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healthy eating and physical activity have been associated with increased life expectancy, increased quality of life, and reduced risk for many chronic diseases (9,14--16). bethesda, md: national asthma education and prevention program; national heart, lung, and blood institute; 2005. position of the american dietetic association: individual-, family-, school-, and community-based interventions for pediatric overweight. health services staff members, in partnership with medical providers and families, play a key role in developing and coordinating the implementation of individualized health plans established for students with chronic health conditions (509,533,534,536,537) and encouraging them to participate fully in structured and unstructured physical activity, regardless of ability, unless medically contraindicated. each of the nine guidelines is accompanied by a series of strategies for schools to implement. maintenance of the classroom health education curricula: results from the catch-on study. for reports describing evaluation studies, cdc scientists identified and documented the sample size, demographic makeup of study participants, duration of study, method of group assignment (e. schools should develop and adopt policies that require certified physical education teachers, rather than teachers who are certified to teach other subject areas, to teach physical education in grades k--12 to ensure that students receive quality instruction. quality health education assessment protocols include criteria for examining student work (such as a rubric) and incorporate multiple measures over time (453,460,461). school health, mental health, and social services staff members should collaborate with community health-care providers to increase student access to care, coordinate care, and promote evidence-based physical activity and healthy eating initiatives (215). growing up in the playground: the social development of children. schools that provide meals that meet these recommendations will receive an additional

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increasing access to places for physical activity through a joint use agreement: a case study in urban honolulu. encourage increased participation in school meal programs by all students, schools can use the following strategies:Offer breakfast to all students at no cost to increase overall participation in the school breakfast program (315). and implement strategies for motivating families to participate in school-based programs and activities that promote healthy eating and physical activity. school breakfast program and national school lunch program play major roles in the diets of children and adolescents in the united states. although diet and physical activity can help control blood glucose levels and reduce complications from both types of diabetes, type 1 diabetes is an autoimmune disease of the pancreas, and little is known about prevention (29).. promising practice in chronic disease prevention: a public health framework for action. physical environment can be both a benefit and a barrier to being physically active. behaviors and attitudes among children and adolescents are related to healthy eating. frozen fruits or canned fruits packed in juice instead of canned fruits packed in syrup.., unions), teachers, teacher aides, custodians and maintenance staff members, bus drivers, technology staff members, secretaries, and school nutrition employees;. a short-term longitudinal study of children's playground games across the first year of school: implications for social competence and adjustment to school. health benefits of a pedometer-based physical activity intervention in sedentary workers..) in addition, the task force on community preventive services reviewed 13 studies that focused on improving physical education through policy, curriculum, and instructional changes. people 2020 objectives for healthy eating and physical activity among children and adolescents. overweight children and adolescents: a risk group for iron deficiency. blacks and hispanics have the highest prevalence of undernutrition (60), and food insecurity and hunger might be associated with lower dietary quality and undernutrition in children and adolescents, especially in adolescents (61). however, almost all persons in the united states consume more than the recommended amount of sodium. in 2002, the joint committee on health education terminology defined health education as ''the development, delivery, and evaluation of planned, sequential, and developmentally appropriate instruction, learning experiences, and other activities designed to protect, promote, and enhance the health literacy, attitudes, skills, and well-being of students, prekindergarten through grade 12" (454). meal programs are stigmatized when low-income students can receive free or reduced-price meals but only higher-income students can purchase competitive foods and beverages. schools that communicate with families and community members about healthy eating and physical activity initiatives create a greater understanding of school activities, which might increase support and participation in school policies and practices from students and their families (188,557). a laboratory and field testing analysis of a preventive intervention. physical surroundings and psychosocial climate of a school should encourage all students to make healthy eating choices and be physically active. instructional strategies in physical education that enhance students' behavioral skills, confidence in their abilities, and desire to adopt and maintain a physically active lifestyle. for example, they can adopt and enforce a universal bullying prevention program that addresses weight discrimination and teasing (215,282,283), ensure that students of all sizes are encouraged to participate in a wide variety of physical activities (279), display posters or other visual materials that feature a diverse combination of students being active and eating healthy, and avoid practices that single out students on the basis of body size or shape (283). analyzing workers' compensation claims might identify needs for improved worksite safety programs that include physical activity. assessment also enables staff members to identify students in need of counseling and referral services. among females aged 12--19 years, the prevalence of iron deficiency is 9% (74). joint use agreement 3: opening school facilities for use during non-school hours and authorizing third parties to operate programs. viewing, nonactive computer use, and nonactive video and dvd viewing are all considered sedentary behaviors. hunger in children in the united states: potential behavioral and emotional correlates. report card on school snack food policies among the united states' largest school districts in 2004--2005: room for improvement. a student with disabilities participates in the general physical education class, works with a teaching assistant in a general physical education class, participates in a separate class with teaching assistants, or receives one-on-one instruction, appropriate modifications should be in place. and implement strategies for motivating families to participate in school-based programs and activities that promote healthy eating and physical activity. television, video, and computer game usage in children under 11 years of age. development can enhance teachers' instructional strategies for increasing student physical activity during physical education classes and can enable teachers to develop lesson plans that emphasize student skill development and improve students' enjoyment of being physically active (383,644,663,664). the most commonly available competitive foods are high in sugar, fat, and calories, including high-fat salty snacks, high-fat baked goods, and high-calorie sugar-sweetened beverages, such as soft drinks, sports drinks, and fruit drinks (105,344,346). growth during adolescence is particularly crucial for achieving optimal bone health because bone mass peaks in late adolescence (56,57). events that engage the community in physical activity, such as runs, walks, and bicycle rides, also can be used to raise money. gimme 5: an innovative, school-based nutrition intervention for high school students. community resources can address health, mental health, and social service gaps that the school might not have the resources or expertise to address adequately. that physical education and other physical activity programs meet the needs and interests of all students. foods, which are any foods or beverages sold or served outside of the school meal program, are the principal source of the low-nutrient, energy-dense foods that students consume at school. will enforce the policy and how they will do so;. school-based interventions improve heart health in children with multiple cardiovascular disease risk factors. a comprehensive cdc literature review that included 50 studies synthesized the scientific literature on the association between school-based physical activity, including physical education, and academic performance, including indicators of cognitive skills and attitudes, academic behaviors (e. on behalf of students to create a healthy, safe, and supportive school environment that allows students to make healthy dietary and physical activity choices both in and out of school. nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children. employee wellness programs for healthy eating and physical activity could include the following components: information and educational activities (e. of human resources, employee assistance programs, workers' compensation, benefits, and facilities;. more research could contribute to the strength of these recommendations. a qualitative study of junior high school principals' and school food service directors' experiences with the texas school nutrition policy. as a result of participation in a k--12 health education curriculum that includes physical activity, students should have the knowledge and skills to be able to do the following (147,462):Engage in moderate to vigorous physical activity for at least 60 minutes every day. any social stigma attached to, and prevent the overt identification of, students who are eligible for free and reduced-price school meals (317). children's self-efficacy, motivational intentions, and attributions in physical education and sport.., after school programs and parks and recreation programs) offer additional opportunities to reinforce health promotion messages taught in schools and can engage students in healthy eating and physical activity (606). based on research and consensus among physical education experts, the national standards provide the framework for identifying student performance expectations for each grade level. key stakeholders in district- and school-level policy processes include students, families, school nutrition service staff, physical education teachers, health education teachers, school nurses, school principals and other administrators, staff from local health departments, health-care providers, and staff from local community organizations and businesses. this trend continues through adulthood, with females remaining less physically active than males (119). children and adolescents from low-income households are less likely to eat whole grain foods (93). participation in recess is associated with academic benefits, such as improving attentiveness, concentration, behavior, and time-on-task in the classroom (280,281,420,426--429). 2006, 78% of all states and 91% of all districts provided funding for staff development or offered professional development for physical education teachers on at least one physical education topic (e. participation in physical activity among children and adolescents is related to demographic, personal, social, and environmental factors. pw, beveridge sk, eisenman pa, watson dl, shultz bb, ransdell lb. will increase state, territorial, tribal, and local education and health agency awareness of these guidelines through training sessions, conference presentations, webinars, listservs, and other methods. school staff members' and occupational health nurses' evaluation of the promotion of occupational well-being---with good planning to better practice. however, children and adolescents report disordered eating behaviors that are clinically severe but do not meet full criteria for an eating disorder. ongovernment taskelected governmentblunt beniciobenicio thebrolin benicioand beniciomovie beniciowatch sicarioreview sicarioforwardsicario (2015) denis villeneuvesee moremovies waitingon2017films moviegenre filmspure moviesnet moviewatch filmsdrama moviesfilms seriesmovie stillsforwardthe shacksee morepassengers (2016)passengers openspassengers movie 2016flicks moviesmovies movies moviesmovies to watchmovies seriesyears early90 yearsawakened 90forwardpassengers (2016) postersee moredressmaker katedressmaker googlethe dressmaker moviedressmaker onlinedressmaker clothingdressmaker trailermovies trishafavourite movieskatewinslet thedressmakerforwardafficher l'image d'originesee morewomen’s fashionweddingstraveltechnologytattoosquotesphotographyoutdoorsmen’s fashionkids and parentinghome decorhealth and fitnesshair and beautygardeningfood and drinkeducationdiy and craftsdesignartarchitecturepicked for yousign uplog inpinterestsearchlog in with googleprivacy. education curricula should reinforce the information taught in physical education classes and provide opportunities for students to apply physical activity knowledge and skills. in addition, as described in guideline 2, schools should use constructive classroom rewards that support student health and do not include food. school health personnel should establish systematic processes and criteria for referring students to external primary health-care providers (215). o'toole, phd, howell wechsler, edd, cdc, atlanta, georgia; mara galic, mhsc, columbus technologies, atlanta, georgia; michael w. reducing children's television viewing to prevent obesity: a randomized controlled trial. morejon lucaslucas scottl'wren scottoverdue freedomconventional responsibilitiesresponsibilities goingmoms posterappreciated momskunis kristenforwardbad momssee morelovingmoney monster (2016)monster fullmonster 2016monster tremonster januarylee gatesmonster onlinewatch moneymovie moneyfilm moneyforwardmoney monster (2016)- george clooney, julia roberts, jack o'connell, catriona balfesee moreclooney mattgeorge clooneyclooney jeanclooney 2014sexy clooneywar moviesmovies postermovies tvmovies watchedforward"the monuments men" - george clooneysee morefrom premiere.., administering or using fitness tests, student assessment, chronic health conditions, and injury prevention) during the 2 years before the study (144). schools should adhere to the naspe recommendations that students engage in moderate to vigorous physical activity for at least 50% of the time they spend in physical education class, one of the most critical outcome measures in determining the quality of a physical education program (398--400). studies indicate that the overall energy intake among children (aged 2--5 and 6--11 years) remained relatively stable from 1971 to the late 1990s and 2000 (84,89,90). increasing children's physical activity levels during recess periods in elementary schools: the effects of providing game equipment. administrative support should come from the district superintendent, the principal, and other decision-makers, such as managers or counselors from employee assistance programs, human resource officers, and chief financial officers who oversee annual budgets for school districts. in children and adolescents is associated with numerous immediate health risks, including high blood pressure, high blood cholesterol levels, type 2 diabetes, metabolic syndrome, sleep disturbances, orthopedic problems, and social and psychological problems, such as discrimination and poor self-esteem (7,35,45). healthy, hunger-free kids act of 2010 (207) updated requirements for local school wellness policy to include, at a minimum,Goals for nutrition promotion and education, physical activity, and other school-based activities that promote student wellness;. fourteen percent of these middle schools and 20% of these high schools allowed students to be exempted from physical education for participation in school activities other than sports such as band or chorus (144). in addition, participation in sports programs has been associated with improved mental health and fewer risky health behaviors (440,441). counseling can begin with motivational interviewing, a nonjudgmental, empathetic, and encouraging approach that allows students to express positive or negative feelings toward healthy eating and physical activity and identify their own reasons and plans for improvement. education, health education, and other teachers; school nutrition service staff members; school counselors; school nurses and other health, mental health, and social services staff members; community health-care providers; school administrators; student and parent groups; and community organizations should work together to maximize healthy eating and physical activity opportunities for students (box 1). worksite health promotion programs with environmental changes: a systematic review. like other athletic coaches, volunteer coaches should receive professional development on how to provide experiences for students that emphasize enjoyment, participation, skill development, building confidence, and self-knowledge and also promote healthy behaviors (e. database of food and nutrition software and multimedia programs [database]. this type of event might include skill-building workshops for families on preparing healthy meals or physical activity stations to participate in active games (564,572,574,577). a comprehensive program includes before, during, and after-school physical activity through recess and other physical activity breaks, intramurals and physical activity clubs, interscholastic sports, walk- and bicycle-to-school initiatives, and quality physical education (376,377). in 2002, 62% of children and adolescents aged 9--13 years did not participate in any organized physical activity during nonschool hours, and 23% did not engage in any free-time physical activity (109). marketing techniques can be used to promote healthy foods and beverages among students. parental correlates of physical activity in children and early adolescents. schools can work with families and community members to design needs assessments to gather information on the types of communication that families and community members would like to receive and identify resources offered within the community (588). school environment should support students with disabilities and chronic health conditions in being physically active and making healthy eating choices. when making substitutions or reductions in ingredients, schools should standardize the recipe to account for the changes in yield and meal pattern requirements. input from the individual experts on the nine guidelines and corresponding strategies and actions were reviewed and integrated into the guidelines. therefore, helping students stay healthy is a fundamental part of the mission of schools (177--180). the catch kids club: a pilot after-school study for improving elementary students' nutrition and physical activity. the ultimate goal is to implement all guidelines recommended in this report, not every guideline and its corresponding strategies will be feasible for every school to implement. yrbss data are used to 1) measure progress toward achieving national health objectives for healthy people 2020 and other program and policy indicators, 2) assess trends in priority health-risk behaviors among adolescents and young adults, and 3) evaluate the effect of broad school and community interventions at the national, state, and local levels. in 2006, 4% of elementary schools, 8% of middle schools, and 2% of high schools provided daily physical education for the entire school year for students in all grades in the school (144). administrative support for and staff involvement in school employee wellness.., 1,300 mg/day), yet most children and adolescents do not drink the recommended amounts (3). in process evaluation, educators collect and analyze data to determine who, what, when, where, and how much of program activities have been conducted. naspe has established and recommends the national standards for beginning physical education teachers, which outlines the areas in which a highly qualified physical education teacher entering the school system should have expertise, including content knowledge, child and adolescent growth and development, diversity in learning, classroom management and student motivation, communication, planning and instruction, student assessment, reflection, use of technology, and collaboration (647). in the 2004--2005 school year, boys participated in the school breakfast program at a higher rate than girls, non-hispanic black students participated at a higher rate than hispanic students and non-hispanic white students, elementary school students participated at a higher rate than middle and high school students, students who were eligible for free and reduced-price meals participated at a higher rate than students who were not income eligible, students who spoke spanish in the home participated at a higher rate than students who spoke english, and rural students participated at a higher rate than urban students (314). some schools offer physical activity in the classroom as part of planned lessons that teach mathematics, language arts, and other academic subjects through movement. nutrition and education: a randomized trial of the effects of breakfast in rural primary school children. a lifestyle intervention improves plasma insulin levels among native american high school youth. the professional development topics that physical education teachers most reported wanting were teaching methods to promote inclusion and active participation of overweight children, chronic health conditions, using physical activity monitoring devices, helping students develop individualized physical activity plans, and encouraging family involvement in physical activity (144). often, students who have disabilities or chronic health conditions are discouraged from participating in physical education class and other forms of physical activity. providing students with choices during physical education class might increase students' confidence in their ability to participate in physical activity in general (414--416). an environmental intervention to promote lower-fat food choices in secondary schools: outcomes of the tacos study. a comprehensive school employee wellness program includes goals, objectives, and activities for promoting healthy eating and physical activity. school nutrition services should serve healthy food in an environment that allows students to pay attention to what they are eating and enjoy social aspects of dining (215,220--223). diet and lifestyle recommendations revision 2006: a scientific statement from the american heart association nutrition committee. taste testing provides students an opportunity to inform staff members which healthy food and beverage products they like and dislike (268). many states and districts required newly hired staff members to be certified, licensed, or endorsed by the state to teach physical education. an evaluation of client satisfaction with training programs and technical assistance provided by florida's coordinated school health program office. professional development should help physical education teachers provide instruction that meets the interests and skill levels of all students. energy and fat intakes of children and adolescents in the united states: data from the national health and nutrition examination surveys. the findings in this report will help cdc prioritize interventions for school health policies and practices and to identify and develop tools that will assist schools with implementing various components of the guidelines. engage in physical activities that enhance cardiorespiratory endurance, flexibility, muscle endurance, and muscle strength. promotions to increase lower-fat food choices among students in secondary schools: description of outcomes of tacos (trying alternative cafeteria options in schools). weight status in persons aged 2--19 years is determined by comparing their bmi to other persons of the same sex and age in a reference population. agencies can use these guidelines to establish professional development materials, programs, and resources for partners and constituents. position of the american dietetic association: child and adolescent food and nutrition programs. pilot implementation of sb 19 in california middle and high schools: report on accomplishments, impact, and lessons learned. in 2006, 94% of all states offered some type of certification, licensure, or endorsement to teach health education (455).., fruits, vegetables, 100% fruit juice, and low-fat or fat-free dairy products) or selling nonfood items such as wrapping paper, candles, or student artwork can support student health. dietary and physical activity behaviors of children and adolescents are influenced by many sectors of society, including families, communities, schools, child care settings, health-care providers, faith-based institutions, government agencies, the media, and the food and beverage industries and entertainment industry. yrbss includes a national, school-based survey conducted by cdc and state, territorial, tribal, and district surveys conducted by state, territorial, and local education and health agencies and tribal governments. if students participate in daily physical education, they might not always be adequately active during class. quality professional development should be provided for leaders of out-of-school--time programs to assist them in educating children and adolescents on the importance of making sound decisions about healthy eating and physical activity (678). these systems provide information about the degree to which students are participating in healthy behaviors and schools are developing and implementing the policies and practices recommended in the guidelines. the importance of school health and safety policies and activities within the school, as well as to parents and the community. en streaming vf gratuit et complet, regardez vos films préférés sans limitation de temps, streaming vf, streaming mobile, filmze streaming, streaming vk, film streaming ,vf film streaming ,telecharger film dvdrip gratuit , film streaming gratuit459747021707a93b1dc6a677b78801e6. other ideas include serving foods such as salsas for fresh flavor and less fat; making reductions and substitutions, such as reducing salt and using low-fat mayonnaise and salad dressings; and preparing foods in different ways, such as baking rather than frying french fries or serving baked potatoes instead (322,323)., mental health, and social services staff members serve as liaisons between school staff members, students, families, community programs, and health-care providers (515). recess allows children to apply skills learned in physical education (e. long-term effects of a physical education curriculum and staff development program: spark. report describes school health guidelines for promoting healthy eating and physical activity, including coordination of school policies and practices; supportive environments; school nutrition services; physical education and physical activity programs; health education; health, mental health, and social services; family and community involvement; school employee wellness; and professional development for school staff members. the power of partnerships: school, family, and community collaborations to improve children's health. 5-a-day power plus: process evaluation of a multicomponent elementary school program to increase fruit and vegetable consumption. these services include school-linked health clinics, local health departments, universities, medical schools, outside health-care providers (e. for example, cafeteria taste tests offer students an opportunity to taste the healthier options offered in the cafeteria (355,367).., data about the eating and physical activity habits of students) and concise information about the policy. after the review, the task force strongly recommended enhanced school-based physical education as an intervention strategy to increase youth physical activity (378). university, ms: university of mississippi, national food service management institute; 2009. the role of peer social network factors and physical activity in adolescent girls. recommendations for treatment of child and adolescent overweight and obesity.. children and adolescents: data from the 1994--1996 continuing survey of food intakes by individuals. the national staff development council has developed and recommends the use of standards for professional development that include context standards (e. adolescents who do not achieve optimal bone mass during this period will lack the adequate support to sustain normal losses of bone mass later in life. marketing food to children and adolescents: a review of industry expenditures, activities, and self regulation. for example, students classified as obese or overweight after bmi screening require further medical examination to determine whether the student in fact has excess body fat or other conditions related to obesity (e. increasing the number of schools that require health education and teach ways to prevent important health problems, such as those resulting from poor dietary behaviors and lack of physical activity, are national health objectives (objective emc 4) (10). if feasible, arrangements can be made to bring community-based services to the school. furthermore, the cdc staff members identified enough scientific evidence to support the inclusion of two additional guidelines: 1) using a coordinated approach for nutrition and physical activity policies and practices and 2) professional development for school staff members.., concentration, attentiveness, and time on task), and academic achievement (e. because of resource limitations, some schools might need to implement the guidelines incrementally. are in a unique position to promote healthy dietary behaviors and help ensure appropriate food and nutrient intake among their students. y, kafatos a, preventive medicine and nutrition clinic university of create research team.., comprehensive health education, physical education, and health services: mental health and social services, school nutrition services, healthy and safe school environment, school employee wellness, and family and community involvement) (188). dental caries and childhood obesity: roles of diet and socioeconomic status.., enjoyment of pleasant conversation, good table manners, and responsible student behavior), and maintain safe, orderly, and pleasant eating environments. emphasizing the benefits of healthy eating and regular physical activity and encouraging students to be role models for their peers are ways to reinforce these behaviors (215,498,524). trends in food and nutrient intakes by adolescents in the united states. because every guideline might not be appropriate or feasible for every school to implement, individual schools should determine which guidelines have the highest priority based on the needs of the school and available resources. requirement that the local education agency inform and update the public on local school wellness policy content and implementation;. therefore, the recommendation is for schools to identify which guidelines are feasible to implement, based on the top health needs and priorities of the school and available resources. discrepancies among coders were resolved through group discussion and consensus. planned progression of developmentally and culturally appropriate lessons or learning experiences that lead to achieving these objectives;. targeting parents exclusively in the treatment of childhood obesity: long-term results. that schools have kitchen facilities and equipment needed to cook quality, appealing meals. the los angeles lift off: a sociocultural environmental change intervention to integrate physical activity into the workplace. nationwide in 2006, 27% of states offered certification, licensure, or endorsement for district nutrition services directors, and 22% of states offered this to school nutrition services managers. ovens, instead of deep-fat fryers, are needed to bake fries, but not all schools have such equipment and need financial support to purchase these types of items (190,325,326). a chronic health condition is defined as any illness, disease, disorder, or disability of long duration or frequent recurrence, including asthma, diabetes, serious allergies, epilepsy, and obesity (287). the policy should cover all venues where foods and beverages are available, during the regular and extended school day, and all families and staff members should be informed of the policy (215). examples might include biology lessons on energy balance (458) and the physics of body movement, math lessons on nutrient analysis, family and consumer science courses on cooking skills, and language arts lessons analyzing food advertisements (459). total of 6,213 abstracts were screened to identify full scientific reports to be retrieved.., whether student