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New Study: Kids Who Eat School Food Are Fatter

by: euclidarms

Tue Mar 16, 2010 at 02:55:44 AM PDT


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( - promoted by Jill Richardson)

By Ed Bruske
aka The Slow Cook

A new study from the University of Michigan finds that kids who eat the food served in schools are more likely to be overweight or obese than peers who bring lunch from home, and also are more likely to suffer from high levels of "bad" cholesterol.

euclidarms :: New Study: Kids Who Eat School Food Are Fatter
The study, which examined the eating habits of some 1,300 Michigan sixth-graders over a three-year period, found that children who get their food at school eat more fat, drink more sugary sodas, and consume far fewer fruits and vegetables. The findings, presented last week at the American College of Cardiology annual scientific session, are said to be the first to assess the impact of school food on children's eating behaviors and overall health.

Specifically, 38.8 percent of students who routinely eat school lunch were found to be overweight or obese, compared to 24.4 percent of kids who brought their own food from home. The children consuming school food were twice as likely to drink sodas, and a measly 16.3 percent reported eating fruits and vegetables on a regular basis, compared to 91.2 percent of the kids who got homemade food.

"This study confirms the current and escalating national concern with children's health, and underscores the need to educate children about how to make healthy eating and lifestyle choices early on," said Elizabeth Jackson, M.D., MPH, assistant professor of internal medicine at the University of Michigan Health System, in a release put out by the university. "Although this study doesn't provide specific information on nutrient content of school lunches, it suggests there is a real opportunity to promote healthy behaviors and eating habits within the school environment. This is where kids spend a majority of their time."

It would be dangerous to read too much into a study that is based solely on student questionnaires and suggests correlations, not cause and effect, between self-reported eating habits and specific health issues. For instance, it could be that children who tend to be overweight or obese must eat the food served at school because they get it free courtesy of the federally-subsidized school lunch program. The researchers acknowledge that there could be a correlation "between socioeconomic status and heart health in children of low-income families who take advantage of free school meal programs."

The findings, based on what students reported about their eating habits during the entire day, not just at school, certainly suggest a strong link between what kids learn about food at home and the kinds of food they choose at school. But even parents who pack "healthful" lunches can never be sure what their children are actually eating, the researchers report, since most children in public schools are exposed to "competitive" foods -- those sold outside the regular lunch line -- that encompass all kinds of junk food, as well as the stuff sold in vending machines.

Amy Kalafa, producer of the food documentary Two Angry Moms, filmed herself having her eyes opened to her daughter's true eating habits when she checked the computer records in the school cafeteria. "All our efforts at home were being undermined by the school," Kalafa said yesterday. "When I casually asked for a readout, just to demonstrate how the system worked, I was genuinely shocked to learn that my daughter was regularly buying chips, fries, Rice Cispy treats and Pop Tarts.  And it's not just about obesity.  Diabetes and sugar sensitivity runs in my family."

My own 10-year-old daughter has noticeably put on some girth since switching last fall from home-made meals to the ones served in school here in the District of Columbia. Her pediatrician wasn't at all surprised. Her kids gained 10 pounds, she said, when they started eating school meals. When my daughter heard that, she decided to switch back to taking her own food.

What's more, only 7 percent of school food operations fully comply with the nutrtional standards laid down by the U.S. Department of Agriculture for the federal meals program. During the week I spent recently in the kitchen at my daughter's school, it was clear that schools trying to feed kids on a budget rely heavily on industrially-processed convenience foods laced with additives and sugar. Fresh vegetables are a rarity.

A study of how schools use government donations of surplus farm commodities, conducted by the Robert Woods Johnson Foundation (PFD) two years ago, found that California schools ordered far more meat and dairy products and rarely touched the offerings of fresh vegetables and whole grains. The reason is simple enough: kids don't like vegetables and whole grains. Unless, of course, they've already been trained to like them at home.

