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Nutrition quality and education in K-12 schools
practice applications
FOR YOUR INFORMATION
Nutrition Quality and Education in K-12 Schools
T
he nutritional quality of meals served in public kindergarten through 12th grade (K-12) US schools has been examined extensively by dietetics and other health care professionals and government agencies, and this scrutiny led to significant progress among schools to reach the goals set forth by the US Department of Agriculture (USDA) School Meals Initiative for Healthy Children. According to the School Nutrition Dietary Assessment Study II (1) published in 2001, although improvements on National School Lunch Program meals are still needed, between school year 19911992 (when it was not required that school foodservice meals be consistent with the US Dietary Guidelines) and school year 1998-1999, there was statistically significant improvement in lowering levels of fat and saturated fat and a marked increase in providing meals consistent with US Dietary Guidelines/School Meals Initiative for Healthy Children standards (1). Despite these improvements, there are remaining issues that K-12 schools confront. AN ECONOMIC ISSUE The controversy regarding the presence of foods of minimal nutrition value in schools has received much press in recent years. In the late 1990s, many junior high and high schools began to compensate for budget shortfalls, especially for extracurricular student activities, by signing exclusive contracts with corporations to provide soda pop and foods of minimal nutritional value for vending machines in schools. These contracts existed mainly at the middle school and high school level. According to Monique Derricote, MBA, RD, a registered dietitian for the Food Services Department at San Juan Unified This article was written by Karen Stein, MFA, freelance writer in Chicago, IL. doi: 10.1016/j.jada.2005.01.012
334
School District in California, very few districts at the elementary school level, if any, offer soft drinks and foods of minimal nutrition value. But there has since been a backlash against such corporate contracts. For example, in 2000, the Madison School Board in Wisconsin—which in 1997 was among the first school districts in the United States to enter into an exclusive vending contract—voted to terminate its agreement with CocaCola (2). In response to this change, Andrew Hagelshaw, executive director for the Center for CommercialFree Public Education, said, “Districts are realizing that these deals only take advantage of under-funded schools and turn students into a captive audience for brand name advertising . . . and for an unhealthy product at that” (3). In January 2001, California Senate Bill (SB) 19, The Pupil Nutrition, Health, and Achievement Act of 2001—a bill that removed all foods of minimal nutritional value from all elementary schools—was implemented; then, in July 2004, SB 677, The Food and Nutrition Bill, was implemented to address the same issue in middle schools beginning in September 2005 (3). For high schools, SB 677 requires that the ban of soda pop sales would apply only to on-campus activities during the school day starting in September 2006 (3). Although the removal of foods of minimal nutritional value from schools is beneficial from a nutrition point of view, the full financial impact of this decision remains to be seen. Neither SB 19 nor SB 677 appropriated funding to offset foodservice costs, says Derricote. In fact, a school that participated in a 2-year pilot program for implementing SB 19 experienced substantial financial loss as a result of terminating its vending contract. However, Derricote does not believe the outlook is necessarily grim: “Overall, it’s too early to determine the impact on the financial health of foodservice departments. Fortunately, companies are recognizing the shift in demand and developing
Journal of the AMERICAN DIETETIC ASSOCIATION
products that meet nutritional standards of school foodservice.” According to Making It Happen—a joint project of Team Nutrition of the Food and Nutrition Service, the USDA, the Division of Adolescent and School Health of the Centers for Disease Control and Prevention, the US Department of Health and Human Services, and the US Department of Education to improve the nutrition quality of foods served in US schools—schools’ finances remain healthy after switching to more healthful vending options. Of 17 schools and school districts that reported income data, 12 increased their revenue as a result of the changes and four reported no change (4). AN EDUCATIONAL ISSUE AT THE INSTITUTIONAL LEVEL Beyond addressing the health and financial implications of vending contracts, providing nutrition education to students at all has also been a challenge to schools across the United States. Currently there is an emphasis in schools on student performance on standardized tests, which has led to a de-emphasis on or elimination of programs considered “extra,” including art, music, and physical education. However, according to Derricote, in the previous system, students received a limited amount of nutrition education via physical education, health, and/or science classes. “Because physical education has been cut and many schools no longer require or even offer health classes,” says Derricote, “nutrition education opportunities are limited. Thus, nutrition educators, or people wishing to incorporate nutrition into the general education system, must be creative. Some examples include using recipes to teach fractions in math, reading nutrition-related books for literature assignments, researching a country’s food customs in geography or history classes, or investigating the reaction when cooking foods in physics class.” Many school districts have also experienced budget cuts that, in many
© 2005 by the American Dietetic Association
FOR YOUR INFORMATION cases, have had an impact on school nutrition processes and outcomes. Examples from a December 2003/January 2004 report published by the National Education Association (5) include the following: ● ●
●
●
Detroit: School lunch prices were raised. Missouri: The superintendent, to compensate for eliminated staff, would cook student meals in the cafeteria. New York: At 177 schools that serve fewer than 200 students each for summer classes, the cafeterias were shut down. Oklahoma: Teachers were tasked with cafeteria cooking duties to counteract the impact of being short-staffed.
