The Federal Budget Process: Effects on Child Feeding Programs Keith-Thomas Ayoob, EdD, RD, FADA March 2, 2009 School Nutrition Association.

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]