Every day at school, Kenzie Warren, a sophomore at West Plains High School, sets her backpack down at one of the six rows of rectangular tables that line the cafeteria. She walks over to the small table in the corner and pulls a knob on a glass dispenser to fill a disposable, plastic cup. A thick, maroon-colored smoothie blend folds into the cup at her fingertips. Walking back to the table, Kenzie and her friend, Kaley, pluck their straws into their smoothies.
Kenzie says after almost an entire school year of drinking smoothies with her lunch, she has more energy and likes the taste of more fruits and vegetables than she did before.
“The smoothies...at first, they were kinda hard to get used to because I don’t really like strawberries and I think there were strawberries in there. But as you went along, they asked you how they tasted and they just got better. But you know, the important thing: I was getting my fruits and vegetables and I feel healthier,” Warren said.
Students from West Plains and several other small towns across a six-county region in rural southern Missouri are drinking these smoothies as part of a much larger health initiative.
The program started in 2013 and was funded by the USDA. The original goal was actually related to building a healthier workforce so the rural area could attract more businesses.
The board members of the Southern Ozarks Alliance for Rural Development or ‘SOAR,’ sought to answer the question: “How do you create a healthy workforce?”
Mary Sheid, a physical therapist in West Plains and one of the board members spearheading the project, says creating jobs is crucial to the core of every community – and health is directly related to that.
“One of the things that is so expensive for businesses is health care. If you have healthier employees, health care costs will go down and we also know that healthier employees can be more productive and happier,” Sheid said.
So here's where the kids come in. The SOAR board decided to tackle the issue with a bold, preventative approach.
They created an initiative called SOARHigh and started Phase I, a study that assessed the health risks in the area’s youth.
The study ran health risk assessments on more than 600 students in 14 schools in the region. The students ranged from 6th through 10th grade. The results found that 80 percent of students did not get enough fruits and vegetables in their diets.
One in five students were pre-diabetic and 15 percent were obese.
Sheid says an even more surprising data point was that 49 percent of students fell outside of normal healthy weight ranges with 34 percent of them being underweight.
Carmen Boyd, an assistant professor of dietetics at Missouri State University, says hunger and malnutrition lower a kid’s ability to think straight and concentrate in school because their brains aren’t provided the energy they need.
Boyd said rural areas have widespread problems with hunger due to poverty.
“When you look at it from a national perspective, you’ve got a large group of kids that aren’t ever going to reach their intellectual potential. And if they’re not going to reach their intellectual potential, they’re not going to be contributing to society like you would expect. You know, that impacts regions. That impacts states. That impacts nations,” Boyd said.
Shannon Crosby, a registered dietician at CoxHealth, says hunger also affects behavior and emotional and cognitive development.
After releasing the results of SOARHigh Phase I, Sheid says the Missouri Foundation For Health granted funding for a second phase of the project in 2017.
Both Missouri State University and the Missouri University Extension have also joined to contribute resources to the project.
The goal of Phase II is to create a preventative model for schools to encourage healthy habits for kids. Phase II consists of three pillars: nutrition, exercise and emotional wellbeing.
To provide students with the daily nutrition they need, SOAR gave five of the participating nine high schools a juicer and a smoothie machine.
Dr. Sherry McMasters, superintendent at Couch R-1 School District in Oregon County says she tried the smoothies the first few days of the program because students were complaining about how they tasted. But it may have been their taste buds adjusting to fresh fruits and vegetables – because by the end of that week, she says the students were eager to get the smoothies.
McMasters incorporated this into her daily routine, too – and by doing nothing other than adding the smoothies to her diet, she’s seen her triglycerides – fat found in your blood – decline from around 800 in August to 350 by October.
“I think that they are proud now to be a part of this research as the year has progressed – that they are included in on something that could affect a lot of people, and I think they're proud of that,” McMasters said.
Students were also given an online program called Emode. Developed by Dr. Joe Hulgus, a psychologist and professor at MSU, Emode is a module of videos on personal well being that tackle subjects like self care, relationships, gratitude and mindfulness.
Hulgus says the social and emotional developmental piece is the thing that's missing from many other health programs.
“It’s really a unique project – as best I can search out in the literature –it hasn’t quite been done anywhere else in the country. And it's specifically focused on how to positively impact the health of rural youth. So it’s unique and we’re quite hopeful at our outcomes,” Hulgus said.
Incorporating emotional wellbeing has shown positive physical responses in the body, says Hulgus, like less stress, resulting in less cortisol and less stored up food reserves.
The other four high schools participating in Phase II who did not get the smoothies and Emode programs were given an exercise program called Spark.
Mary Sheid, the West Plains SOAR board member, has just been appointed to the State Board of Education. She says she hopes to develop a model for school systems statewide and eventually across the country with the results from Phase II.
“Our goal is that we would not only have a third phase so we can crunch down even more in terms of what the actual needs are, but part of what we’re doing with Phase II is first just figuring out and working closely with the public schools on how to integrate these interventions,” Sheid said.