Using the School Environment to Promote Physical Activity and Healthy Eating

Wechsler, Howell; Devereaux, Randolph S.; Davis, Margarett; Collins, Janet L.

doi:10.1006/pmed.2000.0649

Cited by 355 publications

(302 citation statements)

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“…The school environment is recognised as an important setting where changes can be made to curb the increasing prevalence of overweight and obesity in children (Centers for Disease Control and Prevention, 1997;Weschler et al, 2000;Carter & Swinburn, 2004;Lobstein et al, 2004). Students spend approximately 32 h per week at school and this setting has been demonstrated to have a powerful influence on students' eating behaviours (Kubik et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Lunchbox contents of Australian school children: room for improvement

et al. 2005

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Objective: In light of the increasing prevalence of obesity in children and the potential of schools as a setting for intervention, we aimed to identify the main foods and beverages consumed at primary school and to determine differences in consumption patterns between children who used the school canteen and those who did not. Design: Cross-sectional survey of school foods in 1681 5-12 y old children, [2003][2004]. Setting: Barwon South-Western region of Victoria, Australia. Results: The school food provided an average (7s.e.m.) of 3087726 kJ. Bread was the most frequently consumed food and contributed 20% of total energy at school, biscuits 13%, fruit 10%, muesli/fruit bars 8%, packaged snacks 7%, and fruit juice/ cordial 6%. About 10% of children used the school canteen and these children obtained more total energy and more energy from cakes, fast foods and soft drink than noncanteen users (Po0.001). In all, 68% of children had fruit in their lunchboxes, however, over 90% of children had energy-dense, micronutrient-poor snacks ('junk food'). Conclusions: Fruit intake in primary schools seems reasonably high but could be targeted for further increase as part of promoting a healthy diet. Of concern, however, are the excessive amounts of energy-dense foods in school lunchboxes. These should be considered a priority for health promotion efforts along with reducing the consumption of sweetened drinks. These measures are urgently needed to improve the school-based diets of Australian children and attempt to curb the increasing prevalence of childhood obesity.

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Section: Introductionmentioning

confidence: 99%

Lunchbox contents of Australian school children: room for improvement

et al. 2005

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“…The development of our programs has benefited from previous similar intervention trials such as the CATCH and Pathways studies as well as from the related guidelines and recommendations made by other researchers and the CDC (Centers for Disease Control and Prevention, 1996, 1997Perry et al, 1997;Resnicow and Robinson, 1997;Gortmaker et al, 1999;Story, 1999;Wechsler et al, 2000;Baranowski et al, 2002;Stone et al, 2003). The design of our intervention program shares some similarities with the previous CATCH Study conducted between the 1980s and 1990s (Perry et al, 1997;Stone et al, 2003) and the recent PATHWAYS study conducted in American-Indian communities (Gortmaker et al, 1999).…”

Section: Discussionmentioning

confidence: 93%

“…Recently, Wechsler et al (2000) suggested that new research is needed in five key areas of the school environment to promote PA and healthy eating: recess periods, intramural sports and PA programs, physical activity facilities, foods and beverages available at school outside of the school meals program, and psychosocial support. Our study addressed several of these areas.…”

Section: Discussionmentioning

confidence: 99%

“…However, few school-based randomized trails have been conducted to test effective approaches for prevention of excessive weight gain. A number of schoolbased trials focused on the prevention of cardiovascular disease in young people provide useful insights (Resnicow and Robinson, 1997;Story, 1999;Meininger, 2000;Nicholson, 2000;Wechsler et al, 2000). One large-scale study is the Child and Adolescent Trial for Cardiovascular Health (CATCH) conducted between 1987 and 1994, which involved over 5000 students from 96 schools in several states (Perry et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

“…In general, most previous intervention studies, in particular, those with a focus on education, are costly and not effective in preventing obesity (Bautista-Castano et al, 2004;Caballero, 2004), and these studies are predominately conducted in the United States although increasing efforts are made in other countries (Muller et al, 2001;Sahota et al, 2001;Bautista-Castano et al, 2004;Caballero, 2004). Research on school-based environmental strategies to promote healthy eating and physical activity (HEPA, or 'HEAL', healthy eating and active lifestyle) is urgently needed (Story, 1999;Wechsler et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Obesity prevention in low socioeconomic status urban African-American adolescents: study design and preliminary findings of the HEALTH-KIDS Study

