Nutritional integrity in

our schools and the

impact on child health

Tiffany Ford, Mike Gilmer,

Jennifer Heidel, Micah
Morris, Nishi Parikh,
Heather Schillinger,
Rebecca Willis
 CURRENT
NUTRITIONAL
STATUS
Join the School Lunch Revolu
 POSITION STATEMENT
• It is the position of the
American Dietetic
Association that children
ages 2 to 11 years should
achieve optimal physical and
cognitive development,
attain a healthy weight,
enjoy food, and reduce the
risk of chronic disease
through appropriate eating
 STATS/FACTS
• The number of children who are
overweight has more than
tripled among 6- to 11-year-old
children
• Approximately 10.4% of children
2 to 5 years of age and 15.3% of
children 6 to 11 years of age are
overweight.
• Overweight is now more
prevalent among American
 THE IMPACT
• Healthful eating habits in childhood
help to prevent chronic undernutrition
and growth retardation as well as acute
child nutrition problems such as iron-
deficiency anemia, dental carries.
• Proper eating habits and physical
activity can also prevent long-term
health problems, such as obesity, type
2 diabetes, stroke, cancer, and
osteoporosis.
• Additionally, overweight also often
experience psychologic stress, poor
 TODAY’S CONCERNS
• Particular eating concerns
include the overconsumption of
dietary fat, especially saturated
fats, and inadequate intake of
calcium and iron.
• Approximately 68% to 75% of US
children exceed the current
dietary recommendations for
intake of total or saturated fats.
 WHY IS A BALANCED DIET
IMPORTANT?
• Iron-deficiency anemia in the United
States has negative effects on child’s
motor and mental development and thus
on their work capacity.
• High intakes of saturated fats have been
linked with increased plasma total and
low-density lipoprotein (LDL) and
cholesterol in childhood and can
ultimately increase the likelihood of
cardiovascular disease.
• Failure to meet calcium requirements in
combination with a sedentary lifestyle in
 REFERENCE

am Diet Assoc. 2004;104:660-677.

 CURRENT
PROGRAMS
 UNITED STATES DEPARTMENT
OF AGRICULTURE (USDA)
FOOD AND NUTRITION SERVICE
*Administers National School Lunch
Program and School Breakfast
Program
*Provides nutritionally balanced, low-
cost or free lunches and breakfasts
*USDA school meals programs
operation
*National School Lunch Act and Child
Nutrition Act
 NATIONAL SCHOOL LUNCH
PROGRAM (NSLP)

 Healthy Meals, Healthy Schools, Healthy Kids. United States

Department of Agriculture. 2007.
 NATIONAL SCHOOL LUNCH
PROGRAM CONT.
·30 million students
participate each school
day in NSLP in approximately
101,000 schools
·17.5 million students receive
a free or reduced-price school
lunch every school day
·More than 2 million children
have been added to the NSLP
·NSLP and Vegetables
·After School Snacks
 SCHOOL BREAKFAST
PROGRAM (SBP)
·Nearly 10 million
children in 82,000
schools receive a
school breakfast
every school day
·7.7 million students
received a free or
reduced-price
breakfast
·More than 2 million
children have been
 SUMMER FOOD SERVICE
PROGRAM
·Provides free, nutritious meals and
snacks to children in low-income areas
·Served in congregate settings,
primarily low-income areas
·SFSP operation
 TEAM NUTRITION
·Provides support
through training and
technical assistance
for food service,
nutrition education
for children and their
caregivers, and
school and
community support
for healthy eating and
physical activity
 REFERENCE
Healthy Meals, Healthy Schools, Healthy Kids. 
United States Department of Agriculture. 
2007; 1-4.  Available at
http://www.ask.com/bar?q=healthy+meals
%2C+healthy+schools
%2C+healthy+kids+USDA+School+meals&page
=1&qsrc=0&ab=1&u=http%3A%2F
%2Fwww.fns.usda.gov%2Fcga%2FFactSheets
%2Fschool_meals.htm.  Accessed September
16, 2009.
CURRENT
POLICIES
 LEGISLATIVE
APPROACHES/POLIC
•NutritionES
Standards for Tennessee
schools enacted to promote childhood
obesity taskforces
•The Coordinated School Health
Improvement Act of 1999
•Federal Child Nutrition Act in TN
•State legislation for “wellness
policies”
Child Nutrition and Wellness Act
of 2005
•2005 BMI legislation
 TENNESSEE’S
COORDINATED SCHOOL
HEALTH
The Coordinated School INITIATIVE
Health Improvement Act of
1999:
1. Comprehensive School
Health Education (grades K-
12)
2. Physical Education and
Activity
3. Nutrition Services *
4. School Health Services
5. School Counseling,
Psychological and Social
http://www.state.tn.us/education/s
Services choollhealth/
6. Healthy and Safe School
 TENNESSEE’S
COORDINATED SCHOOL
HEALTH
The Coordinated School INITIATIVE
Health Improvement Act of
1999:
1. Comprehensive School
Health Education (grades K-
12)
2. Physical Education and
Activity
3. Nutrition Services *
4. School Health Services
5. School Counseling,
Psychological and Social
Services
6. Healthy and Safe School
 STUDENT
NUTRITION
EDUCATION
 STUDENT NUTRITION
EDUCATION
• Schools are capable of reaching a large
amount of students and provide an
environment in which students can learn
• Current state requirements
• What are students really learning?
• Where do we go from here?
 CURRENT
CONCERNS:
What Can I Do?
 CURRENT CONCERNS
•Funding
• “The ‘Calories in, Calories Out’ study
found that high poverty schools were
less likely to have any scheduled recess
or compared with schools with lower
poverty.”1

