the federal budget process: effects on child feeding programs keith-thomas ayoob, edd, rd, fada...
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The Federal Budget Process:Effects on Child Feeding Programs
Keith-Thomas Ayoob, EdD, RD, FADAMarch 2, 2009School Nutrition Association
Where we came from
• NSLA of 1946 General national policy Focus on protecting kids against
nutritional deficiencies Outlet for surplus commodities
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
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………………..
Old Problem: “Malnourished Kids”
New Problem:
BRAVE NEW WORLD
• Kids have food everywhere• Kids eat food everywhere• Kids got fatter
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…”
WHERE WE NEED TO BE
• “Optimal nutrition”• Obesity prevention• Disease prevention
but there’s just one thing……....
…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
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
What you need: ONE NATIONAL POLICY
• Meets the needs of MOST children• Supplies the good stuff• Minimizes the bad stuff (excesses,
including LNED foods)
What you need: ONE NATIONAL POLICY
• Keeps up with DGAs without “overachieving”
• National policy means national funding
• Can drive reformulation of foods by industry
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
likelyGordon, et al, JADA 2009
40% of children 40% of children don’t eat don’t eat breakfast breakfast everydayeveryday11
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 overweight1 General Mills Bell Institute of Health & Nutrition Dietary Intake Research
2 Wahlstrom et al. Top Clin Nutr 19993 Murphy et al. Arch Pediatr Adolesc Med 1998
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
Where you have problems
• Competitive foods, especially LNED ones
• Compliance with national standards Too much sodium Low fiber Too much fat & saturated fat
How often is it “The only meal for the day?”
How communities “overachieve”
• NY and school milk
February 2, 2006:
“In New York Schools, Whole Milk Is Cast From the Menu”
Also removed (2006):
2% milk1% chocolate milk All other flavored milk
RESULT: Milk consumption drops 10% in 2006
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
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
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.”
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
Follow the 2005 DGAs
• Whole grains• Fruits and vegetables (attn:
legumes)• Low-fat/fat-free milk
Age-appropriate portions and calories
• Base on age and ACTIVITY level• Currently: 1989 REA for active kids
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
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”
Communication Research
Journal of the AmericanDietetic Association
June 2003
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
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
WHAT SNA NEEDS MOST
• Legislation for a single national wellness policy
• Ensure all legislation is FUNDED
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
REMEMBER THE GOAL
HEALTHIER CHILDREN
Keith-Thomas Ayoob, EdD, RD, FADA
Associate Clinical Professor of PediatricsAlbert Einstein College of Medicine
718-430-3970 [email protected]