Healthy Children Ready Learners Dorothy Caldwell, Coordinator School Health Initiative, NC Division of Public Health.

Healthy ChildrenHealthy ChildrenReady LearnersReady Learners

Dorothy Caldwell, CoordinatorDorothy Caldwell, CoordinatorSchool Health Initiative, NC Division of Public HealthSchool Health Initiative, NC Division of Public Health

Serving EducationServing Education

Helping StudentsHelping Students

Eat to LearnEat to Learn

Learn to EatLearn to Eat

West Virginia a LeaderWest Virginia a Leader

Long history ofLong history of Extraordinary leadershipExtraordinary leadership High standardsHigh standards Strong trainingStrong training High level of supportHigh level of support National recognitionNational recognition

West Virginia a LeaderWest Virginia a Leader

Integrating Child Nutrition into EducationIntegrating Child Nutrition into Education

Proactively Planning for ChangeProactively Planning for Change No plan, however good, works foreverNo plan, however good, works forever

Continuous ImprovementContinuous Improvement

Learning - Achievement Learning - Achievement ConnectionConnection

Always been part of education in theoryAlways been part of education in theory 1700’s Germany1700’s Germany 1800’s France, England, Holland1800’s France, England, Holland United StatesUnited States

Counts, members of parliament, members of Counts, members of parliament, members of congress, surgeon generals, secretaries of congress, surgeon generals, secretaries of education, superintendents of schools, education, superintendents of schools, teachers, parents…..ALL acknowledge that teachers, parents…..ALL acknowledge that hungry children can’t learn.hungry children can’t learn.

National School Lunch ActNational School Lunch Act

Protect the health and well being of the Protect the health and well being of the nation’s childrennation’s children

Hearing transcripts show that members Hearing transcripts show that members of congress often included the of congress often included the connection between nutritious meals connection between nutritious meals and learning in the NSLA debateand learning in the NSLA debate

ResearchResearch

School breakfast research is clearSchool breakfast research is clear School Breakfast Program and School Breakfast Program and

Performance Study, 1989 TuftsPerformance Study, 1989 Tufts State of Minnesota School Breakfast State of Minnesota School Breakfast

Study, 1997Study, 1997 Harvard School Breakfast research, 1998Harvard School Breakfast research, 1998

Consistent findingsConsistent findings Less absenteeism and tardinessLess absenteeism and tardiness Fewer behavioral problemsFewer behavioral problems Improved test scoresImproved test scores

Experts SpeakExperts Speak ““Wide body of research clearly outlines that when children’s basic nutritional and fitness needs are met, they have cognitive energy to learn and achieve. Wide body of research clearly outlines that when children’s basic nutritional and fitness needs are met, they have cognitive energy to learn and achieve. West Virginia Department of EducationWest Virginia Department of Education October 23, 2003 October 23, 2003

Conversely, pooConversely, poo

r nutrition and lack of physical activity lead to lower academic achievement.”r nutrition and lack of physical activity lead to lower academic achievement.”

--Gerald Tirozzi, Exec. Director NASSP, Healthy Schools Summit, October 2002

Experts SpeakExperts Speak

““Maryland’s Meals for Achievement Maryland’s Meals for Achievement provides data to back up the name.”provides data to back up the name.”

““In Maryland, chronic health conditions In Maryland, chronic health conditions account for nearly a quarter of a million account for nearly a quarter of a million visits to school health rooms this year. visits to school health rooms this year. The most rapidly increasing condition is The most rapidly increasing condition is Type 2 diabetes, associated with Type 2 diabetes, associated with obesity.”obesity.”

--Nancy Grasmick, PhD, Maryland Superintendent of Schools, Healthy Schools Summit, 2002

ConundrumConundrum

““Educators understand this connection, but Educators understand this connection, but reading and math are such high priorities reading and math are such high priorities that they put time and energy there.that they put time and energy there.

““Need a policy paradigm shift to include Need a policy paradigm shift to include academic, social, emotional, nutritional and academic, social, emotional, nutritional and healthy growth and development.”healthy growth and development.”

-- Gerald Tirozzi, PhD, Exec Director NASSP Healthy School Summit, 2002

National ResolveNational Resolve

““Goals of Leave No Child Behind in Goals of Leave No Child Behind in academic core subjects can be greatly academic core subjects can be greatly enhanced with the same national resolve enhanced with the same national resolve and commitment to ensure all students have and commitment to ensure all students have nutritious meals, engage in physical activity, nutritious meals, engage in physical activity, and participate in health education and participate in health education programs.”programs.”

