Healthy Choices at School: Nutrition Guidelines that Can Make a Difference

1. Healthy Choices at School:Nutrition Guidelines that Can Make a Difference Action for Healthy Kids Minnesota Pamela Van Zyl York, MPH, PhD, RD, LN Teresa Rondeau-Ambroz, RD, LD January 13, 2005 Minnesota

2. Minnesota • Action for Healthy Kids Minnesota works to improve nutrition and physical activity of children and teens through collaboration with diverse stakeholders.

3. HEALTHY SCHOOLS SUMMIT: TAKING ACTION FOR CHILDREN’S NUTRITION & FITNESS October 7-8, 2002 The Ronald Reagan Building and International Trade Center Washington, DC

4. Educators School administrators Health and nutrition professionals Government leaders Student leaders Concerned parents Community and business leaders MN State Team Members

7. Child and Adolescent Overweight by Race: 1988-94 to 1999-2000 2010 Target 1988-94 Total White Black Mexican American Female Male 0 10 20 30 Percent Note: Overweight is defined for ages 6-19 years as BMI >= gender- and weight-specific 95th percentile from the 2000 CDC Growth Charts for the United States Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 19-3c

9. Healthy eating and physical activity are important to health – not just body weight Healthy growth and development Calcium, Iron and other minerals Vitamins Protein Other disease protective factors Chronic disease prevention Academic achievement Enjoyment Caution: Beyond Calories

10. Did you know? • Kids with high added-sugar diets eat fewer fruits and vegetables and drink less milk • Poor nutrition can compromise cognitive development and school performance • Poor nutrition can increase the chances of getting a cold or the flu and lead to missed days at school

11. Environment of abundance and convenience: The Toxic Environment • Cheap, mass-produced, good-tasting food that is packed with calories is available 24/7 at very little effort. • Supersizing portion sizes at all levels • Incessant advertising • Physical activity increasingly unneeded • Modern conveniences, auto-based transportation, communities are not walkable and have no destinations

13. Increased Introduction of Large Portion Sizes in the US Young and Nestle, JADA 2003

14. Soda 20 Years ago Today ??? calories 12 fluid ounces 110 calories Twenty years ago, 12 fluid ounces was the popular size for soft drinks and provided 110 calories. How many calories do you think are in today’s popular soft drink portion? 125 250 500

15. Environment

16. Availability

17. Promotion

18. Annual NCI budget for 5-a-day nutrition education $ 1 million McDonald’s “we love to see you smile” campaign $ 500 million

19. U.S. government’s entire budget for nutrition education Is one-fifth the advertising budget for… Altoids mints Nestle, 2002

20. Revenue Concerns “For decades, soft drink companies have had an important presence in our nation’s schools” “The revenue generated from the sale of beverages in schools is an important part of the education funding equation in the United States” Web Site, 5/18/02

21. Change the Person versus Change the Environment Change the Person - Education alone is not enough Change the Environment - Supportive environment makes healthy food choices easier

22. What can we do to change the environment? • Recreation opportunities – schools, worksites, rec centers, other community spaces • Availability, accessibility, acceptability • Support healthy food environment • Promote availability of healthy foods and decrease availability of unhealthy foods • Vending machines, cafeterias, other sales venues • Support healthful messages and counter advertising campaigns

23. What does your school food environment look like?

26. Strategies that Support Healthy Eating … • Allow adequate time to eat • Provide adequate space and comfortable seating • Restrict availability of vending machines during school • Only allow water in classrooms • Use non-food items for fundraising

27. More Healthy Strategies… • Close the campus so students don’t get fast food • Serve lunch after recess • Integrate nutrition education into curriculum (and food service) • Provide nutrition-related in-service to staff

28. More Healthy Strategies… • Encourage staff to model healthy eating • Educate parents and staff about a healthy school environment in newsletters, etc. • Make healthier foods more price appealing • Involve students

30. Strategies for Improving Vending • Improve the offerings…healthy options are available (involve kids) • Adjust the pricing to encourage the healthy choice • Research shows profits can be maintained Source: French, et al. Am J Public Health 2001;91:112-117.

31. Success Stories North Community High School – Mpls Limited soft drinks to just 1 machine, added water, juice, sports drinks. Vending profit increased $4,000 Whitefish Central School in Montana replaced junk foods and pop with fruits, bagels, 100% juice, milk and water. Profits remained the same 2003, Action for Healthy Kids

32. Choices must be available, accessible and affordable for individuals to make choices Question assumptions about what is needed, what is possible and what can be changed

33. Why the “Guidelines for Good Nutrition at School”? • Kids are not meeting their nutritional needs and often get too many calories • Meals and snacks at school can provide one-third to one-half of a child’s daily nutritional needs • More children are selecting a la carte and vending items…which are not regulated for nutritional value JADA – April, 2003

34. Fruit and Vegetable Intake Among MN Youth(MN Student Survey, 2001 and 2004)

35. 25% of all vegetables eaten in the U.S. are French Fries Krebs-Smith, Cancer, 1998

37. 15 teaspoons of sugar per day On average, adolescents aged 12-17, get 11% of their calories from soft drinks*: *Soft drinks = carbonated beverages, fruit-flavored and part juice drinks, and sports drinks Source: USDA, Continuing Survey of Food Intake by Individuals, 1994-96

38. Beverages Consumed by MN Youth(MN Student Survey, 2001 and 2004)

39. Beverages Consumed by MN Youth(MN Student Survey, 2001 and 2004)

40. Schools are Taking Action • Proactive schools have taken positive steps to make improvements in school foods, however, definitions of “healthier choices” are not consistent • No simple nutrition guidelines existed for competitive foods in schools

41. New Requirement for Local Wellness Policy Local Wellness policies must be in place by July 1, 2006 Must include goals for nutrition education and nutrition guidelines for ALL foods available on each school campus Must form a task force or work group as defined by the law (Child Nutrition Reauthorization, 2004) P.L. 108-265

42. AFHK MN Goal • Develop statewide nutrition guidelines with the support of students, families, community and school to ensure a healthy school nutrition environment

43. Guidelines vs Policy • With the Guidelines for Good Nutrition at School as a standard from with to base local discussions individual schools or districts can make local policies

44. Vending machines A la carte in cafeteria School stores Concession stands Snack bars Fund-raising events Classroom parties School-related meetings Other foods in schools not regulated by USDA Guidelines are for Non-Regulated Foods

45. Priorities Set • Kids health is first and foremost • Keep it simple • Foods kids will eat! • Recognize local fiscal constraints and needs

46. Nutrition Goals • To provide healthier food choices for students (and staff!) • To reduce the availability of high-sugar, high-fat candy and beverages • To work with the school to help the students reach their full potential having had healthier food choices for breakfast and lunch

47. Three Nutrition Criteria • Serving size • Dietary fat • Added sugars

48. Serving Size • People eat more food and calories when they are served larger portions • Larger portions can lead to weight problems • Guideline: Defines sensible serving sizes except for water, fruits and vegetables

49. Wanted: Fruits and Vegetables • Half of children eat less than one serving of fruit a day • One-third don’t even get a serving of vegetables that have not been fried • Most miss out on the health benefits

50. Fats • High fat diets increase the risk for heart disease, stroke, some types of cancer and other chronic conditions in adulthood and can add excess calories • Some fats may reduce the risk for heart disease and some types of cancer • Guideline: Limit total fats to about less than 35% total calories except for nuts and seeds