Daily physical activity supports youth physical and phychosocial health and is also important for obesity prevention. Schools are an important location for physical activity promotion and obesity prevention given youth spend up to half of their waking hours in school. The latest study from Nutrition Policy Institute (NPI) researchers suggests that United States Department of Agriculture (USDA) Supplemental Nutrition Assistance Program Education (SNAP-Ed, and known asCalFresh Healthy Living (CFHL) in California) physical activity interventions at school-sites are associated with slightly lower body mass index (BMI) and greater cardiovascular fitness in students compared to sites that did not receive these interventions. Further, schools with higher intervention levels had students with the highest cardiovascular fitness levels. Interventions included physical activity-related direct education, where students were actively engaged with an educator; indirect education, where students received information or resources related to physical activity; or changes to the school or district's physical activity related policies, systems, and/or environments (PSE). Student-level FitnessGram(R) data from between 2015-2016 was obtained from the California Department of Education for the study. Researchers compared BMI and student cardiovascular fitness levels from over 97,000 fifth and seventh grade students from 904 California public schools that implemented the SNAP-Ed physical activity interventions to over 372,000 fifth and seventh grade students from 3,506 California public schools that did not implement the interventions. These findings are important as the California Department of Public Health's Nutrition Education and Obesity Prevention Branch distributes over $50 million in CFHL funding to local health departments to implement physical activity and nutrition interventions, which primarily occur in the public school setting. Also, California has more public schools than any other US state. The study was published online in the journal Preventive Medicine Reports. The study was conducted by NPI's Hannah Thompson, Sridharshi Hewawitharana, Janice Kao, Carolyn Rider, Evan Talmage, Wendi Gosliner and Gail Woodward-Lopez in collaboration with Lauren Whetstone of the California Department of Public Health. The study was funded by the California Department of Public Health, with funding from the USDA Supplemental Nutrition Assistance Program. The full study is available online.

Plain water is recommended to replace sugar-sweetened beverages to support health, yet concerns about tap water safety and barriers to access present challenges to making water the beverage of choice. In a new article, Nutrition Policy Institute (NPI) researchers and collaborators review evidence through a socioecological lens – considering the complex web of individual, relationship, community, and societal factors that influence water consumption. The paper reviews intake of drinking water in the US compared to requirements across age and racial/ethnic groups showing that most people do not drink enough plain water. It describes US regulations that support safe drinking water as well as strategies to reduce drinking water exposure to lead. Programs, policies, and environmental interventions that support access to safe and appealing drinking water, which is necessary to improve water intake, are also discussed, concluding with recommendations for research, policies, regulations, and practices needed to ensure optimal water intake by all. The review was published online in September 2020 by the journal Annual Review of Nutrition. Authors include Anisha Patel of Stanford Medicine Division of General Pediatrics, NPI researchers Christina Hecht and Lorrene Ritchie, Angie Cradock of Harvard T.H. Chan School of Public Health, and Marc Edwards of Virginia Polytechnic Institute and State University.

Behavioral health disorders, such as depression and anxiety, affect a significant number of Americans each year. In 2017 one in eight youths between 12 to 17 years old experienced a major depressive episode compared to one in 14 adults. Approximately one in three people in the US have experienced an anxiety disorder in their lifetimes, with women experiencing anxiety at rates two times that of men. Further, rates of these illness have increased since the coronavirus pandemic came to the US. Poor diet quality has been implicated with the development of depression, anxiety and other psychiatric conditions given the essential role of key dietary nutrients in the body's nervous and hormone systems. Nutrients naturally found in food and beverages--such as tryptophan, vitamin B6, vitamin B12, folate, phenylalanine, tyrosine, histidine, choline, and glutamic acid--are critical for the production of the key neurotransmitters--serotonin, dopamine, and norepinephrine--involved in the regulation of mood, appetite and cognition. Therefore, improving diet quality may contribute to the prevention and treatment of these illnesses.

Nutrition Policy Institute (NPI) researcher Gail Woodward-Lopez contributed to a collaborative narrative review that describes the global burden and features of depression and anxiety and summarizes the latest scientific evidence on diet and nutrition in the prevention and management of these illnesses. The review concludes with a call for nutritional medicine to be incorporated into psychiatric practice to support individuals in achieving a healthy dietary pattern, one rich in fruits, vegetables, whole grains, low-fat dairy, and lean protein foods. It further recommends additional research be conducted to better understand how diet affects behavioral health disorders. The review was published online in the journal Nutrition Reviews on May 24, 2020. The study was conducted in collaboration with Penny Kris-Etherthon and Kristina Petersen of the Pennsylvania State University, Department of Nutritional Sciences; Joseph Hibbeln of the National Institute of Health, National Institute on Alcohol Abuse and Alcoholism; Daniel Hurley of the Mayo Clinic; Valerie Kolick of the US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; Sevetra Peoples of the George Washington University, Milken Institute School of Public Health; and Nancy Rodriguez of the University of Connecticut, Department of Nutritional Sciences. The study was conducted as a project of the President's Council on Fitness, Sports & Nutrition Science Board, of which NPI's Woodward-Lopez was a member. The study is available online. 

Schools across the nation are instituting new policies to remove chocolate milk from their meal programs in an effort to reduce students' added sugar intake. These efforts have some stakeholders concerned that this policy may lead to a decrease in students' milk consumption--specifically the essential nutrients that milk provides such as calcium, protein and vitamin D--and may also lead to an increase in milk waste. However, the latest study from the Nutrition Policy Institute shows promising results that may alleviate these concerns. The study found that although the number of students that selected milk during lunch dropped by about 14% in the year the chocolate milk removal policy was implemented, there was no significant difference in the proportion of milk wasted before and after policy implementation. Further, although milk consumption declined by about 1 ounce per student post policy implementation, there was no significant decrease in the average amount of calcium, protein, or vitamin D consumed from milk. Finally, the chocolate milk removal policy did result in a significant reduction in added sugar consumption from milk, by an average of 3.1 grams per student. These results suggest that a school meal chocolate milk removal policy may reduce middle and high school students' added sugar intake without compromising intake of essential nutrients nor increasing milk waste. The study was conducted by NPI affiliated researchers Hannah Thompson and Esther Park from the UC Berkeley School of Public Health in collaboration with NPI researchers Lorrene Ritchie and Wendi Gosliner, and Kristine Madsen from the Berkeley Food Institute and UC Berkeley School of Public Health. The study was published online on August 27, 2020 in the journal Preventing Chronic Disease. The full study is available online.