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Running head: EXERCISE, NUTRITION AND BEHAVIOR

The Effects of Poor Nutrition and Exercise on Behavior

Amanda Kelley and Sue Stapleton
Arizona State University

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Introduction
Children who are able to achieve a balance of physical exercise and proper nutrition are more
capable of achieving personal and academic success in the classroom.
A growing trend toward reallocating time in school to accentuate the more academic
subjects has put this important facet of a childs school day at risk. Recess serves as a
necessary break from the rigors of concentrated, academic challenges in the classroom.
But equally important is the fact that safe and well-supervised recess offers cognitive,
social, emotional, and physical benefits that may not be fully appreciated when a decision
is made to diminish it (Bossenmeyer, 2013).
For children to maintain a healthy weight, the amount of calories they consume daily must be
balanced with their physical activity. The goal for overweight children is to reduce the rate of
weight gain while allowing normal growth and development. Children should not be placed on a
weight reduction diet without the consultation of a health care provider (www.cdc.gov).
Some consequences of childhood and adolescent overweight are psychosocial. Obese children
and adolescents are targets of early and systematic social discrimination. The psychological
stress of social stigmatization can cause low self-esteem which, in turn, can hinder academic and
social functioning, and persist into adulthood (www.cdc.gov).
Given the increased prevalence of obesity in young adults over the last two decades and
the health risks associated with obesity during young adulthood, it is important to identify
factors in young adults lives that contribute to excess weight gain and decreased

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participation in weight-related behaviors, including healthy eating and physical
activity. (Berge, Larson, Bauer, & Neumark-Sztainer, 2011).

Link to Sue Stapletons E-Portfolio: http://suestapleton.weebly.com/

Link to Amanda Kelleys E-Portfolio: http://amandakelleyppe310.weebly.com

Literature Review
A study, Long-term Student Outcomes of an Integrated Nutrition and Physical Activity
Program, sought to examine the effects of an INPAP, a school-based nutrition education program
(Puma, Romaniello, crane. Scarbro, Belansky and Marshall, 2013). School-based nutrition
education programs have the opportunity to play a vital role in improving children's health and in
preventing later adult chronic diseases (Puma et al., 2013). The rates of childhood obesity have
risen drastically in the last several decades. This study was designed was to see if a nutrition
program will cultivate lifelong habits for children.
This study estimated the impact of an Integrated Nutrition and Physical Activity Program
(INPAP) on a target population. A group of second grade students in the fall of 1999 and did not
receive the INPAP intervention and were compared to a cohort of students who began second
grade in 2000 who received the INPAP curriculum delivered by a resource teacher. The students
were trained in the program for two consecutive years. To evaluate long-term effects, children in
both cohorts completed assessments each spring from fifth through eighth grade. This study was
approved by the Colorado Multiple Institutional Review Board (Puma et al., 2013).

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This study was conducted in a single school district in south-central Colorado in a rural
county that had an estimated fifteen thousand residents. Over the course of the study the
percentage of students who received free and reduced lunch increased and primarily identified

themselves as Hispanic. Classroom surveys, writing samples and body mass index were the
measures used in the study.
The results of the study had mixed outcomes. While the percentage of correct responses
decreased over time for the intervention group, significant findings also emerged in favor of the
intervention group for knowledge about identifying which foods are healthier in a recipe (Puma
et al., 2013).
None of the nutrition items related to self-efficacy revealed statistically significant
differences for the intervention and comparison groups. In terms of attitudes, students in
the intervention cohort were more likely to report that the foods they eat now will affect
their health now and as an adult (Puma et al., 2013).
In the classroom surveys that were related to physical activity the control group reported that
they felt the benefits of physical activity. Most students emphasized either activity or eating but
seldom both. Weight gain, drinking water and eating sweets was also shared by both cohorts.

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The purpose of our second study, Classroom teachers and physical activity integration
hoped to inform schools that they have the ability to serve as primary intervention sites to
counteract negative national health trends. Research repeatedly finds that many children are
physically inactive and become even less active as they grow (Cothran, Kulinna, and Garn,
2009). This project involved twenty-three teachers who integrated physical activity into their
school day. The teachers represented multiple grade levels and worked in schools that served
Native American students in the United States. Biannual interviews were conducted with the
teachers. Their willingness to engage was influenced positively by caring about their students
and their personal wellness history (Cothran, Kulinna, and Garn, 2009).
The teachers volunteered to participate in a year-long curricular change initiative
designed to integrate physical activity and academic content during the school day. Twenty-three
classroom teachers (fourteen female and nine male) from ten schools participated in the study,
and they were comprised of various ethnicities (Cothran, Kulinna, and Garn, 2009). Teachers
were aware of the general goals of the program which were to increase student physical activity
and knowledge about healthy living via academic integration lessons. Teachers received training
in a series of workshops throughout the year and also received some basic equipment including a
pedometer set for their class (Cothran, Kulinna, and Garn, 2009). The individual teacher training
in physical education varied. None of the teachers had training or incorporated healthy living
behaviors in their lessons (Cothran, Kulinna, and Garn, 2009). The group consisted of
elementary, middle and high school teachers that were public, parochial or governed by the
Native American community via the Bureau of Indian Affairs (Cothran, Kulinna, and Garn,
2009). Of those schools, five were elementary, three were middle, and two were high schools.
The schools were located on the same reservation and had relatively small enrollments and they