In addition to cuts in programs, students are experiencing cuts in time to eat. According to the American Dietetic Association 2003 Position Paper (6) on school nutrition services, “In an attempt to provide increased classroom time within the existing school day, schools have decreased the amount of time available for students to eat lunch. The majority (82%) of high school students report that lunch periods are too short, and two-thirds (62%) report that lunch lines are too long.” This shortchanging of mealtime often leads to students seeking lunch from a vending machine or skipping the meal altogether. AN EDUCATIONAL ISSUE AT THE TEACHER LEVEL Many agencies, organizations, and associations have collaborated—in a program called Team Nutrition—to promote healthful eating behaviors in schools and address many of the challenges confronting school foodservice. Team Nutrition (7) calls for action on the part of students, parents, educators, government, and community leaders to address many issues, including promoting healthful eating patterns, integrating behavior-focused nutrition education in K-12 curricula to be delivered by appropriately-trained staff, providing adequately-funded nutrition education programs, and fostering healthful eating patterns by selling foods from the five major food groups of the Food Guide Pyramid (8).
Although an ideal approach to this call to action at the educator level would be for schools to hire a menu planner and a nutrition educator, many schools address the need for nutrition education by having regular classroom teachers incorporate such lessons into the curriculum. In fact, in 2003, 61% of US schools had no nutrition education coordination program (6). According to Derricote, this approach could shortchange the students. “As most people know,” says Derricote, “teachers are perpetually stretched in a variety of directions and often work long hours outside of their regular workday. Teachers have little time to research and create nutrition lessons. In addition, they usually lack the background knowledge to decipher which information is accurate. With recent emphasis on students meeting standardized test scores, few teachers can spare any time to teach nutrition in the classroom. As a result, our children are missing out on valuable knowledge that is essential to creating lifelong healthful habits.” A 2000 survey of nutrition education at the K-5 level, performed in response to a request by the USDA’s Food and Nutrition Service, shows the difficulty of providing nutrition education in the classroom. Following are some highlights of the results from this survey of 1,409 US public school K-5 teachers (9): ●
●
●
Approximately half (52%) of respondents have had formal training to teach nutrition in the classroom, yet 88% reported that they taught nutrition lessons to students. The percentages were higher for teachers in kindergarten through second-grade classrooms. Although high availability of resources in support of nutrition education, “including healthy cafeteria meals (82%), reference materials (74%), support for use of instructional time (70%), and a written policy or guidelines (57%),” the results were lower regarding availability of high-quality, in-service, nutrition education training (27%) and a coordinated school nutrition policy (37%). The mean number of hours in a school year spent on teaching nutrition education was 13. (According to the survey authors, 50 hours is
●
●
the minimum amount of time believed to be necessary for impact on behavior.) Nutrition was taught as a separate subject by 35% of respondents, whereas other respondents (39% and 33%, respectively) integrated the lessons into health/ physical education and science curricula. Respondents who indicated barriers to cooperation with school meals staff in providing nutrition education focused on “lack of instructional time and time on the part of the meals program staff, being unsure of what activities are possible, and difficulty of schedule coordination between teachers and meals program staff.” Among respondents, only 24% said the instructional materials they used were up to date to a great extent, 41% reported age-appropriateness of materials to a great extent, and 23% said that the materials were appealing to students to a great extent. Approximately 21% reported not having enough materials for all students in the classroom.
