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	<title>DrGreene.com &#187; Ayala Laufer-Cahana MD</title>
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	<description>Putting the care into children&#039;s health</description>
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		<title>Not a healthy choice: junk foods vs. the school lunch program</title>
		<link>http://www.drgreene.com/perspectives/not-a-healthy-choice-junk-foods-vs-the-school-lunch-program/</link>
		<comments>http://www.drgreene.com/perspectives/not-a-healthy-choice-junk-foods-vs-the-school-lunch-program/#comments</comments>
		<pubDate>Thu, 18 Feb 2010 13:56:38 +0000</pubDate>
		<dc:creator>Ayala Laufer-Cahana MD</dc:creator>
				<category><![CDATA[Perspectives]]></category>
		<category><![CDATA[Nutrition]]></category>
		<category><![CDATA[School Age]]></category>
		<category><![CDATA[Teen]]></category>

		<guid isPermaLink="false">http://www.drgreene.com/?p=18055</guid>
		<description><![CDATA[I devoted the previous posts to the school lunch program, a federally sponsored and regulated program, which complies with some (if not altogether satisfactory) nutrition standards for nutrient content and portion size. I was grousing about the sorry state of the food our young ones are served under the guise of an “improved” lunch program. [...]]]></description>
				<content:encoded><![CDATA[<p></p><p><a href="http://www.drgreene.com/guest-author-posts/not-a-healthy-choice-junk-foods-vs-the-school-lunch-program/"><img class="alignnone size-full wp-image-18056" title="Not a healthy choice: junk foods vs. the school lunch program" src="http://www.drgreene.com/wp-content/uploads/Not-a-healthy-choice-junk-foods-vs-the-school-lunch-program.jpg" alt="Not a healthy choice: junk foods vs. the school lunch program" width="443" height="281" /></a></p>
<p>I devoted the previous posts to the school lunch program, a federally sponsored and regulated program, which complies with <em>some</em> (if not altogether satisfactory) nutrition standards for nutrient content and portion size. I was grousing about the sorry state of the food our young ones are served under the guise of an “improved” lunch program.<span id="more-18055"></span></p>
<p>But to get the full picture of the school food environment, we need to also look at the competitive foods sold in schools–foods that are expressly marketed to our kids–which make up a big part of what kids <em>actually</em> eat while they’re in school.</p>
<p>What are competitive foods? They’re <strong>anything sold, served or given to the kids that isn’t part of the school subsidized lunch. They are comprised of foods and beverages sold in the cafeteria or in a school store, from a vending machine or in fundraising events.</strong> The lunch money parents give their kids may very well be spent on these offerings, rather than on the school lunch.</p>
<p>Kids love the vending machines and the school stores, but that’s not the only reason these outlets exist. Schools depend on the revenues that vendors bring in to fund much-needed programs. This creates an unusual and worrying conflict, in which <em>schools share an interest with the manufacturers of snacks and junk foods</em>.</p>
<p>The US Department of Agriculture administers and regulates the school lunch program, but has <em>practically no control over other foods and drinks available at schools</em> (although some school districts have <a href="http://www.fns.usda.gov/cnd/" target="_blank">taken initiatives</a> to impose restrictions banning some junk food sales in schools). In fact, the only existing federal restriction is that foods of “minimal nutritional values”, such as candy and soda, won’t be sold in the cafeteria <em>during</em> meal times. That of course doesn’t mean they can’t be sold right outside the cafeteria doors.</p>
<p>You can imagine that if the content of the regulated school lunch leaves a lot to be desired, the completely unregulated competitive food scene would be a free-for-all candyland galore.</p>
<p>The <em>Journal of the American Dietetic Association’s</em> <a href="http://www.adajournal.org/content/2009suppl" target="_blank">special supplement</a> analyzed the data from the third School Nutrition Dietary Assessment Study. One of the papers is devoted to competitive foods. The data was collected in 287 nationally representative schools and included 2,314 kids.</p>
<p>These were the main findings:</p>
<ul>
<li><strong>Availability</strong>: One or more sources of competitive foods were available in <strong>73 percent of elementary schools, 97 percent of middle schools, and 100 percent of high schools.</strong> À la carte foods sold in the cafeteria were common in all school levels. <em>Vending machines were available in more than one quarter of elementary schools, 87 percent of middle schools and virtually all high schools.</em></li>
<li><strong>Consumption of competitive foods</strong>: Overall about <strong>40 percent of the kids consumed these foods on any given day</strong>. Consumption was much higher in high school and reached 55 percent.</li>
