To assist school interventions nationwide, the CDC (National Centers for Disease Control, Atlanta) defined “Coordinated School Health Programs” with eight components:

	Health education
	Physical education
	Nutrition services
	Family/community involvement
	Health services
	Counseling, psychological and social services
	Healthy school environments
	Health promotion for staff

Texas schools face a September 2007 deadline to have coordinated health programs in place. The first four components of the CDC definition were chosen as initial program goals. In May 2003, two programs had been approved: CATCH (see below) and Great Body Shop.

	Large numbers of school kids in four states are testing the CATCH program, which found positive changes in diet/physical activity lasted three years. -Archives of Pediatric and Adolescent Medicine, 1999

(Note: 96 elementary schools in California, Louisiana,

Minnesota and Texas were CATCH participants.)

CATCH: Child and Adolescent Trial for Cardiovascular Health

CATCH is an elementary school-based, NIH-funded program that combines educational, behavioral, and school environment components. It’s one of the most extensively implemented and evaluated efforts of its kind. And it’s now widely available.

Goals were met by:

	Improving the school cafeteria (food service modifications, food service personnel training to improve nutrition)
	Physical education programs (PE interventions, teacher training to deliver more fun, moderate-to-vigorous physical activity)
	Health curricula (on eating habits, physical activity and tobacco)
	Establishing a non-smoking school district environment

A parent component is included, and parents have been kept updated on their children's risk factor profile for cardiovascular disease in grades 3, 5 and 8.

In CATCH cafeterias:

	Chicken nuggets are baked, not fried
	Dessert is fruit, not a high-cal, high-fat treat
	For youngest diners, the Go Slow and Whoa system: Each food on the serving line has a colored dot beside it. Green means “go” (have as much as you want of these).  Yellow means “slow” (foods to eat in moderation). And red means “whoa” (foods to be eaten only once in awhile).

After the program, students consumed less total and saturated fat, and participated in more physical activity.  These behavioral effects were still found three years after the program's completion, though the impact on physical activity had declined for the oldest group of participants.

Since results have been published by the Journal of the American Medical Association, Preventive Medicine, and Journal of School Health, CATCH is available to interested schools and districts nationwide.

For more information, contact the CDC in Atlanta.

CATCH IN TEXAS

Bryan, Texas ISD is one of 800 Texas schools to adopt CATCH.

TACOS: Trying Alternative Cafeteria Options in Schools

	Assessed nutrition environment
	Increased availability of lower-fat items in schools’ á la carte areas, and
	Used peer programs to promote the availability of the low-fat items.

(Source: American Journal of Public Health, 2002)

The goal of the TACOS study was to boost availability and sales of lower-fat, healthful foods in á la carte lines and vending machines, in 20 Minneapolis-St. Paul-area secondary schools over a two-year period.

Results of the TACOS pilot study:

	Low-fat products in the á la carte line rose from 32% to 42% (of 142 total items).
	School-wide participation in a low-fat food promotional coupon return was 39%.
	46% of students reported that they would buy more low-fat foods if there were a larger selection available in the school cafeteria.
	While schools showed only a slightly higher percentage sales of lower-fat foods in year one (27.5% vs. 19.6%, p = .10), they saw a significantly higher percentage of lower-fat item sales in year two (33.6% vs. 22.1%, p = .04).
	Student surveys found that taste (93%), price (71%) and fat content (37%) were important factors in student food choices in the cafeteria.
	41% reported difficulty knowing which foods were lower in fat.

The study was led by Simone French, Ph.D., University of Minnesota and funded by the National Heart, Lung, and Blood Institute, Centers for Disease Control.

Conclusion

Greater availability and promotion of lower-fat foods can lead adolescents to purchase of more of them.

USDA TEAM NUTRITION

The American Academy of Pediatricians and the USDA (U.S. Department of Agriculture) collaborated with other leading medical associations to offer schools, communities and parents educational materials and resources.

The Team Nutrition website at http://www.fns.usd.gov/tn/ provides a wide range of resources on nutrition and healthy eating.

	Training Grants
	Healthy School Nutrition Environments
	HealthierUS Initiative
	School Meals Initiative (SMI) Training

You can review the available resources at http://www.fns/tn/Resources/resourceguide.html. Materials are available in English and Spanish.