TACKLING THE ISSUES Although it is a great challenge for schools to meet the nutrition goals set forth by government and health care organizations given the political and economic hurdles, schools have many options for pursuing a comprehensive nutrition program. For example, the collaborative Team Nutrition developed Ten Keys to Promote Healthy Eating in Schools (7) to “assist each school community in writing its own prescription for change” (Figure). In addition, competitive grants for states are available via Team Nutrition for training and materials and to facilitate collaboration among child nutrition staff and teachers “to design and implement nutrition education programs that integrate healthy eating messages into the entire school environment” (6). According to Derricote, schools’ dietetics professionals also have a variety of options to increase nutrition education throughout the district. Derricote’s suggestions include the following: ●
Put nutrition articles for parents and activities for children on the back of school menus.
March 2005 ● Journal of the AMERICAN DIETETIC ASSOCIATION
335
FOR YOUR INFORMATION ● Students, parents, educators, and community leaders will be involved in assessing the school’s eating environment, developing a shared vision, and an action plan to achieve it. ● Adequate funds will be provided by local, state, and federal sources to ensure that the total school environment supports the development of healthful eating patterns. ● Behavior-focused nutrition education will be integrated into the curriculum from pre-kindergarten through grade 12. Staff who provide nutrition education will have appropriate training. ● School meals will meet the US Department of Agriculture’s nutrition standards as well as provide sufficient choices, including new foods and foods prepared in new ways, to meet the taste preferences of diverse student populations. ● All students will have designated lunch periods of sufficient length to enjoy eating healthful foods with friends. These lunch periods will be scheduled as near the middle of the school day as possible. ● Schools will provide enough serving areas to ensure student access to school meals with a minimum of wait time. ● Space that is adequate to accommodate all students and pleasant surroundings that reflect the value of social aspects of eating will be provided. ● Students, teachers, and community volunteers who practice healthful eating will be encouraged to serve as role models in the school dining areas. ● If foods are sold in addition to National School Lunch Program meals, they will be from the five major food groups of the Food Guide Pyramid. This practice will foster healthful eating patterns. ● Decisions regarding the sale of foods in addition to the National School Lunch Program meals will be based on nutrition goals, not on profit making. Figure. Team Nutrition’s Prescription for Change: Ten keys to promote healthful eating in schools. Adapted from (7). ●
●
●
●
●
●
● ●
●
Use the cafeteria as the “nutrition laboratory”—for example, display posters with nutrition information (eg, posters from 5 A Day, Team Nutrition, Dairy Council); display nutrition information about the menu; or do cooking demonstrations, taste tests, or both. Highlight certain fruits, vegetables, and so forth. For example, implement a “Harvest of the Month” program where citrus fruits are highlighted, or ask staff to provide certain nutrition messages to students (eg, “Eat your mandarin orange for vitamin C!”). Collaborate. Many community organizations are eager to work with schools. Find an organization that could present a 30-minute, nutrition-related assembly for students. Create a nutrition resource library with books, videos, curricula, food models, games, and so forth that teachers can borrow. Conduct onsite training for teachers on various nutrition curricula and lessons that will meet state curricula standards. Write newsletters for teachers that provide tips on incorporating nutrition into the classroom. Be a special guest in the classroom, no matter what grade level. Work with biology and other science teachers to incorporate nutrition into their lessons. Provide nutrition curricula to physical education teachers and train them for using these materials.
