Understanding Obesity & Childhood Nutrition

Panel Perspectives: SchoolsFebruary 17, 2008

Virginia A Stallings, MDChildren’s Hospital of Philadelphia

University of Pennsylvania School of Medicine

The most pressing challenge to nutritional health in this first decade of the 21st century is obesity.

Competitive Foods are Widely Available in Schools

Percentage of Schools Offering Competitive Foods

Food Venue Elementary Middle High

A la carte 67 88 91

Vending Machines

46 87 91

Snack Bars 15 25 54

Competitive Foods are Widely Available in Schools

Percentage of Schools Offering Low Fat

a la carte foods

Bread Product

s

Lettuce,

Veggies,

Beans Salads

Salty Snacks

Yogurts

Veggies other than

potatoes

2000 51 53 38 36 51

2006 67 73 53 50 71

School-Related Health Policy

• 2004 Child Nutrition and WIC Reauthorization Act

• Wellness Policy Required by 2006– Nutrition education goals– Physical activity goals– Nutrition guidelines– Other school-based activities

Nutrition Guidelines• All foods available on campus with

objective of promoting health and reducing obesity

• FY 2005 Congress directed CDC to initiate an IOM study to review the evidence and make recommendations

Committee’s Task• Review evidence and make nutrition

standard recommendations:– for availability of sale, content and

consumption of foods and beverages at schools;

– with attention to foods and beverages in competition with federally reimbursable meals and snacks.

Process and Approach• Ten Guiding Principles• Tier 1: All students all day “F, V, WG, D”

Tier 2: High school students after school• Includes recommendations for:

– Non-nutritive sweeteners– Caffeine– Water availability– Sport drinks– Food for student reward and punishment– Fund raising

CaloriesWeight managementPhysical activity

Food groups to encourageFatsCarbohydratesSodium, potassiumAlcoholic beveragesFood safety

U.S. Department of Health and Human ServicesU.S. Department of Agriculture

www.healthierus.gov/dietaryguidelines

Dietary Intake Data

• <2% meet the Food Guide Pyramid recommendations

• 16% did not meet any of the Pyramid food group recommendations

• Too few fruits, vegetables, whole grains; not enough fiber- or calcium-rich foods

• Too much fat, sodium, added sugar

Are children’s diets meeting theDietary Guidelines for Americans?

Key MessagesFederal school nutrition programs are

the main source of nutrition provided at school. However, if opportunities for students to select competitive foods and beverages arise, they should be used to encourage greater consumption of fruits, vegetables, whole grains, and nonfat or low-fat dairy foods.

The IOM recommendations ensure that competitive foods and beverages are consistent with the DGA and will promote healthful life-long eating patterns.

Recommended Standards for Competitive Foods

• Two Tiers– Tier 1 are “foods to be encouraged”

based on the Dietary Guidelines for American (F, V, WG, LFD)

– Tier 2 foods are consistent with the Dietary Guidelines but offer more choice and flexibility for high school students

Examples of Tier 1 Foods

• Fresh, pureed, or dried fruits (apples, pears, applesauce, raisins)

• Fresh vegetables (baby carrots, celery sticks)

• Whole grain low sugar cereals• Low-fat fruit flavored yogurt• Low-fat flavored milk

Examples of Tier 2 Foods

• Low salt baked potato chips crackers, or pretzels

• Graham crackers with no more than 35% calories from sugar

• Low-fat, low sugar ice cream products

Foods that do not Meet the Standards

• Potato chips and pretzels with too much fat or sodium• Cheese crackers with too much fat or sodium• Breakfast for granola bars with too much fat or sugar• Ice cream products with too much fat• Cake, cupcakes, cookies with too much sugar or salt• Fortified sports drinks or fortified water• Gum, licorice, candy• Fruit smoothies with too much added sugar• Regular colas or sodas with sugar or caffeine

Key Elements for Success

Awareness and understanding of the standards by schools, parents, students, and federal, state, and local as well as other private stakeholders.

Impact

• CDC Implementation Guide for Nutrition Standards for Foods in Schools – under development

• West Virginia schools – new legislation to implement IOM recommended standards

• House bill (January, 2008) to require food served in schools to meet federal nutrition guidelines and IOM recommended standards

Web Information

Nutrition Standards in Schools reporthttp://www.nap.edu/catalog.php?record_id=11899

National Academics Presshttp://www.nap.edu