School Nutrition and Childhood Obesity

The obesity epidemic in the United States is staggering, with nearly a third of American children and adolescents overweight or obese. If you're anything like me, when you read that you wondered what really constituted 'overweight' and whether a figure such as that was really so bad when you consider that one or two pounds overweight isn't such a big deal.

The ugly truth, however, is that in the past 30 years, obesity has more than doubled in children and more than quadrupled in adolescents. To put that into perspective, in 1980, only 7% of first through sixth-graders were obese, or about one of 15. In 2012, that number had risen to approximately 18%, or about one of every six ^1,2.

Let's Move!

In 2010, Michelle Obama spearheaded a campaign to end childhood obesity called "Let's Move!" in one generation. Up until the First Lady's initiative, the governmental rules concerning what can and should be served at school lunches had not been altered in any meaningful way since the 1990s, despite our understanding of nutrition altering dramatically in that same timeframe. The Partnership for a Healthier America was formed from both for-profit and non-profit interests to help research and fund the campaign, and President Obama created the first ever Task Force on Obesity to help address the problem.

Some changes directly or indirectly related to the campaign include clarity of packaging with nutritional content prominently displayed; pediatricians regularly checking BMI and writing lifestyle prescriptions for obese children; the creation of an updated food pyramid; and the Let's Move! public awareness campaign, which promotes healthy eating and active play.

School Lunch

Then of course there's the focus on school lunches.

This is important, because kids get a majority of their calories at school, but because focus on school lunches can be a way to enact major change in a child's diet. Students spend about half of their waking hours at school, and typically eat either one or two of their meals there. This is a significant amount of time and potentially more than half of their caloric intake. Why not make the food available to them as healthy as possible?

The new rules regarding school lunches emphasize whole foods, including fresh fruit, whole grains, and veggies, while still allowing the occasional dessert or treat. The regulations have divided vegetables up into subgroups with similar nutrient profiles, and recommended a certain amount of vegetables from each category per week.

Here are some clarifying statements about the rules regarding the food offered at school, or the 'School Meal Patterns' and 'Smart Snacks' regulations.

• Servings of different food groups are measured not per meal but per week, allowing some flexibility meal to meal. Calorie limits apply to the average meal per week, not to every meal individually.
• Schools are not required to conduct a nutrient analysis on their own. Only the state is required to do so, and only if there is already reason to believe a school is at risk for violating the requirements.
• The rules do not apply except during school hours on campus. Therefore, after-school bake sales are still perfectly okay. If you wish to conduct a fundraiser for food that doesn't meet the criteria, it's possible to apply for and receive an exception.
• The rules don't apply to food in the teacher's lounge, the office, or any other location on-campus not frequented by students.
• Food given to students to celebrate special events, such as a birthday or holiday, do not have to comply with the standards. It's only food that is sold by the school during school hours that applies.
• Food brought from home does not have to meet the standards.
• These standards are minimum requirements; schools that already have more stringent nutritional standards do not have to relax them to meet the federal standards!

The new plan has come under fire for being too expensive and too difficult to implement, and that kids don't want healthy foods and will refuse to eat them. Once implemented, however, new and more substantive concerns were raised.

First, the food quality still appears to be lacking in many schools. The idea of having to supply fruit and vegetables, even smoothies or a salad bar seemed to panic school districts into bidding lower for food than they ever had before, serving gelatin-like meats and vegetables so overcooked they are ready to dissolve. How can kids get excited about eating well when schools obey the letter of the law rather than the spirit by providing such pseudo-food? More funding is necessary to provide real food for growing minds and bodies.

Finally, according to the USDA, 15.8 million children have food insecurity in their households. How ethical is it to worry about obesity when many children in the United States go hungry every day? The answer to this question is more complicated. It is actually our nation's poorest children who have the highest rate of obesity: they are eating cheap, processed foods that don't have enough fiber to keep them full, or nutrients to keep them going. Our over-fed kids are our under-nourished.

Ten to 20 years down the line, the nation will be paying for these children's heart operations, cholesterol medication, and insulin injections, not to mention the revenue that will be lost as they become too ill to work. By paying more per child to nourish them now, we prevent far greater expenditure in the future.

References:
¹National Center for Health Statistics. Health, United States, 2011: With Special Features on Socioeconomic Status and Health. Hyattsville, MD; U.S. Department of Health and Human Services; 2012.
²Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association 2014;311(8):806-814.