NEW YORK (Reuters Health) - Philadelphia schools that cut out soda, revamped snack selections and took other measures to prevent childhood obesity were able to halve the odds of students becoming overweight by sixth grade, a study has found.
Among fourth-graders at five schools that instituted the new nutrition policy, 7.5 percent became overweight over the next 2 years, compared with 15 percent of students at five city schools that did not make the changes, researchers report in the journal Pediatrics.
The findings show that a comprehensive approach to battling childhood obesity in schools can make a significant difference, according to lead researcher Dr. Gary D. Foster of Temple University.
Schools have been at the center of the controversy over what to do about U.S. children's rising rates of overweight and obesity. Critics have pointed to vending machines, sugary "a la carte" items in school cafeterias, and reductions in gym class as part of the problem.
At the same time, schools are considered the ideal place for children to learn healthy eating and exercise habits, and various school-based programs have been developed with that aim. The results have been mixed, however.
For their study, Foster and his colleagues evaluated a program developed by a non-profit community group called the Food Trust. Ten schools enrolled in the study; half were randomly assigned to adopt the nutrition program, while the other half served as a comparison group.
Schools in the program made an array of changes. They replaced soda with water, low-fat milk and 100-percent fruit juice, and rid vending machines and cafeterias of snacks that did not meet certain nutrition criteria. They educated students on how diet and exercise affect their health, and gave them raffle tickets for bikes and other prizes to reward them for choosing healthy snacks.
The schools also got parents involved through meetings and nutrition workshops that encouraged them to give their kids more fruits, vegetables and other healthy foods.
Among the 1,349 students Foster's team followed from fourth to sixth grade. As mentioned, there was about a 50 percent reduction in the incidence (new cases) of overweight at the end of 2 years among the children attending the program schools, while no changes were seen among the children attending the schools without a program.
The prevalence (total number) of overweight children also declined during the study period in the program group. However, no differences in the prevalence of obesity were seen between the program group and the comparison group.
The results, Foster told Reuters Health, underscore the benefits of schools having a comprehensive nutrition program, rather than taking only individual measures -- like removing vending machines, for instance.
He and his colleagues also stress that the urban schools in this study had largely low-income, minority student populations -- children who are at particularly high risk of obesity. Black children appeared to particularly benefit from the nutrition policy.
In the sixth grade, the study found, African-American children in these schools were 41 percent less likely to be overweight than African Americans in the comparison schools.
Despite the success, Foster's team writes, the fact that 7.5 percent of children in the program schools still became overweight shows that even more needs to be done.
They say that obesity-prevention programs should start before fourth grade, and possibly include a broader range of measures -- such as devoting more time to gym class and enlisting the corner stores near schools to offer healthier snack options.
SOURCE: Pediatrics, April 2008.
I applaud any effort to improve the food choices available to kids at school. When I think back to my high school cafeteria days, I feel a gentle wave of nostalgia for brown food: fries and gravy, burgers, perfectly square breaded & deep-fried chicken patties. Oh wait - that's not nostalgia. It's nausea.
Grade school for me was bagged lunches - we didn't have a cafeteria. It always surprises me a little to hear about 8-year-olds lining up with trays to buy their lunch (I'm assuming lunch isn't free). What doesn't surprise me is that the choices available to little kids are about as horrible nutritionally as the choices I had in high school. Cheap, ready-made non-food. Feeding on a mass scale is first and foremost determined by budget, after all, not health.
But these improvement efforts, although a step in the right direction, still fall short because they're based on recommendations that themselves are based on faulty science: fat makes you fat. There's recognition that sugar plays a role - getting rid of sodas and sugary 'a la carte' items is a great idea - but anyone who knows anything about current government nutrition guidelines knows that "snacks that don't meet certain criteria" means anything that contains too much fat, saturated in particular, and not enough fibre. What's ignored is that kids need fat - and calories - in order to grow and develop properly.
Sandy Szwarc, BSN, RN, CCP of Junkfood Science blogged about a 2007 University of Delaware study that went totally unreported in the media. The study, a small clinical trial of ten kids, aged six to ten, set out to determine how much fat prepubescent children burn in order to support normal growth and energy needs. What did they find?
...children’s bodies naturally need more fat to fuel growth processes, such as higher rates of protein synthesis, lipid storage and bone growth, and to meet their energy needs, the researchers said. Females also have higher nutritional needs for fat.
They reported that low-fat diets do not meet the nutritional needs for children and, instead, can interrupt normal growth and development. Sadly, diets recommending restricting fats to 30% of calories have been “translated by some in an overzealous, but well-intentioned, manner to provide as little fat as possible in the diet, leading to inadequate energy intake and compromised growth,” they said. The National Academies’ 2002 recommendations, they noted, are that children 1-3 years old to be allowed as much as 40% fat, and children and teens up to 18 years of age consume up to 35% of their calories as fat (25-35%).
