Should Schools be Fully Responsible for Improving Child Health?

Should Schools Fully Responsible for Improving Child Heath? Marissa McLaughlin The University of North Carolina at Charlotte

Fall 2013

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Introduction Monkey Joes is a large indoor playground that offers children twelve and under a place to play while they are also receiving physical activity. Lack of physical activity in children has become a nationwide issue because childhood obesity has become more prevalent in the last 30 years. Childhood obesity has become such an issue to where it is now considered a public health crisis. There are several factors that result in the decreased health of children including poor diet, lack of physical exercise, and their familys behavior. I believe that childhood obesity is in issue that should be a main priority because it can lead to lifelong health complications like diabetes and high blood pressure. Fortunately this can be avoided if the proper precautions are made. In order to avoid childhood obesity, it is important to increase every childs level of daily physical activity. Increasing the amount of physical activity that a child participates in is something that can be done in fun ways and not just the typical laps around the track. Places like Monkey Joe mixes fun with exercise and children actually enjoy it and want to come back to play. It is similar to hiding a kids cauliflower in their mashed potatoes. They do not realize that they are eating something healthy because it is hidden within something that they enjoy. By implementing this simple idea, it is possible to help prevent and reverse childhood obesity through creativity. Within the last 20 years, technology has caused children to become lazy and more dependent on television and video games. This in addition to poor diets has made childhood health a main priority in schools nationwide. Schools have created special meal plans and have enforced the participation of Physical Education classes. This raises the question of whether or not all of the responsibility should be on the school system. While most children spend the majority of their day at school, the habits that they practice at home are also essential to their

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overall health. So what are parents doing to keep their child healthy? Are their bad health habits rubbing off on their children? Are they expecting the school systems to make the only changes to their childs lifestyle? School systems have begun to implement new health smart programs for children, but all of the information that the kids learn in school will be a waste if these healthy practices are not enforced when they go home. While at school children are learning so much about healthy habits and what it means to live a healthy lifestyle, but if their parents do not have any interest in promoting healthy eating, the children will continue to be unhealthy because they can only eat what their parents feed them. A parents knowledge about nutrition is directly linked to the development of obesity in a child. Children who have parents that live an unhealthy lifestyle are at higher risk of becoming obese themselves. There are many factors that contribute to a child becoming obese and there are several publications that examine these factors and how schools are encouraging a healthy lifestyle and what parents can do to help with their effort.

25.00 20.00 15.00 10.00 5.00 0.00 1984 1989 1994 1999 2004 2009

Obese Overweight

This chart from the North Carolina Enhanced Nutrition standards for Child care shows the prevalence of overweight and obesity among children 2-4 years seen in health department sponsored clinics in North Carolina, by calendar year.

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Literature Review According to the 2000 National Health and Nutrition Examination Survey, the prevalence of obesity in children and youth in the United States is over 15%, a value that has tripled since the 1960s (Pate 2006). Obesity is a term that is used often, but the facts behind the term are not as familiar. The American Academy of Child and Adolescent Psychiatry developed an article titled Obesity in Children and Teens which examines obesity and its causes. There is a difference between an overweight child and an obese child. A child is not considered obese until their weight is at least ten percent higher than what is recommend for their height and body type. A child that becomes obese during the ages of ten and thirteen has an eighty percent chance of becoming an obese adult. This article also provides the numerous factors that can cause obesity including poor eating habits, lack of exercise, and low self-esteem. It has become common knowledge that childhood obesity has become an issue, but how can this be prevented? If childhood obesity was not always an issue, what makes it such an issue today? Once a child has become obese, is there a way to reverse their behavior so they live a healthy lifestyle as an adult? What is being put into effect in order to for children to learn healthy living? It is pivotal to practice healthy living as a child because during childhood you pick up habits that you will continue to practice during you adult life. There are different ways to prevent a child from becoming unhealthy but there is no set strategy that will eliminate all unhealthy patterns in children. Successfully preventing unhealthy behavior is more likely to be achieved by implementing policies that can be easily integrated into multiple aspects of a childs life. In order to have the most significant effect on a childs life,

