By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
In October 2010, Jamie Oliver, a TV chef known for embracing simplicity, flavor and nutrition in his “naked” food preparations, publicly voiced concern over Congress’ delay in passing the Child Nutrition Bill (also known as the Healthy, Hunger-Free Kids Act). The bill, which Michelle Obama had pushed for as part of her campaign to end childhood obesity and hunger, finally passed two months later, then was signed into law by President Obama on December 13th. Oliver’s support for the new law reflects his dedication to helping change the way Americans eat through publicity efforts (online advocacy and a television show).
By improving the nutrition of the food provided in public schools, the Child Nutrition law is designed to help reduce the incidence of childhood obesity. Approximately one-third of all children in the U.S. ages 2 to 19 are considered overweight, and almost 17 percent are obese. Obesity, which tends to go hand-in-hand with type II diabetes, places children at risk, much earlier on in life, for serious health conditions like hypertension, cardiovascular disease, cancer and osteoarthritis; cardiovascular disease is the leading cause of death in the U.S. and cancer, the second. Recognizing that obesity is largely preventable, the drafters of the Child Nutrition law aimed to ensure that healthier food and beverages are made available to children during and after the school day, when many children have the greatest access to food.
Implementation of the law will mean that processed foods (those high in added sugars and hydrogenated fats) will be harder to come by, as schools will now be subject to nutritional standards set by the USDA. These standards will go beyond school breakfasts and lunches, and extend to edibles that are regularly sold in vending machines, “a la carte” lunch lines, and school-stores. Representing breakthrough change, this mandate that private vendors, and not just lunch ladies, comply with science-based nutritional standards will hopefully have a domino effect that will pervade vending services in adult establishments around the U.S. as well.
Another important provision is expanded access to drinking water, particularly during mealtimes, which should reduce intake of empty calories from high-sugar drinks. Additionally, as designed, the law may help schools develop wellness policies revolving around the promotion and education of good nutrition and physical activity, as well as establish local farm-to-school networks and create school gardens. To ensure compliance with the new mandates, the Child Nutrition law provides for better training of school food service providers, more readily available information about nutritional value of school meals, and the auditing of schools every three years.
What Kind of New Nutritional Standards are We Talking About?
Every 5 years, the U.S. Departments of Agriculture and Health and Human Services jointly review and revise the Dietary Guidelines for Americans. The 2010 revisions reflect that obesity poses the “single greatest threat to public health in this century,” and that the majority of people who are overweight or obese (approximately two-thirds of the U.S. population), are simultaneously malnourished.
In its evaluation, the Dietary Guidelines Advisory Committee (DGAC) found that the average American consumes “too few vegetables, fruits, high-fiber whole grains, low-fat milk and milk products, and seafood,” and eats “too [many] added sugars, solid fats, refined grains, and sodium,” i.e. empty calories.
The 2010 guidelines, then, have been designed to reverse these trends through consumption of more energy-balanced and nutrient-dense foods, as well as increased physical activity. Based on scientific evidence it reviewed, the DGAC citedthe adoption of “certain Mediterranean-style dietary patterns” as a potential dietary approach.
So, based on these recently revised guidelines, what kinds of foods can parents expect their children to be served in school? In general:
- More high fiber and/or nutrient-dense foods like vegetables, fruits, whole grains, fish (omega-3), eggs, unsalted seeds and nuts, and low-fat dairy products;
- Less processed foods like sodas, sugar-sweetened fruit drinks, sugars, syrups, sweets, puddings, grain-based dessert products (cookies, crackers, donuts, pastries, and croissants), pasta, rice-based dishes, pizza, tacos, ice cream, and higher-fat dairy products;
- Less foods with dietary cholesterol such as fatty meats, butter, and cheeses;
- Less sodium-dense goods such as canned and processed foods.
While the 2010 guidelines are somewhat behind the mark of cutting-edge science (for example, they reflect beliefs that dietary supplementation is only beneficial for unhealthy people and that high cholesterol causes cardiovascular disease), they represent a giant step in the right direction toward making positive, sustainable changes in our overall food environment, with application far beyond school nutrition programs.
Goal 2: Fighting Childhood Hunger
The number of families requiring federal food assistance has dramatically increased, especially since the 2007 economic recession began. In 2009, almost seven million households in the U.S. reported having “very low food security,” that is, one or more family members had to reduce their food intake or change their eating patterns due to lack of financial resources. Children in these households likely depend on federally-funded school meal programs for most of the sustenance they receive daily, which increases the urgency of providing nutritious food in schools.
To help better sustain this population segment, the Child Nutrition law also increases the number of children eligible for enrollment in school meal programs. Additionally, the law provides schools with standardized and performance-based reimbursement increases: children on Medicaid now have automatic eligibility, schools in all 50 states can now get reimbursed for providing after-school snacks, and schools which successfully implement the revised nutrition standards will be rewarded with greater reimbursement funds.
A Good Investment
Providing more children better nutrition through the majority of the meals they receive each day seems one of the best preventative measures we, as a society, can take against the “diabesity” epidemic. Despite passage, the Child Nutrition law is not without its opposition; it will cost an estimated $4.5 billion, approximately half which is to be financed through cuts in the Supplemental Nutrition Assistance, or “food stamp,” Program. While President Obama has stated that he will try to help find other ways to finance the law, some critics find the current plan difficult to stomach, as the federal government’s nutritional provisions would ultimately trump nutritional choices made by parents utilizing food stamps. On one hand, a standardized nutrition program may be the most effective solution to the national childhood obesity problem; it also raises an issue of overarching government authority which could set the precedent for other authoritative legislative mandates later on.
Federalist concerns aside, a law providing for the nutritional needs of school children is absolutely worth the increased costs when compared with the medical and emotional costs associated with obesity and obesity-related illnesses. These reimbursement increases, the first in three decades despite inflation, demonstrate societal dedication to nipping childhood obesity and hunger in the bud. Children develop eating habits, for better or for worse, early on in life. Making better nutrition the norm, rather than the anomalous, will pay us back, as a society, huge health dividends.
In light of how our entire (conventional) health care system is founded on the reparation of devastated health, not the preservation of good health, the decision to spend a few extra dollars up-front for our children’s health is a big step toward a shift in public health consciousness. This new legislation sends a message that children’s nutrition is a priority. Hopefully, prevention will become a legislative trend, one that will move us toward positive changes in health insurance reimbursement policies and increase awareness of the need for preventative lifestyles. Remember… health is the greatest wealth.
References and Resources:
- Pear, Robert. “Congress Approves Child Nutrition Bill.” NYTimes.com, Dec. 2, 2010.
- Lee, Jesse. “The President & First Lady on Child Nutrition Bill: ‘The Basic Nutrition They Need to Learn and Grow and to Pursue their Dreams.’” Whitehouse.gov/blog, Dec. 13, 2010.
- Wootan, Margo. “A landmark step as the Child Nutrition Bill is signed into law.” Jamieoliver.com, Dec. 22, 2010.
- Report of the Senate Committee on Agriculture, Nutrition and Forestry on the Healthy, Hunger-Free Kids Act of 2010. Ag.senate.gov, May 5, 2010.
- Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans 2010. USDA.gov. Accessed Jan. 17, 2011.
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