So kids need fat. Again, it's a start. I'd argue, of course, that restricting fat intake, in anyone, to even 40% is unnecessary, but in this nutritional climate that's a hard row to hoe. Never mind that a diet high in fats (and correspondingly low in carbohydrates) has been demonstrated to help epilepsy, stabilize blood sugar and, in some cases eliminate symptoms of diabetes, and reduce heart disease. Saturated fat in particular is vital for cell membrane integrity, the proper absorption of calcium, immune system function, and the proper utilization of essential fatty acids. See this article, by Mary Enig, for more information.
And of course, fat has never actually been proven to cause any of the health conditions it has become synonymous with. What has been demonstrated to have an effect? Carbohydrates - mainly, sugars and starches.
In spite of all this, improved school lunches are going to focus on getting the fat out and on reflecting the ubiquitous pyramid - the one that many of us have grown fat and diabetic on.
Want your kid to avoid the cafeteria altogether, but don't have time to pack them a lunch? Never fear! There's always pre-packed lunch options, full of all the things growing kids need.
Like Lunchables! Why not a Ham & Cheese Wrap, with a Squeezable, Low Fat Berry Yogurt Jammer and 100% Fruit Juice Punch? Sounds wholesome enough. And at only 430 calories and 13g fat, it's gosh darn good fer ya. Or a Schneiders Smart Lunch of a Whole Wheat Bagel with Light Cream Cheese, Turkey Pepperettes, and Craisins, for a measly 340 calories and 9g fat. Healthy, right? (note from the marketing team: foods that begin with Capital Letters are perceived as Trustworthy and Nutritious and Positively Reflect The Brand)
Wrong. These lunches have 65g and 49g carbs worth of sugar and starch respectively (if you follow Schneider's suggestion to add, say, a small banana and a box of OJ, you could be looking at 97g) - more than some low-carbers eat in an entire day. These carbs will be converted to glucose within minutes, and swept out of the bloodstream by a whoosh of insulin. Some will be stored in the liver and muscles as glycogen - the excess will be stored as fat. About 90 minutes later, blood sugar will fall to normal levels, but insulin is still busily shuttling glucose to the fat cells. Blood sugar falls below normal, and the kidling feels hungry again - and reaches for another healthy goodie, like apples or Triscuits and low fat cheese, and the whole cycle begins again.
If your kids are eating high levels of carbs all day, week after week, year after year, this cycle is constantly going on. And it doesn't matter if those carbs are coming from french fries and a Coke or a raisin bran muffin and a banana - as far as the body is concerned, glucose is glucose. Continual high levels of insulin then lead to insulin resistance - it takes more and more insulin to get that glucose out of the blood. Suddenly, we've got a chubby kid with a ravenous appetite. Much of what s/he eats is being tucked away as fat, and insulin ensures that fat can't be accessed to use as energy. The body needs nourishment and can't get it, so it signals hunger.
And even if they don't gain weight in childhood, this cycle sets them up for weight gain in adolescence or adulthood, along with an increased risk of diabetes and all the other fun 'diseases of civilization' we've come to both dread and expect. And all the grains and dairy can, in susceptible individuals (and there's more of us than mainstream medicine will believe), lead to GI problems, acid reflux, tooth problems, headaches, acne, allergies and a host of other maladies that we've come to consider normal.
So what to do? Schools can't afford to serve your kids t-bones every day, and you can't send them off to school with Filet Mignon.You can, however, send them off with real food in their Dora lunchbox. Egg or tuna salads, sliced meats and cheese, veggie sticks and full-fat dip - heck, even leftovers from last night's dinner make a good, filling lunch, as do thermoses full of chili, stew or chunky meat and veggie soups and chowders. Oopsie rolls, crackers or muffins made with nut/seed flours and/or butters, hard boiled eggs, mixed nuts, pickles and olives make great snacks (if your kids like pickles and olives - my nephew goes insane for them, and will pick them over fries any day. My niece prefers spicy beef sticks. When we take them to the zoo, they barely even glance at the Harvey's, and if we eat there they don't finish their burgers - they delve into our snacks instead. They rock.)
Schools are a whole other ballgame. I know what they're up against - I have two step-parents who are grade school principals, and my mum teaches nursery kids. All of my parents friends were teachers, so I've been around them socially and heard the crap they have to put up with since I was in Grade 2. The school cafeteria is under budget, and that's going to determine what they serve. But as Jamie Oliver demonstrated in his School Dinners series, healthy options are possible with proper planning.
But who the hell am I to talk? I don't even have kids. On that note, Richard Morris, author and successful loser (of weight, that is), has some wonderful advice for parents here.
So how do you deal with school lunches? What does your child's school provide for them? Any tips on packing healthy lunches?