A Survey of Kentucky Schools: Food and Nutrition Environment

Emma S. Walters, MS, RD, LD

Dietitian Consultant

Kentucky Department for Public Health

Objectives By the end of the session, program

participants will be able to: Describe the survey design and data

collection method used in this study. Discuss the current status of the food and

nutrition environment in Kentucky schools. Identify ways to use survey data to support

public health initiatives.

How did this even get started? In March 2001, Lt. Governor Stephen Henry

spoke at the Kentucky Public Health Association meeting.

A Kentucky Public Health dietitian from Lexington-Fayette County HD spoke with him of her concerns: Increase in obesity in children and adolescents in

KY Increase in Type 2 Diabetes in children and

adolescents in KY

Obesity in Kentucky Youth Data is limited for KY

Over the last 5 years, a 19% increase in obesity has been seen in children served in WIC.

KY 2001 indicates that 14.2% of the children on WIC are above the 95th percentile wt./ht. as compared to 13.1% nationwide.

KY 2001 indicates that 15.7% of children age 2 and older are at risk for overweight (85th to 95th percentile) as compared to 16.8% in the nation.

NHANES III indicates that 20% of children and adolescents are now overweight (BMI > 85th percentile.

Type 2 Diabetes Taskforce First meeting held June 19, 2001 Agenda topics

Nutrition and physical activity among youth National School Lunch Program in KY Physical fitness in KY schools Type 2 Diabetes in Youth

Taskforce Workgroups Nutrition Education/Media Legislative Concerns Physical Education

GOAL developed on July 26, 2001

Reduce the prevalence of Type 2 Diabetes

Nutrition Workgroup/Subcommittee First meetings focus:

Analysis of school meals/plate waste study Develop assessment tool

Total calories Fat grams Carbohydrates Protein

Sample schools across the state Develop pilot project on school nutrition and

physical activity

Plate waste study Scrapped

Cost Difficult to conduct with manpower available Timeframe – trying to develop legislation for

January 2002 Session Concern about information that would be

generated

New focus What can Nutrition Workgroup/Subcommittee

accomplish that can affect eating habits of KY children? Vending machines Ala carte items School rewards centered on foods

School Health Policies and Programs Study (SHPPS) - CDC National survey conducted to assess school

health policies and programs at following levels: State District School Classroom

SHPPS Areas Health education Physical education and activity Food service School policy and environment Faculty and staff health promotion Family and community involvement

Website http://www.cdc.gov/nccdphp/dash/shpps/

Sample Question - SHPPS Has your state adopted a policy stating

that schools will offer students a choice between the following items each day for lunch?1. 2 or more different entrees or main courses

2. 2 or more different vegetables

3. 2 or more different fruits or types of 100% fruit juice

Kentucky Survey Epidemiologist (KDPH) selected sample of

schools 200+ elementary schools 200+ middle and high schools

Total of 471 schools were selected for the sample.

Kentucky Survey Design Face-to-face interviews with school

principal Short as possible Sections:

Vending machines School Store, Canteen or Snack Bar Food Used As Rewards Classroom Parties/Celebrations

How surveys were conducted? Elementary schools

School sample divided by counties Sent supply of surveys to Public Health

Dietitian/Nutritionist, Nurse or WIC Coordinator with name and address of school, name of principal

Middle/High Schools School sample divided by counties Sent supply of surveys to Extension Agents with

name and address of school, name of principal

Packet included letter from Lt. Gov. and letter from Public Health or Extension

Results 471 schools selected for sample 343 returned the sample (73% return)

Vending machines 97% of high schools 88% of middle schools 44% of elementary schools

Vending Machines More than one vending machine existed in

many schools Range of machines in elementary schools

0 to 11 Range of machines in middle schools

0 to 16

Average number in high schools – 8 (with a maximum of 29)

Accessibility of Vending Machines Before school 11.7% Throughout the day 5.8% During lunch 5.6% After lunch 54.3% After school 59.2% Other 19.3%

Revenue from Vending Machines Ranged from $100.00 to $44,000.00

High schools highest $9,736.27 Middle schools next $5,933.13 Elementary schools $3,145.50

83% of schools that have vending machines have contracts with soft drink companies (56% - Pepsi; 47% - Coke); or 56% of the total schools have contracts with soft drink companies

Vending machines - Other beverage and snack items Few healthy snack items

Ratio of regular soft drinks to diet soft drinks was 6 to 1

Ratio of chips/fried snack items to granola bars and trail mix was 9 to 1

School stores/Canteens/Snack Bars 36% of the schools have store Accessibility

Before school 6.4% Throughout day 1.6% During lunch 33.6% After lunch 33.6% After school 13.6% Other 25.6%

Stocked Items Chips/fried snacks 68% Candy 61% Water 51% < 100% Juice 54% Cookies 53% 100% Juice 23% Yogurt 16%

Food Rewards/Class Parties 81% of all the schools use food as a reward

for behavior, attendance or academic achievement

Almost 90% of elementary and middle schools use food rewards; 57% high schools

89% of all schools use non-food rewards

Types of food rewards Candy 67% Soft drinks47% Pizza 83% Ice Cream 44% Fruit 12%

Celebrations 93% of schools have holiday or birthday

celebrations Only 15% of these have policies regarding

the types of food.

Pizza is the food of choice

Physical Activity 90% of elem. schools offer PE grades P– 4; data

for grades 5 – 12 could not be determined due to ineffective classification

Minutes spent per week in PE Elementary 67 minutes Middle 34 minutes 9th 36 minutes 10th 9 minutes 11th 4 minutes 12th 6 minutes

Average Recess Time Elementary 14 minutes Middle 2.5 minutes High 2 minutes

Where do we go from here? Data was used in position paper for

legislature Introduce legislation Community awareness Media/video Future taskforce(s) Site Based Decision Making Councils