School Health Guidelines

CDC integrated research and best practices related to promoting healthy eating and physical activity in schools, culminating in the School Health Guidelines. There are 9 School Health Guidelines that serve as the foundation for developing, implementing, and evaluating school-based healthy eating and physical activity policies and practices for students.

School Health Guidelines At a Glance

Use a Coordinated Approach to Develop, Implement, and Evaluate Healthy Eating and Physical Activity Policies and Practices

Representatives from different segments of the school and community, including parents and students, should work together to maximize healthy eating and physical activity opportunities for students.

Strategies

• Coordinate healthy eating and physical activity policies and practices through a school health council and school health coordinator.
• Assess healthy eating and physical activity policies and practices.
• Use a systematic approach to develop, implement, and monitor healthy eating and physical activity policies.
• Evaluate healthy eating and physical activity policies and practices.

Resources

• CDC’s School Health Index: A Self-Assessment and Planning Guide
• Alliance for a Healthier Generation School Health Index
• Rudd Center WellSAT 2.0

Establish School Environments that Support Healthy Eating and Physical Activity

The school environment should encourage all students to make healthy eating choices and be physically active throughout the school day.

Strategies

• Provide access to healthy foods and physical activity opportunities and to safe spaces, facilities, and equipment for healthy eating and physical activity.
• Establish a climate that encourages and does not stigmatize healthy eating and physical activity.
• Create a school environment that encourages a healthy body image, shape, and size among all students and staff members, is accepting of diverse abilities, and does not tolerate weight-based teasing.

Resources

• USDA School Food Safety Resources
• USDA School Garden Fact Sheet [PDF-160KB]
• CDC’s Increasing Access to Drinking Water in Schools Toolkit [PDF – 2 MB]
• U.S. Consumer Product Safety Commission Resources
• ChangeLab Solutions Joint Use Agreement Resources
• Action for Healthy Kids Non-Food Reward Ideas [PDF-793KB]

Provide a Quality School Meal Program and Ensure that Students Have Only Appealing, Healthy Food and Beverage Choices Offered Outside of the School Meal Program

Schools should model and reinforce healthy dietary behaviors by ensuring that only nutritious and appealing foods and beverages are provided in all food venues in schools, including school meal programs; à la carte service in the cafeteria; vending machines; school stores and snack bars/concessions stands; fundraisers on school grounds; classroom-based activities; staff and parent meetings; and after-school programs.

Strategies

• Promote access to and participation in school meals.
• Provide nutritious and appealing school meals that comply with the Dietary Guidelines for Americans.
• Ensure that all foods and beverages sold or served outside of school meal programs are nutritious and appealing.

Resources

• US Department of Agriculture’s Team Nutrition
• US Department of Agriculture’s School Meal Program
• CDC guidance and resources about school nutrition
• CDC’s Comprehensive Framework for Addressing the School Nutrition Environment and Services [PDF – 2.95MB]
• Alliance for a Healthier Generation School Meal Resources
• Alliance for a Healthier Generation School Snacks and Beverages Resources
• Action for Healthy Kids Healthy Fundraising Ideas

Implement a Comprehensive Physical Activity Program With Quality Physical Education as the Cornerstone

Children and adolescents should participate in 60 minutes of physical activity every day. A substantial percentage of students’ physical activity can be provided through a comprehensive, school-based physical activity program that includes these components: physical education, recess, classroom-based physical activity, walk and bicycle to school, and out-of-school time activities.

Strategies

• Require students in grades K–12 to participate in daily physical education that uses a planned and sequential curriculum and instructional practices that are consistent with national or state standards for physical education.
• Provide a substantial percentage of each student’s recommended daily amount of physical activity in physical education class.
• Use instructional strategies in physical education that enhance students’ behavioral skills, confidence in their abilities, and desire to adopt and maintain a physically active lifestyle.
• Provide ample opportunities for all students to engage in physical activity outside of physical education class.
• Ensure that physical education and other physical activity programs meet the needs and interests of all students.

Resources

• CDC’s Comprehensive School Physical Activity Program: A Guide for Schools [PDF-6.44MB]
• CDC’s Physical Education Curriculum Analysis Tool
• CDC’s Youth Physical Activity Guidelines Toolkit
• SHAPE America’s Essential Components of Physical Education [PDF-391KB]
• National Center for Safe Routes to School

Implement Health Education That Provides Students With the Knowledge, Attitudes, Skills, and Experiences Needed for Lifelong Healthy Eating and Physical Activity

Health education is integral to the mission of schools, providing students with the knowledge and skills they need to become successful learners and healthy adults.

