Participation in School Physical Education and Selected Dietary Patterns Among High School Students United States, 1991
I
nadequate physical activity and unhealthy dietary patterns - particularly diets high in fat and low in fruits, vegetables, and grains - established during youth may extend into adulthood and may increase risk for chronic diseases, such as coronary heart disease and cancer.’-’ This report examines the prevalence of selfreported enrollment, attendance, and participation in school physical education (PE) and examines selected dietary patterns among students in grades 9-12 from two school-based components of CDC’s Youth Risk Behavior Surveillance System:6 1) the national Youth Risk Behavior Survey, conducted during April-May 1991, and 2) individual state and local Youth Risk Behavior Surveys, conducted by departments of education in 23 states and 10 cities during the same time. The national survey used a three-state sample design to obtain a sample of 12,272 students representative of students in grades 9-12 in the 50 states and the District of Columbia. The 33 state and local sites drew probability samples from well-defined sampling frames of schools and students. Seventeen sites had adequate school- and student-response rates, which allowed computation of weighted results of known precision; 16 sites had overall response rates below 60% or unavailable documentation, which precluded making estimates of known precision. The school-responserate for the national survey was 75%, and the student-response rate was 90% (Table 1). For the state and local surveys, school-response rates ranged from 48% to 100%; student-response rates ranged from 44% to 96%. State and local sample sizes ranged from 369 to 5,834 students. Students in most Reported by: J. Moore, Alabama State Dept. of Education, J. Campana, San Diego Unified School District, M, Lam, San Francisco Un$ed School District, D. Sandau-Christopher, State of Colorado Dept. of Education, J. Sadler, District of Columbia Public Schools, D. Scalise, School Board of Broward County, N.Gay. School Board of Dade County, Florida, R. Stalvey, Georgia Dept. of Education, J . Schroeder, Hawaii Dept. of Education. J. Pelton, Idaho Dept. of Education, B. Johnson Biehr, Chicago Public Schools, J. Harris, Iowa Dept. of Education, N . Strunk, Boston Public Schools, R. Chiotti, Montana Office of Public Instruction. J. Owens-Nausler, Nebraska Dept. of Education, B. Grenert, New Hampshire State Dept. of Education, D. Chioda, Jersey City Dept. of Education, D. Cole, New Jersey State Dept. of Education, K . Meurer, New Mexico State Dept. of Education, G. Abelson, New York City Board of Education, A . Sheffield, New York State Education Dept., P. Ruzicka, Oregon Dept. of Education, C. Balsley, School District of Philadelphia, M . Sutler, Pennsylvania Dept. of Education, M. del Pilar Cherneco, Puerto Rico Dept. of Education, J . Fraser, South Carolina State Dept. of Education, M. Carr, South Dakota Dept. of Education and Cultural Affairs, E. Word, Tennessee State Dept. of Education, P . Simpson, Dallas Independent School District, L. Lacy, Utah State Office of Education, S. Tye, Government of the Virgin Islands, Dept. of Educalion, B. Nehls-Lowe, Wisconsin Dept. of Public Instruction, B. Anderson, Wyoming Dept. of Education, American Cancer Society, Atlanta, and the Division of Adolescent and School Health. National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control, 1600 Cliyton Road, NE. MS-33, Atlanta, G A 30333.
