The childhood nutrition and weight status are currently shifting from the conventional healthcare system to the current school system. An intervention study of school-based weight management program is vital in addressing the problems that the elementary school children face such as obesity and increase in the body mass index ( Brown et al., 2014) . The population group selected for this analysis comprises of the elementary school children, where they rely upon the school feeding program ( Fakhouri et al., 2013) . An analysis of the priorities for the promotion of health and prevention of disease according to the Healthy People 2020 stipulates the promotion of health and the reduction of chronic disease risk through the consumption of healthful diets ( Gunte et al., 2015) . They also dwell on the achievement and maintenance of healthy body weights, which falls under the restriction of consumption of healthy foods ( Larson & Story , 2013) . Nutrition and the weight status among elementary school children is thus a vital topic of discussion as it depicts the models of meeting the nutritional needs of the scholars, while it defines the ways of prevention of nutritional diseases such as diabetes.
Analysis
The priorities for the promotion of health and prevention of diseases according to the Healthy People 2020 include the focus on the nutrition and weight status in elementary school children. It is evident that nutritionally related disorders such as obesity are priority areas of the objectives set in the Vision 2020 of the Health People, where the primary goal is to promote health and reduce chronic disease risk by consuming healthful diets and the achievement and maintenance of healthy body weights. The objective is vital as it does not only address the nutritional needs of the elementary school children alone but also sheds light on the society to promote health by reducing the possible chronic risks resulting from the consumption of unhealthy diets ( Fakhouri et al., 2013) . This implies that the vision of the objectives set in the Healthy People 2020 should be utilized by the elementary schools and the community within which the child resides as a proactive way of protecting the health of the child.
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The objectives for Healthy People 2020 regarding nutrition and weight largely reflect upon the strong science that supports the health benefits of consumption of healthy diets and maintenance of healthy body weight among all populations including the elementary school children ( Weir et al., 2015) . In addition, the objectives stipulate the efforts put in changing diets and maintaining diets in the sense that they address the individual behaviors, the policies and the environments supporting these behaviors especially in the school settings ( Brown et al., 2014) . The goal of promotion of healthful diets and healthy weight encompasses the increase in household food security as well as the elimination of hunger. They also address the constraints brought about by unhealthy diets such as those that may lead to vulnerability to the health of the elementary school children ( Fakhouri et al., 2013) . Some of the nutritional health requirements addressed in the objectives of Healthy People 2020 include the need for the provision of diets that cannot increase the vulnerability of the children to chronic disease such as obesity.
Since the issue of nutrition and weight status in elementary school children is a priority set in Healthy People 2020 objectives, there are different guidelines given in the achievement of healthful diets among the elementary school children. The first guideline is the need to consume a variety of nutrient-dense foods within and across the food groups, where the food groups that are included are the grains, fruits, vegetables, low-fat and fat-free milk and its products. The objectives can also be achieved if the nutrient-food groups such as lean meats and other protein sources are consumed in their right amounts ( Fakhouri et al., 2013) . The elementary school children with healthful diets are also defined as those who limit the intake of saturated and trans-fats, additional sugars, sodium, and alcohol. Consequently, achievement of healthful diets involves limiting the caloric intake, which is a proactive way of meeting the caloric needs. The objectives set under Healthy People 2020 further stipulate that all Americans including the elementary school children should avoid unhealthy weight gain, where those having high levels of weight in terms of high body mass index are required to lose weight ( Brown et al., 2014) . The other goal set in the Healthy People 2020 objectives is to define the reasons why nutrition and weight status are important elements of consideration ( Gunte et al., 2015) . The objectives consider diet and body weight of a person are being correlated to his or her health status. This means that good nutrition is vital to the growth and development of children. Healthful diets are also important as they help the children in reducing their risks for most of the health conditions including overweight and obesity, malnutrition, anemia resulting from iron deficiency and heart disease. Healthy diets may also prevent the occurrence of ailments such as high blood pressure, dyslipidemia as marked by poor lipid profiles and the Type II diabetes. Moreover, the health of a child is not only a contributory factor in the growth and development but also a contributory factor in the functionality and performance of other related activities such as learning and acquisition of knowledge from their immediate environment ( Fakhouri et al., 2013) . Healthy People 2020 objectives stipulate why nutrition and weight status in elementary school children is an issue of concern. For instance, they show the nature of children who are healthy and why deviation from the norm is a health problem ( Gunte et al., 2015) . For instance, they show that the children who are at a healthy weight are less likely to develop risk factors related to chronic diseases such as blood pressure and dyslipidemia. Such children will not be at the likelihood of developing chronic diseases such as type II diabetes, heart disease osteoarthritis and all forms of cancers. The objectives also define the diet of a child as a reflection of the variety of foods and beverages that are taken over time and in the settings such as schools and the home. Interventions supporting healthier diets are considered to include those that can help to ensure that the individuals have knowledge and skills in making healthier choices. Such interventions should also support a healthier diet that helps in ensuring that the healthier options are not only available but affordable.
