Improving the quality of school and out of-school time nutrition programs


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Improving the quality of school and out of-school time nutrition programs

  1. 1. Improving the Quality of School and Out-of-School Time Nutrition Programs Heather Hartline-Grafton, DrPH, RD Senior Nutrition Policy Analyst Anti-Hunger Policy Conference Washington, DC | March 8, 2010
  2. 3. U.S. Prevalence of Overweight & Obesity 31.3 31.6 28.8
  3. 4. <ul><li>In general, rates are: </li></ul><ul><li>Higher (and have increased more rapidly over time) among African-American and Hispanic children than White children </li></ul><ul><li>Higher in the South </li></ul>Child Overweight & Obesity | Disparities Sources: Freedman et al., 2006; Ogden et al., 2010; Singh et al., 2008
  4. 5. <ul><li>Obesity rates increased by 10% for all U.S. children between 2003 and 2007, but by 23% for low-income children </li></ul><ul><li>Source: Singh et al., 2010 </li></ul><ul><li>Obesity rates were over 50% higher among poor adolescents </li></ul><ul><li>Source: Miech et al., 2006 </li></ul><ul><li>Rates of severe obesity were 1.7 times higher among poor children and adolescents </li></ul><ul><li>Source: Skelton et al., 2009 </li></ul>Child Overweight & Obesity | Low-Income
  5. 6. Dietary Intake of US Children <ul><li>Generally nutritionally adequate </li></ul><ul><ul><li>Of potential concern: magnesium, phosphorus, calcium, potassium, and vitamins A, C, and E </li></ul></ul><ul><li>Too high in saturated fat and sodium </li></ul><ul><li>Too low in fiber </li></ul><ul><li>Source: Clark & Fox, 2009 </li></ul><ul><li>32.2% meet fruit recommendations </li></ul><ul><li>13.2% meet vegetable recommendations </li></ul><ul><li>Source: CDC, 2009 </li></ul><ul><li>HEI score of 55.4 out of 100 </li></ul><ul><li>Source: Guenther et al., 2008 </li></ul>
  6. 7. Dietary Intake | School & Out-of-School Time <ul><li>Low-income children who eat school breakfast have better overall diet quality than those who eat breakfast elsewhere or skip breakfast </li></ul><ul><li>Source: Basiotis et al., 1999 </li></ul><ul><li>School meal participants are: </li></ul><ul><ul><li>Less likely to consume “competitive foods” at school </li></ul></ul><ul><ul><li>Less likely to have nutrient inadequacies </li></ul></ul><ul><ul><li>More likely to consume fruit, vegetables, and milk at breakfast and lunch </li></ul></ul><ul><ul><li>Sources: Clark & Fox, 2009; Condon et al., 2009; Fox et al., 2009 </li></ul></ul>
  7. 8. <ul><li>Children have higher daily intake of fruits, vegetables, milk, and key nutrients on days they eat an afterschool supper </li></ul><ul><li>Source: Plante & Bruening, 2004 </li></ul>Dietary Intake | School & Out-of-School Time
  8. 9. Role of the Federal Nutrition Programs in Obesity Prevention Reduce Overweight & Obesity Federal Nutrition Programs Improve Dietary Intake Reduce Food Insecurity
  9. 10. <ul><li>School breakfast participation is associated with a significantly lower BMI </li></ul><ul><li>Source: Gleason & Dodd, 2009 </li></ul><ul><li>Food insecure girls in the school lunch, school breakfast, or SNAP/Food Stamp programs (or all 3 combined) have a lower risk of overweight </li></ul><ul><li>Source: Jones et al., 2003 </li></ul><ul><li>Children are more vulnerable to rapid BMI gains and food insecurity during the summer </li></ul><ul><li>Sources: Nord & Romig, 2006; von Hippel, 2007 </li></ul>Role of the Federal Nutrition Programs in Obesity Prevention
  10. 11. “ We also find that subsidized meals at school or day care are beneficial for children’s weight status, and we argue that expanding access to subsidized meals may be the most effective tool to use in combating obesity in poor children .” Source: Kimbro & Rigby, 2010
