"Combatting Childhood Obesity through School-Based Initiatives" by Isabella Pan
Obesity and its associated comorbidities, such as type II diabetes and hypertension, have emerged as a major health problem in the U.S., with over one-third (36.5%) of U.S. adults being obese (CDC). The onset of obesity may often be very early in life; therefore, public health agencies must place emphasis on the prevention of obesity in children. Childhood obesity is a growing issue in low-resource settings of the United States, afflicting around one in five school-aged children. Obese children are ten times more likely than their peers to become obese as adults, and thus face much higher risk of developing comorbidities and losing life years. The recommended preventative and reductive measures for childhood obesity primarily involve healthy diet and regular physical exercise, but many children, especially those living in low-resource settings, lack adequate access to fresh, healthy food or safe spaces to play. It is unsurprising, then, that childhood obesity disproportionately afflicts the children of minorities and of low-socioeconomic backgrounds (21.9% of Hispanic children and 19.5% of African American children are obese, compared to 14.7% of white children, and children living in low-income areas are 20-60% more likely to be obese than children living in high-income areas). Given the variability of access to healthy foods and exercise across homes, one promising point of obesity prevention and intervention is the public school system. Students spend a large proportion of their days in school; thus, the Department of Education should ensure that public schools play a larger role in combatting obesity through offering more nutritious meal options and increasing opportunities for physical activity and exercise.
By and large, public schools across the United States already offer some type of food assistance such as free-or-reduced lunches, supported mainly by the National School Lunch Program (NSLP). However, significant changes must be made to ensure that the lunches offered to students are of high nutritional value: currently, most schools do not prepare their lunches directly, but rather “heat and serve”, an approach that saves time and money but largely keeps fresh fruits and raw vegetables out of students’ diets. A recent School Nutrition and Dietary Assessment study undertaken by the United States Department of Agriculture found that 42% of schools participating in the NSLP did not offer fresh fruits or raw vegetables on a daily basis, and served/stocked breads made from whole grains only 5% of the time due to higher costs. For many low-income children, free-or-reduced school meals may be their main sources of nutrition during the week. Stricter legislation from the The Department of Education would ensure that schools offer meals that comply with higher nutritional standards. This would not only lower students’ intake of low-nutrition and high-calorie food, but also help students to develop healthier eating habits that can impact their food choices later in life.
Not only should schools aim to affect more positive change in children’s dietary habits, but also they should provide more opportunities for students to exercise and play. Many students in low-resource settings lack access to safe outdoor spaces to engage in physical activity, and school activities like physical education and outdoor recess have been shown to significantly reduce risk of childhood obesity. However, since the No Child Left Behind Act was passed in 2001, placing greater emphasis on academic achievement in subjects such as reading and mathematics, physical education and recess time have been reduced in 44 percent of schools. Currently, only six states abide by standards set by the National Association of Sports and Physical Education that students should engage in 2.5 hours of physical education per week, and only three states offer 20 minutes of recess every day. Previous research has even shown that play time in schools correlates with higher academic achievement, and thus recess should not be viewed by schools as an impediment to meeting academic goals. The United States Department of Education should therefore enact more stringent measures to ensure that school systems across the country are held to these nationally-set standards.
Childhood is a formative period for individuals, and the health-related habits established during this time, whether conducive or deterrent to health, can be long-lasting. Schools are well-positioned to play an impactful role in preventing childhood obesity by providing children with the necessary resources and opportunities to develop healthy habits. Incorporating more nutrition into school meals and increasing opportunities for physical activity in schools across the country will be costly and difficult, but these interventions are necessary in order to protect children from developing obesity, a condition linked to many other chronic ailments that can dramatically worsen their quality of life. Investing in children’s health now will also mean saving significantly in long-term healthcare costs. An old adage in public health states that “prevention is cheaper than cure.” This is certainly applicable in the case of obesity; a recent study determined that proposed policies that would strengthen nutrition standards for food and beverages provided in and outside schools would save significantly more in medical expenditures than they would cost, and have been predicted to prevent between 129,000 and 576,000 cases of childhood obesity by 2025. Just as schools work to nurture children’s mental and intellectual development, so should they place emphasis on shaping children’s physical health.
 “Adult Obesity Facts”, Centers for Disease Control and Prevention, 2017.
 “Approaches to Physical Education in Schools”, Kohl, 2013.
 “Childhood Obesity Facts”, Centers for Disease Control and Prevention, 2017
 “Childhood Obesity: Most U.S. Schools Don’t Require P.E. Class or Recess”, Rochman, 2011.
 “National School Lunch Program”, US Department of Agriculture, 2016.
 StateofObesity.org: Better Policies for a Healthier America, 2017.
 “The Fourth R: Recess and Its Link to Learning”, Stupiansky & Findlay, 2008.
 “The Role of School Physical Activity Programs”, Fernandes & Sturm, 2011.
 “Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement”, Gortmaker et al., 2015.