Because the weight status among children is influenced by energy as measured in terms of calories consumed and expanded, different interventions for improvement of weight can aid in the changes in diet or physical activity. Such interventions can help in changing the knowledge and skills of the individual in reducing the exposure to foods low in nutritional value and those that have high calories ( Brown et al., 2014) . They may also increase the opportunities for the individual to attain physical activity as a proactive way that can help in burning up the accumulated calories. Interventions can prevent problems such as weight gain or lead to the facilitation of weight loss among obese children ( Gunte et al., 2015) . They can also be delivered in multiple settings including the healthcare settings and the schools or the homecare setting of the children.
The Problem
Childhood obesity is considered one of the serious problems in the United States, where it puts children at the risk of poor health. The statistical analysis shows that the prevalence of overweight is 18.5%, where the condition has affected about 14 million children. The prevalence rate of obesity is currently at 13.9% among children aged 2-5-year-olds, while it is rampant among the 6-5-year-olds, where it stands at 18.4%. The prevalence of obesity is rampant among specific populations, where the rate stands at 25.8% among the Hispanics, while 22% of the non-Hispanic blacks have higher rates of prevalence as compared to the non-Hispanic whites, whose prevalence rates are 14.1% ( Gunte et al., 2015) . The prevalence rates of obesity among the elementary school children are also varied with the socio-economic status with the socioeconomic status. For instance, the prevalence of obesity decreases with the increase in the level of education of the household head among the elementary school children ( Brown et al., 2014) . For instance, the obesity prevalence rate among the children from lower-income households is 18.9%, while those from the middle-income family heads have a prevalence rate of 16% ( Weir et al., 2015) . Those from the high-income family households have a prevalence rate of less than 10%, which implies that there are comorbidity factors such as alignment to schools that adhere to healthy nutrition, which contribute to the discrepancies in the prevalence rates.
The prevalence of childhood obesity is rising at the global scene, where it is accelerating among countries that are experiencing a rapid economic development ( Gunte et al., 2015) . The statistical analysis shows that the prevalence of overweight among Chinese population and especially the mainland China is slowly catching up with the prevalence rates that have been experienced in the United States. For instance, there have been signs of an epidemic of childhood obesity in the elementary schools in cities such as Hong Kong, Taiwan, and Macao. Other developing countries such as Brazil have been depicted to have higher rates of growth in the population of elementary school children diagnosed with nutritional diseases. For instance, there was an increase of 6% from 2016 to 2017 among the children who were diagnosed with obesity in Brazil compared to the 10% among the children residing in the US ( Fakhouri et al., 2013) . This means that obesity is a significant risk factor that accounts for the global burden of diseases. It is also evident that obesity among children poses immediate health concerns and long-term health risks among world populations, with the increase of over $2 billion spending on diet-related diseases in the US over the past one year. Obesity has posed problems in the learning programs, where the diet and physical activity explains up to 30% of the variance in the academic performance after the control of major confounders in the USA alone.
A recent systematic review found out those lifestyle interventions that incorporate exercise and dietary components with or without behavioral therapeutic interventions lead to the improvements in the weight and cardio-metabolic outcomes among elementary school children. The latest statistical data shows that national childhood obesity prevalence rates among 2-10-year-old in the US are 19%. The prevalence rate is determined by the age groups, where the rate rises with the age, while the childhood comorbidity factors highly contribute to the prevalence of obesity at old age ( Brown et al., 2014) . On the contrary, there have been declines in the signs that childhood obesity rates especially among young children especially those who herald from the low-income families and in those communities taking up comprehensive obesity-prevention approaches such as the sound provision of sound nutritional needs for the elementary school children.
Statistical analysis reveals that between 2010 and 2014, 31 states in the USA reported a decline in the rates of obesity among the school-age children especially those whose families participated in the supplemental nutritional program (SNAP) for children. During the same period, there were reported declines from 16%-14% of the prevalence rates of obesity among children who took proactive measures to promote healthy diets. Evidence has also depicted that the home and schooling environments that promote unhealthy eating habits and physical inactivity are the common precursors of weight increase among children. Healthy setting approaches such as health promotion school have been found to deliver health promotion activities including contexts of life such as the promotion of social structures targeting defined populations such as the elementary scholars.
Complications
The possible complications for the lack of adherence to healthy diets include the nutritional diseases, which may cause adverse effects in the elementary school children. Lack of adherence to proper diets at the elementary schools may lead to deficiencies or excesses in diets, obesity and eating diseases ( Brown et al., 2014) . Children who are exposed to poor diets may develop chronic complications such as cardiovascular diseases, hypertension, and cancer and type II diabetes ( Niemeier et al., 2012) . Nutritional complications may also include the developmental ailments that could have been prevented by rich diets, hereditary metabolic disorders that may result from the dietary treatments and interaction of foods and nutrients with drugs. The body of the child may also develop allergies in reaction to the unfavorable foods, while some may develop intolerances and potential hazards resulting from the nature of the supply of the food.
