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School Nutrition. A Recipe for Success. Denyse Traeder, MPH Student Walden University PUBH-6165-5 Professor Patrick Tschida Summer, 2011. Agenda (the menu). The benefits of implementing a nutritional program/policy in Mineral County Elementary Schools
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School Nutrition A Recipe for Success Denyse Traeder, MPH Student Walden University PUBH-6165-5 Professor Patrick Tschida Summer, 2011
Agenda (the menu) • The benefits of implementing a nutritional program/policy in Mineral County Elementary Schools • Nutrition and brain development/function • Nutrition and behavior • The recipe for effective change • Evidence based policy and implementation • Conclusion and wrap-up
Learning Outcomes (the meat) • Believe that nutrition is important in education • Gain an overview of brain development and function in relation to food intake • Understand how healthy eating affects classroom and everyday behavior • Begin to think about internal changes to existing programs • Agree that evidence and policies exist that can be implemented in your school • Continue to research and implement changes to the nutrition program and nutrition policy in your school
Why nutrition? The Directions
Childhood Obesity (the table) Mineral County National Approximately 24% Of children and adolescents in Mineral County Schools are obese. *Sare, M. (2011). Mineral County Community Health Assessment. HB173; 3. Approximately 17% of children and adolescents aged 2—19 years are obese. *CDC. (2011). Obesity and Overweight Facts. Data from the National Health and Nutrition Examination Survey. Retrieved on July 25, 2011 from http://www.cdc.gov/obesity/childhood/data.html
Benefits of Healthy Food Programs • Food fuels the mind • Attention and focus are improved with healthy foods • Class room behavior is calmer and more easily adjusted with proper nutrition • Information retention capacity is heightened after consuming “brain” foods *Cormier,E., & Elder, J.H. (2007). Diet and Child Behavior Problems: Fact or Fiction? Pediatric Nursing, 33(2), 138-143. Retrieved on July 15, 2011.from http://ecs.ovec.org/documents/lowincidence/Autism/Resource%20Binder/4%20Dietary/Diet%20and%20Child%20Behavior%20Problems.pdf
A Difference You Can See *Brown, L.J., & Pollitt, E. (1996). Malnutrition, Poverty and Intellectual Development. Scientific American, February, 38-43. Retrieved on July 18, 2001 from http://www18.homepage.villanova.edu/diego.fernandezduque/Teaching/PhysiologicalPsychology/AllPhysio/Ll11b_Eating/a12_Malnutrition/Malnutrition.pdf
Brain Development/Function and Nutrition The Ingredients
Food for Thought • American children…are at risk for iron deficiency and mild to-moderate protein-energy malnutrition (PEM), which involves shortages of both protein and calories. • Iron-deficiency anemia afflicts about one quarter of low-income children in the US and is known to impair brain development when severe. *Farah, M.J., Noble, K.G., & Hurt, H. (2005). Poverty, Privilege, and Brain Development: Empirical Findings and Ethical Implications. Pediatric Research, University of Pennsylvania-Research Project, Submitted for Publication, 1-27. Retrieved on July 17, 2011 from http://intraspec.ca/nordic-walking-overview.php/farah_SES_05.pdf
Nutrition and Cognition Suboptimal nutrition in brain development has been shown to have permanent effects on cognitive function (Lucas, 1998). Undernutrition - the consumption of a diet that is not only inadequate in quantity, but of a quality insufficient to meet physiological and developmental needs. Inadequate dietary energy compromises a child's engagement with her social environment, thereby impeding cognitive and social development (Brown and Sherman, 1995). *Lucas, A. (1998). Programming by Early Nutrition: An Experimental Approach. The Journal of Nutrition, 128(2), 401s-406s. Retrieved on July 22, 2011 from http://jn.nutrition.org/content/128/2/401S.short . *Brown,L.J., & Sherman, L.P. (1995). The Relationship Between Undernutrition and Behavioral Development in Children: Policy Implications of New Scientific Knowledge. The Journal of Nutrition, 125(2), 2281s-2284s. Retrieved on July 17, 2011 from http://jn.nutrition.org/content/125/8_Suppl/2281.full.pdf.