The University of Michigan researchers said they are encouraged by a recent movement toward exposing children to fresh, local produce and programs that encourage children to walk to school and exercise more -- just the sort of things being pushed by Michelle Obama in her "Let's Move" campaign, as well as "Healthy Schools" legislation pending here in the District of Columbia. The USDA also is considering new school food standards developed by the Institute of Medicine that would put a cap on the number of calories served in school meals, reduce starchy foods, and increase servings of fruits, vegetables and whole grains.

The University of Michigan study comes as Congress considers re-authorization of the Child Nutrition Act, for which President Barack Obama has proposed splitting an additional $1 billion annually between school meals and other food programs. Some advocates say that amount is not even enough to put an apple on kids' cafeteria trays. Ann Cooper, the "renegade lunch lady," in a recent op-ed in The Washington Post, says what schools really need is another $1 per day for each child in the federal program, which would work out to something like $5.4 billion a year.

But this latest study points to something even more ominous that should occupy the attention of federal lawmakers: a growing bifurcation of the food system wherein poor kids are routinely subjected to cheap processed food that damages their health, while kids from wealthier families get access to the best our local farms have to offer. That is the underlying message of the growing Farm to School movement: that all kids deserve fresh, wholesome food, not just the ones whose parents shop at Whole Foods or the farmers market.

More studies like this one will undoubtedly show that school food quality is a social justice issue that demands immediate attention. And while some politicians might be loathe to pay for improving it -- that is, if they think about it at all -- it is also a health issue with potentially devastating consequences for the national budget.

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RWJF reasons (4.00 / 1)
The RWJF report gave reasons food directors concentrate their commodity entitlement resources on meat and cheese. One was that, when they compare obtaining a food through the commodity program vs. buying it outside the commodity system, they can save the most money by selecting meat and cheese commodities. Another was that, because meat and cheese are expensive compared to whole grains (for example), selecting meat and cheese helps them use up their commodity entitlements.

The reason is simple enough: kids don't like vegetables and whole grains. Unless, of course, they've already been trained to like them at home.

Did the RWJF report say that? I don't remember it.


the billion dollars (4.00 / 1)
Some advocates say that amount is not even enough to put an apple on kids' cafeteria trays.

That statement is true. Nevertheless, "some advocates say" strikes this reader as an unhelpful journalistic weasel.

I don't know how much an apple costs a school district, but

If 100% of the additional billion dollars went to school nutrition programs, and if 100% of the money went to improved food quality, and if school [meal program] enrolment remained unchanged from SY 2006-2007, the maximum benefit would be less than $0.14 per meal.

None of the conditionalities is true. $0.14 per school meal will not be realized.

My original comments, with arithmetic and souce links.


arithmetic (4.00 / 1)
Looking at my original comment, I guess I assumed that dividing 1 billion dollars by 7.3 billion meals was mental arithmetic.

[ Parent ]
sugar grams per tsp (4.00 / 1)
By the way, Ed, one of your previous diary threads contained a discussion about where the "grams per teaspoon" number for sugar came from. The number can be found at Sugars, granulated in the USDA National Nutrient Database for Standard Reference, Release 22

NDB No: 19335
Common Name:  sucrose

Click on the check boxes preceding the weights to be reported. If you select 100 grams, then standard error and number of data points will also be displayed. You may select up to 5 weights. Nutrient values can be calculated for any desired gram weight by clicking on the amount field for the weight to be reported and entering a decimal multiplier to calculate the desired weight. Then click on the Submit button. Click here to enter a new query.

For example: if the gram weight is 100 and you would like a report of the nutrient values for 75 grams, simply enter .75 in the amount field for 100 grams. For help with the decimal values for some common fractions click here for tips on Fractions.

 100 grams 100

 1 serving packet 2.8

 1 tsp 4.2

 1 cup 200

 1 serving 1 cube 2.3



grams in a teaspoon (4.00 / 1)
Thanks, I am always impressed by the thoroughness of these comments.

