This study examined the BMI, dietary habits, body perception, physical activity patterns, and nutrition knowledge and opinions of 599 fourth grade public school students in Wells County, Indiana, in 2003-04 and 2005-06. Participants completed the School Physical Activity and Nutrition (SPAN) survey and had their height and weight measured. Almost half (49.9%) of the participants were at risk for or were overweight. More than one-quarter (29.1 %; n=91) normal weight students perceived they did not weigh enough. At risk for overweight children were more likely to participate in exercise that did not raise their heart rate than normal weight children. Normal weight children participated in more cardiovascular-raising activity than overweight children did. Students engaged in significantly more cardiovascular exercise in 2005-06 than in 2003-04. Students "usually" spent 3.4 ± 2.0 hours per day in screen time. Interventions that encourage healthy eating and physical activity would benefit students in this community.