Context Research consistently shows that the majority of American children do not consume diets that meet the recommendations of the Dietary Guidelines for Americans, nor do they achieve adequate levels of daily physical activity. As a result, more children are overweight today than at any other time in U.S. history. Schools offer many opportunities to develop strategies to prevent obesity by creating environments in which children eat healthfully and engage regularly in physical activity. Methods This article discusses the role of schools in obesity prevention efforts. Current issues in schools’ food and physical activity environments are examined, as well as federal, state, and local policies related to food and physical activity standards in schools. The article is organized around four key areas: (1) school food environments and policies, (2) school physical activity environments and policies, (3) school body mass index measurements, and (4) school wellness policies. Recommendations for accelerating change also are addressed. Findings The article found that (1) competitive foods (foods sold outside of federally reimbursed school meals) are widely available in schools, especially secondary schools. Studies have related the availability of snacks and drinks sold in schools to students’ high intake of total calories, soft drinks, total fat and saturated fat, and lower intake of fruits and vegetables; (2) physical activity can be added to the school curriculum without academic consequences and also can offer physical, emotional, and social benefits. Policy leadership has come predominantly from the districts, then the states, and, to a much lesser extent, the federal government; (3) few studies have examined the effectiveness or impact of school-based BMI measurement programs; and (4) early comparative analyses of local school wellness policies suggest that the strongest policies are found in larger school districts and districts with a greater number of students eligible for a free or reduced-price lunch. Conclusions Studies show that schools have been making some progress in improving the school food and physical activity environments but that much more work is needed. Stronger policies are needed to provide healthier meals to students at schools; limit their access to low-nutrient, energy-dense foods during the school day; and increase the frequency, intensity, and duration of physical activity at school.

Objective-The High 5 for Preschool Kids (H5-KIDS) program tested the effectiveness of a home based intervention to teach parents how to ensure a positive fruit-vegetable (FV) environment for their preschool child, and to examine whether changes in parent behavior were associated with improvements in child intake. Results-When compared to control parents, H5-KIDS parents reported an increase in FV servings (MN=.20, p=.05), knowledge and availability of FV within the home (p=.01), and decreased their use of noncoercive feeding practices (p=.02). Among preschoolers, FV servings increased in normal weight (MN=.35, p=.02) but not overweight children (MN=-.10, p=.48), relative to controls. Parent's change in FV servings was a significant predictor of child's change in FV in the H5-KIDS group (p=.001). Methods Conclusion-H5-KIDSsuggests the need for, and promise of, early home intervention for childhood obesity prevention. It demonstrates the importance of participatory approaches in developing externally valid interventions, with the potential for dissemination across national parent education programs as a means for improving the intake of parents and young children.

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The purpose of this study was to examine associations between adolescents’ and friends’ healthy eating behaviors, specifically breakfast, fruit, vegetable, whole grain and dairy food intake as reported by both adolescents and their friends. Data for this study were drawn from EAT-2010 (Eating and Activity among Teens), a population-based study examining multi-level factors of eating, physical activity, and weight-related outcomes among adolescents (80% racial/ethnic minority) in Minneapolis/St. Paul, Minnesota during the 2009–2010 academic year. In-class surveys were completed by 2043 adolescents in 20 schools. Adolescents identified friends from a class roster; friends’ survey data were then linked to each participant. Generalized estimating equation linear regression models were used to examine associations between adolescents’ healthy eating behaviors and these behaviors from their friends (friend group and best friends), adjusting for socio-demographic characteristics. Significant positive associations were found for breakfast eating between adolescents and their friend groups and best friends (friend groups β=0.26, p<0.001; best friends β=0.19, p=0.004), as well was for whole grain (friend groups β=0.14, p<0.001; best friends β=0.13, p=0.003) and dairy food intake (friend groups β=0.08, p=0.014; best friends β=0.09, p=0.002). Adolescents’ and their best friends’ vegetable intake were also significantly related (β=0.09, p=0.038). No associations were seen among friends for fruit intake. Findings from this study suggest that adolescent friends exhibit similarities in healthy eating patterns. Dietitians and health professional may consider developing strategies to engage friends to promote adolescents’ healthy dietary behaviors.

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