Ed Bruske aka The Slow Cook

[ Parent ]
Michigan (4.00 / 1)
Michigan was not a state that had laws or regulations for school nutrition programs, as of 2008, according to a list from the School Nutrition Association.

Summary of State School Nutrition Standards


assessment (4.00 / 1)
said to be the first to assess the impact of school food on children's eating behaviors and overall health

If that's true, isn't it a shocking testament to derelict, irresponsible stewardship?

The statement probably is more true than not. USDA conducts a program of school nutrition dietary assesssments which seem to skew toward finding that school nutrition programs do a great job. These studies examine the whole program, not just sixth graders. The most recent results, SNDA-III, were published in 2007 based on data from SY 2004-2005.

School Nutrition Dietary Assessment Study-III

We developed the sample design and recruited over 400 schools in 135 districts, collecting information on all foods served over a five-day period.
...

Trained interviewers collected 24-hour intake data from close to 2,500 children drawn from 300 of the schools.

From School Nutrition Dietary Assessment Study-III: Summary of Findings

Page 19 (23 of 36)

An important part of the SNDA-III study was comparing school-day dietary intakes of NSLP and SBP participants and nonparticipants. Such comparisons provide useful information about the diets of students who do and do not participate in the school meal programs. Statistical techniques were used in most analyses to account for differences in observed characteristics of school meal participants and nonparticipants. However, even with statistical controls, unobserved differences between participants and nonparticipants may remain. For this reason, differences in the nutrient intakes of the two groups of students may not be indicative of effects of the school meal programs.

Page 21 (25 of 36)

Among elementary and high school students, NSLP participants had significantly higher usual daily intakes of energy than nonparticipants. On average, the usual daily energy intakes of NSLP participants in elementary schools were about 100 calories higher than the usual daily energy intakes of elementary school nonparticipants (2,051 versus 1,952 calories). Among high school students, the difference between the usual daily energy intakes of NSLP participants and nonparticipants averaged 265 calories (2,386 versus 2,121 calories).

"On average," that's a lot of extra calories. One thing that surprises me is that, for nonparticipants, calorie intake of elementary school students was so close to calorie intake of high school students. Is that reasonable?


More from SNDA-III (4.00 / 1)
Association between School Food Environment and Practices and Body Mass Index of US Public School Children

February 2009

From the abstract

Subjects/setting
The study included 287 schools and 2,228 children in grades 1 through 12.

Statistical analyses performed
Ordinary least squares regression was used to estimate the associations between school food environments and practices and BMI z scores and logistic regression was used to estimate associations between school food environments and practices and the likelihood of obesity (defined as BMI-for-age [greater than or equal to] 95th percentile). Models included controls for sociodemographic characteristics of schools and children, to control for potential endogeneity of school environments and practices, as well as controls for children's dietary and physical activity behaviors outside of school.

Results
Among elementary school children, offering french fries and similar potato products in subsidized school meals more than once per week and offering dessert more than once per week were each associated with a significantly higher likelihood of obesity. Among middle school children, the availability of low-nutrient, energy-dense foods in vending machines in or near the foodservice area was associated with a higher BMI z score, and the availability of such foods for a la carte purchase in the cafeteria was associated with a lower BMI z score.

Conclusions
Findings from this analysis suggest that limiting children's access to low-nutrient, energy-dense foods at school may hold promise as a tactic for reducing children's total calorie intake and controlling children's BMI.

School Breakfast Program but Not School Lunch Program Participation Is Associated with Lower Body Mass Index

February 2009

From the abstract

Results
No evidence was found of any relationship between usual school lunch participation and any of four different measures of weight status based on students' BMI. School breakfast participation was associated with significantly lower BMI, particularly among non-Hispanic, white students.

Conclusions
There was no evidence that either the school breakfast or lunch program is contributing to rising rates of childhood obesity. In fact, School Breakfast Program participation may be a protective factor, by encouraging students to consume breakfast more regularly.

Clicking the previous-next buttons at the links gets you to an interesting series of papers based on SNDA-III.


