Fat Child

By Melinda Hemmelgarn

Missouri State Teacher Association Website, School & Community Feature

July 2005

Online at: http://www.msta.org/services/publications/snc/featured.asp?TOC_ID=284

Poor nutrition, inactivity and a childhood obesity crisis are compromising student health and achievement.

No child is left behind when it comes to risk for obesity in our land of plenty. In the past 25 years, the proportion of overweight children between the ages of 6 and 11 has more than doubled, and the rate for adolescents has tripled. Childhood obesity is a public health crisis. Are schools contributing to this crisis? Is there something they can do about it?

The dollar drain

Nationally, estimates for children's medical costs that may be attributed to overweight top $127 million. However, that figure does not include the costs of lost education opportunity from missed days at school.

A 2004 Action for Healthy Kids report documents how poor nutrition, inactivity and weight problems adversely affect academic achievement and cost school districts funding and staff time. In states that use attendance to determine state funding, a single-day absence by just one student can cost a district anywhere from $9 to $20.

Health risks, medical costs and budget losses concern school personnel, but children say the worst part about being overweight is the accompanying teasing, bullying and discrimination, which lead to eroded self-esteem, depression and poor school performance.

The land of brand loyalty

Kelly Brownell, director of the Yale Center for Eating and Weight Disorders, describes our environment as “toxic,” thanks to 24/7 access to fast food, super-sized portions, sedentary lifestyles and unbridled food marketing directed toward children on television, in video games and even in schools.

Advertising directed toward children has come under increased scrutiny for its contribution to youth obesity. During the past decade, public schools have become venues for food and beverage marketing because schools face chronic funding shortages, and the food industry wants to increase market share and build brand loyalty.

“The school system is where you build brand loyalty,” John Alm said in 2003. Alm is president and CEO of Coca Cola Enterprises.

According to the U.S. General Accounting Office, food sales are the most prevalent form of commercial activity in schools. “Competitive foods,” or those foods and beverages sold in competition with the USDA's school meal programs —in school stores, ala carte, vending and fundraising — demand the most serious concern.

Vending machines, for example, emblazoned with images of brand-name soft drinks, function as mini-billboards as well as beverage dispensers and revenue generators.

The School Health Policies and Programs Study 2000 found that students could purchase sweetened beverages in a vending machine, school store or snack bar in 58 percent of the nation's elementary schools, 83 percent of middle schools and 94 percent of high schools.

Most schools receive a percentage of sales revenues; some also receive incentives such as cash awards or donated equipment after revenues reach a specific amount. Contract terms vary, but many are highly lucrative. Missouri's Rockwood R-6, for instance, has a contract with Coca Cola that provides $240,000 dollars to district schools to use for student scholarships and activities.

The Columbia School District does not have an exclusive soft drink contract, but vending revenue for the 2001-02 school year totaled more than $34,000 from the city's two high schools.

Penny-wise but pound-foolish

Terry Ferguson, director of food service for Jefferson City Public Schools, described soda machines as “easy money, but bad nutrition.” She's right. Each 20-ounce soft drink delivers a whopping 16 teaspoons of sugar and 260 calories. Estimates vary, but between 56 and 85 percent of children in school consume at least one soft drink daily. Consumption of sugary soft drinks significantly increases the risk of weight gain and Type 2 diabetes.

A statewide Team Nutrition Survey conducted by the Missouri Department of Health and Senior Services is the first of its kind to supply comprehensive data on school nutrition policies specific to Missouri.

Preliminary results show that the majority of responding schools have a closed campus, which is good news because it means less competition from outside food establishments and a captive audience for potentially healthful meals. However, most schools do not sell fruits and vegetables in vending or school stores.

Parents and teachers must ask whether branding is a legitimate activity in public schools, and if it's worth funding school activities with foods and beverages that contribute to obesity, Type 2 diabetes, osteoporosis and tooth decay. National health and education associations — from the American Academy of Pediatrics to the Missouri Congress of Parents and Teachers — advise putting children's health first. They recommend eliminating soft drinks and sweetened beverages from all schools and improving the overall quality of foods and beverages sold in the school environment.

Moving toward better policies

From California to Maine, local school districts and state legislatures are setting new food policies to protect children's health. For example, in August 2003, the Austin, Texas, school system took the state's already-improved regulations one step further by extending limits on carbonated beverages and foods of minimal nutritional value to high schools.

Austin Superintendent Pat Forgione explains the philosophy behind the move. “While schools are not totally responsible for what children eat, we can do our part to point them in much healthier directions that will benefit them throughout their lives,” she says. Forgione believes that if state law requires children to be in school five days a week, students should be provided with nutritious food choices.

The good news is that switching to healthful choices has not hurt revenue streams as severely as many originally feared. Austin's communications specialist, Carmen Luevanos, said that while they are not making as much, they “certainly are not losing it, or in dire straits as predicted.”

In 2004, Philadelphia implemented a 100 percent juice, milk and water policy district-wide. In its pilot, monthly sales from beverage vending increased slightly. Aptos Middle School in San Francisco reported an increase in revenue when the physical education department replaced soda with bottled water in locker room machines. And, in a pilot study in Arizona where all sugared sodas and candy in vending were replaced with water, juice, low-fat milk, granola bars, fruits and vegetables, schools made as much money — or more.

The healthy kids solution

According to the U.S. Department of Health and Human Services report, Healthy People 2010, “Schools have more influence in the lives of youth than any other social institution except the family, and provide a setting in which ... norms that govern health are developed and
reinforced.”

With school meals and snacks providing one-third to one-half of many students' daily nutritional needs, schools have a unique opportunity to teach and model healthful eating and physical activity.

If your school district isn't helping lead the way to better student health, it's time to get started.

Melinda Hemmelgarn is a registered, licensed dietitian with more than 25 years of experience in health and nutrition education. She conducts statewide media literacy education training for the Missouri Department of Health and Senior Services. She also is a 2004-05 W.K. Kellogg Food and Society Policy Fellow. You may reach her at foodsleuth@mchsi.com.

For more information

Action for Healthy Kids: A nationwide initiative dedicated to improving the health and educational performance of children. It offers evidence that improvements in school food and activity policies make a difference in test scores. Go to www.actionforhealthykids.com.

“Constructive Classroom Rewards: Promoting Good Habits While Protecting Children's Health,” Center for Science in the Public Interest. Go to cspinet.org/nutritionpolicy/constructive_rewards.pdf.

“Community Action to Change School Food Policy: An Organizing Kit.” Compiled by the Massachusetts Public Health Association, this comprehensive guide includes sample policies and how to be an advocate for change. Find it at www.mphaweb.org/home_food_policy_kit.pdf.

Missouri Department of Health and Senior Services; links to state survey data and “Changing the Scene Toolkit.” Go to www.dhss.mo.gov/Obesity/Childhood.html.