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healthy habits like physical activity needs to be promoted at home, in the community and at school. Physical activity is important for preventing childhood obesity. The Centers for Disease Control published an article titled, How much physical activity do children need? It is recommended that children do at least sixty minutes of physical activity each day. This article discusses the various types of exercises that children can do in order to achieve their sixty minutes of recommended daily exercise which includes aerobic activity, muscle strengthening, or bone strengthening. The article also describes various age-appropriate activities that are considered to be better suited for children than adolescents. Many people find it difficult to promote physical activity with their children because they feel that basic exercise is not appealing to children. The American Academy of Pediatrics wrote the article Active Healthy Living: Prevention of Childhood Obesity through Increased Physical Activity. This article examines the prevention and treatments of childhood obesity. It describes the factors that contribute to obesity, physical activity in schools, how to manage childhood obesity, the overall health benefits of physical activity, and how to prevent childhood obesity. It also describes the different types of physical activity schools promoted based on grade level. For example for Preschool-aged children free play is encouraged with emphasis on fun, playfulness, exploration, and experimentation. During this early stage of childhood, children are looking for a simpler way of playing and will react in a positive way if exercise is received through activities like swimming, running, and gymnastics. In Monkey Joes, preschool aged children explore through the inflatables because they are something that they are not familiar with but soon after being introduced to them, but as soon as they are comfortable they play and jump only stopping

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for a quick drink of water. During these activities, children are learning a new activity while also receiving physical activity. In the Active Healthy Living: Prevention of Childhood Obesity through Increased Physical Activity article, it also discusses the recess and intramural sports that seventy-one percent of elementary schools nationwide provide on regular basics. The intramural sports that the children take part in are typically the traditional sports like basketball, football, and soccer. These organized sports are offered to all children but the children that choose to participate are usually those who are already active. Programs like the one described in the Promoting Physical Activity in children and youth article are becoming more common nationwide. Russell Pate described the increased presence that physical activity is making in public schools in his article Promoting Activity in Children and Youth. He examined the changes that schools are putting into place in order to promote healthy lifestyles among elementary school aged children. His article offers insight on the changes that schools are putting in effect to prevent childhood obesity. Some school systems have put Senate bills in effect in order to increase physical activity. In Kelders article Implementation of Texas Senate Bill 19 to Increase Physical Activity in Elementary Schools, he discusses the regulations that are being put into effect in public schools in order to increase the amount of physical activity that each child receives. It defines the terms and regulations of the Senate Bill 19 which requires elementary school children to participate in 30 minutes of daily physical activity. This article represents how schools are taking dramatic actions in order to promote a healthy lifestyle.

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While increasing physical activity is important in order to prevent childhood obesity, the eating habits they practice both at home and school are also important. Demattia discusses the influence a childs entire lifestyle has on their overall health. In her article Overweight and Obesity in Americas children: Causes, Consequences, and Solutions, she examines the different factors that can contribute to obesity including the eating habits that children practice while they are at home and school. This article looks into all aspects of a childs life in order to identify what habits children need to practice in order to maintain a healthy lifestyle. In order to fully treat and prevent childhood obesity it is important to understand where the root of the issues and correct this issue. While several people believe that it is the school systems responsibility to teach children healthy living, I believe that the majority of the responsibility falls on the parents. Entering the Conversation In recent years, public schools have taken the initiative to promote healthy lifestyles among children. While teaching healthy living in schools is a big step towards creating a healthy generation, I do not think that it is as important as children being taught healthy habits at home. The majority of the articles concerning childhood obesity state that it is the schools responsibility to provide a healthy meal and daily exercise, but thats only a small portion of the solution. If a child learns that they should mainly eat fruits, vegetables, and fresh foods while they are at school, but when they go home they are only served junk food, what they have learned at schools becomes obsolete because they are only going to eat what their parents feed them even if they know that it is unhealthy. I believe that the eating habits of the people that a child is

