THIRD EDITION & Eat Well Keep Moving An Interdisciplinary Elementary Curriculum for Nutrition and Physical Activity Lilian W.Y. Cheung, DSc, RD Harvard T.H. Chan School of Public Health Hank Dart, MS Health Communication Consultant Sari Kalin, MS, RD, LDN Nutritionist and Health-Promotion Writer/Editor Brett Otis, BS Harvard T.H. Chan School of Public Health Steven L. Gortmaker, PhD Harvard T.H. Chan School of Public Health Human Kinetics Library of Congress Cataloging-in-Publication Data Eat well & keep moving : an interdisciplinary elementary curriculum for nutrition and physical activity / Lilian W.Y. Cheung, DSc, RD, Harvard T.H. Chan School of Public Health [and four others]. -- Third edition. pages cm 1. Nutrition--Study and teaching (Elementary) 2. Exercise--Study and teaching (Elementary) I. Cheung, Lilian W. Y., 1951- II. Title: Eat well and keep moving. 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Contents Preface vii Acknowledgments xi Introduction xv Accessing the Web Resource xxxi Section 1 Nutrition and Physical Activity Classroom Lessons and Promotions 1 Part I Classroom Lessons for Fourth Graders 3 Lesson 1 Healthy Living 5 Lesson 2 Carb Smart 15 Lesson 3 Safe Workout: An Introduction 23 Lesson 4 Balancing Act 31 Lesson 5 Fast-Food Frenzy 37 Lesson 6 Snack Attack 43 Lesson 7 Sugar Water: Think About Your Drink 49 Lesson 8 Water Water Everywhere . . . And It’s the Thing to Drink 55 Lesson 9 Safe Workout: Snacking’s Just Fine, If You Choose the Right Kind 61 Lesson 10 Prime-Time Smartness 69 Lesson 11 Chain Five 75 Lesson 12 Alphabet Fruit (and Vegetables) 81 Lesson 13 Brilliant Breakfast 87 Lesson 14 Fitness Walking 93 Part II Classroom Lessons for Fifth Graders 101 Lesson 15 Healthy Living, Healthy Eating 103 Lesson 16 Keeping the Balance 113 Lesson 17 Safe Workout: A Review 119 Lesson 18 Hunting for Healthy Fat 129 Lesson 19 Beverage Buzz: Sack the Sugar 137 Lesson 20 Go for H O 143 2 Lesson 21 Snack Decisions 149 Lesson 22 Snacking and Inactivity 155 Lesson 23 Freeze My TV 159 Lesson 24 Menu Monitoring 165 Lesson 25 Veggiemania 171 Lesson 26 Breakfast Bonanza 175 Lesson 27 Foods From Around the World 181 Lesson 28 Fitness Walking 187 Part III Promotions for the Classroom 197 Lesson 29 Freeze My TV 199 Lesson 30 Get 3 At School and 5+ A Day 205 Lesson 31 Class Walking Clubs 211 Lesson 32 Tour de Health 217 iv Section 2 Nutrition and Physical Activity Physical Education Lessons and Microunits 223 Part IV Physical Education Lessons 225 Lesson 33 Three Kinds of Fitness Fun: Endurance, Strength, and Flexibility 227 Lesson 34 Five-Foods Countdown 233 Lesson 35 Musical Fare 239 Lesson 36 Bowling for Snacks 245 Lesson 37 Fruits and Vegetables 251 Part V FitCheck Guide 257 Lesson 38 Teachers’ Guide to FitCheck 259 Lesson 39 Students’ Guide to FitCheck 263 Part VI FitCheck Physical Education Microunits 265 Lesson 40 Charting Your FitScore and SitScore 267 Lesson 41 What Could You Do Instead of Watching TV? 271 Lesson 42 Making Time to Stay Fit 275 Lesson 43 Setting Goals for Personal Fitness 279 Part VII Additional Physical Education Microunits 283 Lesson 44 Thinking About Activity, Exercise, and Fitness 285 Lesson 45 Be Active Now for a Healthy Heart Later 289 Lesson 46 Be Active Now for Healthy Bones Later 293 Lesson 47 Let’s Get Started on Being Fit 297 Lesson 48 More on the Three Areas of Physical Fitness 301 About the Authors 305 v Preface Eat Well & Keep Moving is a school-based program that equips children with the knowl- edge, skills, and supportive environment they need in order to lead more healthful lives by choosing nutritious diets and being physically active. Research shows that a good diet and physical activity can significantly reduce the risk of obesity and chronic diseases such as heart disease, high blood pressure, and type 2 diabetes, all of which can begin early in childhood. However, many children are not living or going to school in an environment that allows them to eat the food and get the exercise they need in order to combat these chronic diseases and promote lifelong health. Indeed, childhood obesity is still a major public health issue in all developed countries; type 2 diabetes, once found primarily in adults, is increasingly being diagnosed in youths. It is especially disconcerting that, as children move into adolescence and then adulthood, they become progressively less active and choose less healthy diets. This trend makes it even more important for children to be surrounded by healthful environments and to