- Fast-food menu offerings vary in dietary quality, but are consistently poor
- Estimated energy expenditures for school-based policies and active living
- AAP calls for schools to maintain daily recess and breaks
- CDC infographic explores impact of eating away from home, obesity
- Study: Childhood obesity rates drop in New York City, Los Angeles
- Screen time not linked to kids' physical activity
- Adding minutes to family mealtime can help keep childhood obesity at bay
- Kids who play food product games may eat more junk food
CHILDHOOD OBESITY NEWS
- Pediatricians issue first-ever diabetes guidelines for children
- The war on tater tots: Enlisting daycare centers in the fight against childhood obesity
- Reading, writing, and raisins: How school food innovations are reducing childhood obesity
- On Japan’s school lunch menu: A healthy meal, made from scratch
Feb. 2, 2013, The Washington Post
Goodbye candy bars and sugary cookies. Hello baked chips and diet sodas.
The government for the first time is proposing broad new standards to make sure all foods sold in schools are more healthful, a change that would ban the sale of almost all candy, high-calorie sports drinks, and greasy foods on campus.
Under new rules the U.S. Department of Agriculture (USDA) proposed Feb. 2, school vending machines would start selling water, lower-calorie sports drinks, diet sodas, and baked chips instead. Lunchrooms that now sell fatty “a la carte” items like mozzarella sticks and nachos would have to switch to healthier pizzas, low-fat hamburgers, fruit cups, and yogurt.
The rules, required under a child nutrition law passed by Congress in 2010, are part of the government’s effort to combat childhood obesity. While many schools already have made improvements in their lunch menus and vending machine choices, others still are selling high-fat, high-calorie foods.
Under the proposal, the USDA would set fat, calorie, sugar, and sodium limits on almost all foods sold in schools. Current standards already regulate the nutritional content of school breakfasts and lunches that are subsidized by the federal government, but most lunch rooms also have “a la carte” lines that sell other foods. And food sold through vending machines and in other ways outside the lunchroom has not been federally regulated.
“Parents and teachers work hard to instill healthy eating habits in our kids, and these efforts should be supported when kids walk through the schoolhouse door,” said Agriculture Secretary Tom Vilsack.
Most snacks sold in school would have to have less than 200 calories. Elementary and middle schools could sell only water, low-fat milk, or 100 percent fruit or vegetable juice. High schools could sell some sports drinks, diet sodas, and iced teas, but the calories would be limited. Drinks would be limited to 12-ounce portions in middle schools, and 8-ounce portions in elementary schools.
The standards will cover vending machines, the “a la carte” lunch lines, snack bars, and any other foods regularly sold around school. They would not apply to in-school fundraisers or bake sales, though states have the power to regulate them. The new guidelines also would not apply to after-school concessions at school games or theater events, goodies brought from home for classroom celebrations, or anything students bring for their own personal consumption.
The new rules are the latest in a long list of changes designed to make foods served in schools more healthful and accessible. Nutritional guidelines for the subsidized lunches were revised last year and put in place last fall. The 2010 child nutrition law also provided more money for schools to serve free and reduced-cost lunches and required more meals to be served to hungry kids.
Iowa Sen. Tom Harkin, a Democrat, has been working for two decades to take junk foods out of schools. He calls the availability of unhealthful foods around campus a “loophole” that undermines the taxpayer money that helps pay for the healthier subsidized lunches. “USDA’s proposed nutrition standards are a critical step in closing that loophole and in ensuring that our schools are places that nurture not just the minds of American children but their bodies as well,” Harkin said.
Last year’s rules faced criticism from some conservatives, including some Republicans in Congress, who said the government shouldn’t be telling kids what to eat. Mindful of that backlash, USDA exempted in-school fundraisers from federal regulation and proposed different options for some parts of the rule, including the calorie limits for drinks in high schools, which would be limited to either 60 calories or 75 calories in a 12-ounce portion.
The department also has shown a willingness to work with schools to resolve complaints that some new requirements are hard to meet. Last year, for example, the government relaxed some limits on meats and grains in subsidized lunches after school nutritionists said they weren’t working.
Schools, the food industry, interest groups, and other critics or supporters of the new proposal will have 60 days to comment and suggest changes. A final rule could be in place as soon as the 2014 school year.
Margo Wootan, a nutrition lobbyist for the Center for Science in the Public Interest, says surveys done by her organization show that most parents want changes in the lunchroom.
“Parents aren’t going to have to worry that kids are using their lunch money to buy candy bars and a Gatorade instead of a healthy school lunch,” she said.
The food industry has been onboard with many of the changes, and several companies worked with Congress on the child nutrition law two years ago. Major beverage companies have already agreed to take the most caloric sodas out of schools. But those same companies, including Coca-Cola and PepsiCo, also sell many of the non-soda options, like sports drinks, and have lobbied to keep them in vending machines.
A spokeswoman for the American Beverage Association, which represents the soda companies, says they already have greatly reduced the number of calories kids are consuming at school by pulling out the high-calorie sodas.
PUBLICATIONS AND TOOLS
By analyzing the food menus from the top fast-food restaurant chains in America, new research published in the journal Public Health Nutrition shows that these restaurants do not offer many menu items that meet dietary guidelines for healthy eating. Even those menu items that were part of the kid’s menu or marketed specifically as healthy, still fell far short of meeting dietary recommendations for fruit, vegetables, and whole grains.
