Methods:

This was a prospective study of sixth-grade students from 23 middle schools in 12 cities in southeast and mid-Michigan with varying populations. The students served as historical controls in this 10-week program. The educational component of the program was delivered through 10 interactive, 20-minute long learning modules addressing the following five goals: 1) increasing intake of fruits and vegetables, 2) decreasing intake of high-sugar beverages, 3) performing at least 150 minutes of exercise per week, 4) decreasing intake of fast and fatty food, and 5) decreasing “screen” time with television and computer/video games. Learning modules were taught by advisory (or “homeroom”) teachers or Health Ambassadors. Environmental change involved significant modifications in the school cafeteria (e.g., addition of a salad bar). Health behaviors were assessed before and after participation through responses on the modified School-Based Nutrition Monitoring behavioral questionnaire. The authors also collected physiologic data before the 10-week program and again 1-3 months after program completion, collected data included body mass index, systolic and diastolic blood pressures, cholesterol panel, and random blood glucose.