NASP Communiqué, Vol. 33, #3
Prevention in Children: Strategies
for Parents and School Personnel
By Jessica Blom-Hoffman, PhD,
The high incidence of children
classified as overweight or obese in this country has become a major national
concern. In his Call to Action, the U.S. Surgeon General referred
to obesity and overweight as "a public health issue that is among the most
burdensome faced by the Nation" (U.S. Department of Health and Human Services,
2001, p. 1).
Over the past 3 decades,
the percentage of overweight school-age children has nearly quadrupled
(4% in 1965 to 15% in 2001). In addition, data collected as part of the
National Health and Nutrition Examination Survey (see "Resources" below)
revealed that ethnic minority children and children from poorer families
are at increased risk for overweight and obesity. For example, Mexican
American and African American children and adolescents are twice as likely
as their Caucasian peers to be overweight. Obesity is associated with
a number of serious medical conditions including premature death, type
2 diabetes, heart disease, stroke, hypertension, sleep apnea, osteoarthritis,
gallbladder disease, asthma, breathing problems, cancer, and depression.
The epidemic rate of obesity
in this country is a major problem. However, it is important to recognize
that obesity in many cases can be a preventable health condition. While
many factors including genetic predisposition contribute to obesity, dietary
behaviors and rates of physical activity are two major factors that can
be modified. Schools, families, and communities can work together to alter
the trend toward obesity. Teaching about healthy diet and the importance
of maintaining a health activity level to young children is important as
obesity is more easily prevented than treated. It is important to begin
prevention efforts early in childhood because obesity in adolescence
is the strongest predictor of obesity in adulthood. The following
strategies are suggestions for parents and school personnel to work together
to promote the health and well-being of our nation's children.
for Parents and Caregivers
good role models. Show your children how important it is for all family
members to make healthy food choices.
your children with healthy food choices. Provide snacks that are low in
fat, sodium, and refined sugar and are high in fiber, vitamins, and minerals.
young children to develop good eating habits and preferences for healthful
foods because eating behaviors that develop during childhood tend to track
not prohibit your children from eating unhealthy foods. The key is moderation. Limit
your children's portion sizes and make sure the diet is consistent with
the recommendations of the food guide pyramid.
your child's pediatrician or nurse to find out how much food your child
should be eating if you are not sure what portion sizes are appropriate
for your child, or consult the resource books listed below.
television viewing. Research suggests that increased television viewing
is related to the development and maintenance of obesity. This is not
surprising given the number of advertisements for unhealthy foods targeted
at child consumers, the sedentary nature of watching TV, and the fact that
most people eat while viewing TV.
your children to be active, but ensure appropriate safety precautions.
For example, make sure your children wear protective gear including a helmet
when they ride a bike or roller blade.
with community groups to develop safe walk-to-school programs if it is
unsafe for your children to walk to school.
about supervised activities offered by after-school programs at schools
and community centers if you live in a neighborhood that is unsafe for
children to play in the street or on the playgrounds.
your children in food purchasing by taking your children food shopping
and allowing them to help select healthy foods. Also, involve your in
the food preparation process such as washing vegetables and pouring and
your children specific praise for making healthy food choices. For example, "I
like how you ate all of your spinach! It will make you very healthy and
that food preferences develop over repeated exposure and time. Try to
present new foods in small quantities and encourage your children to just
take a bite at first. Over time, you can increase the portion size of
the new food.
sure your children try to eat at least five servings of fruits and vegetables
each day, such as 100% fruit and vegetable juices and raw, cooked, canned,
or dried fruits and vegetables. Easy accessibility to fruits and vegetables
is important. Have fresh fruits and vegetables such as grapes and baby
carrots washed and placed in a prominent location in the refrigerator.
an advocate for your children at school. Does your school have a vending
machine that allows children to purchase soda and candy at school? If
so, speak with the principal and other administrators and the parent-teacher
organization about the possibility of having the vending machine disperse
water, 100% fruit or vegetable juice, milk, and healthier snacks (such
as granola bars, boxes of raisins, graham crackers, and pretzels). This
alternative enables the school to earn money, but not at the expense of
its students' health.
fresh fruits and vegetables and low-fat and skim milk be served in the
cafeteria if it does not do so. Speak with the principal, food service
administrators, and the parent-teacher organization.