Current dietary guidelines focus on encouraging Americans to eat healthy by increasing their consumption of fruits, vegetables, whole grains, and low-fat dairy and decreasing calories from solid fats (e.g., butter, cream) and added sugars. In order to determine the extent to which fast-food chains meet the dietary guidelines, researchers analyzed the menus from the top five fast-food chain restaurants (Burger King, McDonald’s, Subway, Taco Bell and Wendy’s) using the Healthy Eating Index-2005 (HEI-2005), a measure of diet quality. Researchers also looked at menu items specifically marketed for children, menu items that comprised a dollar or value menu, and those items that were advertised as healthier options.
Researchers found that each restaurant’s full menu scored fewer than 50 points on the HEI-2005 relative to a maximum of 100 points, which would be a perfect alignment with dietary guidance. The components that scored the poorest reflect the overall dietary patterns of many Americans. Menus did not have enough Whole Fruit, Dark Green and Orange Vegetables and Legumes, and Whole Grains and had too many calories from Solid Fats and Added Sugars. However, all ﬁve restaurants were close to meeting the recommendations for Total Grains and Meat and Beans components, areas where many Americans tend to be better at eating the recommended amount of servings.
The Physical Activity Guidelines for Americans, issued by the federal government in 2008, recommend that children and adolescents be active for at least 60 minutes per day. But in 2003-2004 only 42 percent of children ages 6 to 11 met that standard and fewer than eight percent of adolescents did.
This study estimated the number of minutes of moderate-to-vigorous physical activity various policy changes could support among youths. To conduct the assessment, researchers analyzed 85 past studies that used objective measurements of physical activity, such as accelerometers, pedometers, heart rate monitors, and direct observation. They then converted the measurements of energy expenditure from those studies into a standard estimate of minutes of physical activity.
- Daily physical education in school could support 23 minutes of physical activity per day.
- Classroom physical activity breaks could support 19 minutes.
- Increasing walking or biking to school could support 16 minutes.
- Renovating parks to include more equipment and opportunities for physical activity could support 12 minutes.
The study includes time estimates for nine different types of policy changes, in both schools and communities. These researchers conclude their findings could help policy makers make well-informed decisions regarding the best way to support physical activity among children and adolescents.
The American Academy of Pediatrics (AAP) recently released a policy brief that calls on all schools to have daily recess and breaks in order to promote activity and a healthy lifestyle. According to the AAP, “safe and properly supervised recess offers children cognitive, physical, emotional, and social benefits. It should be used as a complement to physical education classes, not a substitute, and whether it’s spent indoors or outdoors, recess should provide free, unstructured play or activity.” The AAP also says that recess should never be withheld as a punishment and the authors add that “minimizing or eliminating recess can negatively affect academic achievement, as growing evidence links recess to improved physical health, social skills, and cognitive development.”
The Centers for Disease Control and Prevention (CDC) released a new infographic on Jan. 22 to coincide with the time when many Americans have returned to their busy schedules and are challenged to stick to New Year’s resolutions.
The infographic, “Go Light When You Have A Bite,” examines how Americans’ food spending habits have shifted since the 1960s and the impact that eating four meals away from home – the number of meals the average American eats away from home each week – can have on waistlines. The infographic also includes simple solutions for eating healthier when away from home.
Jan. 17, 2013, HealthDay
By Steven Reinberg
Both New York City and Los Angeles are beginning to see real declines in childhood obesity rates, with policies initiated earlier in New York giving that city an edge, a new study shows.
"In New York City, the prevalence of obesity appeared to have peaked around 2003-2004, whereas in Los Angeles it appeared to have leveled off around 2008-2009 and started to decline in 2010-2011," said study author Jackson Sekhobo, director of research and evaluation in the division of nutrition at the New York State Department of Health.
Los Angeles trailed New York City in making strides against childhood obesity largely because New York unveiled a government program that promoted healthy behaviors among low-income kids sooner, Sekhobo said.
"The New York State WIC [Women, Infants and Children] program was among the first programs to bring attention to the growing epidemic of child obesity in the mid-1990s," he explained.
As part of the program, health officials began promoting nutrition messages in a citywide initiative called "Eat Well Play Hard," Sekhobo said. Messages focused on drinking low-fat milk, "which was innovative at the time," he noted.
The program also promoted eating more fruits and vegetables and exercising, along with aggressively supporting breast-feeding and limiting television viewing for young children, he said.
"New York City has been experiencing declines for several years, while Los Angeles has just peaked," Sekhobo noted. "There are other cities where the problem of childhood obesity is still growing." Sekhobo said similar initiatives are spreading across the country. "These efforts should be sustained, but change does take time," he said. "This is not something that can be done overnight."
One expert agreed.
"These findings suggest that ongoing education, support and approaches that target specific cultural and socioeconomic groups can have positive effects in reducing childhood obesity," said Samantha Heller, clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Conn.
"However, there is still much that needs to be done to encourage our families and children to be healthy," she said.
Educating parents as well as children on the importance of healthful food and regular physical activity may help shift cultural habits in a more positive direction. Limiting the number of fast-food restaurants in low-income areas and around schools may also make a dent in childhood obesity rates, Heller said.
"Bringing the healthy lifestyle message into the schools will be helpful as well. Nutrition programs and physical activity programs in schools for children of all ages should be a required part of the curriculum, and can help turn the tide toward reducing childhood obesity," she said.
Screen time not linked to kids' physical activity
Jan. 10, 2013, Reuters
By Genevra Pittman
Just four in 10 U.S. kids met dual national guidelines for getting enough physical activity and for limiting "screen time," researchers found – but the likelihood of kids exercising regularly didn't depend on whether they kept away from screens.
"I don't think it's as simple as, if a child is not watching television, then by default that child will be physically active," said the study's lead author, Tala Fakhouri, from the Centers for Disease Control and Prevention (CDC).