392
Journal of School Health
October 1992, Vol. 62, No. 8
-
samples were distributed evenly across grades and between genders. The ethnic characteristics of the samples varied. Students were asked “In an average week when you are in school, on how many days do you go to physical education (PE) classes?” and “During an average physical education (PE) class, how many minutes do you spend actually exercising or playing sports?” Enrollment in PE classes was defined as attending PE class at least one day in an average week. Students also were asked about foods they had consumed the day preceding the survey, including fruit; fruit juice; green salad; cooked vegetables; hamburgers, hot dogs, or sausage; french fries or potato chips; and cookies, doughnuts, pie, or cake. These foods were selected as typical of the diets of adolescents and were not intended to represent complete dietary histories. The total number of servings of fruit, fruit juice, green salad, and cooked vegetables was estimated by adding the number of servings of fruits and vegetables consumed during the day preceding the survey. Similarly, the total number of servings of foods typically high in fat was estimated by adding the number of servings of hamburger, hot dogs, or sausage; french fries or potato chips; and cookies, doughnuts, pie, or cake eaten during the day preceding the survey. Students who replied they had not consumed a particular type of food were assigned a frequency of 0; students who replied they had consumed a particular type of food “once only” were assigned a frequency of 1; and students who replied they had consumed a particular type of food “twice or more” were assigned a frequency of 2. Among state and local surveys, the percentage of students in grades 9-12 who participated in PE classes varied considerably (Table 2): 24% to 96% of students (median: 52%) reported being enrolled in PE classes; 2% to 74% (median: 35%) reported attending PE classes daily; and among students enrolled in PE class, 52% to 90% (median: 75%) reported spending more than 20 minutes exercising or playing sports during an average class. In most sites, more male than female students were enrolled in PE class, attended such classes daily, and spent more than 20 minutes exercising or playing sports during the average class. The national prevalence estimates were similar to the median prevalence estimates from the state and local surveys. Students’ dietary patterns (Table 3) varied less among the state and local surveys than did participation in PE classes: 8% to 18% of students (median: 13%) reported consuming five or more (range: 0-8) servings of fruit and vegetables during the day preceding the survey; and 57% to 83% (median: 69%) reported eating two or fewer (range: 0-6) servings of foods typically high in fat. In all sites, male students were more likely than female students to consume five or more servings of fruits and vegetables, but female students were more
likely than male students to eat two or fewer servings of foods typically high in fat. The national prevalence estimates were similar to the median prevalence estimates from state and local surveys. Editorial Note: The findings in this report are consistent with results from other recent national surveys that measured participation in school PE and selected dietary patterns among y o ~ t h . Because ~ , ~ the quality of the samples varied among the state and local surveys, data across sites may not be comparable. Nonetheless, these results can be useful in planning and evaluating broad national, state, and local interventions and in monitoring progress toward achieving the national health objectives for the year 2000.5 National health objectives 1.8 and 1.9 are to increase to at least 50% the proportion of children and adolescents in grades 1-12 who participate in daily school PE and to increase to at least 50% the proportion of school PE class time that students spend being physicdly
active.' At every site, among students enrolled in PE class, at least half reported exercising or playing sports for more than 20 minutes during an average PE class. However, at only six of the 33 sites did at least 50% of the students report daily attendance in PE class. National health objectives 2.5 and 2.6 are to reduce dietary fat intake among persons ages = 2 years and to increase complex carbohydrates and fiber-containing foods in the diets of adults.5 The American Cancer Society (ACS) has developed two similar goals specifically for high school students: to increase to 35% the proportion who daily consume five or more servings of fruits and vegetables and to increase to 80% the proportion who daily eat no more than two servings of selected foods typically high in fat.' None of the sites in this report have achieved the first ACS goal; only one site has achieved the second goal. Specific strategies to meet the national health objectiyes and ACS goals include implementing state and