Behavior and Nutrition The Fuel
Sustained Fuel for All Students • “Good nutrition contributes to the development of complex mental abilities and is associated with better developmental outcomes. For this reason it is very important to ensure adequate dietary intake even when there is less ability to improve other social and environmental conditions of children” (Brown and Sherman, 1995). • A United States study of 328 families showed that hungry children had higher scores than at-risk and not-hungry children for school problems and attention problems…(Taras, 2005). *Brown,L.J., & Sherman, L.P. (1995). The Relationship Between Undernutrition and Behavioral Development in Children: Policy Implications of New Scientific Knowledge. The Journal of Nutrition, 125(2), 2281s-2284s. Retrieved on July 17, 2011 from http://jn.nutrition.org/content/125/8_Suppl/2281.full.pdf. *Taras, H. (2005). Nutrition and Student Performance at School. Journal of School Health, 75(6); 199-213. Retrieved on July 17, 2011 from http://www.hawthorne.k12.ca.us/ourpages/auto/2009/1/30/51331740/Nutrition%20and%20Student%20Performance%20JSH%208-05.pdf .
Brain and Body Behavior • The brain is fueled by the food we eat, far more than most organs in the body. Metabolism is central to brain function, particularly in growing children. • “Children’s brains are hungrier, more metabolically active, and proportionally larger than adult’s brains. Per pound of body weight, children eat more food, drink more fluids, and breathe more air than adults,…children are more likely than adults to have acute brain and behavioral dysfunctions related to toxins, allergens, and metabolic byproducts”.*Bruno, J. (2004). The Diet-Behavior Connection. Peninsula Child and Youth Assessment Clinics, Child Wisdom. Retrieved on July 17, 2011 from http://www.childwisdom.org/dietbehavior/ .
ADHD and Nutrition ARE Linked A “western” or American diet may be associated with ADHD diagnosis and symptomatic behavior. “ADHD diagnosis was not associated with the “Healthy” dietary pattern” (Howard, et al, 2010). *Howard,A.L., Robinson, M., Smith, G.J., Ambrosini, G.L., Piek, J.P., and Oddy,W.H. (2011). ADHD Is Associated With a “Western” Dietary Pattern in Adolescents. Journal of Attention Disorders, 15(5); 403-411. Retrieved on July 21, 2011 from http://jad.sagepub.com/content/15/5/403.short
Effective Change Mixing it all together
Breakfast is Important • Children who eat a healthy breakfast with the proper nutrients are less likely to be tardy and/or absent. Evaluation of existing menus, current staff beliefs and student conditions need to be assessed and evaluated.
Lunch Gets Students Through the Day • Protein, iron rich and omega rich foods help concentration and memory. Evaluation of current menus, portion size, availability, staff attitude towards food and student behavior must be assessed and evaluated.
Pinch Time Snacks and Beverages • To ensure prolonged, sustained and proper energy and concentration, youth need fuel. Adequate, healthy and desirable snacks and beverages are key. Communication with vendors to promote and make available healthy choices such as juice, water and milk must be addressed. Snacks should provide natural sugars, whole grains, vitamins, and complex carbohydrates.
Effective Policy Cooking it and Serving it
Desired Outcomes Craft a policy based on scientific evidence that will work for your culture, community and school. Identify the intended outcomes and design policies geared toward those ends • Is obesity an issue at your school? • Are there high rated of ADHD or similar behaviors? • Are you experiencing high rates of tardiness and absences? • Are there a high number of ill students?
