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 likely

Gordon, 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 overweight

1 General Mills Bell Institute of Health & Nutrition Dietary Intake Research2 Wahlstrom et al. Top Clin Nutr 1999

3 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 x6412ktayoob@msn.com