Nutritional integrity in our schools and the

impact on child health

Tiffany Ford, Mike Gilmer, Jennifer Heidel, Micah Morris, Nishi Parikh, Heather Schillinger,

Rebecca Willis

Join the School Lunch Revolution!

CURRENT NUTRITIONAL

STATUS

ADA POSITION STATEMENT

• It is the position of the American Dietetic Association that children ages 2 to 11 years should achieve optimal physical and cognitive development, attain a healthy weight, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity.

http://eatright.org/cps/rde/xchg/ada/hs.xsl/index.html

STATS/FACTS• The number of children who are

overweight has more than tripled among 6- to 11-year-old children

• Approximately 10.4% of children 2 to 5 years of age and 15.3% of children 6 to 11 years of age are overweight.

• Overweight is now more prevalent among American children, including low-income children, than underweight or growth retardation.

THE IMPACT• Healthful eating habits in childhood help

to prevent chronic undernutrition and growth retardation as well as acute child nutrition problems such as iron-deficiency anemia, dental carries.

• Proper eating habits and physical activity can also prevent long-term health problems, such as obesity, type 2 diabetes, stroke, cancer, and osteoporosis.

• Additionally, overweight also often experience psychologic stress, poor body image, and low self-esteem.

TODAY’S CONCERNS• Particular eating concerns include the

overconsumption of dietary fat, especially saturated fats, and inadequate intake of calcium and iron.

• Approximately 68% to 75% of US children exceed the current dietary recommendations for intake of total or saturated fats.

WHY IS A BALANCED DIET IMPORTANT?

• Iron-deficiency anemia in the United States has negative effects on child’s motor and mental development and thus on their work capacity.

• High intakes of saturated fats have been linked with increased plasma total and low-density lipoprotein (LDL) and cholesterol in childhood and can ultimately increase the likelihood of cardiovascular disease.

WHY IS A BALANCED DIET IMPORTANT?

• Failure to meet calcium requirements in combination with a sedentary lifestyle in childhood can impede the achievement of maximal skeletal growth and bone mineralization, thereby increasing the diet-related risk of developing osteoperosis.

REFERENCE

J am Diet Assoc. 2004;104:660-677.

CURRENT PROGRAMS

UNITED STATES DEPARTMENT OF AGRICULTURE (USDA)

FOOD AND NUTRITION SERVICE

•Administers National School Lunch Program and School Breakfast Program•Provides nutritionally balanced, low-cost or free lunches and breakfasts•USDA school meals programs operation•National School Lunch Act and Child Nutrition Act•Food provided by USDA

NATIONAL SCHOOL LUNCH PROGRAM (NSLP)

 Healthy Meals, Healthy Schools, Healthy Kids. United States Department of Agriculture. 2007.

NATIONAL SCHOOL LUNCH PROGRAM CONT.

·30 million students participate each school day in NSLP in approximately 101,000 schools·17.5 million students receive a free or reduced-price school lunch every school day·More than 2 million children have been added to the NSLP·NSLP and Vegetables·After School Snacks

SCHOOL BREAKFAST PROGRAM (SBP)

·Nearly 10 million children in 82,000 schools receive a school breakfast every school day·7.7 million students received a free or reduced-price breakfast·More than 2 million children have been added to the school breakfast program·Effects of Eating Breakfast

SUMMER FOOD SERVICE PROGRAM

·Provides free, nutritious meals and snacks to children in low-income areas ·Served in congregate settings, primarily low-income areas·SFSP operation

TEAM NUTRITION

·Provides support through training and technical assistance for food service, nutrition education for children and their caregivers, and school and community support for healthy eating and physical activity·Goal of Team Nutrition

REFERENCE

Healthy Meals, Healthy Schools, Healthy Kids.  United States Department of Agriculture.  2007; 1-4.  Available at http://www.ask.com/bar?q=healthy+meals%2C+healthy+schools%2C+healthy+kids+USDA+School+meals&page=1&qsrc=0&ab=1&u=http%3A%2F%2Fwww.fns.usda.gov%2Fcga%2FFactSheets%2Fschool_meals.htm.  Accessed September 16, 2009.

CURRENT POLICIES

LEGISLATIVE APPROACHES/POLIC

ES•Nutrition Standards for Tennessee schools enacted to promote childhood obesity taskforces•The Coordinated School Health Improvement Act of 1999•Federal Child Nutrition Act in TN•State legislation for “wellness policies”

Child Nutrition and Wellness Act of 2005•2005 BMI legislation

TENNESSEE’S COORDINATED SCHOOL

HEALTH INITIATIVEThe Coordinated School Health Improvement Act of 1999:1. Comprehensive School Health Education (grades K-12)2. Physical Education and Activity3. Nutrition Services *4. School Health Services5. School Counseling, Psychological and Social Services6. Healthy and Safe School Environment7. Student, Family and Community Involvement in Schools8. Health Promotion for School Staff

http://www.state.tn.us/education/schoolhealth/

STUDENT NUTRITION EDUCATION

“It is not enough to change the food on their plates; we must also provide the knowledge and skills that enable children to make choices that lead to a nutritious diet and improved health.”

Jennifer Thomas, RD

STUDENT NUTRITION EDUCATION

• Current national/state requirements• Congress has mandated Local

Wellness Policies (LWP) which include components such as Nutrition Education, Nutrition standards, and Physical Activity components

• Healthy People 2010

STUDENT NUTRITION EDUCATION

• What are students really learning?

• Where do we go from here?

