Addressing childhood obesity outside of school

By Dennis Archambault

Last year, remote learning situations have upset not only educational achievement but fitness and nutrition. A  Harvard Medical School study published this month, along with other research, underscores the concern that extended disconnection between young people and schools has not been good for student wellness – physical or emotional.

As published in Obesity Medicine:

• Prior studies have already shown unhealthy weight gain in children occurs mainly during the summer months, when children are out of school (Rundle et al., 2020).
• At home, children tend to eat more unhealthily, which is exacerbated in food-insecure households that rely on school meals for healthier and often more expensive food choices (Rundle et al., 2020).
• They may also have fewer opportunities to engage in physical activity without school activities, particularly during periods of COVID-19 lockdown.
• The COVID-19 pandemic and the subsequent restrictions are expected to double out-of-school time for children in the US. (Rundle et al., 2020)
• All these factors likely contribute to increasing in weight gain during periods when students are out of school.

“Out of school” time – after school, before school, and summer programs – are one way of influencing childhood obesity. The CDC defines such programs as Out of School Time (OST) is a supervised program that young people regularly attend when school is not in session. This can include before- and after- school programs on a school campus or facilities such as academic programs (e.g., reading or math-focused programs), specialty programs (athletic teams, STEM (Science, Technology, Engineering, Mathematics), arts enrichment), and multipurpose programs that provide an array of activities (e.g., 21st Century Community Learning Centers, Boys & Girls Clubs, YMCAs).

About 7.7 million American children head to after-school programs when the school day ends. Young people who stay for after-school programming spend a large part of their waking hours on the school campus. OST programs provide youths with safety and supervision. Research shows that some OST programs can support student academic achievement and may play a role in reducing health disparities.   Additionally, programs that follow evidence-based practices aimed at improving the personal and social skills of youths are linked with positive social behaviors.

Recently, Authority Health recommended that the sponsors of Michigan House Bill 4848 require after school programs to adopt the recommendations of the

National Afterschool Association standards for healthy eating and physical activity. The standards address snack content and quality, staff training, curriculum, social support (including staff role modeling, parent engagement and children’s social development), program support, and environmental support. The standards include:

• Programs serve foods and beverages in amounts and types that promote lifelong health and help prevent chronic disease. These include minimally processed foods made with whole grains and heart-healthy fats or oils and without added sugar or trans fats; fruits and vegetables; and beverages made without added sugars.
• Staff regularly participate in learning about healthy eating grounded in effective training models using content that is evidence-based
• Programs that offer nutrition education classes will ensure that materials presented to children are evidence based, do not support a particular industry or food sector agenda, and delivered by quailed personnel.
• The program creates a social environment, including positive relationships, that encourages children to enjoy healthy foods. Research shows that children’s food choices are influenced not only by food appearance, taste, and familiarity, but also by social factors including peers, role models, group dynamics, and having healthy options.
• The infrastructure supports healthy eating through management and budgeting practices.
• The program’s physical environment supports healthy eating. Availability of vending machines, advertising, and availability of kitchen facilities can all influence food choices and food availability.
• The program’s physical activity offerings support the USDHHS 2008 guidelines recommending that all children and youth obtain at least 60 minutes of physical activity per day that includes a mixture of moderate and vigorous-intensity activity as well as bone and muscle-strengthening activities.
• The program creates a social environment, including positive relationships, that encourages children to enjoy and participate in physical activity. Research shows that children’s physical activity choices are influenced not only by preference and familiarity, but also by social factors including peers, role models, group dynamics, and having multiple options

Meanwhile, the New York Times published a report about a South American study which found that it’s actually what and how much children eat, more than how much exercise they get, that determines their risk for obesity.

But they do not burn more calories day-to-day, a surprising finding that implicates the urban children’s modernized diets in their weight gain. The findings also raise provocative questions about the interplay of physical activity and metabolism and why exercise helps so little with weight loss, not only in children but the rest of us, too.

Dennis Archambault is vice president of Public Affairs at Authority Health.