Many parents will have breathed a sigh of relief at the prospect of their children returning to school after the summer vacation. But rather than having to think of ways to keep them entertained or out of mischief, parental thoughts now turn to ensuring that they stay fit and well throughout the school term.

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Keeping healthy is key to a child enjoying and performing well at school.

According to the US National Center for Education Statistics, around 50.1 million students will attend public elementary and secondary schools this fall, with another 4.9 million students estimated to attend private schools.

Each of these children will experience school differently. Some may be incredibly excited about entering the classroom, while others may find it anxiety-inducing and stressful.

Although each child will have unique perceptions of school, there are also a number of concerns that apply to schoolchildren almost universally, such as what should be eaten at lunch and what bags should be worn.

As a result, there are a number of health tips that can be followed to ensure that all children are in the best possible position to succeed at school.

In this Spotlight, we take a look at some of the measures that can be taken to help children heading back to the classroom stay as healthy as they possibly can, and in doing so, help them both enjoy and perform well at school.

The best fit for a healthy back

When you picture a child heading off to school, one of the first things that comes to mind is their backpack. It is an essential piece of equipment that no young student can do without. Considering the amount of books and supplies that are carried in these bags, it is unsurprising that they can have a significant impact on health and wellbeing.

"A child wearing a backpack incorrectly or that is too heavy can be contributing risk factors for discomfort, fatigue, muscle soreness, and musculoskeletal pain especially in the lower back," states Karen Jacobs, clinical professor of occupational therapy at Boston University, MA.

Indeed, the US Consumer Product Safety Commission reported that almost 28,000 sprains, strains, dislocations and fractures were treated in emergency rooms and clinics in 2010 attributable to backpack wearing.

As a result, great care should be taken when deciding what backpack a child wears. Although children can be picky with what they wear, there are a number of factors that should always be taken into consideration when selecting a backpack.

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Wearing an uncomfortable and ill-fitting backpack can lead to numerous health problems associated with the back and shoulders.

The most important thing is that a backpack should fit, in the same way that a new pair of shoes should be comfortable to wear. A good backpack should not be wider or longer than the torso of the wearer, and should be from around 2 inches below the shoulder blades to around waist level.

"The right fit should be your top criteria when selecting your child's backpack," advises Jacobs. "If you order online, be sure that the seller has a return policy just in case the backpack is not quite the best fit for your child and needs to be exchanged."

When wearing a backpack, the wearer should always use both straps to ensure that its weight is distributed evenly across the body. Ideally, a backpack's straps should be padded to provide additional support and to stop them from digging into the shoulders.

Padding in the back of the pack serves the dual role of providing extra support and protecting the wearer from pointed edges such as the corners of large books.

Some backpacks also come with hip belts, which are terrific for taking some of the weight off of the wearer's shoulders and neck. These can also improve the wearer's balance.

Finally, backpacks should not be too heavy, ideally weighing no more than 10% of a wearer's body weight. Ensure that a backpack only contains the items it has to, making use of storage spaces both at home and at school. Distribute weight wisely as well, positioning heavier items next to the back and lighter items in outer compartments.

Aside from routinely weighing a child's backpack, there are a number of signs that can suggest when a backpack is too heavy. Changes in posture when the bag is being worn, having difficulty with putting the bag on or taking off, pain, numbness and red marks associated with wearing the backpack all signify that a bag is too heavy.

Packed lunches: a balancing act

One item that can be found in many school backpacks is a packed lunch. Parents who prepare the lunches that their children eat at school play an important role in both the health of their children and their academic performance.

Not only have the Centers for Disease Control and Prevention (CDC) suggested that hunger can lead to poor school performance, but healthy students tend to perform better than unhealthy ones. This indicates that healthy and filling lunches could be crucial to how a child does at school.

Most advice on healthy packed lunches recommends being creative as well as health-conscious, in order to keep a packed lunched nutritionally balanced but also easy to eat. Packed lunches should aim to contain a mixture of different types of food:

  • Starchy food, such as bread, tortilla wraps, rice or pasta
  • Protein food, such as meat, fish, eggs or beans
  • A portion of fruit or vegetables
  • A dairy item, such as cheese or yogurt.

To prevent making lunches that tick all these boxes from becoming a formulaic chore, the American Heart Association (AHA) have a number of suggestions that can make it easy to provide a balanced meal.

Sandwich staples such as cheese and mayo can be substituted for slightly more healthy options such as avocado and hummus that have similar textures. Adding extra vegetables to sandwiches can be done subtly. Shredded carrot and zucchini can be used in a similar way to lettuce and tomato and augment a standard turkey sandwich with a different taste experience.

Leftovers from family dinners can also make providing a healthy and fulfilling lunch a simpler task. Some meals can provide the basis for sandwiches - leftover grilled chicken, for example - while other meals can provide a lunch in and of themselves, such as leftover chili, pasta or casserole.

