School-based nutrition education is a pivotal component of our Nation's strategy for health promotion. In 1991, the U.S. Department of Health and Human Services published Healthy People 2000: National Health Promotion and Disease Prevention Objectives. One health objective for the year 2000 was to "increase to at least 75 percent the proportion of the Nation's schools that provide nutrition education from preschool through 12th grade, preferably as part of quality school health education."
With the Food and Nutrition Service (FNS) and the Cooperative Extension System (CES) as partners, USDA is in a unique position to promote the nutritional well-being of the Nation's school children through nutrition education. The future health of our citizenry may depend on how well we do today in imparting a very basic life skill—eating to promote health and well-being—to our young people.
Partner Agencies
FNS administers the National School Lunch Program, begun in 1946, and the National School Breakfast Program. The school lunch program serves about 24 million children each school day, about half of them from low-income families. Its goal is to provide low-cost or free lunches as one way to safeguard the health and well-being of our Nation's children. FNS also administers the Nutrition Education and Training Program (NET), established by Congress in 1977 to enable teachers and school foodservice personnel to provide coordinated classroom and lunchroom experiences for effective nutrition education.
The CES includes an extensive network of educators in each land-grant university and nearly all 3,150 counties in the United States. As part of the land-grant system, CES professionals, paraprofessionals, and trained volunteers provide food and nutrition education to meet locally identified needs. CES has been a major and effective force in addressing the public's food and nutrition concerns.
The Gap Between Knowing and Doing
Childhood and adolescence are life stages marked by considerable change. Eating behaviors often reflect these physical, psychological, and social changes. For example, appetite fluctuations usually correspond to spurts and plateaus in growth; changes in food preferences may reflect an increasing need to assert independence or a response to new social and environmental situations. Nutrition and exercise patterns that are formed during the first two decades of life can shape an individual's health and well-being—now and in the future.
Recent surveys indicate that children and adolescents know a lot about nutrition. Yet this knowledge isn't necessarily translated into positive eating practices. To explain why they don't make positive health choices, adolescents often give reasons relating to lack of self-discipline and lack of a sense of urgency about diet and health. Many don't feel responsible for their own food choices, explaining that they rely on adults to keep them healthy. As one student said, "When you're a kid, your parents, they always watch out for you and eating and stuff like that. When you're older, you're watching out for your own self and you're taking responsibility for you and other people won't."
New York Educators Address the Challenge
The Nutrition for Life program illustrates one State's response to the challenge of school-based nutrition education. New York State's successful program forged partnerships among CES, NET, the State departments of health and education, and industry.
"Nutrition is not peripheral to a child's learning. It is a basic skill, a basic need," says Matilda Cuomo, New York State's First Lady, who challenged educators to create a comprehensive school-based nutrition education program. Developed by CES faculty in the Division of Nutritional Sciences at Cornell University, the three integral components of Nutrition for Life are: (1) a comprehensive set of teaching materials for kindergarten through 12th grade (K-12), (2) a peer training team model for disseminating the materials and training local teachers, and (3) an evaluation plan for determining program effectiveness.
Teaching Materials
Nutrition for Life is helping thousands of students develop a basic life skill—eating to promote health and well-being. Learning experiences throughout the K-12 materials emphasize the importance of meeting nutrient needs without excess fat, sugar, or sodium, concepts drawn from the Dietary Guidelines for Americans, which were jointly issued by USDA and the Department of Health and Human Services (HHS).
Elementary school children explore, experiment, and experience personal nutrition issues. For example, students learn to "Be A Choosy Chewer" by choosing good snacks and being physically active; science experiments in "The Nutrient Connection" reveal the relationship between what students eat and what happens inside their bodies; in "A Case of Waste," students examine the ecological consequences of food waste.
The seven segments of learning experiences provide opportunities to participate in interdisciplinary approaches to solving problems and making decisions. Not only do elementary school students learn important nutrition skills, but they also learn math by measuring and estimating; science by observing, comparing, classifying, inferring, and applying; language arts by reading, writing, analyzing, and interpreting; social studies by exploring people, places, and situations; and the arts through music, drama, drawing, and creative expression.
The 7th and 8th grade teaching materials complement New York State's curricula for Health and Home and Career Skills. Students examine nutrition problems and needs of people at different stages of the life cycle, explore influences on their personal food choices, and develop a personal contract for fitness. As one teacher described the materials, "It takes nutrition out of any kind of textbook and puts it into a context that the kids can see in their everyday lives and use."