Table 1 Size, Response Rates, and Demographic Characteristics of Samples, United States and Selected U.S. Sites, Youth Risk Behavior Surveys, 1991
Sample
Sib WelgMed Data NltloMl SIJNEy
size
Response rate (K) School Student Overall
Gender K Fernla M I
8
Demographlc chmcterlrtlc Gnde (96) Ethnlclty (X) 10 11 12 Whits. Black' Hlrpanlc
12,272
75
90
68
49
51
25
25
23
26
70
14
9
7
2,480 2,272 4,218 2,459 3.155 3.433 2,233 5.034 1.377 4,580
100 93 92 81 73 72 100 71 96 100
83 84 84 NA3 89 86 96 07 91 81
83 78 77 NA 65 62 96 62 87 81
50 50 46
29 31 28 26 28 27 29 31 28 28
26 26 26 26 28 26 28 26 26 26
23 22 24 24 22 24 24 22 24 24
22 20 22 23 19 24 20 21 23 22
72 65 88 87 26 81 12 60 85 86
24 29 1
1 1 4 2
48 50 52 49 49 50
50 50 54 50 52 50 48 51 51 50
36 1 1
4 69 1 1 5
2 5 7 5 38 7 14 3 14 7
1,558 3,343
92 100
72 80
66 80
51 51
49 49
33 26
30 48
20 17
16 9
7 14
58 51
27 30
8 6
1,308 369 2,155 1,573 658
100 100 100 100 100
80 74
55 51 50 54 49
45 49 50 46 51
30 37 28 37 28
28 25 27 26 27
22 18 23 20 25
20 19 22
56 5
NA 62
80 74 85 NA 62
20
12 23 47
26 44 28 57 12
11 40 53 10 17
8 11 6 10 24
1.170
65
83
54
48
52
27
26
23
24
80
2
12
6
1,525 4.822 1,773 2,549 1,928 2,092 2,005 2,217 2,469 1,506 1,440 3,513
94 95 64 63 67 54 60 52 48 89 59 70
60 81 89 80 66 91 80 86 84 65 90 82
56 77 57 50 44 49 48 45 40 58 53 57
50 50 50 52 49 52 48 47 51 52 50 47
50 50 50 48 51 48 52 53 49 48 50 53
5 30 27 35 27 26 25 26 24 26 26 28
33 26 29 22 26 28 26 25 33 17 33 26
35 24 24 20 26 26 25 24 23 22 23 25
26 21 19 21 21 20 24 24 20 13 18 20
4 16 94 85 94 63 86 91 89 2 85 86
84 2 1 1 1 15 3 4 8 82 8 2
7 4 1 2 1 14 3 2 1 6 3 6
6 78 4 13 4 8 8 3 3 9 4 6
2.108 1,033 1,984
100 100 100
52 65 44
52 65 44
55 51 52
45 49 48
26 13 24
24 27 33
25 29 25
24 30 17
15 30 12
48 22 12
11 31 17
26 18 59
Stab SUNWS Alabama Georgia Idaho Nebraska New Mexico New Vork' Puerto AICO' South Carolina South Dakota Utah
50
Local surveys Chicago Dallas Ft Lauderdale. Fla Jersey City N J Miami Philadelphia San Oiego
Other
05
18
5 2 8
5
34
UnwelgMed Data
Sbb Sumyr Colorado' District of Columbia* Hawaii Iowa Montana New Hampshire New Jersey' Oregon Pennsylvania' Tennessee Virgin Island' Wisconsin Wyoming
LMI SUN@yS Boston New Yolk City San Francisco
'NOn-HiSpanIC. 'Surveys did not include students from the largest city 2Categorizedas a state for funding purposes. "of available because of lack of documentation.
Journal of School Health
October 1992, Vol. 62, NO. 6
393
Table 2 Percentage of High School Students Enrolled in Physical Education Classes, Who Attended Such a Class Daily, and Who Exercised or Hayed SporIs More than 20 Minutes During the Average Class, by Gender, United States and Selected U.S. Sltes, Youth Risk Behavior Surveys, 1991 site
Exerclsed > 20 mln. Enrolled In PE AHonded dilly per ckss Females Mobs Total Femaks Males Total Fenules Males Total
Weighted Dab National s u ~ e y
45
53
49 37
46
42 75
85
81
slate surveys Alabama Georgia Idaho Nebraska New Mexico New York' Puerlo Ricol South Carolina South Dakota Utah
40 31 38 38 43 96 24 34 22 56
63 50 52
55 53 96 30 43 26 66
52 40 46 47 48 96 27 38 24 61
36 28 35 28 39 4 18 32 14 34
55 43 45 41 47 4 21 37 17 41
46 35 40 34 43 4 20 34 15 37
71 74 85 70 76 62 49 72 76 80
84 85 89 81 84 76 66 79 90 87
79 81 87 76 80 69 58 76 84 83
89 32
87 47
88 77 39 28
70 38
74 65 33 61
70 73
67 68
32 80 47 70 59
51 76 55 73 76
40 78 51 72 67
41 56 49 52 62
32 62 45 41
81 61 75 62 92
77 52 70 60 90
Local SUN8VS Chicago Dallas Ft. Lauderdale. Fla. Jersey City, N.J Miami Philadelphia San Olego
25 68 40 34 49
72 44 63 59 55 88
Unwelghted Data slate surveys Colorado' District of Columbia' Hawaii Iowa Montana New Hampshire New Jersey' Oregon Pennsylvania Tennessee Virgin Islands' Wisconsin Wyoming LOCd 8UNOVS Boston New Yolk City San Francisco
41
53
47 31
40
36 80
88
84
33 37 94 58 46
43 50 96 65 51
14 9 1 44 13
17 14 2 51 17
15 12 2 47 15
64 76 70 80 73
62 79 78 85 78
63 78 74 82 75
NA'
NA
NA
NA
NA NA
NA
NA
41
95 31 76 69 52
55 95 40 77 73 63
38 44 95 62 48 NA 48 95 35 76 71 58
36 8 27 50 27 48
49 11 35 50 28 57
43 9 31 50 28 53
81 69 72 70 70 81
86 78 81 71 79 87
84 74 77 70 74
76 82 50
84 84 60
79 5 83 55 54 44
9 58 51
7 41 57 63 47 67
63 74 80
52 68 74
-
84
-
'Surveys did not include students from the largest city. 'Categorized as a state for funding purposes. %Notavailable; survey did not include these questions.