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surrounded by at home have more of impact of their overall health when compared to the habits that they practice while they are at school. Creating a healthy child may seem like a daunting task for parents, but making simple changes to their diet can have a significant impact. The North Carolina Enhanced Nutrition Standards for Child Care offers several changes for child health that can easily be made at home: Ensure that they consume a variety of foods within and among the basic food groups while staying within energy needs Increase daily intake of fruits and vegetables, whole grains, and non-fat or low fat milk and milk products Be physically active everyday

There are also dietary recommendations for infants and toddlers (0-24 months) that can be practiced in order to have healthy child during their first stages of development. Those recommendations include: Continue breastfeeding for at least the first year of life Delay introduction of cows milk until one year old Serve whole milk between one and two years old Delay the introduction of 100% juice until at least six months of age Limit juice to 4-6 fluid ounces per day Do not introduce foods with little nutritional value simply to provide calories

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Making dietary changes may seem like an overwhelming chore for parents, but these changes can be beneficial for both the child and the parent. There are also fun physical activities that both the entire family can take part in like swimming, horseback riding, hiking, and canoeing. In addition to these family activities, parents can also get their children involved in organized sports. Organized sports like baseball, basketball, football, and soccer offer children a source of physical activity while also teaching them teamwork helping their self-esteem. Making healthy choices in the home is a change that can help the entire family become healthier. I do not think that it is a coincidence that when the adult obesity rate increased so did the rates for childhood obesity. It was not because the schools were doing anything different; it was because parents were practicing unhealthy habits which rubbed off on their children and led to the decrease of the childs overall health. I believe that with children learning healthy habits at school and practicing those habits at home these increased rates can decrease and create a healthy child and family. Below is an example of a week meal option for kids with a Halloween theme (Healthy Kids 2012). Monday Breakfast Nut Butter and Banana Bagel Lunch Chickpea Salad Pita Snack Candy Corn Fruit Cup Dinner Portobello Cheesesteak Sandwiches Terror Taco Salad

Tuesday

Wednesday

Thursday (Halloween) Friday

Booo-Tiful Not-So Sushi Sweet Potato Breakfast (Eggs, Peanut Butter and Finger Fries and toast) Jelly roll-ups Jack-O-Lantern Frankenstein Yummy Mummy Juice Triple Decker Frozen Bananas Sandwiches Chocolate Spider Sandwiches Halloween Trail Pumpkin Pancakes Mix Strawberry Banana Flax Smoothie Ham and Carmelized onion grilled cheese Apple Monster Mouth

Little Shells of Green Pasta and Shallots Very Veggie Crockpot Chili Baked Parmesan Chicken and Butternut Squash

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Terms BMI: BMI = Weight (kg) / (height) (m^2) Overweight: Overweight in children and adolescents is defined as the 95 percentile BMI for their age, meaning that ninety-five percent of children of the same age and gender have a lower BMI Physical Activity: Any body movement produced by skeletal muscles that result in energy being used Physical Fitness: Physical attributes related to a persons ability to perform activities that require endurance, strength, and flexibility. Aerobic Activity: Aerobic activity should make up most of the hour of recommended daily activity. Aerobic activity can vary from brisk walking to running. Muscle Strengthening: Muscle Strengthening should be done at least three days a week and can be achieved through gymnastics or pushups. Moderate to Vigorous Activity: Activity that causes some increase in breathing and heart rate. Exercises include brisk walking, dancing, swimming, or cycling on a flat surface. Bone Strengthening: Bone Strengthening should be done three days a week and a larger variety of child friendly activities like jumping rope, relay races, and soccer.

