The strength of school wellness policies: one state's experience.

Children obtain about one third of their total daily energy requirements from school lunch and should expend about 50% of their daily energy expenditure while at school.1 The importance of establishing a comprehensive school environment that supports a good overall diet and adequate physical activity is recognized by several Healthy People 2010 objectives.2 However, school food and activity environments have transitioned from fairly simple to more complex, making achievement of these national goals difficult.3 Participation in the school lunch program has declined, while competing foods and beverages have emerged. In 2000, food and beverage items were sold to children from vending machines, school stores, and a la carte lines in 98% of high schools, 74% of middle schools, and 43% of elementary schools.4 Not surprising, the nutritional quality of these foods is poor—mostly high in fat and sugar. Current physical activity recommendations for children advocate a minimum of 60 minutes of moderate to vigorous physical activity each day.5 Since children spend most of their day in school, experts recommend that 30 minutes (half of the overall recommended amount) be accrued during the school day. However, only 8% of elementary schools and 6% of middle and senior high schools provide daily physical education. About one third of schools provide physical education 3 days a week with a steady decline after the elementary grades.6 These changes in the school environment coincide with a dramatic increase in childhood overweight and obesity. Among 6 to 11-year-olds, obesity has tripled during the past 20 years. Between 1963 and 2000, average weights increased 11 pounds among both 10-year-old girls (from 77 to 88 pounds) and boys (from 74 to 85 pounds) and increased 10 pounds among 15-year-old girls (from 124 to 134 pounds) and boys nearly 15 pounds (from 136 to 150 pounds).7 In response to the growing awareness of the school environment’s influence on nutritional intake and physical activity of the majority of the nation’s students, the Child Nutrition Reauthorization Act (CNRA) of 2004 included a school wellness component requiring school districts to develop a wellness policy by July 1, 2006. This federal law outlines 5 content areas to include in the wellness policy: (1) goals for nutrition education, physical activity, and other school wellness programs, (2) nutrition guidelines for foods provided at school, (3) assurance that guidelines for school meals meet United States Department of Agriculture (USDA) guidelines, (4) a plan for monitoring the policy, and (5) involvement of parents, students, representatives of the school food authority, the school board, school administrators, and the public in development of school wellness policy content.8 Several health organizations, such as the School Nutrition Association, Action for Healthy Kids, Alliance for a Healthier Generation, National Governor’s Association, and the National Alliance for Nutrition and Activity, have established and disseminated recommendations for wellness policy content under these broad categories.9–13 Recommendations typically include items that have been established in the literature or suggested by expert panels. Examples include nutritional guidelines for foods provided in vending machines, guidelines for the number of recesses provided each day in elementary school, statements outlining physical education frequency and content, and recommendations to prohibit rewarding students with food or punishing them by withholding recess. To date, there has not been a systematic evaluation of these wellness policies to see whether recommendations have been incorporated into procedural documents. This article will analyze policies written in response to the federal wellness policy requirement in Utah, including: (1) compliance with the 5 general federal requirements, (2) compliance with state recommendations developed by a community coalition, and (3) strength of the language used in writing the policies.