Implementation • Involve all stake holders in the process • Set a realistic timeline • Hire-recruit a guide that will help the policy change process go smoothly • Be sure to address concerns before they become problems • Make it fun and realistic • Shoe evidence for the policy • Evaluate, assess and change process as needed
Next Steps The Dessert
Recap of Outcomes (reheat) • Believe that nutrition is important in education • Gain an overview of brain development and function in relation to food intake • Understand how healthy eating affects classroom and everyday behavior • Begin to think about internal changes to existing programs • Agree that evidence and policies exist that can be implemented in your school • Continue to research and implement changes to the nutrition program and nutrition policy in your school
References (the original cooks) *Brown,L.J., & Sherman, L.P. (1995). The Relationship Between Undernutrition and Behavioral Development in Children: Policy Implications of New Scientific Knowledge. The Journal of Nutrition, 125(2), 2281s-2284s. Retrieved on July 17, 2011 from http://jn.nutrition.org/content/125/8_Suppl/2281.full.pdf *Brown, L.J., & Pollitt, E. (1996). Malnutrition, Poverty and Intellectual Development. Scientific American, February, 38-43. Retrieved on July 18, 2001 from http://www18.homepage.villanova.edu/diego.fernandezduque/Teaching/PhysiologicalPsychology/AllPhysio/Ll11b_Eating/a12_Malnutrition/Malnutrition.pdf *Bruno, J. (2004). The Diet-Behavior Connection. Peninsula Child and Youth Assessment Clinics, Child Wisdom. Retrieved on July 17, 2011 from http://www.childwisdom.org/dietbehavior/ *CDC. (2011). Obesity and Overweight Facts. Data from the National Health and Nutrition Examination Survey. Retrieved on July 25, 2011 from http://www.cdc.gov/obesity/childhood/data.html *Cormier,E., & Elder, J.H. (2007). Diet and Child Behavior Problems: Fact or Fiction? Pediatric Nursing, 33(2), 138-143. Retrieved on July 15, 2011.from http://ecs.ovec.org/documents/lowincidence/Autism/Resource%20Binder/4%20Dietary/Diet%20and%20Child%20Behavior%20Problems.pdf *Farah, M.J., Noble, K.G., & Hurt, H. (2005). Poverty, Privilege, and Brain Development: Empirical Findings and Ethical Implications. Pediatric Research, University of Pennsylvania-Research Project, Submitted for Publication, 1-27. Retrieved on July 17, 2011 at http://intraspec.ca/nordic-walking-overview.php/farah_SES_05.pdf *Lucas, A. (1998). Programming by Early Nutrition: An Experimental Approach. The Journal of Nutrition, 128(2), 401s-406s. Retrieved on July 22, 2011 from http://jn.nutrition.org/content/128/2/401S.short *Howard,A.L., Robinson, M., Smith, G.J., Ambrosini, G.L., Piek, J.P., and Oddy,W.H. (2011). ADHD Is Associated With a “Western” Dietary Pattern in Adolescents. Journal of Attention Disorders, 15(5); 403-411. Retrieved on July 21, 2011 from http://jad.sagepub.com/content/15/5/403.short *Sare, M. (2011). Mineral County Community Health Assessment. HB173; 3. *Taras, H. (2005). Nutrition and Student Performance at School. Journal of School Health, 75(6); 199-213. Retrieved on July 17, 2011 from http://www.hawthorne.k12.ca.us/ourpages/auto/2009/1/30/51331740/Nutrition%20and%20Student%20Performance%20JSH%208-05.pdf
Sources for More Information (tweaking the recipe) • Academy for Educational Development (1996) Final Report: Nutrition Communication Project. Washington, DC: AED. • Davis EP. Bruce J. Gunnar MR. (2002). The anterior attention network: associations with temperament and neuroendocrine activity in 6-year-old children. Developmental Psychobiology. 40, 43-56. • Galler, J. R., Ramsey, F. & Forde, V. (1986) A follow-up study of the influence of early malnutrition on subsequent development. 4. Intellectual performance during adolescence. Nutrition and Behavior, 3:211-222. • Janssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics 2004; 113: 1187–1194. • Ruel MT, Levin C, Armar-Klemesu M, Maxwell D & Morris SS. (1999) Good Care Practices can Mitigate the Negative Effects of Poverty and Low Maternal Schooling on Children’s Nutritional Status: Evidence from Accra. International Food Policy Research Institute Discussion Paper no. 62. Washington, DC: IFPRI. • Schnoll, R. Burshteyn, D., & Cea-Aravena, J. (2003). Nutrition in the treatment of attention-deficit hyperactivity disorder: A neglected but important aspect. Applied Psychobiology and Biofeedback, 28(1), 63-72. • Schnoll, R. Burshteyn, D., & Cea-Aravena, J. (2003). Nutrition in the treatment of attention-deficit hyperactivity disorder: A neglected but important aspect. Applied Psychobiology and Biofeedback, 28(1), 63-72. • Zeitlin M. Nutritional resilience in a hostile environment: positive deviance in child nutrition. Nutrition, 1991;49(9):259–68. • Wolraich, M L., Stumbo, P., Milich, R., Chenard, C., & Shultz, F. (1986). Dietary characteristics of hyperactive and control boys. Journal of the American Dietetic Association , 86, 500-504.
Denyse Traeder, Assistant DirectorMineral County Health Department Phone: (406)822-3564 Email: dtraeder@co.mineral.mt.us