Nutrition Screening

School Nutrition Education Program

The Department of Health and Senior Services administers a nutrition surveillance system involving Missouri school-age children. A sample letter is provided that the school may use to inform the parent/guardian of the nutrition screening. Approximately 15,000 students in participating schools are weighed and measured using the U.S. Centers for Disease Control and Prevention (CDC) protocols for accurate collection of weight and heights. From this information, a Body Mass Index (BMI) is calculated. This BMI is used to evaluate the child’s growth development by comparing the child’s BMI to age-based and gender-specific national norms. Access CDC’s BMI calculator here. The BMI-for-age is then plotted on the appropriate growth chart for girls or boys age 2-20. The following categories are used to determine risk:

Underweight – BMI-for-age < 5th percentile
Normal weight – BMI-for-age > 5th to < 85th percentile
At-risk for overweight – BMI-for-age > 85th to < 95th percentile
Overweight – BMI-for-age > 95th percentile

For a complete explanation of the new BMI measurement tool for children age 2-20, go to www.cdc.gov/growthcharts/. Online continuing medical education training is available for physicians and nurses until December 2004.

Students also complete a Food Frequency Questionnaire developed and copyrighted by Harvard University School of Public Health. Examples are found at the following sites:

Food Frequency Questionnaires NPE-1 Nutrition Questionnaire for Elementary and Middle Schools, pink
NPE-2 Nutrition Questionnaire for High School, green
NPE-1S Nutrition Questionnaire for Elementary and Middle Schools - Spanish, pink
NPE-2S Nutrition Questionnaire for High Schools - Spanish, green

Based on the answers given to questions of how often different foods are eaten, the student receives a printout of results with the number of servings of each food group consumed in a day, a percentage of key nutrients consumed daily, and the percentage of carbohydrate, fat, and protein consumed in a typical day. Daily activity levels are also assessed from questions about physical activity and TV viewing. Students review their individual results with the help of an interactive Power Point presentation "The Foods You Eat Each Day." This presentation incorporates concepts from curriculum frameworks used to meet the Show-Me Standards, focusing on behaviors and knowledge appropriate to students in grades 5-8 and 9-12 in the areas of personal and family health, and nutrition principles and practice.

A simple summary of FFQ results may also be shared with students on the forms "Your Food Intake Results" and "Your Physical Activity Results."

A sample letter is provided that the school may use to inform the parent/guardian of screening results. School nurses make appropriate referrals of students who are identified as at nutritional risk through the screening and use of protocol tools, <5th percentile or >95th percentile.

A summary report of school year 2001-2002 data collection is available. Public and non-public schools in Missouri will participate in a random sampling to achieve a representative sample in school year 2004-2005. Participating schools receive the benefits of the program, including school-specific data that can be used for grant writing or policy recommendations regarding the prevalence of at-risk for overweight and overweight, what children eat, and activity levels. Contact us if you are interested in finding out more about the nutrition screening program.