school district policies requiring comprehensive school health education programs that include nutrition education and daily attendance in PE c l a s ~ e s To . ~ carry out these and other important strategies, coordinated efforts are needed from federal, state and local education and health agencies, voluntary health organizations, families, media, community organizations, and youth themselves. Reference 1 . Powell KE, Caspersen CJ, Koplan JP, Ford ES. Physical activity and chronic disease. Amer J Clin Nutr. 1989;49:999-1006. 2. Paffenbarger RS Jr, Hyde RT, Wing AL, Hsieh CC. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 1986;314:605-613. 3 . The Surgeon General's Report on Nutrition and Health, US Dept of Health and Human Services publication no (PHS) 91-50212. Washington, DC: US Dept of Health and Human Services; 1991. 4. National Research Council. Diet and Health: Implications for reducing chronic disease risk. Washington, DC: National Academy
394
Journal of School Health
October 1992. Vol. 62, No. 8
Table 3 Percentage of High School Students Who Consumed Five or More Servings of Frults and Vegetables and No More Than Two Servings of Foods Typically High in Fat* the Day Preceding the Survey, By Gender, United States and Selected U.S. Sites, Youth Risk Behavior Surveys, 1991 Sb WelgMed Date Natlonal SUNOV slate surveys Alabama Georgia Idaho Nebraska New Mexico New York3 Puerto Rico" Soulh Carollna South Dakota Utah
Local surveys Chicago Dallas Fl. Lauderdale, Fla. Jersey City, N.J. Miami Philadelphia San Diego UnwelgMed Data state survey Colorado' District of Columbia' Hawaii Iowa Montana New Hampshire New Jersey5 Oregon Pennsylvania3 Tennessee Virgin Islands' Wisconsin Wyoming Local surveys Boston New York City San Francisco
Frulls and vegetables' Females Male8 Total
Foods typlctlly hlgh In fata FenuIes Maka Total
57
65
10
15
13
6 13 10 11 9 12 8 11 14
12 17 17 17 13 17 15 13 16 18
9 15 14 14 11 15 11 10 14 16
69 72 76 66 76 77 79 66 66 78
56 60 60 50 62 61 76 52 51
7 7 10 8 7 11 12
10 10 18 11 12 10 16
9 8 14 9 9 10 14
63 70 79 72 76 72 76
53 58 67 79 68 62 65
15 11 14 10 13 16
16 12 22 20 19 18
16 11 18 15 16 17
NA' NA
NA NA
57 62 63 45 57 60 71
64 69 69 57 66 70 76
NA
NA
NA
15 10 10 10 11
21 14 13 12 16
NA NA 18
72 75 74 70 74 80 80
12 12 11 14
76 67 83 70 71
63 51 82 53 52
69 59 83 62 61
11 12 17
13 16 19
13 14 18
80 82 80
73 70 73
77 76 77
a
73
62
63 66 67 58 68 69 78 59 58 70 58 64
74 71 72 68 70
'Students who replied that they did not consume a particular fype of food were assigned a frequency of 0;students who replied that they consumed a particular fype of food "once only" were assigned a frequency of 1 ; and students who replied that they consumed a particular type of food "twice or more" were assigned a frequency of 2. The number of servings of fruits and vegetables ranged from 0 through 8. The number of servings of foods typically high in fat ranged from 0 through 6. 'Fruit, fruit juice. green salad, and cooked vegetables. 'Hamburger, hot dogs, or sausage; french fries or polato chips; and cookies, doughnuts, pie, or cake. 3Surveysdid not include students from the largest cify. 'Categorizes as a state for funding purposes. *Not available; survey did not include these questions.
Press; 1989. 5 . Healthy People 2000: National health promotion and disease prevention objectives - full report, with commentary, US Dept of Health and Human Services publication no (PHS) 91-50212. Washington, DC: US Dept of Health and Human Services; 1991. 6. Kolbe LJ. An epidemiological surveillance system to monitor the prevalence of youth behaviors that most affect health. Health Educ. 1990,21:44-48. 7. Participation of high school students in school physical education - United States, 1990. MMWR. 1991;40:607,613-615. 8. American School Health Association, Association for the Advancement of Health Education, Society for Public Health Education. The National Adolescent Student Health Survey. Oakland, Calif: Third Party Publishing; 1989. 9. Report of the Planning Advisory Council. Atlanta, Ga: American Cancer Society; 1990.