Guidelines from the National Institutes of Health and the American Academy of Pediatrics call for elementary school-aged kids to get at least one hour of exercise and spend less than two hours in front of screens every day.
The new findings are based on just over 1,200 U.S. children, aged 6 to 11, whose parents answered questions about their health and behavior. The survey group was designed to be representative of all kids nationwide in 2009-2010.
Fakhouri and her colleagues found that 70 percent of kids met the recommendations for daily physical activity and 54 percent met the screen-time recommendations, according to their parents' reports. Thirty-eight percent met both sets of guidelines.
Hispanic and older children and girls were less likely to get at least an hour of exercise each day than their white, younger, and male peers.
Older kids were also less apt to meet screen-time recommendations, as were black youth. However, Hispanic children were more likely than white kids to keep their screen time under two hours daily.
Obesity was tied both to not getting enough exercise and to spending too much time in front of TV and computer screens, according to the findings published this week in JAMA Pediatrics . But otherwise, there was no link between the odds of meeting one recommendation and meeting the other, the researchers said.
According to the CDC, 17 percent of U.S. kids and teens are obese. Getting kids off the couch and outdoors – as well as improving the nutritional content of meals at home and at school - is considered key to keeping that number from rising further.
But researchers said the new study backs up earlier findings showing too much screen time and not enough exercise may be separate issues that parents and schools need to address independently.
"These results show that we would be wrong in assuming that if school-based and/or community-based programs to increase children's physical activity are implemented, we would automatically see a reduction in sedentary behaviors (like watching TV)," Tami Benham Deal, who studies kids' physical activity at the University of Wyoming in Laramie, told Reuters Health in an email.
"Similarly, just turning off the TV or computer will not cause children to be more active," added Benham Deal, who wasn't involved in the new research.
Fakhouri told Reuters Health that parents in the study may have overestimated how active their kids are – so the real number of elementary school students getting an hour of exercise daily may be less than 70 percent. A similar 2003-2004 U.S. study, which used small devices called accelerometers to measure kids' activity, found just 42 percent met the recommendations, she said.
For parents, Benham Deal recommended making family time more physically active and giving kids toys that promote physical activity, rather than inactivity.
"As a parent, I always tried to use screen time as a reward for being physically active and when we watched TV, we would use the commercial breaks as fitness breaks," she added.
Jan. 18, 2013, RedOrbit
By Lawrence LeBlond
With the ever-present epidemic that is childhood obesity, it makes sense for parents to find ways to help teach their kids about healthy eating. A new study from the University of Illinois wants to help get that message across, especially to low-income families.
The researchers, led by Barbara H. Fiese, director of University of Illinois’ Family Resiliency Program, said when lower income families devote an extra three or four minutes to regular family mealtimes, it helps their children better learn to achieve and maintain normal waistlines.
“Children whose families engaged with each other over a 20-minute meal four times a week weighed significantly less than kids who left the table after 15 to 17 minutes,” said Fiese in a statement. “Over time, those extra minutes per meal add up and become really powerful.”
Childhood obesity in low-income households is a very complex issue, she added. There are many contributing factors, including being in a single-parent family, having a mother with little education, and living in poor neighborhoods with less access to healthy foods.
But, even as these risk factors accumulated, low-income children’s participation in regular high-quality family mealtimes made a difference in their weight levels, the study found.
In Fiese’s study, her and her colleagues observed mealtimes of 200 families, gathering data on the cumulative effects of socioeconomic factors and mealtime behaviors of families with children in elementary school. The authors noted the importance of several mealtime factors, including sharing a meal, scheduling family meals, and the attachment of special meaning to mealtime practices.
The authors found that socioeconomic circumstances mattered greatly when it came to childhood obesity in regards to length of mealtime. Children raised in a single-parent home were more likely to be overweight or obese than kids with two parents in the household. And when factoring in the neighborhood level, high concentrations of children living in poverty were associated with greater childhood obesity risks in the home.
Fiese and her colleagues pointed out that the quality of interaction at mealtimes also mattered. Families who said that their shared mealtimes are an important part of family life and have special meaning for them were less likely to have children that were obese. And families who talked more during mealtimes and interacted more positively were more likely to have children with normal waistlines.
Teaching low-income families how to make mealtime more important is a work in progress, Fiese noted.
“This is something we can target and teach. It’s much more difficult to change such factors as marital status, maternal education, or neighborhood poverty,” she added.
However, Fiese said that it may not be enough to advise families that eating together four or more times weekly is beneficial if they do not have the time, resources, or ability to communicate positively with each other. Many low-income parents are pressured for time, meaning that planning ahead, budgeting, shopping, preparing a healthy meal, and then sitting down to enjoy it with their children is a challenge, she added.
She recommends that programs should be developed and implemented to include information on the importance of shared mealtimes, time management, stress management, parenting skills, cooking lessons, and shopping strategies. If parents are taught to value family mealtimes and learn to make them a priority, they may protect their children from dangerous obesity and the harmful effects of living in a resource-starved environment.
Jan. 9, 2013, NPR (The Salt Blog)
By Nancy Shute
Some kids can't get enough of online games where they can pretend to run a candy factory or decorate cakes. But children who play with these games may eat more, and eat more junk food, even if the game features fruit or other healthful choices, according to new research.
Food industry critics have long bemoaned the fact that many popular food games for computers and other devices are actually "advergames," created by food manufacturers to market their products. Some argue marketing junk food to kids is unethical, even if it's through tiny bits of entertainment software.