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Conclusion By promoting healthy lifestyles but not actively asking parents and guardians to help assist with their efforts, public schools are fully taking on a responsibility that should be shared. Children spend the majority of their time at school, but they eat the majority of their meals at home. Schools offer students healthy choices in the lunch line, but if a child is living an unhealthy lifestyle at home they will bring their junk food from home to school and the schools efforts become ineffective. The idea of having parents help with creating a healthy child is similar to the concept of giving students homework. They are taught the information at school but for the information to useful they must practice it at home in order to better understand the material. The school systems are doing a great job in giving children the tools they need for healthy living but for them to be the most effective in creating a healthy lifestyle amongst its students, they must also have the cooperation of the parents and guardians.

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References
Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity.(2006) The American Academy of Pediatrics. Retrieved from http://pediatrics.aappublications.org/content/117/5/1834.full DeMattia, Laure. (January 2008). Annals of the American Academy of Political and Social Science, Vol. 615, Overweight and Obesity in Americas Children: Causes, Consequences, Solutions. Retrieved from http://www.jstor.org.librarylink.uncc.edu/stable/pdfplus/25097977.pdf?&acceptTC=true&jpdCon firm=true

Healthy Meal Plans for Kids (2012) Super Healthy Kid. Retrieved from http://www.superhealthykids.com/healthy-meal-plans.php
How much physical activity do children need? (2011) Centers for disease control and prevention. Retrieved from http://www.cdc.gov/physicalactivity/everyone/guidelines/children.html Kelder, Steven. (2009). Implementation of Texas Senate Bill 19 to Increase Physical Activity in Elementary Schools. Journal of Public Health Policy. Retrieved from http://www.jstor.org.librarylink.uncc.edu/stable/40207261?&Search=yes&searchText=schools&s earchText=education&searchText=health&list=hide&searchUri=%2Faction%2FdoBasicSearch% 3FQuery%3Dhealth%2Beducation%2Bin%2Bschools%26Search%3DSearch%26gw%3Djtx%26 prq%3Dchild%2Bnutrion%26hp%3D25%26acc%3Don%26aori%3Da%26wc%3Don%26fc%3D off&prevSearch=&item=1&ttl=198164&returnArticleService=showFullText McLaughlin, Marissa (2013 September) Assignment One: Monkey Joes. Retrieved from https://moodle2.uncc.edu/course/view.php?id=17502 North Carolina Enhanced Nutrition Standards for Child Care (2011) North Carolina Public Health. Retrieved from http://ncchildcare.dhhs.state.nc.us/pdf_forms/child_nutrition_study.pdf Obesity in Children and Teens.(2011) American Academy of Child and Adolescent Psychiatry. Retrieved from http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pag es/Obesity_In_Children_And_Teens_79.aspx+ Pate, Russell (2006, Aug.14). Promoting Physical Activity in Children and Youth. American Heart Association. Retrieved from http://circ.ahajournals.org/content/114/11/1214.full Raczynski, James (2009) Arkansas Act of 2003 to Reduce Childhood Obesity. Journal of Public Health Policy. Vol. 30. Retrieved from http://www.jstor.org.librarylink.uncc.edu/stable/40207261?&Search=yes&searchText=schools&s earchText=education&searchText=health&list=hide&searchUri=%2Faction%2FdoBasicSearch% 3FQuery%3Dhealth%2Beducation%2Bin%2Bschools%26Search%3DSearch%26gw%3Djtx%26 prq%3Dchild%2Bnutrion%26hp%3D25%26acc%3Don%26aori%3Da%26wc%3Don%26fc%3D off&prevSearch=&item=1&ttl=198164&returnArticleService=showFullText

Should Schools be Fully Responsible for Improving Child Health? 13 Sekhobo, Jackson. (2010). Trends in Prevalence of Obesity and Overweight among Children enrolled in the NY State WIC Program . Public Health Reports. Retrieved from http://www.jstor.org.librarylink.uncc.edu/stable/pdfplus/41434773.pdf?acceptTC=true&acceptTC =true&jpdConfirm=true