Training 3

Eat Well &

Keep Moving
By Dr. Lilian W.Y. Cheung, Hank Dart, Sari Kalin,
Brett Otis, and Dr. Steve Gortmaker

From L.W.Y Cheung, H. Dart, S. Kalin, B. Otis, and S.L. Gortmaker, 2016, Eat Well & Keep Moving, 3rd ed. (Champaign, IL: Human Kinetics).
Eat Well & Keep Moving Introductory
Workshop Agenda Topics
I. Introductions

II. What Is Eat Well & Keep Moving? (Presentation)

III. Are You Concerned About Your Students’ Nutrition and Physical Activity
Habits? (Discussion)

IV. The Health of Young People: Alarming Trends in Nutrition, Physical Activity,
and Inactivity (Presentation)

V. Turning the Tables: Why Schools Need to Be Part of the Solution

(Presentation)

VI. Eat Well & Keep Moving Curriculum Overview (Presentation)

VII. Eat Well & Keep Moving’s Nutrition and Physical Activity Messages
(Demonstration Lessons)

VIII. Talking to Youth About Nutrition and Physical Activity Habits (Role Play,
Discussions)
 Eat Well & Keep Moving
Demonstration Lessons
• Healthy Living: Lesson 1 (4th grade)
• Chain Five: Lesson 11 (4th grade)
• Hunting for Healthy Fat: Lesson 18 (5th grade)
• Beverage Buzz: Lesson 19 (5th grade)
• Thinking About Activity, Exercise, and Fitness:
Lesson 44 (physical education lesson)
• Safe Workout: An Introduction: Lesson 3 (4th
grade)
• Freeze My TV: Lesson 29 (promotional campaign)
 What Is Eat Well & Keep Moving?
• It’s an interdisciplinary health program for
4th- and 5th-grade students that teaches
students about nutrition and physical
activity.
• It builds skills and competencies in
language arts, math, science, social studies,
and physical education.
 Eat Well & Keep Moving Health Goals:
The Principles of Healthy Living
• Make the switch from sugary drinks to water.
• Choose colorful fruits and vegetables instead of junk food.
• Choose whole-grain foods and limit foods with added sugar.
• Choose foods with healthy fat, limit foods high in saturated fat,
and avoid foods with trans fat.
• Eat a nutritious breakfast every morning.
• Be physically active every day for at least an hour.
• Limit TV and other recreational screen time to 2 hours or less
per day.
• Get enough sleep to give the brain and body the rest they need.
Eat Well & Keep Moving Promotes...

Active Literacy
learning across the
curriculum

Curriculum
frameworks
 is Student centered

Critical thinking,
Active problem solving,
learning encourages inquiry, cooperative
learning, a variety of
learning styles

Constructivist
uses
approach
Constructivist Approach

Get them thinking

Find out what they know

Use active learning to build

on what they know
 Curriculum
frameworks

Eat Well & Keep Moving classroom lessons

• address learning standards in core subjects,
• use content and skills specific to one of the
academic subject areas,
• address one or more of the health learning
standards, and
• incorporate language skills.
 Why Use This Program?

Available at www.HumanKinetics.com
Research on Eat Well & Keep Moving
• 4th- and 5th-grade students in 14 Baltimore
public schools
• Program is designed to meet these goals:
– Increase fruit and vegetable consumption
– Reduce saturated fat intake
– Reduce TV watching
– Increase moderate and vigorous physical activity
• Classroom, food service, school-wide
campaign, and community components
 Eat Well & Keep Moving
Has Been Evaluated and
Shown to Be Effective
Effective in
• reducing saturated fat intake,
• increasing fruit and vegetable intake,
• increasing fiber and vitamin C intake, and
• reducing TV viewing.

It was well received by school staff and students.

 Acceptability of
Eat Well & Keep Moving
100% of responding teachers said they would teach
the curriculum again.

“What impresses me most about this program is its

integrative quality…. Principals, teachers, students,
food staff, and parents benefit from increased
knowledge and awareness of issues that are
fundamental to improving one’s life.”

Principal, elementary school

What Are the Benefits of Good
Nutrition and Physical Activity?
Healthy Eating and Active Living…
• Promote normal physical growth and development.
• Prevent childhood and adolescent health problems
such as obesity, dental cavities, iron-deficiency
anemia, and even diabetes.
• Provide nutrients for brain development, immunity,
healing, and healthy skin and eyes, among other
functions.
• Lower the risk of chronic diseases such as heart
disease, diabetes, osteoporosis, and some cancers.

