stakeholders—teachers, students, principals, health educators, dietitians, after-school personnel, food service providers, industry representatives, state government and community leaders, and researchers—and learn about innovative interventions, challenges in implementing and evaluating school-based and after-school programs, and opportunities for evaluating policies and initiatives. In addition to the symposium, the committee draws from reports, scientific literature, and the media to provide examples of obesity prevention activities in schools for this chapter.

The obesity prevention effort in schools is an active area for change, and the committee recognizes that it can capture only a small proportion of the obesity prevention-, physical activity-, and nutrition-related policies and programs being implemented. This chapter focuses on assessing progress and ensuring that evaluations are conducted so that the most promising approaches can be identified and disseminated. As noted in the Health in the Balance report (IOM, 2005), there is a relative paucity of scientific data on obesity prevention efforts in schools. Teachers, schools, school districts, states, and the nation are in the midst of many exploratory efforts and new interventions, which provide opportunities to build the evidence base in order for promising efforts to be replicated and scaled up. Additionally, it is important that efforts found to be ineffective are either revised or discontinued, so they do not use resources that can be more effectively used for other efforts.

The multitude of actions revolving around nutrition and physical education in schools is a positive step forward. However, as detailed in a recent report examining state and regional obesity prevention-related policies, much remains to be done to provide a consistent healthy school environment that promotes energy balance for children and youth (TFAH, 2005). Although many states are addressing nutrition-related issues, these efforts are not being implemented in all states, and limited attention is focused on concurrently increasing physical activity levels and reducing sedentary behaviors.

Highlights from the 2005 Trust for America’s Health (TFAH) report indicate that, as of the time of publication of the report:

  • Six states (Arkansas, Kentucky, South Carolina, South Dakota, Tennessee, and Texas) have mandated nutritional standards for school meals and snacks that are stricter than current USDA requirements.

  • Eleven states (Arizona, California, Hawaii, Kentucky, Maryland, New Mexico, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia) have established nutritional standards for competitive foods sold in schools. Many of these changes had occurred recently with six states setting requirements for competitive foods since 2004.

  • All states except South Dakota have physical education require-



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