““What better time and place to start that What better time and place to start that resolve than resolve than now -- in schoolsnow -- in schools.”.”

-- Gerald Tirozzi, PhD, Exec Director NASSP Healthy School Summit, 2002

Managing Child Nutrition Programs: Leadership for Excellence Aspen Publishers, 1999

Schools

Need

Support

A Child Nutrition VisionA Child Nutrition Vision

““Every student and staff Every student and staff member will show an member will show an

understanding of nutrition by understanding of nutrition by selecting healthful meals at selecting healthful meals at

school and away from school.”school and away from school.”

A Child Nutrition VisionA Child Nutrition Vision

“Each student’s readiness to “Each student’s readiness to learn will not be impaired by learn will not be impaired by

nutritional inadequacies.”nutritional inadequacies.”

Is the vision a Is the vision a shared vision?shared vision?

Dilemmas….Stephen Covey in Principle Centered Leadership

MissionMission((making vision a reality)making vision a reality)

““To foster the service of To foster the service of nutritious meals and the nutritious meals and the

development of development of environments supportive of environments supportive of healthful eating behaviors of healthful eating behaviors of

all students and staff.”all students and staff.”

Beyond the Mission StatementBeyond the Mission Statement

Turn our Mission Statement into Turn our Mission Statement into our guiding force our guiding force

““Get the largest number of students Get the largest number of students possible to eat the most nutritious meals possible to eat the most nutritious meals possible.”possible.”

Reimbursable School LunchesReimbursable School Lunches

More nutritious than any other noon More nutritious than any other noon time choicetime choice

Participants eat more vegetables, Participants eat more vegetables, grains, grain mixtures, and milkgrains, grain mixtures, and milk

Fewer sweetened beverages and salty Fewer sweetened beverages and salty snacks than students who don’t snacks than students who don’t participateparticipate

» SNDA II 1995SNDA II 1995

Getting Better Every DayGetting Better Every Day

School Nutrition Dietary Assessment Study School Nutrition Dietary Assessment Study (98-99 data published in 2001)(98-99 data published in 2001) Students in 82% of elementary schools and Students in 82% of elementary schools and

91% of secondary schools had the 91% of secondary schools had the opportunityopportunity to select lunches that met both to select lunches that met both fat and saturated fat standardsfat and saturated fat standards

One in 5 elementary schools and one in 7 One in 5 elementary schools and one in 7 secondary schools met recommendation for secondary schools met recommendation for fat and saturated fat for all lunchesfat and saturated fat for all lunches

Average for all lunches -- 33% of calories from Average for all lunches -- 33% of calories from fat and 12% from saturated fatfat and 12% from saturated fat

Declining ParticipationDeclining Participation

Between 1979 and 1998 the national Between 1979 and 1998 the national average decline in SL Participation was average decline in SL Participation was 4.4 percentage points -- from 61.2% to 4.4 percentage points -- from 61.2% to 56.8%56.8%

West Virginia’s decline was 8.2 -- from West Virginia’s decline was 8.2 -- from 75.7% to 65.5%75.7% to 65.5%

North Carolina’s drop was 20 North Carolina’s drop was 20 percentage points -- 83% to 63%percentage points -- 83% to 63%

Delaware had no participation declineDelaware had no participation decline

Super Sized Fast FoodSuper Sized Fast Food

1610 Calories

1610 Calories

63 gm fat63 gm fat

Shifts in Food Practices in the United States

Shifts in Food Practices in the United States

Fast food consumptionFast food consumption Reduced frequency of family mealsReduced frequency of family meals Restrained eating, meal skippingRestrained eating, meal skipping Consumption of soft drinks-Consumption of soft drinks-

increased from 27 to 44 gal/y from increased from 27 to 44 gal/y from 1972-19921972-1992

30,000 products in supermarkets30,000 products in supermarkets Increased portion sizeIncreased portion size

Fast food consumptionFast food consumption Reduced frequency of family mealsReduced frequency of family meals Restrained eating, meal skippingRestrained eating, meal skipping Consumption of soft drinks-Consumption of soft drinks-

increased from 27 to 44 gal/y from increased from 27 to 44 gal/y from 1972-19921972-1992

30,000 products in supermarkets30,000 products in supermarkets Increased portion sizeIncreased portion size

ChallengesChallenges

Consumer PreferencesConsumer Preferences

Fiscal ConstraintsFiscal Constraints

What Are Your Major What Are Your Major Barriers?Barriers?