(continued)
Healthy Eating and Active Living…
(continued)
• Make you strong and fit.
• Brighten your mood and build a positive
self-image.
• Help you maintain a healthy weight.
• Are important for learning.
• Are fun!
Are You Concerned About Your
Students’ Nutrition and Physical
Activity Habits?
The Health of Young People

Trends in Nutrition,
Physical Activity, and Inactivity
 Children Are At Risk!
Trends in Nutrition
• Too many sugary drinks!
– 27% of teens drink one or more soda a day
– 19.4% drink two
– 11.2% drink three or more
• Children and youth still consume too much
saturated fat.
• Four out of five children do not eat enough
fruits and vegetables.
– 1/3 of children eat less than a serving of vegetables
per day
– Half of children eat less than a serving of fruit per
day
 Children Are At Risk!
Trends in Screen Time
Amount of time youth spend
on screen time activities for fun

7.5
hrs./day

Generation M, Kaiser Family Foundation, 2010

 Children Are At Risk!
Trends in Physical Activity

• Only 4% of elementary schools provide daily

PE for all grades.
• 23% of children do not participate in any free
time physical activity in a typical week.
• Participation in organized physical activity is
declining: Children ages 6-12 who played
sports regularly fell from 44.5% in 2008 to
40% in 2013.
 Children Are at Risk!
Trends in Overweight

• The percentage of children who are

overweight has risen dramatically over the
past 30 years.
Children Are At Risk! Trends in Child
and Adolescent Obesity
Health Consequences of Overweight
Overweight and obese people are at increased risk for
the following:
• Type 2 diabetes
• Heart disease
• Depression
• High blood cholesterol
• Premature death
• Stroke
• Hypertension
• Asthma
• Some cancers
 What Is Causing This Epidemic
of Poor Lifestyle?

Environmental and • More TV/video games

Social Changes • Fewer PE classes
• Fewer options for after-
school programs
• More food available
• Fewer students
• More unhealthy foods with
walking/biking to school
high calories
• Lower perception of
• Growth of food industry
safety
and advertising
• More meals away from Decreased
home Energy
• Increased serving size Expenditure
• More sugar-sweetened
beverages

Increased
Energy Intake
 What Does Screen Time and
Sugary Drink Consumption Have
to Do With It?
Media Use Over Time by Children 8-18
Years Old
5 hrs.

4 hrs.

3 hrs.

2 hrs.

1 hr.

0 hrs.

Data from Kaiser Family Foundation. (2010). Generation M Squared: Media in the lives of 8-18 year olds.
 Prevalence of Obesity by
Hours of TV per Day

Data from W.H. Dietz and S.L. Gortmaker, 1985, “Do we fatten our children at the television set? Obesity and
television viewing in children and adolescents,” Pediatrics 75: 807-812.
Hypothesized Impact of Television
Viewing on Obesity
Beverage Intake Among School-Aged
Children in the U.S., 1989-2008
 Sugar-Sweetened Beverage
Consumption and Overweight
• Sugar-sweetened beverages contribute to
childhood obesity and to adult obesity
and type 2 diabetes.

• Reducing intake of sugar-sweetened

beverages can reduce the prevalence of
overweight among youth.
 Turning the Tables:
Why Schools Need to Be Part of
the Solution!
Promoting Healthy Eating and
Active Living

Education
Individual behaviors
and choices

Environment
Policies

• Home

• School

• Community
Surgeon General’s Recommendation:
School-Based Action
A comprehensive wellness plan that includes effective
health education for all.
•A sequential health education curriculum, a school wellness
policy, professional development for teachers and staff,
partnerships with families, and external community members
•Nutrition: Ensure availability of healthy foods at every eating
occasion at school, promote healthy choices, limit vending
machine access, provide adequate time to eat meals,
availability of water throughout the day
•Physical Activity: Daily PE, recess, extracurricular PA
opportunities, active transportation programs, community use of
facilities for out of school time hours
Healthy Eating and Physical Activity Are a
Critical Part of Learning and Achievement
• Brain development and function require an adequate
supply of nutrients.
• Eating breakfast increases academic test scores, daily
attendance, concentration, and class participation.
• Children learn through movement.
• Physical activity increases alertness.
• Schools that offer intensive physical activity programs
see no negative effects on academic achievement
scores even when time for physical education is taken
from the academic day.
• Children spend more time reading and doing homework
when parents set limits on TV viewing and other
recreational screen time.
Eat Well & Keep Moving
Curriculum Overview and
Educational Approach
 

Eat Well & Keep Moving Lessons

Principles of Healthy Living
•Make the switch from sugary drinks to water.
•Choose colorful fruits and vegetables instead of junk food.
•Choose whole-grain foods and limit foods with added sugar.
•Choose foods with healthy fat, limit foods high in saturated fat, and avoid foods with
trans fat.
•Eat a nutritious breakfast every morning.
•Be physically active every day for at least an hour.
•Limit TV and other screen viewing to 2 hours or less per day.
•Get enough sleep to give the brain and body the rest they need.

