News: CJ Exclusives

Responding to Obesity Epidemic

North Carolina debates statewide, local fitness policy

RALEIGH — According to a recent assessment of American health and fitness by the U.S. government, “Fitness problems such as obesity and overweight have reached truly epidemic proportions in the United States.”

The report, which appears on the HealthierUS.gov website, says obesity rates among adults have increased by 60 percent in the last 20 years. Obesity among American youth is rising even more quickly. Type 2 diabetes makes up 50 percent of all diabetes diagnoses in young people today. Until 10 years ago, Type 2 diabetes was virtually unheard of in people under 40.

In response to these and other alarming health statistics, the North Carolina State Board of Education adopted a new physical activity policy at its meeting in Raleigh in January. The move incited controversy over who would have the authority to decide exactly how schools carry out the mandate. Schools want autonomy, but districts want oversight.

Schools take an active role

North Carolina schools are being enlisted to combat obesity. For now, they are encouraging more physical activity. By 2006-07, schools will require children to participate in physical activity in school. The new state plan calls for a minimum number of weekly minutes of physical exercise during school hours. The requirement is framed in minutes-per-week, and schools will have some discretion in how to accomplish that goal.
Schools have attempted to make children more active, encouraging sports instead of television, video games, and other passive recreational pursuits. But pressures on school time and other concerns have all but eliminated physical activity during school hours, especially in higher grades. As a result, the only children who spend significant time in physical activity are those who join sports teams on after-school or private clubs.

Dr. Onkar Sharma, of the Family Medical Center of Matoon, Illinois, said that preventing obesity and avoiding diabetes requires remaining active. It also means controlling common overindulgence in food, Sharma said. “Overindulgence in food has become America’s favorite pastime. Adolescents also spend so much time in front of the TV or video games that they hardly have any time for exercise,” he said.

The National Institute of Diabetes and Digestive and Kidney Diseases sponsored a study called the Diabetes Prevention Program. The study looked at 3,000 people to determine what the effect of dietary and activity changes might be. According to their results, “even moderate lifestyle changes — eating less fat, exercising at least two hours a week, and losing a modest amount of weight — cut the incidence of Type 2 diabetes by more than half among those who are most at risk.”
Schools in North Carolina are now charged with attempting to reverse the trend toward sedentary behavior by the very young. If they follow the guidelines set out by HealthierUS.gov, students will have some regular, moderate aerobic exercise each week.

Goals for 2006-07

The State Board agreed on a fitness goal for schools for the 2006-07 school year. The 2006-07 time horizon gives schools notice that they must work the new standards into their curriculum.

Since scheduling physical activity into the school day will require planning, schools are now on notice that they have to make exercise a priority.

The amount of exercise time officials are requiring for each school varies with age level. Elementary schoolers will have a minimum of 150 minutes of physical activity time each week. Middle-school students will have 225 minutes.

Middle schools must spread activity time across the week, with exercise scheduled at least every other day. Officials want to avoid having all of the exercise occur on a single day. That would mean two-and-a-half to four hours of activity crammed into one session.

Benefits

The Department of Public Instruction is not only looking for minutes spent in an “exercise period,” they are hoping to make some difference in the level of students’ physical fitness. Earlier attempts have failed mainly because they had no real effect on student’s health. A description of what has passed for physical education explains why: Few cardiovascular benefits accrue from manual dexterity activities such as ‘cup-stacking’ and ‘handkerchief juggling,’ which are actual physical-education activities used in some schools in Raleigh and Fayetteville.

According to a joint report of the Centers for Disease Control and Prevention, and the President’s Council on Physical Fitness and Sports, “schools are an efficient vehicle for providing physical activity and fitness instruction because they reach most children and adolescents.”

The report also says that “many children are less physically active than recommended, and physical activity declines during adolescence.” It would be particularly important, in that case, to reach the preteen and teen-age group with a plan for improved fitness.
A final issue that may affect the state’s new plan is the amount of physical-education class time actually spent on physical activity. If students must get at least two hours of cardiovascular conditioning weekly, schools will have to avoid wasted time. Typically, less than 50 percent of physical education class is used in activity, according to the same CDC and President’s Council report.

“Studies have shown that spending 50 percent of physical education class time on physical activity is an ambitious but feasible target. Being active for at least half of physical education class time on at least half of school days would provide a substantial portion of the physical activity time recommended for adolescents.”

Although the North Carolina plan does not include a high school plan, the President’s Council recommends both secondary and postsecondary exercise programs.
The cost of the new policy has not yet been totaled. Resources will be needed for instructors, coaches, and other personnel to run and supervise the program. The State Board has left resource allocation out of its specific plans. Funding questions may not be resolved until a decision about school control vs. district control is settled.

Priorities for schools and students

Can schools afford the time for more physical education? The State Board has decided that the benefits outweigh the costs. In fact, the board is so emphatic about the need for immediate action that it has prohibited schools from dropping activity time as a form of student punishment. They expect to be able to slow the trend toward student inactivity and obesity.

The new urgency surrounding student health also reflects a turnaround in attitude for school administrators. Physical education used to be an easy target in the search for more ‘academic’ time. Because ‘gym,’ or physical education class, had little academic content, schools viewed it as expendable. The lure of TV and other passive recreation has made exercise even less important to children.

As many out-of-shape Americans are aware, fitness requires an ongoing commitment. Most of us begin over and over again in the struggle to establish a healthy body weight and fitness level.

But exercise gurus agree that fitness for life means lifestyle changes. They recognize that breaking the sedentary habit is difficult. Developing good habits early works best.

Palasek is assistant editor at Carolina Journal. Intern Summer Hood contributed to this report.