The Federal Budget Process: Effects on Child Feeding Programs

1. The Federal Budget Process:Effects on Child Feeding Programs Keith-Thomas Ayoob, EdD, RD, FADA March 2, 2009 School Nutrition Association

2. Where we came from • NSLA of 1946 • General national policy • Focus on protecting kids against nutritional deficiencies • Outlet for surplus commodities

3. Where we came from • Child Nutrition Act of 1966 • School breakfast established • To help meet the nutritional needs of low income families • First large-scale entitlement feeding program for children

4. Where we came from • Dietary Guidelines for Americans of 1995: • Standard established for school meals • Goal: to minimize risk of chronic diet-related diseases • Prevention of more than just nutritional deficiencies • Beyond commodities • And then………………..

5. Old Problem: “Malnourished Kids” "MISNOURISHED KIDS" New Problem:

6. BRAVE NEW WORLD • Kids have food everywhere • Kids eat food everywhere • Kids got fatter

7. BRAVE NEW WORLD • “Childhood obesity is the #1 health problem in children” • “Today’s kids will have shorter lives than their parents” • “SOMEONE is to blame for this…”

8. WHERE WE NEED TO BE • “Optimal nutrition” • Obesity prevention • Disease prevention but there’s just one thing……....

9. …the “local wellness policy” • A festival of individualization at the district level • Community-driven, parent-focused • Budget can conflict with reality • Often where philosophy trumps the science

10. Local policy “wish list” components include… • Organic food • Organic local food • No sugar • No HFCS • No gluten • No eggs • No dairy • No peanuts • Nothing that could possibly cause an allergy • Low-glycemic foods only

11. What you need: ONE NATIONAL POLICY • Meets the needs of MOST children • Supplies the good stuff • Minimizes the bad stuff (excesses, including LNED foods)

12. What you need: ONE NATIONAL POLICY • Keeps up with DGAs without “overachieving” • National policy means national funding • Can drive reformulation of foods by industry

13. Why school meals work • Breakfast & lunch participants: • 4 X more likely to drink milk • Eat more fruits and vegetables • Get more calcium & potassium – nutrients of concern • Non-participants: • More likely to eat LNED snacks & desserts • Drink more junk beverages – 4 X more likely Gordon, et al, JADA 2009

14. Do they eat breakfast? • Children who eat breakfast… • score higher on tests3 • have better school attendance2 • have better diets • Iron, Zinc, Vitamin A, B Vitamins, Calcium1 • may be less likely to be overweight 40% of children don’t eat breakfast everyday1 1 General Mills Bell Institute of Health & Nutrition Dietary Intake Research 2 Wahlstrom et al. Top Clin Nutr 1999 3 Murphy et al. Arch Pediatr Adolesc Med 1998

15. How it’s working • Fresh fruit offered (50% of menus vs. 41%) • i.e. an increase of 25% • Whole milk decreased by 40%, flavored skim milk increased by 40% -- a GOOD thing

16. Where you have problems • Competitive foods, especially LNED ones • Compliance with national standards • Too much sodium • Low fiber • Too much fat & saturated fat

17. How often is it “The only meal for the day?”

18. How communities “overachieve” • NY and school milk

19. February 2, 2006: “In New York Schools, Whole Milk Is Cast From the Menu” • Also removed (2006): • 2% milk • 1% chocolate milk • All other flavored milk RESULT: Milk consumption drops 10% in 2006

20. Flavored milk: Friend or foe? • 2763 children 6-11 years 1125 teens, 12-17 years • 3 groups: • Non-consumers of flavored milk • 0-240 g • >240 g Johnson, R et al, 2002, JADA

21. Flavored milk • Flavored milk drinkers had: • More calcium ~100-150 mg/day • No additional intake in added sugars • Lower intake of soft drinks/fruit drinks Johnson, R et al, 2002, JADA

22. AAP Policy Statement:Prevention of pediatric overweight & obesity “Dietary practices should be fostered that encourage moderation rather than overconsumption, emphasizing healthful choices rather than restrictive eating patterns.”

23. What RDs want (and where a national standard could help) • Update to 2005 DGAs • Age-appropriate portions • Cut fat and sodium where possible • Make participation cool again • Address competitive foods

24. Follow the 2005 DGAs • Whole grains • Fruits and vegetables (attn: legumes) • Low-fat/fat-free milk

25. Age-appropriate portions and calories • Base on age and ACTIVITY level • Currently: 1989 REA for active kids

26. Cut fat & sodium • More unprocessed entrees • Semi-scratch cooking • Work with vendors to drive reformulation • Advocate for USDA to lower fat/sodium in commodities • Ditch the deep-fries

27. Make it cool again • Emphasize green aspects of healthier eating • Less meat/fat/processed food, more plant-based food • Fewer competitive foods mean more participation • Emphasize that “kids who eat school meals have healthier diets overall”

28. Communication Research Journal of the American Dietetic Association June 2003

29. Implications from Research • Students and parents: common interests but different information needs • Students—“fun,” “cool,” and “not boring” • Parents—“quick,” “easy to use,” and “credible” • Redefine “fitness,” “healthy eating,” and “health” • Facilitate communication between students, parents, and school nutrition personnel

30. Address competitive foods • Participation goes up when they’re not around • Often a nutritional nightmare • Usually an image problem • Responsible for a day’s worth of “discretionary calories” just at lunch • Keep vending machines to “better-for-you” options

31. WHAT SNA NEEDS MOST • Legislation for a single national wellness policy • Ensure all legislation is FUNDED

32. Address the role of parents • Necessary partners with SNA • Primary influencers • Family meals • Expose kids to a wide range of foods • Model good eating behavior

33. REMEMBER THE GOAL HEALTHIER CHILDREN

34. Keith-Thomas Ayoob, EdD, RD, FADA Associate Clinical Professor of Pediatrics Albert Einstein College of Medicine 718-430-3970 x6412 ktayoob@msn.com