Celebrating Cristo Rey Jesuit High School & The Healthy Lifestyle Program in Baltimore, MD

By Antonia Demas, Ph.D.

“Cristo Rey gives the reasons behind good food.”

 – Student from Cristo Rey Nutrition class

“Little kids need to learn to be healthy – we need to be role models. We should go to elementary schools and be role models.”

 – Student from Cristo Rey Nutrition class

The Cristo Rey Jesuit High School in Baltimore, Maryland, received funding from the National Recreation Foundation to implement a Healthy Lifestyle program that involved improving nutrition, exercise, and outdoor education. The grant provided three years of funding to develop the program, and the infrastructure was put into place during the 2009 – 2010 school year. This included a classroom food and nutrition education program based on the Food is Elementary curriculum written by Dr. Antonia Demas, physical fitness tests, improving school food, the beginning of a school garden, pre and post testing, and the initiation of a wellness committee. Dr. Demas was hired as a consultant on the grant and she was involved in designing, implementing, and evaluating the program. There were valuable lessons learned from the first year and it became apparent that strong classroom management, record keeping, coordination with other team members, and delivery of curricular services were top priorities for the next year.

The second year of the Healthy Lifestyle program focused on coordination of the wellness team so that they will be able to articulate a clear and consistent vision for the school. A recommended priority for this year was to develop a wellness policy for the school that the entire staff will support. It was highly recommended that a professional development workshop for staff take place to unveil the policy and make sure that all staff would support the policy. The policy was made clear to all students along with the rationale behind it. The primary purpose of the policy was to create a safe, consistent food/health environment within the school. Adults needed to model these behaviors for the policy to be effective and students needed to understand the objective is a caring one.

Wellness Team

The wellness team members included the food educator who taught the nutrition classes, the school nurse, physical education teacher, food service director, school counselor, and two members of the school development team. The wellness team met monthly and was led by the newly hired food educator Lesley Vogel, a Registered Dietician.

A publication, REVIVE, was published quarterly with contributions from the team members. Bulletin boards on whole foods, stress management, heart health and substance abuse were created by the Wellness Chair and school nurse.

Food Education Program

The most significant change for the second year of the grant was the hiring of Lesley Vogel, RD (Registered Dietitian) as the food educator and chair of the wellness committee. Ms. Vogel did an exceptional job and elevated the program to where it needed to be in terms of the program delivery to the students and integration with the staff.

The food education program included weekly nutrition classes for all of the freshman students (approximately 100 students) along with culinary arts and gardening education. Students were given a pre-test and health survey before the food education lessons began. They were given the same tests at the end of the school year. Students maintained journals each week of class and the journals were sent home at the end of the school year to be shared with families. Dr. Demas, author of Food is Elementary, had extensive weekly phone conversations with Ms. Vogel to prepare for each unit with debriefings afterwards. In addition, Dr. Demas made numerous trips to the school in which she assisted Ms. Vogel in the classroom, and they strategized for ways to continue to improve the program and meet with other staff and gather data.

Principal Tom Malone elevated the status of the food education class to an academic class. Students received grades based upon participation, vocabulary acquisition, and an individual and group project each semester.

Networking

The second year of the program involved increased networking with community resources such.

Mr. Cole & Ms. Holt at Baltimore International College training

Baltimore International Culinary Arts College

Dr. Demas and Ms. Vogel visited the Baltimore International College Culinary Arts Program to discuss possible collaborations. The Baltimore International Culinary Arts College agreed to partner with the school and began by having a guest chef demonstrate knife safety in the classroom. Six members of the Wellness Team attended a healthy cooking class at the Baltimore International College.  This was a good educational experience and training for everyone involved as well as a team building and bonding experience for the committee.

Great Kids Farm

Dr. Demas and Ms. Vogel made a trip to Great Kids Farms and Real Food Farm, both Baltimore gardening/nature education programs that Dr. Demas had worked with in the past. Great Kids Farm, a hub for hands-on Farm to School opportunities, is owned and operated by Baltimore City Public Schools Food & Nutrition Services. Ms. Vogel was able to arrange for a field trip for her nutrition students to Great Kids Farm during which the students were able to learn about organic agriculture and botany. At the Great Kids Farm, the students split into 4 groups and each group performed a different task on the farm. One of the groups harvested spinach and the spinach was served for lunch in the form of a spinach salad with strawberries. There was extra spinach which was brought back to Cristo Rey and served at lunch the next day. Other students planted an herb garden, learned about composting, toured the green house, and mulched a strawberry patch. Although some students complained they were hot and tired, there were many who were really into the experience and were clearly excited to learn how to work on a real farm.

When the visitors from other Cristo Rey Schools met with Cristo Rey Healthy Lifestyle personnel, they were also able to take a field trip to Great Kids Farm.

Johns Hopkins School of Public Health

Dr. Demas is a Visiting Scholar at the Johns Hopkins School of Public Health. In this capacity she mentors graduate students in nutrition research. She was able to arrange for Micaela Cook, graduate student, to assist with the pre and post test data analysis.

Cafeteria and Food Service

Ms. Lanciotti, food service director, made enormous strides in improving the menu and offering healthier options. She has increased the participation of students in the breakfast and lunch program. Father Swope offered staff a very reasonable price for school lunches ($2.00/day) to encourage them to eat the same meal students are eating and support the program.

Ms. Lanciotti’s staff, Ms. Helen and Ms. Curtis, were offered the opportunity to take turns attending Ms. Vogel’s food education class each week. In this way there was dialogue between the classroom education and the kitchen. Unfortunately, due to time constraints and the fact that only three people run the kitchen, this did not occur.

A culinary after school class was led by Ms. Lanciotti each month. Students had a great time. The class met every Thursday for at least an hour and there were between 5 and 12 students at each class. One of the Cristo Rey teachers, Tim is a chef, and he did a guest lecture/cooking class. Items the culinary class prepared include baked ziti, muffins, salad dressings, and spice mixes.

Ms Lanciotti was able to prepare three of the items that were taught in the nutrition class to freshman and serve them on her menu: the 3 sisters casserole, the tabouli, and the pasta fagioli. She noted that the freshman (who had the classroom experience preparing and learning about these items), accepted them far more than the other students.