develop healthful habits early in life so that they can sustain these practices into adulthood. Initially designed as a joint research project between the Harvard School of Public Health (presently the Harvard T.H. Chan School of Public Health) and Baltimore City Public Schools, Eat Well & Keep Moving has evolved into a comprehensive program that can be introduced in other school systems throughout the country, including urban, sub- urban, and rural schools. The program received the Dannon Institute Award for Excellence in Community Nutrition in 2000. Since the publication of the first edition of Eat Well & Keep Moving in 2001, the program has been disseminated throughout all 50 U.S. states and in more than 20 countries. Unlike traditional health curricula, this program encompasses all aspects of the learning environment, including the classroom, cafeteria, gymnasium, school hallways, homes, and even out-of-school-time programs and community centers. This approach, as recom- mended by the Centers for Disease Control and Prevention’s coordinated school health program model, reinforces crucial messages about nutrition and physical activity and increases the chance that students will eat well and keep moving throughout their lives. Numerous existing curricula address either nutrition or physical activity independently, yet few address nutrition and physical activity simultaneously. This program is a significant addition to elementary school curricula not only because it was among the first to address both nutrition and physical activity but also because it was among the first to address children’s physical inactivity (namely screen-time activities such as watching television or playing computer games). In this third edition of Eat Well & Keep Moving, we include two additional core Principles of Healthy Living messages, one focusing on sleep and its association with screen time and the other promoting the consumption of water. To expand on our existing lessons on sugar-sweetened beverages, two new lessons focus on and further emphasize water as the healthy alternative to sugary drinks that are a key factor in childhood obesity. These and the existing six core messages have also been updated to reflect targets as defined vii viii Preface by the CDC-funded Childhood Obesity Research Demonstration (CORD) partnership. In addition, the entire curriculum reflects the latest research at the time of publication and incorporates recommendations from the Dietary Guidelines for Americans 2015. Included throughout this updated edition is the Kid’s Healthy Eating Plate. The plate is an adaptation of the Healthy Eating Plate, which was created by nutrition experts at the Harvard T.H. Chan School of Public Health and editors at Harvard Health Publications to address key limitations in the U.S. Department of Agriculture (USDA)’s MyPlate. The Kid’s Healthy Eating Plate provides detailed visual guidance, in a simple format, that educators and caregivers can use to help children make the best eating choices. Classrooms familiar with the USDA’s MyPlate can easily incorporate the Kid’s Healthy Eating Plate into their programs. The six interlinked components of Eat Well & Keep Moving—classroom education, physical education, schoolwide promotional campaigns, food service, staff wellness, and parent involvement—work together to create a supportive learning environment that promotes the learning of good lifelong habits. But this program does more than just work well for students. Because it uses existing school resources, fits in most school curricula, contains camera-ready teaching materials, and is inexpensive to implement, teachers and schools find it easy to adopt as well. Feedback from the teachers who have taught the curriculum has been exceptionally positive. In particular, teachers have praised the integration of the lesson plans into core subject areas, and they see that integration as fundamental to the program’s success. Schools are hard pressed to find time for additional subjects; with the integrated design of Eat Well & Keep Moving, nutrition and physical activity can be taught by classroom teachers in core subject areas (including math, lan- guage arts, and science). You can make the Eat Well & Keep Moving program as broad or as focused as you like. Choose the approach that works best for you. Focusing solely on the classroom portion of the program will provide students with excellent knowledge and skills that they can apply throughout life. The program is at its strongest, though, when