Make A Difference At Your School! Cdc Resources Can Help You ...
Make a Difference
at Your School!
CDC Resources Can Help You Implement Strategies
to Prevent Obesity Among Children and Adolescents
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
The Impact of Obesity
Obesity is increasing rapidly in the United States, affecting children, adolescents, and adults of all races, ethnicities,
and income levels.
Since 1980, the percentage of obese children aged 6 to 11 has doubled, and the percentage of obese
adolescents aged 12 to 19 has tripled. Childhood obesity has both immediate and long-term serious health impacts.
• In some communities, almost half of pediatric diabetes cases are type 2 diabetes, which was once
believed to affect only adults.
• In one large study, 61% of obese 5- to 10-year-olds already had risk factors for heart disease, and
26% had two or more risk factors for the disease.
• Obese children have a greater risk of social
and psychological problems, such as
discrimination and poor self-esteem.
• Obese children have a 70% chance of being
overweight or obese as adults—facing higher risks for
many diseases, such as heart disease, diabetes, stroke, and
several types of cancers.
The costs of treating obesity-related diseases are staggering and rising rapidly.
In 2004, direct and indirect health costs associated with obesity were $98 billion.
Good eating habits and regular physical activity are critical for maintaining a
healthy weight. Unfortunately, less than 25% of adolescents eat enough fruits
and vegetables each day. Sixty-four percent of high school students don't meet
currently recommended levels of physical activity.
The Role of Schools in Preventing Childhood Obesity
Reversing the obesity epidemic requires a long-term, well-coordinated approach to
reach young people where they live, learn, and play, and schools have an important
role. Working with other public, voluntary, and private sector organizations, schools
can play a critical role in reshaping social and physical environments and providing
information, tools, and practical strategies to help students adopt healthy lifestyles.
• More than 95% of young people are enrolled in schools.
• Students have the opportunity to eat a large portion of their daily food intake
and to be physically active at school.
• Schools are an ideal setting for teaching young people how to adopt and
maintain a healthy, active lifestyle.
• Research shows that well-designed, well-implemented school programs
can effectively promote physical activity and healthy eating.
• Emerging research documents the connections between physical activity,
good nutrition, physical education and nutrition programs, and
academic performance.
Ten Strategies for Schools to Promote Physical Activity and Healthy Eating
The Centers for Disease Control and Prevention (CDC) reviews scientific evidence to determine which school-based
policies and practices are most likely to improve key health behaviors among young people, including physical activity
and healthy eating. Based on these reviews, CDC has identified 10 strategies to help schools prevent obesity by
promoting physical activity and healthy eating. CDC and its partners have developed user-friendly tools that help schools
effectively implement each of the strategies.
Building the Foundation (Strategies 1–4)
Health Is Academic: A Guide to Coordinated
Schools can build a strong foundation that will enable
School Health Programs
them to effectively promote physical activity and healthy
Developed by the Education Development Center with
eating as well as other health-enhancing behaviors.
support from CDC and
The first four strategies help schools develop a tailored
in collaboration with
approach that meets their specific, local needs and
more than 70 national
interests; earn the support and commitment of the
organizations, this
school community; use the insights gained from
book describes how
scientific research; and emphasize teamwork and
the eight components
collaboration to maximize effectiveness and efficiency.
of a CSHP can work
together to support
Strategy 1: Address physical activity and
students and help
nutrition through a Coordinated School
them acquire the
Health Program (CSHP).
knowledge and skills
they need to become
healthy, productive
adults. It includes
CSHP implementation action steps for schools, districts,
state agencies, national organizations, colleges,
and universities. Search on the American School
Association’s website.
www.ashaweb.org/store/products/
Strategy 2: Maintain an active school health
CSHPs provide a systematic approach to promoting
council and designate a school health
student health and learning. The model promoted by
coordinator.
