School-Based Intervention Trials for Childhood Obesity Prevention

Introduction and Research Background

In recent years, the number of children who are overweight or obese has climbed rapidly. The purpose of this paper is to examine the problems that overweight and obese children face—both physically and emotionally—and to explore how schools can intervene to lessen the prevalence of obesity in the United States.

One of the chief concerns regarding childhood obesity and weight gain is the amount of fast food that children consume (Gillman, et al, 2001). Over the last 20 years, fast food purchases in the United States have increased until they comprise 40% of the money spent on food in the average household (Gillman, et al, 2001).

Additional concerns have been raised about soda consumption and television viewing time among children. In 1972, children drank an average of 27 gallons of soda per child annually. By 1992, that number had risen to 44 gallons per child (Gillman, et al, 2001). Portion sizes are also increasing, and collectively these factors work against children's efforts to maintain a healthy weight (Gillman, et al, 2001). The prevalence of bicycle riding among children in the United States is decreasing. In contrast, other countries continue to use bicycles as a popular means of transportation. The Netherlands has 30% of trips made by bicycle, but the United States has only 1% (Gillman, et al, 2001).

There does not appear to be an easy solution to childhood obesity (Epstein et al., 1995). Many parents are too busy to monitor exactly what their children eat, and family mealtimes are nonexistent in many households (Epstein, et al, 1995). More children now eat in front of the television or snack on high-calorie foods and fast food rather than home-cooked, nutritious meals (Epstein, et al, 1995).

Although some fast food businesses offer healthier options, most children prefer less healthy choices (Epstein, et al, 1995). Without parental supervision to ensure proper nutrition and exercise, many children spend their free time watching television with high-calorie snacks and soda (Epstein, et al, 1995).

Genetics plays a role in weight gain and obesity, but it is not impossible for individuals from obese families to remain thin (Epstein, et al, 1995). Obesity concerns extend beyond physical consequences. Neurological effects and other complications emerge in obese and overweight children (Epstein, et al, 1995). Many of these children experience clinical depression and often eat when feeling sad, which contributes to obesity and prevents healthy weight loss (Epstein, et al, 1995). Teaching children appropriate weight management strategies is essential for them to develop healthier bodies and improved self-image (Epstein, et al, 1995).

When children lose weight, their resolve strengthens and interest in other activities often increases as they feel less restricted by their bodies (Mokdad et al., 1999). However, not all children successfully lose weight regardless of intervention methods, and these children may become overweight adults.

Many such individuals continue to feel poorly about themselves and may raise overweight children as well (Mokdad, et al, 1999). While some genetic component may exist—as obesity often runs in families—not everyone from obese families becomes obese themselves (Mokdad, et al, 1999). However, children with obese or overweight parents face greater struggle, as they lack the genetic predisposition to thinness and experience constant modeling of overeating (Mokdad, et al, 1999). They learn to perceive large portions and heavy eating as normal, failing to develop adequate nutrition knowledge (Mokdad, et al, 1999).

If these children were raised in families where healthy eating and maintenance of normal weight were standard, genetic factors might exert less influence and environmental factors would play a greater role in obesity outcomes (Mokdad, et al, 1999).

Despite disagreement about obesity's exact causes, there is widespread agreement that it is a serious problem that continues to worsen (Mokdad, et al, 1999). While genetics may play a role, this explanation seems unlikely given current evidence (Mokdad, et al, 1999). The rapid growth in overweight individuals over the past decade suggests environmental causes rather than genetic changes (Mokdad, et al, 1999). This is not to say genetics plays no role, but many overweight children lack genetic predisposition and are victims of sedentary lifestyles and overeating (Mokdad, et al, 1999).

Fast food, soda, and sedentary living are largely to blame (Mokdad, et al, 1999). Urban sprawl makes walking or biking to work infeasible in many areas, requiring people to drive several miles daily (Mokdad, et al, 1999). Children who previously walked to school often live too far away to do so. Even those living close to schools often do not walk because parents fear unsafe conditions (Mokdad, et al, 1999).

Many parents work long hours, creating latchkey children who lack close parental supervision (Mokdad, et al, 1999). Children who once played outdoors now remain inside watching television or playing video games while snacking (Mokdad, et al, 1999). While healthy household food makes this less problematic, many homes stock potato chips, candy, soda, and other foods unsuitable for daily childhood diets (Mokdad, et al, 1999).

Contributing Factors to Childhood Obesity

Based on the information presented, four specific research questions guide this study:

Chapter One presents basic information including the problem statement and rationale. Chapter Two reviews relevant literature on childhood obesity and associated theories. Chapter Three details the methodology, ensuring clarity of analysis, limitations, and validity considerations. Chapter Four presents data analysis and results to test hypotheses. Chapter Five summarizes findings, presents conclusions, and recommends future research directions, addressing study limitations and possibilities for subsequent investigations.