Summary of Recommended Evaluation Methods

The following list was developed by Dr. Demas as feasible ways to evaluate the program. All of the recommendations were implemented with the exception of the water cooler in the classroom and some minor differences. This demonstrated a remarkable commitment to the program and if there is ongoing evaluation, the program will be able to continue to develop so that there are sustainable changes in the program over time that will be easier for others to replicate.

  • Development of a Wellness Policy for the school
  • Staff in-service on wellness issues
  • Monthly wellness bulletin board
  • Pre & Post tests for food and nutrition
  • Pre & Post survey for health survey
  • Student journals
  • Baltimore International College Culinary Arts partnership
  • Water cooler in classroom
  • Academic status of food education class
  • Collaboration with Johns Hopkins Parent University
  • Increase participation rates in school breakfast & lunch
  • Cafeteria staff attending food education classes
  • Culinary class to meet and to possibly prepare healthy snacks for school
  • Food choice of healthy new foods taught in food education class and offered as a choice in the cafeteria
  • Local sourcing of fresh produce
  • Visits to local farms
  • Expansion of after-school fitness programs
  • Nurse observations
  • Ancient Medicinal Herb garden and alley garden
  • Garden club after-school
  • Compost program for food education classes

Purpose of Grant – Measurable Goals

 

Grant Goal #1. Participants will have increased access to nutritious and healthy food.

Barbara Lanciotti, food service director, did an exceptional job in terms of offering a variety of high-quality foods to the Cristo Rey community. Most meals in other schools have a weekly or bi-weekly rotation of meals, most of which are based on highly processed government commodity foods provided by the USDA. These items have long shelf lives but are typically of marginal nutritional quality. Ms. Lanciotti does scratch cooking and her menus are different each day of the month. This is highly unusual especially considering some of the options she serves such as Shrimp Gumbo, Mango Chicken, and Tilapia.  The breakfast foods were all of high quality as well with no sugar cereals, fruit daily (including more unusual choices such as star fruit, persimmons, and passion fruit), whole grain breads and Greek yogurt rather than the processed type of yogurt that is typically laden with sugar and chemicals.

All meals at Cristo Rey were prepared by Barbara with assistance from two part-time staff members. Barbara orders the food and shops for the specialty items. Planning, cooking, serving, and cleaning up for two meals/day and providing food for special events is a very demanding job for only three people. It is important that Ms. Lanciotti is supported by staff who work well together to keep the kitchen running smoothly since this can be a burn-out job where it is impossible to please everyone all of the time. The variety of served meals is quite remarkable however there is no choice. If additional staff were in place, it might be possible to offer choice in the menu in the future or at the very least have a salad bar.

Nutrition Standards from USDA

The United States Department of Agriculture (USDA) administers the National School Lunch Program (NSLP) and makes it possible for poor children to eat for free through use of the commodity program and government subsidies. Schools are reimbursed by the USDA for free or reduced priced meals served to students. The nutritional requirements of the USDA have to do primarily with servings of grains, proteins, vegetables and fruit. Milk is required to be served as a beverage. This is unfortunate because many ethnic populations such as African American and Hispanic, who comprise the majority of the students at Cristo Rey, are lactose intolerant and therefore not able to digest dairy efficiently.

The following charts are from the traditional food-based menu planning and the enhanced based menu planning for high school students. Both are used as guidelines for reimbursable meals. The enhanced requirements include larger amounts of plant-based foods and are therefore healthier.

TRADITIONAL FOOD-BASED MENU PLANNING

APPROACH–MEAL PATTERN FOR LUNCHES

RECOMMENDED QUANTITIES

FOOD COMPONENTS AND FOOD ITEMS GROUP V  AGES 12 AND OLDER   GRADES  7-12
Milk (as a beverage) 8 fluid ounces
Meat or Meat Alternate (quantity of the edible portion as served):

Lean meat, poultry, or fish

Alternate Protein Products1

Cheese

Large egg

Cooked dry beans or peas

Peanut butter or other nut or seed butters

Yogurt, plain or flavored, unsweetened or sweetened

The following may be used to meet no more than 50% of the requirement and must be used in combination with any of the above:

Peanuts, soynuts, tree nuts, or seeds, as listed in program guidance, or an equivalent quantity of any combination of the above meat/meat alternate (1 ounce of nuts/seeds=1 ounce of cooked lean meat, poultry, or fish)

3 ounces

3 ounces

3 ounces

¾ cup

6 tablespoons

12 ounces or

1½ cups

1½ ounces

=50%

Vegetable or Fruit: 2 or more servings of vegetables, fruits or both ¾ cup
Grains/Breads: (servings per week):  Must be enriched or whole grain. A serving is a slice of bread or an equivalent serving of biscuits, rolls, etc., or ½ cup of cooked rice, macaroni, noodles, other pasta products or cereal grains 10 servings per week2

minimum of

1 serving per

day

1 Must meet the requirements in appendix A of 7 CFR 210.

2 For the purposes of this table, a week equals five days.

The Traditional Food-Based Menu Planning Approach is designed to meet nutritional standards set forth in program regulations.

The Enhanced Food-Based Menu Planning Approach

The Enhanced Food-Based Menu Planning Approach is a variation of the Traditional Menu Planning Approach.  It is designed to increase calories from low-fat food sources in order to meet the Dietary Guidelines. The five food components are retained, but the component quantities for the weekly servings of vegetables and fruits and grains/breads are increased.

ENHANCED FOOD-BASED MENU PLANNING APPROACH-MEAL PATTERN FOR LUNCHES MINIMUM REQUIREMENTS

FOOD COMPONENTS AND FOOD ITEMS GRADES 7-12
Milk (as a beverage) 8 fluid ounces
Meat or Meat Alternate (quantity of the edible portion as served):

Lean meat, poultry, or fish

Alternate protein products1

Cheese

Large egg

Cooked dry beans or peas

Peanut butter or other nut or seed butters

Yogurt, plain or flavored, unsweetened or sweetened

The following may be used to meet no more than 50% of the requirement and must be used in combination with any of the above:

Peanuts, soynuts, tree nuts, or seeds, as listed in program guidance, or an equivalent quantity of any combination of the above meat/meat alternate (1 ounce of nuts/seeds equals 1 ounce of cooked lean meat, poultry or fish).

