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Connecting Health with Educational Goals - Marilyn Briggs

Connecting Health with Educational Goals

Connecting Health with Educational Goals

School nutrition is often the last district partner to be brought into the change process, but it is the one upon which all others rely for success.

School districts, especially those that undergo a food policy development process, should plan on implementing a program of professional development for nutrition services staff. Professional development is a direct and critical investment in the individuals the district is counting on to make the change.

New menus based on cooking from scratch may require nutrition services employees to learn new skills, especially if the current service is thaw-and-serve. The menus the district intends to serve will tell you what skills your staff needs to acquire. It is also true that employees’ jobs become more rewarding and satisfying when the work is less routine and requires skillful execution. It is through professional development that the nutrition services staff acquires those valuable and transferable skills, which might qualify them for higher pay. When staff members find the work more satisfying, and receive the respect they deserve, enthusiasm will build for the new program.

Many nutrition services directors provide professional development. The California Department of Education offers a food service professional development infrastructure through universities and colleges. Discussion of making such training mandatory is under way.

At a policy level, I would advocate for better pay for nutrition services staff, and development of some professional requirements and expectations for anyone who is involved in the preparation of food for children. These would include cooking skills, basic sanitation, and safety training. We’re not there yet.

The emphasis on the farm-to-school approach to improving food in schools comes at a time when we are facing a national health crisis, and much of that crisis is nutrition-related. Childhood obesity has reached epidemic proportions. Some 4.7 million children between 6 and 17 (11 percent) are overweight; the prevalence of obesity among children aged 6 to 11 years increased from 6.5 percent in 1980 to 19.6 percent in 2008. The prevalence of obesity among adolescents aged 12 to 19 years increased from 5.0 percent to 18.1 percent. Type II diabetes was once called “adult onset” diabetes. Today, it’s one of the most serious health problems of overweight children, and its rates have recently escalated.

Reports to the U. S. Department of Agriculture show that only 2 percent of school-age children meet the USDA’s serving recommendations for all five major food groups. Just over half eat less than one serving of fruit a day. Nearly 30 percent eat less than one serving a day of vegetables that are not fried. Added sugar contributes to 20 percent of total food energy in children’s diets; 56 percent to 85 percent of children consume soda on any given day.

According to the U. S. Department of Health and Human Services, poor diet and physical inactivity are responsible for as many premature deaths as is tobacco—more than 1,200 deaths a day. The Centers for Disease Control (CDC) identifies diet as a “known risk” for the development of the nation’s three leading causes of death: coronary heart disease, cancer, and stroke, as well as for diabetes, high blood pressure, and osteoporosis, among others.

If one of our primary goals as educators is to help students prepare for healthy and productive lives, then nutrition and health education are central to that goal. The most systematic and efficient means for improving the health of America’s youth is to establish healthy dietary and physical activity behaviors in childhood. The CDC reports that “young persons having unhealthy eating habits tend to maintain these as they age. Behaviors and physiological risk factors are difficult to change once they are established during youth.”

Yet fewer than one-third of schools provide thorough coverage of nutrition education related to influencing students’ motivation, attitudes, and eating behaviors.

Most of us already connect nutrition with health. If we go one step further to connect health with educational goals, then we have effectively connected nutrition to academic performance. There is so much concern over test scores these days. But if kids aren’t in a position to learn because they’re hungry, or they don’t get enough nutritious food at home, then schools that don’t make the nutrition– performance connection in the cafeteria end up undermining what they’re trying to do in the classroom. They know this, too. As an example, on the day before schools administer standardized tests, they’ll tell kids to eat breakfast in the morning, or they’ll serve a breakfast on campus on test days.

Studies repeatedly link good nutrition to learning readiness, academic achievement, and decreased discipline and emotional problems. A hungry child is not equipped to learn. Any teacher knows that if children are hungry, they’re not thinking about their lessons. Educational theorists sometimes forget that.