is physically active for ≥60 minutes per day through free play, time spent outside, physical education, and involvement in organized activities such as school or community recreation programs). access to sugar-sweetened beverages and low-nutrient, energy-dense foods at school significantly increases student calorie intake from sugar-sweetened beverages per school day. the school-linked health center: a promising model of community-based care for adolescents. obesity, shame, and depression in school-aged children: a population-based study. analyzing reasons for absenteeism and health insurance claims can assist in identifying health conditions that could be addressed through school employee wellness programs (625). television viewing habits associated with obesity risk factors: a survey of melbourne schoolchildren. a 2001 report to congress, usda highlighted four major concerns about competitive foods (351):Many competitive foods and beverages are low in nutrient density and high in fat, sugar, and calories; these products can negatively affect student diets and increase the risk for excess weight gain (352,353).., tracking activity levels over time), self-management, goal-setting, and decision-making might help students establish and maintain regular involvement in physical activity (380,384,387,411,412). that physical education and other physical activity programs meet the needs and interests of all students. outcome evaluation can require a great deal of time, money, and expertise, and individual schools are unlikely to be able to conduct outcome evaluations on their own. development for health education is associated with successful implementation of the classroom curriculum (217) and contributes to the implementation of innovative health education methods and techniques (669). education teachers, health education teachers, and nutrition services staff members should receive regular professional development to improve their knowledge, skills, and competencies and be current on the most effective and innovative teaching and programmatic strategies.. department of agriculture (usda), in conjunction with the cdc director, "prepare a report on the implementation, strength, and effectiveness of the local school wellness policies" (207). strategies to determine whether students have achieved the desired learning objectives. students, regardless of sex, race/ethnicity, health status, or physical or cognitive ability or disability, should have access to physical education and other physical activity programs. growing body of research focuses on the association between school-based physical activity, including physical education, and academic performance among school-aged children and adolescents. the surgeon general's call to action to prevent and decrease overweight and obesity.. that meals meet students' cultural preferences; for example, encourage students and parents to participate in planning meals and incorporating cultural and regional preferences. school garden programs have the potential to strengthen the healthy development of students through improved knowledge about fruits and vegetables (228,231,235), increased preference for fruits and vegetables (228,231,235), and increased consumption of fruits and vegetables (230,231,235,236). classification of body fatness by body mass index-for-age categories among children. among females, the lifetime prevalence of anorexia nervosa is approximately 0. they identify what should be done, why it should be done, and who is responsible for doing it. the health of students is strongly linked to their academic success, and the academic success of students is strongly linked with their health. in 2006, approximately 43% of school districts provided funding for or offered professional development for health services staff members to provide nutrition and dietary behavior counseling; and 41% of districts provided funding for or offered professional development for physical activity and fitness counseling during the 2 years before the study (510). competencies, knowledge, and skill statements for district school nutrition directors/supervisors. boning up on osteoporosis: a guide to prevention and treatment. the pro children intervention: applying the intervention mapping protocol to develop a school-based fruit and vegetable promotion programme. that injuries, including concussions, are healed before allowing further participation; and. intramural physical activities should provide opportunities for both males and females; meet the needs of students at all levels of skills and physical abilities, particularly those who are not athletically gifted; and reflect student interest (246). pain from untreated caries can affect school attendance, eating, speaking, and subsequent growth and development (80). the relations of school staff smokers' attitudes about modeling smoking behavior in students and their receptivity to no-smoking policy. united states cancer statistics: 1999--2007 incidence and mortality web-based report. list of referral services should be based on the health needs of the student population, barriers to health care in the community, past student use of community services, and current community culture. schools also might consider conducting confidential health screenings for conditions such as high cholesterol or high blood pressure, as well as assessments of employees' eating and physical activity behaviors (625). disciplining students for unacceptable behavior or academic performance by not allowing them to participate in recess or physical education prevents students from 1) accumulating valuable free-time physical activity and 2) learning essential physical activity knowledge and skills., mental health, and social services staff members can advocate for schools to develop strong policies and practices that help students achieve healthy eating and physical activity recommendations (515,520,552--554). this deficiency can increase fatigue, shorten attention span, decrease work capacity, impair psychomotor development, affect physical activity, and reduce resistance to infection (70,71). these state laws and policies vary in strength and breadth when compared with the iom nutrition standards for foods in school (238,343).., health and wellness facilities such as ymcas) might increase the availability and quality of intramural programs, as well as the time students spend being active (118,328). access to healthy foods and physical activity opportunities and to safe spaces, facilities, and equipment for healthy eating and physical activity. understanding evaluation: the way to better prevention programs describes evaluation activities that school districts and community agencies can use to assess various programs (214). physical food environment in the community, including the presence of fast-food restaurants, grocery stores, schools, and convenience stores, influences access to and availability of foods and beverages (98). youth perceptions and parent reports of support for physical activity are strongly associated with participation in both structured and nonstructured physical activity among children and adolescents (112,122,133--135). department of health and human services, us department of agriculture. advocacy efforts should promote a safe and supportive environment for all students, regardless of athletic ability, weight status, special needs, or chronic health condition (515). the effects of the child and adolescent trial for cardiovascular health upon psychosocial determinants of diet and physical activity behavior. appropriate strategies for adolescents include skill development (such as learning a dance or preparing a certain fruit), self-monitoring (such as a diary of physically active and sedentary behaviors or tracking fruit and vegetable consumption), and promotion of regular physical activity and healthy eating (498). tracking of body mass index in children in relation to overweight in adulthood. the framework is coordinated by a multidisciplinary team such as a school health council and is accountable to the school and community for program quality and effectiveness (182). lytle, phd, university of minnesota, minneapolis, minnesota; mary mckenna, phd, university of new brunswick, fredericton, new brunswick, canada; russell r.. adults in 2004 (53) and 9% of adolescents in 2010 had metabolic syndrome (54), with hispanic males having the highest prevalence among adolescents (54). the recommendation for persons aged 5--18 years is 21/2--61/2 cups of fruits and vegetables each day, depending on age and calorie requirements (5). performance-based assessments are designed to measure a student's knowledge, ability, skill, and attitude consistently, emphasizing methods other than standardized achievement tests, particularly those using multiple-choice formats (453,465,468,469). all staff members should be aware of early signs and symptoms of mental health problems that might become evident during physical activity, dietary, and weight assessments (519). the guidelines also recommend that children aged 4--8 years drink 2 cups of fat-free or low-fat milk or equivalent milk products per day and persons aged 9--18 years drink 3 cups per day (i. school-gardens: an experiential learning approach for a nutrition education program to increase fruit and vegetable consumption among second-grade students. staff members who provide counseling should have the appropriate training necessary to counsel students about eating healthfully and being active (520). a school employee wellness committee, and identify a leader for the committee. health-related quality of life of severely obese children and adolescents. schoolwide food practices are associated with body mass index in middle school students. a community intervention reduces bmi z-score in children: shape up somerville first year results. schools might consider providing transportation to and offering child care during events (558). learn about these behaviors through enjoyable, participatory activities rather than through lectures (230,488--490);. health education curricula should be developmentally appropriate and address physical, mental, emotional, and social dimensions of health to improve health knowledge, attitudes, skills, and behaviors (452,453) (box 5). as a general recommendation, all protective equipment should 1) be in good condition; 2) be inspected and maintained frequently; 3) be replaced if worn, damaged, or outdated; 4) provide a good fit for the athlete; and 5) be appropriate for the sport and position. department of agriculture, us department of health and human services. the coordinated school health approach was used to organize the literature search results for school-based nutrition and physical activity as they related to a healthy and safe school environment; nutrition services; physical education and school-based physical activity; health education; health services and counseling, psychological and social services; family and community involvement; and health promotion for staff members. billion was spent promoting foods, beverages, and fast-food restaurants to children (108). walking and bicycling to school has become less common among school-aged children and adolescents.., no whistles and no orders to eat in silence [silent lunch]); and. garden-enhanced nutrition curriculum improves fourth-grade school children's knowledge of nutrition and preferences for some vegetables. accountability by identifying who is responsible for healthy eating and physical activity programs and policies; and. techniques include the following (5,105,332):Use cooked dry beans, canned beans, soybeans, or other meat extenders instead of meat. a systematic approach to develop, implement, and monitor healthy eating and physical activity policies. this difference also is evident during childhood and continues through adulthood, with non-hispanic white adults having the highest prevalence of activity compared with other ethnic groups (111). because many foods and beverages with added sugar tend to contain few or no essential nutrients or dietary fiber, the guidelines advise that one way to reduce intake of added sugar is to replace sweetened foods and beverages with those that are free of or low in added sugars (5). many state boards of education, state departments of education, and local school boards have adopted their own state or local health education standards using the national health education standards as a guide. health and nutrition education in primary schools in crete: 10 years follow-up of serum lipids, physical activity and macronutrient intake. the power of choice: helping youth make healthy eating and fitness decisions. impact of a universally-free, in-classroom school breakfast program on achievement: results from the abell foundation's baltimore breakfast challenge program. school-based research and initiatives: fruit and vegetable environment, policy, and pricing workshop. usda provides guidance on accommodating children with special dietary needs, supported by the usda nondiscrimination regulation (285), allowing for substitutions or modifications in the national school meals program for children whose disabilities restrict their diet as certified by a licensed physician (286). school health, mental health, and social services staff members can. active healthy living: prevention of childhood obesity through increased physical activity. soft drink availability, contracts, and revenues in american secondary schools. a total of 15% of students in grades 9--12 drank three or more glasses of milk per day in 2009 (5,78). linkages between the school's health-related programs and services and health-related resources in the community (189,196,197);. eating disorders can cause severe complications, and mortality rates for these disorders are among the highest for any psychiatric disorder (79). as a result of participation in a k--12 health education curriculum that includes nutrition, students should have the knowledge and skills to do the following (199,200,462,483):Eat a variety of whole grain products, fruits and vegetables, and nonfat or low-fat milk or equivalent milk products every day. attending schools without stores or snack bars that sell foods or beverages is estimated to significantly reduce sugar-sweetened beverage consumption by 22 kcal per school day for middle school students and 28 kcal per school day for high school students (349). however, in 2006, only 55% of school districts provided a curriculum to elementary schools; 58% provided a curriculum to middle schools; and 56% provided a curriculum to high schools (144). students should have access to a well-maintained cafeteria that is clean, is pleasant, has appropriate seating arrangements, and does not exceed 100% capacity (215,219--221). in addition to the process evaluation topics, schools might evaluate changes that occurred after a policy, program, or practice was implemented. schools have a responsibility to help prevent obesity and promote physical activity and healthy eating through policies, practices, and supportive environments. in 2009, 20% of non-hispanic white high school students, compared with 16% of hispanic students and 17% of non-hispanic black students, had been physically active for 60 minutes every day in the previous week (78). washington, dc: council of chief state school officers, resource center on educational equity; 1991.., after-school snack programs and summer feeding programs) and promote participation in these programs by all students (298,299). changes in the nutrient content of school lunches: results from the catch eat smart food service intervention. in 2006, 16% of schools offered physical activity and fitness counseling for school staff members, 17% offered nutrition education, and 17% offered weight management services (624). usda a menu planner for healthy school meals provides information on how to plan, prepare, serve, and market healthy school meals (322). and deliver a presentation that identifies the need for and benefits of a school employee wellness program in the context of coordinated school health. the use of goal-setting skills also can be integrated into health education to help students identify personal goals for dietary and physical activity behaviors (488). each district should have a school health council to help ensure that schools implement developmentally appropriate and evidence-based health policies and practices. skills include the ability to assess individual and community health needs; plan, implement, and evaluate health education programs; coordinate health education programs and services; act as a resource person for health education; and communicate health and health education needs, concerns, and resources (654). omission of active commuting to school and the prevalence of children's health-related physical activity levels: the russian longitudinal monitoring study.., financial support was reported and was provided by a federal agency or federal agency sponsor, a national nongovernmental organization such as the american academy of pediatrics, national association for sport and physical education, or american dietetic association, or a state-level health or education department); 2) the convening group was an established organization, federally sponsored committee, or a partner funded by the cdc division of adolescent and school health; and 3) the expert statements could be associated with an evidence base (e. therefore, the evidence suggests that 1) substantial evidence indicates that physical activity can help improve academic achievement, including grades and standardized test scores; 2) physical activity can affect cognitive skills and attitudes and academic behavior (including enhanced concentration, attention, and improved classroom behavior); and 3) increasing or maintaining time dedicated to physical education might help and does not appear to adversely affect academic performance (187). when a school offers a family activity confined to only one format, the activity is often not successful at attracting high levels of participation (563,564,566,569,570,572,577). schools should link students to appropriate services within the local medical community that are staffed by employees with appropriate training and are accessible to all students, including those with low family incomes or without insurance (215)./_107th/123_farm_bill/agency_activities/us_department_of_agriculture/usda_farm_bill_summary_child_nutrition_programs. employee wellness programs typically include health screenings to identify chronic disease risk factors such as high blood pressure or high cholesterol, health education classes, organizational policies that support worksite wellness, and employee assistance programs (624). with the assessment of student health needs and evaluation of school health policies and activities. rather than excluding these children from physical education and activity programs, teachers and program leaders should modify physical education and other school- and community-based programs for these students. factors in the school cafeteria influencing food choices by high school students. are intensified physical education sessions able to elicit heart rate at a sufficient level to promote aerobic fitness in adolescents? students are more likely to adopt healthy eating and physical activity behaviors when. students on how to achieve healthy eating and physical activity recommendations. should provide students with access to breakfast, lunch, and other important programs (e. the interests and understanding the culture of families in the community can help schools offer diverse physical activity initiatives that are feasible and aligned with community interests (588,597,607). bone health and osteoporosis: a report of the surgeon general. school employee wellness: a guide for protecting the assets of our nation's schools, from directors of health promotion and education, is a step-by-step guide for implementing school employee wellness programs (625) (box 8). most research on healthy eating and academic performance has focused on the negative effects of hunger and food insufficiency (62) and the importance of eating breakfast (65,183,184). and district policies are supportive of hiring qualified physical education teachers. parents are key players in the prevention and treatment of weight-related problems. mediated approaches for influencing physical activity: update of the evidence on mass media, print, telephone and website delivery of interventions. shape the context of children's everyday social and physical environments; they control the availability of food and influence eating and activity practices (560--562). deficiency is a condition resulting from too little iron in the body (69). the expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity include detailed guidance on assessment, counseling, and management for health-care workers providing care for overweight and obese young persons (37,38,520,539). data indicate that most children and adolescents do not follow critical dietary guidelines. explicit safety rules should be taught to and followed by students in physical education, extracurricular physical activity programs, and community sports and recreation programs (244,246,254). the following guidelines reflect the coordinated school health approach and include additional areas deemed to be important contributors to school health: policy development and implementation and professional development for program staff. for children, adolescents, and adults, knowledge about how to be physically active might be more important than knowledge about why physical activity is beneficial (387,388). nationwide, 62% of schools had students with long-term physical, medical, or cognitive disabilities. however, the energy intake among persons aged 12--19 years increased significantly during the same period (84,90,91). aerobic dance and physical self-perceptions in female adolescents: some implications for physical education. trained staff members or volunteers, including coaches, teachers, parents, paraprofessionals, and community members, should supervise all physical activity programs. the impact of parent interactive activities on students in a school-based aids prevention program. on increasing the personal perception of risk and harmfulness of engaging in specific health risk behaviors as well as reinforcing protective factors. quality physical education serves as the cornerstone of a comprehensive program because it provides the unique opportunity for students to obtain the knowledge and skills needed to establish and maintain physically active lifestyles throughout childhood and adolescence and into adulthood. process evaluation is the foundation of evaluation because it specifies the activities involved in policies, programs, and practices, and whether they were implemented as intended. black adolescents are more likely than white or hispanic adolescents to report eating fruits and vegetables five or more times per day (78).. schools that have a nurse-student ratio of at least 1:750 well children (objective ecbp 5) (10). ta, meriweather ra, baker et, watkins lt, johnson cc, webber ls. ar, cohen r, crepinsek mk, fox mk, hall j, zeidman e. teachers, coaches, and other school and community personnel should not use physical activity as punishment or withhold opportunities for physical activity as a form of punishment.. public health strategies for preventing and controlling overweight and obesity in school and worksite settings. those responsible for implementation should be prepared to address challenges, such as perceptions that the policy is low priority, limited resources for full implementation, changes in school administrators and school staff members, and concerns such as lost revenue from certain food and beverage sales and resolving scheduling conflicts for use of physical activity facilities because of increasing numbers of physical activity programs (210).., the dietary guidelines for americans and meal pattern requirements), including those for children with special needs;. ml, majer ls, alensworth d, farquhar bk, kann l, pateman b c. adequate calcium and vitamin d intake, along with weight-bearing physical activity (e. the broader impact of walking to school among adolescents: seven day accelerometry based study. for example, staff members might emphasize good nutrition and healthy eating habits, speak well of the school nutrition program, support social aspects of the meal program (e. schools communicate about the development, implementation, and monitoring of healthy eating and physical activity policies to school administrators, school staff members, and others affected by the policies? and nutrition service, us department of agriculture; cdc, us department of health and human services; us department of education. staff members can further assess students' readiness and motivation to change by asking how important it is to them and how confident they feel about their ability to change.., substituting one type of ingredient for another), reduction techniques (i. expert panel report 3: guidelines for the diagnosis and management of asthma. strategies that are enjoyable and participatory, emphasize the benefits of healthy eating and physical activity, or provide exposure to new foods and activities are more likely to contribute to student adoption of healthy behaviors (457,473,666--668). television viewing and its associations with overweight, sedentary lifestyle, and insufficient consumption of fruits and vegetables among u. familial approach to the treatment of childhood obesity: conceptual model. by 2007--2008, most school districts had a local wellness policy; however, the quality of policies varied across school districts. many schools provide students with access to foods and beverages in various venues across the school campus, including meals served in the cafeteria as part of the federally reimbursable school meal program and competitive foods (i. partners might include businesses, health departments, community health educators, health-care providers, health-care organizations, parks and recreation departments, universities and educational institutions, transportation authorities and other government agencies, faith-based organizations, senior citizen organizations, cultural institutions, local foundations, national service and volunteer organizations, local chefs, and other community volunteers (556). one person, such as the school health coordinator or lead physical education teacher, should be responsible for ensuring that safety measures are in place and updated as needed (198,255); however, minimizing physical activity--related injuries and illnesses among children and adolescents is the joint responsibility of teachers, administrators, coaches, athletic trainers, school nurses, other school and community personnel, parents, and students (254,256). a primary challenge for schools is increasing the professional qualifications of nutrition services staff members to have the skills needed to provide nutritious and appealing school meals that comply with the dietary guidelines for americans and to consistently offer students healthy food and beverage options (658). the play approach to learning in the context of families and schools: an alternative paradigm for nutrition and fitness education in the 21st century.., four-square, active tag, or flag football) for interested students (241,420,424,425,430--432). although few studies have examined the effect of using food rewards on students' long-term eating habits, the iom nutrition standards for foods in schools report determined that such use of foods in schools is inappropriate (238) because this practice establishes an emotional connection between foods and accomplishments. however, the national cancer institute does have a system, the research-tested intervention programs (rtips), which includes a scoring process for comprehensive school-based programs focused on healthy eating and physical activity. offering transportation to and from these programs might increase student participation (574,607). for involving families include family homework assignments, healthy eating and physical activity newsletters (334,472,479,564,566,567,569--572), family nights focused on health promotion (564,572,574,577), and internet-based programs (563). the probability of childhood obesity persisting into adulthood increases as children enter adolescence (46,47); even obesity during early childhood (ages 2--5 years) increases the risk for adult obesity (47--49). home environment offers children and adolescents many opportunities for television viewing, including eating meals while watching television or having a television in their bedroom (162--165). an environmental intervention to improve a la carte foods at middle schools. a school-based physical activity program to improve health and fitness in children aged 6--13 years ("kinder-sportstudie kiss"): study design of a randomized controlled trial. c, platat c, schweitzer b, wagner a, oujaa m, simon c. each guideline is followed by a series of strategies for implementing the general guidelines. in addition, obesity in children and adolescents is associated with orthopedic complications such as fractures, musculoskeletal pain, impairment in mobility, and abnormal lower extremity alignment (58). state and local education agencies and schools can consult with evaluators at universities, school districts, or state departments of education and health to identify methods and materials for evaluating their efforts. disorders that do not meet all criteria for either anorexia nervosa or bulimia nervosa are referred to as eating disorders not otherwise specified. report includes nine general guidelines for school health programs to promote healthy eating and physical activity. a randomized trial of the effects of reducing television viewing and computer use on body mass index in young children. feasibility and benefits of a parent-focused preschool child obesity intervention. results from a nationally representative survey found that in the 2004--2005 school year, one or more sources of competitive foods were available in 75% of elementary schools, 97% of middle schools, and 100% of high schools (106). children and adolescents are exposed to many forms of marketing, including television advertisements, advertising on the internet and advergames (i. the hiring of physical education teachers, health education teachers, and nutrition services staff members who are certified and appropriately prepared to deliver quality instruction, programs, and practices. in 2001, the prevalence of type 2 diabetes in a sample of u. when possible, schools can support those supervising unstructured physical activity by following the national program for playground safety (npps) recommendations that the playground supervision ratio of teachers to students be equal to the indoor classroom ratio (263). daily quality physical education provides consistent instruction in various motor skills, movement forms, self-assessment and management, physical activities, and fitness activities that are important to become physically active for a lifetime. to master skills and establish self-confidence in their ability, students should be taught skills that are broken down into components ranging from easy to hard (394). observed levels of elementary and middle school children's physical activity during physical education classes.., taking attendance and making announcements) that do not facilitate moderate to vigorous physical activity (383,403--406). guidelines for overweight in adolescent preventive services: recommendations from an expert committee. in addition, state, territorial, and local agencies and nongovernmental organizations use yrbss data to set and track progress toward meeting school health and health promotion program goals, support modification of school health curricula or other programs, support new legislation and policies that promote health, and seek funding and other support for new initiatives. schools can refer students for additional care to community agencies, organizations, or health-care providers not on the school property or to school-based health centers. no comprehensive system or set of criteria specifically focused on physical education curricula exists. healthy eating through environmental strategies such as prompts, parental outreach, and point-of-purchase promotions (269,270) because point-of-purchase signage and parental newsletters highlighting parents' healthy eating behaviors influence children's food selections (269,271). students who participate in school meal programs have been found to consume more milk, fruits, and vegetables and have better nutrient intake than those who do not participate (306,307). a full-fledged outcome evaluation might be beyond the reach of most schools and is more likely the purview of state and local education agencies. oakland, ca: national policy and legal analysis network to prevent childhood obesity; 2009.. public school children and the role of the school meals program. physical activity and health: a report of the surgeon general. overall, personal fulfillment influences the motivation both of boys and girls to be physically active (121). cardiovascular health in childhood: a statement for health professionals from the committee on atherosclerosis, hypertension, and obesity in the young (ahoy) of the council on cardiovascular disease in the young, american heart association.