To find out if advergames affect how children eat, Dutch researchers had children ages 8 to 10 play either a game that featured a popular brand of candy, or one that featured fruit. Another group of children played an online game involving a toy. All the games tested the children's memory skills. Afterwards, the children were offered bowls of jelly candy, chocolate, sliced bananas, and apples.
The researchers say they assumed that the children who played the fruit game would choose fruit. But boy, were they wrong. All the children who played a food-themed game ate more, and ate more candy, even if they played the fruit game.
"We were very surprised," Frans Folkford, a graduate student in communications at the University of Amsterdam who led the study, tells The Salt. The children who played food-themed games took in about twice as many calories as children who played a non-food game, or played no game at all. The work was published online in the American Journal of Clinical Nutrition.
Just looking at pictures of food is enough to make people want to eat, as any dieter can tell you. But food-themed games may be more persuasive, Folkford says, because children are actively engaged with them, and less likely to realize that the game is actually an advertisement.
Games may get children to eat more healthfully, but it's tricky, says Jennifer Harris, director of marketing initiatives at the Rudd Center for Food Policy & Obesity at Yale University. She found in a study she did last year that children who played an online game from the Dole fruit company did eat more fruit – but they also ate more overall. "A lot depends on the game and the actual messages in there," Harris says. "It's very complicated."
Over the past decade hundreds of food companies have launched online advergames aimed at children, Harris says, and millions of kids are playing them. Many mobile apps aimed at kids are also designed to market junk food to them. "Pay attention to what your kids are downloading," Harris says. "A lot of parents figure as long as it's free and it's listed as for children, they assume it's safe and not harmful. You really can't assume that."
It's harder to track children's use of advergame apps for mobile phones or tablets, she notes, but ones like "Cookie Dough Bites Factory" or "Candy Sports" often show up on lists of favorite downloads.
"The apps are made very appealing to deeply engage young users," says Jeffrey Chester, director of the Center for Digital Democracy, which lobbies on digital privacy. "They can be helpful, but they're also tiny spies lurking on your cellphone or other devices to market to you."
Food and beverage marketers have dramatically increased their spending on online and mobile marketing to kids and teens, according to a Federal Trade Commission report released in December.
CHILDHOOD OBESITY NEWS
Pediatricians issue first-ever diabetes guidelines for children
Jan. 28, 2013, TIME
By Bonnie Rochman
With childhood obesity rates on the rise, pediatricians are doing something they couldn’t have imagined a need for a decade ago: They’re debuting guidelines for managing weight-related diabetes among youngsters.
Children have long been diagnosed with type 1 diabetes, in which the body fails to make enough insulin-producing cells to process glucose in the blood, but doctors are now seeing an increasing number of children with type 2 diabetes, in which fat cells that enlarge with weight gain thwart the body’s ability to break down sugars. Up to a third of cases being diagnosed in kids these days are type 2, which generally develops later in life, generally after age 40. “We’re seeing it much more than we did before,” says Dr. Janet Silverstein, co-author of the new American Academy of Pediatrics (AAP) guidelines on diabetes and professor of pediatrics at the University of Florida. “Many pediatricians were never trained in managing type 2 because it just wasn’t a disease we used to see. It was a disease of adulthood. But as we’re seeing more obesity in kids, we’re seeing adult diseases in childhood.”
As pediatricians continue to encounter more children with diabetes, the AAP decided there was a need for clear, consistent advice on how to treat these kids. The group’s first recommendation: Screen all obese children for diabetes. Next: Figure out what type of diabetes they have.
The guidelines, which are the first of their kind for kids between the ages of 10 and 18, were developed in collaboration with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians, and the Academy of Nutrition and Dietetics.
They emphasize the importance of distinguishing between type 1 and type 2 to determine an appropriate treatment plan. Children with type 2 don’t necessarily need insulin. They may initially be treated with medication that increases their sensitivity to insulin. And they should be encouraged to move; doctors should advise them to exercise at least an hour a day and limit screen time that’s not related to schoolwork to under two hours a day.
But children diagnosed with type 1 diabetes always need insulin to regulate glucose levels in their blood. If doctors aren’t certain which kind of diabetes a patient has, they should start with insulin therapy until a more refined diagnosis can be made.
Each week at Children’s Hospital at Montefiore in the Bronx. N.Y., Dr. Rubina Heptulla sees up to three children who have recently been diagnosed with diabetes; about half have type 2. Heptulla, chief of the division of pediatric endocrinology and diabetes, says the number of cases of diabetic children is a pediatric “epidemic.” “I did not see this as a resident or fellow,” says Heptulla, who was not involved in developing the guidelines. “We would not have had these guidelines 10 years ago because there were not many cases. Now these guidelines are very relevant.”
While medications can control blood sugar levels, the guidelines also stress that parents and patients be aware that changes in diet and exercise can also be important in reducing risk of the disease. Pediatricians should be advising overweight and obese children to lose weight, and to exercise regularly. Studies of such diet and physical activity changes in adults showed that many diabetics could reduce their dependence on medications, and people who are likely to develop the disease could lower their risk by 58 percent compared to those who didn’t change their eating and exercise habits. Heptulla says the same should be true among children. “The way to make a difference is before they develop diabetes,” she says.
The war on tater tots: Enlisting daycare centers in the fight against childhood obesity
Jan. 4, 2012, TIME
By Jackie Mader
The childcare centers Debbie Ellis owns in Greenwood, Miss., used to serve instant potatoes, chocolate pudding, and fried food. Now she has a caterer prepare meals with whole grains and vegetables. And thanks to subsidies from the U.S. Department of Agriculture (USDA), she’s actually saving money by offering her kids healthier fare. They don’t have as much fun eating it, she says, “but we do have good quality.”