alternatives with fundraising organizers if your school engages in fundraising
activities that encourage children to eat candy, chips, and other foods
that contribute to childhood overweight and obesity. Suggest a fresh fruit
for School Personnel
a good role model. Show your students how important it is for you and
them to make healthy food choices.
an advocate of healthy eating in school. If your school has a vending machine
that allows students to purchase soda and candy at school, work with administration
and parents to limit vending machine options to water, 100% fruit and vegetable
juice, milk, and healthier snacks (such as granola bars, boxes of raisins,
graham crackers, and pretzels). Your school will still earn money without
compromising students' health.
nutrition education lessons into the curriculum. Learning is improved
when new information is presented in a familiar context. You can implement
nutrition education information into science, math, language arts and health
a family involvement component when working with young children, because
young children rely on caregivers to purchase and provide healthful foods.
families about what their children are learning regarding healthy eating
concrete, culturally appropriate suggestions for parents to help their
children make healthful choices.
using candy as a reward. When candy is used as a reward, children are
more likely to develop preferences for these foods. In effect, when candy
is used as a reward, its value will increase.
and use alternative fundraising activities that do not involve the sale
of candy, cookies, and cake.
junk food and candy in school. Institute no junk food days in your building. Help
students understand that foods high in sugar and fats are fine to eat as
long as they are eaten in moderation.
students to healthful foods during nutrition education lessons. Taste
testing is an enjoyable activity for children. Many children have never
eaten certain types of fruits and vegetables. However, before doing taste-testing
activities at school, check with your students' caregivers
to make sure they are not allergic to any of the foods you will be serving.
nutrition education lessons with class trips to the fruit and vegetable
section of a local grocery store or a farm. Lessons can focus on selecting
ripe fruit and vegetables, learning how fruits and vegetables grow, and
tasting fresh fruits and vegetables.
a class-wide motivational system to encourage students to eat a healthful
breakfast every day. For example, you can set up a weekly raffle with
a mystery motivator prize that students can enter each day by bringing
in a signed breakfast raffle ticket to the classroom. If students are
eligible to participate in the school breakfast program, you can give them
a blank raffle ticket that they can have the food service staff sign that
they ate breakfast that day. If students eat breakfast at home, their
caregivers can sign the breakfast raffle ticket.
that the provision of knowledge does not necessarily translate into behavior
change. Simply informing students about the importance of daily physical
activity and healthy eating behaviors does not mean they will adopt these
behaviors. It is also important to provide students with an environment
that supports these behaviors, motivation and reinforcement for engaging
in these behaviors, and role models who espouse these behaviors.
students set realistic, well-defined, measurable goals for themselves regarding
healthy eating and physical activity. For example: "I will eat five servings
of fruit and vegetables each day." "I will eat breakfast every day this
week." "I will play basketball at least 4 days this week." In addition
to setting the goal, have them record their progress over time. Students' performance
on their goals can be graphed and incorporated into a math lesson.
Center for Disease Control. (2003). National Health
and Nutrition Examination Survey. Available: www.cdc.gov/nchs/nhanes.htm
Dietz, W. H., & Stern, L. (1999). The
official complete home reference guide to your child's nutrition. Elk Grove Village, IL: American Academy of Pediatrics. Available: 888-227-1770.
Shield, J., & Mullen, M. C. (2002). The
American Dietetic Association guide to healthy eating for kids: How your
children can eat smart from five to twelve. New York: Wiley. ISBN: 0471441449.
U.S. Department of Health and Human Services
(2001). The Surgeon
General's call to action to prevent and decrease overweight and obesity. Rockville, MD: Author. Available: www.surgeongeneral.gov/topics/obesity/default.htm
American Obesity Association-www.obesity.org/subs/childhood/prevention.shtml
Food and Nutrition Information Center (food and nutrition resources for grades preschool
© 2004, National Association of School Psychologists. Jessica Blom-Hoffman, PhD, NCSP, is an
Assistant Professor of School Psychology at Northeastern University
in Boston, MA. Her research is focused on developing, implementing,
and evaluating school-based programs that promote healthful eating
behaviors in young children. Reprinted from Helping Children at
Home and School II: Handouts for Families and Educators (NASP, 2004).