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working to keep school children healthy: the complementary roles of school staff and school nurses. requirement that the local education agency designate one or more local education agency officials or school officials to ensure that each school complies with the local school wellness policy. are responsible for the physical health, mental health, and safety of students during the school day (215).. 3, safe, accountable, flexible, efficient transportation equity act: a legacy for users (safetea-lu). that school administrators attend school wellness conferences offered within their state or by the state education agency. an empirical analysis of and policy recommendations to improve the nutritional quality of school meals. jf, mckenzie tl, alcaraz je, kolody b, faucette n, hovell mf. expert statements also were reviewed for strategies and actions that are supported by opinions, commentaries, or consensus statements from public health and education organizations or agencies about youth nutrition, physical activity, or obesity prevention. decisions about the specific foods to offer and how to prepare them are made by local school food authorities.., parties and rewards or behavior-management tools), staff and parent meetings, and after-school programs (344,345). increasing students' self-efficacy for engaging in physical activity increases the likelihood of enjoyment and therefore the likelihood of regular participation in physical activity (384,411). lessons for older students should emphasize personal responsibility for making healthy and positive choices, decision-making skills for healthy eating and physical activity, analysis of dietary and physical activity behaviors and their influence on chronic disease risk, resisting negative social pressures, and advocating for individual, family, and community health (500--502). position of the american dietetic association, society for nutrition education, and american school food service association---nutrition services: an essential component of comprehensive school health programs. tables and chairs of appropriate size, with space to accommodate all students with special needs (e., mental health, and social services staff members can take an active role in implementing coordinated school health practices and be highly involved in the school health council (513,515). outcome evaluation can focus on short- or long-term outcomes of policies, programs, or practices, including changes in practices at the school level or changes in student knowledge, attitudes, skills, behaviors, or health outcomes. a comprehensive worksite wellness program in austin, texas: partnership between steps to a healthier austin and capital metropolitan transportation authority. with school employees using multiple methods such as e-mail, websites, printed materials, and announcements;. the cdc staff members concluded that there was enough scientific evidence on school-based nutrition and physical activity for each component of the coordinated school health framework to be an independent guideline. taste preferences for fruits and vegetables are one of the strongest reported correlates of fruit and vegetable intake among males and females (94). generation m: media in the lives of 8- to 18-year-olds. school health councils, teams, and coordinators can lead the development, implementation, and monitoring of policies (194,196). students can enjoy meal time more when they feel relaxed and are able to socialize without feeling rushed. resurrecting free play in young children: looking beyond fitness and fatness to attention, affiliation, and affect. in 2009, 33% of 9th- through 12th-grade students reported watching ≥3 hours of television on an average school day, and 25% reported using a computer ≥3 hours on an average school day (78). schools develop a communications and marketing plan to promote participation in school breakfast, lunch, and other feeding programs that provide foods consistent with the dietary guidelines for americans? serving baked instead of fried foods can make a substantial difference in the amount of calories, fat, and saturated fat that children consume. focus groups and structured interviews also can be used, and direct observations of the school environment can help identify characteristics that influence health-related behaviors (e. education supports the development of health-related knowledge, skills, and attitudes to increase the likelihood that students engage in healthy behaviors and to avoid or reduce health risks. collaboration among school staff responsible for the health and safety of students;. if you are good you can have a cookie: how memories of childhood food rules link to adult eating behaviors. children who are obese have been found to have higher rates of dental caries than their normal weight peers (82). engaging members from all cultural or language groups represented in the community can foster stronger partnerships among students, families, and community members (589,594,608).., perceive themselves as very overweight) are at increased risk for suicide ideation and suicide attempts (532). effective administrative, procurement, and other financial management protocols to ensure quality food production and distribution;. pathways process evaluation results: a school-based prevention trial to promote healthful diet and physical activity in american indian third, fourth, and fifth grade students. obtaining a more accurate assessment of younger students might require posing questions to parents or caregivers (520). in general, playground supervisors should 1) repetitively teach children playground rules; 2) prevent, recognize, and stop children's dangerous and risky behavior; 3) help children to identify, acknowledge, and prevent their risky behavior; and 4) model appropriate safety behavior (243,262). reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with 'best practice' recommendations. children and adolescents tend to have diets high in added sugar (84), with added sugar contributing approximately 18% of their total daily calories (86). student achievement or positive classroom behavior should only be rewarded with nonfood items or activities. addition to the review of research and evaluation studies, cdc staff members identified, collected, and considered for inclusion all relevant reports from the task force on community preventive services. with a comprehensive referral system in place, health, mental health, and social services staff members are able to respond to requests from families seeking guidance and increase access to care among students (546). the childhood obesity epidemic and the chronic diseases associated with poor dietary habits and physical inactivity are not likely to be reversed without a strong contribution from schools. low body weight, weight loss, physical inactivity, and dieting among children and adolescents can lead to low bone density. in addition, professional development for nutrition services staff members should also address how to positively influence student food choices at the point of purchase (642). scheduled recess periods enable children to accumulate a portion of their recommended 60 minutes of daily physical activity (422--424). children and adolescents are more likely than adults to report fast-food consumption (104). one study found that policies to regulate food used for fundraising were more common in middle schools than in high schools, where the sale of foods high in fat and added sugar remained a prevalent fundraising practice (375). the findings were consistent for both sexes and all childhood age groups studied in the cohort (2--5 years, 6--8 years, 9--11 years, 12--14 years, 15--17 years) (47). the guidelines establish a foundation for developing, implementing, and evaluating school-based healthy eating and physical activity policies and practices for students (appendix a). metabolic syndrome is defined as the presence of three or more of the following metabolic risk factors: abdominal obesity, high triglyceride levels, low high-density lipoprotein cholesterol (hdl-c) levels, high blood pressure, and high fasting glucose levels (52). internet-based interventions are appealing because parents and children can participate in the program at a convenient time; however, an evaluation of one study found low participation, possibly because of the time required (563). factors, including demographic, personal, and environmental factors, influence the eating behaviors of children and adolescents. all school staff members and teachers, in particular, need sufficient time to implement the policy and make agreed-on changes in the school environment to support the policy (211). of adolescent and school health, national center for chronic disease prevention and health promotion. primary audience for this report includes state and local education and health agencies, federal agencies, and national nongovernmental organizations that focus on the health of students in school.., genetics and physical maturation) that are beyond the control of teachers and students (396,397). bulimia nervosa is characterized by repeated episodes of binge eating followed by compensatory behaviors such as self-induced vomiting (76). outcomes of a field trial to improve children's dietary patterns and physical activity. in addition to poor health outcomes, behavioral and psychosocial problems also have been associated with food insecurity and hunger in children and adolescents (62--64,66). impact of television viewing patterns on fruit and vegetable consumption among adolescents. in addition, in 2006, 35% of school districts provided funding for or offered professional development for mental health and social services staff members on nutrition and dietary behavior counseling, and 36% of districts provided funding for or offered professional development on physical activity and fitness counseling during the 2 years before the study (677). including students with severe, multiple disabilities in general physical education. strategies for guideline 6: provide students with health, mental health, and social services to address healthy eating, physical activity, and related chronic disease prevention. using formative research to develop a worksite health promotion program for african american women. effects of blood pressure on reduced dietary sodium and the dietary approaches to stop hypertension (dash) diet. staff training to implement changes within the school meal program can lead to a reduction in calories from total fat, saturated fat, and sodium (673). the recommended 225 minutes per week for physical education can be difficult in the many secondary schools that have block schedules, which feature a fewer number of classes, and these classes last longer than those at schools with different schedules. rewarding students with food during class also reinforces eating outside of meal or snack times. among the 84% of middle schools and 95% of high schools that required physical education in 2006, 12% of middle schools and 25% of high schools allowed students to be exempted from physical education requirements for participation in school sports. school employee wellness leader can be the school health coordinator or an employee who is committed to offering quality programs for all school staff members. this group of stakeholders will contribute to the development, implementation, and monitoring of healthy eating and physical activity policies. to foster administrator support, schools might consider the following methods (625):Provide a rationale and demonstrate a need for the program by providing local information and data, such as employee absenteeism rates and reasons for absenteeism. impact of recess on classroom behavior: group effects and individual differences. naspe has produced guidelines for elementary, middle, and high school physical education, which state that physical education should be taught by a qualified teacher with a degree in physical education (for the appropriate grade level) and a current state license to teach physical education (647--650). in a recent report to congress, the federal trade commission estimated that in 2006, approximately . consumption of low-nutrient, energy-dense foods and beverages at school, home, and other locations among school lunch participants and nonparticipants. develop successful and meaningful partnerships, all partners involved should demonstrate a commitment to student health and communicate intent and expectations about their level of involvement and respective roles in making decisions. measurements are more likely to be accurate when they are made by trained professionals (518). data and information to determine the nutrition and physical activity needs of school staff members and assess the availability of existing school employee wellness activities and resources. employee wellness programs might increase healthy eating and physical activity among staff members, these staff members would model positive health behaviors for students (619,620). school staff members with annual professional development opportunities to deliver quality physical education, health education, and nutrition services. pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: a three-year prospective analysis. guidelines recommend that children and adolescents consume at least half of their daily grain intake as whole grains, which for many people is 2- to 3-oz equivalents, depending on age, sex, and calorie level (5). as of 2005, <15% of children and adolescents walked or bicycled to and from school (110). community resources to help provide healthy eating and physical activity opportunities for students.., perceiving parents will do physical activity with them and sign them up for sports or other physical activities) to a parent's reported support (e.. elementary schools is associated with higher frequency of fruit and vegetable consumption. school nurse perceptions of barriers and supports for children with diabetes. trends in food and nutrient intakes by children in the united states. finally, faculty members in institutions of higher education can use these guidelines to teach students of school health, public health, physical education, health education, exercise and wellness, physical activity, dietetics, nutrition education, nursing, elementary and secondary education, and other health- and education-related disciplines., follow-up, and treatment of health and mental health conditions related to diet, physical activity, and weight are important for student health (182,518). then, guidelines pertaining to nutrition services and physical education are provided, followed by guidelines for health education, health, mental health and social services, family and community involvement, staff wellness, and professional development for staff. nationwide, in 2006, 73% of districts had one or more school health councils at the district level that offered guidance on the development of policies or coordinated activities on health topics (193). school-based weight management services: perceptions and practices of school nurses and administrators. nurses can play a critical role in coordinating student health-care services at the school. rp, pugh ja, hernandez ae, menchaca vd, ramirez rr, mendoza m. in addition, process evaluation allows education agency staff members to assess how well a policy, program, or practice has been implemented and what strengths and improvements are necessary. dietary sources of energy, solid fats, and added sugars among children and adolescents in the united states. requirement that the local education agency permit parents, students, representatives of the school food authority, teachers of physical education, school health professionals, the school board, school administrators, and the general public to participate in the development, implementation, and periodic review and update of the local school wellness policy;. in a national sample, children and adolescents who were overweight or obese were approximately twice as likely to be iron deficient than those of normal weight (75). implement a comprehensive physical activity program with quality physical education as the cornerstone. although the scientific interventions highlight what schools can do to address these health behaviors, information is lacking about certain specific intervention strategies that have a long-term effect. hispanic and non-hispanic black students are less active than their non-hispanic white counterparts (78). the existing federal requirement, last updated in 1985, prohibits the sale of foods of minimal nutritional value (fmnv) during meal periods in areas where reimbursable school meals are served (338,339). schools can offer cost-effective incentives to compensate for volunteers' time (e. probart, phd, the pennsylvania state university, university park, pennsylvania; marlene b. the school nutrition service staff members also should consider making food substitutions for students with food allergies, for students with food intolerances, or on a case-by-case basis for students who are medically certified as having a special medical dietary need (286). establish school environments that support healthy eating and physical activity. school meal program should provide various healthy, appetizing, and culturally appropriate choices to help students meet their nutritional needs. do attributes of the physical environment influence children's physical activity? eating and physical activity control body weight through a balance of energy expenditure and caloric consumption (35). a planned and sequential curriculum that is culturally and developmentally appropriate. however, all of these guidelines are not appropriate for every school. school meals: types of foods offered to and consumed by children at lunch and breakfast.- and district-level education agencies and boards can influence local school practices by establishing professional preparation and certification requirements in addition to offering professional preparation and development opportunities. therefore, secondary schools with block schedules are recommended to provide 450 minutes of physical education every 10 days. role of behaviour modification in the treatment of childhood obesity with the parents as the exclusive agents of change. nutrition service staff members should be provided with information and support to assist students who are on nutrition programs or diets prescribed by their health-care provider. effects of two types of activity on the performance of second-, third-, and fourth-grade students on a test of concentration.. department of health and human services, rockville, maryland; food and nutrition service, u. however, recess should not replace physical education or be used to meet time requirements set forth in physical education policies., implement, and evaluate healthy eating and physical activity programs for all school employees. checklist of health promotion environments at worksites (chew): development and measurement characteristics. prevention of the epidemic increase in child risk of overweight in low-income schools: the el paso coordinated approach to child health. for example, in 2009, in a nationally representative sample of high school students, 11% of students had gone without eating for >24 hours; 5% had taken diet pills, powders, or liquids without a physician's advice; and 4% had vomited or taken laxatives to lose weight or to keep from gaining weight during the 30 days before the survey (78). pathways: a culturally appropriate obesity-prevention program for american indian schoolchildren. direct certification to automatically qualify students who participate in temporary assistance to needy families, the supplemental nutrition assistance program (formerly the food stamp program), and the food distribution program on indian reservations for free meals without requiring additional applications. parent and family support for physical activity can be defined as a child's perception of support (e. student assessment should help improve and inform teaching practices and promote learning (453,462--464), use multiple sources of information, and provide fair, valid, and reliable information (453,465). and criteria have been created to identify evidence-based interventions for certain school health topics such as hiv prevention. however, schools can sell these foods and beverages at other locations on the school campus during the entire school day, and other foods and beverages of low nutritional value such as chips, most candy bars, and noncarbonated, high-sugar drinks can be sold anywhere on campus, including the food service area. health, mental health, and social services staff members can work with physical education and health education teachers, nutrition service staff members, principals, and other school staff members to establish a healthy environment and consistently promote healthy eating and physical activity messages and activities throughout the school setting (542,550,555). school-based research on health behavior change: the stanford adolescent heart health program as a model for cardiovascular disease risk reduction [chapter 4]. foodservice staff perceptions of their influence on student food choices. the impact of diabetes mellitus on mortality from all causes and coronary heart disease in women: 20 years of follow-up. for example, parents rate distance and safety as top barriers for their children walking to school (143). families and health-care providers should notify schools about dietary restrictions or modifications and schedules for meals and snacks related to the condition (519). for scientific reports, the rating process focused on rigor, confidence in the findings, efficacy, and feasibility. volunteer groups also can recruit from existing parent networks (such as the pta) in the school or community. may consider conducting fitness testing to provide feedback to students and their parents, teach students how to apply behavioral skills (e. the effect of multicolor playground markings on children's physical activity level during recess. out-of-school--time programs serving meals or snacks to students need to ensure the provision of nutritious food to give students the energy and nourishment needed to benefit fully from the educational, enrichment, and physical activities being offered. family meal patterns, healthy household eating rules, and healthy lifestyles of parents influence fruit, vegetable, calcium and dairy, and dietary fat intake of adolescents (94--97). comparison of barriers self-efficacy and perceived behavioral control for explaining physical activity across 1 year among adolescent girls. motivational interviewing involves staff members asking, informing, advising, and listening about healthy eating and physical activity behaviors. unlike school meals, which must meet specified nutrition standards, foods and beverages sold or provided outside of the meal program are largely exempt from federal requirements or standards. public hearings or other meetings that gather wider input from the school and community might be beneficial or required. promoting dietary change in adolescents: a school-based approach for modifying and maintaining healthful behavior. communication among schools, families, and community members to promote adoption of healthy eating and physical activity behaviors among students. the school setting: an opportunity for the implementation of dietary guidelines. furthermore, school staff members are more likely to abstain from use of tobacco on school grounds when they believe that they influence the students' behavior (621). from concept to practice: using the school health index to create healthy school environments in rhode island elementary schools. from health education, physical education, health services, nutrition services, and mental health and social services;. and community members should be invited to provide input on the planning and implementation of healthy eating and physical activity policies, programs, and practices. the association of television and video viewing with fast food intake by preschool-age children.., spearing in football, high-sticking in hockey, throwing a bat in baseball, and use of alcohol and other drugs by athletes) can be prohibited by establishing and enforcing rules (252,253). furthermore, according to the 2009 national youth risk behavior survey (yrbs), only 22% of students in grades 9--12 reported consuming fruits and vegetables five or more times per day (78). the national health education standards and performance indicators outline the health-related concepts, skills, and healthy beliefs, values, and norms students need for healthy behaviors (453)., implement, and evaluate healthy eating and physical activity programs for all school employees. pricing strategies, such as lowering the price of nutritious items and, if offered, raising the price of less nutritious items, because this practice encourages students to purchase more healthy items (269,272--274). local media outlets provide an opportunity to disseminate school messages and remind families and community members to engage in healthy behaviors (589,590). annual professional development opportunities for staff members who lead or supervise recess and cafeteria time.. children: results from the third national health and nutrition examination survey, 1988--1994. the surgeon general's vision for a healthy and fit nation. coronary disease risk factor reduction and behavior modification in minority adolescents: the path program. similar to physical education, most of the school-based programs included in rtips have a health education component; however, the curricula are not extensively or separately analyzed (additional information available at http://rtips. exclusion from physical education or recess for bad behavior in a classroom deprives students of physical activity experiences that benefit health and can contribute toward improved behavior in the classroom (280,281). weight gain occurs when persons expend less energy through physical activity than they consume through their diet (35). physical activity within the regular classroom also can enhance on-task classroom behavior of students (433) and establish a school environment that promotes regular physical activity. whether this association exists among iron-deficient children and adolescents without anemia is unclear (73). the school health index can lead to positive changes in the school health environment. for example, nutrition education for younger children should focus on concrete experiences, such as increasing exposure to many healthy foods and building skills in choosing healthy foods (230,490,497). school based youth health nurses' role in assisting young people access health services in provincial, rural and remote areas of queensland, australia. a planned and sequential health education curriculum that is culturally and developmentally appropriate, addresses a clear set of behavioral outcomes that promote healthy eating and physical activity, and is based on national standards. staff members should schedule follow-up sessions to assess students' progress toward their goals (520). schools play a particularly critical role by establishing a safe and supportive environment with policies and practices that support healthy behaviors. the effect of adult participation in a school-based family intervention to improve children's diet and physical activity: the child and adolescent trial for cardiovascular health.., larger or lighter bats, balls in various sizes and textures, or lowered goals or targets) that can be used with ease; 3) adapted instructional strategies such as simplified movement patterns and modified body positions; and 4) frequent rest periods (451). nationwide, 77% of middle schools and 91% of high schools offered interscholastic sports programs in 2006 (144); in 2009, 58% of high school students reported that they had played on one or more sports teams run by their school or community group (78). for example, teachers might read a book aloud while students walk at a moderate pace around the room. passage of the healthy, hunger-free kids act of 2010 requires usda to develop federal nutrition standards for competitive foods consistent with the dietary guidelines for americans (342). the national standards provide guidance for states and school districts that are developing state-level standards, instructional frameworks, and curricula. bmi is calculated and plotted by age on a sex-specific growth chart to determine a bmi-for-age percentile. access to healthy foods and physical activity opportunities and to safe spaces, facilities, and equipment for healthy eating and physical activity. this network is important to facilitate quick notification to all parties when a change is observed in the students' health status or when there is a revision to the health management plan (538)., roast, grill, or bake other vegetables such as broccoli, carrots, or green beans. policies that restrict sweetened beverage availability may reduce consumption in elementary-school children. influence on having breakfast on cognitive performance and mood in 13- to 20-year old high school students: results of a crossover trial.., interactive, electronic games on a company-sponsored website that prominently feature one or more of the company's products or services), contests and prizes, television and movie product placement, marketing in schools (e. are perceived neighborhood hazards a barrier to physical activity in children? evaluation explores whether intended outcomes or specific changes occur as a direct result of policies, programs, or practices. support should be provided to schools to upgrade kitchen facilities with state-of-the-art equipment, which can help ensure that school meals are appealing to children and that they are prepared using the most healthy cooking techniques and food products available. male and female adolescents who reported frequent fast-food restaurant visits (three or more visits in the past week) were more likely to report that healthy foods tasted bad, that they did not have time to eat healthy foods, and that they cared little about healthy eating (95). thus, physical education curricula also should include the development of safe and effective individualized physical activity plans. 2006, two thirds or more of nutrition services managers received professional development on food safety, healthy food preparation methods, personal safety for nutrition services staff members, using hazard analysis and critical control points, selecting and ordering food, and implementing the dietary guidelines for americans in school meals during the 2 years before the study. overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. preferences of children and adolescents are a strong predictor of their food intake (94).