There have been a lot of stories this year about the USDA’s new nutrition requirements for school lunches, which started to kick in this fall. But less attention has been paid to places like Mississippi — which has the highest rate of childhood poverty and childhood obesity in the United States — where efforts are underway to help kids form better eating habits before they even reach elementary school.
Childcare centers are in a unique position to combat the problem since obesity usually begins between the ages of 5 and 6, according to the American Academy of Child and Adolescent Psychiatry. That’s why it’s essential to introduce children to a healthy diet as early as possible, says Geraldine Henchy, director of nutrition policy at the Food Research and Action Center in Washington. “They’re in childcare the majority of working days, and that’s where they’re really going to get nutrition and learn good eating habits.”
The new menus at Ellis’s daycare centers are approved by the federally funded Child and Adult Care Food Program, which reimburses centers for the cost of serving children a more nutritious diet. Ellis enrolled her two centers six years ago and, as a result, is saving more than $1,600 on food each month. But despite the obvious health and financial benefits, less than half of childcare centers across the United States participate in the program, which the USDA has acknowledged can place an undue burden on childcare centers.
To enroll, directors must attend two days of training; in Mississippi, these are usually held in Jackson, which is more than 100 miles away from Greenwood and other low-income towns in the Mississippi Delta. Then comes a trial period, monitored by the state. Afterwards, providers must submit daily attendance records, meal logs, and grocery receipts in order to get reimbursed.
Participating daycare centers have to place youngsters in one of six age groups, and since each age group requires different types and amounts of food, even serving something as simple as a smoothie can be a complicated process. A four-page memo released in July details what needs to be in the drink to qualify for reimbursement, the rates for which also differ by meal and by a child’s family income.
Furthermore, the program only covers the cost of food if the child shows up to eat it. If a youngster does not attend on any given day, providers must swallow the costs. The same is true for childcare centers that make a mistake, such as giving a child the wrong food; they too will owe money.
“Your thought is, I don’t want to deal with another agency and red tape,” said Donna Nicholson, owner of Kids Konnection in Richland, Miss. The childcare center has been open for 16 years, but did not enroll in the 44-year-old food program until April. Why did Nicholson wait so long? She says that the paperwork involves a lot of math, and she is nervous about making mistakes that would prevent her from being reimbursed.
Hot dogs and potato chips
Centers that don’t participate in the federal program have been known to serve more affordable, but unhealthy meals of hot dogs, chicken nuggets, potato chips, and fruit punch. In Mississippi, centers are required to submit menus to the state Department of Health whether or not they participate, but nutrition advocates say no one monitors them.
“These are small centers with very limited resources, just frightfully limited resources,” said Warren Yoder, executive director of the Public Policy Center of Mississippi. “They’re feeding children a very inadequate diet.”
In 2007, a federally commissioned group of experts attempted to simplify the most cumbersome of the requirements. Some of these recommendations were put in place three years later by the Healthy, Hunger-Free Kids Act.
But even with these improvements in place, “it is extraordinarily difficult for a small rural center in an underdeveloped area without much administrative capacity,” said Yoder.
“I think we’ve probably gotten as far as we can go,” he said. “And now, we’ve got to look for another model to make [participation] happen.”
In 2011, only about 38 percent of Mississippi’s 1,800 childcare centers participated, even though nearly all were eligible, according to Lenora Phillips, who directs the program for the Mississippi Office of Healthy Schools. Although participation rates in Mississippi have increased 93 percent since 1996 — the year welfare reform created eligibility guidelines for the program — it’s far less than advocates had hoped. Nationally, participation rates have only increased 59 percent over the same period.
Even more discouraging are participation rates for family daycare homes — largely unlicensed programs that do not have to comply with childcare center regulations — which have plummeted in Mississippi and across the country. In a 2003 memo, the USDA attributed this to complicated changes in the program. Since 1996, the year these changes were implemented, the number of family daycare homes enrolled in the food program has dropped nearly 60 percent.
A scattered but growing network of Mississippi nonprofits has been leading the efforts in the state to bolster participation, by convincing centers of the federal food program’s value and supporting them through administrative tasks.
The need to improve nutrition is urgent in Mississippi, where more than two-thirds of adults could be obese by 2030 if current trends continue, according to a recent report by Trust for America’s Health and the Robert Wood Johnson Foundation.
Obese children may face long-term health problems and are at higher risk of social, psychological, and academic problems, including lower math scores.
A report released in early September suggests that recent school-based efforts to combat childhood obesity in the state have been relatively successful. In 2006, Mississippi established nutritional standards for food sold in school vending machines. A year later, a state law was passed requiring public schools to provide more physical activity time. Since then, obesity has decreased 13 percent for school-aged children.
A complex program
In Leland, a town where 67 percent of children ages 5 years and younger live in poverty, Deloris McWright works to boost enrollment in the federal program. McWright has helped eight centers in the Mississippi Delta — the poorest part of the state — make it through the application process; seven more are on a waiting list for her support.
But in a state where the median income is about $24,000 — and even lower for single parents — thousands of low-income families in the state cannot access quality childcare, much less ensure their children eat nutritious food. Only 35 percent of working families who qualify for federally subsidized childcare are being served, said Carol Burnett, director of the Mississippi Low-Income Child Care Initiative.
McWright thinks better communication about the financial and nutritional advantages of participating would encourage other centers to enroll. She still owns her own center and spends time every morning making sure all is running smoothly, even though it’s not easy. “It is a passion for me because I know how hard it was for me when I started,” she said.