2 ounces

2 ounces

2 ounces

1

½ cup

4 tablespoons

8 ounces or

1 cup

1 ounce

=50%

Vegetable or Fruit:  2 or more servings of vegetables, fruits or both 1 cup
Grains/Breads(servings per week):  Must be enriched or whole grain. A serving is a slice of bread or an equivalent serving of biscuits, rolls, etc., or ½ cup of cooked rice, macaroni, noodles, other pasta products or cereal grains 15 servings per week2– minimum of 1 serving per day3

Must meet the requirements in appendix A of 7 CFR 210.

For the purposes of this table, a week equals five days.

Up to one grains/breads serving per day may be a dessert.

The Enhanced Food Based Menu Planning Approach is designed to meet the nutritional standards set forth in program regulations.[1]

Ms. Lanciotti served the required amounts of foods to meet with the government regulations but used whole foods that required cooking rather than rely on processed items. She estimates that approximately 1% of the foods she used were commodity foods consisting of USDA low-fat shredded cheese, tuna, and canned corn. The rest of the items she purchased through local vendors and in October 2010, she purchased some items from the Farmer’s Market.

Fruits were offered daily and some of the new varieties offered included Starfruit, Clementine, and Anjou pears. The students always asked what type of apples or pears they would be eating. Many students never had a Gala or McIntosh apple. In February an orange which was a cross between a Clementine and a navel orange was served and the students loved them. Bananas were still the all time favorite.

Vegetables different than the norm were also introduced in the second year of the program. In October, Ms. Lanciotti purchased purple and white peppers. Although they looked great and tasted the same as a green bell pepper, the students did not like the color. This is important to note because it is common for people to reject foods they are not familiar with. Ms. Vogel’s class was an ideal place to have students become familiar with new foods through positive hands-on classroom exposure. Mashed cauliflower seemed to be enjoyed by many. Glazed whole carrots were also a big hit. Spinach harvested by students in the Cristo Rey garden were used in salads when possible.

Below is a list of the breakfast items served:

Breakfast Items

Applesauce
Canadian bacon
Egg casserole
Egg patty
Fruit
Granola
Hard boiled eggs
Kashi
Oatmeal
Sausage & cheese on muffin
Scrambled egg
Scrambled eggs with turkey sausage
Strawberries
Strawberry smoothie
Turkey sausage
Whole wheat English muffin
Whole wheat English muffin w/ peanut butter
Yogurt – Greek

The school lunches reflected a diversity of healthy foods. The following is a list of menu items color-coded as to how they meet the USDA requirements for reimbursable foods based upon protein, fruit, vegetable, and grain requirements.

Lunch Items

Apples
Applesauce
Asparagus
Asparagus salad
Bahamas taco
Baked beans
Baked chicken
Bananas
Bean burrito
Bean soup
Beef & pepper on rice
Beef hot dogs on whole wheat roll
Beef stew
Black bean & corn salad
Black bean burger
Black bean burger on roll
Black beans & corn
Broccoli
Brown rice
Carrot salad
Cauliflower
Cheese
Chicken Alfredo
Chicken noodle soup
Chicken tenders
Chicken with cheese broccoli
Chicken with rice
Chili
Clementine
Cole slaw
Collard greens
Collard greens & corn
Corn
Corn & black beans with rice
Corn bread
Enchiladas
Fish tacos
Fried chicken
Fruit
Fruit cocktail
Garlic bread
Grilled cheese
Green beans
Ham
Mac & cheese
Mango chicken
Mashed cauliflower
Mashed potato
Meat sauce
Meatballs
Meatless lasagna
Meatless spaghetti
Mixed veg
Olives
Oranges
Pasta fagioli
Pears
Pineapple
Pizza
Pizza on pita bread
Potato salad
Potatoes
Pulled pork
Pumpkin pie
Red beans
Rice
Rigatoni
Romaine
Salad
Salmon fillet
Salmon sliders
Shredded lettuce
Shrimp gumbo
Shrimp or chicken Jambalaya
Spaghetti
Steak & peppers
Steamed carrots
Stir fry beef with peppers
Strawberry & pineapple salad
Stuffing
Succotash salad
Sunflower chicken
Sweet pot fries
Sweet potato
Tilapia
Tomato soup
Tuna on roll
Tuna platter with tomato & egg on ww roll
Turkey
Turkey & bacon sandwich
Vegetarian chili
Yams

Cost

The majority of students at Cristo Rey are from low-income backgrounds and are therefore eligible for free lunch. However, due to difficulties in filling out the forms at the beginning of the year, many students were not classified as eligible. When school began, there were 309 students enrolled with 137 signed up for free meals, 26 reduced and 146 paying. If the sign-up had not been an issue, the majority would be free meals.

The cost for reduced lunch was .40/day. The cost for full price lunch was $3.50/day. The teacher’s meals are subsidized, and teachers pay $2/day for lunch which comes out of their paychecks.

Many of the students complained about the cost of the lunch being too high. The City of Baltimore which had 83% of students qualifying for free or reduced lunch in 2011, charges $2.25 for paying students in elementary or middle school and $2.50 for students in high school, Cristo Rey peers. The government reimburses the city $2.77 for each meal served to free lunch qualifying students. When evaluating the $3.50 charge it is important to put it in context of what the students were used to paying prior to attending Cristo Rey.

Cost is an important issue because Burger King is across the street from the school. Burger King offers 8 different one-dollar menu items. Dr. Demas and Ms. Vogel checked out their prices and the garden salad was the most expensive (and only nutritious) item on their menu at $5.29. Their garden salad’s benefits would be negated if one ate the salad slathered in the prepared dressings that it comes with. The next most expensive item on Burger King’s menu was 20 pieces of chicken at $4.99.

Student turns his fruit tart into the “Healthy Golden Arches”

Participation

This year a system was put into place to track daily participation and record menus as a result of the difficulty in documenting this information the previous year. Dr. Demas created a monthly chart to be filled in and Cristo Rey intern Mike O’Neil did the lunch counts. Julie Price from the development office oversaw the collection of this data which worked well. There needs to be a format such as the current one in place to simplify data collection and keep records of menus and participation.

