“How do you change the culture in a school? You don’t just say ‘we’re changing everything.’ You have to work on it, it takes time. You have to build that relationship with the principal, and make sure the principal is on board. And the parents. And you slowly start to shift toward healthy choices for our kids that might help them. You start talking about test scores, you know... most principals want to hear about that, right? And you want to have less discipline problems… ... So let’s start working in that direction.” – A state PTA leader

Consumption of high-calorie nutrient-poor foods has been linked to adverse health outcomes in childhood, including an increased risk of childhood obesity. Between one-third to one-half of children’s and adolescents’ daily energy intake occurs at school, and school practices are associated with children’s dietary behaviors and weight outcomes. Fundraisers on campus can be problematic nutritionally because, historically, sugary baked goods, candies, and sugar-sweetened beverages have often been sold at fundraising events. Consumption of ‘empty calories’ are major contributors to childhood obesity and school-wide nutrition practices such as food-related fundraising may be associated with obesity among students.