Factors affect the Body Mass Index

Environment
A Healthy school environment includes not only the physical surroundings of the school but also
the psychosocial atmosphere and culture of the school, all of which can have an impact on
health. The physical environment includes exposure to chemical and other hazards
(disinfectants and other cleaning supplies, dust, mold) as well as building conditions such as
temperature, noise, and lighting. The psychological environment includes the physical,
emotional, and social

Health promotion is not solely for students. Health promotion for staff provides an
opportunity for school staff engage in activities that assess their health and teach them about
health, health behaviors, and provide them with fitness activities. Health promotion encourages
staff to engage in a healthy lifestyle that will contribute to their own improved health well-
being, and will also create positive role modeling for students.

Physical activities
o The combination of poor nutrition and inadequate physical activity was reported as the
second leading cause of death in the United States in 2000. Several studies have shown
that levels of physical activity are reduced in obese children and this helps to maintain a
vicious circle. Treatment protocols including an exercise program were move effective
that protocols that had none.

It is not easy to determine what the calorie cost of various physical activities, especially
in children. The intensity of physical activity may be expressed as the equivalent of
metabolic thermogenesis of MET (international unit of energy expenditure), which
represents a ratio of energy expenditure for a particular type of physical activity and
energy expenditure at rest.

The improvement of the detection technologies of physical activity daily has been with
the advent of portable instruments with motion sensors such as Pedometers and
Accelorometers that allowed quantifying physical activity in condition of real life. These
tools detect objectively the activities, are simple to use, small, do not involve an
impediment to physical activity.

Pedometer. The pedometer does not accurately reflects the totality of usual activities.
The instrument can also record in fact passive movements of the body to the prevailing
vertical component, does not discriminate the intensity of the movement recorded and
does not measure activities carried out by stationary or low vertical component.

Accelerometer. The monitoring of physical activity by accelerator, measures the
acceleration due to body movements. It is an instrument by means of a piezoelectric
transducer measures the transducer that produces a current proportional to the force
exerted on it. New instruments are smaller, are equipped with memory functions for
storing data for extended periods of time. The use of these devices has been recognized
as a valid tool for evaluation of intensity and energy expenditure of physical activity.
In the guidelines established by the National Association for sport and Physical
Education in 1993 is recommended for children who attend elementary school physical
activity lasting at least 30-60 minutes a day.

The UK Health Education authority recommends that all young people accumulate at
least 1 hour of physical activity per day of atleast moderate intensity. The 2002 report of
Institute of Medicine (National Science Academy Washington DC) is recommended for
adults and children at least 1 hour of physical activity if your goal is weight maintenance.

As noted, the Centers for Disease Control and Prevention (CDC) developed a
Coordinated school Health Program (CSHP) model. The CSHP model was developed to
Intergrated the activities and resources of education, health and social services
agencies to efficiently and effectively provide a full set of health programs and services.
This model comprises a network of eight components:
Health Education
Physical education
Health services
Nutrition services
Counseling, psychological, and social services
Healthy school environment
Health promotion for staff
Family/community involvement
Together, these components work to develop and interfere and reinforce health
knowledge, skills, attitudes and behaviors. As such, these components are
linked into web of mutual support.

Food intake
Eat fit, a nutrition education program, was designed to improve dietary and physical
activity skills and behaviors among adolescent 11 to 15 years of age. This school-based
program was divided into three components: workbook; web-based assessment; and
teacher led classroom curriculum. Each student received a 20 page workbook that
provided information, worksheets, quizzes, and games. The web-based assessment
assisted students in their own personalized diet assessment, where students recorded
their 24-hour diet, established personal goals, and received personalized feedback. The
curriculum included nine experiential lessons teachings students skill, practice
behaviors, and goal performance feedback. Dietary topics included: dietary and
physical activity goal setting, reading food labels, eating at fast-food restaurants,
learning about physical activities, and understanding media influence. A small quasi-
experimental evaluation assessed the short-term benefits of this program on student
academic performance and found improvements in listening and speaking,
mathematical reasoning, and algebra; but there were no improvements in
understanding and calculating statistics (such as mean, median, and mode).

Personality
Genetic factors

The tendency to deposit fat around the middle is influenced by a persons genes.
However, you can take this genetic tendency into account and still do something about
it. Being physically active, avoiding smoking and eating unsaturated fat instead of
saturated fat have been shown to decrease the risk of developing abdominal obesity.

Personality is often mentioned as a potential determinant of preferences for decision
making, yet very few studies have empirically tested it. Qualitative research with older
adults suggest that self-regulatory processes such as low self-efficacy impede
participation in decisions about medications (Belcher, Fried, Agostini, & Tinetti, 2006).
Other studies have also found correlations between self-efficacy and active
participation in health care decisions (Arora, Ayanian &Gomez, 2004). One qualitative
study (N=25) of cancer patients found that patient shyness hindered active
participation (Sainio, Eriksson, & Lauri, 2001). A study of undergraduate students found
no significant relationships between preferences for information or decision making
and five factors of personality (using the NEO-Five Factor Inventory; Auerbach & Pegg,
2002). However, to our knowledge the relationships between a comprehensive
assessment of personality and health care decision-making style remains unexplored
within a population of older adults, who will have had more interactions with doctors
and the health care system.

In the absence of research on personality and health care decision-making
styles, examining the relationship between personality and health outcomes may be
informative. The five-factor model of personality has formed a strong basis for these
studies, which have often associated personality trains with disease and aging (Smith
and Spiro, 2002).

Conscientiousness , one of the five factors, predicts, longetivity (Friedman,
2000), most likely through social environmental factors and health behaviors (rather
than psycho physiological mechanisms; Adler and Matthews, 1994; Roberts, Walton, &
Bogg, 2005). In an extensive meta-analysis, Bogg and Roberts (2004) found that
conscientiousness was consistently negatively related to risky health behaviors such as
drug use violence and was positively related for beneficial health behaviors such as
physical fitness. As conscientious individuals tend to take a more active role in trying to
improve their health, we hypothesize that they will prefer more active participation in
health care decision making as well.

Research suggests that neuroticism influences patient illness behavior;
potentially in two different ways. Freidman posited that for some neurotic patients,
negative affect leads them to give up on treatment regimens and avoid interpersonal
assistance that could improve their health. The second sort of neurotic patient is the
health nut or worried well patient who is hyper vigilant about germs and getting
medical attention for symptoms, and who could try to influence doctors toward more
aggressive therapies. However, an experimental test of this theory found that neurotic
individuals who present more elaborate symptoms can actually harm their credibility
with doctors. The presentation of psychological concerns may lead doctors to
misdiagnose the patients disease and recommend psychological interventions in lieu
of medical treatments (Ellington & Wiebe, 1999). We hypothesize that individuals with
higher neuroticism may prefer a less active role in health care decision making, in an
effort to avoid interactions with doctors or because of high anxiety about treatment
decision making.