In 2003, I served as one of the writers for a joint position statement of the American Dietetic Association, the Society for Nutrition Education, and the American School Food Service Association. Part of our statement read: “ . . . comprehensive nutrition services must be provided to all of the nation’s preschool through grade twelve students. These . . . shall be integrated with a coordinated, comprehensive school health program and implemented through a school nutrition policy. The policy shall link comprehensive, sequential nutrition education; access to and promotion of child nutrition programs providing nutritious meals and snacks in the school environment; and family, community, and health services’ partnership supporting positive health outcomes for all children.”

To me, that means that you need to connect health, through nutrition education, to the whole curriculum—not merely as one of the components in the curriculum, but as something that’s embedded in all aspects of it. It means making school meals part of the nutrition education program. That connection feels self-evident, but schools and districts have been slow to make it. The lunch period has more often been regarded as time stolen away from the curriculum than as part of the curriculum.

Implementing a program that addresses nutrition, health, and school lunches through an integrated curriculum requires many steps. It’s a circle that can be entered at numerous points, including the many sections of the “Rethinking School Lunch” guide, but it all starts with the food on children’s plates.

Menus are the heart of the whole system. Kitchens should be designed to prepare the menus you want to serve, and not the other way around. Menus also provide the basis for reviewing nutrition services staffing and staff development programs, facilities, budget, and the procurement system, to see what needs to change.

School meal programs have the potential to provide students with better nutrition for one or two meals every day, which would be a great health improvement for many students. Lunches brought from home often provide as little as one-third the Recommended Dietary Allowance for food energy, vitamin A, B vitamins, calcium, iron, and zinc.

But it’s not enough that school food be nutritious. Healthy meals won’t make a difference to student health if students reject them or throw them away. The food needs to be delicious, attractive, and appealing to young people. Fortunately for nutrition educators, good fresh food usually does taste better. When children taste freshly picked or prepared foods—sometimes for the first time—they often discover that they like them. More and more schools are now buying and preparing fresh food.

I much prefer this approach to the negative approach of “Do not eat this, and do not have that.” It’s a more positive, much more educational way for students to learn how delightful and wonderful it can be to add fruits, vegetables, and whole grains to their diet. Rather than calling attention to a banned food, which then becomes more attractive, enjoyment of fresh food’s natural tastiness will help to establish new attitudes toward food and lifelong healthy eating habits.

Offering nutritious food, even if it tastes good, may still not be enough by itself. The pervasive availability of high-fat foods, non-nutritious foods served in the influential environment of restaurants geared to young children, and children’s predisposition to these foods all contribute to unhealthy diets. The media has the capacity to persuade children to make poor food choices. Studies have shown that even brief exposure to televised food commercials can influence preschool children’s food preferences. A successful program may also need to use the tools of marketers to reach both children and parents. And when school gardens or cooking classes are also integrated into the curriculum, so that children grow or prepare the foods they eat, the food almost always becomes more attractive.

Buying food locally, to be prepared and served fresh, helps local farmers who are often struggling to compete with agribusiness. It gives local farmers a chance to diversify their markets, and that in turn helps the local economy. Healthy farms provide jobs, pay taxes, and keep working agricultural land from going to development. The benefits of preserving farmland include lower costs of community services, more open space, valuable flood control, diversified wildlife habitat, and greater community food security.

Schools represent a reliable and steady demand for produce and products that farmers can plan for, allowing farms to establish better controls on planting, harvesting, and marketing. Buying locally also reduces the transportation costs, packaging, fossil fuel use, and exhaust emissions caused by shipping food over long distances. In many cases, food bought locally costs schools less. Having local food sources also enables schools to bring farmers to the classroom, and allows students to go on field trips to farms and at farmers’ markets.

The lifelong nutrition habits and lessons that children acquire from school food programs don’t end with eating better food. A food systems curriculum promotes understanding about where food comes from and the natural cycles that produce it. The way that meals are served and eaten is part of the hidden curriculum that tells students what the school really believes about food. Does the school encourage fast-food attitudes by providing short lunch periods in which eating competes with getting out of the cafeteria and onto the playground? Or does the school model a belief that mealtime is part of living a healthy life?

I advocate serving meals family style, around a table, as an alternative to “grab and go” through a cafeteria line. When the social experience of sitting together with other students and calmly eating the food is a positive one, children want to make time to have that experience with their friends and families. In order for this to happen, the cafeteria needs to be a positive environment in all respects.