There is a clear need for physical education and health education classes in schools. This paper discusses the importance of physical education in lowering childhood obesity rates.

A growing obesity trend is affecting the nation, with schools partly blamed due to the elimination of mandatory physical education classes, particularly in higher grades. This trend now affects children, causing diseases such as type II diabetes, formerly seen only in adults (Langford & Carter, 2003).

The medical community is alarmed by adult diseases appearing in children and by obesity prevalence. What one generation practices, it passes to the next. Over 60 percent of Americans are now overweight, a trend that did not occur overnight but clearly requires reversal.

One strategy to reverse this trend is beginning with children. When children learn healthy habits, they teach these to their own children, gradually diminishing obesity trends. However, the challenge is not only generating interest in physical activity but maintaining it long enough to develop lasting adult habits.

This problem affects parents and teachers, but primarily harms students, many unaware of consequences. Childhood habits often carry into adulthood; sedentary habits lead to obesity and related health problems (Burgeson et al., 2001; Pennington & Krouscas, 1999; Chung & Phillips, 2002).

Whether the school system bears responsibility for obesity is debatable. However, physical education in schools has declined in recent years, while overweight and obese children have risen. Though a direct correlation cannot be proven due to other contributing factors, one out of every three school children between ages 6 and 11 has a weight problem, and childhood overweight rates have doubled over 30 years (Burgeson, et al, 2001).

School-Based Physical Education and Fitness Curricula

Parents and teachers share concern, though schools are not entirely responsible. Beyond lacking physical education, other factors contribute to childhood obesity. This paper focuses on physical fitness and competitive sports teaching to students of all ages, helping them learn health, fitness, and sportsmanship.

Physical education is a complex topic because different age groups require different teaching methods, and not all children enjoy it. High school students are more vocal about physical education preferences than younger children, though some express preferences at all levels. Students have great potential to help create fitness programs they and peers can enjoy while meeting school curriculum guidelines (Kinchin & O'Sullivan, 1999).

Many people, including children, view physical education as a necessary evil (Ryan, Fleming & Maina, 2003). Various reasons prevent exercise participation: time constraints, dislike, or other excuses to avoid needed activity. School-based physical education classes are often mandatory, while sports and enjoyable activities are not (Ryan, et al, 2003).

School physical education classes typically emphasize cardiovascular activities and running, teaching important health and fitness concepts. However, these classes often lack sports that children could enjoy lifelong. Additionally, classes teaching some sports typically cover only basics without sufficient depth for students to determine genuine interest or potential long-term participation (Martin, 2002).

Teachers face difficulty determining whether sports or general physical fitness approaches should dominate. While these areas can overlap, many fitness activities involve no sports, and some sports are not physically demanding (Langford & Carter, 2003).

Bowling, for example, requires minimal physical fitness but teaches sportsmanship, friendship, mathematics (scoring), and other important lessons. However, bowling does not promote weight loss or physical conditioning. Many schools teaching such sports help students learn important lessons but do not adequately address obesity (Langford & Carter, 2003).

Given this difficulty and growing school-age obesity, studies must investigate creating fitness curricula that benefit children now and in the future. This research will help teachers provide health and fitness information that younger children retain and use throughout life. Retention is critically important.

If students do not apply health and fitness learning to daily life, they gain only credit for completing a required class. Some schools employ a service-learning approach to physical education, allowing students to see how learning applies to daily life (Cutforth, 2000). This demonstrates that fitness can be enjoyable and vital not only for children but increasingly as they age.

This educational challenge has far-reaching effects, affecting current and future school populations. It impacts broader society as overweight and obese individuals face employment difficulties, discrimination, and health problems limiting work capacity, especially with age (Pennington & Krouscas, 1999).

Physical fitness classes occupy a unique position to combat obesity. However, disagreement about physical fitness teaching methods undermines student benefits, and many teachers do not fully recognize obesity significance and physical education's lasting effects (Buell & Whittaker, 2001).

This confusion harms students, so physical education curricula should be adjusted for enjoyment while maintaining essential educational content. Sports are undeniably important, teaching competition, sportsmanship, and manners. However, actual fitness should also be taught, and these sometimes conflict. When sports and fitness do not align, teachers face difficult choices about emphasis.

Because both areas matter and students often miss one when gaining the other, finding balance becomes increasingly challenging. Without achieving balance in teacher discussions about curriculum, school boards must decide which emphasis benefits students most. This determination is difficult but necessary for physical education to continue effectively and beneficially (Humphries, Lovdahl, & Ashy, 2002).

Whether or not the school system bears primary responsibility for obesity is currently a matter of opinion. The purpose of this paper is to discuss issues relating to teaching physical fitness and competitive sports to students of all ages throughout the school system. In this way, they learn health, good sportsmanship, and other essential skills.