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in reviewing and making recommendations about health-related curricula and instructional materials;. students the skills they need to live a healthy life;. television viewing and television in bedroom associated with overweight risk among low-income preschool children. in addition, a greater percentage of adolescents from families in poverty are obese (23%) compared with those from families not in poverty (14%) (44). school meal programs: competitive foods are widely available and generate substantial revenues for schools. department of education, office of healthy school and child nutrition programs. school employee wellness program should be supported by an environment and a culture that are conducive to health (618,626--628). activities to promote healthy eating and physical activity that emphasize informational, behavioral skill, and policy and environmental approaches. prioritizing needs and identifying resources to help implement the guidelines is an important step toward sustaining healthy eating and physical activity policies and practices in schools. protective clothing and equipment includes footwear appropriate for the specific activity; helmets for bicycling; helmets, face masks, mouth guards, and protective pads for football and ice hockey; shin guards for soccer; knee pads for in-line skating; and reflective clothing for walking and running. for example, a physical activity objective might be, "by may 2012, physical activity classes will have been offered once per week for all staff members throughout the entire school year. a pricing strategy to promote sales of lower fat foods in high school cafeterias: acceptability and sensitivity analysis. family involvement in health can increase their children's knowledge and attitudes about healthy lifestyles (569), influence behavior change (570,575,576,578--581), and provide social support for being healthy (573). the following should be in place to support safe and enjoyable student physical activity: 1) safe and age-appropriate playgrounds and equipment for physical education, physical activity, and recess during the school day (187,241--244); 2) safe routes to school, particularly for students living ≤1 mile from school (110); and 3) access to extracurricular programs such as intramurals and interscholastic sports that are age appropriate, are safe, provide proper equipment when needed, and are available for all students (241,242,245,246). in addition to integrating local agriculture products, such as fruits, vegetables, and eggs, into the school cafeteria, farm-to-school activities include hands-on education through school garden programs and field trips to local farms, classroom nutrition education, and alternative fundraising using local produce (234). schools provide training to physical education teachers on instructional strategies that would keep all students active for most of physical education class time? health education curricula that are consistent with the national health education standards. in addition, many of the policies lacked plans for implementing and monitoring the status of the wellness policy (206). students should take all required physical education courses and no substitutions, waivers, or exemptions should be permitted (385). a randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children. maintenance of a health promotion program in elementary schools: results from the catch-on study key informant interviews. the following techniques have been used in schools to increase the likelihood of students choosing healthier foods and beverages:Placing nutritious products so that they are easy for students to choose, such as featuring fruits and vegetables, low-fat and fat-free milk and other dairy products, and whole grains in prominent places in cafeteria lines (268). students have access to needed health, mental health, and social services. preservice and in-service professional development should help school staff members, coaches, community volunteers, and staff members from partner organizations such as parks and recreation departments plan and implement out-of-school--time healthy eating and physical activity programs that meet a range of student needs and interests. to ensure greater support for policy adoption, school health council members or other policy makers should be given time to share the draft policy with their partners and gather reactions. outcome evaluation topics include the following:Did all foods and beverages sold in school stores, vending machines, and a la carte lines adhere to strong nutrition standards for all foods in schools?., traffic, strangers, poorly maintained or unsafe facilities, poor lighting, or negative social influences) also are associated with physical activity participation (139--142). school nurses, together with other health, mental health and social services staff members, can assess the healthy eating and physical activity behaviors of students during routine interactions. some schools might already be implementing the majority of the guidelines, and other schools might choose to implement only certain guidelines. children and adolescents who believe they have the ability to address external barriers and opportunities and lead a physically active life have more motivation for participation in physical activity (413). an additional 343 descriptive articles were included in the document to support the background information (e. strategies for guideline 8: provide a school employee wellness program that includes healthy eating and physical activity services for all school staff members. students with chronic illnesses: guidance for families, schools, and students.., reducing the amount of an ingredient), fat-reduction techniques when preparing meat and poultry, and vegetable preparation techniques. family meals during adolescence are associated with higher diet quality and healthful meal patterns during young adulthood. for example, community agencies and organizations can use school facilities for after-school physical fitness programs for students, weight management programs for overweight or obese students, and sports and recreation programs for students with disabilities or chronic health conditions. input from students about menu choices through taste-testing and the school health council. for example, among the schools that had students with disabilities enrolled, only 59% had students with long-term disabilities participate in required physical education (144). these programs provide local produce, promote and support locally based agriculture, and often connect farmers and students with visits to farms and visits from farmers to the classroom, enabling students to learn how and where food is produced (599). whole grains are an important source of fiber and other nutrients. all students in all grades participate in daily recess throughout the school year? all school staff members may be given guidance on how to recognize early signs of these risk behaviors and confidentially refer students with diet, physical activity, or mental health concerns to health, mental health, and social services staff members. the presence of a television in a child's bedroom is associated with more hours spent watching television (0. social norms and support from friends and family encourage youth involvement in physical activity among all children and adolescents (112,122,124--132). employees feel that their nutrition and physical activity needs have been met? indicate that cvd risk factors occur more frequently in obese children. recess before lunch, which can reduce plate waste, increase student consumption of food (225), decrease student wait time in line, and reduce student discipline referrals (226);. education agencies and schools should designate a person to take the lead on evaluation activities. student assessment results will guide the counseling sessions, and staff members can ask students to identify the behavior they might be interested in changing or that might be easiest to change (37,520). certified physical education teachers teach longer lessons, spend more time developing motor and movement skills, impart more knowledge, and provide more moderate and vigorous physical activity than do classroom teachers with little or no specialized training in physical education (146,383,401,641). in a community-based sample of obese children aged 5--17 years, 70% had at least one cvd risk factor, such as a high cholesterol or triglyceride level, high blood pressure, or high insulin level, and 39% had two or more risk factors (23). schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. diabetes is a result of defects in insulin production, insulin action, or both and is classified as either type 1 (insulin-dependent diabetes) or type 2 (usually non--insulin-dependent diabetes) (26). school nutrition policy should ensure a safe environment for students with chronic health conditions. injury prevention for children and adolescents: integration of research, practice, and advocacy. naspe has outlined three characteristics of quality intramural programs: 1) students have a choice of activities or participation, 2) every student is given equal opportunity to participate regardless of ability level, and 3) students have the opportunity to be involved with planning and implementing activities (246)..Sand Castles Film en Streaming VF Francais - Filmvivo | Film Regarder GratuitForgot password? epidemiologic and surveillance data also were used to develop the introductory text. the presentation should include background information about why the policy is needed (e. during 2007--2008, females aged 12--19 years had a particularly low intake of calcium, consuming an average of 878 mg of calcium daily, which is 67% of the recommended dietary allowance (5,83). in 2006, 67% of elementary schools offered recess 5 days per week for ≥20 minutes on average in all grades (421). initiation of a school employee wellness program: applying the comprehensive health education model.., meat, poultry, egg yolk, dried fruit, dried peas and beans, nuts, green leafy vegetables, whole grain breads, and fortified cereals), as well as foods high in vitamin c (e. the role of race and poverty in access to foods that enable individuals to adhere to the dietary guidelines. locally, physical education and health education teachers, school nutrition directors, school health councils, and other school staff members; health-care providers; community members; policy makers; parents; and students can use these guidelines to establish, implement, and assess healthy eating and physical activity policies and practices in schools. in the last decade, a total of 39 states passed a law or policy addressing competitive foods and beverages in schools that was stronger than the current federal requirements. psychological environment at a school should support all students in making healthy eating choices and being physically active, regardless of race/ethnicity, income, sex, and physical ability (215). cultural awareness in healthy eating and physical activity practices throughout the school. that foods and beverages sold or served outside of school meal programs follow the dietary guidelines for americans and are consistent with the most recent scientific guidelines for nutrition standards. education instruction should include the use of active learning strategies that encourage student participation and help develop the concepts, attitudes, and skills needed to make healthy eating choices and be physically active from childhood through adulthood (485). and sustaining school-based healthy eating and physical activity policies and practices will make a substantial contribution toward a healthy future for children and adolescents in the united states. to the american psychiatric association, the prevalence of anorexia nervosa and bulimia nervosa in u. a climate that encourages and does not stigmatize healthy eating and physical activity. influencing students' attitudes toward and perceptions of physical activity might affect their involvement in physical activity outside of physical education class (417,418). for example, students can track via computer their daily physical activity for a week and receive a report on how many days they met the physical activity guidelines. a student has a medical provider--prescribed weight management plan, then health, mental health, and social services staff members can communicate with the student's health-care provider to discuss their role in monitoring implementation and assisting the student with compliance. department of agriculture, food and nutrition service; fox mk, crepinsek mk, connor p, battaglia m, eds. perceptions of physical and social environment variables and self-efficacy as correlates of self-reported physical activity among adolescent girls.., physical education and activity and nutrition services) at the state, district, school, and classroom (where applicable) levels across elementary, middle, and high schools; 2) identify persons responsible for coordinating and delivering each school health program component and their qualifications and educational background; 3) identify collaborations that occur among staff members from each school health program component and with staff members from outside agencies and organizations; and 4) describe changes in key policies and practices over time. adoption typically requires that the drafted policy be presented to the policy-making body (e. interactive computer programs can help students learn and assess their own physical activity and healthy eating skills (505--507). hhs also recommends encouraging children and adolescents to participate in activities that are age appropriate, are enjoyable, and offer variety (9). criteria, including clearance by a health-care provider, for reentering play after an injury to ensure that injuries are fully healed. healthy people 2020 national health objective strives to reduce iron deficiency among young children (aged 1--4 years) and females of childbearing age (aged 12--49 years) (objective nws 21) (10). to establish a referral system, health, mental health, and social services staff members should identify health-care services and school- or community-based programs that encourage healthy eating and physical activity and address obesity and eating disorders. food insufficiency and american school-aged children's cognitive, academic and psychosocial developments. safety on the playground: mechanisms through which adult supervision might prevent playground injury. staff members from universities, hospitals, health centers, and other health organizations in school initiatives on healthy eating and physical activity.., using student data to determine staff learning priorities, preparing school staff members to apply research to decision-making, and using learning strategies appropriate to intended goals), and content standards (e. girls are motivated by physical activities that they prefer and by their confidence in their ability to perform an activity (123). health education teachers should receive professional development to effectively teach students about foods and nutrients, physical activity, and their connections to health, obesity, and other chronic diseases; to provide students with the knowledge and skills they need to select physical activities they enjoy and healthy foods to prepare; to help students assess their own physical activity and eating habits and plan for change; to identify valid sources of nutrition and physical activity information; to acquire advocacy skills for improving nutrition and physical activity environments; and to facilitate students' ability to identify and correct nutrition and physical activity misconceptions (462,640,644,660,661,665). state, local, and territorial education and health officials use profiles data to 1) describe school health policies and practices and compare them across jurisdictions, 2) identify professional development needs, 3) plan and monitor programs, 4) support health-related policies and legislation, 5) seek funding, and 6) garner support for future surveys. a healthy people 2020 national health objective (nutrition and weight status [nws]) is to reduce the proportion of children aged 6--11 years who are obese to 16% and reduce the proportion of persons aged 12--19 years who are obese to 16% by 2020 (objectives nws 10. schools also can work with the community to address barriers to healthy eating and physical activity, such as areas that lack access to affordable foods needed for a healthy diet (i. among female adolescents, self-efficacy to make healthy food choices and positive attitudes toward nutrition and health are significantly related to calcium intake (92). school health councils should include representatives from different segments of the school and community, including health and physical education teachers, nutrition service staff members, students, families, school administrators, school nurses and other health-care providers, social service professionals, and religious and civic leaders (193--195). persons aged 4--18 years do not eat the minimum recommended amounts of whole grains. managing sales of beverages in schools to preserve profits and improve children's nutrition intake in 15 mississippi schools. in 23% of schools, staff members were allowed to exclude students from all or part of physical education as punishment for bad behavior in another class (144). factors influencing the performance of volunteers who provide physical activity in middle schools. use of multiple formats provides families with options and the ability to choose activities that are interesting and fit their schedule (574,575,588). students with weight concerns are at increased risk for unhealthy dieting behaviors (530,531). health policies are official statements from education agencies and other governing bodies (e. can we skill and activate children through primary school physical education lessons? the expert statements and input gathered and reviewed for this report helped contribute to the development of the guidelines and their corresponding strategies. although these percentages are similar to those suggested by the dietary guidelines for total fat consumption (25%--35% of total calories), persons aged 6--19 years consumed more than the recommended amount of saturated fat (10% of total calories), ranging from 11%--12% (5,83). the professional development topics that nutrition service managers reported wanting most were making school meals more appealing, food biosecurity, menu planning for healthy meals, increasing student participation in school meals programs, procedures for food-related emergencies, and using the cafeteria for nutrition education (105). these approaches can include education, employee and peer support for physical activity, physical activity breaks during staff meetings (634,635), ongoing incentives for behavior change, access to safe facilities and nutritious foods, and systematic reminders for healthy eating (636--639). child and adolescent perceptions of their ability to perform a physical activity (i. a, van beurden e, barnett l, brooks lo, dietrich uc. in daily physical education is associated with an increased likelihood of participating regularly in moderate to vigorous intensity physical activity (118). increase in the sale of competitive foods and beverages is associated with a decrease in student participation in the reimbursable school meal program, which might affect the viability of the program (354). process evaluation topics for schools might include the following:Did schools establish a school health council and conduct an assessment of their existing healthy eating and physical activity policies and practices? administrator from the school who will communicate with the school board or superintendent or both;. such criteria are based on scientific evidence of effectiveness and can help school districts and schools select and approve curricula. two overall types of scientific reports were used to identify the new guidelines and corresponding strategies and actions: 1) reports that included cross-sectional, prospective, and randomized controlled trials that were designed to improve healthy eating and physical activity and prevent youth obesity and to promote wellness among school employees and 2) expert statements that included opinions, commentaries, or consensus statements from public health and education organizations or agencies about youth nutrition, physical activity, or obesity prevention. the third school nutrition dietary assessment study found that sugar-sweetened beverages (not including flavored milk) obtained at school contributed to an additional 29 kcal per school day for middle school students and 46 kcal per school day for high school students. integration of health topics throughout the school curriculum should not replace health education as a course in school; a comprehensive health education curriculum is necessary to enable students to achieve the national and state standards for health education. community resources can expand existing school programs by providing program staff members as well as intramural and club activities on school grounds. professional development needs reported by school food service directors and recommendations for meeting directors' needs. swimming upstream: faculty and staff members from urban middle schools in low-income communities describe their experience implementing nutrition and physical activity initiatives. education should incorporate student assessment strategies that enable students to demonstrate their understanding of primary health concepts and apply health-related skills to real-life situations. for example, a community-based study found that among boys aged 9--11 years, 4% of those with a childhood bmi <50th percentile (normal weight) and 22% of those with a childhood bmi of 50th--84th percentile (normal weight) became obese adults, whereas 76% of those who were obese (bmi ≥95th percentile) became obese adults. predictors of initiation and persistence of unhealthy weight control behaviours in adolescents. for expert statements, the rating process focused on the organization that published or wrote the report, conflicts of interest, and evidence to support the statement. support such demanding job requirements, school nutrition directors should have, at minimum, a bachelor's degree in a nutrition-related field or food-service management, a dietetics degree, or a certification or credentialing in nutrition services from either the school nutrition association or a state program (299). schools may consider usda foods (commodities), which have been modified to reduce sodium and fat, including saturated fat, as substitutions for less healthy ingredients. in 2006, only 33% of required physical education classes or courses and 41% of required health education classes or courses had a teacher who had received instruction in the past 2 years on encouraging family and community involvement (593). cardiovascular risk factors and excess adiposity among overweight children and adolescents: the bogalusa heart study. physical activity places a mechanical load on the skeleton, and the body responds by strengthening bone mass to support the activity. implementing nutrition standards can involve increasing food and beverage options, such as requiring that schools offer fruits or vegetables at all locations where other foods are available, and limiting options, such as stipulating that schools cannot sell foods with more than a specified number of calories and grams of fat per serving. schools should communicate with families and community members frequently to emphasize that they are a valuable asset in student learning, health, and well-being (556,585). television viewing as a cause of increasing obesity among children in the united states, 1986--1990. the guidelines recommend a diet rich in fruits and vegetables, whole grains, and fat-free and low-fat dairy products for persons aged ≥2 years. schools offer an ideal setting for delivering health promotion strategies that provide opportunities for students to learn about and practice healthy behaviors. children and adolescents who are obese or who have physical or cognitive disabilities, chronic diseases (e. if fitness assessments are used, students should be taught the skills needed for self-monitoring or self-testing of health-related physical fitness (392--395). 2007--2008, the average percentage of calories from fat consumed by persons aged 6--19 years was 33%. although typically limited to students who are athletically gifted, interscholastic sports also provide unique opportunities for applying skills (e. policy language should be consistent with state, district, and school visions for student learning and health and other policies in the same jurisdiction. perceptions about exercise and intrinsic motivation of students attending a health-related physical education program. to ensure appropriate and safe oversight, the health, mental health, and social services staff member coordinating care with the student's health-care provider needs to have training in pediatric weight management or behavioral counseling (539). promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial. policies likely will require final approval by the school board, the district superintendent, or both. requirement that the local education agency periodically measure and make available to the public an assessment on the implementation of the local school wellness policy, including the level of school implementation, how the local school wellness policy compares with model policy, and a description of progress made toward goals; and. these measurable goals and objectives enable the school or school district to ensure that students' iep physical education goals and objectives are being met (451). children and adolescents are more likely to engage in unhealthy eating behaviors when watching television (155,168,169) and are exposed to television advertisements promoting primarily restaurants and unhealthy food products (151,170). neighborhood environments: disparities in access to healthy foods in the u. relationship of physical activity and television watching with body weight and level of fatness among children: results from the third national health and nutrition examination survey. for example, schools might address food deserts by ensuring that healthy options are offered or available for purchase at all school-sponsored activities (on and off campus) (600). students in grades k--12 to participate in daily physical education that uses a planned and sequential curriculum and instructional practices that are consistent with national or state standards for physical education. for example, they can support adoption of a universal bullying prevention program to address disrespectful behavior and prevent bullying of students with chronic health conditions or weight issues and all other students (518). school employee wellness programs should be evaluated to determine whether objectives have been met, whether employees are satisfied, and what can be done to improve the program., philadelphia, pennsylvania; action for healthy kids, chicago, illinois; alliance for a healthier generation, new york, new york; american academy of pediatrics, elk grove village, illinois; american association for health education, west chester, ohio; american association of school administrators, arlington, virginia; american cancer society, atlanta, georgia; american dietetic association; american heart association, washington, dc; american school health association, bethesda, maryland; consortium to lower obesity among chicago children, chicago, illinois; illinois association of school nurses, wheeling, illinois; michigan association of school nurses, troy, michigan; national association for sport and physical education, reston, virginia; national association of school nurses, silver spring, maryland; national association of secondary school principals, reston, virginia; national association of state boards of education, arlington, virginia; national education association, washington, dc; national food service management institute, university, mississippi; national recreation and parks association, ashburn, virginia; national school boards association, alexandria, virginia; prevention institute, oakland, california; school nutrition association, national harbor, maryland; society for nutrition education, indianapolis, indiana; society for public health education, washington, dc; society of state directors of health, physical education, and recreation, arlington, virginia; ymca of the usa, washington, dc. school food environments and practices affect dietary behaviors of u. another school or district employee wellness program that has resulted in multiple benefits. school meal programs: revenue and expense information from selected states. and spas designed, constructed, and retrofitted to eliminate entrapment hazards (including evisceration or disembowelment, body entrapment, and hair entrapment or entanglement). ultimately, 255 research and evaluation studies and 112 expert statements were rated as presenting evidence of sufficient relevance for a strategy or action to be included in the revision of the guidelines. familial resemblance for v02max in the sedentary state: the heritage family study. can serve various purposes, including 1) improving the content, support for, and implementation of physical activity and healthy eating policies and practices; 2) documenting changes in the school environment, physical education and health education curricula, physical activity and healthy eating services for students and school staff members, physical activity and dietary habits, and health outcomes such as blood pressure and blood glucose levels; 3) identifying strengths and weakness of policies and practices and making a plan for improvement; and 4) responding to new and changing needs of students and school staff members. an appropriate ambient noise level using acceptable and positive enforcement practices (e. a review of correlates of physical activity of children and adolescents. schools should avoid elimination games such as dodge ball, bombardment, and elimination tag that limit opportunities for all students to be active (284). adolescent males also report a greater intention to be physically active in the future than females (120). improving and intensifying efforts to promote healthy eating and physical activity is entirely consistent with the fundamental mission of schools: educating young persons to become healthy, productive citizens who can make meaningful contributions to society. rockville, md: us department of health and human services, public health service, office of the surgeon general; 2001. increased television viewing among children and adolescents is associated with consuming more products such as fast food, soft drinks, and high-fat snacks (151,156,165,171--173) and consuming fewer fruits and vegetables (151,155,174). data and information can be gathered about the process of implementing program strategies and policies. guidelines in this report are not clinical guidelines; compliance is neither mandatory nor tracked by cdc. the effects of a family fitness program on the physical activity and nutrition behaviors of third-grade children. neema: a school-based diabetes risk prevention program designed for african-american children. health, mental health, and social services staff members should be equipped with skills to either refer appropriately or assist students with nutrition-related, physical activity--related, or weight-related health problems (675,676). marketing fruits and vegetables to middle school students: formative assessment results. body mass index (bmi) is a ratio of weight and height (kilograms/meters2) and is the most widely used and recommended measure to estimate weight status. increased effort is needed to ensure that participation in a school meal program that complies with the dietary guidelines for americans is promoted and supported. for example, behavior-change strategies that are initiated by children and adolescents (e. families, school personnel, health-care providers, businesses, the media, religious organizations, community organizations that serve children and adolescents, and the students themselves also should be systematically involved in implementing the guidelines to optimize a coordinated approach to healthy eating and regular physical activity among school-aged children and adolescents. content or materials that correspond with the sequence of learning events and help teachers and students meet the learning objectives;. physical inactivity and obesity are established risk factors for metabolic syndrome, and a poor diet can accelerate the risk for developing cvd among persons with metabolic syndrome (52). health, mental health, and social services staff members should be prepared to promote positive body image and body satisfaction; help students overcome barriers to healthy eating and physical activity; help students find social support, cope with teasing, set goals, and make decisions; and refer students who might require primary medical care (518). to assessment and motivational interviewing, staff members can use behavioral strategies, such as goal-setting, positive reinforcement, and self-monitoring, to facilitate changes in students' health behaviors (520). a school meal program offers students the opportunity to apply knowledge and skills learned through nutrition education, can affect students' food choices by providing nutrient information of the foods available, and can encourage students to make healthy choices (98,300,301). comparisons of teaching presentation and development of content: implications for effectiveness of teaching. of the importance of health and safety policies and activities to the superintendent, school board, schools, and community;.., setting goals for fruit and vegetable intake or rewarding themselves for eating fruits and vegetables) and positive feelings toward eating fruits and vegetables are predictors of fruit and vegetable intake (95). team of four cdc scientists used a database to record descriptions of each of the 1,325 scientific reports and expert statements, including health topics (e. this law allows school food authorities to identify potential food hazards, identify critical points where hazards can be eliminated or minimized through control measures, and establish monitoring procedures and corrective action.., established organization, ad hoc committee, federally sponsored committee, or cdc-funded grantee), and how evidence was presented in the expert statement. health, mental health, and social services staff members should seek out partnerships and serve on community health coalitions (515). physical education should help students master and gain confidence in motor, movement, and behavioral skills needed to establish and maintain physically active lifestyles. curricula that are consistent with scientific evidence of effectiveness in helping students improve healthy eating and physical activity behaviors. certain schools might need a higher nurse-student ratio for students who require daily professional nursing services or students with complex health needs (509). schools using provision 2 and provision 3 establish claiming percentages for reimbursement and serve meals free to all participating students for 4 years. coordination between health services staff members, special education, nutrition services staff members, and health and physical education staff members can help ensure that these policies are established. aa, ogden cl, johnson c, caroll m, curtin l, flegal k. the school health council provides input on decisions about how to promote health-enhancing behaviors, including healthy eating and physical activity among students. the relationship between physical fitness and physical activity during adolescence and cardiovascular disease risk factors at adult age. substantial percentage of recommended child and adolescent physical activity can be provided through a comprehensive school-based physical activity program.