Strategies

• Require health education from pre-kindergarten through grade 12.
• Implement a planned and sequential health education curriculum that is culturally and developmentally appropriate, addresses a clear set of behavioral outcomes that promote healthy eating and physical activity, and is based on national standards.
• Use curricula that are consistent with scientific evidence of effectiveness in helping students improve healthy eating and physical activity behaviors.
• Use classroom instructional methods and strategies that are interactive, engage all students, and are relevant to their daily lives and experiences.

Resources

Provide Students With Health, Mental Health, and Social Services to Address Healthy Eating, Physical Activity, and Related Chronic Disease Prevention

Schools are responsible for students’ physical health, mental health, and safety during the school day. Schools should ensure resources are available for identification, follow-up, and treatment of health and mental health conditions related to diet, physical activity, and weight status.

Strategies

• Assess student needs related to physical activity, nutrition, and obesity, and provide counseling and other services to meet those needs.
• Ensure students have access to needed health, mental health, and social services.
• Provide leadership in advocacy and coordination of effective school physical activity and nutrition policies and practices.

Resources

• Body Mass Index Measurement in Schools: Executive Summary [PDF – 1.6 MB]
• Helping the Student with Diabetes Success: A Guide for School Personnel

Partner With Families and Community Members in the Development and Implementation of Healthy Eating and Physical Activity Policies, Practices, and Programs

Partnerships among schools, families, and community members can enhance student learning, promote consistent messaging about health behaviors, increase resources, and engage, guide, and motivate students to eat healthily and be active.

Strategies

• Encourage communication among schools, families, and community members to promote adopting healthy eating and physical activity behaviors among students.
• Involve families and community members on the school health council.
• Develop and implement strategies for motivating families to participate in school-based programs and activities that promote healthy eating and physical activity.
• Access community resources to help provide healthy eating and physical activity opportunities for students.
• Demonstrate cultural awareness in healthy eating and physical activity practices throughout the school.

Resources

• CDC’s Parents for Healthy Schools
• CDC’s Strategies for Involving Parents in School Health [PDF-1.74MB]
• National Network of Partnership Schools

Provide a School Employee Wellness Program That Includes Healthy Eating and Physical Activity Services for All School Staff Members

School employee wellness programs can improve staff productivity, decrease employee absenteeism, and decrease employee health care costs.

Strategies

• Gather data and information to determine the nutrition and physical activity needs of school staff members and assess the availability of existing school employee wellness activities and resources.
• Encourage administrative support for and staff involvement in school employee wellness.
• Develop, implement, and evaluate healthy eating and physical activity programs for all school employees.

Resources

• Healthy School, Healthy Staff, Healthy Students: A Guide to Improving School Employee Wellness [PDF-1.81MB]
• CDC Worksite Health Promotion Tools and Resources

Employ Qualified People, and Provide Professional Development Opportunities for Physical Education, Health Education, Nutrition Services, and Health, Mental Health, and Social Services Staff Members, as well as Staff Members Who Supervise Recess, Cafeteria Time, and Out-of-School-Time Programs

Providing certified and qualified staff with regular professional development opportunities enables them to improve current skills and acquire new ones.

Strategies

• Require the hiring of physical education teachers, health education teachers, and nutrition services staff members who are certified and appropriately prepared to deliver quality instruction, programs, and practices.
• Provide school staff with annual professional development opportunities to deliver quality physical education, health education, and nutrition services.
• Provide annual professional development opportunities for school health, mental health, and social services staff members, and staff members who lead or supervise out-of-school time programs, recess, and cafeteria time.

Resources

• National Staff Development Council
• RMC Health
• CDC’s Professional Development and Training resources

Tips for Teachers [PDF – 548 KB]
Tips and resources for teachers to promote healthy eating and physical activity in the classroom.

2020–2025 Dietary Guidelines for Americans
Science-based recommendations to help people aged 2 years or older implement good dietary habits that can promote health and reduce the risk for major chronic diseases.

Physical Activity Guidelines for Americans, 2 nd edition
Science-based recommendations to help people aged 6 years or older improve their health through physical activity.

Healthy People 2030 Topics and Objectives
Science-based, 10-year objectives for improving the health of Americans.

The purpose of this module is to provide you with in-depth information on the School Health Guidelines to Promote Healthy Eating and Physical Activity. After this module, you will be ready to take initial steps to improve healthy eating and physical activity in your school or district.

1. US Department of Agriculture, US Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th edition. Washington, DC: US Government Printing Office; 2010.
2. US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: US Department of Health and Human Services; 2019.
3. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2020. Rockville, MD: 2010. Report No. B0132.