Classroom Lessons  
Physical Education Lessons

14 14 4 School- FitCheck +
fourth- fifth-grade wide
grade lessons promotions 4 microunits
lessons --------------- and 5 PE
5 PE lessons microunits
 Lesson Components

• Teacher resource pages

• Lesson procedures
• Worksheets and activities
• Illustrations
• Charts and tables
• Eat Well cards and Keep Moving cards
• Strength and stretching diagrams
 Eat Well & Keep Moving Health Goals:
The Principles of Healthy Living
• Make the switch from sugary drinks to water.
• Choose colorful fruits and vegetables instead of junk food.
• Choose whole-grain foods and limit foods with added sugar.
• Choose foods with healthy fat, limit foods high in saturated fat,
and avoid foods with trans fat.
• Eat a nutritious breakfast every morning.
• Be physically active every day for at least an hour.
• Limit TV and other recreational screen time to 2 hours or less
per day.
• Get enough sleep to give the brain and body the rest they need.
Copyright © 2015, Harvard T.H. Chan School of Public Health. For more information about The Kid’s Healthy Eating Plate, please see
The Nutrition Source, Department of Nutrition, Harvard T.H. Chan School of Public Health,
www.hsph.harvard.edu/nutritionsource/kids-healthy-eating-plate
 Eat Well & Keep Moving
Fruits and Vegetables Message

Choose colorful fruits

and vegetables
instead of junk food.
• Fruits and vegetables provide vitamins, minerals, and
carbohydrate.
• Choose fruits and vegetables in a rainbow of colors (choose
especially dark-green and orange vegetables).
• Getting 5 or more servings each day can reduce the risk of
diabetes, heart disease, obesity, and possibly some cancers.
 Eat Well & Keep Moving
Water Message

Make the switch from

sugary drinks to water.
• Water is essential to human survival, optimal functioning,
and health.
• Sugary beverages such as soda, sports drinks, energy
drinks, and fruit drinks are filled with empty calories,
meaning they provide many calories but almost none of
the nutrients the body needs to stay healthy and grow
strong.
Worksheet: Where’s the Sugar?
 Eat Well & Keep Moving
Fat Message
Choose foods with healthy
fat, limit foods high in
saturated fat, and avoid
foods with trans fat.
• Healthy fat can help lower the risk of heart disease and
stroke.
• Unhealthy fat—including saturated fat and especially
trans fat—increases the risk of heart disease and stroke.
• Avoid trans fat, since it raises the risk for heart disease
in many ways and may increase the risk for diabetes.
What’s the Rap on Fat?

(continued)
What’s the Rap on Fat? (continued)
 Eat Well & Keep Moving
Activity Message

Be physically active every

day for at least an hour.

• Regular physical activity helps prevent unhealthy weight gain,

obesity, and several chronic diseases.
• Children and teenagers need at least 60 minutes per day.
• This can include active free play, as well as structured activities
that are age-appropriate, enjoyable, and offer variety. Any
episode of moderate- or vigorous-intensity physical activity,
however brief, counts toward the daily goal.
Positive Effects of Physical
Fitness
•Being physically fit does the
following:
– Makes you healthier.
– Helps you build a positive self-
image.
– Helps you feel better about
yourself.
•Fitness is fun, and it feels
great!
 Eat Well & Keep Moving
Inactivity Message

Limit TV and other

recreational screen time to
two hours or less per day.

Recreational screen time = TV + movies + texting

+ video and computer games + social media

Does not include educational screen time, such as

school work completed on computer
Talking to Youth About Nutrition
and Physical Activity Habits
 What would you say if
your students ask . . .

• Why do we need to do these Eat Well &

Keep Moving lessons?
• Is fat bad for me?
• I don’t like exercise. Why is it important?
• I like to watch TV. Why do I need to stop
watching TV?

(continued)
 What would you say if
your students ask . . . (continued)

• Are soda and candy bad for me?

• Vegetables are nasty! Why do I need to eat
them?
• The cafeteria food is awful! How can I eat a
healthy lunch at school?
• It’s not safe to play outside where I live. My
mom tells me to stay at home and watch TV.
What can I do to get more physical activity?
Questions?
Planning the Eat Well & Keep Moving
Implementation