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a climate that encourages and does not stigmatize healthy eating and physical activity. certain improvements in academic performance such as improved math scores also were noted (65,183). schools also should identify and link students and their families to community-based health promotion programs that encourage physical activity and healthy eating. all elementary schools should follow the naspe recommendation that at least one daily 20-minute period of recess be provided to all students (420). atlanta, ga: us department of health and human services, cdc; 2009. approximately 30 million students participate in the national school lunch program every school day, with approximately 63% of school lunches served free or at a reduced price for students from low-income families (303). that all foods and beverages sold or served outside of school meal programs are nutritious and appealing. community resources to help provide healthy eating and physical activity opportunities for students. department of health and human services, public health service, office of the surgeon general. reports were included if they had a rigorous study design with, at a minimum, a matched comparison group, strong study methods that contributed to confidence in the results, evaluation efficacy that included one or more positive results, and feasibility of implementing the intervention rated as medium or better. learning strategies, teaching methods, and materials that are culturally inclusive. schools may choose to enlist local universities, the health department, or the education department to assist with the evaluation of school policies and practices. successful program implementation can be influenced by staff training on proper program implementation (435) and coordination with community groups (436). pathways curriculum and family interventions to promote healthful eating and physical activity in american indian schoolchildren. school health council should identify strategies for establishing partnerships with families and community members. relationship between hunger and psychosocial functioning in low-income american children. receive inconsistent messages when they are taught about good nutrition and healthy food choices in the classroom but are surrounded by various venues offering primarily less nutritious foods. the development of self-perceptions of ability and achievement goals and their relations in physical education. in 2002, the national school lunch act (232) was amended with a provision encouraging institutions participating in the school lunch and breakfast programs "to purchase unprocessed agricultural products, both locally grown and locally raised, to the maximum extent practicable and appropriate" (233). students walk or engage in other forms of physical activity, rather than sitting or standing during roll call (146,382,409,410). physical education teachers should have professional development opportunities that teach concepts of quality physical education instruction, such as how to improve teaching methods, administer fitness tests and assess student performance, encourage family involvement in physical activity, incorporate national or state standards into the curriculum, conduct fitness education, use fitness-oriented technology, and increase active time during physical education class (145,641,644,663). taste preference for milk, among both males and females, is associated with calcium intake (92).., citrus fruits, tomatoes, melons, peppers, greens, cabbage, broccoli, strawberries, kiwis, and potatoes), to help the body absorb iron efficiently (70). intake, which is associated with increased blood pressure (85), has increased steadily during the last 35 years, in large part because of increased consumption of processed foods such as salty snacks and increased frequency of eating food away from home (84). because of the concern regarding the effect of food marketing on the diets of children and adolescents, congress ordered the creation of an interagency working group on food marketing to children in 2009 to develop recommendations for foods marketed to persons aged <18 years. url addresses listed in mmwr were current as of the date of publication.., random, quasiexperimental, or single group); length of follow-up after baseline measures; and outcomes of the study, such as impact on participant knowledge, attitude, behavior, or health status. the everyday realities of the multi-dimensional role of the high school community nurse. the healthy, hunger-free kids act of 2010 requires each school district's local wellness policy to include nutritional guidelines for all foods available on each school campus that promote student health and reduce childhood obesity (358). anorexia nervosa is characterized by a refusal to maintain a normal body weight. partnerships between schools and local government can create joint-use agreements to use school facilities to host farmers' markets, plant community gardens, or allow public access to school facilities, fitness centers, gymnasiums, or running tracks (601). therefore, activities or assignments that enable students to identify and address external and internal barriers and opportunities for physical activity should be integrated into physical education. university faculty members and students in the health field can provide programmatic and evaluation assistance to schools while gaining practical experience (603). a report on recommendations of the task force on community preventive services. the risk factors and precursors to these diseases are being detected in obese children (23), and national concern exists that this trend might lower the age of onset of chronic conditions and diseases and possibly decrease the quality of life or shorten the lifespan of obese children (51). students are eligible to participate in the school meal program; however, schools receive a smaller reimbursement for students who exceed income limits than for students from low-income families. pr, kaczorowski j, benioff s, tonniges t, schwartz d, palfrey j. the questions should be age appropriate; students aged <10 years might not be able to answer questions as reliably as older students. suggestions from students and families for meals and snack items that might be offered; and. provide a quality school meal program and ensure that students have only appealing, healthy food and beverage choices offered outside of the school meal program. provide a school employee wellness program that includes healthy eating and physical activity services for all school staff members. nationwide, in 2006, 40% of schools had a school health council that offered guidance on the development of policies or coordinated activities on health topics (193). type 2 diabetes was previously observed primarily among adults but has become more common among children and adolescents (26,29). policy is an important component of many of the nine guidelines. instructional strategies in physical education to improve students' confidence in their ability to be physically active and maintain physical activity behaviors. are elementary schools teaching our children to prefer candy but not vegetables? local wellness policies: assessing school district strategies for improving children's health 2006--07 and 2007--08. teachers' perspective on barriers to implementing physical activity curriculum guidelines for school children in toronto. annual professional development opportunities to staff members who lead or supervise healthy eating and physical activity programs during out-of-school time. effect of the bienestar health program on physical fitness in low-income mexican american children.., in a supportive, comfortable, and attractive environment with a minimal wait time (222). by middle school, students can understand and act on the connection between physical activity, healthy eating behaviors, and their overall health as well as the role these behaviors play in preventing chronic diseases (453,491). impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving. js, larsen js, sallis jf, conway tl, powers hs, mckenzie tl. in: allensworth d, lawson e, nicholson l, wyche j, eds. according to the 2005--2006 nhanes, 16% (overall) of persons aged 12--19 years and 30% of obese persons aged 12--19 years had prediabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes (26,34).., sudden weight loss, eating disorders, or obesity) should be referred to a primary health-care provider for diagnosis and, if needed, establishment of management or treatment plans. washington, dc: us department of agriculture, food and nutrition service; 2004. j, hoerr s, heine l, frost s, roisen d, berkimer m. outcomes of a high school program to increase fruit and vegetable consumption: gimme 5---a fresh nutrition concept for students. the effects of school gardens on students and schools: conceptualization and considerations for maximizing healthy development. influencing healthful food choices in school and home environments: results from the teens study. beurden e, barnett lm, zask a, dietrich uc, brooks lo, beard j. tl, sallis jf, prochaska jj, conway tl, marshall sj, rosengard p.., changes in school environment, norms, or curricula) and at the individual level (e. developing and maintaining a supportive school environment can improve the sustainability of healthy eating and physical activity policies and practices that support healthy lifestyles (147,217,218) (box 2). beltsville, md: us department of agriculture, national agricultural library, food and nutrition information center; 2005. the relationship of meal and recess schedules to plate waste in elementary schools. prevalence of overweight and obesity in the united states, 1999--2004. providing an additional stipend or ensuring that school employee wellness responsibilities are written into a leader's job description might increase the likelihood of sustaining programmatic activities. changes in nutrient intakes of elementary school children following a school-based intervention: results from the catch study. colorful and imaginative language and images of fruits and vegetables on menus, in hallways, and in the cafeteria;. participation in school meal programs, particularly breakfast, has been shown to be associated in the short term with improved student functioning on a broad range of psychosocial and academic measures (65,310--312). to address mental health concerns, schools might link students to school-based health centers or community-based services or employ mental health and social services staff members. this option, as well as direct certification, provision 2 and provision 3, and alternate service methods are described in usda food and nutrition service school breakfast toolkit (available at http://www. related topicscgioliver stonemoviesstonesjosephgordonlevittt snowdensnowden postersnowden 2016watch snowdensnowden leaksstone snowdensnowden josephreview snowdennice snowdenforwardsnowden en streaming complet. rates of obesity among children and adolescents are of particular concern because those who are obese are more likely to become overweight or obese adults and have related chronic diseases (8). school health, mental health, and social services staff members can play a key role in helping to communicate and promote these practices.., school score boards, vending machines, book covers, and homework incentives), and use of licensed characters to promote foods or restaurants. family involvement in weight control, weight maintenance and weight-loss interventions: a systematic review of randomised trials. however, to have an effect on children's health knowledge, attitudes, and behaviors, schools must strive to achieve high levels of parent participation and provide parents with multiple opportunities to participate and engage in activities (569). state and local education agencies can pass nutrition standards that are stronger than the federal requirements limiting the sale of competitive foods. the third school nutrition dietary assessment study: background and study design. almost two thirds (61%) of all schools required health instruction in at least one specific grade, but 34% of schools with 9th-grade students required it in 9th grade, 25% in 10th grade, 12% in 11th grade, and 9% in 12th grade (455). timeline indicating when the policy will be adopted, take effect, and expire. viewing and other screen-based media behaviors of children and adolescents. the ches examination is a competency-based test that measures the possession, application, and interpretation of knowledge related to health education (655). in the 2004--2005 school year, boys participated in the national school lunch program at a higher rate than girls, elementary school students participated at a higher rate than middle and high school students, students who were eligible for free and reduced-price meals participated at a higher rate than students who were not income eligible, rural students participated at a higher rate than urban students, and students whose parents did not attend college participated at a higher rate than those parents who did. restricting access to palatable foods affects children's behavioral response, food selection, and intake. volunteers have been shown to be an important component for sustaining programs, even when limited funding is available (447,584,592). a systematic review of environmental correlates of obesity-related dietary behaviors in youth. national health objective strives to increase the proportion of schools that require newly hired staff members who teach required health education to be certified, licensed, or endorsed by the state in health education (objective emc 4. a national study conducted during the 2004--2005 school year found that approximately 85% of public schools offering the national school lunch program served meals that met the standards for protein, vitamins, and minerals; 88% offered a vegetable (not including french fries) every day; 50% offered fresh fruit every day; and 62% offered canned fruit every day (306,321). school health, mental health, and social services staff members need preservice and in-service professional development in promoting healthy eating and physical activity and providing healthy eating and physical activity assessment, counseling, and referral. the psychosocial environment includes the social norms established by policies and practices that influence the physical activity and eating behaviors of students and staff members (216). a school environment that encourages a healthy body image, shape, and size among all students and staff members, is accepting of diverse abilities, and does not tolerate weight-based teasing. ds, kettel khan l, serdula mk, ogden cl, dietz wh. however, participants in the school breakfast program and national school lunch program also have higher sodium intake from school meals than those who do not participate (308). rationale for the policy, including emphasis on the effects of health on academic achievement;. all students have enough needed equipment such as balls and jump ropes to prevent students from waiting in lines and to allow adequate time for skill practice and participation (382,409,410). gender differences in physical activity in older children and adolescents: the central role of organized sport. engaging employers to develop healthy workplaces: the workwell initiative of steps to a healthier washington in thurston county. physical activity levels of children who walk, cycle, or are driven to school. the relationship between staff development and health instruction in schools in the united states. strategies for guideline 1: use a coordinated approach to develop, implement, and evaluate healthy eating and physical activity policies and practices. scientific reports were included if they were published during 1995--2009 to update and expand on research described in the previous guidelines. frozen vegetables or low-sodium canned vegetables instead of regular canned vegetables. describing the characteristics of evaluation studies and expert statements, four cdc staff members rated the relevance of each for inclusion in the guidelines. in addition, schools that establish and sustain school employee wellness programs generally encourage staff members to request activities, classes, and information that are most important for them personally (619,620,632). in addition, regular participation in the school breakfast program is associated with lower bmi among students (309). black high school students most frequently reported excessive television viewing (≥3 hours/day) (56%), compared with their hispanic (42%) and non-hispanic white (25%) counterparts. students' consumption of fruits and vegetables increase after their school increased the availability of fruits and vegetables? overall, these guidelines provide a comprehensive framework for schools to address healthy eating and physical activity. a controlled evaluation of a fitness and nutrition intervention program on cardiovascular health in 10- to 12-year-old children. intramural physical activity programs provide additional opportunities for students to achieve their recommended daily amount of physical activity. health education that incorporates the topics of healthy eating and physical activity has been shown to improve student dietary behaviors (148,467,470--472) and physical activity participation levels (148,217); reduce sedentary behaviors (159,457,473); and improve serum cholesterol levels (474--476), blood pressure (474,477), and bmi (457,459,474,477). staff members who teach physical education or health education, lead nutrition services programs, and implement health, mental health, and social services require certification or specialized training or both (640--642). parents, other family members, and community members can volunteer their time and skills to support school initiatives and help provide necessary assistance and supervision. effects of fast-food consumption on energy intake and diet quality among children in a national household survey. in conjunction with district-level human resources, risk management, and employee benefits staff members, school employee wellness committees can identify critical data related to school employee well-being, such as health insurance costs, workers' compensation claims, absenteeism rates (includes costs of substitute teachers), and employee turnover rates. schools have direct contact with students for approximately 6 hours each day and for up to 13 critical years of their social, psychological, physical, and intellectual development (176). a potential decline in life expectancy in the united states in the 21st century.., regular encouragement of physical activity or regularly placing value on being active). children with a tv in their bedroom at higher risk for being overweight. a study of the association between children's access to drinking water in primary schools and their fluid intake: can water be 'cool' in school? student needs related to physical activity, nutrition, and obesity, and provide counseling and other services to meet those needs. among persons aged 2--20 years, overweight is classified as bmi ≥85th to <95 percentile for age and sex; obesity is classified as bmi ≥95th percentile for age and sex (38).., self-efficacy) and perceived competence affects their participation in the activity (112,121--123). qualified professionals such as nurses, physicians, dentists, health educators, and other allied health personnel provide school health services. a certification in the specialty of school nursing is preferred, with a current state license as a registered nurse to be able to serve both as a full-time health-care provider and health educator (509,511,512). the lighting in the serving area and placing the salad bar near the cashier rather than away from the main serving area. the hiring of physical education teachers, health education teachers, and nutrition services staff members who are certified and appropriately prepared to deliver quality instruction, programs, and practices. effect of including parents in a school-based exercise and nutrition program for children. health professionals outside of the school can advise on health education curricula and contribute to lessons and presentations specific to nutrition and physical activity; conduct health screenings; provide expertise on nutrition and physical activity at health fairs, family or teacher workshops, and for health services; and initiate walking and other physical activity initiatives (592,602). practice documents, position statements of individual persons or on behalf of organizations, and convened expert panels that covered topics related to youth physical activity and nutrition were included in the expert statements that were read and rated for sufficiency of evidence. school setting can offer multiple opportunities for students to enjoy physical activity outside of physical education class and increase daily amounts of physical activity, including (377,419). in 2006, among the 73% of school districts that had a district school health council, 89% included community members, 76% included families of students, 51% included local health-care providers, 50% included representatives from the local health department, 40% included representatives from local social service agencies, and 26% included representatives from local health organizations (e.., expert group statement, best practices document, or position statement), who convened the statement process, who funded the statement process, the nature of the convening group (e. washington, dc: us department of agriculture, food and nutrition service; 2008. finally, students with disabilities should have measurable physical education goals and objectives (established by the physical education teacher or other school staff members) included in their iep. the review identified a total of 251 associations between school-based physical activity and academic performance. differences in response to nutrition and fitness education programmes in relation to baseline levels of cardiovascular risk in 10- to 12-year-old children. written curricula should be based on an appropriate sequencing of learning activities, including the following: 1) lessons focused on motor skills, physical activity, and fitness assessments that are age and developmentally appropriate; 2) methods of teaching motor, movement, and behavioral skills that ensure basic skills lead to more advanced skills; and 3) student assessment plans to appropriately monitor and reinforce student learning., districts, and schools should use a systematic approach when developing, implementing, and monitoring healthy eating and physical activity policies.., local ymca or parks and recreation departments) who lead or supervise recess should be appropriately trained to provide active supervision, promote physical activity during recess, minimize conflict among students, and maximize cooperation among students. other examples include basketball and golf tournaments, dance-a-thons, and car washes. regular inspection and maintenance of indoor and outdoor play surfaces should ensure that environmental safety devices are provided and maintained, including (244,248). most districts (57%) required only a high school diploma or its equivalent for newly hired district nutrition services directors; 24% of districts did not have any minimum level of education for newly hired district nutrition services directors; 74% of districts required only a high school diploma or its equivalent for newly hired school nutrition services managers; and 22% of districts did not have any minimum level of education for newly hired school nutrition services staff members. a planned and sequential health education curriculum that is culturally and developmentally appropriate, addresses a clear set of behavioral outcomes that promote healthy eating and physical activity, and is based on national standards.., establishment of adult learning communities, improving leadership, and garnering resources), process standards (e. in 2006, 33% of elementary schools, 71% of middle schools, and 89% of high schools had a vending machine or a school store, canteen, or snack bar where students could purchase foods or beverages (103). most of the ≥60 minutes/day should be either moderate- or vigorous-intensity aerobic physical activity., mental health, and social services staff members play an important role in developing and marketing a referral system for students and families (215,498,513,535). guidelines for all foods available on each school campus under the jurisdiction of the local educational agency during the school day that are consistent with requirements in the act and that promote student health and reduce childhood obesity;. the list should include services that are accessible to all students, including those with low family incomes or without health insurance or transportation. health education for middle and high school students should focus on self-assessment and setting personal goals (498,499). eating and regular physical activity play a substantial role in preventing chronic diseases, including heart disease, cancer, and stroke, the three leading causes of death among adults aged >18 years (1--5). 1994--1998, approximately three in 10 children and adolescents consumed at least one fast-food meal per day; those who reported eating fast foods consumed more total calories than those who did not (103).., ensuring that school meals have appealing fruits, vegetables, whole grains, and low-fat or fat-free milk products); competitive food policies; increasing the percentage of students participating in school meals; making school meals more appealing to increase student participation in meal programs; menu planning for healthy meals; preparing fresh fruits and vegetables; food safety; using the cafeteria for nutrition education; offering an array of healthy and culturally appropriate foods and beverages; and reinforcing classroom lessons on healthy food choices in the cafeteria (105,299,671,672). information about the number of students in the school who meet diet, physical activity, and weight status recommendations can be used to guide program planning and policy advocacy efforts. in older adults, fractures lead to physical disabilities, depression, reduced quality of life, and potentially death (56,57). consequently, offering competitive foods in vending machines at schools is associated with significantly higher bmi among middle school students (348). staff members can work through the school health council to establish policies and practices that promote the school health agenda. nights are designed to attract families to the school to engage them in health education and promotion activities. healthy people 2020 national health objectives include an objective on increasing the proportion of adolescents who meet current federal physical activity (pa) guidelines for aerobic physical activity and for muscle-strengthening activity (objective pa 3) (10). policy and environmental strategies should aim to make sustainable organizational changes, such as improving access to healthy foods, providing more on-site opportunities for physical activities, and point-of-decision prompts that encourage use of stairwells (378,633). le film Évolution 2016 complet en streaming vf movies online complet sur le web site streaming http://filmvfmovies. / top films / aventure / américain / science fiction / date de sortie : 2016. health education teachers who receive topic-specific professional development include more instruction on health topics within their lessons than teachers who do not receive topic-specific professional development (670). are some topics that a health practitioner can address during a rapid physical activity assessment (37,38,520):Amount of daily physical activity participation (e. food security, poverty, and human development in the united states. parent, family, and community volunteers to assist with healthy eating and physical activity initiatives. bridging the gap between schools and community: organizing for family involvement in a low-income neighborhood. the new guidelines in this report synthesize the scientific evidence and best practices during 1995--2009 and combine healthy eating and physical activity into one set of evidence-based guidelines for schools serving students in kindergarten through 12th grade (grades k--12); other educational programs within schools, such as prekindergarten, might also be able to apply these guidelines in their settings. health, mental health, and social services staff members can assess which services are available at the school and which require outside referral (182). among adults aged ≥20 years, overweight is classified as bmi ≥25 to <30 kg/m2; obesity is classified as bmi ≥30 kg/m2. evidence indicates that these behaviors are associated with energy intake and can be a focus of change if needed (37,38,520):Frequency of eating fast food or outside the home in restaurants. for example, the 2010 guidelines provide guidance on the amount of fruits and vegetables that children and adolescents should consume.. national diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the united states, 2011. calcium and dairy intakes of adolescents are associated with their home environment, taste preferences, personal health beliefs, and meal patterns. facilitating change in school health: a qualitative study of schools' experiences using the school health index. an after-school obesity prevention program for african-american girls: the minnesota gems pilot study. importance of healthy eating, including eating breakfast, for the overall health and well-being of school-aged children cannot be understated. the impact of a school-based nutrition education intervention on dietary intake and cognitive and attitudinal variables relating to fruits and vegetables. a brief review on correlates of physical activity and sedentariness in youth. other teaching practices that might increase students' participation in physical activity include enthusiastic role modeling and positive verbal reinforcement for being active (146,383,402). strategies for guideline 5: implement health education that provides students with the knowledge, attitudes, skills, and experiences needed for healthy eating and physical activity. only 16% of all districts required a newly hired school nutrition services manager to be certified, licensed, or endorsed by the state (105). is the second leading cause of death in the united states, and black adults have a higher incidence rate of cancer than persons of any other racial/ethnic group (18,24). schools should use this information to promote healthy diets and recipes that are feasible for students and their families to incorporate into their lifestyle (573). effects of the catch physical education intervention: teacher type and lesson location. iron deficiency ranges from depleted iron stores without functional or health impairment to iron deficiency with anemia, which affects the functioning of several body systems (70). educational activities might include lectures, written materials, and educational software (378,633). partners, including individual persons, agencies, and organizations, can offer multiple resources for healthy eating and physical activity initiatives at schools (e. trends of elevated blood pressure among children and adolescents: data from the national health and nutrition examination survey 1988--2006. nationwide, 58% of high school students reported playing on at least one sports team run by their school or a community group in 2009 (78). non-hispanic black and hispanic students also were more likely to report excessive computer use (≥3 hours/day) (30% and 26%, respectively) compared with non-hispanic white students (22%) (78).., walking, jogging, and weightlifting), provide bones with proper support for healthy growth. professional development also might influence physical education teachers' personal attitudes and beliefs toward physical activity and fitness (643,645).