336
March 2005 Volume 105 Number 3
No matter what approach is used, it is essential that schools continue to develop and implement sound nutrition policies because, as stated by Team Nutrition (7) in its policy statement, “studies show that eating habits established early in life tend to persist into adulthood.” References 1. US Department of Agriculture, Food and Nutrition Service. School Nutrition Dietary Assessment Study II: Summary of Findings. Available at: http://www.fns.usda.gov/oane/menu/ published/cnp/files/sndaIIfindsum. htm. Accessed October 28, 2004. 2. Center for Commercial-Free Public Education. Madison School Board Votes to Leave Coke Contract [press release]. Available at: http:// www . ibiblio . or / commercialfree / presscenter/pr_82900.html. Accessed November 11, 2004. 3. Fletcher E. California State Senate OK’s Soda Ban. Available at: http://www.bridges4kids.org/articles/ 6-03/SacBee5-30-03.html. Accessed November 11, 2004. 4. Making It Happen—School Nutrition Success Stories [US Department of Agriculture Web site]. Available at: http://www.fns.usda. gov/tn/Healthy/ExecSummary_ RevenueInfo.pdf. Accessed February 1, 2005. 5. National Education Association. Cuts Leave More and More Public School Children Behind. De-
6.
7.
8.
9.
cember 2003/January 2004. Available at: http://www.nea.org/esea/ storiesfromthefield.html. Accessed November 11, 2004. Position of the American Dietetic Association: Nutrition services: An essential component of comprehensive health programs. J Am Diet Assoc. 2003;103:505-514. Food and Nutrition Service. Team Nutrition Policy Statement. Available at: http://www.fns.usda.gov/ tn/Default.htm. Accessed November 4, 2004. Food Guide Pyramid. A Guide to Daily Food Choices. Washington, DC: US Department of Agriculture, Human Nutrition Information Services; 1992. Home and Garden Bulletin No. 232. Celebuski C, Farris E, Burns S. Nutrition Education in Public Elementary School Classrooms, K-5. Statistical Analysis Report—February 2000 [National Center for Education Statistics Web site]. Available at: http://nces.ed.gov/surveys/ frss/publications/2000040. Accessed November 9, 2004.
FOR YOUR INFORMATION
Nutrition Quality and Education in K-12 Schools
T
he nutritional quality of meals served in public kindergarten through 12th grade (K-12) US schools has been examined extensively by dietetics and other health care professionals and government agencies, and this scrutiny led to significant progress among schools to reach the goals set forth by the US Department of Agriculture (USDA) School Meals Initiative for Healthy Children. According to the School Nutrition Dietary Assessment Study II (1) published in 2001, although improvements on National School Lunch Program meals are still needed, between school year 19911992 (when it was not required that school foodservice meals be consistent with the US Dietary Guidelines) and school year 1998-1999, there was statistically significant improvement in lowering levels of fat and saturated fat and a marked increase in providing meals consistent with US Dietary Guidelines/School Meals Initiative for Healthy Children standards (1). Despite these improvements, there are remaining issues that K-12 schools confront. AN ECONOMIC ISSUE The controversy regarding the presence of foods of minimal nutrition value in schools has received much press in recent years. In the late 1990s, many junior high and high schools began to compensate for budget shortfalls, especially for extracurricular student activities, by signing exclusive contracts with corporations to provide soda pop and foods of minimal nutritional value for vending machines in schools. These contracts existed mainly at the middle school and high school level. According to Monique Derricote, MBA, RD, a registered dietitian for the Food Services Department at San Juan Unified This article was written by Karen Stein, MFA, freelance writer in Chicago, IL. doi: 10.1016/j.jada.2005.01.012
334
School District in California, very few districts at the elementary school level, if any, offer soft drinks and foods of minimal nutrition value. But there has since been a backlash against such corporate contracts. For example, in 2000, the Madison School Board in Wisconsin—which in 1997 was among the first school districts in the United States to enter into an exclusive vending contract—voted to terminate its agreement with CocaCola (2). In response to this change, Andrew Hagelshaw, executive director for the Center for CommercialFree Public Education, said, “Districts are realizing that these deals only take advantage of under-funded schools and turn students into a captive audience for brand name advertising . . . and for an unhealthy product at that” (3). In January 2001, California Senate Bill (SB) 19, The Pupil Nutrition, Health, and Achievement Act of 2001—a bill that removed all foods of minimal nutritional value from all elementary schools—was