• Lack of funds and time

REFERENCES• Gross SM. Coordinated School Health Program and

Dietetics Professionals: Partners in Promoting Healthful Eating. J Am Diet Assoc. 2004; 104: 793-798.

• Murphy AS. Federally-Mandated Local Wellness Policies for School Districts. Available at: http://eatright.org/cps/rde/xchg/ada/hs.xsl/career_8792_ENU_HTML.htm

• Thomas J. Educating Our Children. Today’s Dietician. 2004; 28-31.

CURRENT CONCERNS:

What Can I Do?

CURRENT CONCERNS•Funding

• “The ‘Calories in, Calories Out’ study found that high poverty schools were less likely to have any scheduled recess or compared with schools with lower poverty.”1

• “Members of Congress are looking for ways to ‘find’ additional funds for federal feeding programs.”2

• Funds are being cut 3

• Contact your representative

CURRENT CONCERNS

•Support from school faculty• Setting a good example• Education

•Support from students• Multiple sources-Community 3

• Family

CURRENT CONCERNS•Family support

• Eat together • Eat breakfast• Get active• Offer healthy options without many

restrictions 3

CURRENT CONCERNS1. Yeager, Valerie. Local wellness policies. Today’s Dietitian. 2006; September:

45-50. 2. Yeager, Valerie. Local wellness policies. Today’s Dietitian. 2006; September:

45-50. 3. Detchie, D. Larrene, PhD, RD; Gred Welk, PhD; Dennis Styne, MD; Dana E.

Gerstien, MPH, RD; Patricia B. Crawford, DrPH, RD. Family Environment and Pediatric Overweight: What is a Parent to Do? Journal of the American Dietetic Assocoation 2005. S70-S79.

4. J Am Diet Assoc. An essential component of comprehensive school health programs. 2003 p.505-514 http://www.eatright.org/ada/files/Servicesnp.pdf. Accessed September 19, 2009.

5. Richtchie, DL, Weld G, Styne D, Gerstien DE, Crawford PB. Family environment and pediatric overweight: what is a parent to do. J Am Diet Assoc. 2005; S70-S79.

CURRENT CONCERNS

What is one way you can support your community progress in its efforts to improve the health of its children?

COMPETITIVE FOODS

WHAT ARE COMPETITIVE FOODS

Competitive foods are:“Foods offered at school, other than meals served through school meal programs-school lunch, school breakfast, and after-school snack program.”

WHERE ARE COMPETITIVE FOODS FOUND?

• Competitive foods are typically available in cafeteria a la carte lines

• Vending machines• School stores.

WHO SELLS COMPETITIVE FOODS?

• Student /Booster Clubs through direct involvement in sales of candy and baked goods for fund-raisers.

• School food services

WHO SELLS COMPETITIVE FOODS?

• High and middle schools were most likely to sell competitive foods than elementary schools.

• Approximately 30 percent of high schools generate more than $125,000 per school.

• Elementary schools averaged $5,000 per school through these sales.

COMPETITIVE BEVERAGE SALES

Besides the cash incentives for exclusive beverage contracts noncash benefits included athletic scoreboards and in-kind support of school events.

COMPETITIVE FOODS• Also received were athletic

equipment, facilities or uniforms, scholarships and personal items for students and school staff, such as cups and coolers.

• Other school groups often used revenues for activities such as field trips and assemblies

SO WHAT?Since 1980• The number of children

that are overweight has more than doubled.

• The number of adolescents that are overweight has more than tripled.

• These changes are related in part to poor nutrition.

COMPETITIVE FOODS• According to U.S. Department of

Agriculture more than 60 percent of young people eat too much fat and less than 20 percent of the recommended daily servings of fruits and vegetables.

• Children spend a large part of their day in school and providing them with healthy nutritious food options is an important step in assuring quality nutrition.

WHY NOT STOP COMPETITIVE FOOD SALES?

Barriers to changes in restricting the availability in competitive foods are mainly the concerns of officials due to potential revenue losses and the source of funding that they provide.

COMPETITIVE FOODSAccording to the Government Accountability Office

(GAO), some School Food Administrators (SFA) directors stated that they sold competitive foods in order to maintain balanced budgets

SFA commented that the food service would not be able to maintain a balanced budget without the substantial revenue generated through a la carte sales.

Another commented that the district food service generated nearly half of its revenue through competitive food sales.

WHAT TO DO???Make changes to competitive foods in all of the

schools rather than changes only to certain schools, such as elementary.

 Make changes to the availability of competitive foods throughout the entire school day, rather than availability only during certain hours of the day.

Change fund raising sales to non food items only.Increase school funding to help alleviate short fall

in revenue. Make simultaneous changes to foods served

through school meals.

WHAT TO DO???• Steps needed to increase the availability of

healthy competitive foods:Make water and juices more available by

replacing them with soda in vending machines.

Replace fried potato chips with baked chipsReplace packaged desserts with granola

bars or similar items. Increase the variety of flavored milk to

encourage milk consumption.

RESOURCESCDC’s Division of Adolescent and School Health:

www.cdc.gov/HealthyYouth/shpps/index.2009htmlGovernment Accountability Office:

http://www.gao.gov/new.items/d04673.pdf2009htmlpdf

USDA’s Food and Nutrition Service: www.cspinet.org/Foods_Sold_in_Competition_with_USDA_School_Meal_Programs.pdf2009html

Action for Healthy Kids: www.actionforhealthykids.org/tools/profiles.2009html