At the senior high level, Nutrition for Life targets three groups of students. Students in health and physical education classes devise a program of physical activity and eating that will enable them to be personally fit. Students in home economics classes apply the options and control over time, money, skills, and ingredients when preparing foods that are consistent with the Dietary Guidelines. Pregnant and parenting teens acquire skills in making decisions that will positively affect their own and their babies' health. Through the use of participatory, real-life nutrition situations, high school students develop problem-solving, decision-making, and resource management skills as well as valuing the wise use of personal and community resources.
ALIVE! Food & Fitness for Life, an innovative magazine for high schoolers with a popular press style, integrates the three teaching units. Its goal is to motivate teenagers to learn about positive nutrition practices. Many teens consider nutrition boring, unimportant to their health now, and something that is more their parents' responsibility than their own. The 32-page, full-color magazine meets this challenge with its upbeat, positive tone to promote self-esteem, personal situations and experiences, and a contemporary, mature design. Personal interviews, soap-opera fiction, question and answer columns, and a peer advice column are used to engage the reader. The lead article features interviews with athletes to set the pace for this classroom magazine aimed at attracting both male and female readers.
Comments from classroom teachers, school psychologists, dietitians in private practice, 4-H leaders, church youth leaders, PTA presidents, and parents indicate that ALIVE! is being used effectively with teenagers in a variety of educational settings. One nutritionist said, "It's a good way to start conversations with my clients."
Peer Training Team Model
No matter how well developed a school-based program is, it will be successful only if it is effectively distributed and supported. This involves persuading a school system of the wisdom of adopting a program, training teachers in using the materials, and maintaining the quality of the program.
To meet this challenge in New York State, a peer training team model was adopted to distribute the 7th through 12th grade materials. A similar model had been used to effectively distribute a newly mandated Home and Career Skills curriculum throughout the State. Fifteen training teams were formed, each including at least one representative of the target groups: classroom teachers, school administrators, local CES agents, and (for the pregnant teen material) a community health educator. The collective efforts of 41 CES staff, 100 teachers and school administrators, and 16 community health educators were reflected in the training teams.
Each regional training team was charged with distributing the program to peer teachers and supporting its use through local or area workshops. Teams were encouraged to foster links between school-based personnel and local community resources in a way that would promote long-term involvement and continuity in nutrition education. The involvement of local CES agents made this possible.
The 15 training teams received initial training, support materials, ongoing technical assistance, and a small stipend from Cornell. NET educators provided extended distribution and maintenance of the program. The NET-CES partnership was a key to long-term programming.
Evaluation Methods and Results
Over 90 percent of the teachers who attended local workshops during the project's first year rated them as excellent or good. Teachers were excited about the new teaching materials and planned how to use them in their classrooms to meet curriculum goals. As one educator said, "It's a comprehensive approach and it ties in not only home, school, and community but also departments within the school."
Nutrition for Life makes teaching easier, better organized, more up-to-date, and more detailed, according to the majority of teachers questioned in a statewide random survey. Teachers also agree that students became more involved and interested in learning about nutrition.
Tools used to evaluate the effectiveness of Nutrition for Life included: (1) a mail survey of 2,425 randomly selected K-12 teachers in New York State and (2) a written nutrition test of 2,863 7th and 8th grade students from 103 randomly selected classrooms.
Results of these evaluations indicated that about half the 7th and 8th grade health and home and career skills teachers received the program, as did one-third of high school health, home economics, and physical education teachers, and one-fourth of elementary school teachers in New York State. Three-fourths of the teachers who received Nutrition for Life used the materials in teaching, and the teachers who attended training workshops were most likely to use the materials.
Modest but statistically significant effects on students' knowledge, attitudes, and behavior were found in classrooms where Nutrition for Life was used. In schools with a high proportion of low-income students, additional hours of Nutrition for Life teaching was associated with significantly higher nutrition attitude and behavior scores, compared with those of students in other schools.
Making a Difference in the Nation's Health
Effective partnerships among NET, CES, school administrators, teachers, and community health educators are needed to tackle complex and expansive issues such as health promotion. Nutrition for Life affords the opportunity for reaching the Nation's more than 41 million children and adolescents with effective school-based nutrition education.