Regulations for Nutrition Standards for Competitive Foods in Schools February 9, 2011.
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Transcript of Regulations for Nutrition Standards for Competitive Foods in Schools February 9, 2011.
Regulations for Nutrition Standards for Competitive
Foods in Schools
February 9, 2011
2
Childhood Obesity in Massachusetts
• Children 2-5 years old – 18.4% “at risk of overweight” and 15.4% “overweight” (WIC Program 2007)
• Middle School Students– 17% overweight and 10% obese (2009 MA YHS)
• High School Students– 15% overweight and 11% obese (2009 YRBS)
• Low-income Black and Hispanic youth/adolescents – Black 18%, Hispanic 15% and White 9% (obesity only, 2009 YRBS)
• BMI screening data on 109,674 students in grades 1, 4, 7 and 10– 16.9% overweight and 17.3% obese (2008-2009)
3
MA Students with BMI for Age in Overweight/Obese Category by Grade & Gender,
2008-2009
32.9
39.737.7
32.331.0
35.533.5
28.6
0
10
20
30
40
Grade 1 Grade 4 Grade 7 Grade 10
Per
cen
t
Male FemaleSource: MDPH, Bureau of Community Health, Access and Prevention, Division of Primary Care and Health Access, School Health Unit
4
5
Childhood Obesity and Median Household Income
0
5
10
15
20
25
30
35
40
45
50
$0 $20,000 $40,000 $60,000 $80,000 $100,000 $120,000 $140,000 $160,000 $180,000
Median Household Income (2000 Census Data)
% O
verw
eigh
t or O
bese
Chi
ldre
nChildhood Obesity is Not
Randomly Distributed
6
Increasing Population Impact
Increasing IndividualEffort Needed
Lasting Protective Interventions
Clinical Interventions
Counseling &Education
Changing Context to Support Healthy Default Decision Making
Socioeconomic Factors
Health Impact Pyramid
Adapted from T. Frieden, AJPH, April 2010
7
Policy, Systems and Environmental Change Strategies to Support
Healthy Eating in Schools
Policy Changes• School Nutrition Regulations
System Change• School policies and practices that support healthy
eating campus-wide 24/7
Environmental Changes• Healthy foods available in vending machines, school
stores or served in cafeterias
School Nutrition Bill Provisions
9
Overview of Key Elements of Bill
• Requires nutritional standards for “competitive foods” in public schools
• Requires regulations to promote school wellness advisory committees
• Requires training of public school nurses in screening and referral for obesity, diabetes and eating disorders
• Establishes Commission on School Nutrition and Childhood Obesity
10
Definition of Competitive Foods
• All food/beverages not part of school breakfast, lunch and CACFP programs– A la carte lines– School stores– Snack bars– Vending machines– Fundraising activities– School sponsored events
• Excludes non-sweetened carbonated water
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Establish Nutritional Standards
• DPH to issue regulations establishing standards for competitive food/beverages– Based on dietary recommendations from HHS,
USDA, AHA, IOM, School Nutrition Association of MA, American Dietetic Association
• Apply to competitive foods sold 30 minutes before through 30 minutes after the school day
• Update standards every 5 years in consultation with ESE
12
Possible Exceptions
• Food/beverages sold up to 30 minutes before or 30 minutes after school day– School district may choose to apply standards
beyond this time frame
• DPH may make exceptions for– Booster sales– Concession stands– School-sponsored or school-related fundraisers
and events
Nutrition Standards for Competitive Foods and Beverages
14
Standards Development
• Interagency workgroup– DPH obesity prevention and school health staff– DESE health and nutrition staff– John Stalker Institute at Framingham State– Boston Public Health Commission– Harvard School of Public Health
• Multiple sources of information– Institute of Medicine Nutrition Standards for Foods in
Schools– MA Action for Healthy Kids– Alliance for a Healthier Generation– MA Public Health Association– MA School Nutrition Association– MA Executive Order 509 – Other states – CA, CT, MI, WV, PA, RI
15
General Nutrition Standards – Specified in Statute
1. Plain water readily available during school day at no cost
2. Offer fresh fruits/non-fried vegetables wherever food is sold (except vending machines)
3. Make nutrition info available for non-prepackaged foods by August 2013 (except fresh fruits/vegetables, food/beverages sold at booster sales and other school sponsored events)
4. Prohibit use of fryolators in preparing competitive foods
5. Ensure food preparation and all foods/beverages meet state and federal food safety guidelines
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Competitive Food Standards - Beverages
Proposed Massachusetts Standard Institute of Medicine
Juice
100 % fruit or vegetable juice with no added sugar
Elem and middle – 4 oz serving; High – 8 oz serving
Same
Milk and Milk Substitutes
All milk/milk substitutes (incl. lactose free and soy milk) shall be low fat (1%) or fat-free
8 oz serving
Meet USDA standards for fluid milk and milk substitutes
Flavored milk ≤ 22 g sugar/8 oz
Same
Water
Water without added sugars, sweeteners, artificial sweeteners, but can contain natural flavoring and/or carbonation
Same except no carbonation or natural flavors
17
Competitive Food Standards - Beverages
Proposed Massachusetts Standard Institute of Medicine
Other Beverages
No beverages other than juice, milk, milk substitutes and water shall be sold or provided
For High School after school: allows non-caffeinated, non-fortified beverages with less than 5 calories per portion, with or without non-nutritive sweeteners
Beverages with added sugar or sweeteners
These will be phased out by August 2013, except for flavored milk or milk substitutes that contain same amount or less sugar than plain fat-free or low-fat milk.
