Tuesday, August 26, 2014

Kids PlayingObesity has become an increasingly prevalent health concern amongst the youth in the United States. According to the Centers for Disease Control and Prevention, childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of overweight children aged 6–11 years in the United States increased from 7% in 1980 to nearly 18% in 2012. Additionally, obese adolescents aged 12–19 years increased from 5% to nearly 21% over the same period. As weight has increased, other health issues have become major concerns for this population. Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. They are more likely to have prediabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes. They are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems. In order to reverse this trend, the federal government has targeted school lunches as one way to improve nutrition among youth populations.

The Healthy, Hunger-Free Kids Act of 2010 serves to fund child nutrition programs and free lunch programs in schools for 5 years and set new nutrition standards for schools. The goal of the law was to improve child nutrition and provide food security for children by helping schools across the country produce balanced meals and provide children with access to healthy foods during the school day. The legislation is groundbreaking in that it allowed the U.S. Department of Agriculture (USDA) the opportunity to make noteworthy reforms to these feeding programs by improving the critical nutrition and hunger safety net for millions of children for the first time in more than 30 years. First Lady Michelle Obama championed the Act, as it has played a significant role in her fight against childhood obesity as part of her Let’s Move initiative.

USDA based the new school meal standards on independent, expert recommendations from the Institute of Medicine report School Meals: Building Blocks for Healthy Children to ensure that children receive healthy food at school. A total of $4.5 billion of federal funding was allocated by Congress in 2010 to address the National School Lunch Program; the School Breakfast Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; the Summer Food Service Program; and the Child and Adult Care Food Program. Significant results have already occurred in response to this legislation. According to a June 2014 press release, more than 90% of schools reported to USDA that they have successfully met the updated nutrition standards. A Harvard study that took place from 2011 through 2012 also concluded that children are eating 16% more vegetables and 23% more fruit at lunch under the new standards. Additionally, the 2014 report Student Reactions During the First Year of Updated School Lunch Nutrition Standards by the Robert Wood Johnson Foundation found that children enjoy the more nutritious school meals. Seventy percent of elementary and middle school administrators and 63% of high school administrations felt that their students generally liked the new lunches; in addition to this, elementary school respondents reported that the healthier meals had no impact on student participation in the lunch program, or on plate waste. Twenty percent of schools reported an increase in plate waste, and 21% reported a decrease.

Despite these successes, many schools systems nationwide have struggled to initially implement the new standards for a variety of reasons or have felt that the rules are too confining. These districts note that they have had trouble finding affordable products that meet the nutrition standards. Meanwhile, others claim that plate waste has increased and that students are now more prone to throw away the mandatory healthy food on their tray, specifically fruits or vegetables. Students have also disputed the legislation; a popular YouTube video parody by high school students in Kansas claims that although meal options are healthier, they are now hungrier due to smaller portion sizes.

These criticisms have led to an even deeper divide between the aisles of Congress. Earlier this year, House Republicans backed an effort by the School Nutrition Association to challenge the law; the provision would allow schools districts that have been operating at a loss to seek a 1-year waiver from the nutrition guidelines. Meanwhile, the White House has argued that USDA has already been significantly flexible and that they would not be willing to turn over the debate of what is nutritious to lawmakers, noting that lawmakers have bent to food industry complaints in the past. The First Lady has personally become more noticeably involved in the legislative debate regarding this issue since the law passed. She has publicly criticized lawmakers for playing “politics with our kid’s health” and claims that it is “unacceptable to me not just as a First Lady but also as a mother.”

As the 5-year implementation period is nearing its conclusion, it is important that the public health and prevention communities take definitive action in ensuring that the Healthy, Hunger-Free Kids Act is properly implemented and fully enforced. Schools play a vital role in enhancing the dietary and physical activity behaviors of children and adolescents, given the significant amount of time children spend at school. Studies have found that the health of students is linked to their academic success, so both physical activity and healthy eating may additionally help improve academic accomplishments. With proper nutrition standards set, schools can now create an environment supportive of efforts to eat healthy and to maintain an active lifestyle.

All postings to the Health Policy Forum (whether from employees or those outside the Institute) represent the views of the individual authors and/or organizations and do not necessarily represent the position, interests, strategy, or opinions of Altarum Institute. Altarum is a nonprofit, nonpartisan organization. No posting should be considered an endorsement by Altarum of individual candidates, political parties, opinions or policy positions.



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