I
nadequate physical activity and unhealthy dietary patterns - particularly diets high in fat and low in fruits, vegetables, and grains - established during youth may extend into adulthood and may increase risk for chronic diseases, such as coronary heart disease and cancer.’-’ This report examines the prevalence of selfreported enrollment, attendance, and participation in school physical education (PE) and examines selected dietary patterns among students in grades 9-12 from two school-based components of CDC’s Youth Risk Behavior Surveillance System:6 1) the national Youth Risk Behavior Survey, conducted during April-May 1991, and 2) individual state and local Youth Risk Behavior Surveys, conducted by departments of education in 23 states and 10 cities during the same time. The national survey used a three-state sample design to obtain a sample of 12,272 students representative of students in grades 9-12 in the 50 states and the District of Columbia. The 33 state and local sites drew probability samples from well-defined sampling frames of schools and students. Seventeen sites had adequate school- and student-response rates, which allowed computation of weighted results of known precision; 16 sites had overall response rates below 60% or unavailable documentation, which precluded making estimates of known precision. The school-responserate for the national survey was 75%, and the student-response rate was 90% (Table 1). For the state and local surveys, school-response rates ranged from 48% to 100%; student-response rates ranged from 44% to 96%. State and local sample sizes ranged from 369 to 5,834 students. Students in most Reported by: J. Moore, Alabama State Dept. of Education, J. Campana, San Diego Unified School District, M, Lam, San Francisco Un$ed School District, D. Sandau-Christopher, State of Colorado Dept. of Education, J. Sadler, District of Columbia Public Schools, D. Scalise, School Board of Broward County, N.Gay. School Board of Dade County, Florida, R. Stalvey, Georgia Dept. of Education, J . Schroeder, Hawaii Dept. of Education. J. Pelton, Idaho Dept. of Education, B. Johnson Biehr, Chicago Public Schools, J. Harris, Iowa Dept. of Education, N . Strunk, Boston Public Schools, R. Chiotti, Montana Office of Public Instruction. J. Owens-Nausler, Nebraska Dept. of Education, B. Grenert, New Hampshire State Dept. of Education, D. Chioda, Jersey City Dept. of Education, D. Cole, New Jersey State Dept. of Education, K . Meurer, New Mexico State Dept. of Education, G. Abelson, New York City Board of Education, A . Sheffield, New York State Education Dept., P. Ruzicka, Oregon Dept. of Education, C. Balsley, School District of Philadelphia, M . Sutler, Pennsylvania Dept. of Education, M. del Pilar Cherneco, Puerto Rico Dept. of Education, J . Fraser, South Carolina State Dept. of Education, M. Carr, South Dakota Dept. of Education and Cultural Affairs, E. Word, Tennessee State Dept. of Education, P . Simpson, Dallas Independent School District, L. Lacy, Utah State Office of Education, S. Tye, Government of the Virgin Islands, Dept. of Educalion, B. Nehls-Lowe, Wisconsin Dept. of Public Instruction, B. Anderson, Wyoming Dept. of Education, American Cancer Society, Atlanta, and the Division of Adolescent and School Health. National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control, 1600 Cliyton Road, NE. MS-33, Atlanta, G A 30333.
