A Healthy School Environment

Tips for School

The policies of schools can play a vital role in improving children’s diets. For instance, policies that disallowed the sale of sweetened drinks (including carbonated beverages, fruit drinks, and sports drinks) in school vending machines in Boston Public Schools successfully reduced intake of such beverages in high school students.1 Similarly, increasing the availability of water and actively promoting its intake increased its consumption in younger German children.2
Not surprisingly then, schools are also important venues for intervention in Asian countries. A comprehensive program which improved the nutritional quality of foods available at school cafeterias, restricted the sale of carbonated beverages, and educated children, parents, and teachers was found to reduce waist size and improve the ability of the body to use glucose in Indian teens.3 School-based programs have helped to reduce the prevalence of obesity in Singaporean children as well.4
Some important opportunities for improvement in schools are highlighted below:
1. Nutrition education: School curriculums should have a minimum of 50 hours of nutrition education per school year as a way of a promoting improvement in eating habits.5 Nutrition education interventions that focus on specific behaviors, are tailored to students’ interests, approach problems from many different angles, and offer training to staff are more likely to be successful.6
2. Increased availability of healthy foods: Making healthy foods more accessible is associated with increased intake in children.7 School-lunch programs should serve nutrient-dense foods, such as whole grains, lean-protein sources, low-fat dairy, fruits, and vegetables, in a form that is attractive and appealing to children. Since eating breakfast is associated with maintenance of healthy body weight8 and improved academic performance,9-10 schools may explore the feasibility of also offering breakfast options. Take a look at the Harvard Healthy Eating Plate for more information on how to create healthy, balanced meals.
3. Ensure access to clean water: Schools should maintain functional water fountains and make sure clean water is available to students. When students are thirsty, teachers and administrators should encourage students to drink water and avoid soft drinks and other sugared drinks.11 Drinking sugar sweetened beverages has been linked to obesity in children,12 and water should be the default choice for drinks in schools.
4. Regulating food advertisements to children: As children and adolescents are less capable of distinguishing the difference between advertisements and factual information,13 and as advertisements can influence food choice,14 schools should regulate the type of food advertising permitted.5 For public schools, this can fall under the purview of local or central government policy.
5. Regulation of competitive foods and drinks: Other foods available at or around the school environment, such as those sold at vending machines or by local street vendors, often compete with foods available at school or packed from home. As many of these foods are high calories and low in nutrition, regulation of these foods should also be considered.5
6. Encourage healthy exercise habits: Schools should allow children opportunities to be physically active at school. Gym classes and recess are especially important chances for children to be physically active. While repetitive exercise routines may work well for adults, children need for their exercise to be varied and fun in order to feel motivated to continue.15 If children learn to enjoy exercising, they will be more likely to have healthy habits and continue exercising as they get older.
2 Muckelbauer R, Libuda L, Clausen K, Toschke AM, Reinehr T, Kersting M. Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trialPediatrics. 2009;123(4):e661-667.
4 Toh CM, Cutter J, Chew SK. School based intervention has reduced obesity in SingaporeBMJ. 2002;324(7334):427.
6 Fleischhacker S, Schure J, Contento I, et al. On behalf of the Society for Nutrition Education. State of Nutrition Education and Promotion for Children and Adolescents. Society for Nutrition Education Web site. http://www.sneb.org/documents/SNENENPreport630_Final_000.pdf. Published 2009.
7 Evans CE, Christian MS, Cleghorn CL, Greenwood DC, Cade JE. Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 yAm J Clin Nutr. 2012;96(4):889-901.
9 Adolphus K, Lawton CL, Dye L. The effects of breakfast on behavior and academic performance in children and adolescentsFront Hum Neurosci. 2013;7:425.
10 Hoyland A, Dye L, Lawton CL. A systematic review of the effect of breakfast on the cognitive performance of children and adolescentsNutr Res Rev. 2009;22(2):220-243.
11 Kids Health. Mass in Motion Web site. http://www.mass.gov/eohhs/gov/departments/dph/programs/community-health/mass-in-motion/kids-health/. Accessed February 24, 2014.
12 Ruyter JC, Katan MB, et al. A trial of sugar-free or sugar-sweetened beverages and body weight in childrenN Engl J Med. 2012;367:1397-1406.
15 U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.