What are the children eating?

1. What are the children eating? Janeime N. Asbury Walden University Public Health 6165

2. Introduction • Thousands of children within the United States are not having their basic nutritional needs met. • The multitude of food choices available often have little to no nutritional value. • Reduced budgets, and discontinued extracurricular activities are leaving our children left with nothing to do physically. • Teaching healthy nutritional choices is essential for children and adolescents to grow and thrive. • Image Source Page: http://c3south

3. What’s at Stake? A unhealthy diet can lead to a magnitude of health issues. Currently our youth are plagued with three very serious health issues: Obesity: “obesity affects approximately 12.5 million children and teens which has an increase from “5% to 15% between 1960-1990”.(MMWR, 2011) Type 2 diabetes: . “ between 2002 and 2003, and estimated 15,000 youth are diagnosed with type 1 diabetes, and 3,700 youth diagnosed with type 2 diabetes”. (CDC, 2010) Cardiovascular disease: “ In a population-based sample of 5-17-year-olds, 70% of obese children had at least one CVD risk factor while 39% of obese children had two or more CVD risk factors”. (CDC, 2010) • MMWR. (2011). CDC Grand Rounds: Childhood Obesity in the United States. 60(02); 42-46. Retrieved January 22, 2011 from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6002a2.htm?s_cid=mm6002a2_w • CDC. (2010) Children and Diabetes Search for diabetes in youth. Retrieved January, 18, 2011 from: http://www.cdc.gov/diabetes/projects/diab_children.htm#1

4. Type 2 diabetes is associated with high blood sugar levels that accompany increased sugar consumption which is associated with obesity. Diabetes can lead to heart disease,blindness, kidney failure causing it to be the sixth leading cause of death in the United States. (CDC, 2010) The problem is so prevalent that the makers of Healthy People 2020, have pledged to reduce the incidence of chronic kidney disease as an objective. Heart Disease is another risk factor associated with obesity. (CDC, 2009) “In 2010, heart disease will cost the United States $316.4 billion.3 This total includes the cost of health care services, medications, and lost productivity.” (CDC, 2009) Improving cardiovascular health is also a current objective of Healthy People 2020. CDC. (2010). Basics about Diabetes. Retrieved January 15, 2011 from: http://www.cdc.gov/diabetes/consumer/learn.htm U.S. Department of Health and Human Services. (2010). Healthy People 2020. Retrieved from: http://www.healthypeople.gov/2020/default.aspx CDC. (2009) Coronary Artery Disease (CAD). Retrieved from: http://www.cdc.gov/heartdisease/coronary_ad.htm What’s at stake II ?

5. What's at Stake? III • In 2005, the United States department of Agriculture revised the original food guide pyramid which was originally created in 1980. • When using the healthy eating index, researchers found that children consumed the most healthy diet with 78% meeting the dietary recommendations, however the percentages declined as the children aged. (USDA, 2009) • Children between the ages of 11-18 only had a daily average intake of daily dietary recommendation of 61.825%, which researchers attributed to a decline in diet quality and eating less than the daily recommendations of milk and fruit. (USDA, 2009) • USDA. (1998). Report card on the diet quality of children. Nutrition Insight 9. Retrieved from: http://www.cnpp.usda.gov/Publications/NutritionInsights/insight9.pdf • USDA. (2009). The Quality of Children’s Diets in 2003-04 as Measured by the Healthy Eating Index-2005. Nutrition Insight 43. Retrieved January 18, 2011 from: http://www.cnpp.usda.gov/Publications/NutritionInsights/Insight43.pdf • Britten, P., Marcoe, K., Yamini, S., and Davis, C. (2006). Development of Food Intake Patterns for the MyPyramid Food Guidance System. J Nutr Educ Behav. 2006;38:S78-S92. Retrieved from: http://www.cnpp.usda.gov/Publications/MyPyramid/DevelopmentMaterials/JNEBsupplement/JNEBDevelPatterns.pdf

6. What can we do? . In many school systems across the nation, school may serve as the sole source of nutrition for a child. “In 2004, Congress passed the Child Nutrition and Reauthorization Act which required schools receiving federal dollars to develop local wellness policies by 2006”. (Pennybacker, 2005) The Child Nutrition and Reauthorization Act requested that “nutritional guidelines be available, goals be set for nutrition education, physical activity, and other school based activities.” (Agron et. al., 2010) While the food served in our schools has improved slightly, there is still more work to be done. • Pennybacker, M. (2005). Attending to Children's Health at Home and School. World Watch, 18(6), 15. • Agron, P., Berends, V., Ellis, K., & Gonzalez, M. (2010). School Wellness Policies: Perceptions, Barriers, and Needs Among School Leaders and Wellness Advocates. Journal of School Health, 80(11), 527-535. doi:10.1111/j.1746-1561.2010.00538.x