CDC consists of eight components that can strongly
influence student health and learning including health
Establishing a school health council (SHC) is an
education, physical eduation, and school meals, which
effective way to achieve an enduring focus on
are present in most schools. CSHPs focus on improving
promoting physical activity and healthy eating. SHCs can
the quality of each of these components and expanding
help schools meet the federal law passed in 2004 that
collaboration among the people responsible for them
requires all school districts that participate in
in the school and in the community. Active coordination
federally funded school meal programs to establish
is needed to engage school staff, implement district/
a local school wellness policy through a process that
school priority actions; assess programs and policies;
involves parents, students, school representatives, and
create a plan based on data, sound science, and
the public.
analysis of gaps and redundancies in school health
programming; establish goals; and evaluate efforts.
Comprising representatives from the home, school, and
A well-coordinated school health program results in
community, SHCs establish goals for the school health
an organized set of courses, services, policies, and
program and facilitate health programming in the school
interventions that meet the health and safety needs of all
and between the school and community. Guided by
students from kindergarten through grade 12.
the SHC’s vision, a school health coordinator manages
and coordinates all school health policies, programs,
CDC’s School Health Index (SHI):
activities, and resources. SHCs have helped create
A Self-Assessment Planning Guide
lasting changes in school environments, such as the
This easy-to-use self-assessment and planning tool
adoption of nutrition standards, establishment of student
enables SHCs and others to analyze the strengths
and staff walking programs, the provision of adequate
and weaknesses of
class time for physical education and health education,
their school health
and the opening of school facilities for after-school
policies, curricula,
physical activity programs.
and services. The SHI
features eight self-
Promoting Healthy Youth, Schools, and
assessment modules,
Communities: A Guide to Community-School
each corresponding
Health Councils
to one of the CSHP
This how-to manual offers a practical, five-step
components. Based on
approach to planning, developing, maintaining, and
their self-assessment,
evaluating SHCs. It was developed by a number
school health teams
of CDC partners—originally produced by the Iowa
identify goals and
Department of Public Health, it was adapted for use
create an action plan
by the American Cancer Society in collaboration with
tailored for their school.
the American School Health Association, American
Many schools are incorporating these plans into their
Academy of Pediatrics, and National Center for
overall educational improvement plans. The SHI can be
Health Education.
completed using a paper or online version.
www.cancer.org/schoolhealthcouncil
www.cdc.gov/HealthyYouth/SHI
Effective School Health Advisory Councils:
Strategy 4: Strengthen the school’s nutrition
Moving from Policy to Action
and physical activity policies.
This guide was developed by CDC’s partners at
the North Carolina Department of Public Instruction to
School policies can dictate how often students attend
help school district personnel and others develop new
physical education, which items go into school vending
SHCs or strengthen existing ones that can effectively
machines, which topics and skills are taught in health
support school health policies and programs.
education, which foods are served in the cafeteria, and
www.nchealthyschools.org/docs/resources/tools/
much more. School policies directly affect students’
shacmanual.pdf
opportunities for physical activity and healthy eating and
can support the implementation of all other
Strategy 3: Assess the school’s health policies
strategies listed in this document.
and programs and develop a plan
for improvement.
Fit, Healthy, and Ready to Learn:
A School Health Policy Guide (FHRTL)
Self-assessment and planning provide structure to a
Developed by the
coordinated school health program in the way that a
National Association
map provides guidance to a driver. The self-
of State Boards of
assessment describes where the program is now, and
Education (NASBE)
the plan provides the destination and directions to make
with CDC support,
improvements. A school health plan is most likely to
this practical guide
be effective when it is based on a systematic analysis
helps schools and
of existing policies and practices, guided by insights
local school districts
from research, and developed by an SHC that includes
establish strong policies
teachers, parents, school administrators, students, and
on physical activity,
the community.
nutrition, and other health issues in the context of a
Strategy 5: Implement a high-quality health
CSHP. FHRTL features sample policies that reflect best
promotion program for school staff.