The following chart summarizes information concerning:

  • The average number of students who had school breakfast each month
  • The average number of students who had school lunch each month
  • The average number of staff who had lunch each month (please note that the staff had a special rate for lunch at $2/day to encourage them to eat the school lunch)
  • The lowest participation day and the highest day of participation (only among students) each month along with the foods served on those days
  • The total number of days each month that lunch was served at the school
  • The cost of foods (from vendors) each month for breakfast and lunch

(Note – data is not available for September & October, 2010 & June, 2011)

Month

 

Breakfast

(Estimate)

Students

Lunch

Students

Staff Range (#Students) & Menu item Total # Days Total Cost
 November, 2010 50 74 22 68: Black bean burger

72: Turkey w/stuffing

19 $5,166.73
December, 2010 50 76 19 51: Grilled cheese

95: Chicken tenders

13 $5,127.68
January,

2011

50 65 21 51: Chicken Alfredo

70: Spaghetti & Meatballs

15 $5,956.28
February, 2011 50 63 21 53: Spaghetti & Meat sauce

84: Chicken tenders

18 $5,596.39
March, 2011 50 66 21 45: Black bean burger

103: Chili & Corn bread

18 $5,796.36
April, 2011 60 61 21 39: Salmon w/rice

80: Jamaican Jerk Chicken

18 $5,765.98
May, 2011 60 66 21 39: Tuna Platter

84:Turkey&Bacon

18 $6,230.45

 

 

 

 

 

Grant Goal #2. Participants will gain a richer understanding of the importance of nutrition and food choices.

Nutrition class was taught to all 9th grade students on a weekly basis by Lesley Vogel. Ms. Vogel did a superb job and brought enthusiasm, energy, and professionalism to the position which was greatly improved from the year before. Though she had never been a teacher before (she is a RD – Registered Dietician), Ms. Vogel was a quick study and worked closely with Dr. Demas to strategize about classroom management issues and creative implementation of Food is Elementary (FIE), Dr. Demas’ award-winning curriculum. Ms. Vogel was dedicated to the students and very positive in her interactions with students and staff.

The intervention for this study was the Food is Elementary curriculum. Ms. Vogel taught it each week to the entire 9th grade on Tuesdays. Dr. Demas assisted in the classroom a number of times and was able to problem-solve and give feedback to Ms. Vogel. An issue that was apparent during the first project that students were assigned (Foods of Thanksgiving) was the lack of academic skills many of the students had when entering the school for 9th grade. Most of the students came from Baltimore City middle schools. Plagiarism was a topic that many of the students did not understand, and they had to be taught not to copy other work unless citations are given. For example, some students felt they could print off a page on their topic from the internet, put their name on the paper, and that would fulfill their assignment. This lack of preparedness for academic work makes it even clearer why we need to have more schools like Cristo Rey in the United States.

Ms. Vogel kept notes on her classes and students really enjoyed the lessons – especially when they got to cook and try new foods. Response was favorable and others in the building could smell the wonderful aromas of fresh herbs and healthy foods simmering in the pot. Students and staff would stop by asking if there were leftovers on a regular basis.

Pre and post tests were conducted following standard protocols. A Johns Hopkins University graduate student, Micaela Cook, worked with Dr. Demas to analyze the data. Student retention of the information taught was statistically significant as their knowledge about food and nutrition improved dramatically. Many of the students came to class with minimal exposure to whole fresh foods and were introduced to a long list of health promoting foods. Because Food is Elementary first teaches nutrition concepts via hands-on activities, students understood the “why” behind the lessons. As one of Ms. Vogel’s students said during a focus group interview,

The more you learn what we are learning now [about nutrition] – we should have learned in 1st grade – high school is too late. We are asking questions about food now but should have learned this early.”

Data Results

Nutrition Knowledge Assessment

Results of the pre and post tests concerning nutrition knowledge were highly significant. The nutrition knowledge pre and post test was directly linked to the Food is Elementary curriculum with a concentration on general nutrition concepts. A total of 81 students took both the pre and post test. Out of a possible score of 29 correct answers the lowest score for the pretest was 3 and a number of students had near perfect scores (28) for the post test. The mean average improvement was 8.47 which has a P-value of <0.0001.

The pre-test scores ranged from 3 – 26 with 11% of the students scoring 19 or above.

The post-test scores ranged from 5 – 28 with 85% of the students scoring 19 or above.

Students retained what they learned. The previous year, the food educator reviewed all of the information with the students and basically gave them the answers. The average mean improvement score then was 6.0 which is not an accurate read because of the manner in which it was administered.

Ms. Vogel, the food educator in the second year, did not review the information with her students prior to the test and the post tests were graded by an independent person. This is a much more accurate assessment of what students learned and retained throughout the year. Ms. Vogel also taught Food is Elementary in the way she was trained by asking students each week to tell her what they had learned the previous week, so review was done each week by the students. She also had students write in their journals so that there were multiple supports to reinforce the information students were learning.

Health Surveys

Nutrition self-assessments are notoriously inaccurate for a variety of reasons. People forget what they eat unless they write it down as they eat, people do not have an accurate sense of portion sizes, people are embarrassed by what they eat and don’t want to share this information with others, and in a school setting, there is often a desire to please the teacher. It is interesting to look at the self-assessment of the Cristo Rey student’s pre and post. These scores decreased with the post assessments (with race and gender factored in). There were no significant differences with race or gender.

The health surveys asked students to assess their general health and nutritional status and daily consumption of healthy and unhealthy items such as soda, junk foods, fruits and vegetables. When carefully examining the raw data, it is obvious that some of the students did not report things accurately and wrote numbers that were “too good to be true” such as reporting that they consume “10 servings of vegetables every day”.

There were a total of 9 possible points for the health surveys reporting on health behaviors such as consumption of junk foods. The only two areas that had a significant difference were an increase in the self reported servings of beans and a decrease in the self reported servings of vegetables. Gender was related to the self-reported increase in bean consumption with females significantly reporting more bean consumption than males.

The following chart summarizes the results of the pre and post nutrition tests and health surveys.

Cook, Micaela, MPSH Candidate, Johns Hopkins School of Public Health, Biostatistics 140.624, 2011 class paper, “Investigation of the effectiveness of a school-based educational intervention on increasing nutrition knowledge and improving health behaviors among 9th grade students in Baltimore City.”