Latest Recommendations
There are evidence-based practices that are viable in addressing the issue of nutrition and weight status among elementary school children. The practices stem from an analysis of the problems posed by poor diets and the analysis of the Healthy People 2020 objectives of promoting healthy diets ( Taber et al., 2012) . The latest recommendations define the importance of promoting healthful diets and healthy weight, which encompasses the increase in household food security and elimination of hunger. The recommendations also feature the promotion of promotion of health through ensuring that children adopt healthy practices including exercise and feeding on low-fat foods. All stakeholders should be included in the multi-prolonged approach that should be taken by schools, families and the government in responding to the constraint of nutritional needs of children. Preventing childhood obesity involves measures such as healthy diets that can meet the nutritional requirements. For instance, schools should be proactive in the implementation of nutritional standards for all foods and beverages that are served to the scholars. They should recognize that there has been a rapid increase in the availability and marketing of foods that are locally acquired from the vending machines that have high-calories and low nutrients.
Elementary schools should also expand opportunities for the children to engage in timely vigorous physical activity on a daily basis, which can help in burning up of the accumulated calories ( Gunte et al., 2015) . The elementary schools should ensure that the children are in close proximity to physical exercise facilities including education on the adoption of measures that can promote healthy lifestyles. There are also measures that have been taken to ensure that the schools have records of weights of the children to ensure that deviations from the norm are addressed at early stages in life.
The latest interventions are also focused on the application of objectives of Healthy People 2020. These objectives give emphasis that the efforts that are meant to change diet and weight should also address the individual behavior of the child ( Fakhouri et al., 2013) . This implies that the policies that are put forth by institutions such as putting in place policies that address the health requirements of the minors ( Quinn, 2013) . The goal of promotion of healthful diets and healthy weight should involve the increase in the household food as well as address the constraints such as food security in the educational institutions ( Brown et al., 2014) . The policymakers should ensure that the children consumer a variety of nutrient-dense foods within and across the specified food groups, which should not only be limited to the grains, and low-fat milk. The institutions should also ensure that the diets that the children consume are limited in terms of intake of saturated trans-fats, cholesterol, and added sugars. They should also ensure that the caloric intake meets the caloric needs of the children.
Preventive Services
The food supplements that the elementary school children get at school are the likely causes of nutritional problems such as obesity and overweight. Getting their obesity and overweight epidemic under control involves more than just the prescription of healthy diets ( Gunte et al., 2015) . This implies that there should be an integrated approach that involves steps such as the promotion of healthy eating habits and encouragement of exercise, the development of public policies for the promotion of access to healthy, low-fat, and high-fiber foods ( Brown et al., 2014) . The other service will include training the healthcare professionals and the caregivers such as the educators to effectively support the children who have been identified to gain higher body mass indices. The children must be provided with healthy foods such as fruits, vegetables, nuts and whole grains. They should also be encouraged to cut down on their levels of consumption of fatty and sugary foods. The diets at school should also comprise of vegetable-based fats as compared to the animal-based fats.
Guidelines
The first step should involve behavior change counseling, where the treatment programs involving the management of obesity should incorporate behavior change components at the school and family level ( Gunte et al., 2015) . For instance, the caregivers should ensure that the children are provided with healthy diets that do not pose the risk of nutritional disorders such as obesity. For instance, the food supplements for the children should include vegetable oils, while the animal oils should be avoided at all times. The children should also be provided with health education programs including consistent exercise.
The different guidelines for approaching the problem of nutrition and weight status among elementary school children pose various advantages and disadvantages. For instance, the use of exercise as a model of reducing weight among the elementary school children poses the benefit of achieving better results as it is a cost-effective approach ( Brown et al., 2014) . On the contrary, the method may pose constraints such as physical involvement, which may not be liable for the environmental settings of the elementary school children ( People, 2020 ) . On the other hand, the use of healthy diets solves the problem of nutritional needs of the children in as much as it might consume more costs.
Conclusion
This paper has shown that nutrition and weight status among elementary school children is currently a health concern. This is from the statistical evidence that reveals that lack of proper nutrition may cause health problems such as obesity among the children. It is also evident that the evidence-based models such as healthy nutrition and exercise among elementary school children can help in addressing the constraints of increase in weight and obesity among the participants. The paper draws evidence from the Healthy People 2020 objectives, which give the requirement of promotion of healthful diets and healthy weight, which encompasses increasing the institutional food security and elimination of hunger. The institutions have the jurisdiction of ensuring that the children consume a variety of nutrient-dense foods within and across the food groups, which include the grains, and vegetables, while they should limit the intake of saturated and trans-fat foods among the population of elementary school children.
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