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

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

Minnesota

HEALTHY SCHOOLS SUMMIT: TAKING ACTION FOR CHILDREN’S NUTRITION & FITNESS

October 7-8, 2002 The Ronald Reagan Building and International Trade CenterWashington, DC

MN State Team Members

Educators

School administrators

Health and nutrition professionals

Government leaders

Student leaders

Concerned parents

Community and business leaders

Obj. 19-3c

Total

Female

Male

WhiteBlack

MexicanAmerican

0 10 20 30

Percent

Child and Adolescent Overweight by Race:

1988-94 to 1999-2000

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.

2010 Target1988-94

Caution: Beyond Calories

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

Did you know?

Kids with high added-sugar diets eat fewer fruits and vegetables and drink less milkPoor nutrition can compromise cognitive development and school performancePoor nutrition can increase the chances of getting a cold or the flu and lead to missed days at school

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 unneededModern conveniences, auto-based

transportation, communities are not walkable and have no destinations

Young and Nestle, JADA 2003

Increased Introduction of Large Portion Sizes in the US

Soda

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?

12 fluid ounces 110 calories

??? calories

125 250 500

20 Years ago Today

Environment

Availability

Promotion

Annual NCI budget for 5-a-daynutrition education

$ 1 million

McDonald’s “we love to seeyou smile” campaign

$ 500 million

U.S. government’s entire budgetfor nutrition education

Is one-fifth the advertisingbudget for…

Altoids mints

Nestle, 2002

Web Site, 5/18/02

“The revenue generated from the sale ofbeverages in schools is an important

part of the education funding equationin the United States”

Revenue Concerns

“For decades, soft drink companieshave had an important presence

in our nation’s schools”

Change the Person versus Change the EnvironmentChange the Person

- Education alone is not enough

Change the Environment

- Supportive environment makes healthy food choices easier

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

What does your school food environment look like?

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

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

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

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.

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

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

Why the “Guidelines for Good Nutrition at School”?

Kids are not meeting their nutritional needs and often get too many caloriesMeals and snacks at school can provide one-third to one-half of a child’s daily nutritional needsMore children are selecting a la carte and vending items…which are not regulated for nutritional value

JADA – April, 2003

Fruit and Vegetable Intake Among MN Youth

(MN Student Survey, 2001 and 2004)

Students eating 5 or more servings of fruit and vegetables on the previous day

6th grade 9th grade 12th grade

2001 2004 2001 2004 2001 2004

Boys 21% 20% 17% 16% 15% 13%

Girls 22% 22% 13% 14% 11% 12%

Krebs-Smith, Cancer, 1998

25% of allvegetables eaten

in the U.S. are

French Fries

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 drinksSource: USDA, Continuing Survey of Food Intake by Individuals, 1994-96

15 teaspoons of sugar per day

Beverages Consumed by MN Youth

(MN Student Survey, 2001 and 2004)

Three or more glasses of milk

6th grade 9th grade 12th grade

Boys 46% to 42% 44% to 42% 37% to 35%

Girls 37% to 34% 27% to 25% 19% to 18%

One or More Glasses of Pop or Soda

Boys 70% to 64% 76% to 71% 77% to 72%

Girls 60% to 55% 60% to 54% 62% to 56%

One or More Glasses of Sports Drinks

Boys 33% to 40% 32% to 41% 27% to 38%

Girls 21% to 27% 14% to 22% 8% to 15%

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

One or more glasses of Fruit Drinks

6th grade 9th grade 12th grade

Boys 61% to 60% 57% to 55% 59% to 48%

Girls 60% to 58% 52% to 51% 43% to 40%

One or more glasses of 100% Fruit Juices

Boys 64% to 61% 64% to 60% 62% to 61%

Girls 63% to 59% 59% to 54% 56% to 52%

Five or more glasses of Water

Boys 46% to 47% 38% to 39% 32% to 34%

Girls 42% to 44% 32% to 35% 27% to 31%

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

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

AFHK MN Goal

Develop statewide nutrition guidelines with the support of students, families, community and school to ensure a healthy school nutrition environment

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

Guidelines are for Non-Regulated Foods

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

Priorities Set

Kids health is first and foremost

Keep it simple

Foods kids will eat!

Recognize local fiscal constraints and needs

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

Three Nutrition Criteria

1. Serving size

2. Dietary fat

3. Added sugars

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

Wanted: Fruits and Vegetables

Half of children eat less than one serving of fruit a dayOne-third don’t even get a serving of vegetables that have not been friedMost miss out on the health benefits

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 caloriesSome 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

Added Sugars

Kids get 20% of their calories from added sugars!

Sweetened beverages are the biggest source of added sugars

Extra calories may contribute to obesity

Added Sugars

Some sugars found naturally in food

- Whole fruits

- 100% fruit juice

- Milk

Labels don’t indicate the source of sugars

Guideline: “Sugar is not the first ingredient” except “no added sugar” in most beverages

Wanted: More Calcium

Half of adult bone mass is built during adolescent years

By age 13, 95% of girls and 75% of boys are not getting adequate calcium

Wanted: Whole Grains

Most kids missing out

Less risk of heart disease, certain cancers, type-2 diabetes

Three are key!

Cereals, tortilla chips, popcorn, whole-grain breads

Promote Healthier Choices

Whole-grain cereals and breakfast barsBaked chipsNuts and seedsFruits and vegetablesSkim, 1% milks and yogurt100% juices

Limit Amounts

Most candy barsSweetened beveragesMost cookiesHigh-fat chipsHigh-fat milks, meats and other high-fat foods

Guideline Pilot Test: Apple ValleyAllowed flavored milks

Allowed for 1 oz. cookies

Allowed cereal bars & granola bars within the guidelines

Allowed small muffins, bagels

Allowed for small bags of snacks

Allowed for ice creams, frozen yogurts

Key LearningsFood industry still needs to improve on availability and sizing of healthier snacksPricing is still a big factorWith increase market share, hopefully pricing will become more attractiveManufacturers are responding to needsStudents will choose healthy options if provided

Support Better Nutrition in Schools for…

Better learning

Better behavior

Better life-long habits

Better health

Better futures

Healthy foods for kids Guidelines for good nutrition at

schoolsAction for Healthy Kids MN

www.actionforhealthykids.org, click on MN on pull down menu

Visit the AFHK Websitewww.ActionForHealthyKids.org

Click on Minnesota on the pull down menu