Nutrition Goes to School

With the start of school only weeks away, there is finally some good news about childhood obesity. The Centers for Disease Control and Prevention recently reported that the obesity rate among preschoolers in low-income families has fallen in 19 states and American territories. This decline is encouraging, but there is still ample room for improvement. One in eight preschoolers in the United States is currently obese, and overweight preschoolers are more likely to become overweight adolescents and adults.

Continued progress requires addressing obesity on multiple fronts and in a range of settings. We already know that when schools adopt healthier menus for student meals, the proportion of students who are overweight declines. But in many cases, meals are only part of schools’ nutrition environment, which increasingly includes vending machines or “snack bars.”^[i] In an announcement earlier this summer, the U.S. Department of Agriculture, which also sets standards for school meals, issued revised standards for these other foods and beverages sold in schools.

A colorful graphic makes clear some of the changes (in effect starting July 1, 2014). Out are chocolate sandwich cookies, fruit-flavored candies, chocolate bars, donuts, and cola. In are light popcorn, low-fat tortilla chips, granola bars, and no-calorie flavored water.

How controversial was this change? Well, USDA received about a quarter of million public comments prior to issuing its final rule. The upshot is there are lots of exceptions, big and small, in the fine print. For one, caffeinated drinks are not permitted in elementary or middle schools, but they are allowed (in servings up to 20 ounces) in high schools.

And how big a deal is this change? Research and data suggest it’s a fundamental sea change. Some infants are introduced to solid foods (including french fries, peanut butter, and sweets) before they are six months old—physicians’ recommendations notwithstanding. Americans of all ages don’t eat enough fruits and vegetables (less than half what’s recommended), and we eat and drink too many sweets, fats, and refined grains. Our children are skipping more meals (close to four in ten at least sometimes skip breakfast, and three in ten skip dinner at least sometimes), and eating more snacks instead (three per day, on average, compared with one per day in the 1970s).

The results are all around us. You don’t have to be a member of the food police to be concerned about what these trends mean for our health, our nation’s health care bill, and the quality of life available to our children.

Effective strategies to begin to address this issue include interventions to alter individual decision-making, but also attention to the media environment and physical settings (neighborhoods, schools, workplaces) which can encourage either healthy, or unhealthy, eating. It is the latter that are most susceptible to policy-level changes, and which have the potential to have an impact on the greatest numbers.

With about one third of all American children overweight or obese, the amount of adverse health effects among youth alarmingly high. And, children who are overweight or obese as preschoolers are five times as likely as normal-weight children to be overweight or obese as adults. This means that to stop the obesity epidemic in adults, it must first be halted in children.

So, thank you, USDA, for making it a little easier for us to do the right thing.