derstand 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 behavior choices related to obesity develop during school-age years, schools offer an opportunity to teach children improved eating, activity, and snacking habits (Carter, 2002).
Meerschaert (2002) reported that the National Center for Health Statistics stated that one in five children in the U.S. are now overweight. This increase in childhood obesity is explained by environmental factors such as nutritional and physical activity behaviors. Childhood behaviors set patterns for later nutritional and activity patterns, which can have long-term health effects (Dietz, Bland, Gortmaker, Molloy, & Schmid, 2002; Welk, 1999). Childhood obesity treatments are needed (Abbasi, 2001; Epstein, Myers, Raynor, & Saelens, 1998).
Ebbeling, Pawlak, and Ludwig (2002) pointed out that parental efforts to ensure nutrition may affect lifelong obesity risk, in them...