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    classroom instructional methods and strategies that are interactive, engage all students, and are relevant to their daily lives and experiences. of the range of activities that require the involvement of various professionals, staff members should work collaboratively to coordinate student care and school health, mental health, and social services both within and outside of the school setting (215,509,514--517). each of the 53 agencies provided a review of the guidelines and proposed revisions. / top films / américain / français / science fiction / date de sortie : 2016. education instruction, including student fitness and physical activity assessment results. disorders are psychological disorders characterized by severe disturbances in eating behavior. implement health education that provides students with the knowledge, attitudes, skills, and experiences needed for healthy eating and physical activity. these guidelines support the 2010 dietary guidelines for americans (5), the 2008 physical activity guidelines for americans (9), and the healthy people 2020 objectives related to healthy eating and physical activity among children and adolescents and schools (10). guidelines presented first focus on the importance of a coordinated approach for nutrition and physical activity policies and practices within a health-promoting school environment. a review of studies on the effect of iron deficiency on cognitive development in children. in addition, students with extreme perceptions of body size (e. advertising and marketing influence food and beverage preferences and purchase requests of children and adolescents (i. parent involvement with children's health promotion: the minnesota home team.. department of agriculture, alexandria, virginia; office of safe and drug-free schools, u. fruits, vegetables, whole grain products, and fat-free or low-fat dairy products should be offered, whereas foods that do not contain important nutrients; foods that are high in fat, added sugar, or sodium; and sugar-sweetened beverages should be eliminated or limited. students have access to needed health, mental health, and social services. these products, referred to as competitive foods and beverages because they are sold in competition with traditional school meals, often are sold in the school cafeteria and are available throughout school buildings, on school grounds, or at school-sponsored events.., recess and intramural programs) should complement rather than take the place of physical education by serving as venues for students to explore various physical activities. school environment also influences youth eating behaviors and provides them with opportunities to consume an array of foods and beverages throughout the school day. home environment and parental influence are strongly correlated with youth eating behaviors. various formats for involving families and offer frequent opportunities for participation. without a physical education curriculum, documenting what should be taught, what has been taught, and whether students are achieving learning objectives or outcomes is difficult. breakfast habits, nutritional status, body weight, and academic performance in children and adolescents.: a randomized controlled trial for overweight prevention in preschool minority children. 2008, the prevalence of obesity among children aged 6--11 years was 20%, nearly triple the prevalence in 1980 (7%) (6,39--41). process evaluation of a physical activity self-management program for children: spark. the physical activity and nutritional needs of students with chronic health conditions. practice guideline for the treatment of patients with eating disorders, 3rd ed. schools should establish policies that allow full participation by all students in physical activity, including extracurricular activities, and ensure access to preventive and quick-relief medications as indicated by a student's individualized health care plan, 504 plan, individualized education plan (iep), or all of these as appropriate (204,288--297). the claxton elementary school health program: merging perceptions and behaviors to identify problems. of trade names and commercial sources is for identification only and does not imply endorsement by the u. health, mental health, and social services are accessible to students who have special needs or chronic health conditions and those who do not have health insurance or might not make regular visits to a health-care provider. schools should provide a respectful and welcoming climate to families and outside organizations, and the school principal should fully support outside involvement (556) (box 7).., parent-teacher associations [ptas]) might help recruit other interested participants through announcements, telephone trees, and reminders when families are at the school (585). parents' perceptions about environmental factors also influence physical activity among children and adolescents. washington, dc: executive office of the president of the united states; 2010. listening to girls and boys talk about girls' physical activity behaviors. all groups invested in school health, including families and community members, and those who will be affected by policies or programs should have representation on the school health council (194,586,591,592). specifically, 69% of states and 84% of districts had a policy stating that newly hired elementary school physical education teachers be certified, licensed, or endorsed by the state to teach physical education; 88% of states and 87% of districts had such a policy at the middle school level, and 90% of states and 93% of districts had such a policy at the high school level (144). cultural awareness in healthy eating and physical activity practices throughout the school. low-nutrient, energy-dense foods obtained and consumed at school contributed 86 kcal per school day for middle schools students and 111 kcal per school day for high school students. streaming, streaming film, telecharger, films, regarder film streaming, dvdrip, film en streaming, streaming iphone, gratuit. strategies for guideline 4: implement a comprehensive physical activity program with quality physical education as the cornerstone. monitoring policy implementation allows school staff members to determine whether the policy yielded the expected results and which changes could be made to improve the results. jf, conway tl, prochaska jj, mckenzie tl, marshall sj, brown m. strategies for guideline 2: establish school environments that support healthy eating and physical activity. physical education teachers often use too much of their class time for activities related to administrative and management tasks (e. diagnosis and management of the metabolic syndrome: an american heart association/national heart, lung, and blood institute scientific statement. or community-based sports programs provide structured time for children and adolescents to accumulate minutes of physical activity, establish cooperative and competitive skills, and learn sport-specific and performance-based skills.. preschool children and nonpregnant females of childbearing age: national health and nutrition examination survey 2003--2006. furthermore, lower-income and minority neighborhoods tend to have more fast-food restaurants than high-income and predominately white neighborhoods (101). adequate professional development should be offered to teachers because these active learning strategies may be unfamiliar to some (182). the 2009 iom report school meals: building blocks for healthy children (319) recommendations reflect current dietary guidance including increasing the requirements for fruits, vegetables and whole grains, requiring only fat-free and low-fat milk, and decreasing the amount of sodium and trans fat in school meals. one person, such as the school health coordinator (at the district or school level, depending on the level at which the policy is to be implemented), should assume or be designated with overall responsibility for coordinating and implementing healthy eating and physical activity policies. department of education, national center for education statistics, national forum on education statistics; szuba t, young r, school facilities maintenance task force, eds. nutrition integrity in mississippi schools, replacing kitchen fryers with combination oven steamers: six steps to success. public health and clinical recommendations for physical activity and physical fitness: special focus on overweight youth. schools should seek out and taste test standardized recipes that are low in fat, oil, salt, and sugar to ensure that they are acceptable to students.. school challenge commit to meeting specified criteria including stricter nutrition standards such as increasing the number of servings of whole-grain foods, dark green and orange vegetables, and dry beans and peas. health education is a fundamental part of an overall school health program. the physical environment includes the entire school building and the area surrounding it; facilities for physical activity, physical education, and food preparation and consumption; availability of food and physical activity options; and conditions such as temperature, air quality, noise, lighting, and safety (215).., traffic interventions), attract awareness about healthy lifestyle behaviors, repeat consistent health messages, increase support for school initiatives to promote healthy eating and physical activity, and ensure sustainable funding (447,583,589,597,598). y, carroll m, prineas rj, mcdowell ma, louis t, tilert t. for example, the task force on community preventive services reported insufficient evidence for school-based nutrition programs and for obesity prevention and control programs in schools. cdc also garnered input from 53 federal and state education and public health agencies, as well as from nongovernmental organizations that represented policy makers, educators, parents, students, school nurses, physicians, and other health-care providers. worksite characteristics and environmental and policy supports for cardiovascular disease prevention in new york state. national health education standards emphasize the development of skills and specify that, as a result of health education, students should be able to 1) understand concepts related to health promotion and disease prevention; 2) analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors; 3) access valid information, products, and services to enhance health; 4) use interpersonal communication skills to enhance health and avoid or reduce health risks; 5) use decision-making skills to enhance health; 6) use goal-setting skills to enhance health; 7) practice health-enhancing behaviors and avoid or reduce health risks; and 8) advocate for personal, family, and community health (453). professional development formats most preferred by nutrition services personnel include hands-on workshops, use of demonstrations, and skill-building workshops with active involvement of participants (672). g, tang j, piessens p, grant u, johnson n, murray h. contribution of organized sports participation to estimated daily energy expenditure in youth.., forcing students to perform push-ups or sit-ups for bad behavior in physical education) might create negative associations with physical activity in the minds of students (279). solving the problem of childhood obesity within a generation: report to the president. school staff members with comprehensive professional development to deliver quality health education, physical education, food services, and health services. for example, allowing students to choose the type or intensity of a specific physical activity might help increase their confidence in their ability to perform the activity in the future; they can progressively add more intensity (412). a systematic approach to develop, implement, and monitor healthy eating and physical activity policies. many of the programs included within rtips have a physical education component, although the curricula are not extensively or separately analyzed. from concept to application: the impact of a community-wide intervention to improve the delivery of preventive services to children. dance and reducing television viewing to prevent weight gain in african-american girls: the stanford gems pilot study. counseling that involves students' families might have a greater impact on the environmental influences that shape students' diet and physical activity behaviors away from school (37). correlates of physical activity in a national sample of children aged 9--13 years. re, murphy jm, little m, pagano j, wehler ca, regal k et al. although evaluations of the effects of family involvement in school and community-based health interventions have been inconclusive (largely because of variability in study design and inadequate family participation) (334,472,479,563--577), certain findings are worth noting. in addition, children and adolescents need to be trained to use equipment correctly; this is particularly true of helmets (261). schools also need access to a consulting physician to provide services such as school-based standing orders, consultations and supplementary training for staff members, recommendations for families, review of school health and health services policies and procedures, and communication with and referrals to physicians or other health-care providers (182,215,509). breathing difficulties related to physical activity for students with asthma: exercise-induced asthma.., whether student is viewing >1--2 hours of quality programming per day). the 2009 national yrbs indicated that only 18% of high school students had been physically active for 60 minutes every day in the previous week (78). prevent injuries during unstructured play time, schools should consider implementing training sessions for staff members focusing on observation techniques, behavior management, appropriate supervision, and emergency response procedures (244). undernutrition can have lasting effects on overall health, cognitive development, and school performance (62--65). a substantial percentage of each student's recommended daily amount of physical activity in physical education class. the guidelines recommend a maximum daily intake of sodium of 2,300 mg or 1,500 mg, depending on age and other individual characteristics. spaces and facilities for physical activity, including playing fields, playgrounds, gymnasiums, swimming pools, multipurpose rooms, cafeterias, and fitness centers, should be regularly inspected and maintained, hazardous conditions should be corrected immediately, and a comprehensive safety assessment should be done at least annually (247,248). jm, wehler ca, pagano m, little m, kleinman r, jellinek ms. volunteer coaches who work with beginning athletes in schools should have the level 1 coaching competency delineated by naspe (259) and other professional organizations that provide coaching certification. in 2006, 26% of elementary schools did not provide regularly scheduled recess for students in all grades in the school (144). department of health and human services, national diabetes education program. american cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. a quality physical education program: 1) meets the needs of all students, 2) is an enjoyable experience for students, 3) keeps students active for most of physical education class time, 4) teaches self-management as well as movement skills, and 5) emphasizes knowledge and skills that can be used for a lifetime (293,378). evaluation of a health and nutrition education program in primary school children of crete over a three-year period. the national school lunch program and school breakfast program were initiated, in part, as a way to reduce undernutrition among children and adolescents (68). with eating disorders, who are binge eating, or who have other weight concerns might need more specific mental health and social services (519).., private physicians and dentists, hospitals, psychologists and other mental health workers, pediatric weight management clinics, community health clinics, and managed care organizations), and community-based nutrition and physical activity providers and services (e. schools can take numerous steps to help shape a health-promoting psychological environment. are some of the topics that a health practitioner can address during a rapid dietary assessment.., students and school staff members) to which the policy applies;. and physical activity topics also can be integrated into other academic disciplines to complement comprehensive health education and physical education programs (456,457). expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. following is a list of key healthy eating and physical activity policies that are described in the remaining guidelines:Provide nutritious and appealing school meals that comply with the u. association of perceived environmental characteristics and participation in organized and non-organized physical activities in adolescents. environmental, policy, and organizational approaches might result in positive behavior change among school employees. the healthy, hunger-free kids act of 2010 requires usda to update the meal patterns and nutrition standards for the national school lunch program and school breakfast program based on recommendations made by the food and nutrition board of the national research council of the national academies of sciences (318).., profiles) is a system of surveys assessing school health policies and practices in states, large urban school districts, territories, and tribal governments. ample opportunities for all students to engage in physical activity outside of physical education class. students who use physically active forms of transportation have higher overall levels of physical activity (442--444) and are more likely to meet physical activity recommendations (445,446). some progress has been made in limiting the availability of unhealthy foods in schools. these efforts ensure that students who require ongoing management for chronic health conditions will receive continuous care and monitoring at school. sports programs should provide structured, competitive opportunities for students to develop both sport-specific and behavioral skills (260). instructional strategies to improve students' behavioral skills in physical education and physical activity programs. television viewing among children and adolescents, in particular, has been shown to be associated with childhood and adult obesity (150--157). have repeated opportunities to practice physical activity and healthy eating behaviors that are relevant to their daily lives (485,488,489,495,496). diet and physical activity are critical to the management of many chronic health conditions, such as asthma, diabetes, obesity, and food allergies.. children aged 6--11 years and 18% of persons aged 12--19 years were obese, percentages that have tripled since 1980 (6). the guidelines also recommend that children, adolescents, and adults limit intake of solid fats (major sources of saturated and trans fatty acids), cholesterol, sodium, added sugars, and refined grains (5). fmnv are defined as foods and beverages with <5% of the recommended dietary allowances per serving for eight key nutrients; fmnv include soda, water ices, chewing gum, and certain types of candy, including gum drops, jelly beans, and candy-coated popcorn (340,341). children and adolescents experiencing hunger also are more likely to be absent and tardy from school than other children and adolescents (64). assessments that are performance based (rather than based on recall and recognition) enable students to apply knowledge and skills and are well-suited to learning skills such as effective decision-making and interpersonal communication (453,462,467). playing it safe: the influence of neighborhood safety on children's physical activity---a review. members of a school employee wellness committee should review organizational policies, programs, strengths, and barriers to identify priorities for nutrition and physical activity (192,620). students to community-based health-care providers and healthy eating and physical activity services. der horst k, paw mj, twisk jw, van mechelen w. education should be part of a comprehensive school health education curriculum. annual professional development opportunities for school health, mental health, and social services staff members and staff members who lead or supervise out-of-school--time programs, recess, and cafeteria time. on a typical school day during the 2004--2005 school year, among students who participated in both the school breakfast program and the national school lunch program, an average of 47% of their calories came from meals and snacks consumed at school (305). health, mental health, and social services staff members can collaborate with students' families and health-care providers to maximize student participation, provide modified activities when appropriate, and eliminate barriers to student participation. np, denk jp, roberts jk, tharp bz, bost m, thompson wa. lack of trained staff is a barrier to implementing safe, organized and effective programs, instruction, and services. education curricula, regardless of the topic, should reflect the research that emphasizes teaching functional health information (essential concepts), shaping personal values that support healthy behaviors, shaping group norms that value a healthy lifestyle, and developing essential health skills necessary to adopt and maintain health-enhancing behaviors. school employee wellness programs that include healthy eating and physical activity components can increase teacher morale and improve general well-being and perceived ability to handle job stress (616--618). c, smit e, troiano rp, bartlett s, macera c, andersen r. healthy and safe school environment, part 1: results from the school health policies and programs study 2006. the prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. substantial barriers to family participation in school-based programs and activities are scheduling conflicts and lack of transportation. unless specified otherwise, the goal of the weight management strategy should be weight maintenance versus weight loss. one technique to overcome these barriers is to link health promotion initiatives to activities that already involve family members (580), such as pta meetings, parent-teacher conferences, tutoring programs, interscholastic sports, and school plays. | about us | support us | contact us | terms of use | datalife engine documents | host dle websites. employ qualified persons, and provide professional development opportunities for physical education, health education, nutrition services, and health, mental health, and social services staff members, as well as staff members who supervise recess, cafeteria time, and out-of-school--time programs. marketing healthy options might persuade students to purchase healthy foods and beverages. classroom health education teachers who receive specialized training on health education topics have been shown to effectively implement health education programs (217,651--653). internet-based programs might include interactive online activities such as prompts to be physically active or eat a nutritious snack, weight and behavioral assessments, goal-setting, tracking progress toward achieving health goals, and suggestions for overcoming barriers. changing fruit and vegetable consumption among children: the 5-a-day power plus program in st. exemptions and waivers deprive students of instruction time that is critical for developing motor, movement, and behavioral skills that are essential for the lifelong maintenance of a physically active lifestyle; furthermore, exemptions and waivers might send the message to students that physical education is not as important as other academic content areas and activities (385). the expert committee on clinical guidelines for overweight in adolescent preventive services. information with school administrators about the benefits of employee wellness programs and the interests and needs of school staff members can increase their support and resource allocation for such programs (628,629). school food authorities are required to develop and implement a food safety program based on a hazard analysis critical control point system (320). psychosocial correlates of fruit, vegetable, and dietary fat intake among adolescent boys and girls. school environment can also influence the participation of children and adolescents in physical activity. representatives from health departments, health care, recreation and fitness centers, businesses, and nonprofit organizations.., increase physical education from 1 or 2 days per week to at least 3 days per week).. department of health and human services (hhs) recommends that children and adolescents engage in ≥60 minutes of physical activity daily. coordination of services might increase student and family participation in community-based healthy eating, physical activity, and obesity prevention programs (540--542).. recommendations to prevent and control iron deficiency in the united states. national, state, and local education and health agencies; institutions of higher education; and national and state professional organizations should collaborate to provide professional development opportunities to school health staff members (box 9). prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among u. the national food service management institute and usda's food and nutrition service offer various trainings and resources to assist school food authorities in implementing food safety programs. overweight and obesity are associated with increased risk for numerous types of cancer, including cancer of the breast, colon, endometrium, esophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix, and prostate, as well as multiple myeloma and hodgkin's lymphoma (17). determinants of physical activity and low-fat diet among low income african american and hispanic middle school students. modifying the recess before lunch program: a pilot study in kaneohe elementary school. lee, phd, cdc, national center for chronic disease prevention and health promotion, 4770 buford hwy ne, ms k-12, atlanta, ga 30341. trends in the association of poverty with overweight among u. i, van der horst k, wendel-vos w, kremers s, van lenthe fj, brug j. for example, in 2006, all states offered at least one type of certification, licensure, or endorsement to teach physical education (144). however, although three fourths of schools met the fat standards in school breakfasts, less than one third of schools met the standards for calories from fat or saturated fat in the average lunch (321). alexandria, va: us department of agriculture, food and nutrition service, office of analysis, nutrition and evaluation; 2002. differences in behavior, psychological factors, and environmental factors associated with participation in school sports and other activities in adolescence. as a liaison between the school and those who oversee school health and safety programs at the district level and in other schools;. however, among children of normal weight, 26% had at least one risk factor, and 13% had two or more risk factors (23). diet and physical inactivity are risk factors for numerous conditions that affect overall health and quality of life, and many of these conditions can lead to chronic diseases. students in grades k--12 to participate in daily physical education that uses a planned and sequential curriculum and instructional practices that are consistent with national or state standards for physical education. opportunities for students to wash or sanitize their hands in a convenient place before eating;. using technology to promote self-efficacy for healthy eating in adolescents. evaluation of a community-based intervention to promote physical activity in youth: lessons from active winners. school staff members with annual professional development opportunities to deliver quality physical education, health education, and nutrition services. using the school environment to promote physical activity and healthy eating. of cultural heritage, family attitudes and customs, and differences in physical activity and diet of students when designing lesson plans; and. physical education should encourage students to believe that physical activity is important and enjoyable. understanding the differences between what teachers want and what they receive is important to identify any gaps in professional development topics and plan for future trainings or workshops.) the use of practice-based expert opinion refines research-based guidelines to ensure that recommendations are accessible, given limited funding and resources; credible, allowing them to be implemented in various school settings and communities; and reasonable in terms of the expectations they set for professional practice and health outcomes (13). promoting physical activity and a healthful diet among children: results of a school-based intervention study. among these states and districts, most require or recommend standards or guidelines based on the national standards for physical education (144), which describe what students should know and be able to do as a result of quality physical education. each school should establish a school health team, representative of school and community groups, to work with the greater school community to identify and address the health needs of students, school administrators, parents, and school staff. volunteer youth sport coaches' perspectives of coaching education/certification and parental codes of conduct. education can increase student participation in physical activity, increase their physical fitness (146,147,380--383), and enhance their knowledge and skills about why and how they should be physically active (380,384). reviewing the relationship between school factors and substance use for elementary, middle, and high school students..During the last 3 decades, the prevalence of obesity has tripled among persons aged 6--19 years.'s framework for program evaluation in public health summarizes and organizes essential elements of program evaluation (212). data from 2003--2006 national health and nutrition examination survey (nhanes) indicated that 3% of children and adolescents aged 8--17 years had increased blood pressure and that this risk was significantly greater among those who were obese (8%) (22). schools should implement nutrition standards that provide students with only healthy choices throughout the regular and extended school day and throughout the campus that are consistent with and reinforce positive nutrition education messages received in the classroom. a systematic review of the effect of breakfast on the cognitive performance of children and adolescents. 1980, blacks aged <20 years have experienced greater bmi increases than both white and mexican-american persons of the same age (42).

