campus

Though challenging, improving the nutrition environment in our schools is vital--and district leaders are demonstrating that it can be done. They are changing a la carte sales, vending machine offerings and fundraising practices. A number of California school districts have already met nutrition standards for all food and beverages sold on campus, exceeding the USDA requirements for Foods of Minimal Nutritional Value and implementing new state laws ahead of time.

Doing this isn't always easy, but leaders take the high road--even when doing so may be unpopular. In 2005, The San Gabriel Valley Tribune highlighted the leadership of Principal Albert Clegg of Wilson High School in the Hacienda La Puente School District, who said that he was "only following the law" when he decided to suspend student food sales during lunch, drawing criticism from campus clubs who were losing revenue.

"We're allowed four student food sales throughout the year, and that's what we're doing," Principal Clegg explained. He understood that student food sales cannot compete or conflict with food service sales, and therefore made important changes, taking a stand that some considered unpopular.

Teamwork is also vital when making these changes. Superintendent Dave Cowles and Director of Child Nutrition Services Enid Hohn of Vista Unified School District recently spoke at Harvard's Kennedy School of Government about how their leadership--and district-wide teamwork--led to healthier vending machine options in the district.

Eight years ago, Hohn approached Superintendent Cowles about the high schools' fundraising efforts, which used candy and soda sales to raise money. The district principals expressed concern that replacing candy and soda with healthy food and beverages in vending machines would cut into a revenue stream they depended on to support sports programs and extracurricular activities. However, they took the risk and Hohn delivered on her promise to meet previous year revenue levels.

Recent research conducted by the University of California at Berkeley Center for Weight and Health found that school and district leadership is a key determinant of school nutrition environments. Specifically, UCB learned that a substantial number of districts were not meeting current competitive food and other nutrition requirements due to perceived costs and other challenges; at least five of the 11 student store or athletics advisors interviewed reported continued sales of non-compliant food, regardless of whether the policy prohibiting the food was local, state or federal.

UCB's preliminary findings centered on how compliance with state and federal nutrition requirements tends to depend on how district leaders support and enforce competitive food and beverage policies on campus.

According to UCB's research, three main factors are necessary to sustain and monitor competitive food and beverage policies over time:

1. The establishment of clearly articulated guidelines at the state level that can serve as a template for district policy;

2. Involvement of food service directors and site cafeteria staff in district policy development, implementation and enforcement; and

3. Support by district administrators and school board members who oversee and approve the district policies.

Wellness policies

Strong leadership is key in creating wellness policies required by the federal Child Nutrition Act of 2004 for districts participating in the National School Lunch Program or School Breakfast Program. Wellness policies focus on three parts of a healthy school environment: nutrition education, physical activity and the food available on campus.

Superintendent O'Connell's recently established Advisory Committee on Nutrition Implementation Strategies promotes local wellness policies by addressing topics such as stakeholder and student involvement, nutrition education, access and participation, a healthy school environment, funding, professional development, and continuous monitoring and accountability.

Over the past five years, many California school districts have formed nutrition committees and school health councils that still meet regularly, similar to those required by the Act. In the Laytonville Unified School District, Principal Paul Jones-Poulton established a School Nutrition Advisory Committee in 2002; in the Orcutt Union School District, Associate Superintendent Ken Parker invited a doctor, school nurses, a public health nutritionist and a farmer to sit on a nutrition education steering committee in 2003; and in Hacienda La Puente School District, Superintendent Edward Lee Vargas, in collaboration with Food Service Director Geri Dee, formed a nutrition policy committee in 2004 that includes school board members, school food service staff, parents and students.

Environments that promote student health

With wellness policies and food and beverage standards in place, leaders can establish healthy school environments by supporting nutrition education, healthful and appealing school meals and high-quality facilities. Partnerships with food service staff, farmers, teachers and community members are each vital to successful school environment transformations.

"Partnerships are what sustain our program," explained Associate Superintendent Parker. "We have a lot of people with whom we can partner in the agricultural domain, but I just think whether you live in downtown Los Angeles or here in Orcutt, there are plenty of people who want to see kids living well."