392
Journal of School Health
October 1992, Vol. 62, No. 8
-
samples were distributed evenly across grades and between genders. The ethnic characteristics of the samples varied. Students were asked “In an average week when you are in school, on how many days do you go to physical education (PE) classes?” and “During an average physical education (PE) class, how many minutes do you spend actually exercising or playing sports?” Enrollment in PE classes was defined as attending PE class at least one day in an average week. Students also were asked about foods they had consumed the day preceding the survey, including fruit; fruit juice; green salad; cooked vegetables; hamburgers, hot dogs, or sausage; french fries or potato chips; and cookies, doughnuts, pie, or cake. These foods were selected as typical of the diets of adolescents and were not intended to represent complete dietary histories. The total number of servings of fruit, fruit juice, green salad, and cooked vegetables was estimated by adding the number of servings of fruits and vegetables consumed during the day preceding the survey. Similarly, the total number of servings of foods typically high in fat was estimated by adding the number of servings of hamburger, hot dogs, or sausage; french fries or potato chips; and cookies, doughnuts, pie, or cake eaten during the day preceding the survey. Students who replied they had not consumed a particular type of food were assigned a frequency of 0; students who replied they had consumed a particular type of food “once only” were assigned a frequency of 1; and students who replied they had consumed a particular type of food “twice or more” were assigned a frequency of 2. Among state and local surveys, the percentage of students in grades 9-12 who participated in PE classes varied considerably (Table 2): 24% to 96% of students (median: 52%) reported being enrolled in PE classes; 2% to 74% (median: 35%) reported attending PE classes daily; and among students enrolled in PE class, 52% to 90% (median: 75%) reported spending more than 20 minutes exercising or playing sports during an average class. In most sites, more male than female students were enrolled in PE class, attended such classes daily, and spent more than 20 minutes exercising or playing sports during the average class. The national prevalence estimates were similar to the median prevalence estimates from the state and local surveys. Students’ dietary patterns (Table 3) varied less among the state and local surveys than did participation in PE classes: 8% to 18% of students (median: 13%) reported consuming five or more (range: 0-8) servings of fruit and vegetables during the day preceding the survey; and 57% to 83% (median: 69%) reported eating two or fewer (range: 0-6) servings of foods typically high in fat. In all sites, male students were more likely than female students to consume five or more servings of fruits and vegetables, but female students were more
likely than male students to eat two or fewer servings of foods typically high in fat. The national prevalence estimates were similar to the median prevalence estimates from state and local surveys. Editorial Note: The findings in this report are consistent with results from other recent national surveys that measured participation in school PE and selected dietary patterns among y o ~ t h . Because ~ , ~ the quality of the samples varied among the state and local surveys, data across sites may not be comparable. Nonetheless, these results can be useful in planning and evaluating broad national, state, and local interventions and in monitoring progress toward achieving the national health objectives for the year 2000.5 National health objectives 1.8 and 1.9 are to increase to at least 50% the proportion of children and adolescents in grades 1-12 who participate in daily school PE and to increase to at least 50% the proportion of school PE class time that students spend being physicdly
active.' At every site, among students enrolled in PE class, at least half reported exercising or playing sports for more than 20 minutes during an average PE class. However, at only six of the 33 sites did at least 50% of the students report daily attendance in PE class. National health objectives 2.5 and 2.6 are to reduce dietary fat intake among persons ages = 2 years and to increase complex carbohydrates and fiber-containing foods in the diets of adults.5 The American Cancer Society (ACS) has developed two similar goals specifically for high school students: to increase to 35% the proportion who daily consume five or more servings of fruits and vegetables and to increase to 80% the proportion who daily eat no more than two servings of selected foods typically high in fat.' None of the sites in this report have achieved the first ACS goal; only one site has achieved the second goal. Specific strategies to meet the national health objectiyes and ACS goals include implementing state and