practice and can be adapted to fit local circumstances;
it also includes explanations of the points addressed
Staff wellness programs provide opportunities for school
in the sample policies and excerpts of actual state and
staff members to participate in health assessments,
local policies.
nutrition classes, physical activity programs, and other
ww.nasbe.org/HealthySchools/fithealthy.html
health promotion activities. These opportunities can
contribute to improvements in physical and mental
NASBE also maintains a database of state school
health outcomes; increases in morale, productivity, and
health policies that can serve as models for new policy
positive role modeling; and decreases in absenteeism
development.
and health insurance costs.
www.nasbe.org/HealthySchools/States/
State_Policy.asp
School Employee Wellness: A Guide for
Protecting the Assets of Our Nation's Schools
Wellness Policy Guidance
Developed by the
Developed in collaboration with CDC and the U.S.
Directors of Health
Department of Education, this U.S. Department of
Promotion and
Agriculture (USDA) website provides information on how
Education (DHPE) with
to create, implement, and evaluate wellness policies
CDC support, School
that meet the requirements of federal law.
Employee Wellness: A
www.fns.usda.gov/tn/Healthy/wellnesspolicy.html
Guide for Protecting the
Assets of Our Nation's
Wellness Policy Development Tool
Schools, is designed to
Developed by Action for Healthy Kids in partnership
help schools, districts,
with CDC and USDA, this searchable online database
and states develop
consists of existing or model nutrition and physical
comprehensive school
activity policies from states and districts around the
employee wellness
country. Schools can easily use language from policies
programs. This resource provides guidance for obtaining
in the database to build local wellness policies.
program support, developing a school employee
www.actionforhealthykids.org/resources_wp.php
wellness team, using existing data to optimize a new
or existing program, and implementing policies and
Taking Action (Strategies 5–10)
practices to support employee wellness.
www.schoolempwell.org
With a strong foundation in place, schools can work
on improving programs and activities that serve both
Strategy 6: Implement a high-quality course of
students and staff members. Strategies 5 through 10
study in health education.
are derived from CDC’s research-based guidelines that
identify school practices that promote lifelong physical
Health education provides formal opportunities for
activity and healthy eating.
students to acquire knowledge and learn essential life
skills that can foster healthy behaviors, such as physical
activity and healthy eating. Taught by qualified teachers,
quality health education includes instruction on essential
topics and skills that protect and promote physical,
social, and emotional health and safety and provides
students with ample opportunities to practice health-
enhancing behaviors. State-of-the-art health education
features a sequential curriculum consistent with state
or national standards, adequate instructional time, and
assessment to improve students’ knowledge and skills.
Health Education Curriculum Analyses Tool
CDC’s Physical Education Curriculum Analysis
(HECAT)
Tool (PECAT)
This tool enables
This tool enables educators to evaluate physical
schools or school
education curricula based on the extent to which the
districts to choose
curricula align with national standards, guidelines, and
or develop health
best practices for quality physical education programs.
education curricula
The PECAT can be
that meet local needs
used to identify where
and interets and are
revisions might be
likely to be effective
needed in a locally
in improving students'
developed curriculum
knowledge, skills,
or to compare strengths
and health behaviors.
and weaknesses of
The HECAT is
published physical
based on rigorous
education curricula
reviews of research evidence and is closely aligned
being considered for
with the National Health Education Standards. It allows
adoption. For those
educators to evaluate curricula based on the extent
schools without a
to which they contain elements of effective health
physical education
education: those characteristics that are common to
curriculum, the PECAT
effective programs and most likely account for their
provides a vision of what should be included in a high-
positive outcomes. This edition of the HECAT covers
quality written physical education curriculum.
physical activity, nutrition, and tobacco, along with
www.cdc.gov/HealthyYouth/PECAT
alcohol and other drugs. Available in early 2008.
www.cdc.gov/HealthyYouth
Strategy 8: Increase opportunities for
students to engage in physical
School Health Education Resources
activity.