Discussion

It is very interesting to note that the nutrition knowledge, a much more reliable measure since it is not subjective, increased significantly at the end of the year yet the self-reported nutritional assessment went down significantly. One plausible explanation for this is that as the students became more aware of nutrition issues, they also became more aware of their own health and had a more objective way to look at it. They were able to understand that consumption of junk foods had a negative effect on their general health and the reasons behind this such as empty calorie foods full of sugar and chemicals and lacking in the nutrients necessary for organ systems to function properly. Throughout the year, students were encouraged to “experiment” on themselves and see how they felt after eating junk food versus healthy food.

Another possible explanation for the decline in self-assessment reports is that these students came to Cristo Rey with minimal research skills or knowledge about food and nutrition issues. This was evident when they were assigned their first “research” paper and did not understand issues around plagiarism or academic integrity. As students were taught and supported academically by Cristo Rey faculty and expectations for scholarship were raised, student skill levels increased. This includes issues of personal integrity as it relates to schoolwork which Cristo Rey stresses. So it could be that students were more honest with themselves at the end of the school year and realized the purpose of the nutrition program was to provide them with information that could vastly improve their quality of life if they were able to assimilate it into daily routines.

Focus Groups

Father John Swope suggested that it would be interesting for Dr. Demas to conduct Focus Groups to highlight any differences from the first year to the current year in terms of student knowledge and attitudes about food and nutrition. Dr. Demas and Ms. Vogel conducted 3 focus groups –

  1. With the students who took nutrition during the first year,
  2. With Ms. Vogel’s students, and
  3. With seniors who did not take nutrition.

The results were very interesting and demonstrate that it is important to have a strong food educator in place.

For example, none of the students who were in the nutrition class the first year (when the food educator did not teach the curriculum appropriately), cited school as a place to go for nutrition information. Indeed, they said nothing about the class until the very end of the interview when one of them spoke about the previous year’s food educator making shrimp fried rice one day and relating it to the fact they get hungry. These students said they get nutrition information from their biology teacher, TV (such as Oprah or Dr. Oz), or relatives but did not mention their nutrition class as a source of information. They also mentioned how fast-food costs less than healthy food and expressed a desire to learn how to cook (which Food is Elementary stresses).

Students who were currently enrolled in Ms. Vogel’s class cited school and the food served at Cristo Rey as sources of nutrition information. Overall, they had a much more positive outlook regarding the lunch program and in making changes to become healthier. They also expressed a desire for younger kids to learn what they were able to learn in class:

“Little kids need to learn to be healthy – we need to be role models. We should go to elementary schools and be role models.”

 

When reading the responses from Ms. Vogel’s students it is clear that students were applying what they had learned:

“The vitamin lesson [taught by Lesley] – very important – I did research after that.”

“I now eat five whole grains a day.”

 

The seniors who did not have nutrition class thought that schools should teach it and regretted that they were not able to participate: “Cristo Rey has an obligation to get information to you. . . It would have been nice if we had had nutrition in school. . . I would remember if we had it long term in school.”

They also complained about the cost of food at Cristo Rey saying it was less at their previous school and wishing there was more choice. All groups talked about diet-related health problems that affected their relatives.

Ms. Vogel asked the questions and Dr. Demas recorded the answers. Dr. Demas discussed the ground rules and explained the purpose of the focus groups first including the following:

Preliminary intro – ask if anyone has objection to tape recorder.

Explanation of confidentiality and that names will not be used.

State purpose of the focus group – to get honest opinions in a safe setting.

The following general questions were covered:

  • The role of food
  • The role of food in health
  • Where do you get nutrition information from
  • Where do you think you should get nutrition information from
  • How important do you think nutrition information is
  • Do you think it is easy or hard to change your eating behavior?
  • What do you think about the Cristo Rey School food environment?

Click here to read transcripts of the 3 different focus groups

Click here to read the Nutrition Course Outline 

Interviews with Nutrition Students

Conducted by Dr. Antonia Demas

Please Note: These interviews were not conducted with a random sample of students due to the fact that this was their last class of the year. Students either volunteered or were selected by Ms. Vogel. One can argue that these may have been the most motivated students, however, it is fair to say that in general all of the students enjoyed the class because it was fun and a departure from their other classes due to the hands-on nature of the classes and the fact that they got to eat new foods.

Dr. Demas asked students to:

  1. Describe what they liked about the nutrition class.
  2. Describe what they thought could be improved about nutrition class.
  3. Describe any effects the class had on their personal and/or family eating/nutrition behaviors.
  4. Describe if they thought the class was sufficient in terms of their knowledge base or if it should be continued next year.

Student #1 Interview 

  • Excellent class.
  • Loved the cooking.
  • Changed my perspective – I am now vegan.
  • The 2001 report you [Dr. Demas] gave about the students in Miami changed who I am and what I am striving for. I am now vegan.
  • I now understand how my body works.
  • The vitamin lesson I remember as well as calcium and protein from plants.
  • Cooking methods and safety – i.e. how to use a knife, clean hands and surfaces.
  • Food combos that taste good like the 3 sisters casserole and the symbiotic relationship between the plants growing together.
  • We should have the class at least 2 days/week and each year at CR,
  • The older you get the more independent you are so you can go to Burger King so we really need nutrition to understand why we shouldn’t do this.
  • My mom is positive about me turning vegan. Her brother was vegetarian and ate ginger root if he was sick.
  • This summer I will have a growing spurt – I am concerning about this. My other family members are obese. I have a ten year old brother, my mom and dad. My dad calls himself a “meatatarian” but my mom is open.
  • The class was fun. The other kids smell the foods in the hall and want to join.

Student #2 Interview

  • I like trying new foods.
  • I loved the special guests.
  • Cooking.
  • Learning about farms & how animals are raised.
  • Vitamins – this was the easiest way to learn about them.
  • How food gives you more energy.
  • I liked everything.

Student #3 Interview

  • Cooking.
  • Nutrition facts.
  • New and different information from my old school.
  • How to eat less.

