Figure 1: Steps in the Development of the Nutrition and Physical Activity Education Model (NPAEM)

(a-d) Body system craft; Coloring by nutrients; Jumping rope; Coloring bacteria
Figure 2 a-d:  Sample lesson activities completed by participants in the Nutrition and Physical Activity Education Model (NPAEM) (with permission)

Figure 3: Pre- and posttest mean scores for the Alabama Black Belt students participating in the Nutrition and Physical Activity Education Model (NPAEM) for the three schools, GWC, NHS and DCW

Total F = total fat; S.F = saturated fat; M.F. = monounsaturated fat; P.F. = Polyunsaturated fat; D.C = dietary cholesterol
Letters ‘a’ and ‘b’ for each type of fat indicate significant (P<0.05) reductions in mean dietary intake at pre- and post-assessment
** Total fat and total saturated fats measured in grams.
*** Monounsaturated fat, polyunsaturated fat and dietary cholesterol measured in milligrams
Figure 4: Alabama Black Belt students’ mean dietary intakes from different types of fat in the Nutrition Physical Activity Education Model (NPAEM) during pre- and post-assessment
PARTICIPATING SCHOOLS
Characteristics

GWC
n=18

 NHS
n=25

DCW
n=38
  Number % Number % Number %
Gender
Boys 8 44 13 52 22 58
Girls 10 56 12 48 16 42
Age (Years)
8 15 83 10 40 16 42
9 3 17 12 48 10 26
10 0 0 2 8 7 18
11 0 0 1 4 5 13
Ethnicity
% African American 18 100 23 92 38 100
% White 0 0 2 8 0 0
% Hispanic 0 0 0 0 0 0

Table 1: Characteristics of the 8 to 11-year-old students (N=81) in the Nutrition and Physical Activity Education Model (NPAEM)
Lessons
Mean lesson scores for each school ± standard deviation
GWC
n=18
NHS
n=25
DCW
n=38
P value
Introduction to the Human Body
 58.2±3.6a 68.7±3.0a 87.9±2.5b 0.0001
Health, Food and Nutrients
60±3.8b
84±3.1a
87.9±2.6a
0.0001
MyPlate Food Groups
60.4±2.7b
91.7±2.2a
88.9±1.8a
0.0001
Healthy Eating Habits 77.6±3.5b 96.1±2.9a 82.4±2.4b 0.0001
Physical Activity and Health 94.1±3.2a 92±2.6a 91.9±2.1a 0.8201
Diet and Obesity 82.9± 3.1a 83.6±2.5a 88.6±2.1a 0.177
Diet and Cancer 79.4±2.0a 98.1±1.6b 87.2±1.3c 0.0001
Reading Food Labels 97.5±3.0a 96±2.5a 87.4±2.2b 0.006
Food Safety 95.9±2.4ab 96.5±2.0a 89.4±1.6b 0.011
Food Preparation 86.4±2.4b 98.8±2.0a 89.4±1.7b 0.0002
Finding Nutrition and Physical Activity Information 90.9±2.8ab 83.2±2.3b 91.3±1.9a 0.022

Means with the same letter in the same row are not significantly different at P<0.05
Table 2:  Mean lesson scores for the Alabama Black Belt students (N=81) in the three participating schools in the Nutrition and Physical Activity Education Model (NPAEM)
Nutrients Pre-assessment
(Mean±SD)		 Post-assessment
(Mean±SD)		 P value
Protein 15.0±2.7 14.0±2.3 0.01
Carbohydrate 52.4±8.0 51.1±6.6 0.03
Fat 36.5±5.6 35.1±5.1 0.5

Table 3: Alabama Black Belt students (N=81) in the Nutrition and Physical Activity Education Model (NPAEM): Mean percent calories consumed from protein, carbohydrate and fat; pre- and post-assessment
Dietary Vitamins Pre-assessment
(Mean±SD)		 Post-assessment
(Mean±SD)		 P value
Vitamin A (μg RAE) 1153.3±567.5 1217.8±720.3 0.05
Vitamin B1(Thiamine) (mg) 2.2±1.1 3.09±1.9 0.0002
Vitamin B2 (Riboflavin) (mg) 2.6±1.2 3.5±2.0 0.0013
Niacin (mg) 27.3±15.0 39.5±24.6 0.002
Vitamin B6 (mg) 2.4±1.2 3.4±1.9 0.0009
Vitamin B12 (mg) 5.5±3.7 16.8±12.7 0.005
Vitamin C (mg) 231.8±155.7 319.4±215.3 0.004
Vitamin D (IU) 196.6±98.9 223.9±146.4 0.17
Vitamin E (mg) 8.7±6.5 12.1±8.0 0.12

Table 4: Alabama Black Belt students (N=81) in the Nutrition and Physical Activity Education Model (NPAEM): Mean dietary intake of vitamins; pre- and post-assessment
Dietary Minerals Pre-assessment
(Mean±SD)		 Post-assessment
(Mean±SD)		 P value
Calcium (mg) 1220.5±600.6 1612.3±951.5 0.002
Phosphorous (mg) 1720.5±872.4 2396.7±1458.4 0.0004
Iron (mg) 21.0±10.7 28.9±17.2 0.0008
Sodium (mg) 6494.2±3886.8 4577.6±2491.5 0.0003
Potassium (mg) 3683.9±1756.4 4890.1±2802.1 0.002
Zinc (mg) 16.1±9.3 22.4±14.0 0.001
Zinc from animal source (mg) 9.0±5.9 12.9±8.6 0.001
Magnesium (mg) 385.2±197.0 516.6±311.2 0.002
Copper (mg) 2.6±1.6 1.8±1.0 0.0004
Selenium (μg) 190.2±119.7 132.9±75.5 0.0004

Table 5: Alabama Black Belt students (N=81) in the Nutrition and Physical Activity Education Model (NPAEM): Mean dietary intake of minerals; pre- and post-assessment
Food Groups Pre-assessment
(Mean±SD)		 Post-assessment
(Mean±SD)		 P value
Fiber from Beans (g) 3.6±2.6 3.6±3.0 0.99
Fiber from Grain (g) 6.5±4.1 9.5±6.10 0.0004
Fiber from Fruits and Vegetables (g) 12.9±7.0 13.3±8.5 0.8
Vegetable (servings/day) 4.1±3.7 4.3±2.5 0.7
Fruit and fruit juices (servings/day) 2.7±1.5 3.0±1.8 0.4
Grain (servings/day) 6.6±3.7 9.1±6.0 0.001
Meat (servings/day) 4.9±3.3 3.5±2.2 0.002
Dairy (servings/day) 1.9±1.1 2.4±1.7 0.0002
Fat (servings/day) 6.6±4.4 4.34±2.9 0.0002

Table 6: Alabama Black Belt students (N=81) in the Nutrition and Physical Activity Education Model (NPAEM): Mean dietary intake from different food groups; pre- and post-assessment