The headline could not have been more dramatic – or encouraging: “Obesity Rate for Young Children Plummets 43% in a Decade,” said the Feb. 25, 2014 edition of The New York Times. And while some experts were reluctant to draw conclusions from the Centers for Disease Control and Prevention (CDC) report, others saw it as a milestone in the fight against an epidemic.
“I am thrilled at the progress we’ve made over the last few years in obesity rates among our youngest children,” said Michelle Obama in a statement accompanying the CDC report. Four years earlier, the first lady had launched her “Let’s Move!” campaign to combat childhood obesity by emphasizing healthy eating habits and exercise.
The CDC report came with a caveat: While obesity had plunged among 2- to 5-year-olds from 14 percent in 2004 to 8 percent in 2012, the rate for a larger age span of youth – ages 2 to 19 – did not budge. Then, six weeks later, another report came out, this one from the University of North Carolina. It found that over a longer term – 14 years – the obesity rate for 2- to 5-year-olds was also flat.
Both reports were right, in their own way. But together they begged a deeper question: Are we making any progress in reducing childhood obesity? And if progress is being made, what actions are contributing?
Can Schools Make a Difference?
Childhood obesity is a complex problem. It’s difficult to pinpoint its exact causes: Healthy food availability, exercise and activity options, cultural expectations, and family habits and attitudes all play a role.
Many of these factors are beyond the reach of government intervention. Schools, however, have been at the epicenter of policies and regulations aimed at combating the problem. After all, many students eat at least one meal a day and sometimes two at school. School is one place where they can learn about healthy eating and exercise.
Schools participating in the federal school lunch program have seen a steady increase in regulations in the past decade, including more stringent nutrition guidelines for meals and requirements to establish schoolwide wellness committees and policies. The U. S. Department of Agriculture (USDA) even has proposed that outside food available in schools –such as birthday treats –meet nutritional guidelines consistent with school lunch standards.
Have these efforts moved the needle on childhood obesity? It depends on whom you ask. Some nutritionists –including Marion Nestle, professor in the department of nutrition, food studies, and public health at New York University – say that school meals are pivotal to efforts to make children healthier.
“They set an example of what healthy meals are supposed to be,” she says. “They feed kids who may not be fed nearly as well at home. And we have considerable evidence that kids who eat healthier meals in schools are healthier and less obese than kids who don’t.”
Leah Schmidt does not think school lunches play such a pivotal role. The president of the School Nutrition Association (SNA) and director of food and nutrition services for Missouri’s Hickman Mills C-1 School District says school lunches are only giving students a third of their calories. “It’s probably things they are doing outside of school” that contribute to obesity.
Not surprisingly, research on the topic is mixed as well.
A 2011 University of Michigan study of more than 1,000 sixth-graders from southeast Michigan found that those who regularly had school lunch were 29 percent more likely to be obese than those who brought their lunch from home.
Conversely, Daniel Taber, a research at the University of Texas School of Public Health, looked at more than 20 years of data from the National School Lunch Program. He found a correlation between stronger state school lunch standards and lower obesity among those students receiving free and reduced-price lunch.
Taber examined was collected before 2012, when the USDA strengthened national regulations for school lunches by setting calorie limits, reducing fat and starches, and increasing requirements for serving fruits and green vegetables.
“The science has shown that strong nutritional standards can have an impact on obesity,” he says. However, he added: “The school can make a lot of changes, but if the school is surrounded by fast-food outlets and convenience stores, you may not see much difference.”
Focus on Overall Wellness
Healthy students do better in school, and that fact makes student wellness a priority in schools across the country.
In recognition of the complexities of the obesity issue, school wellness programs focus on more than just food. Many wellness programs involve partnerships with community members, social service agencies, colleges, and hospitals. They include teachers, school staff, parents and families.
Several southeast Michigan school districts, including Detroit, Ann Arbor, and Ypsilanti participate in the University of Michigan’s Project Healthy schools. This middle school program takes a holistic, community-based, and collaborative approach to improving student health.
Participating schools form wellness committees and appoint a wellness chair, usually a teacher who gets a stipend. Wellness coordinators train student mentors to model healthy habits, including the five program goals: eat more fruits and vegetables, make better beverage choices, eat less food, spend less time in front of a screen, and be active every day.