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shared similar circumstances including low student attendance and retention, as well as poor
student performance on standardized academic tests (Cothran, Kulinna, and Garn, 2009).
The students in the district had many risk factors including obesity, diabetes, and drug and
alcohol addiction.
This project lasted a year and found some significant resulted in significant findings. The
first is that teachers willingness to engage in the project was largely the result of a mix of
stakeholder and personal presses (Cothran, Kulinna, and Garn, 2009). The stakeholders involved
in the project had a desire to meet the needs of the whole student and the teachers who engaged
were committed to their learners beyond the classroom. The study encountered challenges in
how to integrate the activities given the academic testing pressures of the high stakes exams. The
number one reason for teacher engagement in the classroom intervention was a desire to
positively impact student wellness needs (Cothran, Kulinna, and Garn, 2009).
The purpose of the study, Food Additives and Behavior in 8- to 9-Year-Old Children in
Hong Kong was to determine if artificial food coloring and or preservatives such as sodium
benzoate, cause an increase in misbehavior or an increase in ADHD behaviors. One hundred and
thirty children in Hong Kong completed a six-week study in which their diets excluded all
preservative and artificial colors. Children were split up into two groups, placebo group, and the
active group. The placebo group was given pills that did not contain artificial colors or
preservatives. In week 1they asked the children to eat their typical diet, weeks 2-6 they asked
families only to give them food that did not contain food coloring or preservatives without
changing the base of their diet. Parents were given a shopping book that contained approved
foods and brands that could be purchased at their local grocery store. Children who were
receiving the active pills were given them on weeks 2,4, and 6. Behavioral results were collected

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by parents and teachers filling out questionnaires based on the strengths and weaknesses of
ADHD symptoms and normal behaviors (SWAN) rating scale that teachers and parents filled in;
and (2) the child behavior checklist according to the article. (Lok, Chan, Lee, Leung, Leung, C.,
Leung, J. and Woo, 2013).
The results of the study reported that 62.4% of the subjects that they still followed an
additive-free diet for a couple reasons, increased knowledge (32%) and perception of child being
healthier (19%). Parents (43.4%) believed that additives did affect their children's behavior, of
which 20.5% observed a behavior change, 9.4% temper change, 6.8% mood change, 3.4% less
hyperactive, and 2.6% attention change. A sociocultural study examined the parental perception
of tolerance to food intolerance. It aimed to examine food intolerances through the sociocultural
lens and make educators more aware of how to better serve students who may have food
intolerances. There were three women and six children who participated in this study, all of
whom had food intolerances. The mothers kept a journal of their kid's behavior on and off of
particular food intolerance diets. The food they used in this study was the failsafe elimination
diet (Golemac, 2015). The parents wrote in their journals entries that reflected over the childs
food and behavior, anxiety, sleeping patterns, language, concentration, and social skills.
Parents of children with food intolerance often struggle in the social aspect of the
sociocultural theory. Educators could help ease this by accepting the familys claims of food
intolerance and not making the parents feel dismissed, like so many people in our culture do with
food intolerances. Educators could help remove this stigma by talking about food intolerances
and including in literature or visuals into the classroom and integrating it into the curriculum.