  11. 12. Increase participation in the federal nutrition programs
  12. 13. Current State of School Meals <ul><li>On target for: </li></ul><ul><ul><li>Protein </li></ul></ul><ul><ul><li>Cholesterol </li></ul></ul><ul><ul><li>Many vitamins and minerals (e.g., iron, calcium, vitamin C) </li></ul></ul><ul><li>Too high in: </li></ul><ul><ul><li>Fat </li></ul></ul><ul><ul><li>Saturated fat </li></ul></ul><ul><ul><li>Sodium </li></ul></ul><ul><li>Too low in: </li></ul><ul><ul><li>Fiber </li></ul></ul>Source: Crepinsek et al., 2009
  13. 14. Competitive Foods in Schools <ul><li>Widely available </li></ul><ul><li>Contribute to poor dietary intake </li></ul><ul><ul><li>40% consume 1+ competitive foods </li></ul></ul><ul><ul><li>Consume >150 calories in low nutrient, energy dense competitive foods </li></ul></ul><ul><li>Hurt school meal participation </li></ul><ul><li>Harmful to low-income children </li></ul><ul><li>Send mixed message about nutrition </li></ul>Source: FRAC, 2006; Fox et al., 2009
  14. 15. IOM Report: School Meals – Building Blocks for Healthy Children <ul><li>8 recommendations </li></ul><ul><li>Adopt standards for menu planning that: </li></ul><ul><ul><li>Increase the amount and variety of fruits, vegetables, and whole grains </li></ul></ul><ul><ul><li>Set a minimum and maximum level of calories </li></ul></ul><ul><ul><li>Increase the focus on reducing the amounts of saturated fat and sodium </li></ul></ul>
  15. 16. Key Recommended Changes for School Lunch Gradually but markedly decrease sodium to the specified level by 2020 None (decreased level recommended) Sodium Must be within minimum and maximum level Must meet minimum level Calories Fat-free (plain or flavored) and plain low-fat milk only Whole, reduced-fat, low-fat, fat-free milks (plain or flavored) Milk At least half must be whole grain rich No requirement for whole grains Grains/ Breads Two servings required daily, amount increased. Must include dark green, bright orange, legumes, starchy, and other vegetables each week Vegetables Required daily amount increased Considered together as a fruit and vegetable group. No specifications for the type of vegetable Fruits Recommendations Current Requirements Type of Specification
  16. 17. <ul><li>Such changes likely will require: </li></ul><ul><ul><li>Higher federal meal reimbursement </li></ul></ul><ul><ul><li>Capital investment for equipment </li></ul></ul><ul><ul><li>Funds for training </li></ul></ul>IOM Report: School Meals – Building Blocks for Healthy Children Need to expand student access & participation
  17. 18. FRAC Resources & Tools <ul><li>Standards of Excellence </li></ul><ul><li>School Wellness Policy and Practice: Meeting the Needs of Low-Income Students </li></ul><ul><li>How Improving Federal Nutrition Program Access and Quality Work Together to Reduce Hunger and Promote Healthy Eating </li></ul>
  18. 20. <ul><li>Quality of the food </li></ul><ul><li>Health promoting environment </li></ul><ul><li>Nutrition education and activity opportunities (afterschool) </li></ul><ul><li>Outreach efforts (summer) </li></ul>FRAC’s Standards of Excellence
  19. 22. Includes school meal, summer , and afterschool programs
  20. 24. For more information, contact: <ul><li>Heather Hartline-Grafton, DrPH, RD </li></ul><ul><li>Senior Nutrition Policy Analyst </li></ul><ul><li>Food Research and Action Center (FRAC) </li></ul><ul><li>1875 Connecticut Avenue, NW, Suite 540 </li></ul><ul><li>Washington, DC 20009  </li></ul><ul><li>202-986-2200 x3017 (t) </li></ul><ul><li>202-986-2525 (f) </li></ul><ul><li>[email_address] </li></ul><ul><li> </li></ul>