implemented; then, in July 2004, SB 677, The Food and Nutrition Bill, was implemented to address the same issue in middle schools beginning in September 2005 (3). For high schools, SB 677 requires that the ban of soda pop sales would apply only to on-campus activities during the school day starting in September 2006 (3). Although the removal of foods of minimal nutritional value from schools is beneficial from a nutrition point of view, the full financial impact of this decision remains to be seen. Neither SB 19 nor SB 677 appropriated funding to offset foodservice costs, says Derricote. In fact, a school that participated in a 2-year pilot program for implementing SB 19 experienced substantial financial loss as a result of terminating its vending contract. However, Derricote does not believe the outlook is necessarily grim: “Overall, it’s too early to determine the impact on the financial health of foodservice departments. Fortunately, companies are recognizing the shift in demand and developing
Journal of the AMERICAN DIETETIC ASSOCIATION
products that meet nutritional standards of school foodservice.” According to Making It Happen—a joint project of Team Nutrition of the Food and Nutrition Service, the USDA, the Division of Adolescent and School Health of the Centers for Disease Control and Prevention, the US Department of Health and Human Services, and the US Department of Education to improve the nutrition quality of foods served in US schools—schools’ finances remain healthy after switching to more healthful vending options. Of 17 schools and school districts that reported income data, 12 increased their revenue as a result of the changes and four reported no change (4). AN EDUCATIONAL ISSUE AT THE INSTITUTIONAL LEVEL Beyond addressing the health and financial implications of vending contracts, providing nutrition education to students at all has also been a challenge to schools across the United States. Currently there is an emphasis in schools on student performance on standardized tests, which has led to a de-emphasis on or elimination of programs considered “extra,” including art, music, and physical education. However, according to Derricote, in the previous system, students received a limited amount of nutrition education via physical education, health, and/or science classes. “Because physical education has been cut and many schools no longer require or even offer health classes,” says Derricote, “nutrition education opportunities are limited. Thus, nutrition educators, or people wishing to incorporate nutrition into the general education system, must be creative. Some examples include using recipes to teach fractions in math, reading nutrition-related books for literature assignments, researching a country’s food customs in geography or history classes, or investigating the reaction when cooking foods in physics class.” Many school districts have also experienced budget cuts that, in many
© 2005 by the American Dietetic Association
FOR YOUR INFORMATION cases, have had an impact on school nutrition processes and outcomes. Examples from a December 2003/January 2004 report published by the National Education Association (5) include the following: ● ●
●
●
Detroit: School lunch prices were raised. Missouri: The superintendent, to compensate for eliminated staff, would cook student meals in the cafeteria. New York: At 177 schools that serve fewer than 200 students each for summer classes, the cafeterias were shut down. Oklahoma: Teachers were tasked with cafeteria cooking duties to counteract the impact of being short-staffed.
In addition to cuts in programs, students are experiencing cuts in time to eat. According to the American Dietetic Association 2003 Position Paper (6) on school nutrition services, “In an attempt to provide increased classroom time within the existing school day, schools have decreased the amount of time available for students to eat lunch. The majority (82%) of high school students report that lunch periods are too short, and two-thirds (62%) report that lunch lines are too long.” This shortchanging of mealtime often leads to students seeking lunch from a vending machine or skipping the meal altogether. AN EDUCATIONAL ISSUE AT THE TEACHER LEVEL Many agencies, organizations, and associations have collaborated—in a program called Team Nutrition—to promote healthful eating behaviors in schools and address many of the challenges confronting school foodservice. Team Nutrition (7) calls for action on the part of students, parents, educators, government, and community leaders to address many issues, including promoting healthful eating patterns, integrating behavior-focused nutrition education in K-12 curricula to be delivered by appropriately-trained staff, providing adequately-funded nutrition education programs, and fostering healthful eating patterns by selling foods from the five major food groups of the Food Guide Pyramid (8).
