Focus on nutrition, physical activity at school level can pay off for students
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* Julia Haskins

School-based interventions focused on nutrition and physical activity can help students reduce unhealthy weight gain as well as cut down on unhealthy eating, new findings show.

Published in January in the *American Journal of Preventive Medicine*, the study followed about 600 students at 12 schools in New Haven, Connecticut, as they progressed from the fifth to eighth grade. Schools received interventions focused on nutrition, physical activity or both. Other schools received an intervention with other health training, such as cold and flu prevention, and received materials on obesity at the end of the trial.

Schools received technical assistance and support from research staff to implement school wellness policies depending on which intervention the school received. For example, researchers helped students practice healthier eating habits with initiatives such as providing alternatives to food for class celebrations and rewards, creating a cafeteria nutrition program and developing a campaign to promote water over sugar-sweetened beverages. And for schools taking part in the physical activity intervention, researchers helped them promote walking and biking to school, take part in fitness challenges and work with teachers to bring physical activity to the classroom, among other initiatives.

Researchers met with administrators, teachers and parents about incorporating health into their school communities. All the schools in the study also received a yearly stipend to develop a school wellness team.

Students who participated in the nutrition intervention had lower increases in BMI compared with those in schools that did not receive such support. The degree to which the intervention slowed weight gain among students also improved over time.

There were little to no changes in BMI among students in the physical activity intervention. And while students in the nutrition intervention consumed less unhealthy food and sugar-sweetened beverages and ate at fast food restaurants less often, they did not consume more healthy food.

According to senior study author Marlene Schwartz, PhD, director of the University of Connecticut Rudd Center for Food Policy and Obesity, schools in some cases may have experienced a “ceiling effect” for what they could do to improve nutrition and physical activity. For example, schools could not increase the amount of time allotted for physical education classes. And while students cut down on unhealthy snacks and beverages through the interventions, the school district in the study already had a strong meal program with healthy foods, meaning that many children were already eating well.

While most school districts have written policies on school wellness, that does not necessarily translate into implementation, according to researchers. However, such policies mandate the participation of numerous community stakeholders, many of whom took part in the interventions, Schwartz said. From cafeteria managers to principals and teachers to nurses, many individuals were involved in implementing school wellness policies. Getting stakeholders to regularly meet at school and finding ways to incorporate wellness into community events that take place at school was beneficial.

Schwartz encouraged parents to join their school wellness committees and work alongside food service directors to ensure that students eat well at school.

“Trying to get involved locally is really valuable because that’s where the changes happen,” she told *The Nation’s Health.*

Schwartz also underscored the importance of the National School Lunch Program, which serves 30 million children daily.

The program is “a really big part of the diets of a lot of kids in our country, particularly the kids that are most vulnerable,” she said. “It’s worth the political capital to try to make sure that they stay as healthy as possible.”

While interventions at the school level can pay off, new efforts at the federal level may undercut them. In December, the U.S. Department of Agriculture published its final rule that rolls back health standards on school meals, allowing flavored milk, reducing limits on sodium and loosening requirements for whole-grain products.

For more information, visit [https://www.ajpmonline.org/article/S0749-3797(18)32270-0/fulltext](https://www.ajpmonline.org/article/S0749-3797(18)32270-0/fulltext).

*   Copyright The Nation’s Health, American Public Health Association