7. What can we do? II • School systems across the nation have answered the call to modify their nutritional standards and get students healthy again. • Independent school system in Houston involved the community which rallied together to create healthier versions of popular foods, as well as making fresh produce more available to students. • In Michigan, school administrators and community leaders devised ways to increase student activity with incentive programs as well as obtain fresh produce from local farmers. • In California, the state legislature added state legislation to further regulate nutritional standards for foods sold within the vending machines.

8. What can we do? III • Fahlman, et. al., found that nutritional education and counseling in a group setting enabled students to make overall better food choices. • Fahlman, M. M., Dake, J. A., McCaughtry, N., & Martin, J. (2008). A Pilot Study to Examine the Effects of a Nutrition Intervention on Nutrition Knowledge, Behaviors, and Efficacy Expectations in Middle School Children. Journal of School Health, 78(4), 216-222. doi:10.1111/j.1746-1561.2008.00289.x

9. Current trends • In many school systems, the menu and school revenue is supplemented by what is called competitive foods. Currently there are no nutrition standards placed on the competitive foods. • The wellness policy put in place by the Child Nutrition and WIC Reauthorization Bill of 2004, has increased pressure to hold these competitive foods items to current USDA food standards. • Snelling and Kennard found the proportion of foods categorized as red, (having little to no nutritional value) offered in high school was 57% prior to the study. • After the study, the proportion of red foods offered was lowered to 30%, with the biggest reduction coming from soda’s and sugary drinks. • Snelling, A. M., & Kennard, T. (2009). The Impact of Nutrition Standards on Competitive Food Offerings and Purchasing Behaviors of High School Students. Journal of School Health, 79(11), 541-546. doi:10.1111/j.1746-1561.2009.00446.x

10. Current trends II • Currently the USDA has proposed a rule change to make school lunches healthier. • The new guidelines establish “calorie limits for school meals, a ban of most trans fats, a reduction of sodium over the next 10 years, increase the servings of fruits and vegetables, require all milk sold to be non-fat or low fat, as well as required flavored milk to be non-fat, incrementally increase the amount of whole grains required, and eventually requiring most grains to be whole grains, and finally improve school breakfast standards by requiring schools to serve a grain and a protein, instead of one or the other.” (Jalonick. 2011) • The First Lady Michelle Obama, has taken up the initiative to prevent childhood obesity by creating a program called Let’s Move, which focuses in on children making healthy choices as well as having better food choices made available to them. • Jalonick. M. C. (2011) USDA proposes new rules to make school lunches healthier. The Atlanta Journal Constitution. Retrieved from: http://www.ajc.com/news/nation-world/new-guidelines-would-make-802997.html • Jalonick. M. C. (2011) Healthy food campaign. Wal-Mart announces improved food plan. Retrieved from http://www.ajc.com/news/nation-world/wal-mart-to-make-809631.html

11. Conclusion • While great strides have been made already, the education system is in the unique position to do a little more. Studies have shown that a healthy diet is essential to optimal learning. In separate studies conducted by the USDA and The World Health Organization prove that children who ate breakfast tended to have an overall higher diet quality and these studies suggest that school based nutrition interventions can also improve academic performance. (Pennybacker, 2005) • Legislation is finally catching up, giving all those concerned with childhood obesity and it’s severe health effects, the means to become proactive in preventing this life long debilitative condition. • Pennybacker, M. (2005). Attending to Children's Health at Home and School. World Watch, 18(6), 15.