Student #4 Interview

  • How to eat better – most kids don’t know.
  • Exposure to a variety of foods.
  • I even tried onions even though I don’t usually like them
  • Learning how to cook.
  • We only have this class 1 time a week. We should have it at least 3 times a week.
  • All grades should take the class.
  • Learning how to read labels.
  • My mother now wants to try new foods.
  • I want to be a vegan.

Student #5 Interview

  • Learning about new foods.
  • The new foods taste good even though they are healthy.
  • Learning about healthier options besides Burger King.
  • Learning some athletes are vegan.
  • Learning how to measure and follow recipes.
  • Some kids are too loud.
  • The assignments were easy.
  • I tried and ate all of the foods.
  • My mom uses vegetables.

Student #6 Interview

  • Trying new foods.
  • Having outside people come in.
  • Learning how to make nutrition and lifestyle changes.
  • I don’t eat Burger King and McDonald’s since I now know how unhealthy they are.
  • Instead of candies I now eat watermelon and honeydew melon.
  • I don’t eat potato chips anymore. I get my grandma to buy and eat fruits instead.
  • I would like to take the class again.
  • This was good stuff, but we only had it 1 time a week.

Student #7 Interview

  • The class opened my eyes. Kids are not taught to eat well and what good food does for your body
  • The movie Supersize Me affected me – we did an exercise from SS Me for two weeks. I don’t eat junk now.
  • I eat granola and I use to eat candy.
  • I now eat veggies and Brussels sprouts.
  • I tried everything and liked all of it.
  • I didn’t know how to cook before.
  • The journals help a lot – we get to keep them and read them over the summer.
  • I’ve taught my dad. He usually eats greasy foods but now eats salad and fruits. My dad has been supportive and changed with me. [this student lives with her dad].
  • I never liked salad before and now I love it.
  • My attitude changes – I am now always in a good mood and don’t get sick anymore. I have more energy.
  • I use to be negative at times but now have more energy.
  • We should have the class at least 2 times a week.
  • I remember the vitamin lesson and learning to use knives.
  • I like the variety of information and people who came in and the foods we ate.
  • I got my dad to make the potato salad.
  • We bought vegetarian books with recipes.
  • I loved the 3 sisters casserole, the potato salad and the smoothies.
  • I am going to make these foods for my dad for Father’s Day.

Grant Goal #3. Participants will engage in more physical and leisure activities and will gain a richer understanding of its importance to their overall health.

Athletic director Tony Cole taught the freshmen and sophomores one day a week for approximately 50 minutes. The juniors and seniors do not have regular gym class due to their schedule which makes it difficult. During the gym class Mr. Cole walked with students. They walked approximately two miles during this time period.

There are a number of afterschool athletic classes offered by the school. The list with participation levels is below. During the 2010 – 2011 school year yoga and the step team were added to this list.

ATHLETIC TEAM PARTICIPATION DATA, 2010-2011 SCHOOL YEAR
     
Women’s Softball
Grade Number of students  
9 1  
10 3  
11 8  
12 3  
TOTAL: 15  
     
Men’s Baseball
Grade Number of students  
9 5  
10 5  
11 1  
12 3  
TOTAL: 14  
Men’s Lacrosse
Grade Number of students
9 1
10 4
11 3
12 11
TOTAL: 19
   
Women’s Cheerleading
Grade Number of students
9 8
10 2
11 5
12 1
TOTAL: 16
Women’s Basketball
Grade Number of students
9 4
10 2
11 4
12 5
TOTAL: 15
   
Men’s Varsity Basketball
Grade Number of students
9 2
10 0
11 2
12 8
TOTAL: 12
Men’s JV Basketball
Grade Number of students
9 5
10 4
11 0
12 0
TOTAL: 9
Cross Country
Grade Number of Women Number of Men Total Number of Students
9 3 3 6
10 3 3 6
11 2 2 4
12 2 1 3
TOTAL: 10 9 19
Women’s Soccer
Grade Number of students
9 4
10 5
11 2
12 2
TOTAL: 13
Men’s Soccer
Grade Number of students
9 6
10 1
11 0
12 12
TOTAL: 19

Additional Physical and Leisure Activities

The following is a report from Dominic Smith who conducted the gardening program (which offers physical activity and community service):

“We have continued to visit our community garden for monthly 3-hour service trips, tilling the soil, planting flowers, fruit bushes and vegetables; building capacity for future harvests.

Since the club’s inception 18 Cristo Rey students participated in gardening related activities. These activities included:

– 4 students participated in a Compost Tumbler workshop to make 2 compost tumblers for use in the school’s gardens from recycled materials. This Workshop was carried out over 3 weeks, in conjunction with volunteers from the Lutheran Volunteer Corps.

– 3 service trips held jointly with students and faculty from Johns Hopkins Bloomberg School of Public Health Department of Health, Behavior and Society and Maryland Institute College of Art (MICA), to our share crop on Rose Street, maintained as an outreach to Amazing Grace Evangelical Lutheran Church.

– Students installed irrigation to bring water from the sidewalk water meter to a hydrant faucet which they installed  in the center of our share crop at the Rose Street Community Garden.

– Students installing 400 square feet of landscaping fabric at our share crop at the Rose Street Community Garden, to block weeds, in preparation for next spring’s planting season.

– Students planted thyme ground cover, lavender and rosemary hedging, and native perennial flowers to conserve the perimeters of our community plot at Rose Street, and to beautify the neighborhood.

– Students picked up and removing 48 bags of recyclable and compostable trash from the Rose street location.

– Students planted and harvested tomatoes, lettuce, collard greens, lacinato kale, curly kale, okra, green beans, lima beans, zucchini, eggplant, green peppers, jalapeño peppers and peas from our community garden.

– Students planted 8 raspberry bushes for on-going future production.

– Students used the composters they built to start composting food scraps at Cristo Rey.

– Students worked in conjunction with MICA students to plants rosemary, oregano and basil in the future garden plots in Cristo Rey’s new courtyard.

Grant Goal # 4. Participants will gain an appreciation of parks.
The following activities that included trips to parks were done during the 2010-2011 school year:

Student Outdoor Recreational Activities, 2010-11 School Year

November 2010: Freshman class Business Boot Camp ropes course trip with Project Ascent.

February 2011: Snow tubing trip attended by more than 55 students.

