Health & Nutrition Studies
Health and nutrition related curricular competencies are incorporated in both the National Health Education Standards published in 1995 and the National Science Education Standards published in 1996. In addition to these national health standards, there are also state health standards and curriculum frameworks. Most states have their own health and nutrition education guidelines for curriculum and instruction. Effective school nutrition-education programs and curricula increase students' nutrition-related knowledge and improve their nutrition-related decisions and behaviors. Health and nutrition education helps students to enhance their individual lifestyles, develop good personal habits, avoid high-risk behaviors, and control their own health destinies. Schools may actually provide less health and nutrition education in the upper grades, although adolescents and high school students are more likely to engage in high-risk behaviors. Research has demonstrated that the most important factor in understanding students' health behaviors is grade level.
Keywords Curricular Competencies; Health Behaviors; Health Education Curriculum; Health Educators; Health Literacy; Nutrition Education; Nutrition Literacy; Public Health Education
School curricula today must address students' health and nutritional needs. The goal is for students to achieve health and nutrition literacy. Dynamic curriculum models need to be developed and implemented to promote health and nutrition among elementary, middle, junior-high and high-school students (American Association for the Advancement of Science, 1993; Smith, 2003; Wigginton, 1986). The desire of health and nutrition educators is "to have our students be whole" (Wigginton, 1986, p. 308). Students should be given knowledge of health as a total package—health as an understanding of self, health as a growing quality of "wholeness" and health as a way of life. Students should leave schools with a sense of physical and mental wellness (American Association for the Advancement of Science, 1993; Smith, 2003; Wigginton, 1986).
According to O'Byrne (2001), "Good health supports successful learning. Successful learning supports health. Education and health are inseparable" (O'Byrne, 2001, p. 1). Ultimately, the general public's and society's investment in education yields the greatest benefits. As education and health are inseparable, so are health and nutrition. Good health depends on good nutrition, and good nutrition supports good health. A philosophy of nutrition education for schoolchildren is "eat to learn, learn to eat" (Troccoli, 1993).
Historically, one of the primary missions of schools has been to help children grow into healthy and productive adults. The knowledge, skills and attitudes that are manifested in health- and nutrition-education curricula are a selection of what is known and valued at a particular place and time. In addition to specific stand-alone classes and courses in health and nutrition, instruction in these areas has traditionally been incorporated in science curricula (Garrard, 1986; MacDonald & Hunter, 2005; Smith, 2003).
Public school instruction in health and nutrition has been dependent on key medical science and public health issues of the times. This is especially true in the area of communicable diseases. For example, in 1854, the English physician, John Snow (1813–1858), determined that cholera was transmitted and spread by contaminated water. For his contributions to medical science and public health education, Snow has been hailed as the father of modern epidemiology (Melville & Fazio, 2007; Merriam-Webster Inc., 1988).
As health education depended on discoveries and innovations in related medical and health science, nutrition education has been dependent on discoveries and advances in nutrition science. For example, Elmer Vernon McCollum (1879–1967) was one of the earliest nutrition educators in the United States. Among McCollum's scientific accomplishments was his discovery of vitamin A. In addition, McCollum was an important early twentieth century communicator of nutrition education to the public (Johns Hopkins University, 2007; Todhunter, 1979). Graham (2000) traces McCollum's life from a Kansas farm boy to 'Dr. Vitamin,' and proudly proclaims that he "taught the world about nutrition."
The curriculum of health and nutrition education grew along with important medical-, health- and nutrition-related science topics. A curriculum developed by Oliver Byrd in a 1950 paper included some 300 health-science topics and another 200 were more recently added (Byrd, 2001). During the latter half of the twentieth century, health and nutrition education struggled to reach a working consensus on what the philosophy and goals of instruction should be. In the 1960s and 1970s, for example, health educators labored at coalescing the philosophical premise and goals of school health education (Belcastro, 1979). This debate continued through the 1980s and early 1990s. Then in the mid-1990s, progress actually began to be made in developing specific curricular objectives for health and nutrition education.
Establishing Health Education Standards
Many public schools have adopted the National Health Education Standards first released in 1995 by the Joint Committee on National Health Education Standards (JCNHES), with a second edition released by JCNHES and the American Cancer Society in 2007 after a review started in 2004 (Centers for Disease Control and Prevention, 2013). The general standards listed below inform specific performance indicators for prekindergarten through grade 2, grades 3–5, grades 6–8, and grades 9–12, respectively. These standards detail what K-12 students should know and be able to do in health education (Joint Committee on National Health Education Standards, 1995; Smith, 2003; CDC, 2013):
National Health Education Standards, 2007: 1. Students will comprehend concepts related to health promotion and disease prevention to enhance health.
- 2. Students will analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors.
- 3. Students will demonstrate the ability to access valid information, products, and services to enhance health.
- 4. Students will demonstrate the ability to use interpersonal communication skills to enhance health and avoid or reduce health risks.
- 5. Students will demonstrate the ability to use decision-making skills to enhance health.
- 6. Students will demonstrate the ability to use goal-setting skills to enhance health.
- 7. Students will demonstrate the ability to practice health-enhancing behaviors and avoid or reduce health risks.
- 8. Students will demonstrate the ability to advocate for personal, family, and community health.