Table 1 Size, Response Rates, and Demographic Characteristics of Samples, United States and Selected U.S. Sites, Youth Risk Behavior Surveys, 1991
Sample
Sib WelgMed Data NltloMl SIJNEy
size
Response rate (K) School Student Overall
Gender K Fernla M I
8
Demographlc chmcterlrtlc Gnde (96) Ethnlclty (X) 10 11 12 Whits. Black' Hlrpanlc
12,272
75
90
68
49
51
25
25
23
26
70
14
9
7
2,480 2,272 4,218 2,459 3.155 3.433 2,233 5.034 1.377 4,580
100 93 92 81 73 72 100 71 96 100
83 84 84 NA3 89 86 96 07 91 81
83 78 77 NA 65 62 96 62 87 81
50 50 46
29 31 28 26 28 27 29 31 28 28
26 26 26 26 28 26 28 26 26 26
23 22 24 24 22 24 24 22 24 24
22 20 22 23 19 24 20 21 23 22
72 65 88 87 26 81 12 60 85 86
24 29 1
1 1 4 2
48 50 52 49 49 50
50 50 54 50 52 50 48 51 51 50
36 1 1
4 69 1 1 5
2 5 7 5 38 7 14 3 14 7
1,558 3,343
92 100
72 80
66 80
51 51
49 49
33 26
30 48
20 17
16 9
7 14
58 51
27 30
8 6
1,308 369 2,155 1,573 658
100 100 100 100 100
80 74
55 51 50 54 49
45 49 50 46 51
30 37 28 37 28
28 25 27 26 27
22 18 23 20 25
20 19 22
56 5
NA 62
80 74 85 NA 62
20
12 23 47
26 44 28 57 12
11 40 53 10 17
8 11 6 10 24
1.170
65
83
54
48
52
27
26
23
24
80
2
12
6
1,525 4.822 1,773 2,549 1,928 2,092 2,005 2,217 2,469 1,506 1,440 3,513
94 95 64 63 67 54 60 52 48 89 59 70
60 81 89 80 66 91 80 86 84 65 90 82
56 77 57 50 44 49 48 45 40 58 53 57
50 50 50 52 49 52 48 47 51 52 50 47
50 50 50 48 51 48 52 53 49 48 50 53
5 30 27 35 27 26 25 26 24 26 26 28
33 26 29 22 26 28 26 25 33 17 33 26
35 24 24 20 26 26 25 24 23 22 23 25
26 21 19 21 21 20 24 24 20 13 18 20
4 16 94 85 94 63 86 91 89 2 85 86
84 2 1 1 1 15 3 4 8 82 8 2
7 4 1 2 1 14 3 2 1 6 3 6
6 78 4 13 4 8 8 3 3 9 4 6
2.108 1,033 1,984
100 100 100
52 65 44
52 65 44
55 51 52
45 49 48
26 13 24
24 27 33
25 29 25
24 30 17
15 30 12
48 22 12
11 31 17
26 18 59
Stab SUNWS Alabama Georgia Idaho Nebraska New Mexico New Vork' Puerto AICO' South Carolina South Dakota Utah
50
Local surveys Chicago Dallas Ft Lauderdale. Fla Jersey City N J Miami Philadelphia San Oiego
Other
05
18
5 2 8
5
34
UnwelgMed Data
Sbb Sumyr Colorado' District of Columbia* Hawaii Iowa Montana New Hampshire New Jersey' Oregon Pennsylvania' Tennessee Virgin Island' Wisconsin Wyoming
LMI SUN@yS Boston New Yolk City San Francisco
'NOn-HiSpanIC. 'Surveys did not include students from the largest city 2Categorizedas a state for funding purposes. "of available because of lack of documentation.
Journal of School Health
October 1992, Vol. 62, NO. 6
393
Table 2 Percentage of High School Students Enrolled in Physical Education Classes, Who Attended Such a Class Daily, and Who Exercised or Hayed SporIs More than 20 Minutes During the Average Class, by Gender, United States and Selected U.S. Sltes, Youth Risk Behavior Surveys, 1991 site
Exerclsed > 20 mln. Enrolled In PE AHonded dilly per ckss Females Mobs Total Femaks Males Total Fenules Males Total
Weighted Dab National s u ~ e y
45
53
49 37
46
42 75
85
81
slate surveys Alabama Georgia Idaho Nebraska New Mexico New York' Puerlo Ricol South Carolina South Dakota Utah
40 31 38 38 43 96 24 34 22 56
63 50 52
55 53 96 30 43 26 66
52 40 46 47 48 96 27 38 24 61
36 28 35 28 39 4 18 32 14 34
55 43 45 41 47 4 21 37 17 41
46 35 40 34 43 4 20 34 15 37
71 74 85 70 76 62 49 72 76 80
84 85 89 81 84 76 66 79 90 87
79 81 87 76 80 69 58 76 84 83
89 32
87 47
88 77 39 28
70 38
74 65 33 61
70 73
67 68
32 80 47 70 59
51 76 55 73 76
40 78 51 72 67
41 56 49 52 62
32 62 45 41
81 61 75 62 92
77 52 70 60 90
Local SUN8VS Chicago Dallas Ft. Lauderdale. Fla. Jersey City, N.J Miami Philadelphia San Olego
25 68 40 34 49
72 44 63 59 55 88
Unwelghted Data slate surveys Colorado' District of Columbia' Hawaii Iowa Montana New Hampshire New Jersey' Oregon Pennsylvania Tennessee Virgin Islands' Wisconsin Wyoming LOCd 8UNOVS Boston New Yolk City San Francisco
41
53
47 31
40
36 80
88
84
33 37 94 58 46
43 50 96 65 51
14 9 1 44 13
17 14 2 51 17
15 12 2 47 15
64 76 70 80 73
62 79 78 85 78
63 78 74 82 75
NA'
NA
NA
NA
NA NA
NA
NA
41
95 31 76 69 52
55 95 40 77 73 63
38 44 95 62 48 NA 48 95 35 76 71 58
36 8 27 50 27 48
49 11 35 50 28 57
43 9 31 50 28 53
81 69 72 70 70 81
86 78 81 71 79 87
84 74 77 70 74
76 82 50
84 84 60
79 5 83 55 54 44
9 58 51
7 41 57 63 47 67
63 74 80
52 68 74
-
84
-
'Surveys did not include students from the largest city. 'Categorized as a state for funding purposes. %Notavailable; survey did not include these questions.
