Keeping kids thin and fit is no small order in 2011.
Schools experiment with countless ideas to battle children’s obesity. They’ve tried cooking classes, nutrition education, inviting kids to work in school gardens, improving cafeteria food, banning sugary snacks. They’ve upgraded playgrounds, tinkered with recess, mandated daily physical activity, organized bike clubs and revised physical education standards. They’ve coached parents, coached teachers, coached lunch ladies, coached coaches.
Yet for all the different approaches, the empirical evidence proving what works and what doesn’t is remarkably sketchy. Evidence-based anti-obesity programs that repeated studies have proven effective simply don’t exist – yet, according to James O. Hill, director of the Center for Human Nutrition and the Colorado Nutrition Obesity Research Center, and one of the nation’s leading experts in anti-obesity efforts.
“If we’re really looking at programs shown to address obesity, there are none out there,” Hill said. “I recall one school study where they just spent millions of dollars, and they found the group that didn’t get the intervention did just as well as the group that did.”
That doesn’t mean, however, that schools shouldn’t keep trying, he said. And some efforts do seem to hold more promise than others. Below are three different approaches in Denver-area school districts that Hill and others say warrant further study to determine whether their early successes can be replicated. One focuses on nutrition, one on physical activity, and one on school environment.
Aurora: Go, Slow, Whoa! teaches kids to make good food choices
Knowledge is power, so they say. But sadly, it’s not willpower.
Knowing the nutritional facts of life doesn’t necessarily equate to making the best food choices. Just ask anyone who’s ever struggled to resist a doughnut or intended to say, “I’ll take the fruit,” but at the last second caved in to the allure of French fries.
Kids are no different from adults on this point. That’s why so many well-intentioned nutrition education programs succeed in teaching youngsters all about the many wonderful fruits and veggies, food pyramids, caloric requirements and all the other tools needed to create a balanced diet – yet fail to make a dent in real-life eating habits. Study after study shows such programs ultimately don’t change the way kids eat.
It’s still early in the game, but initial results from one nutrition education program being piloted in Aurora Public Schools might just have a measurable impact on children’s food choices.
Funded by a grant from LiveWell Colorado, the Go, Slow, Whoa program was introduced last year in one Aurora school, Laredo Elementary. This year, in partnership with KMGH Ch. 7, the U.S. Department of Agriculture and LiveWell, it has been expanded to seven more schools, and officials hope to eventually expand it to all elementary schools in the district.
A simpler, color-coded food pyramid
Created by the nutritionists at the National Heart, Lung and Blood Institute, Go, Slow, Whoa involves a color coding system that helps youngsters make smart food choices by making it easy for them to identify and eat lots of nutrient-dense foods, but not making any foods totally forbidden.
“It’s a simplified food guide pyramid,” said Mona Martinez-Brosh, a registered dietitian and director of nutrition services for the school district.
As students go through the cafeteria line at school, they’ll see the color-coded symbols above each option. Foods tagged with a green apple symbol are “go” foods. They are high in fiber, low in fats, and good to eat any time you want. They’re things like fresh fruits and vegetables, lean meats, nuts, low-fat milk.
“Slow” foods, tagged with a yellow circle, are still nutrient-dense, but have a little more fat and sugar: they’re things like pancakes, or turkey sausage or peanut butter. They’re things that are still wise choices, but shouldn’t be eaten quite as often or in as great a quantity as the “go” foods.
“The pizza we serve at school – with low-fat cheese and whole wheat crust – is a ‘slow’ food, but we tell them that the pizza you get from your local delivery is not,” Martinez-Brosh said.
“Whoa” foods get a red light symbol. The message is “proceed with care.” It’s on foods high in fat or sugar, typically fried foods, sugary sodas and desserts. Don’t give them up entirely, but they should only be eaten once in awhile.
“You don’t often find these foods on our school menu, but salad dressing can be a ‘whoa’ food. If you eat it frequently, in larger portions, it can lead to gaining weight.”
Teachers, parents must deliver a consistent message
But beyond simply coding foods in the cafeteria, Go, Slow, Whoa seeks to involve parents, and to see to it that students hear a consistent message all day from their classroom teachers and the physical education teacher.
In Aurora, parents were invited to come to a breakfast at the start of the year, and to learn how the program works.
“We tell them we need their help in making sure they’re buying more of those types of ‘go’ foods at home,” Martinez-Brosh said. “I have one of my own employees who came to me and said her child came to her and said, ‘No, we can’t eat that. That’s a ‘whoa!’ food.”
In addition, students get hands-on food preparation instruction and food tastings in their classrooms as part of their regular lesson plans. And, occasionally, students who do a good job of selecting ‘go’ foods with their lunch can win prizes.
Does it work? One study found that elementary-aged children who’d been exposed to a similar program were, three years later, drawing 67 percent of their total calories from heart-healthy foods, compared to less than 57 percent of the total daily calories for children who didn’t go through the program. That same study also confirmed what many parents and nutritionists have long suspected: that just about all children, regardless of their level of nutrition education, still consume about a third of their total daily calories from snack foods, desserts and pizza.
Fresh produce sales climb in Aurora
In Aurora, officials do have a little evidence that their efforts may be making a small but measurable difference. Just before the program was introduced at Laredo in April last year, 200 students were surveyed about their ability to recognize healthy eating choices. For example, they were asked if they should choose popcorn with or without butter at the movies. At a restaurant, should they choose a breaded fried chicken sandwich or a grilled chicken sandwich. A month later, they were given the same survey and the results were compared.
“For most of the choice pairs, it went up from about 75 percent who made the healthy choice in the beginning to about 80 percent on the post-test,” said Mya Martin-Glenn, program evaluator for the school district.
Of course, “should” and “would” are two different things, Martin-Glenn acknowledged. But other questions also indicated a measurable increase in the children’s intentions to make healthy choices.
“We asked them how likely they were to do things like drink low-fat milk instead of whole milk, and we had about 65 percent who said they were likely to in the beginning, and that increased to 73 percent on the post-test,” she said. “But we didn’t actually follow them around to see if that’s what they did.”
A more concrete measure of success came in the Laredo cafeteria, where the quantity of fresh fruits and vegetables consumed climbed between 50 and 75 percent during the month-long pilot program, Martinez-Brosh said. She’s seeing similar increases in the schools participating in the program this year.
“I think the kids at this age want to make those right choices,” Martinez-Brosh said. “They just don’t know which foods are which until we educate them.”
In coming days, EdNews Parent and Education News Colorado are chronicling other school programs aimed at curbing obesity that are showing early signs of success. Read about Denver’s SPARK school fitness program. Read about the fate of workplace wellness strategies in Colorado schools, and an overview of childhood obesity in Colorado.