Creative and appealing alternatives

The UCB research shows that the implementation of nutrition standards requires nutritious and appealing alternatives. Ensuring that school meals appeal to students is imperative, and incorporating fresh produce into school meals is an important part of offering healthier food options. Fostering relationships with regional farmers offers one way school districts can purchase fresh produce at an affordable cost.

"There are other food items that we could serve that would meet the state and federal requirements for a nutritious meal that are cheaper," said Winters Joint Unified School District Superintendent Dale Mitchell. "But they aren't as healthy as a salad bar." Mitchell, together with Food Service Director Christine Dutton and Chief Business Officer Gloria Hahn, is currently working closely with local farmers to find a cost framework that works for the farmers and the district.

In Ventura Unified School District, Superintendent Trudy Tuttle Arriaga supported the inclusion of salad bars in every school as well as school gardens.

"In the beginning, we had many issues to work through. The unions and cafeteria workers got involved when questions came up about who was going to supervise salad bars. We started with those principals who were ready to go; by the fourth year, those who didn't have salad bars wanted them."

Nutrition curriculum

Leaders recognize that promoting healthful food and beverage offerings throughout the school requires consistent nutrition curriculum in the classroom, and vice versa. Berkeley Unified School District's Superintendent Michele Lawrence has been a leader in supporting the integration of nutrition into other applicable curriculum standards, especially since a number of standards address student health. "Our teachers tie health, nutrition and physical education into science, social studies, English and mathematics," she explained. "These are integrated concepts, so it doesn't have to be in addition to what we are doing."

Experiential instructional programs incorporating cooking and gardening teach skills that encourage students to eat healthier foods. "We believe that when students are educated about health and nutrition, they are more likely to try new foods," said Ventura's Superintendent Arriaga. There, nutrition specialists visit the 17 elementary classrooms once a month to talk with students about new salad bar offerings. When a new food gets introduced, students recognize it.

Facilities support a healthy environment

Berkeley's Superintendent Lawrence said improvements were made to two middle school cafeterias where, to offer more fresh foods in the lunch program, the district invested in important infrastructure, including new refrigerators, freezers, point-of-sale systems, food carts and heated cabinets. This enabled salad bars to be used in combination with an "International Marketplace" theme. The new program offers students healthy foods from a variety of different cultures and nations, as well as a full-service salad bar, fruit and milk with each meal.

Looking to the future

Federal and state policy has set the bar for California's site and district leaders. Transforming the nutrition environment in schools takes patience, time, creativity and marketing. Many districts have made significant improvements to their school nutrition environments while also improving their financial bottom line.

However, making the required changes work financially remains a challenge for other districts--a challenge they are willing to address out of a commitment to student health and wellness. Berkeley's Superintendent Lawrence is a leader whose district is still working out the financial piece. "Our cafeteria budget currently is not in the black," she added, "but we are making a conscious decision to support it."

The California Department of Education supports school districts throughout the state as they prepare for these essential changes. Superintendent O'Connell's Advisory Committee on Nutrition Implementation Strategies has recommended approaches for providing high quality, nutritious food that will benefit children as they grow and will influence their eating behaviors long after they leave the educational system. CDE also recently published two "best and promising practices" documents, developed as part of the Healthy Children Ready to Learn Initiative.

Schools are important settings in which to model healthy eating habits because educators and administrators have expertise, credibility and daily contact with children. Strong leadership from site and district administrators is crucial for successful wellness programs--especially around accountability and compliance--because what gets inspected or measured gets done. How seriously California's district leaders embrace development, implementation and compliance with the local school wellness policies will be a key determinant of success in improving students' health and readiness to learn.

District innovations: From parties to fundraising to schedules

Leaders throughout the state have come up with innovative ways to create healthier environments in their schools, including:

* Distributing healthy snack lists to parents.

* Requiring class parties to use non-food treats.

* Starting a nutrition elective at the middle school level where students bake whole grain breads and sell them twice a week to the community.

* Scheduling recess before lunch, so students take their time to eat, produce less waste and return to class calm and ready to learn.

* Changing fundraising efforts by replacing the sale of candy with gift wrap, magazines and jog-a-thons.

* Disallowing the use of food or physical activity as a punishment or reward.

* Hosting nutrition events where students analyze their exercise and eating habits.

Nutrition standards for school districts

Following is an overview of state and federal requirements for creating healthy school environments. These are already in effect, or soon will be.