Synthesis of Current Literature

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Three out of four of the articles had health and nutrition at the heart of their study.
Article 1, Long-term Student Outcomes of the Integrated Nutrition and Physical Activity
Program by Puma et al., Article 2, Classroom teachers and physical activity integration by
Cothran et al. focused on the implementation and power of health and wellness programs in
schools. The third article, Tolerance of food intolerance: a sociocultural study of parent
perceptions on food, behavior and learning in children aged between two and fourteen by
Golemac and Hallowell focused on children getting their nutritional needs met and how certain
foods can affect their bodies and the other aspects of life. The fourth article, Food additives, and
behavior in eight to nine-year-old children in Hong Kong which was a randomized, double-blind,
placebo-controlled trial by Lok, et al. intent was to see if there was a direct correlation between
misbehavior and ADHD and food coloring and preservatives. This study concluded that there
was no relationship between behavior and preservatives and food coloring.
The articles concluded that it is imperative to teach children about healthy eating and the
benefits of regular physical activity. For some, a healthy lifestyle and diet may look different
due to food intolerances and allergies. The debate between food coloring and its correlation to
ADHD is ongoing and inclusive. However, it is certain that all children need to learn about food
and how to live an active lifestyle. This is in agreeance to having happy, healthful children who
will grow and eventually thrive as adults. Our research indicated that further development of
health and wellness programs need to begin with children in elementary school and continue
through adulthood and into the business place.

Practical Implications

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At ABC School we are launching our Healthy School Initiative. We are excited to share
this journey with our students, their families, our staff, district administration and our
community. On October 21st date we are holding our 1st annual health fair, and we hope to get
our community's commitment to making healthy choices for our children because their daily
activity and nutrition is directly correlated to how they perform in the classroom.
On October 21st date we will be hosting our first annual Health and Wellness Fair. We
have invited many community stakeholders including our local gyms, 9-Round kickboxing,
Orangetheory, Daily Method, Crossfit, Zumba, and local Yoga studios. We will have a nutritional
meal preparation activity that will allow each family to make and take three balanced meals. The
event attendees can play our interactive game called My Plate, which will test their knowledge of
how to portion and balance their meals. We will have a variety of exercise class demonstrations
through the fair for all to participate in and a raffle for free memberships from participating
vendors.
We will be launching our ongoing programs. Please stop by and visit our informational
tables to learn about our Running Club, monthly nutritional meetings (held the first Wednesday
of every month in the Library at 8:00 am and 6:30 pm), our school districts weight loss and BMI
reduction challenge, join our social media groups (iPads will be available to sign up) and learn
about our meal planning and recipe sharing application. This plan addresses the need for health
education for children and families through the use of many community partners who help
educate students and parents. Students learn about good and bad food choices, exercise and water
consumption. Local chefs will be coming to the school monthly to teach students about healthy
food and how to prepare it. We have running clubs and transportation for students who
participate in any of our after school activities. We are adding clubs based on interests of the

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students throughout the year. We provide shopping lists and snack alternatives for students and
their families that will be sent home monthly. We give out coupons for produce at local
supermarkets to encourage families to purchase and cook more fresh fruits and vegetables. At the
health fair, we are inviting families to come and have conversations with health professionals.
There are games and education for the students too. During the event, we will have stations
where parents can prepare meals to freeze and pull out at a later date at no cost.
Marketing
Please use this link to access our Google Form for our Health and Wellness Survey:
https://docs.google.com/forms/d/e/1FAIpQLSdecWXsRA6NP19nRMlnTFWlIUkBpjBGS4cvT3EXyoHealP6g/viewform
Pamphlet see attachment
Flier see attachment
Funding
We are going to obtain the funding for our Healthy School Initiative through various
sources. We are going to seek financial support from our Home and School Association, our local
school district, donations from grocery stores, doctors offices, local gyms, personal trainers and
nutritionists. All of the stakeholders have a vested interest in health and wellness education. The
grant funding will provide us the opportunity to teach our children about how to live a healthy
lifestyle. Eating right and getting the right amount of physical activity helps manage the stress
and improves behaviors that occur in the classroom. Childrens education is directly impacted by
their nutrition. We hope to address many classroom behavior challenges through educating our
students and their families about the benefits of proper nutrition and exercise.
Administration Letter see attachment

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Committee
Our wellness committee is comprised of many different stakeholders. We are parents,
educational and healthcare professionals, including a doctor who is providing health screenings
and advice for families. Our physicians attend our health fair and meetings to offer advice to
families free of charge. Nutritionists will provide meal planning and advice for families. They
offer simple solutions for busy families. Some physical trainers who volunteer to help families
come up with individual and family activities and plans to help them stay active. There are a few
chefs who participate in our activities on a bi-monthly basis and in the classrooms. At the fair
the chefs provide recipes and a hands on experience preparing make meals with families.
Educational Component
Educational components will include a weekly health and nutrition class where students
are informed of their bodies nutritional and physical needs. Once a month a chef will conduct a
special cooking lesson where they get to make food and try new things. Students are encouraged
to participate in the various physical activities the school provides such as running club, bike to
school day and the various fitness classes hosted by the school. Students who attend the events
are encouraged to listen to their bodies and participate in what their bodies are capable of.
Students will be encouraged to make connections between their overall health and their healthy
activities. Parents will be invited to attend a health fair where they can learn about how to make
healthy lifestyle changes that will impact their entire family.

