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When Appleton Central Alternative High School opened in 1996, the menu left a sour impression. Its vendor supplied a standard lunch of sandwiches, chips, and milk that was laden with nitrates, fat, sodium, and other ingredients lacking nutrition.
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Then a teacher stumbled upon a bread wrapper touting a sweet deal. Soon, Natural Ovens Bakery in nearby Manitowoc, Wis., began providing whole-grain bagels (free of additives, dyes, artificial preservatives, and saturated fats) and energy drink mixes (made fresh daily with a variety of fruits and flax-based energy powder) to test if power breakfasts could boost academic performance. Sure enough, they did. And wholesome lunches followed.
The students continued to progress both academically and socially. However, the overall objective of providing healthy meals is more than performance-based, says Greg Bretthauer, dean of students at the Wisconsin school for troubled youth. It's important for the students to understand the impact a healthy diet and exercise have on their overall health, and combating obesity is naturally a big part of that, he says.
Interventions like these are taking small bites out of staggering obesity statistics. From yanking soda and snack vending machines to cultivating organic gardens, public schools are learning that healthy bodies fuel strong minds. Meanwhile, some experts say examples such as Appleton Central Alternative High School are too few and far between.
GROWING PROBLEM
A sweeping report from the National Academy of Medicine last fall urged parents, schools, food companies, and lawmakers to launch an unprecedented campaign against childhood obesity.1 Criticism also has been leveled at schools eliminating recess and physical education to spend more time preparing kids for college and raising test scores.
Eliminating such programs does a major disservice to children, says Terri McFadden, MD, assistant professor of pediatrics at the Emory University School of Medicine in Atlanta. "Studies clearly show that children who have a chance to go outside and take a break from the rigors of the school setting actually perform better."
A growing trend blends fitness with academics. Take the Medical College of Georgia FitKid Project, for example. Funded by a $3.3 million National Institutes of Health grant, it will help assess whether after-school hours filled with physical activity, healthy snacks, and academic enrichment can turn the tide of obesity.
In 2003, the college began the 3-year study involving 500 to 600 third-graders in 18 Augusta-Richmond County schools. The control group receives free blood pressure and cholesterol screenings along with aerobic capacity and body-fat tests. Five times a week, the other group also gets primed with nutritious munchies. Then it's time for 40 minutes of homework, followed by 20 minutes of sports instruction and 40 minutes of vigorous play.
Students who have come to the after-school program at least twice a week have experienced a 0.7% decrease in their percentage of body fat. Those who come four or more times per week have so far seen a 1.1% drop. Among children at schools without the intervention, there has been a 0.1% increase in body fat.
COMMUNITIES CAN HELP
Other initiatives that don't detract from classroom time include Safe Routes to School programs, which promote walking and bicycling to and from home. The national coalition—coordinated by the Pedestrian and Bicycle Information Center at the University of North Carolina—involves parents, educators, traffic engineers, city planners, law enforcement officers, and community leaders. They advocate for measures such as building crosswalks and adding crossing guards.
Crime, dangerous roads, and lack of safe storage for bikes at school pose problems, says Howard Taras, MD, member of the American Academy of Pediatrics Task Force on Obesity and professor at the University of California at San Diego School of Medicine. But "together a lot of communities have found ways to overcome them."
Last spring, the California Department of Education convened the first Superintendent's Task Force on Childhood Obesity, Type 2 Diabetes, and Cardiovascular Disease. According to the department's physical fitness tests required by state law, three of four California students are unfit and more than a quarter are overweight.
School districts responded by revamping physical education to emphasize lifelong fitness instead of traditional competitive sports. Many overhauled their approach to nutrition, replacing soda machines and junk food with healthier alternatives—and without losing money as they had feared.
SODA MACHINES
Chicago Public Schools Chief Executive Officer Arne Duncan says he doesn't expect the district to lose money under a new beverage vending contract. The old agreement with Coca-Cola, which expired in November, raked in revenues of about $4 million a year. The new contract with American Bottling Company allows only water, fruit juices, and noncarbonated sports drinks. Only 100% juices are permitted in elementary schools, and the ones sold in high schools must contain at least 50% fruit juice.
The policy also prohibits sales from snack vending machines in lunch-rooms during the school day. Snacks may derive a maximum of 30% of calories from fat and contain no more than 40% sugar by weight. Candy and chewing gum are off-limits.
On a statewide level, a bill banning junk food and sodas from public schools failed to pass last year. "The schools get a lot of revenue from their contracts with vending machine companies," says Allison Jack, senior policy development advisor for education to Illinois Gov. Rod Blagojevich, who proposed the legislation. "That money is totally at their discretion."
Arkansas' share of the national tobacco settlement covers most anti-obesity initiatives in schools. In 2003, the state approved a multi-pronged approach that eliminated vending machines in elementary schools and required measuring and reporting the body mass index (BMI) of each child to parents or guardians annually. Such confidential health reports are recommended by the American Academy of Pediatrics.
"We anticipated that [data would show that] the nation, not just Arkansas, has become increasingly overweight," says Joy Rockenbach, program director of the BMI Initiative at the Arkansas Center for Health Improvement in Little Rock. "In some ways, we were surprised the numbers were as high as they were."
WEIGHTY ISSUES
Word of Arkansas' testing spread when Charles Womack, MD, a urologist and mayor of Cookeville, Tenn., heard about it on the radio. Last fall, Putnam County Public Schools modeled screenings after Arkansas, while adding a blood pressure component. Cookeville Regional Medical Center, Rotary Club, rural clinics, and private donations helped pay for the project conducted by volunteers.
"Hypertension is one of the things we need to watch for with obesity," says Nancy Judd, MSN, RN, the hospital's education director. "I was most surprised by the elevated blood pressures that we found in the elementary schools." The children's pediatricians confirmed the findings and decided to monitor them.
Meanwhile, districts with long-standing initiatives are expanding them. After a successful 9-year experiment in "The Edible School-yard" at Martin Luther King Jr. Middle School, the Berkeley Unified School District plans to implement system-wide food service innovations. This California project will create and nurture organic gardens, cooking classes, and a lunch program integrated into core coursework.
Edible Schoolyard founder and restaurateur Alice Waters said, "We
need a similar curriculum in every school district in the country—not
just serving school lunch, but teaching [healthy eating habits] as an academic
subject." 
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