Although an ideal approach to this call to action at the educator level would be for schools to hire a menu planner and a nutrition educator, many schools address the need for nutrition education by having regular classroom teachers incorporate such lessons into the curriculum. In fact, in 2003, 61% of US schools had no nutrition education coordination program (6). According to Derricote, this approach could shortchange the students. “As most people know,” says Derricote, “teachers are perpetually stretched in a variety of directions and often work long hours outside of their regular workday. Teachers have little time to research and create nutrition lessons. In addition, they usually lack the background knowledge to decipher which information is accurate. With recent emphasis on students meeting standardized test scores, few teachers can spare any time to teach nutrition in the classroom. As a result, our children are missing out on valuable knowledge that is essential to creating lifelong healthful habits.” A 2000 survey of nutrition education at the K-5 level, performed in response to a request by the USDA’s Food and Nutrition Service, shows the difficulty of providing nutrition education in the classroom. Following are some highlights of the results from this survey of 1,409 US public school K-5 teachers (9): ●
●
●
Approximately half (52%) of respondents have had formal training to teach nutrition in the classroom, yet 88% reported that they taught nutrition lessons to students. The percentages were higher for teachers in kindergarten through second-grade classrooms. Although high availability of resources in support of nutrition education, “including healthy cafeteria meals (82%), reference materials (74%), support for use of instructional time (70%), and a written policy or guidelines (57%),” the results were lower regarding availability of high-quality, in-service, nutrition education training (27%) and a coordinated school nutrition policy (37%). The mean number of hours in a school year spent on teaching nutrition education was 13. (According to the survey authors, 50 hours is
●
●
the minimum amount of time believed to be necessary for impact on behavior.) Nutrition was taught as a separate subject by 35% of respondents, whereas other respondents (39% and 33%, respectively) integrated the lessons into health/ physical education and science curricula. Respondents who indicated barriers to cooperation with school meals staff in providing nutrition education focused on “lack of instructional time and time on the part of the meals program staff, being unsure of what activities are possible, and difficulty of schedule coordination between teachers and meals program staff.” Among respondents, only 24% said the instructional materials they used were up to date to a great extent, 41% reported age-appropriateness of materials to a great extent, and 23% said that the materials were appealing to students to a great extent. Approximately 21% reported not having enough materials for all students in the classroom.
TACKLING THE ISSUES Although it is a great challenge for schools to meet the nutrition goals set forth by government and health care organizations given the political and economic hurdles, schools have many options for pursuing a comprehensive nutrition program. For example, the collaborative Team Nutrition developed Ten Keys to Promote Healthy Eating in Schools (7) to “assist each school community in writing its own prescription for change” (Figure). In addition, competitive grants for states are available via Team Nutrition for training and materials and to facilitate collaboration among child nutrition staff and teachers “to design and implement nutrition education programs that integrate healthy eating messages into the entire school environment” (6). According to Derricote, schools’ dietetics professionals also have a variety of options to increase nutrition education throughout the district. Derricote’s suggestions include the following: ●
Put nutrition articles for parents and activities for children on the back of school menus.