Wang

Tussing

Odoms-Young³

et al. 2005

Eur J Clin Nutr

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Objectives: Obesity prevention among children and adolescents is a public health priority; however, limited school-based intervention trials targeting obesity have been conducted. This article provides an overview of the study design and baseline preliminary findings of our ongoing school-based intervention study. Design: Randomized intervention trial to test a school-based, environmental obesity prevention program in urban low socioeconomic status (SES) African-American adolescents. The intervention program was developed based on several behavioral theories and was guided by preliminary findings based on focus group discussion and baseline data. Setting: Four Chicago public schools in the US. Subjects: Over 450 5-7th graders and their families and schools were involved. Results: Our baseline data indicate a high prevalence of overweight (43% in boys and 41% in girls) and a number of problems in these children's physical activity and eating patterns. Only 26% reported spending X20 min engaged in vigorous-moderate exercise in X5 days over the past 7 days; 29% reported spending X5 h each day watching TV, playing video games, or using computer. They also consumed too many fried foods and soft drinks. On average, 55% consumed fried foods X2 times/day over the past 7 days; regarding soft drinks, 70% reported consuming X2 times/day. Conclusion: School-based obesity prevention programs are urgently needed in the target US urban, low SES, minority communities. These data can be used to inform intervention activities.

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Changes in Body Mass Index Among School-Aged Youths Following Implementation of the Healthy, Hunger-Free Kids Act of 2010

et al. 2023

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ImportanceThe prevalence of obesity among youths 2 to 19 years of age in the US from 2017 to 2018 was 19.3%; previous studies suggested that school lunch consumption was associated with increased obesity. The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) strengthened nutritional standards of school-based meals.ObjectiveTo evaluate the association between the HHFKA and youth body mass index (BMI).Design, Setting, and ParticipantsThis cohort study was conducted using data from the Environmental Influences on Child Health Outcomes program, a nationwide consortium of child cohort studies, between January 2005 and March 2020. Cohorts in the US of youths aged 5 to 18 years with reported height and weight measurements were included.ExposuresFull implementation of the HHFKA.Main Outcomes and MeasuresThe main outcome was annual BMI z-score (BMIz) trends before (January 2005 to August 2016) and after (September 2016 to March 2020) implementation of the HHFKA, adjusted for self-reported race, ethnicity, maternal education, and cohort group. An interrupted time-series analysis design was used to fit generalized estimating equation regression models.ResultsA total of 14 121 school-aged youths (7237 [51.3%] male; mean [SD] age at first measurement, 8.8 [3.6] years) contributing 26 205 BMI measurements were included in the study. Overall, a significant decrease was observed in the annual BMIz in the period following implementation of the HHFKA compared with prior to implementation (−0.041; 95% CI, −0.066 to −0.016). In interaction models to evaluate subgroup associations, similar trends were observed among youths 12 to 18 years of age (−0.045; 95% CI, −0.071 to −0.018) and among youths living in households with a lower annual income (−0.038; 95% CI, −0.063 to −0.013).Conclusions and RelevanceIn this cohort study, HHFKA implementation was associated with a significant decrease in BMIz among school-aged youths in the US. The findings suggest that school meal programs represent a key opportunity for interventions to combat the childhood obesity epidemic given the high rates of program participation and the proportion of total calories consumed through school-based meals.

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Using the School Environment to Promote Physical Activity and Healthy Eating

Cited by 355 publications

References 54 publications

Lunchbox contents of Australian school children: room for improvement

Lunchbox contents of Australian school children: room for improvement

Obesity prevention in low socioeconomic status urban African-American adolescents: study design and preliminary findings of the HEALTH-KIDS Study

Changes in Body Mass Index Among School-Aged Youths Following Implementation of the Healthy, Hunger-Free Kids Act of 2010

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