Kids eat healthier when school-based nutrition programs involve teachers, staff, parents

June 27, 2012 in Medicine & Health / Health

Programs to promote healthy eating can substantially reduce the amount of unhealthy foods and beverages on school grounds if the programs focus on a school's specific needs and involve teachers, parents, staff, and administrators, according to a Kaiser Permanente Southern California study published in BioMed Central's open access journal International Journal of Behavioral Nutrition and Physical Activity.

The Healthy Options for Nutrition Environments in Schools (Healthy ONES) study used a public health approach to change nutrition environments and policies in eight elementary and middle schools over a three-year period. The study was funded by the U.S. Department of Agriculture's National Research Initiative and included 400 students.

Researchers found that using a more participatory public health approach decreased by 30 percent the amount of and beverages in intervention schools. Control schools, by comparison, had a 26 percent increase in these items. brought from outside sources also increased during lunch in intervention schools.

"Schools are an ideal place for establishing life-long , but until now that's been easier said than done," said study lead author Karen J. Coleman, PhD, from Kaiser Permanente Southern California's Department of Research and Evaluation. "The Healthy ONES study helped us understand how communities and schools could work together to get kids to eat healthier at school and help address ."

This study reinforces the latest recommendations on from the Institute of Medicine. The new report, Accelerating Progress on Obesity Prevention, describes schools as "the heart of health." The report identifies school-based interventions as among the most promising to prevent childhood obesity and underscores the need to implement policies that change within schools.

"If we want to have the broad reach and impact necessary to address the enormity of the childhood obesity epidemic, it's critical that we engage children and their families within school communities," said Loel Solomon, PhD, vice president of community health at Kaiser Permanente. "Powerful results like these are why school-based interventions are a key element of Kaiser Permanente's prevention strategy, and why we will be redoubling our efforts in schools in the years to come."

In the study, researchers worked with teachers and administrators to change certain unhealthy nutrition practices. They replaced food and beverage classroom rewards with nonfood prizes and implemented nutrition-conscious catering at schoolwide events and classroom celebrations. For fund-raising activities, they served healthy foods and beverages, awarded nonfood prizes, and included games such as a "prize walk," rather than a "cake walk." In addition, schools were able to make more money using healthy events like "jog-a-thons" than fall carnivals with popcorn and pepperoni pizza.

According to the study, a public health approach may be more effective in changing school environments and policies because of stakeholder engagement in intervention design, implementation, and evaluation. This differs from other traditional methods that fundamentally ignore the multiple school-level issues that may affect intervention effectiveness.

Although researchers hypothesized that these school environment and policy changes would reduce childhood obesity rates, no changes were observed. This is likely due to the short period of observation after the changes were implemented in the schools. Nevertheless, by building capacity within schools to make and sustain change, the Healthy ONES model could contribute significantly to efforts to prevent childhood obesity, the authors stated.

"Our findings are significant because previous school-based interventions often have had little success in changing behaviors," said Dr. Coleman. "The Healthy ONES study suggests that community-driven process interventions that focus on implementation and stakeholder engagement can help schools implement their current federally mandated wellness policies. These types of interventions may have a better chance to impact child obesity than other attempts to change school health practices."

This study is part of Kaiser Permanente's ongoing work to identify and treat childhood obesity through research and community programs. Previous research studies related to childhood obesity include:

Kaiser Permanente is working with HBO, the Institute of Medicine, the Centers for Disease Control and Prevention, National Institutes of Health and the Michael & Susan Dell Foundation to address obesity as a critical public health crisis with HBO's latest documentary series: The Weight of the Nation. The series and public health campaign spotlights the severity of the obesity epidemic and showcases strategies that work in order to catalyze action to end obesity.

Provided by Kaiser Permanente

"Kids eat healthier when school-based nutrition programs involve teachers, staff, parents" June 27, 2012