school district policies requiring comprehensive school health education programs that include nutrition education and daily attendance in PE c l a s ~ e s To . ~ carry out these and other important strategies, coordinated efforts are needed from federal, state and local education and health agencies, voluntary health organizations, families, media, community organizations, and youth themselves. Reference 1 . Powell KE, Caspersen CJ, Koplan JP, Ford ES. Physical activity and chronic disease. Amer J Clin Nutr. 1989;49:999-1006. 2. Paffenbarger RS Jr, Hyde RT, Wing AL, Hsieh CC. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 1986;314:605-613. 3 . The Surgeon General's Report on Nutrition and Health, US Dept of Health and Human Services publication no (PHS) 91-50212. Washington, DC: US Dept of Health and Human Services; 1991. 4. National Research Council. Diet and Health: Implications for reducing chronic disease risk. Washington, DC: National Academy
394
Journal of School Health
October 1992. Vol. 62, No. 8
Table 3 Percentage of High School Students Who Consumed Five or More Servings of Frults and Vegetables and No More Than Two Servings of Foods Typically High in Fat* the Day Preceding the Survey, By Gender, United States and Selected U.S. Sites, Youth Risk Behavior Surveys, 1991 Sb WelgMed Date Natlonal SUNOV slate surveys Alabama Georgia Idaho Nebraska New Mexico New York3 Puerto Rico" Soulh Carollna South Dakota Utah
Local surveys Chicago Dallas Fl. Lauderdale, Fla. Jersey City, N.J. Miami Philadelphia San Diego UnwelgMed Data state survey Colorado' District of Columbia' Hawaii Iowa Montana New Hampshire New Jersey5 Oregon Pennsylvania3 Tennessee Virgin Islands' Wisconsin Wyoming Local surveys Boston New York City San Francisco
Frulls and vegetables' Females Male8 Total
Foods typlctlly hlgh In fata FenuIes Maka Total
57
65
10
15
13
6 13 10 11 9 12 8 11 14
12 17 17 17 13 17 15 13 16 18
9 15 14 14 11 15 11 10 14 16
69 72 76 66 76 77 79 66 66 78
56 60 60 50 62 61 76 52 51
7 7 10 8 7 11 12
10 10 18 11 12 10 16
9 8 14 9 9 10 14
63 70 79 72 76 72 76
53 58 67 79 68 62 65
15 11 14 10 13 16
16 12 22 20 19 18
16 11 18 15 16 17
NA' NA
NA NA
57 62 63 45 57 60 71
64 69 69 57 66 70 76
NA
NA
NA
15 10 10 10 11
21 14 13 12 16
NA NA 18
72 75 74 70 74 80 80
12 12 11 14
76 67 83 70 71
63 51 82 53 52
69 59 83 62 61
11 12 17
13 16 19
13 14 18
80 82 80
73 70 73
77 76 77
a
73
62
63 66 67 58 68 69 78 59 58 70 58 64
74 71 72 68 70
'Students who replied that they did not consume a particular fype of food were assigned a frequency of 0;students who replied that they consumed a particular fype of food "once only" were assigned a frequency of 1 ; and students who replied that they consumed a particular type of food "twice or more" were assigned a frequency of 2. The number of servings of fruits and vegetables ranged from 0 through 8. The number of servings of foods typically high in fat ranged from 0 through 6. 'Fruit, fruit juice. green salad, and cooked vegetables. 'Hamburger, hot dogs, or sausage; french fries or polato chips; and cookies, doughnuts, pie, or cake. 3Surveysdid not include students from the largest cify. 'Categorizes as a state for funding purposes. *Not available; survey did not include these questions.
Press; 1989. 5 . Healthy People 2000: National health promotion and disease prevention objectives - full report, with commentary, US Dept of Health and Human Services publication no (PHS) 91-50212. Washington, DC: US Dept of Health and Human Services; 1991. 6. Kolbe LJ. An epidemiological surveillance system to monitor the prevalence of youth behaviors that most affect health. Health Educ. 1990,21:44-48. 7. Participation of high school students in school physical education - United States, 1990. MMWR. 1991;40:607,613-615. 8. American School Health Association, Association for the Advancement of Health Education, Society for Public Health Education. The National Adolescent Student Health Survey. Oakland, Calif: Third Party Publishing; 1989. 9. Report of the Planning Advisory Council. Atlanta, Ga: American Cancer Society; 1990.