May 2011: Freshman class hike/enrichment outing at Carrie Murray Nature Center andGreat Kids Farm.

May 2011: Sophomore class college visit day and hikes at Elk Neck State Park and Hashawha Environmental Center.

June 2011: Senior class trip to Great Wolf Lodge water park in Williamsburg, VA. Students hiked in a park on the way to Williamsburg.

Note: We did not have a junior class hike this year, because the usual field trip to the Chesapeake Bay with the Audubon Watershed Experience had to be cancelled. We anticipate that this field trip will take place again next year.

Grant Goal #4. Participants will understand how physical activity can also contribute to the life of the community through team-building days that focus on community service.

Julie Price, development, wrote the following about team-building focused on community service:

“Students are learning about the importance of healthy recreational activities and nutritious food even as they perform important service in the Baltimore community. Students have fun, get exercise and learn about healthy fruits and vegetables while working at Cristo Rey’s garden on Rose Street. Some of the produce grown in the garden comes back to Cristo Rey for use in the cafeteria, but the rest is donated to a church food pantry to be made available to families in need. A group of students and staff recently participated in a fundraising walk benefiting The Family Tree, a child abuse prevention organization. Students got a great workout (on a drizzly day!) while supporting an organization that does important work in their community.”

Grant Goal #5. Participants will have an increased awareness of how healthy choices contribute to all aspects of life.

Students at Cristo Rey were fortunate because there was a wellness team that meets bimonthly to discuss supporting healthy choices from an interdisciplinary approach. The nutrition class, athletics, recreational program, community service program, gardening and culinary after school classes and health program all ensure that healthy choice messages are highlighted within the school environment. As the group continued to work together to develop a wellness policy for the entire school, this message will become more prominent.

Cristo Rey is fortunate to have an exceptional school nurse committed to education and nutrition. She works well with the team and asks students about nutrition when they make visits to her office.

School Nurse Alexis Holt, wrote the following:

“Students visiting the health suite are for the most part, affected by lack of nutrition and/or hydration directly or indirectly. The chief complaints include headaches and stomachaches that can be directly attributed to lack of nutrition and/or hydration. The BIG difference I am seeing now is that MOST students are aware, that how they’re feeling is related to their nutrition and/or hydration status and are aware of some appropriate remedies that include foods…apples for Advil, as Lesley and I like to say.”

Ms. Holt has said that although the number of visits to the health room did not go down, she has found that students usually know that they need food when they come see her. If they want to leave class to get fruit from the lunchroom to alleviate their headache, they have to go to her office first. So the number of visits has not decreased but often when students top by they say they need fruit rather than asking for and Advil.

Month # School Days/Month # Visits to Nurses Office Average # Visits/Month
September 21 294 14
October 18 184 10
November 19 217 11
December 16 115 7
January 16 121 8
February 19 232 12
March 17 162 10
April 18 191 11
May 21 216 10

Reaching Families

Parent University

General Description and Purpose

Ms. Holt wrote the following about Parent University:

“ Parent University is a parent education program targeted to freshman parents. Parents or guardians are required to attend 4 evening sessions at Cristo Rey and 1 all-day sessions throughout the school year. Parent University was developed primarily to build a partnership with parents, school and student. It is an effort to maximize parenting to their Cristo Rey students who are experiencing great and exciting challenges that require discipline and focus. It is also a forum for parents to get their questions answered.”

Ms. Holt describes two classes she taught at Parent University:

“I spoke at two evening sessions on the adolescent brain and ‘How to Talk to Your Kids About Sex’ and why they should. Theses evenings were comprised of lecture, video, interactive components on communication, parent exchanges and question and answer sessions.”  There was also a healthy dinner served at the last Parent’s Association meeting.

On April 12 and 13th Lesley Vogel traveled to Kansas City, Missouri with other Cristo Rey personnel to give a lunchtime presentation to the Cristo Rey Network Annual Meeting.  All network school presidents, principals, and other various key leaders were in attendance.

The presentation was given by Lesley Vogel and Father John Swope.  We reviewed the foundations of our program and highlighted our main goals and methods for achieving them.   Replications binders were created and given to each school, along with a thumb drive including the powerpoint presentations we used at our mini conference in Baltimore.

In an interview with Julie Price, development, she spoke of the progress the school has made this year. The biggest challenge is to get the whole staff on board although there has been progress in this area with teachers outside of the wellness committee looking to each other for support such as integrating healthy foods into lesson plans. When the Cristo Rey staff is able to speak in one voice concerning these issues, it will be much easier to replicate the program but great progress has been made in developing an infrastructure.

 

End of Year Interviews and Comments

Summary of Nutrition and Food Service from comments from Intern Mike O’Neil

“After working in the Freshman Nutrition Class, as well as the cafeteria during lunch, I feel like I have a unique perspective on the relationship between food at Cristo Rey and the students.  I have witnessed a large number of Freshman students open their minds when it comes to the food that they are willing to eat.  At the beginning of the year, a number of students were suspicious of many of the unfamiliar foods that were served in the cafeteria.  However, as the year went on many of the Freshman, and in turn the older students, were much more willing to experiment with food that they had not seen before.  I think that the main reason for the this is because of the Freshman Nutrition Class and the close relationship between Barbara and Lesley.  The two of them really worked well together and I think that this was reflected in the food cooked in the kitchen, as well as the positive response from the students.  On a number of occasions, the food that was made in the class was served in the kitchen to a very positive response.  And once other students found out that this food was made in class, I found that a number of upper classmen would come into our room after each class looking for healthy food to eat.  This revealed two things to me.  Firstly, the students here are interested in healthy eating, but their lack of exposure makes them unaware and uneasy about it.  The fact that the freshman opened their minds to healthy eating shows to me that the more students know about healthy eating, the more willing they are to experiment with unfamiliar foods.  In addition, I think that freshman’s willingness to eat healthy food set a good example for the rest of the school that students caught on to.   Secondly, the food that was served from the Nutrition Class in the cafeteria was always free to all of the students and I think this had a large impact on the response.  Since I interacted with all of the students on a daily basis when they were getting their lunches, I was able to gauge their reaction to it and often times speak with them about their food.  The response that I got was that many more students were willing to try a healthy alternative when it was free.  I could also see this in the way that certain menu items became more popular over the course of the year.  Most notably, the Shrimp Gumbo was met with suspicion by most of the students when it was first served in the cafeteria, but after trying it it became one of the most popular items served for the rest of the year.  Again, this suggests to me that exposure is one of the most important aspects of educating the students about healthy eating.