Reading, writing, and raisins: How school food innovations are reducing childhood obesity
Jan. 29, 2013, Smartplanet
By Christina Hernandez Sherwood
On a chilly November morning, the auditorium at the Philadelphia School District office was sweltering. In what looked like a flash mob dance rehearsal, dozens of city school students wearing blue T-shirts with the slogan “Believe the Hype” bounced and swayed to the song Gangnam Style. Forming a sweaty, smiling Conga line, they weaved around the room as local health educator and rap artist Sterlen Barr shouted, “That’s what it means to be hype!”
Despite the mid-morning dance party, much of this youth summit meant to encourage students to promote healthy changes at their schools was focused on food. Before busting their moves, the students from 40 city schools enjoyed a breakfast of Greek yogurt and listened as administration officials gave shout-outs to school-based food successes, such as a salad sale at a North Philadelphia elementary school. There’s much to celebrate here. Over the past several years, Philadelphia has revamped its school food offerings with striking success.
Over a lunch of wraps and baked chips, the students split into small groups to brainstorm with classmates about how to keep the momentum going. A handful of Southwest Center City middle-schoolers dreamed up innovative ways to bring healthy change to their school — where many students eat at least two meals a day. While eighth-grader Terell Greennagh resolved, “lunch is going to be hard to change,” his classmates hoped the school would serve snacks of baby carrots or grapes rather than pretzels. Terell’s seventh-grade sister Terria lamented that recess ended at sixth grade. “We used to go outside and play double-dutch every day,” she said. “Instead of just sitting there for lunch, they should let us do something.”
Conversations like these are happening in school district offices, classrooms, and businesses around the globe as much of the world struggles with an obesity epidemic. In the United States, the steady uptick in childhood obesity means today’s children could live shorter lifespans than their parents. Health problems that were once adult conditions — namely diabetes and cardiovascular diseases — now strike children, said Dr. James Marks, senior vice president and director of the Health Group at the Robert Wood Johnson Foundation (RWJF). “Since the late 1970s, the rates of obesity have gone up in children three- to four-fold,” he said. “It increases the likelihood of so many serious illnesses.”
To stem the tide, national and regional healthy food initiatives are targeting schools. “Why are we going to schools?” Marks said. “Because that’s where the kids are.” Children consume as many as half their meals in schools, according to the U.S. Department of Agriculture, with more than 5 billion school lunches served in 2011. With children spending so much time — and so many calories — in school, it’s the ideal place to promote nutrition, Marks said. “If [school] is a healthy place,” he said, “they get used to that.”
A recent study showed the efforts are paying off. In a September report, RWJF found the national childhood obesity rate has remained steady in recent years and some cities and states, including Philadelphia and California, have seen drops. “We’ve had about 30 years of steady increases,” Marks said. “Now we’re seeing a leveling off and, in a few cases, a decline.” The Institute of Medicine reported that if other communities followed the lead of the most successful cities and states, children’s health would continue to improve. “If we act,” Marks said, “we could be confident of a decline.”
Philadelphia, which saw a 4.7 percent decline in its childhood obesity rate from the 2006-2007 school year to the 2009-2010 school year, stands out. It was the first city to show greater reductions in high-risk groups. The obesity rate for African American boys declined by 7.6 percent, the study showed, while the rate for Hispanic girls decreased by 7.4 percent. “If we as a nation had shown greater progress in the well-to-do kids,” Marks said, “we actually would have been exacerbating disparities.”
On a national scale, school food was revamped in 2010 with the passage of the Healthy, Hunger-Free Kids Act, which came into effect this academic year. New lunch standards included reducing fat and sodium content, increasing whole grain foods, and doubling fruit and vegetables. Though the USDA is offering a 6-cent reimbursement rate increase for the new meals, individual cities and states have found creative ways to adhere to the standards in their schools. And many — including Philadelphia — added innovations of their own.
Even as an economically disadvantaged city — with 26 percent of the population below the federal poverty level in 2011, according to the U.S. Census Bureau, Philadelphia is the poorest big city in the United States – the school food movement there made strides. The district banned soda machines, restricted portion sizes and sodium in snacks, introduced a lunch menu with more whole grains, educated parents about healthy eating, and established school wellness councils. Marks remembered visiting a Philadelphia elementary school where students experimented with tasting new fruits and vegetables. He met a third-grade girl who had her first banana at school — and it became her new favorite fruit.
At Francis E. Willard, a K-4 school in North Philadelphia, initiatives include color-based tastings, where red foods like strawberries and cabbage grace the menu, and fundraisers promoting fruit salad and smoothies instead of candy and brownies. At a fall wellness event there, Elaine Rosario, the parent of a fourth-grade girl, said she’s glad the school instills healthy habits. Because Rosario’s children watch her deal with diabetes, including regular finger pricks for blood-sugar testing, they’re motivated to be healthy. “They tell me, ‘Mom, I don’t want to poke myself,’” she said.
When the new national standards were released, some Iowa schools shied away from offering lunchtime salad bars because of difficulties monitoring food distribution for government reimbursement, said Carrie Scheidel, co-director of the nutrition team at the Iowa Department of Education. “We heard schools saying they were just putting their salad bars into storage,” she said. But some now offer a fruit and vegetable bar instead. For a school lunch to be government reimbursable, Scheidel said, a fruit or vegetable must accompany the entree. With a fruit and vegetable bar, students decide whether they’re in the mood for orange wedges or bite-sized broccoli. “You’re not putting something in their plate that they’re not going to eat,” Scheidel said.
