Preventing Childhood Obesity in Schools

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10 Truly Effective Ways to Prevent Childhood Obesity in Schools

It's not enough to just talk about what kids eat at school if we really want to prevent overweight and obese children. More and more, experts are looking at the bigger picture, asking questions like, what kind of cafeteria setting inspires kids to eat healthfully? How can that setting help kids make good food choices? Does it matter how the food is prepared and served? A couple of recent reports say that environment matters, big-time. Here are ten terrific concepts to re-envision school lunchrooms and help prevent childhood obesity in schools.

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1. Put Vending Machines with Unhealthy Foods and Drinks Away from Where Kids Eat

This common-sense idea reminds us that what's in a child’s immediate environment makes a big difference, says Terry T-K. Huang, Ph.D., the co-author of a recent study in the journal Preventing Chronic Disease. Huang and his co-author, Dr. Matthew Trowbridge, developed a tool called the "Healthy Eating Design Guidelines for School Architecture" to promote strategies that can improve school food environments.

"Our bodies evolved to accommodate an environment in which food could be very scarce," says Huang. Couple that with recent changes that have created an abundance of readily available high-fat and high-calorie foods, and it's as hard for kids as it is for adults to pass a candy-bar-laden vending machine and not want to put coins into the machine. "It's the way we are built that is incompatible with the environment," adds Huang. "It's not useful to ask who is to blame. Everybody has a role to play in changing this dynamic."

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2. Plant a School Garden

Ever since this idea was championed by First Lady Michelle Obama, it's caught on around the country. School-building design hasn't changed much in a long time, but the obesity epidemic is so big—and we hear so much about it—that it's not surprising more people are rethinking what can be done right on school grounds without actually building something new, experts say.

In recent years, urban planners have focused on ending the obesity epidemic by constructing buildings that promote physical activity, such as putting stairs in prominent places to encourage walking instead of taking an elevator. Changes to the environment that promote healthy living in schools is only now getting that kind of attention, says Huang. It helps to have the school garden close to the kitchen in order to highlight the connection between locally-grown foods and how those foods are prepared for meals. Schools can extend the garden idea by using edible plants for landscaping, such as herbs.

"I think it's safe to say that we really believe environment does have a role to play in obesity prevention," he says. "Obesity is about the interaction between people and their environment."

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3. Make Fruits and Veggies Easy to Grab

A recent study in The Journal of Pediatrics looked at easy, inexpensive ways to change school cafeterias in schools serving grades 7 to 12. Researchers found that simply making fruits and vegetables more attractive can help. Placing fresh fruit in a nice bowl or in tiered stands next to the cash register were effective, as was asking the cafeteria staff to say simple things to students, like "Would you like to try an apple?"

In the study, making over a school cafeteria to make it "smart" (i.e., healthier) took no more than three hours and cost less than $50. In comparing the lunchroom before and after the makeover, the researchers found that students were 13 percent more likely to take fruits and 23 percent more likely to take vegetables than before.

"Not every school has to incorporate every design element," of a smart cafeteria, Huang says. "For schools not slated for renovation, they can adopt some design features—simple things like where you place your fruit, in a nice bowl next to the cashier at checkout, that don't really cost anything."

While this makeover was aimed at influencing students' behavior, actual policies can help too. Another recent study, this one in the American Journal of Preventive Medicine, found that kids living in states that required schools to offer fruits and vegetables as part of the meal program consumed more fruits and vegetables than those living in states with no such policies.

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4. Get Rid of Self-Serve Cases that Compete with Healthy Foods

Schools have relied on vending machines, self-help coolers (for foods like ice cream), and even pizza delivery to get school meals to kids as fast as possible at as low cost as possible. But let's face it: fast typically doesn't mean healthy. It's time for schools to think less about convenience and more about health.

Schools should abandon deep-fat fryers and spend funds on purchasing large refrigerators, steamers, and tilt skillets that allow for easy cooking of fresh foods, and even canning equipment that allows for the processing and preserving of fresh foods (such as those grown in the school garden).

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5. Show Kids How Fresh Food is Prepared

Schools can take the mystery out of the kitchen by opening up the kitchen prep area and giving it a wide view onto the area where kids sit to eat lunch. Huang and Trowbridge go so far as to suggest an outdoor kitchen and school garden that are grouped in the vicinity of the cafeteria. Teachers could use these areas, too, including the commercial kitchen, for lessons.

"A big phenomenon is to think about the entire school as a teaching tool," Trowbridge says. "How does the school use water or how does the air conditioner work? The cafeteria kitchen is this hidden space...By opening the view between the two you engage all food staff as educators. You increase transparency. Children can see where food is prepared. They can see the people making their food."

And, Huang adds, "There is solid evidence that children learn by doing, and when people participate actively, they take ownership of what they are doing. It makes sense to create a space like this because it will help promote a culture of change."

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6. Offer Express-Checkout Lanes for Students Who Choose Healthy Foods

Having enough time to eat is a common problem that too often gets ignored. Many high-school students in urban areas head off-campus for lunch because the cafeteria lines are so long that by the time they sit down, there's no time left to eat. Under the Healthy Eating Design Guidelines, kids should be able to eat in a calm, peaceful setting with enough time to enjoy the meal. And if they choose foods without extra sugar or salt, they can be rewarded with a quicker trip through the checkout line, leaving them more time to eat lunch. "Kids need a social pleasant environment with enough time to eat," Huang says.

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7. Put Water Everywhere

This is a simple but powerful change: Make water the default choice for students' beverages. That means prominently placed vending machines that dispense only water, access to potable water and cups in the dining area and outdoor dining spaces, and putting drinking fountains in outdoor spaces. "There has been [some] evidence that by making water more accessible in schools it actually impacts obesity prevention," Huang says.

"It's about strategy," Trowbridge adds. "Designate how you place water fountains in places in schools so that it's the default space. And if you need vending machines, put them in a less visible place that is harder to find. You still provide them, but it's harder to use. Make the water fountains beautiful, right in front of your face, and easy to use."

In the era of obesity, water fountains are due for a major redesign, Huang and Trowbridge says. For one thing, fountains should be designed so that people can easily refill a recyclable water bottle.

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8. Put Refrigerators in Classrooms

Many parents would like to send their children to school with a healthy lunch prepared at home but need to make sure the food is still safe to eat by lunchtime. Having even mini refrigerators in each classroom could help persuade more parents and kids to bring a lunch of fresh fruit and a turkey sandwich from home.

Classrooms should also have potable water and cups, the experts say. Simple conveniences like these could keep kids from turning to less-healthy alternatives, such as the soda vending machines or the fast-food restaurant across the street. "You have someone telling you to eat healthy, but then you have these fast-food restaurants enticing you to eat unhealthy," Huang says.

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9. Design Food Spaces the Whole Community Can Use

Schools are only in operation for part of the day, and usually only on weekdays. Why not design food spaces that are flexible for multiple uses by the school, organizations that work with the school (like sports teams), and the larger community? The school could permit a community garden for local use, for example, or farmers markets could be held on school grounds.

Schools could also consider having an outdoor solar kitchen or an open-fire cooking pit—the possibilities are endless for communities wanting to embrace healthier living.

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10. Make Nutritional Information Easy to Find

Not only should a menu of food choices be visible to students, faculty, and visiting parents, but seasonal fresh foods and nutritional information should be easy to see and read—especially at the points where kids are choosing which foods to eat. Schools should also prohibit competitive food marketing campaign signage such as the chocolate "Got Milk?" campaign posters.

" 'What do calories mean?' A good source of learning [for students] is in the cafeteria," Huang says. "That is something easy that all schools could do."