This searchable website provides user-friendly access to
the myriad school health education offerings available
The school setting offers
from CDC, including curricula and lessons, fact
multiple opportunities for all
sheets, and other instructional materials for use by
students, not just those who
teachers and students. The curricular resources
are athletically inclined,
are aligned with the characteristics of an effective
to enjoy physical activity
health education curriculum and the updated
outside of physical
National Health Education Standards, which can
education classes:
be accessed from the website.
walking to and from
www.cdc.gov/HealthyYouth/SHER
school; enjoying recess;
physical activity clubs, and
Strategy 7: Implement a high-quality course
intramural sports programs; and
of study in physical education.
having classroom lessons that
incorporate physical activities.
Physical education is the cornerstone of a
These opportunities help
comprehensive approach to promoting physical activity
students learn how to weave
through schools. All students, from pre-kindergarten
physical activity into their
through grade 12, should participate in quality physical
daily routines.
education classes every school day. Physical education
not only provides opportunities for students to be active
during the school day, but also helps them develop
the knowledge, attitudes, skills, behaviors, and
confidence needed to be physically active for life.
KidsWalk-to-School
calorie beverages. Although federal regulations on these
This manual provides guidance for schools and
foods and beverages are limited, many states, school
communities on how to create an environment that
districts, and schools are establishing strong policies and
supports safe walking and bicycling to school.
innovative marketing practices to promote the sale of
healthier foods and beverages.
It includes educational materials to help promote
walking to school and suggests strategies for
Making It Happen:
communities to overcome barriers to walking to school.
School Nutrition Success Stories
www.cdc.gov/nccdphp/dnpa/kidswalk
This resource, developed by CDC and the USDA’s
Team Nutrition with
Strategy 9: Implement a quality school
support from the
meals program.
U.S. Department of
Education, describes six
Each school day, millions of students eat one or two
strategies that schools
meals provided as part of the federally funded school
have implemented to
meals program. These meals have a substantial impact
improve the nutritional
on the nutritional quality of students’ overall dietary
quality of foods and
intake and provide a valuable opportunity for students
beverages offered on
to learn about good nutrition. CDC supports USDA
campus. It also tells the
efforts to ensure that meals served through the National
stories of 32 schools
School Lunch Program and School Breakfast Program
and school districts
are safe, nutritious, and balanced.
across the country that
have successfully implemented these strategies.
Changing the Scene:
www.cdc.gov/HealthyYouth/nutrition/Making-It-
Improving the School Nutrition Environment
Happen/download.htm
This USDA Team Nutrition tool kit, developed with
Nutrition Standards for Food in Schools: Leading
technical assistance from CDC, provides guidance
the Way Toward
and ready-to-use resources designed to help schools
Healthier Youth
implement a comprehensive and consistent approach
to promoting healthy eating among students. The kit
This report, from the
addresses the entire school nutrition environment and
Institute of Medicine,
includes guidance on serving and marketing quality
makes recommendations
school meals in a pleasant eating environment. Many
about appropriate
other school meal guidance tools are available from the
nutritional standards
Team Nutrition website.
for the availability,
www.fns.usda.gov/TN/resources/changing.html
sale, content, and
consumption of foods
Strategy 10: Ensure that students have
and beverages at
appealing, healthy choices in foods and
school, with particular
beverages offered outside of the school
emphasis on those sold
meals program.
outside of school meals.
www.iom.edu/CMS/3788/30181/42502.aspx
Most schools offer foods and beverages to students
through a variety of channels outside of the federally
regulated school meals program: vending machines,
school stores, concession stands, after-school programs,
fundraising campaigns, and class parties. These
offerings have dramatically increased student access to
high-fat or high-sodium snacks and non-nutritious high-
For more information on the role of schools
in preventing childhood obesity, please visit CDC’s website:
www.cdc.gov/HealthyYouth/KeyStrategies
January 2008 (CS116926)
