To Combat the Childhood Obesity Epidemic, States and Territories Leverage School Nutrition and Physical Activity Policies

November 01, 2018|4:43 p.m.| ASTHO Staff

Earlier this month, ASTHO released “Preventing Childhood Obesity Through Healthy Communities,” a new episode in its Public Health Review podcast series. The episode, featuring leaders from CDC’s Division of Nutrition, Physical Activity, and Obesity and the Tennessee Department of Health, highlights the nation’s childhood obesity epidemic and discusses ways to reduce climbing obesity rates by increasing access to healthy foods and promoting physical activity.

Obesity remains a complex health issue in the United States. Several factors—including behavioral, environmental, and genetic—interact and contribute to increasing obesity rates. Approximately 19 percent of children and adolescents aged 2-19 years old are obese and face a greater risk of developing chronic and other conditions such as diabetes, heart disease, cancer, high blood pressure, asthma, and sleep apnea. By 2012, the estimated annual cost of obesity in the United States was $147 billion, in addition to other social and emotional costs.

The causes of childhood obesity include unavailability of healthy food options, easy access to unhealthy foods, lack of physical activity, as well as policy and environmental factors that do not support healthy lifestyles. Schools play a significant role in diet and activity through the foods and drinks offered and the opportunities for physical activity provided. Recognizing the unique position of schools, states have enacted and proposed legislation to prevent and reduce childhood obesity by: (1) ensuring that nutritious food and beverages are available at schools, and (2) establishing physical activity and education standards at schools. Below is an overview of current laws and recent state and territorial legislative activities to increase the availability of healthy foods and opportunities for physical activity in schools.

School Nutrition Legislation

Children and adolescents consume much of the food they need each day while at school. Children may receive meals from federal programs like the National School Lunch Program and the School Breakfast Program, or they may purchase competitive food and drinks (i.e., food that’s purchased from school-based vending machines, snack bars, or concessions outside of the school’s food service program). Many states have adopted policies to make competitive foods healthier, set limits on food for rewards, and impose restrictions on food and beverage marketing in schools.

A Colorado statute prohibits public schools from making available any food or beverage that contains any amount of industrially produced trans-fat on school grounds. In Kentucky, each school must limit access to retail fast foods in cafeterias to no more than one day each week. Laws in New Jersey prohibit the sale of foods of minimal nutritional value, all food and beverage items listing sugar as the first ingredient, and all forms of candy on school property during the school day.

In 2017, California’s governor approved a bill limiting the advertisement of food and beverages during the school day in schools, school districts, or charter schools participating in federal lunch and breakfast programs. California also prohibited participation in corporate incentive programs that reward children with food and beverages that do not comply with nutrition standards. New Hampshire proposed similar legislation prohibiting the advertisement of any food or beverage that does not meet the minimum nutrition standards as set forth by the school district, as well as participation in a corporate incentive program that rewards children with food and beverages.

Recognizing that many schools lack the necessary equipment to support the storage, preparation, and service of minimally processed and whole foods, the Washington State legislature introduced a bill that would establish a competitive equipment assistance grant program for public schools to improve the quality of food service meals that meet federal dietary guidelines and increase the consumption of whole foods. In 2017, Puerto Rico proposed a bill requiring that vending machines located in public schools only contain products of high nutritional value according to the standards imposed by the federal government.

Physical Activity Legislation

According to CDC, children and adolescents should have one hour or more of physical activity every day. State policymakers often target physical activity and education curriculums in K-12 schools to combat the childhood obesity epidemic. Promising trends include: improving physical education curricula, integrating physical activity into the school day and maximizing recess opportunities, as well as enhancing physical activity opportunities in school-based after-school programs.

Many states have statutes in place or have proposed legislation imposing physical activity and education requirements in schools. Iowa (K-5), Louisiana (K-8), North Carolina (K-8), and Texas (K-5) require 30 minutes of physical activity each school day. Arkansas requires 90 minutes of physical activity each week for grades K-6. South Carolina sets a minimum standard of 150 minutes per week for grades K-5. Colorado requires 600 minutes of physical activity each month for full-time elementary students. In 2017, Tennessee amended its statute to require a minimum of 130 minutes of physical activity per full school week for elementary school students and a minimum of 90 minutes for middle and high school students.

In 2017, Hawaii introduced legislation requesting the board of education to consider requiring students in grades 6-8 to take courses in physical education. In 2018, Maryland proposed a bill requiring that public elementary school students be provided a daily program of physical activity totaling 150 minutes each week. The Massachusetts legislature proposed legislation requiring elementary school students to participate in physical education for at least 150 minutes during each school week and requiring middle school and high school students to participate in 225 minutes of physical education per week.

By mandating or encouraging physical activity and the availability of nutritious food and beverages through legislation, policymakers can increase physical activity and healthy eating opportunities for students. State and territorial health agency leadership play an important role in advocating and supporting policies that encourage healthy students, adequate time and intensity of physical education and activity, access to healthy foods and beverages, and implementation of school wellness policies. ASTHO will continue to track state and territorial legislative activity in this area.

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