Health- and nutrition-related competencies have also been incorporated in the 1996 National Science Education Standards, which put health and nutrition in the curricular context of 'science in personal and social perspective' (National Research Council, 1996; Rye, Zizzi, Vitullo, & Tompkins, 2005). The National Science Education Standards produced by the National Institutes of Health (NIH) Curriculum Supplement Series bring cutting-edge medical science and basic research discoveries into classrooms. The NIH curriculum modules are ideal for middle-school life-science classes for integrating human health, inquiry science, mathematics and science-technology-society issues (National Institutes of Health, 2005).
As of 2003, more than 80 percent of US school districts required schools to teach health education (Smith, 2003). However, a study by the Centers for Disease Control and Prevention's Division of Adolescent and School Health in 2000 concluded that health education in many schools and school districts is not nearly as effective as it could be (Kolbe, Kann, & Brener, 2001).
In 2012, the National Academies Press published A Framework for K–12 Science Education: Practices, Crosscutting Concepts, and Core Ideas, which served as the basis for the development of 2013’s Next Generation Science Standards (NGSS). The NGSS have been adopted by eight states as of October 3, 2013 (Higgins, 2013). Unlike previous national science standards, NGSS does not include a specific standard for personal health.
Health Education Curricula
School-age youth in health classes learn current, research-based, health content knowledge, health concepts, health enhancing skills, and risk-reducing health behaviors. Sound and effective health education programs are comprehensive, competency-based and learner-centered, and involve interactive and meaningful, hands-on activities and experiential learning (Rudy, 2000).
In addition to national health standards, there are state health standards curriculum frameworks. Most states have health-education guidelines for curriculum and instruction. Among the readily accessible examples are those published for the states of Alabama (Geiger, Myers, Atchison, & LaFollette, 2000), Arkansas (Arkansas State Department of Education), South Dakota (South Dakota Department of Education and Cultural Affairs, 2000), Vermont (Vermont Department of Education, 2004; Vermont Agency of Education, 2013), and Wisconsin (Wisconsin Department of Public Instruction, 2002). Although these health education documents capture essential learning competencies that are meant to be assessed on a statewide basis, they are not intended to 'narrow' the curriculum for instructional purposes (Vermont Department of Education, 2004). District-level curriculum guides are based on and developed from state-level documents.
The general priorities in health instruction have included a knowledge of:
• Diet, eating disorders and obesity prevention and oral health;
• The essential nature of vigorous exercise and activity to physical fitness;
• Mental and emotional health including the management of stress and the control of emotions;
• Environmental and community health;
• Communicable diseases and disease prevention;
• Drug, alcohol and tobacco use and prevention;
• Violence and the prevention of injuries; and
• Sexuality, teen pregnancy, sexually-transmitted diseases, and HIV and AIDS prevention (Pealer, 2000; Rudy, 2000; Stang & Miner, 1994).
Nutrition Education Curricula
Effective school nutrition-education programs and curricula increase students' nutrition-related knowledge and improve their nutrition-related decisions and behaviors. Integrated instructional practices and pedagogical approaches foster and improve nutrition education. Practically all United States public elementary, middle, and secondary schools offer nutrition education somewhere in the curriculum. Most schools cover many of the following topics as priorities in nutrition education:
• Children's food-related habits and eating behaviors;
• The relationship of food, diet, and nutrients to health;
• The links between nutrition and cardiovascular health;
• The food-guide pyramid;
• Finding and choosing healthy foods and increasing positive eating patterns;
• Nutrients and their food sources;
• Dietary guidelines and goals that emphasize low-fat, low-salt and increased complex-carbohydrate foods (Celebuski & Farris, 1996; Troccoli, 1993).
Students in nutrition education programs are well-schooled in the use and interpretation of US Department of Agriculture's (USDA) nutrient tables and database. The USDA database of common nutrients explains what different nutrients are, what they do in the human body and common foods in which the nutrients are found. Nutrient tables list the amounts of nutrients and proportions of recommended daily totals. Dietary suggestions for men, women and various age groups differ, and nutrient input varies based on the particular form of food, the number and size of servings and the total weight of food consumed (American Association for the Advancement of Science, 2000).
The study of many health and nutrition issues is interdisciplinary in nature and provides an opportunity for teachers of different subject areas to integrate relevant aspects of health and nutrition education into their own curricula. Although science is a key discipline for the study of health and nutrition, other areas such as history and social studies can introduce other aspects. Many health- and nutrition-related issues-for example, calorie intake and expenditure, human-energy balance, exercise and childhood obesity-cut across the National Science Education Standards (American Association for the Advancement of Science, 1993; National Research Council, 1996; Rye et al., 2005).
Although the 1996 National Science Education Standards focus more on physical than mental health, it is useful to consider mental and psychological health in understanding how students' knowledge grows and transitions from kindergarten through grade 12. Grade K-2 students, for example, can be helped to identify internal feelings and distinguish them from external sensations. Grade 3-5 students know that everyone has emotions and respond to them differently, and that different ways of dealing with emotions have different consequences. Grade 6-8 students connect extremes of emotion to their own intense thoughts and feelings and understand the relationship between emotion and risky behavior. Grade 9-12 students want to know why people behave the way they...
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