12. Thank YouJaneime AsburyPUBH 6165Walden University

13. References: • Agron, P., Berends, V., Ellis, K., & Gonzalez, M. (2010). School Wellness Policies: Perceptions, Barriers, and Needs Among School Leaders and Wellness Advocates. Journal of School Health, 80(11), 527-535. doi:10.1111/j.1746-1561.2010.00538.x • Bauer, L. R., & Waldrop, J. (2009). Trans Fat Intake in Children: Risks and Recommendations. Pediatric Nursing, 35(6), 346-351. • Britten, P., Marcoe, K., Yamini, S., and Davis, C. (2006). Development of Food Intake Patterns for the MyPyramid Food Guidance System. J Nutr Educ Behav. 2006;38:S78-S92. Retrieved from: http://www.cnpp.usda.gov/Publications/MyPyramid/DevelopmentMaterials/JNEBsupplement/JNEBDevelPatterns.pdf • Byrd-Blake, M., Afolayan, M. O., Hunt, J. W., Fabunmi, M., Pryor, B. W., & Leander, R. (2010). Morale of Teachers in High Poverty Schools: A Post-NCLB Mixed Methods Analysis. Education & Urban Society, 42(4), 450-472. • CDC. (2010). Overweight and Obesity. Retrieved from: http://www.cdc.gov/obesity/childhood/index.html • CDC. (2010). Basics about Diabetes. Retrieved from: http://www.cdc.gov/diabetes/consumer/learn.htm • CDC. (2009) Coronary Artery Disease (CAD). Retrieved from: http://www.cdc.gov/heartdisease/coronary_ad.htm • Fahlman, M. M., Dake, J. A., McCaughtry, N., & Martin, J. (2008). A Pilot Study to Examine the Effects of a Nutrition Intervention on Nutrition Knowledge, Behaviors, and Efficacy Expectations in Middle School Children. Journal of School Health, 78(4), 216-222. doi:10.1111/j.1746-1561.2008.00289.x • Hovland, J. A., Mcleod, S. M., Duffrin, M. W., Johanson, G., & Berryman, D. E. (2010). School-Based Screening of the Dietary Intakes of Third Graders in Rural Appalachian Ohio. Journal of School Health, 80(11), 536-543. • Jalonick. M. C. (2011) USDA proposes new rules to make school lunches healthier. Retrieved from: http://www.ajc.com/news/nation-world/new-guidelines-would-make-802997.html • Jalonick. M. C. (2011) Healthy food campaign. Wal-Mart announces improved food plan. Retrieved from http://www.ajc.com/news/nation-world/wal-mart-to-make-809631.html

14. References Continued • Klein, J. I. (2009). Public Schools and the Excuse Culture. U.S. News & World Report, 146(4), 88-87. • MMWR. (2009). Youth Risk Behavior Surveillance-United States. Vol. 59/SS-5. • MMWR. (2011). CDC Grand rounds: Childhood obesity in the United States. 60(02); 42-46. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6002a2.htm?s_cid=mm6002a2_w • Pennybacker, M. (2005). Attending to Children's Health at Home and School. World Watch, 18(6), 15. • Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: Comprehensive School Nutrition Services. (2010). Journal of the American Dietetic Association, 110(11), 1738-1749. doi:10.1016/j.jada.2010.08.035 • Rawlins, E. (2009). Choosing Health? Exploring Children's Eating Practices at Home and at School. Antipode, 41(5), 1084-1109. doi:10.1111/j.1467-8330.2009.00709.x • Satcher, D. (2009). Taking Charge of School Wellness. Educational Leadership, 67(4), 38-43. • Savica, V., Bellinghieri, G., & Kopple, J. D. (2010). The Effect of Nutrition on Blood Pressure. Annual Review of Nutrition, 30(1), 365-401. doi:10.1146/annurev-nutr-010510-103954 • Snelling, A. M., & Kennard, T. (2009). The Impact of Nutrition Standards on Competitive Food Offerings and Purchasing Behaviors of High School Students. Journal of School Health, 79(11), 541-546. doi:10.1111/j.1746-1561.2009.00446.x • USDA. (2009). The Quality of Children’s Diets in 2003-04 as Measured by the Healthy Eating Index-2005. Nutrition Insight 43. Retrieved from: http://www.cnpp.usda.gov/Publications/NutritionInsights/Insight43.pdf • USDA. (1999). Eating Breakfast greatly improves schoolchildren’s diet quality. Nutrition Insight 15. Retrieved from http://www.cnpp.usda.gov/Publications/NutritionInsights/insight15.pdf • USDA. (1998). Report card on the diet quality of children. Nutrition Insight 9. Retrieved from: http://www.cnpp.usda.gov/Publications/NutritionInsights/insight9.pdf • U.S. Department of Health and Human Services. (2010). Healthy People 2020. Retrieved from: http://www.healthypeople.gov/2020/default.aspx • Woodward-Lopez, G., Gosliner, W., Samuels, S. E., Craypo, L., Kao, J., & Crawford, P. B. (2010). Lessons Learned From Evaluations of California's Statewide School Nutrition Standards. American Journal of Public Health, 100(11), 2137-2145. doi:10.2105/AJPH.2010.193490 • Wolfe, P., Burkman, M., & Streng, K. (2000). The Science of Nutrition. Educational Leadership, 57(6), 54.