Businesses join the fight
Behind the scenes, businesses are playing a growing role in the healthy school food movement, especially since the new standards, said Lawrence Soler, president and chief executive of the Partnership for a Healthier America, a nonprofit working with the private sector in the childhood obesity fight. The cookware giant All-Clad agreed to donate $2 million worth of cooking equipment to schools partnering with chefs to improve nutritional education, he said. “There’s been a marked increase in the amount of interest we’ve had from vendors and private sector companies,” Soler said. “They’re going to play a critical role in ensuring that options offered in school food are healthy and appreciated by kids.”
When Kristin Richmond and Kirsten Tobey of Revolution Foods set out to build a company offering delicious and nutritious school meals, they were cheered on by teachers and principals. The educators lamented that some students’ only school-day fuel was Cheetos and a Slurpee — evidenced by red teeth and blue tongues. “If we’re not setting kids up for success with what they’re eating in school,” Tobey said, “we’re not going to set them up for success academically.”
Revolution Foods ignored critics who said kids would never give up junk food. Since its 2005 launch, the company has served more than 50 million meals, many in low-income communities, Tobey said. Its partners include Stonyfield Farms, the organic yogurt company, she said, and one of its most popular items is a five-ingredient hotdog made with grass-fed beef. “Food has to taste good in order for kids to want to eat it,” she said. And while Tobey admitted that healthy food tends to cost more than highly-processed, preservative-packed food, she said Revolution Foods offers meals that can be reimbursed by the federal government.
Farmers have been another private sector partner in the movement to make school food healthier. The USDA’s Farm to School program, which helps bring local or regional food to school cafeterias, is complementary to the new nutrition standards, said Colleen Matts, farm to institution specialist at the Michigan State University Center for Regional Food Systems. “If we can introduce new and different healthy foods to kids,” she said, “those are things that can last with them through their lifetime.” Before connecting them with farmers, Matts helps schools determine which farm-fresh foods to incorporate into their menus. Schools that already serve apples might start there. “Can they substitute in a local apple?” Matts said.
While partnerships with schools aren’t huge moneymakers for farmers, Matts said, they can provide high-volume and guaranteed sales. “Some farmers have been doing less marketing at farmers markets in favor of institutional sales,” she said. Other farmers appreciate the personal connection they get from working with schools, Matts said, such as interacting with students through cafeteria chats and after-school programs. “The students will see them and say, ‘Hey, there’s Farmer Mike with his apples,’” she said.
Even as childhood obesity rates decline, challenges to lasting change remain. Cafeteria staff accustomed to heat-and-serve meal preparation need training to handle fresh food, Matts said, and some schools don’t have the space and equipment to store and prepare it. And while the USDA works to make local food accessible to all schools through its system, Matts predicted success was a long way off. Vendors need to be USDA-certified to participate, she said, and not a single Michigan farmer has signed up for the expensive certification process. “They’re talking about doing the school food system differently,” Matts said. “It’s been institutionalized for so many years.”
Obstacles outside school walls might pose the biggest threat to the school food movement. Terria Greennagh’s Philadelphia community is packed with corner stores, but the nearest supermarket is a mile away. After school, neighborhood kids frequent a pizza shop where slices sell for $1.50. Scheidel of Iowa said the childhood obesity fight needs to move into homes and communities. “When I grew up I didn’t really like school lunch, but I loved my mom’s well-balanced meals,” she said. “It’s almost like we switched roles over the years.” Now, Scheidel said, parents say their children don’t like the new healthy options. “If they’re not eating fresh foods and whole grains at home,” she said, “they’re not going to like school lunch.”
Still, school food officials believe we’re headed in the right direction. Another four years with the Obama administration — and a first lady who has prioritized children’s health — will help institutionalize positive changes, Matts said. And it’ll give schools time to catch up to the new standards by finding available fresh food and learning to handle the products. “I don’t think all schools were ready,” she said. “Schools are adjusting and students are adjusting.” Marks of RWJF said the encouraging signs should be greeted with cautious optimism. “We have to think of these as green shoots,” he said. “They’re early, they’re fragile, they’re encouraging, but our culture isn’t there yet.” We need to go much farther, Marks said. “It’s not just what a local school can do, but what our national companies and organizations can do as well,” he said. “There’s still much more to be done.”
On Japan’s school lunch menu: A healthy meal, made from scratch
Jan. 27, 2013, The Washington Post
By Christina Hernandez Sherwood
In Japan, school lunch means a regular meal, not one that harms your health. The food is grown locally and almost never frozen. There’s no mystery in front of the meat. From time to time, parents even call up with an unusual question: Can they get the recipes?
“Parents hear their kids talking about what they had for lunch,” said Tatsuji Shino, the principal at Umejima Elementary School in Tokyo, “and kids ask them to re-create the meals at home.”
Japan takes seriously both its food and its health and, as a result, its school lunches are a point of national pride — not a source of dismay. As other countries, including the United States, struggle to design school meals that are healthy, tasty and affordable, Japan has all but solved the puzzle, using a system that officials here describe as utterly common sense.
In the United States, where obesity rates have tripled over the past three decades, new legislation championed by Michelle Obama has pushed schools to debut menus with controversial calorie restrictions. But even the healthiest choices are generally provided by large agri-food companies, cooked off site, frozen and then reheated, and forced to compete in cafeterias with all things fried, salty, and sweet.
Schools in Japan, by contrast, give children the sort of food they’d get at home, not at a stadium. The meals are often made from scratch. They’re balanced but hearty, heavy on rice and vegetables, fish, and soups. The meals haven’t changed much in four decades. Mealtime is a scene of communal duty: In both elementary and middle schools, students don white coats and caps and serve their classmates. Children eat in their classrooms. They get identical meals, and if they leave food untouched, they are out of luck; their schools have no vending machines. Barring dietary restrictions, children in most districts can’t bring food to school, either, until they reach high school.
