It's the takes-a-village question, applied to waistlines.
Around the world, children are being weighed and measured not just by their family doctors but by educators – and that information is being tallied alongside their grades on report cards. School nurses in such places as Arkansas, Malaysia and the United Kingdom have been measuring students' body mass index and sending home assessments of their risk for obesity.
Is that going too far? Is it really a school's role to make sure kids are physically healthy? Or is that solely the parents' responsibility?
When Arkansas legislated BMI recording in 2003, many parents were outraged. "There were those who felt like it led to kids being teased and embarrassed, and placed an unfair burden on school districts to conduct the screenings," said Seth Blomley, the communications director of the Arkansas Education Department. "Some felt that parents, not schools, should take the lead in making sure their kids were healthy."
There's no doubt about the need for some intervention: Fewer than 7 per cent of school-age Canadian children are getting the recommended amount of exercise – 60 minutes per day – and more than one in four is overweight or obese. But many argue that schools are overstepping their bounds in telling students when to exercise and what to eat, and that even the toughest school-based efforts, such as BMI on report cards, won't work if parents aren't on board.
"It's the school's responsibility to encourage healthy living, that's, after all, why we have physical education," said Doretta Wilson, executive director of the Society for Quality Education and a parent in Toronto. "But legislating what kids can eat in schools and measuring their BMI is starting to cross that line into the responsibility of parents."
Others say teachers should stick to teaching the core subjects only, especially given how important grades are to getting into postsecondary institutions, while still others are concerned about the increased costs of building gym facilities.
"Schools are there to teach knowledge … but ultimately the primary educator is the parent," said John Del Grande, a trustee with the Toronto Catholic District School Board.
Research has shown that parents are key. The biggest predictor of childhood obesity is an obese mother, and although there's less research on fathers, experts suspect a similar link, according to Geoff Ball, director of the Pediatric Centre For Weight and Health at the Stollery Children's Hospital in Edmonton.
The same applies to efforts to lose weight. "We know that if moms and dads can make healthy changes to their own life, it's going to trickle down and the kids are going to be able to make healthy changes, too," he said. "Parents need to be engaged."
Dr. Ball still believes that schools have an important role to play in promoting healthy lifestyles but that these kinds of approaches can be too one-size-fits-all. "Some kids may need more support, motivation and resources, which is where families and other community services can be complementary," he said.
Mr. Del Grande points to Ontario's new food and beverage policy as an example of schools overstepping their bounds. The new regulations have banned junk food – fries, sugary drinks, even coffee – from student cafeterias. Two Brampton high-school students posted a YouTube video, which went viral, targeting the food ban; by taking away their choice, the two students argue the government is not teaching them to make healthy decisions. And in any case, many students are opting to venture off school property to the local fast-food joint.
When Saskatoon special education teacher Allison Cameron took 20 minutes of Language Arts time and replaced it with exercise for her Grade 9 students, there was "some resistance from the school board that the program was taking too much curricular time." The results quieted naysayers: Writing scores were up 60 per cent and reading 23 per cent, compared with falling 13 per cent and increasing only 9 per cent for those who did not participate.
"In the U.S., there's a trend toward getting rid of gym time and putting such pressure on test scores," said Harvard Medical School psychiatrist John Ratey, who calls that a "very stupid" policy. His 2008 book Spark – which notes physical activity helps students perform academically better and reduces behavioural problems – has been wildly popular with educators across North America.
One of the biggest benefits reaped by Arkansas's BMI policy was that it dramatically raised parents' awareness about their children's health. Early reports indicated many parents were unable to identify healthy weights or were not concerned about obesity, but the latest report from 2009 show 90 per cent believe obesity is a serious problem. And while the national obesity rate has been rising in the U.S., in Arkansas the percentage of Grade 8 and 10 children who are obese has dropped incrementally, from 22.6 per cent in 2004 to 21.6 per cent in 2010.
In many instances, parents are simply too busy or unaware of the health benefits of exercise and healthy nutrition, says Catherine Parsonage, executive director of the Toronto Foundation for Student Success. She saw that in the hardscrabble Jane and Finch neighbourhood, where poverty rates and obesity rates are both high and parents often hold more than one job to make ends meet. The foundation provided breakfast for students in public schools, and tracked the results: Both academic performance and student behaviour improved. When asked if the schools should be responsible for feeding children breakfast, Ms. Parsonage said health-care agencies and parents ought to take the lead.
"Of course it's not the responsibility of schools," she said. "But we are the best delivery point, because by law you know this is where children are going to be. And that's why we have to take on a leadership role and show what's possible."
At James S. Bell Junior Middle School, where the Toronto District School Board will open a sports and wellness academy in the fall, every student is guaranteed at least 150 minutes of physical activity a week. Students are also treated to a hot lunch and a breakfast program.
"In our lunch buffet lines, for example, if a student doesn't have enough green veggies on their plate, they're sent right back to the back of the buffet line again," explained principal John Currie. "Now when you have a six-year-old telling you to not put so much salt in the meal, you know you're doing something right."
Interactive: Click here to explore the problems a generation of sedentary children has created for educators, check out some schools that are working on solutions and share your thoughts and stories.
What our readers have to say on the issue:
"It is the role of schools to educate. Give people the information and let them decide what to do and how to live their lives."
– male reader, 25 to 34, from British Columbia
"They took the junk food out of schools and now kids just go to McDonald's. The bulk of the responsibility must fall on parents."
– female reader, 35 to 44, Nova Scotia
"The school's job is to encourage a healthy lifestyle, but it's the parent's responsibility to ensure that lifestyle is put into place."
– male reader, under 25, from Quebec
"Kids need to be taught at a young age the importance of physical activity to their life. That's the only way to combat obesity."
– male reader, under 25, from Ontario
"Gym class needs to be more active. I remember sitting at a desk and learning the rules. Then we did some drills which didn't required any physical effort."
– female reader, under 25, from Manitoba
"It should not be the school's responsibility to create fit kids. Teachers already have enough to do."
– male reader, 35 to 44, from Alberta
"While I believe that health affects learning, we have to stop expecting schools to do everything and have parents take personal responsibility for their children."
– female reader, 35 to 44, from Saskatchewan
"As a newly retired teacher, I know that healthy kids learn better, but the school day has only so many hours. It takes a village."
– female reader, 55 to 64, from Newfoundland and Labrador