Scheduling Calendars
September 2017 see attachment
October 2017 see attachment

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Conclusion
It is important that students in school learn about healthy lifestyle choices so that they
have the knowledge to make informed decisions about their health. Eating a balanced diet and
getting enough exercise will enable them to perform better in school. Childhood obesity has
more than doubled in children and quadrupled in adolescents in the past 30 years
(Letsmove.org). The education community must realize that they play a pivotal role and have a
significant impact on a childs overall, lifelong health. Children must receive education about
how to live a healthy lifestyle.
In the first year, we will be establishing best practices for our health and wellness committee,
networking with individuals and businesses who can be partners for years to come. We will be
hosting our first annual health fair and will establish wellness clubs for students to participate in
as well as providing nutrition classes. In three years we hope to have a strong network of
volunteers, both professionals, and non-professionals to help host the health fair and we will
have an idea of how much impact our committee is making in our community. In five years our
goal is to have our healthy lifestyle integrated into our community culture. We hope to continue
strong relationships with our partners in our annual health fair and a variety of clubs to help
families stay healthy.
This program was established to help students and their families be informed about how
to live a healthy life and provide them the tools and resources to live a healthy lifestyle. The
needs of each person and family vary, some families need education, others think it is too
expensive to eat healthily, and still others need financial help. Our program has a spectrum of
resources was established to combat those hindrances to a healthy life. Health means different
things to different people. Our plan will take time to define what health means to our students,

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their families, and assist them in determining what they are willing to do or willing to give up
doing to bring better health into their lives (Greenberg, 2013)

References
Arnold, L. E., Lofthouse, N., & Hurt, E. (2012, August 3). Artificial Food Colors and

Attention-Deficit/Hyperactivity Symptoms: Conclusions to Dye for. Neurotherapeutics,

9(3),599-609. doi:10.1007/s13311-012-0133-x

Berge, J. M., Larson, N., Bauer, K. W., & Neumark-Sztainer, D. (2011). Are parents of young
children practicing healthy nutrition and physical activity behaviors? Pediatrics, 127(5),
881-887. doi:10.1542/peds.2010-3218
Bossenmeyer, M. (2013). Favorite Subject at School? Recess of Course! Why Recess Makes
Kids Smarter. Retrieved from
http://www.playgroundprofessionals.com/sites/default/files/playgroundmagazine/pdf/articles/Melinda-Bossenmeyer-Recess-Vol13No4.pdf

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Centers for Disease Control and Prevention. (2015). Healthy Weight. Retrieved from
https://www.cdc.gov/healthyweight/children/
Cothran, D. J., Kulinna, P. H., & Garn, A. C. (2009). Classroom teachers and physical activity
integration. Retrieved from http://ac.els-cdn.com/S0742051X10000612/1-s2.0S0742051X10000612-main.pdf?_tid=20c75b74-a5ec-11e6-82d400000aacb360&acdnat=1478634606_2883dee01808af30851b6711f3beb4aa
Golemac, D., & Hallowell, L. (2015). Tolerance of food intolerance: A sociocultural study of
parent perceptions on food, behaviour and learning in children aged between two and 14.
Australasian Journal Of Early Childhood, 40(4), 96-103.
Greenberg, M. (2013). The Best Quotes on Healthy Living jumpstart your journey to healthier
living . Retrieved from https://www.psychologytoday.com/blog/the-mindful-selfexpress/201305/the-best-quotes-healthy-living
Lets Move, (nd). Get Active. Retrieved from http://www.letsmove.gov/get-active
Lok, K. Y., Chan, R. S., Lee, V. W., Leung, P. W., Leung, C., Leung, J., & Woo, J. (2013,
August). Food Additives and Behavior in 8- to 9-Year-Old Children in Hong Kong.
Journal of Developmental & Behavioral Pediatrics, 34(9), 642-650.
doi:10.1097/dbp.0000000000000005
Puma, J., Romaniello, C., Crane, L., Scarbro, S., Belansky, E., & Marshall, J. A. (2013). Longterm Student Outcomes of the Integrated Nutrition and Physical Activity Program.
Retrieved from http://dx.doi.org/10.1016/j.jneb.2013.05.006
Stevens, L. J., Burgess, J. R., Stochelski, M. A., & Kuczek, T. (2013, September 13). Amounts of
\Artificial Food Colors in Commonly Consumed Beverages and Potential Behavioral

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Implications for Consumption in Children. Clinical Pediatrics, 53(2), 133-140.
doi:10.1177/0009922813502849

Appendix

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