it includes the entire school community: other teachers (classroom and physical education teachers), food service staff, the school food environment and policies, and parents or guardians. The power of the messages is enhanced even further when students are exposed to these messages in other classes, experience them in the cafeteria and school hallways, and put them into practice at home with their parents or guardians. Implementing Eat Well & Keep Moving—either the curriculum or the broad program—can also help schools meet new federally mandated wellness policy criteria. The Eat Well & Keep Moving book and accompanying web resource provide all the information you need to implement the program, whether you are introducing it into a single classroom or expanding it to an entire school community or school system. We encourage you to customize the content of the program according to your school and student population profile. For example, schools can tailor the foods, language, and cus- toms of the lesson plans and activities to their student population. Components of Eat Well & Keep Moving Parts I and II of the Eat Well & Keep Moving book contain the interdisciplinary fourth- and fifth-grade classroom lessons that provide students with in-depth exposure to the program’s themes. Through a feature unique to these lessons, students learn about nutrition and physical activity while actually being physically active in the classroom. This feature is especially valuable in schools where physical education is limited or unavailable. Part III, Promotions for the Classroom, offers students and teachers fun and engaging ways to put the themes of the program into practice. These promotions include class walking clubs, a week of featuring fruits and vegetables through Get 3 At School and 5+ A Day, the Freeze My TV contest, and the Tour de Health game. Preface ix Parts IV, V, VI, and VII contain the physical education lessons, FitChecks, FitCheck physical education microunits, and additional physical education microunits. The physical education lessons offer students more traditional physical education activities, many of which integrate nutrition topics. Students learn as they move, and by doing so they begin to appreciate the importance of both eating well and being physically active. The FitCheck is a tool for self-assessment of activity and inactivity. Teachers and students are taught how to use this tool in order to evaluate how students are progressing. The FitCheck physical education microunits are to be used with the FitCheck materials so that students learn about a variety of topics in physical activity. Likewise, the additional physical education microunits are five-minute lessons that cover a range of physical activity topics. Both the FitCheck microunits and the additional microunits have been formatted dif- ferently from the rest of the book. These units contain many bulleted lists to provide you with an easy outline to follow while you are delivering the lessons to your students. In the microunits you will notice text boxes that contain additional information you can share with your students to help them learn even more about the topic at hand. The Eat Well & Keep Moving web resource provides in-depth implementation manuals and supporting materials for each part of the program as well as information for running workshops to train fellow teachers, food service staff, after-school and out-of-school- time program staff, and community members about nutrition and physical education. It contains a comprehensive list of resources on nutrition, physical activity, improving the school environment, school wellness policies, and other related topics. It includes stretches and strength exercises that you will use throughout the book, the classroom and physical education lessons, worksheets, and other reproducibles contained in this book. It also houses the Eat Well cards and the Keep Moving cards. These cards offer a quick and fun way for students to synthesize and put into practice the information on nutrition and physical activity they learn through the lessons and other promotions. Even more important than the scope of your school’s approach to implementing the Eat Well & Keep Moving program is the fact that you are teaching your students the impor- tance of good nutrition and regular physical activity. This lesson will not only help them be healthier and happier students right now but will also give them the knowledge and skills they need for lifelong health.