Young children often find food that involves dunking especially pleasing, and dunking and dipping snacks represent a great opportunity to provide food that is both healthy and fun. Such food can be sweet or savory; slices of fruit can be dipped into low-fat yogurt and peanut butter, while strips of vegetables can be dunked into hummus or salsa.

Although some children are happy to eat the same thing every day, varying what goes into a lunch box can encourage them to try out new things that they otherwise might not consider.

Finally, including children in the process of choosing and preparing food for packed lunch can also inform them about making healthy choices while improving the likelihood of them eating their lunch. Children are more likely to eat food that they have chosen themselves.

Getting a good night's sleep

Sleep is important for children who are attending school, recharging their batteries so that they have the energy to engage with their schoolwork, while also protecting against the negative consequences of stress.

For many children, returning to school after the summer vacation can be a very stressful experience, particularly if they are starting out at a completely new school and do not know anybody yet.

A recent study, led by researchers from Concordia University in Montréal, Canada, and published in Psychoneuroendocrinology, examined the impact of getting a good night's sleep on children's cortisol levels - a hormone helps regulate the body's cardiovascular, metabolic and immune systems.

Cortisol is produced as a result of stress and is useful for preparing the body's "fight or flight" response to threatening situations. Too much cortisol, however, can increase an individual's risk of certain health problems, such as heart disease and depression.

Lead author Jinshia Ly explains what it means to have a good night's sleep:

"Sleep researchers distinguish sleep duration, or how long one spends sleeping, from sleep quality, or how well one sleeps. Sleeping throughout the night without waking up, feeling rested in the morning, and absence of sleep problems, such as nightmares, apnea and snoring, are examples of a better quality sleep."

For the study, the team measured the cortisol levels of 220 children aged 8-18 years old and surveyed both them and their parents about their sleep habits and stress levels. They found that poor self-reported quality of sleep boosted the negative influence that stress had on cortisol levels.

While it is important the children sleep for the right length of time - around 8-9 hours per night - the researchers argue that consistency is key to children having a good night's sleep.

"It's even more important that they get to bed early with regular sleep and wake times, avoid napping during the day and avoid using electronic devices before bedtime," Ly advises. "It is also important that parents educate their kids at an early age about the importance of consistent and healthy sleep habits."

The team concludes that such an education can enable children to make healthier choices when they have more control over their bedtime routines.

Screen time and keeping active

If a child is stressed, it might be tempting to allow them to relax with video games or watch television, but too much screen time can have a negative impact on their health.

As mentioned above, using electronic devices before bedtime could reduce the quality of sleep. A study published in February in BMJ Open found that if teenagers took more than an hour to get to sleep, there was an almost 50% greater likelihood that they were spending more than 4 hours a day outside of school using electronic devices.

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Electronic devices such as video games, TVs and computers should not be used by children for more than 2 hours a day, according to official recommendations.

The general recommendation for children over the age of 2 is that screen time should be limited to 2 hours a day at the most. Time spent using electronic devices such as computers, TVs and smartphones is time taken away from physical activities that can benefit body and mind.

Spending too much time in front of the TV could increase the risk of a child being bullied at school, according to one study that Medical News Today reported on earlier this year, published in the Journal of Developmental & Behavioral Pediatrics.

On the other hand, researchers who assessed the health of adult women found that the amount of exercise they participated in during their teenage years appeared to reduce their risk of dying from cancer or other causes in adulthood.

Being active, while helping children stay healthy, can also be an opportunity for family time. Walking with children from home to school is the easiest way to do this if the journey is not too far. Turning off the TV during mealtimes and eating together as a family also promotes healthy behavior, according to the National Heart, Lung, and Blood Institute (NHLBI).

The NHLBI state that it is important for parents to be role models for their children when it comes to reducing screen time and engaging in physical activity. A child is less likely to want to do these things if it seems to be alright for their parents to sit around and watch TV all evening. "If you reduce your screen time and move more, your kids will too," the NHLBI advise.

The importance of having good role models

This final point alludes to another pertinent fact; all of these health tips are relevant no matter what age the individual is. Adults can benefit from comfortable backpacks and healthy, balanced packed lunches just as much as children can.

Following these tips as a parent can not only make you a good role model for a child but also a much healthier individual at the same time.

One final point to consider comes from another recent study that MNT reported on. The study, published in the Journal of Positive Psychology, found that children who have caring and less psychologically controlling parents when growing may be more likely to find happiness and satisfaction in later life.

Although parents tend to have their children's best interests at heart, they must be careful to take the feelings of the children into consideration. A child who is given a packed lunch that, despite being healthy, contains food they dislike intensely is one that is likely to be unhappy and less receptive to other healthful strategies.

A child's school days should hopefully be one of the happiest times of their lives. By helping them stay healthy - both physically and emotionally - there is little reason that this should not be the case.