This study is directly contradicted by another... (4.00 / 2)
A study published two weeks ago in the national policy journal Health Affairs directly contradicts this study. It found that young children receiving free school meals had a lower risk of obesity relative to their peers:

http://www.chron.com/disp/stor...

Please tell both sides of the story!


Gullible (0.00 / 0)
How could anyone present both sides of the story based on an uncritical reading of a press release? You linked to a letter-to-the-editor or an op-ed piece, not a journal article, and no information is presented about the study itself except the children were in

National School Lunch or Child and Adult Care Food programs

They weren't limited to school lunch and breakfast programs. And what did the study allegedly find?

a reduced risk of obesity at age 5

Big whoop-de-do. How about Grades 1-12?

Federal Food Policy And Childhood Obesity: A Solution Or Part Of The Problem?

The article is secreted behind a pay wall and the abstract is uninformative, but the abstract does say

Our findings indicate that food assistance may unintentionally contribute to the childhood obesity problem in cities with high food prices. 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.

Aha! Urban food stamps are the problem!

Gullibility is a terrible thing.

Subsidized meals could be part of the solution if quality is improved, no argument about that.

In support of your point, did you read the comment directly above yours? Full texts of those articles are available at the links.


[ Parent ]
I think this is too broad a conclusion (4.00 / 1)
We know that low SES is linked to obesity already; we know that low SES kids almost all do school lunches. They certainly aren't serving sodas as part of the official school lunch.

In addition, this is only Michigan, which does not reflect necessarily what lunches are like nationally, nor is a national comparison all that useful when wondering what's going on in your local school.

As it was, he did a deal with a blancmange, and the blancmange ate his wife.


a conclusion (0.00 / 0)
One true thing is, I think, shockingly little is known about the effects of school meal programs. For all the billions of dollars that have been thrown into that bucket, little good research has been done.

[ Parent ]
little known about effects of school meals programs (4.00 / 1)
Some would argue that federally-subsidized meals keep many children from going hungry. So are kids getting fat off school meals, or just filling their bellies? Lots more study would be needed to answer that question. But typical school meal--shot full of cheap carbs and sugar--puts kids at a definite metabolic disadvantage, whether or not they are drinking soda with it. In most cases, they are drinking chocolate or strawberry milk--the dairy version of Coke and Mountain Dew.

Ed Bruske aka The Slow Cook

[ Parent ]
IOM report (4.00 / 1)
Lots more study would be needed to answer that question.

IOM Report Recommendations

Recommendation 7. Relevant agencies in USDA and other federal departments should provide support for the conduct of studies to evaluate the revised Meal Requirements for the School Breakfast Program and the National School Lunch Program.

1. USDA should continue funding for periodic School Nutrition Dietary Assessment studies, with the intermittent addition of a cost component.

2. USDA should take the lead in providing funding to conduct well-designed short-term studies in varied school settings to better understand how the new Meal Requirements change children's total and school meal dietary intakes, student participation, food service operations, and cost.

Recommendation 8. The committee recommends that agencies of USDA, of other federal departments, and relevant foundations fund research studies on topics related to the implementation of the new Meal Requirements, children's acceptance of and participation in school meals, and children's health-especially the following:

1. Effects of the recommended range of calorie levels on the adequacy of energy intakes for individual children within each of the age-grade categories.

2. Impacts of various approaches to reducing the sodium content of school meals and student acceptance of reduced-sodium foods.

3. Impacts of various approaches to increase the acceptance of whole grain-rich products.

4. Fruit and vegetable options and preparation methods that will increase consumption and decrease waste.

5. Effects on cost, waste, and food and nutrient intakes of various options to govern the number and types of foods students must accept for a reimbursable meal under the offer versus serve provision of the law.

6. Targeted approaches to decreasing the prevalence of nutrient inadequacy that do not require increasing the intakes of all children.

7. Changes in child health as a result of the new standards.

The IOM committee agrees with you.


[ Parent ]
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