et and exercise. Obese children may also have lower self concepts; self-esteem is predictive of adult obesity (Matz, Foster, Faith, & Wadden, 2002).
Childhood obesity is increasing and threatens to become a serious health problem for large numbers of children (Dietz, Bland, Gortmaker, Molloy, & Schmid, 2002). The National Association for the Education of Young Children (2003) reports that early experiences impact future eating habits and childhood health. Poor diet is associated with chronic diseases, including heart disease, high blood pressure, and diabetes. The food pyramid states that a healthy diet includes multiple servings of grains, fruits, and vegetables each day and a limited intake of saturated fat, cholesterol, sodium, and sugar. Teaching good eating habits leads to building self-esteem. Learning activities that help children understand food groups and nutritional value allow for the learning of healthy information in a creative way (National Association for the Education of Young Children, 2003). In addition to a healthy diet, children require regular exercise. Pascual and Waters, (2003) reported that in a recent U.S. Surgeon General's Report on Physical Activity and Health, findings were that half of all children ages 12 to 21 years, were not physically active regularity and enrollment in physical education classes has dropped 41% in high school students in the last five years (Pascual & Waters, 2003).
Since obesity in children is becoming a growing concern, it is important to determine whether teaching children better habits in a school environment would improve eating and activity behaviors, as well as self-esteem. Current studies lack good quality evidence on intervention effectiveness with small trials, high dropout rates, poor reporting, and mixed results (Mayor, 2002), indicating a need for research on treatment of childhood obesity. Since children spend a large amount of their day at school and beh...