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    healthy eating and regular physical activity can help prevent this type of diabetes (29,31,32).., when a child asks a parent to buy a specific item) and influence the dietary intake of children and adolescents (107). addition to the literature search and rating the sufficiency of the evidence, cdc convened a group of 10 experts in youth nutrition, physical activity, school health, school food service, education, and public health to review the scientific evidence and to provide individual input on proposed revisions of the guidelines. student needs related to physical activity, nutrition, and obesity, and provide counseling and other services to meet those needs. partnerships among schools, families, and community members can enhance student learning, promote consistent messages about healthy behaviors, increase resources, and engage, guide, and motivate students to eat healthfully and be active (557,559). these three sectors of society influence the growth and development of children and adolescents and share the responsibility for nurturing them into healthy and productive adults (557,559). material in this report originated in the national center for chronic disease prevention and health promotion, ursula e. students with signs of serious conditions or health risk behaviors should be referred to a primary health-care provider (519). in 2006, nearly one in four schools held fundraiser nights at fast-food restaurants, and 54% sold baked goods that were not low in fat (105). providing students with various activity choices might maximize physically active time during recess, and working with students to resolve conflict might lead to positive peer interaction during recess and within classrooms. the provision of professional development activities for school health staff; and.., raffles, door prizes, grocery coupons, t-shirts, childcare, gift cards, discounted trip tickets, transportation tickets, or gas cards) (604,605). who are already active and have healthy diets should be encouraged to continue these behaviors. for example, during 2006--2008, across 35 states, the median percentage of schools that allowed students to purchase the following items from vending machines or at the school store, canteen, or snack bar decreased: chocolate candy (from 39% to 21%), other kinds of candy (from 43% to 24%), salty snacks not low in fat (47% to 34%), soda pop (from 62% to 38%), and sports drinks (from 72% to 57%) (347). from school staff members is essential when determining their nutrition and physical activity needs and developing program activities that either influence or affect them personally (192,628,629). health education curricula and instruction should address various health topics, including healthy eating and physical activity, systematically and sequentially to ensure attainment of national and state standards and corresponding learning objectives and outcomes (452,453). school nutrition services staff members may modify menus to include healthier foods, such as serving more fruits, vegetables, and whole grains, and offering a greater variety of low-fat foods, including fat-free and low-fat milk. and adolescents also could be provided with, and required to use, protective clothing and equipment appropriate for the type of physical activity and the environment (259). students with signs of disordered eating or diet-related health conditions (e. associations of body mass index and perceived weight with suicide ideation and suicide attempts among u. each of these sectors has an important, independent role to play in improving the dietary and physical activity behaviors of young persons. for example, baked french fries have 55% less total fat and 34% less saturated fat than deep-fried french fries (324). the goal of staff collaboration within the school setting should be to provide consistent messages about health behaviors to all students; delegate case management to the staff member with the most appropriate training, competency, and licensure for a particular health issue (215); and coordinate care among health, mental health, and social services staff members when students have physical health conditions that might coexist with mental health problems (box 6). male adolescents report greater consumption of fruits and vegetables and higher daily intakes of calcium, dairy servings, and milk servings than females (78,92). to provide input on policies, curricula, and programs that are being considered for adoption. portion sizes should be reasonable for the age of the student (35).., unhealthy dietary behaviors and physical inactivity) and the prevalence of obesity and asthma among high school students. an approach to improving science knowledge about energy balance and nutrition among elementary- and middle-school students. teaching teens to cope: coping skills training for adolescents with insulin-dependent diabetes mellitus. garden-based nutrition education affects fruit and vegetable consumption in sixth-grade adolescents. a total of 1,325 full scientific reports and expert statements were retrieved and reviewed for consideration in the guidelines. annual professional development opportunities to school health, mental health, and social services staff members. participation decreased as grade level increased, decreasing from 73% among elementary students to 60% among middle school students and 44% among high school (314). impact of pedometer use and self-regulation strategies on junior high school physical education students' daily step counts. the dietary guidelines do not have a recommendation for the maximum daily intake for added sugar, they do recommend that persons reduce their intake of added sugars (5). healthy living through healthy eating and regular physical activity reduces the risk for the top three leading causes of death in the united states (heart disease, cancer, and stroke), as well as for certain chronic conditions, such as high blood pressure and type 2 diabetes (1,2,17). instructional strategies in physical education that enhance students' behavioral skills, confidence in their abilities, and desire to adopt and maintain a physically active lifestyle. do i view different file formats (pdf, doc, ppt, mpeg) on this site?., running laps or doing push-ups) to punish students for bad behavior in physical education. health, mental health, and social services staff members should be attentive to students with these conditions to ensure they are meeting healthy eating and activity recommendations (533--535). overall, persons aged 8--18 years spend an average of 7 hours and 11 minutes per day watching television, using a computer, and playing video games (161).., individual and group behavior counseling, skill-building activities, and rewards or reinforcement), and policy and environmental strategies (e. oral health in america: a report of the surgeon general---executive summary. these immediate health risks can have long-term consequences for children and adolescents, affecting them into adulthood. development of the guidelines involved an extensive literature search, development and use of a codebook by cdc staff members for rating the sufficiency of the scientific evidence and expert opinion, and an external review by approximately 50 organizations and persons in the fields of school health, education, public health, nutrition, and physical activity. for both breakfast and lunch, average levels of sodium were higher and fiber was lower than the dietary guidelines for americans recommendations (321).., preparing school staff members to understand and appreciate all students, create safe environments, and deepen educators' content knowledge and skills) (659). the current guidelines and the corresponding strategies and actions were developed through a synthesis of scientific reports and expert opinion about effective and feasible practices in u. safe physical activity requires proper conditioning and use of appropriate equipment where needed. shpps data are used to 1) identify the characteristics of each school health program component (e. the president's council on physical fitness and sports research digest 1997;2:1--12. home environmental influences on children's television watching from early to middle childhood. trained school health staff members can collaborate with students' primary health-care providers to ensure monitoring of vital signs and compliance with treatment program and to address students' health issues in a confidential and sensitive manner (519). commuting to school: are children who walk more physically active? schools implementing bmi measurement programs, health, mental health, and social services staff members must have the appropriate training to obtain accurate and reliable results, ensure privacy and confidentiality, and minimize the potential for stigmatization. other factors that can enhance family and community relationships include training of all school staff members in family engagement and hiring staff members and volunteers who reflect the culture of the community (587). healthy eating and physical activity also can contribute to cancer prevention by preventing obesity (9). in 2006, adults used school physical activity or athletic facilities during out-of-school--time hours for community-sponsored sports teams in 47% of all schools, for open gym in 31% of schools, and for physical activity classes or lessons in 23% of schools (144). overview of diabetes in children and adolescents: a fact sheet from the national diabetes education program. districts typically are responsible for identifying and providing schools with a physical education curriculum. safe places to promote physical activity in inner-city children: results from a pilot study of an environmental intervention. lines of communication should be open for feedback from families and other community members (586,587). schools and districts can provide professional development instruction for teachers on engaging families in student learning and school health program activities. the relationship between qualified personnel and self-reported implementation of recommended physical education practices and programs in u. expert statements were included if 1) the experts had no conflicts of interest (i. insufficient public health and education efforts to decrease or minimize these health risks will affect both health-care and education systems. members should also refer to the dietary guidelines for americans for current recommendations for dietary intakes for children and adolescents (5). guided goal setting: effectiveness in a dietary and physical activity intervention with low-income adolescents. breakaway bases: an analysis of a preventative intervention for softball and baseball foot and ankle injuries. nutrition services: an essential component of comprehensive school health programs. communication among schools, families, and community members to promote adoption of healthy eating and physical activity behaviors among students. the prevalence of anorexia nervosa and bulimia nervosa in males is approximately one tenth that in females. in addition, employee wellness programs can increase employee morale and improve worker retention and recruitment of new employees (613,614). fitness testing should be conducted in a manner that respects and preserves the dignity of all students (e. although this is a critical opportunity for children and adolescents to participate in physical activity, schools do not provide it daily. films / date de sortie : 2017 / aventure / australien / américain / biopic / britanique / drame. intermediate outcomes such as obesity, metabolic syndrome, inadequate bone health, undernutrition, iron deficiency, eating disorders, and dental caries can begin in childhood, leading to earlier onset of disease and subsequent premature death. education should foster positive attitudes toward being a physically active person by emphasizing the benefits and enjoyment of physical activity, supporting students who are physically active, and incorporating self-management techniques (e. in reviewing and making recommendations about health-related curricula and instructional materials;. worksite intervention model for facilitating changes in physical activity, fitness, and psychological parameteres. as of 2005, <15% of children and adolescents walked or bicycled to and from school, compared with 41% in 1969 (110). such modifications include adapting activities through 1) changes in games to increase participation by students with disabilities; 2) adaptive equipment (e. washington, dc: us department of health and human services, national institute of dental and craniofacial research, national institutes of health; 2000. exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the council on clinical cardiology (subcommittee on exercise, rehabilitation, and prevention) and the council on nutrition, physical activity, and metabolism (subcommittee on physical activity). in addition, both vitamin d and regular physical activity enhance the positive effects of calcium (56).., results kept confidential and tests only administered after students are aware of the testing procedures). professional development programs should 1) be based on staff level of knowledge, experience, and needs; 2) model behavior change techniques; 3) provide opportunities to practice; 4) involve multiple sessions so that teachers can practice in classrooms and report on their experiences; and 5) provide opportunities for teachers to share their experiences with peers during posttraining sessions (640,644,659--662). physical activities such as walking, running, hiking, swimming, tennis, dancing, and bicycling should be included in intramural programs (246). cl, carroll md, curtin lr, mcdowell ma, tabak cj, flegal km. the 2009 national yrbs indicated that 25% of males and 11% of females had been physically active doing any kind of physical activity for at least 60 minutes per day in the previous week (78). policy and program information that is shared with family and community members should be culturally appropriate and translated as needed, with the goal of respecting diverse backgrounds and beliefs (609). during 2007--2008, non-hispanic black females aged 2--19 years had significantly higher odds of being obese (23%) compared with non-hispanic white females (15%); hispanic males aged 2--19 years had significantly higher odds of being obese (24%) compared with non-hispanic white males (16%) (6). in addition, this collaborative approach keeps the community informed about school-based healthy eating and physical activity initiatives and keeps school staff members aware of community-based services (520). daily intake of foods that are high in energy density. addition to providing care directly to students, school nurses can coordinate school health, mental health, and social services staff member efforts to advocate for a healthy school environment; increase student and staff member knowledge and promote healthy behaviors through health education; lead efforts to assess, develop, and evaluate health policies, practices, and programs; and serve as a liaison between teachers and families regarding student health needs (515,519,542,547--549). national standards emphasize competency in motor skills and movement patterns, movement principles and strategies, regular participation in physical activity, achievement and maintenance of health-related fitness (muscular strength and endurance, cardiorespiratory fitness, flexibility, and body composition), responsible social and personal behavior in physical activity settings, and the value of physical activity for health and enjoyment. use a coordinated approach to develop, implement, and evaluate healthy eating and physical activity policies and practices. in the pima indian community, type 2 diabetes in children and adolescents aged 5--14 years increased significantly from 0. providing certified and qualified staff members with regular professional development opportunities enables them to improve current skills and acquire new ones (402,641,643--646). a new wave of evidence: the impact of school, family, and community connections on student achievement. use of a pedometer-based physical activity program allows employees to determine their current amount of activity, set goals for improvement, and monitor personal progress (636,639). boys are affected by their ability to perform a particular physical activity, as well as by social norms among both friends and parents (123). durability and diffusion of the nutrition intervention in the working well trial. administrative support for and staff involvement in school employee wellness., in 2006, among schools in which school staff members had responsibility for cooking foods for students, the most commonly practiced healthy food preparation methods were using nonstick spray or pan liners instead of grease or oil; draining fat from browned meat; roasting, baking, or broiling meat rather than frying; and steaming or baking other vegetables (excluding potatoes). interactive lessons that include demonstration, modeling, rehearsal, and feedback are more likely to result in positive behavioral changes than a traditional didactic approach (148,482,486,487). for example, the purposes of family homework assignments and activity newsletters are to reinforce health and physical education coursework at school, facilitate communication with families about healthy eating and physical activity initiatives at school and within the community, and increase family knowledge of healthy behaviors (e. the health education profession in the 21st century: setting the stage. each study and expert statement was read, and its evidence was rated. school health advocacy raises awareness about the importance of health behaviors and can increase school and community support for instruction, programs, policies, and environmental changes that support healthy eating and physical activity (550). schools that rely on integration into other academic areas as the sole means of providing health education might provide less instructional time for health and cover fewer topics than when health education is a separate course. accommodating children with special dietary needs in the school nutrition programs: guidance for school food service staff. health promotion for educators: impact on health behaviors, satisfaction, and general well-being. schools have made considerable progress in meeting federal nutrition requirements for school meals. the revised version was sent for review and revision to three experts in the field of school-based nutrition and physical activity who had not previously reviewed the document. evidence indicates that participation in sports is related to higher levels of participation in overall physical activity (437--439). teacher information and plans for professional development that enhance effectiveness of instruction and student learning. goal-setting should be a process, incrementally moving toward the desired outcomes (e. the programs evaluated included at least one of the following components: informational, behavioral, policy, or environmental strategies. quality professional development delivered in group settings, one-on-one, or through communications technology should improve staff knowledge, enable effective implementation of skills and strategies in schools, and positively affect the behaviors of students (659). mf, sallis jf, mckenzie tl, marshall s, armstrong ca, goggin k. and adolescents experiencing hunger have lower math scores and are more likely to repeat a grade in school and receive special education services or mental health counseling than those not experiencing hunger (62,63). schools should model and reinforce healthy dietary behaviors by ensuring that only nutritious and appealing foods and beverages are provided in all venues accessible to students (box 3). activity is defined as "any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level" (9). school nutrition dietary assessment study---iii, vol ii: student participation and dietary intakes. in 2006, 45% of all schools had a nurse-student ratio of at least 1:750; 36% of all schools had a full-time school nurse (510). partner with families and community members in the development and implementation of healthy eating and physical activity policies, practices, and programs. education is integral to the primary mission of schools, providing students with the knowledge and skills they need to become successful learners and healthy adults. project salsa: development and institutionalization of a nutritional health promotion project in a latino community. provide students with health, mental health, and social services to address healthy eating, physical activity, and related chronic disease prevention. behavioral strategies might include individual or group behavioral counseling, skill-building activities, rewards or reinforcement, and inclusion of social support. scientists conducted an extensive search for scientific reports, using five electronic citation databases: medline, cinahl, sports discus, psychinfo, and eric. using a confidential employee survey is one method for collecting such information. can be used to assess and improve policies and practices that promote increased physical activity and healthier eating among students and faculty members. the 1,325 scientific reports and expert statements were coded and categorized by each component for coordinated school health: healthy and safe school environment; nutrition services; physical education and school-based physical activity; health education; health services and counseling, psychological, and social services; family and community involvement; and school employee wellness. me, hanson rl, knowler wc, bennett ph, krakoff j, nelson rg. between lessons or learning experiences that clearly reinforce the adoption and maintenance of specific health-enhancing behaviors;. ample opportunities for all students to engage in physical activity outside of physical education class.. department of education, washington, dc; arizona department of education, phoenix, arizona; colorado department of education, denver, colorado; massachusetts department of elementary and secondary education, malden, massachusetts; michigan department of education, lansing, michigan; wisconsin department of public instruction, madison, wisconsin.., foods and beverages that are sold, served, or given to students but are not part of the school meal program). family and community involvement in schools: results from the school health policies and programs study 2006. changes in energy intake among children and adolescents varied by age. emphasize the positive, appealing aspects of physical activity and healthy eating patterns rather than the negative consequences and present the benefits in the context of what is already important to students (491--494); and. social support, physical activity and sedentary behavior among 6th-grade girls: a cross-sectional study. in 2006, physical education teachers from 88% of required physical education classes or courses received professional development on at least one physical education topic. on average per week, current school lunches must have no more than 30% of calories from fat, with <10% from saturated fat, and must provide one third of the recommended dietary allowances of protein, vitamin a, vitamin c, iron, calcium, and calories. for disease control and prevention   1600 clifton road atlanta, ga 30329-4027, usa. after a rigorous review of worksite health promotion intervention research, the task force on community preventive services recommended worksite obesity prevention and control interventions as an effective method of losing weight. in addition, from the 1970s through the mid-1990s, milk consumption among female adolescents decreased 36% (84). and community members (including community organizations) contribute to the academic success of students and are key stakeholders in healthy eating and physical activity policies and practices in schools (556--558). foods are offered in various school-based venues, such as à la carte in the cafeteria, vending machines, school stores and snack bars and concession stands, fundraisers on school grounds, classroom-based activities (e.., students who use wheel chairs and students with food allergies);. parents can relate to volunteers who are also parents, and this networking can be a useful tool for sustaining participation in volunteer programs (587).., a walking club that meets 1 day per week and is led by a staff member).., self-assessment, goal-setting, decision-making, and self-management), or measure schoolwide fitness levels (392). health, mental health, and social services staff members and staff members who lead or supervise out-of-school--time programs, recess, and cafeteria time (including staff members from partner organizations such as the ymca or parks and recreation department) should receive professional development to obtain the skills needed to lead effective programs and educate students on healthy behaviors (674). schools should provide community access to physical activity facilities, such as gymnasiums, tracks, baseball and softball fields, basketball courts, outdoor play areas, and indoor fitness centers during the school day and out-of-school time (242,264,265). curriculum enrichment with self-testing activities in development of fundamental movement skills of first-grade children in greece. there been a noticeable financial effect through reduced health-care costs or other health-related data? however, cdc monitors the status of student health behaviors and school health policies and practices nationwide through three surveillance systems. school-based policies and practices should be part of coordinated school health programs and reach students from kindergarten through secondary school; prekindergarten programs might also be able to apply these guidelines in their settings. physical education curricula should emphasize knowledge about the physical, social, and mental health benefits of physical activity; components of health-related fitness; the recommended amounts and types of physical activity needed to promote health; the relationship between physical activity and physical fitness (293); principles of exercise; injury prevention; energy expenditure; and social influences on physical activity (386). the third school nutrition dietary assessment study: summary and implications. prevalence of a metabolic syndrome phenotype in adolescents: findings from the third national health and nutrition examination survey. a school environment that encourages a healthy body image, shape, and size among all students and staff members, is accepting of diverse abilities, and does not tolerate weight-based teasing. engaging children and adolescents in healthy eating and regular physical activity can lower their risk for obesity and related chronic diseases (7,8).. trends in leisure-time physical inactivity by age, sex, and race/ethnicity---united states, 1994--2004. in 2009, although 56% of high school students reported being enrolled in physical education, only 33% of high school students nationwide attended physical education classes 5 days in an average school week, a decrease from 1991, when 43% of students attended physical education classes 5 days/week (78). development also should provide health education teachers with the necessary skills to use innovative, nonlecture techniques, such as active learning strategies, for developing students' knowledge, attitudes, and skills for engaging in healthy eating and physical activity. evaluation of jump into action: a program to reduce the risk of non-insulin dependent diabetes mellitus in school children on the texas-mexico border.., applies principles of the hazard analysis and critical control point system, foodborne illness prevention, and food biosecurity);. however, some outcome-related questions can be answered using simple methods available to most schools. anchored portable soccer goals that are stored in a locked facility when not in use;. strategies for guideline 7: partner with families and community members in the development and implementation of healthy eating and physical activity policies, practices, and programs. low-income neighborhoods have fewer grocery stores than middle-income neighborhoods, predominantly black neighborhoods have half the number of grocery stores as predominantly white neighborhoods, and predominantly hispanic neighborhoods have one third the amount of grocery stores as predominantly non-hispanic neighborhoods (102). ensure standardized and reliable coding, four cdc staff worked in pairs to rate a subset of 40 reports. an assessment might also involve collection of data on current eating and physical activity behaviors of students, community-based nutrition and physical activity programs, and student, staff, and parent needs (189). as this imbalance continues over time, the risk for overweight and obesity increases (35). rules to the skill level of students and the protective equipment available (259);. annual professional development opportunities for school health, mental health, and social services staff members and staff members who lead or supervise out-of-school--time programs, recess, and cafeteria time. fit, healthy, and ready to learn, part iii: policies related to asthma, school health services, and healthy environments. studies that have assessed strategies to prevent and treat childhood obesity or promote physical activity and healthy eating have demonstrated more success when focusing on both the family and the child rather than the child alone (571,578,579,582). school, district, and state education and health leaders, community leaders, and families can commit to implementing and sustaining healthy eating and physical activity programs within the schools. evaluating a model of parental influence on youth physical activity. the least commonly practiced healthy food preparation methods were reducing sugar in recipes or using low-sugar recipes, using low-sodium canned vegetables instead of regular canned vegetables, and using cooked dry beans, canned beans, soy products, or other meat extenders instead of meat (105). standardized recipes help to ensure that the products are prepared consistently, provide a defined yield, and list the meal pattern contribution. after identifying each guideline, the cdc staff members reviewed the scientific reports again to identify common strategies and actions within each guideline that resulted in positive associations with student knowledge, attitude, behavior, or health outcomes related to physical activity, diet, weight, or chronic disease risk factors. those who are food insecure have lower physical functioning and quality of life (67). personnel, students, families, community organizations and agencies, and businesses can collaborate to successfully implement the coordinated school health approach and develop, implement, and evaluate healthy eating and physical activity efforts. although evaluations should not be used to audit or rank schools or penalize school staff members (199,200), evaluations can be used to motivate schools to make changes and monitor school-level implementation of school district, state, and federal policies. evidence of leadership, commitment, and support for school health, including healthy eating and physical activity, from school boards, school administrators, and other decision makers;. the association of the school food environment with dietary behaviors of young adolescents. goals should be realistic and written as broad statements, such as, "increase the proportion of school employees that meet the national physical activity guidelines. mississippi department of education, office of healthy schools and child nutrition programs; 2008. beets, phd, university of south carolina, columbia, south carolina; glenn flores, md, university of texas southwestern medical center, dallas, texas; deanna m. school-based type 2 diabetes prevention programs with health education components have resulted in increased knowledge about the disease (478,479) and improvements in student blood glucose levels for diverse groups of students at high risk for the disease (480--482). potential mechanisms through which television viewing might lead to childhood obesity include 1) lower resting energy expenditure, 2) displacement of physical activity, 3) food advertising that influences greater energy intake, and 4) excess eating while viewing (158,159). in 2001, the prevalence of type 1 diabetes among a sample of u. also should take necessary action to prevent or minimize the risk for foodborne illness among participants in the national school lunch program and school breakfast program.