• “Members of Congress are looking for

ways to ‘find’ additional funds for
federal feeding programs.”2

• Contact your representative

 CURRENT CONCERNS
•Support from school faculty
• Setting a good example
• Education

•Support from students

• Multiple sources-Community
• Family
 CURRENT CONCERNS
•Family support
• Eat together
• Eat breakfast
• Get active
• Offer healthy options without many restrictions 3
 CURRENT CONCERNS
• 1
Yeager, Valerie. Local wellness policies. Today’s Dietitian. 2006; September:
45-50.

• 2 Yeager, Valerie. Local wellness policies. Today’s Dietitian. 2006; September:

45-50.
• 3 Richtchie, DL, Weld G, Styne D, Gerstien DE, Crawford PB. Family
environment and pediatric overweight: what is a parent to do. J Am Diet Assoc.
2005; S70-S79.
 CURRENT CONCERNS
What is one way you can support
your community progress in its
efforts to improve the health of
its children?
COMPETITIVE
FOODS
WHAT ARE COMPETITIVE
FOODS
Competitive foods are:
“Foods offered at school, other
than meals served through
school meal programs-school
lunch, school breakfast, and
after-school snack program.”
 WHERE ARE
COMPETITIVE FOODS
FOUND?
• Competitive foods are
typically available in
cafeteria a la carte
lines
• Vending machines
• School stores.
 WHO SELLS
COMPETITIVE FOODS?
• Student /Booster
Clubs through direct
involvement in sales
of candy and baked
goods for fund-
raisers.
• School food services
 WHO SELLS
COMPETITIVE FOODS?
• High and middle schools were most likely
to sell competitive foods than elementary
schools.
• Approximately 30 percent of high schools
generate more than $125,000 per school.
• Elementary schools averaged $5,000 per
school through these sales.
COMPETITIVE BEVERAGE
SALES
Besides the cash incentives for
exclusive beverage contracts
noncash benefits included
athletic scoreboards and in-
kind support of school events.
 COMPETITIVE FOODS
• Also received were athletic equipment,
facilities or uniforms, scholarships and
personal items for students and school
staff, such as cups and coolers.
• Other school groups often used revenues
for activities such as field trips and
assemblies
 SO WHAT?
Since 1980
• The number of children that are
overweight has more than
doubled.
• The number of adolescents that
are overweight has more than
tripled.
• These changes are related in part
to poor nutrition.
 COMPETITIVE FOODS
• According to U.S. Department of Agriculture more
than 60 percent of young people eat too much fat
and less than 20 percent of the recommended
daily servings of fruits and vegetables.
• Children spend a large part of their day in school
and providing them with healthy nutritious food
options is an important step in assuring quality
nutrition.
 WHY NOT STOP
COMPETITIVE FOOD
SALES?
Barriers to changes in restricting the
availability in competitive foods are
mainly the concerns of officials due
to potential revenue losses and the
source of funding that they provide.
 COMPETITIVE FOODS
According to the Government Accountability Office
(GAO), some School Food Administrators (SFA)
directors stated that they sold competitive foods in
order to maintain balanced budgets
SFA commented that the food service would not be able
to maintain a balanced budget without the substantial
revenue generated through a la carte sales.
Another commented that the district food service
generated nearly half of its revenue through
competitive food sales.
 WHAT TO DO???
• Make changes to competitive foods in all of the
schools rather than changes only to certain
schools, such as elementary.
•  Make changes to the availability of competitive
foods throughout the entire school day, rather
than availability only during certain hours of the
day.
• Change fund raising sales to non food items only.
 WHAT TO DO???
• Increase school funding to help
alleviate short fall in revenue.
• Make simultaneous changes to foods
served through school
meals.
 WHAT TO DO???
• Steps needed to increase the availability of
healthy competitive foods:
 Make water and juices more available by replacing
them with soda in vending machines.
 Replace fried potato chips with baked chips
 Replace packaged desserts with granola bars or
similar items.
 Increase the variety of flavored milk to encourage
milk consumption.
 RESOURCES
CDC’s Division of Adolescent and School Health:
www.cdc.gov/HealthyYouth/shpps/index.2009html
Government Accountability Office:
http://www.gao.gov/new.items/d04673.pdf2009htmlpdf
USDA’s Food and Nutrition Service:
www.cspinet.org/Foods_Sold_in_Competition_with_USDA
_School_Meal_Programs.pdf2009html
Action for Healthy Kids:
www.actionforhealthykids.org/tools/profiles.2009html
COMPETITIVE
FOODS