Restructuring Health & Physical Education Programs to Combat Type II Diabetes, Heart Disease, and Obesity

Diabetes, heart disease, and obesity are all preventable diseases which can be both prevented and treated with lifestyle modifications. These lifestyle modifications consist of increased physical activity, improved nutritional intake and cessation in risky behaviors such as smoking and drinking alcohol. While type I diabetes mellitus appears to be primarily genetic, type II diabetes mellitus occurs when the cells in the body have decreased insulin sensitivity, resulting in decreased glucose uptake from the blood. This leads to increased levels of blood glucose and is classified as diabetes when blood glucose levels exceed 125 mg/dL. Research has shown that participating in physical activity utilizes a physiological mechanism known as insulin independent glucose uptake which appears to be beneficial to individuals with type II diabetes. This mechanism is a result of working skeletal muscles during exercise that aid in the mobilization of a protein named GLUT4. This protein serves to transport glucose inside the working cells, without the use of insulin, therefore aiding in the prevention of high blood glucose levels.

 Cardiovascular disease otherwise known as heart disease is an umbrella term including numerous diseases of the heart and blood vessels. Some of these diseases include hypertension, coronary artery disease, and peripheral artery disease. Many of these diseases of the heart are associated with atherosclerosis—the buildup of plaque in the arteries—often resulting from an unhealthy lifestyle. Fortunately, exercise has been shown to improve cholesterol levels, decrease blood pressure, decrease insulin resistance, and decrease obesity, all of which are risk factors for heart disease.

Obesity, another preventable disease, is a risk factor for heart disease, stroke, type II diabetes, and certain types of cancer. This disease has become an epidemic for our nation as more than 40% of Americans are classified as obese. Obesity is classified as a Body Mass Index greater than or equal to 30kg/m2. In order to decrease the severity of diabetes, heart disease, and obesity, it is recommended that individuals with these diseases decrease their weight status through lifestyle interventions. Weight loss through exercise and diet modification has proved to be an effective intervention as it decreases risk and severity of obesity and other comorbidities.

 It is important to understand that decreased insulin sensitivity, atherosclerosis, and obesity can be classified as slow and progressive conditions often beginning in childhood. It is critical children and adolescents are educated about the importance of physical activity and develop an understanding of adequate and proper nutritional intake. Childhood and adolescence are important age groups to intervene with a policy which will improve nutritional intake and physical activity levels since many chronic conditions can be prevented though a healthy lifestyle which can be taught at a young age. Fortunately, physical education and health classes have been implemented in the K-12 education system. However, due to the prevalence of diabetes, heart disease, and obesity in society, I propose changes and improvements be made to the current education system in an effort to instill and develop lifelong skills and habits in today’s children and adolescents with a focused goal of teaching the importance of living a healthy lifestyle.

 To accomplish this goal, a complete restructuring of physical education programs across schools in America must be implemented. Current physical education programs in schools tend to consist primarily of students being instructed to play games like dodgeball and volleyball, or by cycling through different sports every couple of weeks. Many of these games result in the most athletic and/or popular kids being picked first to be on teams, while a majority of the students count down the minutes until gym class is over. Many students dread gym class and therefore do not bring their clothes so they can sit out and receive a poor grade instead of participating. These programs typically result in many students feeling forced to participate in games in which they have no interest while others are completely turned off as they are not competitive by nature. The result is often negative emotions which ultimately become associated with physical activity. After high school graduation, students will no longer be “forced” to be active and will likely have to prioritize physical activity on their own. As a result, many students become sedentary during this transition to adulthood as they have not discovered activities they could incorporate into their personal lives. Rather than making students believe that physical activity must be in the form of organized sports and activities, it is important students are provided opportunities to discover different types of physical activity that appeal to their interests and their fitness levels.

 Since the current physical education and health education programs are not working to combat diabetes, heart disease, and obesity, I propose physical education classes provide students with options during each class period. This will allow students to choose from a variety of different activities such as walking, swimming, lifting weights, yoga/stretching, circuits, and organized games/sports. The number of choices can be determined by the school but should include at least one competitive and one non-competitive choice. This will allow students to choose which activity they would like to participate in each class. Additionally, this policy implements changes in health education. Classes should continue to address the risks of behaviors such as consuming alcohol, smoking tobacco, drug abuse, and unsafe sex. To become more relevant, it must also address vaping and e-cigarette use as well as the dangers of being sedentary and having a poor diet. While educating students on how to live a healthy lifestyle is important, my policy proposes students must also be educated on behavior change techniques to assist students in making lifestyle modifications.

 This policy will recommend schools implement a nutrition course as a required or elective course for students. While it may be impractical to require all schools to implement a separate nutrition course, the policy will require that health classes place a greater focus on education regarding nutrition. Important nutrition topics which must be covered are the Dietary Guidelines for Americans, the differentiation between different types of fats, nutrient dense versus calorically dense food items, and dispelling the myths surrounding nutrition and physical activity. Depending on the school’s accessibility to a kitchen, these classes can also be used to teach high school students, especially seniors who will soon be responsible for making their own nutritional choices, how to prepare healthy and well-balanced meals. It is important these programs cater to individuals of low socioeconomic status by presenting healthy options at a low cost as access to healthy food items can be a barrier.

 When instituting this policy, obstacles will be present. One obstacle for schools is funding to create a separate nutrition course. However, the solution to this obstacle would be the increased integration of nutrition information into health classes. Another obstacle for some schools is the ability to offer many different activities in physical education classes due to lack of access. For instance, some schools will not have a pool, weight rooms, or large gym spaces. While a lack of access may decrease the variety of activities that can be offered, all physical education courses will still be able to provide students the choice to participate in fun and engaging activities. Despite a school’s resources they can always offer activities such as walking, running laps, jump roping, dancing, yoga, conditioning circuits, and games like basketball, volleyball, or dodgeball.

 I strongly believe the implementation of this policy in schools across America will be effective in educating children and adolescents across America on not only how, but also why they should live a healthy lifestyle. Since the program is designed for children and adolescents, it is also important that the education is integrated into the program in a fun and individualized manner tailored to the diverse population of each school. This is critical as children and adolescents must enjoy these programs in order to significantly increase the likelihood they will continue to live a healthy lifestyle following graduation as they transition into adulthood. This is important as the transition to adulthood is the stage of life in which many individuals become increasingly sedentary since they are no longer being “forced” to participate in physical education classes. However, the intention of this policy is help children and adolescents discover physical activity and nutrition practices they enjoy and can easily incorporate in their life after graduation. In addition to introducing children and adolescents to healthy lifestyle behaviors that are fun and enjoyable, this policy will have a high success rate as it pairs the teaching of behaviors with scientific evidence regarding the dangers of living an unhealthy lifestyle. As a result of educating children and adolescents to practice a healthy lifestyle not only during K-12 education, but also following graduation into adulthood, diseases such as type II diabetes, heart disease, and obesity can be prevented. The prevention of these diseases alone can save our nation hundreds of billions of dollars while increasing overall lifespan and quality of life.