* Standards for fat, sugar and calories: Senate Bill 12 sets standards for allowable levels of fat, sugar and calories for all foods sold at California schools, other than full school meals, These standards go into effect in July 2007. Specific requirements are set for elementary, middle/junior and high school levels (some exemptions exist):

* Not more than 35 percent of a snack's total calories shall be from fat in middle, junior and high schools, except food served as part of the NSLP or SBP.

* Not more than 10 percent of a snack's total calories shall be from saturated fat; not more than 35 percent of a snack's total weight shall be composed of sugar, including naturally occurring and added sugar.

* Not more than 175 calories per individual food item in elementary schools, and no more than 250 calories per item in high schools.

* Entree items, except food served as part of the NSLP or SBP, shall contain no more than 400 calories per entree, no more than 4 grams of fat per 100 calories, and shall be categorized as entree items in the NSLP or SBP.

* Beverages: SB 965 prevents soda and other non-compliant beverages from being sold in all California public schools, including high schools, from onehalf hour before the start of the school day to one-half hour after the school day. Certain fruit- and vegetable-based drinks, water, low-fat milk and electrolyte replacement beverages can be sold. By July 2007, at least 50 percent of all beverages sold must meet the criteria. By July 2009, all must comply.

* Foods of Minimal Nutritional Value: USDA requirements prohibit the sale of FMNV during meal periods anywhere reimbursable meals are sold or eaten. FMNV include carbonated beverages, water ices, chewing gum and candies made predominantly from sugar and corn syrup. To the extent that schools lack a cafeteria, FMNV may not be sold anywhere on campus during the meal period; that is, from the time students are released from class to the time they return. Local school wellness policies, required by the 2004 Child Nutrition Act, to be developed by each school district and implemented by the school year beginning after July 2006, must include, but are not limited to, the district's plan for complying with the USDA FMNV requirements.

* Competitive foods: State law (Education Code 38085) requires that 50 percent of the foods sold outside of the NSLP or SBP (competitive foods) must come from a list of foods specified in statute, including (but not limited to) milk and dairy products, fruit or vegetable juice with 50 percent or more juice and fruit nectars, fresh, frozen, canned or dried fruits and vegetables, nut seeds and nut butters, bread/grain products and products made with legumes. State regulations indicate that student organizations at junior high or high schools may sell food during the school day if: 1) the specific nutritious food items are approved by the local governing board: 2) only one such organization each school day sells no more than three types of food and beverage items, and/or food sales by multiple organizations occur no more than four times yearly; 3) the food items sold are not prepared on the premises; and 4) the food items sold are not sold by he district's food service program.

For more detailed information on these regulations, see Management Bulletins 05-110 and 00-810 at www.cde.ca.gov/ls/nu/sn/mb.asp.

Selected resources

Changing the Scene: A Guide to Local Action. (2000). United States Department of Agriculture Food and Nutrition Service, www.fns.usda.gov/tn/Resources/changing.html.

Guidelines for School Health Programs to Promote Lifelong Healthy Eating. (1996). Centers for Disease Control and Prevention, www.cdc.gov/HealthyYouth/publications/guidelines.htm.

Healthy Children Ready to Learn: Facilities Best Practices. (2005). California Department of Education.

Local School Wellness Policy Resource Packet. (2005). CDE Nutrition Services Division, [e-mail] or [phone].

Student Wellness: A Healthy Food and Physical Activity Policy Resource Guide. (2005). California School Boards Association, www.csba.org/PS/hf.htm or [phone].

School Health Index. (2005). Centers for Disease Control and Prevention. http://apps.nccd.cdc.gov/shi.

Taking Action for Healthy School Environments: Linking Education, Activity, and Food in California Secondary Schools. (2005). CDE: www.cde.ca.gov/re/pn/rc or [phone].

Making It Happen! School Nutrition Success Stories. (2005). United States Department of Agriculture Food and Nutrition Service, www.fns.usda.gov/tn/Resources/makingithappen. html.

William J. Ellerbee is deputy superintendent, School and District Operations Branch, California Department of Education, and a member of ACSA's Board of Directors. Phyllis Bramson-Paul is director, Nutrition Services Division at CDE, where Sara Marcellino is a consultant.