Some people argue that cafeteria lines are faster and more efficient, but family-style service can actually be faster because it’s all set up in advance. The kids come in, and the food is there on the table. They actually have the full lunch period to eat without having to stand in line.

In order to serve family style successfully, you do need an adult in the role of “table host” at each table. It quickly becomes too costly if you rely on paid staff, but I’ve been involved in very successful programs in which senior citizens served as the table hosts. Those programs worked very well. The kids ate in a better atmosphere; the senior citizens were able to make a valuable contribution and enjoy a nutritious lunch. The table hosts received stimulation from interacting with the kids; the kids were exposed to new role models. A program like that also helps connect schools to their communities, which can create more advocates for the schools when bond issues and other funding measures come before the community.

Unfortunately, the hidden curricula of most school systems—from industrial cafeteria lines, to the amount of time allotted for lunch, to combining lunch with recess—teach kids that meals are something to rush through on the way to somewhere else. Recent research shows that children eat better when they also have a quiet time that follows eating. The ideal seems to be to have physical activity in the morning, a quiet study time of some type before lunch, then lunch, followed by a reading or quiet time. Physical activity after lunch needs to be delayed until later in the day. It’s pretty obvious that if you go right out to PE, which is often what schools do, then kids who are anxious to get out on the playground shortcut their meals.

We think of today’s kids as having grown up as a junk food generation, but it’s often their parents who grew up surrounded by junk food, and they passed on those habits to their kids. We’ve lost a lot of parent role modeling. Parents often lack the ability to make wise food choices, or lack the skills to prepare fresh food. We’ve lost our home economics courses. Even so, time and time again, I have seen children take food knowledge home and really make a difference with their parents. They often help teach their parents about healthy, fresh food. Sometimes they take their parents to the farmers’ market. Sometimes they bring home food preparation skills that their parents forgot or never had.

When we connect schools and parents, we find that many parents have skills that they can bring into the classroom. This is especially true of parents who have traditional cooking skills from different cultures. I’ve seen it happen so many times, where a parent who might not be participating at all in school is asked to come in and share ethnic recipes—often a traditional recipe that incorporates local seasonal foods. They come, they meet people, and they see the values of their culture being recognized and honored.

That reminds me of a study among the Hmong living in Berkeley. Their kids were taking home processed food like pizza, and the parents felt, Okay, this is the culture, and I want to learn this culture. So, we’d better serve this at home. Meanwhile, the study was busy highlighting the wonderful, delicious, high-nutrient fruit-and-vegetable recipes that the parents knew. Seeing their culture valued, and perceiving themselves as having a rich cultural gift to contribute, can be the door that leads those parents to become much more involved in the school and in the community. I’ve seen that happen repeatedly.

Moving from good ideas to action is never easy. School systems are among the most entrenched systems in our culture, often for good reason. We see programs succeed most often when a key administrator, especially a superintendent, is driving them. Sometimes administrators aren’t ready. Sometimes school lunch and nutrition education programs are too far down their priority lists. In those cases, the change process can still be initiated from the ground up. It can begin with a nutrition services director, or a parent, or a school nurse. I’ve seen it begin with a school board member who became very interested, inspired the rest of the board, and dragged the principal into it. I’ve even seen students take it on as a project.

So it can work from the top down, or from the ground up, but it’s ideal if you have both. The most important thing is to start somewhere, and stay with it. Probably more than anything else you need an advocate, someone who will spend the time and energy to stick with it. The change you want is so positive that many people will be drawn toward it. But you still need an advocate to bring the different groups together.

Building partnerships among administrators and parents, or teachers and nurses, or between schools and the agricultural community, is a way in to involve new partners in the effort. In fact, I did that with school bus drivers, who look skeptically at programs that require changes in the bus schedule—one of the big obstacles to successful breakfast programs. Knowing that food talks, I invited the bus drivers to dinner. We talked about goals, and imagined working together to make the program happen for the kids. The next thing I knew, the drivers were adjusting their schedules to encourage breakfasts for children.

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