Disconnect between what students need Disconnect between what students need and what they want?and what they want?

Need clearer view of what parents want?Need clearer view of what parents want? Need more support from other members Need more support from other members

of School Team?of School Team? Need more $$$$$ for more fruits, veggies Need more $$$$$ for more fruits, veggies

and marketing?and marketing? Need lunch schedules more conducive to Need lunch schedules more conducive to

healthy eating?healthy eating?

Healthy ChildrenHealthy ChildrenReady LearnersReady Learners

What Changes Do You Need?What Changes Do You Need?

What are Your Policy Needs?What are Your Policy Needs? (What is Outside your Span of Control?)(What is Outside your Span of Control?)

Federal?Federal?

State?State?

Local?Local? Start here… good local policy is the best Start here… good local policy is the best

policy and success can help drive state policy and success can help drive state and local policyand local policy

Strategic ImperativesStrategic Imperatives Recognition of the connection between Recognition of the connection between

nutrition and health and health and student nutrition and health and health and student achievementachievement

Service of nutritious, affordable,student- Service of nutritious, affordable,student- oriented school meals and snacks oriented school meals and snacks

School environments that School environments that make available only nutritious choicesmake available only nutritious choices provide adequate time for their selection and provide adequate time for their selection and

enjoymentenjoyment provide pleasant surroundings and positive adult provide pleasant surroundings and positive adult

role modeling to promote consumptionrole modeling to promote consumption

Leverage the Obesity Leverage the Obesity EpidemicEpidemic

Role for EveryoneRole for Everyone

FamiliesFamilies Schools/Child CareSchools/Child Care CommunitiesCommunities Health CareHealth Care Media/Communication Media/Communication Surveillance & ResearchSurveillance & Research

No Data <10% 10%–14% 15%–19% 20%-24% 25%

Source: Behavioral Risk Factor Surveillance System, CDC

Obesity* Trends Among U.S. AdultsBRFSS, 2002

(*BMI 30, or ~ 30 lbs overweight for 5’4” person)

More American More American Children Are Children Are

Overweight Than Overweight Than Ever BeforeEver Before

More American More American Children Are Children Are

Overweight Than Overweight Than Ever BeforeEver Before

00

22

44

66

88

1010

1212

1414

1616

1963-701963-70 1971-741971-74 1976-801976-80 1988-941988-94 19991999

Children 6 to 19 yearsChildren 6 to 19 years20002000

Childhood OverweightChildhood Overweight

Childhood OverweightChildhood Overweight BMI at or above the 95th BMI at or above the 95th

percentile - age and genderpercentile - age and gender US Prevalence US Prevalence

13% of 6 to 11 y/o 13% of 6 to 11 y/o 15.3%15.3% 14% 12 to 19 y/o 14% 12 to 19 y/o 15.5%15.5%

Overweight prevalence steadily Overweight prevalence steadily increasingincreasing

Overweight teen has 70% Overweight teen has 70% chance of being overweight or chance of being overweight or obest adultobest adult

How Did This Happen?How Did This Happen?

Supersize SocietySupersize Society

and aand a

Britney and BarbieBritney and Barbie® CultureCulture

Super Size

!

Super Size

!

But Stay

But Stay

Thin!Thin!

The Way The Way We Eat We Eat TodayToday

The Way The Way We Play We Play TodayToday

Where We Where We Live TodayLive Today

Supersize Me!Supersize Me!

How We Are How We Are Sold TodaySold Today

How We Are How We Are Sold TodaySold Today

childrechildrenn

families

Health care providers

Policy Makers

Business and Industry

EducatorsEducators

Community LeadersCommunity Leaders

researcherresearcherss

““Don’t be afraid to take a big Don’t be afraid to take a big step if one is indicated. You step if one is indicated. You can’t cross a chasm in two can’t cross a chasm in two

small jumps.” small jumps.”

--David Lloyd George--David Lloyd GeorgeFormer British Prime MinisterFormer British Prime Minister