I really feel like the vast majority of the students at Cristo Rey are willing to open their minds about healthy eating and are willing to be educated and challenged to change their eating habits.  However, it is important to remember that this is a high school and the students are very susceptible to the influence of their peers.  As a result, I think that some student’s feel that there is a stigma associated with paying $3.50 for lunch and I have even witnessed many students ridiculing other students for paying full price for a lunch.  The end result is that student’s who want to eat will sometimes not get a lunch because of the negative response from other students, many of whom never had a lunch from the cafeteria.  And this stigma can be seen on the days when lunch was free because greater numbers of students came through, many of whom had not gotten a lunch from the cafeteria all year.  To me, this suggests that students are resentful of the price, but more importantly reflects the fact that the vast majority of the students really do want to eat lunch in the cafeteria.  For a variety of reasons they don’t, but on days when lunch was free (and still healthy) there was an overwhelmingly positive response from students across the board.  In addition, I have witnessed students eat a very large amount of food in Nutrition Class immediately before lunch and then come down to the cafeteria and eat a full lunch immediately after.  So, the students are hungry and willing to try different foods, there just has to be a way to encourage and enable more of them to do so.

In the end, I think that the Nutrition Class was a great success, even if not all of the students are going to take to some of the messages immediately.  At some point in their lives, they will be confronted with health issues, and I think that the lessons learned in the class are going to come back to them.  And there are a number of students who have immediately embraced what Lesley has taught and are even cooking some of our recipes at home.  This sort of response should not be ignored or trivialized because these are young adolescents that are making changes to their lives that some adults can not make.  And as far as the kitchen is concerned, having eaten the food every day this year, I can say with confidence that the food is second to none.  I have even gotten recipes from Barbara and made them at home to rave reviews.  And I think that the students would have the same positive response across the board if there was some way to make buying a lunch an easier and more affordable process.  The program and its relationship with the kitchen is something that I think should really be nurtured over the next few years because I think it can become something really special at Cristo Rey.”

-Mike

Staff Recommendations

Tony Cole – Athletics

  • The weight room needs to be improved by increasing the budget and buying 5 stationary bikes and more weight lifting machines.

Barbara Lanicotti – Food Service

  • There should be a full-time certified cook in the kitchen, a dishwasher (person or machine), a prep cook, and a cashier.
  • There is too much access to the kitchen – people enter all the time without notice and there are constant interruptions.
  • We need regulations for students – it is hard to plan breakfast when students are supposed to come in from 7:15 – 7:45 but sometimes don’t come in until 8:30.
  • Price is an issue and when food is free people participate.

Julie Price Director of Corp. and Foundation Relations

  • Challenges include getting the whole staff to understand the program and their role, plus the benefits to them.

Lesley Vogel – Food Educator

Program strengths:
“The strength of our program continues to grow as the program becomes more established.  First, the dedication of Cristo Rey to the mission of improving student performance through healthy lifestyles is an amazing mission and the school leadership should be commended for making it a priority.  From my perspective, education plays a very important role, and is key to the success of the program.  The hands on curriculum and the ongoing support of Dr. Demas in formulating the lesson plans has allowed us to create lessons that are innovative, interactive and relevant to our students.  It has been amazing to see and hear how exposure and education has impacted our students lives.  I think bringing in partners to expand the sources of the message has been extremely important for the student’s acceptance of the message of health.

Our strengths also lie within our staff who have worked hard and worked together extremely well to accomplish our mission.

Program weaknesses:  We still continue to bring more staff and students into the fold of the program through exposure and education.  Getting everyone (staff, students and parents) educated and excited about the program will take consistent and continued effort.  I think this task will get easier over time as our older students who have had the education begin to trickle down to the younger students.  I look forward to working next year to make the program more accepted and “cool” to the students.  We can accomplish this by giving the students and staff a voice and responding to feedback in a loving and caring way.  We also may want to consider adding a logo for our program so we can advertise the program as a sponsor for the many unique and interesting opportunities our funds support.

Recommendations:

We have made a lot of progress this year.  We should continue to build the foundation of the program.  Consultation with Dr. Demas has been extremely valuable, and her support should continue as much as possible.

I would recommend we continue our work from this year at the same pace.  We need to continue to add to our community partnerships and widen the message the students are getting through community role models.
Our program needs to market itself, too, possibly through a logo or other recognizable representation.”

  • The most important recommendation is to put a school-wide Wellness Policy in place and to have an in-service meeting for the entire staff to ensure that it is enforced in a positive and consistent manner.
  • Most school meal programs have food service directors who are resistant to change and unadventurous to new recipes. Cristo Rey has a very creative cook who enjoys trying new healthy recipes. She needs additional support in staffing who share similar goals.
  • The teachers have their lunches subsidized at $2.00/meal but the students do not. Students pay $3.50 for lunch unless their parents have done the paperwork necessary for them to qualify for free or reduced meals. Because the paperwork was an issue for many of the parents, it is recommended that the school ensure that all of the students eligible for free meals get signed up when they register for the school.
  • The school lunch for paying students costs $3.50/day. The City of Baltimore school lunch costs $2.25 for elementary and middle school students and $2.50 for high school students.
  • Students have limited access to water during the school day and at meals. It is important that there be easy access to clean water throughout the school day. At the very least the nutrition class needs a water cooler in the classroom. It is recommended that all classrooms have water coolers.
  • There needs to be choice in the breakfast and lunch programs.
  • The food education recipes should be served in the cafeteria on a regular basis and further development between nutrition class and the cafeteria needs to be done.
  • There should be professional development for food service. The director should go to conferences and get to know her peer group.
  • The nutrition food education class should continue for more than one year and if possible, should take place at least two days a week – the first day as an academic class and the second day as a food lab.
  • The nutrition class should have its own classroom with a sink with hot water.
  • Parent volunteers should be more actively pursued to participate in classroom and extra-curricular activities.
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