The program offers supports for students and also reaches out to the teachers, who are key role models, says program manager Jean DuRussel-Weston. ‘It’s getting a pronounced cultural change and having it come from within.”
Healthy Schools serves 24,000 students in southeast Michigan. Numerous research studies have shown that the program has lowered students’ cholesterol levels and improved their overall health.”
Helping students find health balance was the goal of the wellness program at Barry Elementary School in Clovis, New Mexico. Fifth-grade teacher Sara Williams surveyed her students and found that they were spending far more time playing video games than they were exercising or playing outside – eight hours on video games and two hours of exercise a week on average.
Barry Elementary School is not far from Cannon Air Force Base, where some of the children’s parents work. Several children in Williams’ class want to be in the military when they grow up. But you can’t get enlisted in the military –or stay enlisted – unless you pass a fitness test, Williams told them. At some point they would have to change their habits to qualify.
Williams and a fellow teacher talked to the children about making healthier food choices. Barry Elementary, which is a Title I school, contributed with a breakfast program and backpacks of healthy foods that students could take home on weekends. And Williams got help from her husband, a sergeant at the air base, who helped administer a modified version of the “PT Test” including push-ups, sit-ups, jumping jacks, and a timed one-mile run.
By the end of three months, every student could do at least 10 push-ups, 25 sit-ups, and 50 jumping jacks. All were able to run the mile in less than 10 minutes, and 86 percent improved their time over the course of the program. All told, 56 percent were able to surpass the fitness requirements.
“Most of it they just did on their own,” Williams says. “I just gave them the tools – and they did it.”
Williams was the grand prize winner in Discovery Education’s Find Your Balance Challenge in spring 2014.
Concern over nutrition and wellness is what spurred Laura Massenat to run for a win a seat on the Oklahoma City School Board two years ago. Reheated frozen foods will be a thing of the past in 10 pilot schools this fall. Cafeteria workers will be cooking in kitchens that had been downgraded through the years to reheating facilities. “The media perspective and the perspective of the parents and kids just have to be positive going in,” Massenat says.
In partnership with the Oklahoma City YMCA, the schools have revised their wellness programs and are transforming the state- required School Health Index into documents that schools can use to set fitness and nutrition goals.
Oklahoma City, like most any city in the country, has a problem with child obesity, but Massenat says that, “for me, it’s never been about obesity. It’s just about health.”
While districts work to create healthy environments and healthy choices for their students, the federal school lunch program continues to be the focus of federal lawmakers with the same goals. However, districts say they are being burdened financially and administratively by increasingly restrictive USDA school meal regulations.
For example, USDA regulations under the Healthy, Hunger-Free Kids Act of 2010 require all bread, pasta and crackers offered in school to be whole-grain rich (currently just half of these items must comply), although the department recently announced temporary relief from the grain standards.
“The latest set of regulations pushes the boundaries of federal oversight so far beyond the boundaries of the federal school lunch program, it’s scary,” says Lucy Gettman, director of Federal Programs for NSBA.
USDA requirements, such as mandating that all students buying federally subsidized school lunches must take a fruit or vegetable, has led to more waste, say officials in Ohio’s Clermont Northeastern Local School District.
NSBA and the SNA are both committed to improving student health yet have serious concerns about the new regulations (see sidebar, page 37).
“We took away our deep fryers long ago,” says Schmidt. “We’re working on decreasing out sodium, doing a little more ‘scratch’ cooking.”
But meeting the USDA requirements, such as finding whole-grain saltines that are widely available and palatable to students, is hard, Schmidt says. Even more difficult will be trying to meet the increasingly restrictive sodium limits, which go down in 2017 (difficult but doable, Schmidt says) and again in 2021 (“Almost impossible. The students will be bringing their own salt shakers.”)
Given these kinds of requirements, coming up with a workable four-week menu can be complicated. Of course, school nutrition directors have their own ideas about what to add to the mix themselves to improve student health. It is, after all, part of their job.
Schmidt says, “Everybody is in this because they want to do the best for kids. That is what we do.”