March 2005 ● Journal of the AMERICAN DIETETIC ASSOCIATION
335
FOR YOUR INFORMATION ● Students, parents, educators, and community leaders will be involved in assessing the school’s eating environment, developing a shared vision, and an action plan to achieve it. ● Adequate funds will be provided by local, state, and federal sources to ensure that the total school environment supports the development of healthful eating patterns. ● Behavior-focused nutrition education will be integrated into the curriculum from pre-kindergarten through grade 12. Staff who provide nutrition education will have appropriate training. ● School meals will meet the US Department of Agriculture’s nutrition standards as well as provide sufficient choices, including new foods and foods prepared in new ways, to meet the taste preferences of diverse student populations. ● All students will have designated lunch periods of sufficient length to enjoy eating healthful foods with friends. These lunch periods will be scheduled as near the middle of the school day as possible. ● Schools will provide enough serving areas to ensure student access to school meals with a minimum of wait time. ● Space that is adequate to accommodate all students and pleasant surroundings that reflect the value of social aspects of eating will be provided. ● Students, teachers, and community volunteers who practice healthful eating will be encouraged to serve as role models in the school dining areas. ● If foods are sold in addition to National School Lunch Program meals, they will be from the five major food groups of the Food Guide Pyramid. This practice will foster healthful eating patterns. ● Decisions regarding the sale of foods in addition to the National School Lunch Program meals will be based on nutrition goals, not on profit making. Figure. Team Nutrition’s Prescription for Change: Ten keys to promote healthful eating in schools. Adapted from (7). ●
●
●
●
●
●
● ●
●
Use the cafeteria as the “nutrition laboratory”—for example, display posters with nutrition information (eg, posters from 5 A Day, Team Nutrition, Dairy Council); display nutrition information about the menu; or do cooking demonstrations, taste tests, or both. Highlight certain fruits, vegetables, and so forth. For example, implement a “Harvest of the Month” program where citrus fruits are highlighted, or ask staff to provide certain nutrition messages to students (eg, “Eat your mandarin orange for vitamin C!”). Collaborate. Many community organizations are eager to work with schools. Find an organization that could present a 30-minute, nutrition-related assembly for students. Create a nutrition resource library with books, videos, curricula, food models, games, and so forth that teachers can borrow. Conduct onsite training for teachers on various nutrition curricula and lessons that will meet state curricula standards. Write newsletters for teachers that provide tips on incorporating nutrition into the classroom. Be a special guest in the classroom, no matter what grade level. Work with biology and other science teachers to incorporate nutrition into their lessons. Provide nutrition curricula to physical education teachers and train them for using these materials.
336
March 2005 Volume 105 Number 3
No matter what approach is used, it is essential that schools continue to develop and implement sound nutrition policies because, as stated by Team Nutrition (7) in its policy statement, “studies show that eating habits established early in life tend to persist into adulthood.” References 1. US Department of Agriculture, Food and Nutrition Service. School Nutrition Dietary Assessment Study II: Summary of Findings. Available at: http://www.fns.usda.gov/oane/menu/ published/cnp/files/sndaIIfindsum. htm. Accessed October 28, 2004. 2. Center for Commercial-Free Public Education. Madison School Board Votes to Leave Coke Contract [press release]. Available at: http:// www . ibiblio . or / commercialfree / presscenter/pr_82900.html. Accessed November 11, 2004. 3. Fletcher E. California State Senate OK’s Soda Ban. Available at: http://www.bridges4kids.org/articles/ 6-03/SacBee5-30-03.html. Accessed November 11, 2004. 4. Making It Happen—School Nutrition Success Stories [US Department of Agriculture Web site]. Available at: http://www.fns.usda. gov/tn/Healthy/ExecSummary_ RevenueInfo.pdf. Accessed February 1, 2005. 5. National Education Association. Cuts Leave More and More Public School Children Behind. De-
6.
7.
8.
9.
cember 2003/January 2004. Available at: http://www.nea.org/esea/ storiesfromthefield.html. Accessed November 11, 2004. Position of the American Dietetic Association: Nutrition services: An essential component of comprehensive health programs. J Am Diet Assoc. 2003;103:505-514. Food and Nutrition Service. Team Nutrition Policy Statement. Available at: http://www.fns.usda.gov/ tn/Default.htm. Accessed November 4, 2004. Food Guide Pyramid. A Guide to Daily Food Choices. Washington, DC: US Department of Agriculture, Human Nutrition Information Services; 1992. Home and Garden Bulletin No. 232. Celebuski C, Farris E, Burns S. Nutrition Education in Public Elementary School Classrooms, K-5. Statistical Analysis Report—February 2000 [National Center for Education Statistics Web site]. Available at: http://nces.ed.gov/surveys/ frss/publications/2000040. Accessed November 9, 2004.