18
Competitive Food Standards - Food
Proposed Massachusetts Standard Institute of Medicine
Calories
Limit 200 calories per item, except for a la carte entrees, which shall not exceed calories in comparable National School Lunch Program entrees
Same
Fat, Saturated Fat, Trans Fat
No more than 35% of total calories from fat
No more than 10% of total calories from saturated fat
All foods shall be trans fat free
Exception – 1 oz of nuts, nut butters, seeds or reduced fat cheese
Same except for the nut/cheese exception
Sugar
No more than 35% of total calories from total sugars, except•Non-fat or low-fat yogurt with maximum of 30g sugar/8 oz•100% added fruit with no added sugar
Same
19
Competitive Food Standards - Food
Proposed Massachusetts Standard Institute of Medicine
Sodium
No more than 200 mg per item
Exception: no more than 480 mg per item for a la carte entrees
Same
Grains
All bread and other grain-based products shall be whole grain Same for snack items but no guideline for a la carte entrees
Artificial sweeteners
No artificial sweeteners allowed. Not mentioned
Caffeine
No more than trace amounts of caffeine allowed. Same
20
Proposed Guideline Topics
• Easy-to-read chart of the guidelines with examples for each category
• List of foods and beverages that meet the guidelines (similar to the MA Action for Healthy Kids “A List” of approved foods and beverages)
• Alternatives for school fund raising activities• Recommendations to create and support a healthy
school environment, e.g., lunch duration• Alternatives for healthy celebrations • Rationale for selected nutrition standards
21
Implementation Assistance
• DPH to work with DESE in implementation of nutritional standards
– Training in nutrition and diet for food/ nutrition service directors
– Assessment of school’s capacity, resources, equipment to prepare recommended foods
Possible Financial Implications of Nutrition Standards
23
What do we know?
• The majority of studies and reports have found that schools implementing healthier competitive foods have not had decreases in overall revenue
• Profitable healthy fundraising alternatives abound– Events such as car washes, fun
runs, walk-a-thons, raffles– Sales of non-food items such as
calendars, greeting cards, flowers/plants, personal care products, wrapping paper
24
On the Horizon
• National efforts– USDA school lunch nutrition standards– USDA competitive food nutrition standards– First Lady’s Let’s Move Cities and Towns
• Other state wide initiatives– Mass in Motion Municipal grants– Act FRESH Campaign– Healthy People, Healthy Economy
25
Timeline
Activity Schedule
Public Health Council February 9, 2011
Public Hearings and public comment period
March 2011
Public Health Council for final vote
Late spring
Implementation August 1, 2012
26
Acknowledgements
• Internal DPH work group– Laura York– Chris Nordstrom– Cynthia Bayerl– Diana Hoek– Paula Dobrow– Howard Saxner– Lauren Smith
• John Stalker Institute– Karen McGrail
• Boston Public Health Commission– Kathy Cunningham
• DESE staff – John Bynoe– Katie Millett– Carol Goodenow– Linda Fischer– Mary Anne Gilbert– Rita Brennan Olson
• Harvard School of Public Health– Eric Rimm– Juliana Cohen– Jessica Garcia
27
28
Commission Membership
– Commissioner of DMH– Commissioner of Agricultural Resources– MA Association of School Superintendents– MA Secondary School Administrators Association– MA Nutrition Board– MA Association for Health, Physical Education, Recreation– American Heart Association– American Diabetes Association– MA Parent Teachers Association– Chair, Student Advisory Council – MA American Academy of Pediatrics– MA School Nutrition Association– Representative of food/beverage industry– 6 members appointed by Senate President & House Speaker