Behavioral habits developed during adolescent years (10-17 years old) are strong indicators of health outcomes and risk for developing chronic disease later in life. Adolescence is a particularly vulnerable time in development because individuals at this age are most sensitive to the influences of their social environments such as school. Because of this vulnerability, it is during this time that adolescents often begin risky behaviors and practices that contribute to mental illness, substance abuse, and poor practices managing nutrition and health. Nutrition and health literacy programs are often removed from school curricula for a number of reasons including budgeting issues and cultural sensitivities that are difficult to address in the environment of public classrooms. Teaching a class with a focus on meat and related products as a source of protein would not be relevant to those whose cultural influences dictate which food sources are available to them. Attempting to tailor a nutrition curriculum that caters to a wide variety of cultural principles provides additional challenges to health curricula that are already stressed by budgetary restrictions. Various organizations and publications have already explored the effects of adolescent health education on health literacy and nutritional decisions later in life. Unfortunately, despite the evidence demonstrating the association between health-related education in this vulnerable time of adolescence and its profound developmental impact on these individuals as adults, there is still a dearth of interventional action within schools.
In adolescence, individuals begin making decisions about the direction of their lives and weighing the consequences of their decisions. Teaching adolescents about the impact of sugar intake, fat intake, exercise, and other metabolic health topics may have a significant impact on knowledge, attitudes, and beliefs about nutrition. If adolescents are educated on why it is important to start properly caring for their body, then they will make more sound decisions regarding nutritional behaviors that impact their health throughout their lives.
We created an intervention to establish a correlation between physical education and health literacy on the likelihood of participants leading a more health-conscious life after our program. If we are able to make a lasting impact on how adolescent students think about the significance of health literacy and decision making over a period of time, it would prove useful in the development of high school health literacy curricula. Our plan was to run several sessions of interventions with high school seniors on several topics including diabetes, heart health, sugar intake, nutrition labels, and mental health. While the impact of these interventions may be more influential during freshman or sophomore year, the elective class that we provided interventions in was only offered to seniors. It was our philosophy that these interventions would indeed prove helpful in positively molding the mindset of students as they transition into adulthood.
To be clear, we were not primarily looking to have these students memorize facts or mechanisms of disease necessarily. Rather, we were looking to see if these interventions – which traditionally are cut from high school curricula– could positively influence physical education, health literacy, and the overall likelihood of participants leading a more health-conscious life after our program.
The program, called Fit for Life, was offered on a quarterly basis as an elective class for high school seniors at Cristo Rey Jesuit High School, located in an underserved area of Chicago with students from low-income families. Though our overarching topics stayed the same quarter-to-quarter, we tried to vary the activities and the way that we delivered the information to the students. For example, during our lesson on cardiovascular health in one quarter, we brought in cadaveric organs such as the heart to demonstrate what arterial plaque feels and looks like; in another quarter, we had students do exercises while monitoring their heart rate, blood oxygen levels, and manual blood pressures to better help them understand cardiovascular exercise physiology.
Even after being involved for two quarters, it became obvious to me that these students wanted to be involved. They wanted to be active, eat more nutritious meals, and participate in our intervention. The students were motivated and interested in our topics, and the more kinetic and interactive we made our lessons, the more participation we earned. Furthermore, as these students became more engaged, they began to ask more questions about how they could incorporate these activities and learning points into their daily lives. At the end of each quarter, we consistently received feedback mentioning how we should offer more than four sessions. The principles that these students had learned in biology class were finally coming to life and were finally becoming relevant. We also started to notice that students were actively trying to change some of their habits. Some reported decreased weekly frequency of sweets, snacks, surgery drinks, and fast food; others reported a more dedicated attempt at reading nutrition labels prior to buying snacks, while some even brought labels in to review them as a group.
The short-term impact that we had on these students included increased motivation, more consideration to impacts on overall health, and improved nutritional label literacy. The impact that we had on administration was similarly beneficial, as they stayed motivated to keep us as a part of the class curriculum, integrating our sessions into their regular schedule. I can only hope that our impact can spark change within the school as a whole to engage the student body on a broader level.
The United States’ rise in diabetes and the global increase in obesity are significantly correlated with poor nutritional habits and lifestyle choices, emphasizing the need for an intervention amongst our youth. In the past few years, there has been an increased focus on introducing more nutrition and health literacy programs into secondary school education, both locally and abroad. Our efforts suggest that incorporating topics related to health and nutrition into high school education can positively influence one’s choices and behaviors regarding his/her health, at least in the short term. These results are consistent with similar interventions in India, Australia, China, Canada, and other parts of the United States. This congruence highlights the effectiveness of repeated interventions in improving lifestyle decisions, and these studies also suggest a reduced propensity to develop chronic conditions like diabetes, cardiovascular disease, or mental illness. Obesity and diabetes are on the rise in our country and healthcare costs associated with these conditions are skyrocketing without showing signs of slowing down; it is imperative that we, as a society, make an effort to intervene early on and educate children, adolescents and teenagers as best we can to help combat these crises at a foundational and developmentally influential stage in our lives.