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      might try to facilitate increased physical activity during recess by having staff members encourage students to be active; providing students with space, facilities, equipment, and supplies that can make participation in activity appealing; using point-of-decision prompts; and providing structured, organized physical activities (e. meeting the needs and interests of all students through various activities, emphasizing the many benefits of physical activity, and integrating opportunities to apply newly acquired skills help students develop positive attitudes toward physical activity. some student assessment results might reveal signs and symptoms of health risks that require urgent attention, such as hypertension, hunger, use of illegal performance-enhancing drugs, or disordered eating. african americans; persons with hypertension, diabetes, or chronic kidney disease; and persons aged ≥51 years should have a sodium consumption of <1,500 mg/day. parental and community concerns might be mitigated by making incremental changes and ensuring that the media receive positive stories about the response to the policy. national athletic trainers' association position statement: head-down contact and spearing in tackle football. other evidence suggests that childhood obesity is significantly more common in american indian/alaska native children than in white or asian children (43). influence of school organizational characteristics on the outcomes of a school health promotion program. schools and school districts should not allow students to be exempted from required physical education for the following reasons: enrollment in other courses, participation in school sports, participation in other school activities, participation in community sport activities, high physical fitness competency test scores, participation in vocational training, or participation in community service activities. caries is the most common chronic condition in children and adolescents, with the greatest prevalence in blacks and mexican-americans and in those who live in poverty (80). families and community members can identify potential challenges to implementation of policies, programs, and practices (588), as well as identify community supporters such as cultural or political leaders critical to the success of the initiative (589,592,594). student activity levels, lesson context, and teacher behavior during middle school physical education. impact of the bienestar school-based diabetes mellitus prevention program on fasting capillary glucose levels. linkages between the district's health-related programs and services and health-related resources in the community; and. in addition, restricting access to snack foods is associated with more frequent fruit and vegetable consumption (350). washington, dc: economic research service; united states department of agriculture; 2009. sufficient time to receive and consume a meal, with at least 10 minutes for eating breakfast and 20 minutes for eating lunch after being seated (215,224);. and adolescents who intend to be active in the future and who believe physical activity is important for a healthy lifestyle engage in more activity. certified health education teachers should have the knowledge and skills outlined and recommended in the american association for health education's standards for health education teacher preparation programs. wd, kroom jjm, greenway fl, bouchard c, ryan d, katzmarzyk pt. in the development of school health and safety policy materials and in the selection of educational materials;. references to non-cdc sites on the internet are provided as a service to mmwr readers and do not constitute or imply. strategies for guideline 3: provide a quality school meal program and ensure that students have only appealing, healthy food and beverage choices offered outside of the school meal program. how best to measure implementation of school health curricula: a comparison of three measures. environmental factors that might pose a barrier to physical activity include low availability of safe locations to be active, perceived lack of access to physical activity equipment, cost of physical activities, and time constraints (126,136--138). the school nutrition program staff members according to all federal, state, and local employment regulations, including leadership of professional development opportunities (656,657). r, libuda l, clausen k, toschke am, reinehr t, kersting m. children and adolescents who report eating fast foods tend to consume more total energy, fat, and sugar-sweetened beverages and consume less milk, fruits, and nonstarchy vegetables (103). for example, school staff members can have a substantial influence on tobacco-free environments in schools (621--623). professionals such as certified school counselors, psychologists, social workers, and, occasionally, psychiatrists provide mental health and social services (508). injury prevention, first aid, cardiopulmonary resuscitation, and precautions against contamination by bloodborne pathogens are other professional development areas for coaches (679,680). although schools are not required to participate in these programs, 94% of schools, both public and private, participate in the national school lunch program (68). healthy eating and physical activity also play a significant role in students' academic performance. schools can leverage community resources to offer health promotion activities and events, purchase equipment and safety gear, pay for staff training, create safer environments for play (e. for example, dietary fiber can decrease the cholesterol concentration in the blood (21), and physical activity can help maintain normal blood glucose levels (9). school nurses have the knowledge and expertise to address a range of services that includes promotion of healthy eating, physical activity, and weight management (513). several observational studies of students' physical activity levels during physical education indicated that students were not moderately to vigorously physically active for at least 50% of class time (383,401,402). children's activity levels and lesson context during third-grade physical education. all four categories had to be rated as acceptable for a study to be included in the review for this guideline document.., walking, bicycling, tennis, and swimming) that students enjoy and succeed in are important to include in physical education lessons (293,386,387). diabetes is the leading cause of kidney failure, nontraumatic lower-extremity amputations, and new cases of blindness among adults and can affect the nervous system and oral health (26). strong nutrition standards for competitive foods consistent with the iom nutrition standards for foods in schools. age-appropriate and developmentally appropriate information, learning strategies, teaching methods, and materials. schools, across all regional, demographic, and income categories, share the responsibility with families and communities to provide students with healthy environments that foster regular opportunities for healthy eating and physical activity. association between school food environment and practices and body mass index of u. of school health programs and events within the school district and between schools and local community groups; and. in 2003, metabolic syndrome was significantly more prevalent among obese persons than among those of normal weight (55). time in physical education class on aerobic activities that can easily be incorporated into students' lifestyles, such as hopping, skipping, dancing, jumping rope, and aerobic games modified to be noncompetitive and that do not include eliminating students from the game (e. environmental interventions for eating and physical activity: a randomized controlled trial in middle schools. of 2009, >95% of children and adolescents aged 5--17 years were enrolled in schools (175). wisconsin worksite resource kit to prevent obesity and related chronic diseases. child nutrition and wic reauthorization act of 2004 required that each school district participating in the federally supported meal program establish a local school wellness policy for the first time by school year 2006 (205). school districts and independent schools that choose to take part in the federal school meal programs receive cash reimbursements and entitlement funds for usda foods (commodities), provided that the meals they serve meet federal requirements and that they offer free or reduced price lunches to eligible students. curricula that are consistent with scientific evidence of effectiveness in helping students improve healthy eating and physical activity behaviors. to the 2004 surgeon general's report on bone health and osteoporosis, diet and physical activity are responsible for 10%--50% of bone mass and structure (56).., nutrition, physical activity, and obesity prevention); component of the coordinated school health framework (e. dietary factors that influence cancer risk include food type, variety, preparation, portion size, and fat content (17,25). providing food based on performance or behavior connects the experience of eating food to the student's perceptions and mood. studies of students who participated more often in school breakfast programs showed increases in test scores and significant decreases in the rates of school absence and tardiness compared with students whose participation remained the same or decreased (65,313). this practice can encourage students to eat treats even when they are not hungry and instill lifetime habits of rewarding or comforting themselves with unhealthy eating, resulting in overconsumption of foods high in added sugar and fat (276--278). an average of 10 million children participate in the school breakfast program each school day, and 82% of these breakfasts are provided free or at a reduced price to students from low-income families (304). dietary guidelines for americans have been published every 5 years since 1980 (5). food environment activities, such as school gardens, school salad bars, and farm-to-school programs, can enrich the eating and educational experience by providing quality produce and opportunities for hands-on multidisciplinary learning (227--231).., types of food allowed at school celebrations and the length of recess provided to students). healthy people 2020 includes objectives related to physical activity and healthy eating among children and adolescents and in schools (appendix b) (10). low bone density leads to osteoporosis, which is the most common cause of fractures among adults. department of health and family services, division of public health, nutrition and physical activity program, wisconsin partnership for activity and nutrition. overweight, obesity, and health-related quality of life among adolescents: the national longitudinal study of adolescent health. os, maxwell dm, dickerson c, hoge p, davies g, yetley a. health, mental health, and social services staff members are ideally situated to engage community health-care providers and organizations in supporting healthy eating and physical activity policies and practices within schools (540,541,551). a fresh fruit and vegetable program improves high school students' consumption of fresh produce. schwartz, phd, yale rudd center for food policy and obesity, yale university, new haven, connecticut; mary story, phd, university of minnesota, minneapolis, minnesota; howard taras, md, university of california san diego, la jolla, california; wendell c. the teacher might then ask students to identify the verbs or action words in the book by acting them out through physical activity (433). that spaces and facilities for physical activity meet or exceed recommended safety standards. dental caries is associated with sugar and full-calorie soda consumption (80,81).., running, hopping, and skipping) should be taught to elementary school students (391). adult supervisors should consistently reinforce safety rules, which should be posted in key locations. pricing and promotion effects on low-fat vending snack purchases: the chips study. school physical education: effect of the child and adolescent trial for cardiovascular health.., high blood pressure and high cholesterol levels) and lack of participation in worksite fitness and wellness programs are related to higher rates of employee absenteeism (615). three-year maintenance of improved diet and physical activity: the catch cohort. effects of an obesity prevention program on the eating behavior of african american mothers and daughters. the guidelines indicate that children and adolescents should include vigorous intensity, muscle-strengthening, and bone-strengthening activities at least 3 days of the week. that all foods and beverages sold or served outside of school meal programs are nutritious and appealing. students opportunities to participate in intramural physical activity programs during after-school hours. this includes assessing student nutrition, physical activity, and weight status and identifying potential nutrition-related and physical activity-related problems such as eating disorders. implementing and sustaining an employee wellness program has the potential to improve staff productivity, decrease employee absenteeism, and decrease employee health-care costs (611,612). a food-safe environment that protects the health and well-being of all school children (e. alexandria, va: us department of agriculture, center for nutrition policy and promotion; 2007. mental health and social services: results from the school health policies and programs study 2006. were excluded from consideration if they included only preschool children or college-age or older adults, were not in english, described clinical trials for weight-loss drugs or other nonbehavioral methods for weight loss, primarily addressed mental health issues such as eating disorders, or described interventions to improve performance in a specific sport or to improve functional ability after illness or injury. in 2006, 21% of states and 42% of districts had a policy stating that newly hired staff members who teach health education at the elementary school level will be certified, licensed, or endorsed by the state to teach health education. contribution of school programmes to physical activity levels and attitudes in children and adults. of all the associations examined, 51% were positive, 48% were not significant, and 2% were negative. iron deficiency hampers the body's ability to produce hemoglobin, which is needed to carry oxygen in the blood. school efforts to promote healthy eating and physical activity should be part of a coordinated school health framework, which provides an integrated set of planned, sequential, and school-affiliated strategies, activities, and services designed to promote the optimal physical, emotional, social, and educational development of students. school health programs and policies might be one of the most efficient means to prevent or reduce risk behaviors, prevent serious health problems among students, and help close the educational achievement gap (181,182). planting the seeds for healthy schools: building effective district wellness policies. activity might contribute to cancer prevention through its role in regulating the production of hormones, boosting the immune system, and reducing insulin resistance (9). three task force reports on nutrition, physical activity, and obesity were relevant (i. guidelines recommend that persons in the united states, including children and adolescents, strive to achieve and maintain a healthy body weight. or promotional flyers, newsletters, telephone calls, conversations at school, communication via e-mail or websites, and media coverage can be used for communication with families and community members (587,589,590). teachers from at least half of required physical education classes or courses received professional development on injury prevention and first aid, teaching individual or paired activities or sports, teaching movement skills and concepts, and teaching team or group activities or sports. schools also provide opportunities for students to learn about and practice healthy eating and physical activity behaviors. pathways: lessons learned and future directions for school-based interventions among american indians. closely with school-level health coordinators to ensure consistent implementation of health policies and practices across schools;. students also can be exposed to interactive computer programs that enable them to track the foods they have eaten over a given period and receive a nutritional analysis. jj, allison kr, barrera m, hansen b, goldenberg e, boutilier ma.., applicable to school settings) and included recommendations from the task force. mt, murphy sk, rowe da, golden j, shields a, raedeke td. the choice of specific assessment methods should be determined by the nature of the learning outcomes being assessed, the purpose of the assessments, and the grade level of the students (466). a national health objective strives to increase the proportion of elementary, middle, and senior high schools that have health education goals or objectives that address the knowledge and skills in the national health education standards (high school, middle school, and elementary school) (objective ecbp 3) (10). in 2006, most (72%) states required or encouraged districts or schools to follow health education standards or guidelines based specifically on the national standards, and most districts (66%) required or encouraged the same for schools (455). strategies to promote the appeal of fruits and vegetables in schools and influence student purchases of healthy foods and beverages include (268,368--371). students who see teachers smoking during a smoking ban are less likely to adhere to the tobacco-free environment rules (623). guidelines were developed through an extensive review of the scientific literature focused on school-based healthy eating and physical activity interventions. racial and ethnic differences in secular trends for childhood bmi, weight, and height. physical education curricula consistent with national or state physical education standards. in addition, staff members who supervise recess, cafeteria time, and out-of-school--time programs can be much more effective if they receive ongoing professional development opportunities. this person also can help identify and involve key stakeholders, including the school health council or team. nationwide in 2006, in 32% of schools, school staff members were allowed to use physical activity (e. environmental correlates of physical activity in youth---a review and update. their input will help create partnerships that appropriately blend into the community's culture, resulting in greater awareness and buy-in from students and families (557,584,586,587,591,594). competencies for school nutrition professionals involve a distinct and complex set of knowledge and skill requirements, such as. multiple chronic disease risk factors, such as high blood pressure, high cholesterol levels, and high blood glucose levels are related to obesity. american academy of pediatrics (aap) recommends no more than 2 hours of quality television and video viewing (e. the widespread availability of foods and beverages served outside of the federal school lunch and breakfast programs is well-documented (105,106). national guidelines for physical activity, many young persons are not regularly physically active. strategies for guideline 9: employ qualified persons and provide professional development opportunities for physical education, health education, nutrition services, and health, mental health, and social services staff members, as well as staff members who supervise recess, cafeteria time, and out-of-school--time programs. fitness testing also can be used to determine student achievement of national or state physical education standards that focus on maintaining a healthy fitness level (293). staff members should be aware of the potential for physical activity--related injuries and illnesses among students so that the risks for and consequences of these injuries and illnesses can be minimized.. children and adolescents do not follow the recommendations for the numbers of daily servings or variety consumed (3). partnerships are beneficial because they conserve resources; reach a wide audience; accomplish objectives of multiple organizations, including schools; increase credibility; improve information sharing; make use of a range of expertise; and foster coordination across sectors of society (596). examples include photo essays, skits, infomercials, public service announcements, and letters to the editor.., diabetes or asthma), or low fitness levels might benefit from physical education and physical activity programs to increase physical activity participation, develop motor skills, improve physical fitness, and encourage enjoyment and success (449,450). school nutrition staff members and teachers collaborate to design and implement nutrition education programs that promote healthy eating messages to the entire school community (299). people 2020 national health objectives include a comprehensive plan for health promotion and disease prevention in the united states.., school breakfast program, school lunch program, menus for school meals, and nutrient analysis of school meals). sugar-sweetened beverages (such as soda and fruit drinks) are major contributors to added sugar consumption and contribute an average of 8% of energy intake among persons aged 2--18 years (86). educational strategies should match the different stages of students' cognitive development. daily physical education for grades k--12 (150 minutes per week for elementary students and 225 minutes per week for secondary students) is recommended by the national association for sport and physical education (293,379) and the more than 30 collaborating organizations that developed the health, mental health, and safety guidelines for schools (215). to prevent iron deficiency, children and adolescents need to consume adequate amounts of foods containing iron (e. bethesda, md: national institutes of health, us department of health and human services; 2007. the burden of diabetes mellitus among us youth: prevalence estimates from the search for diabetes in youth study. collaborations with community resources can link students and their families to programs and services that the school is unable to provide independently. school health and safety priorities to the principal, staff, parents, community organizations, and students;. some types of cancer can be prevented through regular physical activity and a diet consisting of various healthy foods with an emphasis on plant sources (e. when necessary, they coordinate with community health-care providers or school-based health centers providing care to students (509). among school-age children and adolescents with iron deficiency, anemia is associated with poor cognition and lower academic performance (72,73). changing nutrition standards in schools: the emerging impact on school revenue. such programs can provide health-related experiences that are complementary to the school's curriculum (e. although only a few studies have demonstrated that homework activities and newsletters improve student knowledge of and attitudes toward healthy behaviors (566,570) or affect behaviors (569,595), distributing homework and newsletters to families more frequently might increase their effects (569,570). association between child and adolescent tv viewing and adult health: a longitudinal birth cohort study. the results of physical fitness testing should not be used to assign report card grades or be used to assess program effectiveness because the validity of these measurements might vary substantially, and overall fitness and improvements in fitness are influenced by factors (e. obese students, for example, are at increased risk for being teased, bullied, or socially isolated and having low self-esteem and depression (35,282,525--529). the role of michigan schools in promoting healthy weight: a consensus paper. however, in 2006, only 4% of elementary schools, 8% of middle schools, and 2% of high schools provided daily physical education or the equivalent for the entire school year for all students in the school (144). classroom instructional methods and strategies that are interactive, engage all students, and are relevant to their daily lives and experiences. department of agriculture, food and nutrition service; gordon a, fox mk, clark m, et al, eds. an existing committee, such as the school health council or health insurance advisory committee, should have the necessary foundation and components to lead the process of developing a school employee wellness program (628). associations between television viewing and consumption of commonly advertised foods among new zealand children and young adolescents. the effects of a 2-year physical education program (spark) on physical activity and fitness in elementary school students. data and information to determine the nutrition and physical activity needs of school staff members and assess the availability of existing school employee wellness activities and resources. students' levels of physical activity increase after they participated in physical education? the use of food as rewards, especially foods with little nutritional value, might increase the risk that children associate such foods with emotions, such as feelings of accomplishment (268,275). the impact of nutrition standards on competitive food offerings and purchasing behaviors of high school students. this person serves as an active member of the district-level school health council and communicates the district school health council's decisions and actions to school-level health coordinators and teams, staff, students, and parents (189,196--198). health risks such as high cholesterol, overweight or obesity, or high blood pressure decreased? regarder gratuitement snowden streaming vf hd illimité sur vk, youwatchsee morenocturnal animalslivre nocturnalhayvanları nocturnalwatch nocturnalnocturnal animals movieanimals signéanimals 2016hayvanları filmfilm noirhutton morrowforwardsusan, galeriste à los angeles mène une vie bien rangée à la limite de la monotonie, délaissée par son époux hutton morrow.., physical education and health education); setting of the intervention (e." objectives indicate what will be done to achieve the goals; they should be specific, measurable, achievable, relevant, and time sensitive. administrative support for school employee wellness programs that include healthy eating and physical activity. schools also require less health education as students progress through school. activities should reflect both the social and environmental aspects of a community (291,560). school nutrition services staff members should receive professional development on topics that support improving the overall school nutrition environment, including healthy food preparation methods; implementing the dietary guidelines for americans in school meals (e. children and adolescents in food-insecure households have poorer health status and experience more frequent stomachaches and headaches than those from food-secure households (62). specifically, children and adolescents are encouraged to maintain the calorie balance needed to support normal growth and development without promoting excess weight gain (5). when schools provide supportive environments by enhancing physical education (145,146) and health education (147), having staff members become role models for physical activity, increasing communication about the benefits of physical activity, and engaging families and communities in physical activity, children and adolescents are more likely to be physically active and maintain a physically active lifestyle (147--149). reducing obesity via a school-based interdisciplinary intervention among youth: planet health. performance-based assessments typically include performance tasks, exhibitions, demonstrations, written or oral responses, journals, and portfolios (465,469). overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors (36). ideally, a coordinated school health framework integrates the efforts of eight components of the school environment that influence student health (i., a disease characterized by high blood glucose levels (26), was the seventh leading cause of death in the united states in 2007 (18). a site-specific literature review of policy and environmental interventions that promote physical activity and nutrition for cardiovascular health: what works? reports were included if they described practices to improve child and adolescent nutrition and physical activity that were based in schools or that addressed family or community involvement in schools. school breakfast program but not school lunch program participation is associated with lower body mass index. a substantial percentage of each student's recommended daily amount of physical activity in physical education class. ds, kettel l, serdula mk, dietz wh, srinivasan sr, berenson gs. ka, gallahue dl, gruen ge, tridle m, bewley n, steele k. regular physical activity can reduce the risk for developing cancers of the breast and colon, and some evidence indicates that physical activity can reduce the risk for developing endometrial and lung cancers (9). response to the childhood obesity epidemic, much research has been conducted on school-based obesity prevention and healthy eating and physical activity promotion and intervention since the last publication of the guidelines for school and community programs to promote lifelong physical activity among young people (1997) and the guidelines for school health programs to promote lifelong healthy eating (1996). members also might refer to the national association of school nurses' scope (school nurse childhood obesity prevention education) manual (521) or the aap's pediatric obesity clinical decision support chart (522). these standards provide a foundation for selecting or developing curricular and instructional materials, delivering instruction, and assessing student knowledge, attitudes, skills, and behaviors. predicting adolescent eating and activity behaviors: the role of social norms and personal agency. a healthy diet and regular physical activity can prevent and reduce metabolic risk factors that cause cvd, including hyperlipidemia (e. administrative support is essential for a school employee wellness program to be viable and sustainable. in 2006, 68% of teachers of elementary school classes covering required health instruction and 67% of teachers of required health education courses in middle and high schools were certified, licensed, or endorsed by the state to teach health education at the appropriate grade level (455). recent reviews of breakfast and cognition in students (73,185,186) report that eating a healthy breakfast might enhance cognitive function (especially memory), increase attendance rates, reduce absenteeism, and improve psychosocial function and mood. these guidelines, developed in collaboration with specialists from universities and from national, federal, state, local, and voluntary agencies and organizations, are based on an in-depth review of research, theory, and best practices in healthy eating and physical activity promotion in school health, public health, and education.
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      health, mental health, and social services staff members can request written permission from families to exchange confidential health information with students' health-care providers (515).
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