Japan’s system has an envious payoff — its kids are relatively healthy. According to government data, Japan’s child obesity rate, always among the world’s lowest, has declined for each of the past six years, a period during which the country has expanded its dietary education program.
Japan does struggle with childhood and adolescent eating disorders, and government data show a rise in the number of extremely skinny children. But there is virtually no malnutrition resulting from poverty. Japan’s children will live on average to age 83, longer than those in any other country, according to the World Health Organization.
When it comes to food, Japan has some deeply ingrained advantages. Children are taught to eat what they are served, meaning they are prone to accept, rather than revolt against, the food on their plates. But Japan also invests heavily in cultivating this mindset. Most schools employ nutritionists who, among other tasks, work with children who are picky or unhealthy eaters.
Though Japan’s central government sets basic nutritional guidelines, regulation is surprisingly minimal. Not every meal has to meet precise caloric guidelines. At many schools, a nutritionist draws up the recipes — no bureaucratic interference. Central government officials say they have ultimate authority to step in if schools are serving unhealthy food, but they can’t think of any examples where that actually happened.
Funding for lunches is handled locally, too: Municipalities pay for labor costs, but parents — billed monthly — pay for the ingredients, about $3 per meal, with reduced and free options for poorer families. Notable is what’s lacking: You don’t see low-fat options. You don’t see dessert, other than fruit and yogurt. You occasionally see fried food, but in stark moderation. On a recent day at Umejima, kids were served the Japanese version of fried chicken, known as karaage. Each child was allowed one nugget.
Officials at Adachi Ward, in northern Tokyo, say they run a “fairly standard” school lunch program in the ward’s 71 elementary schools and 37 middle schools. And because this is food-obsessed Japan, those standard meals are restaurant-worthy; in fact, the ward publishes a full-color cookbook based on its best school meals.
District officials allow themselves to brag for just one reason, their success in cutting food waste to 5 percent. This follows the “Oishii Kyushoku,” or “Delicious School Lunch,” program they created five years ago to get kids more interested in what they were eating. At Umejima, one of Adachi Ward’s schools, the hallway walls look like the pages of Bon Appetit magazine. Hand drawings of healthy lunches dreamed up by students hang near the principal’s office. There are charts of beans and spices. Then there’s the real food, which is chopped, diced, and simmered every morning, beginning at 8 a.m., by a staff of 12. Shortly after noon, they’ll have meals for 760 students. “Everything is cooked on site,” school nutritionist Kimii Fujii said. “We even make our own broth.”
Fujii has an expansive job — part educator, part chef, and the point person for parent questions. Because of concerns about food contamination in the wake of the Fukushima Daiichi nuclear disaster, Fujii gives a daily account on the school website of where the lunch ingredients are coming from: the sardines from Hyogo, the carrots from Chiba, the bean sprouts from Tochigi.
She writes the recipes, changing them to reflect seasonal ingredients, and she’s realized, over the years, that kids will eat almost anything if you serve it to them right. They’ll eat hijiki, an earthy black seaweed, if you mix it with rice. They’ll eat small whole fish, heads and all, if they are lightly fried. Tofu is an easier bet, but just to be sure, it sometimes comes with minced pork.
Fujii doesn’t teach a class, but three or four times a year, classrooms come visit her for lunch — meaning they eat in the cafeteria, rather than their classrooms. This field trip comes with a small price: After the kids have served themselves the food, but before they can eat, they get a five-minute lecture about the items on their plates.
Lunchtime, on this particular day, begins with a call from the teacher.
“People in charge, please come up.”
Six third-graders put on their white sanitary smocks and caps and take their positions behind serving trays. One child eyes the thick reservoir of Sichuan tofu and wiggles his right arm, as if to warm up his ladling hand. A teacher shows the girl serving rice how much to give each of her classmates — between 160 and 180 grams.
“Is this okay?” the girl asks as the first student comes by.
When everybody sits back down, the lecture begins.
“Today’s meal is made up of various ingredients, but to fill you up, you have to eat everything fully,” Fujii told the class of third-graders. “If you finish this whole lunch, it means you are taking in 21 ingredients.”
One child interrupted.
“You have to eat a balanced meal.”
“That’s right,” Fujii said. “You can get full without vegetables, but we still need them. Why do we need them? Because they have vitamin C, which makes you stronger.”
Eating as education
Japanese food, contrary to the common perception, isn’t automatically healthy; it includes crispy chicken, rich bowls of salty ramen with pork belly, and battered and deep-fried tempura. But, like most cuisines, it can be healthy.
Japan began emphasizing healthy food for its students in the aftermath of World War II, when the government prioritized education and health as a way to catch up to the modernized West. For a decade after the war, school lunch food was still coming from international donations. Many older Japanese remember postwar school meals of powdered skim milk, bread, and daikon radish. But by the 1970s, the school meal came to look much like the modern-day standard. These days, ethnic food (such as Korean or Italian) is mixed in once or twice per week.
Japanese government officials say no other country has copied Japan’s system of made-from-scratch meals eaten in classrooms, or even tried to.
“What is most difficult for me to explain is why we can do this and other countries cannot,” said Masahiro Oji, a government director of school health education.
Oji mentioned that last year he attended an Asia-Pacific Economic Cooperation workshop in Moscow on school lunch programs. Japan sent members of its education ministry, Oji said. Most other nations sent members from their agriculture or farm ministries.
“Japan’s standpoint is that school lunches are a part of education,” Oji said, “not a break from it.” Yuki Oda contributed to this report.