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Recipe for Reducing Kids’ Excess Weight

In's interview with nutritionist Marion Nestle, the author of What to Eat and other books declared, "You've got to get rid of the vending machines in the schools. They shouldn't be there in the first place." A recent study conducted in Philadelphia public schools, while not going to the lengths recommended by Nestle, suggests that a multi-pronged approach —incorporating healthier food choices; nutrition education for teachers, students, and parents; and encouragement of physical activity — can have a substantial impact on the incidence of overweight (a body mass index for their age in the 85th to 94th percentile) among children.

The research, led by Gary D. Foster of Temple University's Center for Obesity Research and Education and just published in the journal Pediatrics, was conducted over two years and followed more than 1,300 fourth- to sixth-graders. Because children from low-income families suffer from disproportionately high rates of obesity, the study was conducted in schools where more than half the students were eligible for free or reduced-price meals. The nutrition program itself was designed and administered by the Food Trust, a community-based organization that promotes broad access to affordable, healthy food.

At schools where the intervention was conducted, all sodas and sugary drinks were banished from vending machines, as were snacks that did not meet nutritional guidelines for saturated fat, sodium, and sugar. As positive reinforcement, students earned raffle tickets for prizes like bicycles and jump ropes for making healthy food choices, and they were encouraged to limit time spent in front of the TV or video game console and to increase their physical activity.

The initiative did not target students exclusively, however. Teachers curtailed the use of food as a reward, and parents scaled back the sale of unhealthy food for fundraising. Parents and teachers also received nutrition education as part of the effort.

At the end of the two-year study period, twice as many students at the control-group schools — where no intervention had occurred — had become overweight, compared to the schools where the healthier policies had been implemented (15 percent versus 7.5 percent). The difference in the overall percentage of overweight children was even more pronounced: intervention schools experienced a decrease of 10 percent, while control-group schools saw a 26 percent jump. The program seemed to have especially beneficial results for African-American children, who were 41 percent less likely than their counterparts at control-group schools to be overweight at the conclusion of the study.

Unfortunately, the results were not as promising for obese students (those whose body mass index for their age fell into the 95th percentile or higher) — the same percentage reached that plateau in both groups. This lead the researchers to suggest that reducing obesity even in this young population "may be more likely to result from ... clinic-based programs."