Nutrition Questions For High School Students

[Mariela Laflam]

TheYouth Risk Behavior Surveillance System (YRBSS), is a biannual measure of self-reported health behaviors among U.S. middle and high school students. It includes several questions regarding behaviors related to nutrition, including ones about soda consumption, fruit and vegetable consumption, and eating breakfast.

Explore national and state-level data on those four questions below. Other data features on the site provide access to YRBSS data on questions related to physical activity, as well as obesity rates based on self-reported heights and weights.

Nutrition and physical activity are important for optimal growth and development and chronic disease prevention. Approximately half of U.S. adults have a chronic disease that is related to inadequate diet quality and physical activity, including type 2 diabetes, cardiovascular diseases, or obesity (1). Such diseases can affect productivity and quality of life and contribute to high health-care costs. Dietary and physical activity behaviors develop during childhood and can create a trajectory that continues into adulthood (1,2). Establishing healthy dietary and physical activity behaviors early in life is a vital public health strategy for promoting lifelong physical health.

Previous data indicate that most adolescents are not meeting recommendations for healthy eating (1) or physical activity (3), which increases the risk for chronic diseases later in life. In addition, disparities by sex and race/ethnicity exist (4). To update national estimates of dietary and physical activity behaviors among U.S. high school students overall and by sex and race/ethnicity and to determine how these behaviors have changed over time, CDC analyzed data from the 2019 Youth Risk Behavior Survey (YRBS) and examined trends in prevalence of these behaviors during the previous 10 years. Public health and school health researchers and practitioners can use these findings to inform policies and practices that support healthy eating and physical activity among adolescents.

The student demographic characteristics analyzed included sex (female or male) and race/ethnicity. Students were classified into four racial/ethnic categories: non-Hispanic white (white); non-Hispanic black (black); Hispanic or Latino of any race (Hispanic); and other or multiple races. The numbers of students in the other or multiple racial/ethnic groups were too small for meaningful analysis; therefore, findings for those groups are not presented; however, the corresponding data remain in the analytic sample. This analysis included six dietary variables and five physical activity variables (Table 1). The dietary variables included the following: during the 7 days before the survey, had eaten fruit or drunk 100% fruit juices

Prevalence estimates and 95% confidence intervals for each 2019 dietary and physical activity behavior were calculated overall and for each sex and racial/ethnic group. Statistically significant pairwise differences by sex and race/ethnicity were determined by t-tests. In addition, prevalence of each dietary and physical activity behavior was compared for 2017 with 2019 by using t-tests. Differences between prevalence estimates were considered statistically significant if the t-test p value was

Improving dietary and physical activity behaviors among adolescents requires efforts across multiple settings. For example, schools can implement policies and practices (e.g., local school wellness policies) ( -school-wellness-policy) that support healthy eating and physical activity, including ensuring the following: 1) that foods and beverages sold during the school day meet Smart Snacks in School nutrition standards, 2) that school meals are appealing and include menu items that students enjoy, and 3) that students have access to free drinking water during the school day (11). Schools can also help students meet the federal physical activity guidelines by providing physical activity opportunities before, during, and after the school day. This can be achieved by developing, implementing, and evaluating a comprehensive school physical activity program, which serves as a national framework for physical education and physical activity in schools. (More guidance on comprehensive school physical activity programs is available at _242620-A_CSPAP_SchoolPhysActivityPrograms_Final_508_12192013.pdf.)

Health education is another way that schools can help students develop the knowledge and skills needed for making health-enhancing decisions. These school efforts can be addressed and coordinated through the Whole School, Whole Community, Whole Child Model, which highlights the interconnectedness of multiple health behaviors and outcomes and promotes collaboration among diverse partners, including mental health professionals, school leaders, school nurses, physical and health educators, and parents for promoting health and well-being for all students. (More information about the Whole School, Whole Community, Whole Child approach is available at )

Community members and parents can reinforce the messages promoted within the school and can participate on the school wellness or school health teams that are addressing healthy eating, physical education, and physical activity. (More information about parent engagement in school health is available at _engagement_strategies.pdf.) In addition, parents and community members can engage in physical activity with adolescents, provide social supports for adolescents that increase physical activity while decreasing sedentary behaviors, and make choices that support healthy eating.

General limitations for the YRBS are available in the overview report of this supplement (5). The findings in this report are subject to at least one additional limitation. Certain questions about dietary behaviors (e.g., fruit consumption) ask about frequency rather than portion size; therefore, these data cannot directly determine whether students are meeting specific recommendations for age and sex (22).

Because of the limited progress in increasing the prevalence of healthy dietary and physical activity behaviors among U.S. high school students, multicomponent approaches, including policy and environmental changes and opportunities for adolescents to learn about and practice making healthy choices, are needed to facilitate healthy dietary and physical activity patterns. Schools, communities, and families can work together in creating healthy environments where adolescents thrive.

1Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC; 2Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; 3Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

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We try to encourage healthy eating with our students, but what does that actually look like? Nutrition lesson plans for high school students help to empower long-term healthy lifestyles that go past being able to recite the food pyramid for a test. Nutrition education is about the long-term benefits we can instill with our students.

Physical education aims to address the total health and wellness of students. Part of living a complete healthy lifestyle is understanding nutrition! Therefore, teachers seek to help students understand nutrition information so that they can make healthy food choices.

We might be eager to jump right into food groups, dietary guidelines, and balanced diets, but we need to progress students through comprehensive nutrition lesson plans just like we do in any other topic or subject.

2) Video Resources: There are many gray areas and questions that come up for high school students when we talk about nutrition. This portion allows students to hear a nutrition expert talk about it and answer frequently asked questions.

3) Chapter Questions: A great way to make nutrition education interactive! Paired discussion questions that support the written and video resources can be used in various ways. For example, you can assign these questions for small groups or class discussions or ask students to submit their answers.

There are formulas and general recommendations, but there can be huge variances based on sex, age, height, muscle mass, and physical activity intensity and duration. Even factors like what we eat, how often we eat, and our mental health can impact energy needs.

How do we assess if we are eating too little or too much? How do we do this in an easy and straightforward way that we can apply to our daily lives? In our next lesson, we will explore ways to listen to the body to determine our energy needs.

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