Program

Dec 06, 2010

OVERVIEW

The School Nutrition Policy Initiative is a
multi-component program designed to prevent overweight and obesity among school
children in 4th through 6th grade. Five components
comprise the program: school self-assessment; nutrition education; nutrition
policy; social marketing; and parent outreach. An experimental evaluation with
random assignment at the school level found significant impacts on the incidence
and prevalence of overweight at the end of the two-year study period. There were
also impacts on total inactivity and total TV viewing. However, there were no
significant differences between the two experimental groups for the incidence
and prevalence of obesity or for the remission of overweight or obesity.

DESCRIPTION OF PROGRAM

Target population: Children in 4th through 6th
grade

The School Nutrition Policy Initiative is a multi-component program designed to
prevent overweight and obesity among school children in 4th through 6th
grade. Five components comprise the program: school self-assessment; nutrition
education; nutrition policy; social marketing; and parent outreach. Using the
Centers for Disease Control and Prevention’s (CDC) School Health Index, each
school assesses its environment on topics such as healthy eating and physical
activity; based on this assessment, schools then develop an action plan such as
encouraging physical activity. Nutrition education includes students and school
staff. Based on the National Center for Education Statistics guidelines,
approximately 50 hours of food and nutrition education is delivered to students
per academic school year; these sessions link food choices with individual
health. In addition, nutrition education is integrated into classroom activities
such as using food labels to practice mathematical fractions. School staff
receive approximately 10 hours of training and receive curricula along with tips
on how to incorporate nutrition and physical activity into classroom lessons.
Based on the Dietary Guidelines, school nutrition policies are modified to meet
nutritional standards such as serving 100% juice and low-fat milk. With the
development of the health message, “Want Strength?…Eat Healthy Foods,”
students are continuously exposed to health messages throughout the school. In
addition, family outreach is conducted through home and school association
meetings, parent education meetings, and weekly nutrition workshops. Students
also participate in the 2-1-5 challenge: less than two hours of TV watching; one
or more hours of physical activity; and eat five or more fruits and vegetables.
The School Nutrition Policy Initiative program has been developed and
implemented the by The Food Trust, which is a community-based organization.

EVALUATION(S) OF PROGRAM

Foster GD, Sherman S, Borradaile KE, Grundy KM,
Vander Veur SS, Nachmani J, Karpyn A, Kumanyika S, Shults J. (2008). A
Policy-Based School Intervention to Prevent Overweight and Obesity. Pediatrics, 121:e794-e802.

Evaluated population: A total of 1,349 students participated in the study. Just over one-half of
students were girls (53.7%), and the mean age was 11 years. More than 40% of
students were overweight or obese and nearly one-quarter (23.8%) were obese at
baseline. Among the control group, 47% of students were black, 28% were Asian,
14% were white, 6% were Latino, and 6% were of another race. This study was
conducted in schools where more than one-half of students were receiving free or
reduced-price meals.

Approach: Schools were the level of random assignment, and 10 schools within the School
District of Philadelphia were included. A total of 600 students made up the
intervention group, while 749 students made up the control group. Students had
their weight and height measurements taken, which were used to calculate Body
Mass Index (BMI). Trained staff computed BMI scores. Additionally, students were
assessed, through self-report surveys, on the following: total energy consumed,
fat consumption, number of fruits and vegetable servings, physical activity, TV
viewing, and body image. Students were assessed at baseline as well as at
the two-year follow-up period; an interim assessment was collected one year
after the baseline assessment. All assessments were conducted during the spring
school semester.

The primary outcome
of the study was to assess the incidence of overweight and obesity–i.e.,
percentage of new cases overweight and obesity at the end of the study. The
secondary outcomes included the prevalence of overweight and obesity–i.e.,
percentage of total cases of overweight and obesity at the end of the study; and
remission of overweight and obesity–i.e., percentage of cases overweight or
obese at the start of the study, but no longer overweight or obese at the end of
the study.

Results: There
were significant impacts on the incidence and prevalence of overweight at the
end of the two-year study period. The impact on the prevalence of overweight
also held for black students. There were also impacts on total inactivity and
total TV viewing. However, there were no significant differences between the two
study groups for the incidence, prevalence, and remission of obesity. There were
also no significant differences for the remission of overweight. In addition,
there were no significant differences between the two study groups for total
energy consumption, total fat consumption, fruit and vegetable consumption, and
total physical activity.

There was no significant difference between the two
study groups for body dissatisfaction, suggesting there were no adverse impacts
on worsening body image. Also, there was no increase in the proportion of
students underweight.

SOURCES FOR MORE INFORMATION

References:

Foster GD, Sherman S, Borradaile KE, Grundy KM,
Vander Veur SS, Nachmani J, Karpyn A, Kumanyika S, Shults J. (2008). A
Policy-Based School Intervention to Prevent Overweight and Obesity. Pediatrics, 121:e794-e802.

For more information about The Food Trust and the School Nutrition Initiative, please visit: http://thefoodtrust.org/what-we-do/schools

KEYWORDS: Children (3-11), Elementary, School-based,
Parent/Family Component, Nutrition, Urban, Health Status/Conditions

Program information last updated on 12/6/10.