<li><strong>Energy contribution of competitive foods</strong>: Overall kids consumed about <strong>280 calories/day from competitive foods</strong>, and <strong>almost two thirds of these calories were from foods of low-nutrient and energy-dense food</strong> (the study defined “low-nutrient energy-dense food” to include cakes/cookies and other desserts, donuts, toaster pastries, snack chips, French fries and caloric beverages excluding milk and 100% juice). These numbers varied by school type, with middle and high school kids getting more calories from competitive foods. <strong>A typical high school kid gets about 340 calories/day from competitive foods, 65 percent (or 220 calories) of which are from junk food</strong>.</li>
<li><strong>The most commonly consumed competitive foods: Desserts and snacks</strong> were selected by just over 50 percent of kids; these products include cakes, cookies, candy and ice cream. <strong>Sweetened beverages</strong> were consumed by almost half the kids&#8211;these include juice drinks (not 100% juice) and carbonated soda.</li>
</ul>
<p>&nbsp;</p>
<p>So, we have <strong>low-quality foods sold in the schools competing with a low-quality school lunch–a competition that’s a lose-lose for our kids</strong>. Wherever our kids turn they have snacking opportunities that contribute mostly empty calories.</p>
<p>Is there a vending machine in your kids’ school?</p>
<p>Do you give your kids money to buy food at school? What advice do you give them about their choices for lunch?</p>
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		<title>The school lunch is fast-food!</title>
		<link>http://www.drgreene.com/perspectives/the-school-lunch-is-fast-food/</link>
		<comments>http://www.drgreene.com/perspectives/the-school-lunch-is-fast-food/#comments</comments>
		<pubDate>Wed, 17 Feb 2010 13:27:13 +0000</pubDate>
		<dc:creator>Ayala Laufer-Cahana MD</dc:creator>
				<category><![CDATA[Perspectives]]></category>
		<category><![CDATA[Nutrition]]></category>
		<category><![CDATA[School Age]]></category>
		<category><![CDATA[Teen]]></category>

		<guid isPermaLink="false">http://www.drgreene.com/?p=18048</guid>
		<description><![CDATA[We looked at a typical school lunch menu in yesterday’s post and at the nutritionist’s analysis of fat, protein, carbohydrates, vitamins and minerals in that food.  From the nutrient point of view the school lunch is a high-fat, high-salt low-fiber diet.  The protein and vitamin content aren’t an issue, since so much of the food [...]]]></description>
				<content:encoded><![CDATA[<p></p><p><a href="http://www.drgreene.com/guest-author-posts/the-school-lunch-is-fast-food/"><img class="alignnone size-full wp-image-18049" title="The school lunch is fast-food!" src="http://www.drgreene.com/wp-content/uploads/The-school-lunch-is-fast-food.jpg" alt="The school lunch is fast-food!" width="507" height="337" /></a></p>
<p>We looked at a typical school lunch menu in yesterday’s post and at the nutritionist’s analysis of fat, protein, carbohydrates, vitamins and minerals in that food.  From the <em>nutrient</em> point of view the school lunch is a high-fat, high-salt low-fiber diet.  The protein and vitamin content aren’t an issue, since so much of the food is vitamin fortified, and protein is abundant in the meat and cheese rich foods our kids are fed.<span id="more-18048"></span></p>
<p>I offer you a very different way to look at the subsidized school lunch. You don’t need to be a nutritionist, you don’t needs charts and a calculator, and you don’t even need to know the <em>Dietary Guidelines for Americans</em> to assess the quality of the offerings we’re serving our next generation.</p>
<p>Picture the food described in yesterday’s post and it’s easy recognize and name it: <strong>The school lunch is fast food! It’s salty, sweet and fatty, the meat is breaded and crunchy, it’s been highly processed—even the fruit and vegetables aren’t fresh for the most part</strong>.</p>
<p>Speaking of vegetables, I have nothing against potatoes; I think they’re nutritious and good to eat in many forms, but French fries aren’t a vegetable by any stretch of the imagination! (And neither is ketchup.)</p>
<p>Most of school lunches are not prepared in the school kitchen—the surplus commodities our food industry produces make their way to our schools as processed food and not as fresh fruits, vegetables and whole grains.   Most of the schools have no kitchens and just heat and un-wrap <a href="http://www.usatoday.com/news/education/2009-12-08-school-lunch-standards_N.htm" target="_blank">low-grade</a> foods.</p>
<p>For those who say that a better school menu would be too expensive, I want you to consider that treating a whole host of chronic diseases, ranging from diabetes to heart disease to cancer—which are the dangerous result of the childhood obesity epidemic and the current lack of healthy nutrition—will cost so much more. <strong>Forty percent of the public school kids in this study were overweight! We definitely can’t afford that!</strong></p>
<p>There are a few schools that serve healthy, nutritious food, made from real ingredients. There are a few schools that teach kids how to cook healthy meals and even grow their own vegetables.</p>
<p>But what most kids learn from the institution that’s supposed to prepare them for life are really bad eating habits that will set them up for a lifetime of struggle with weight. What’s even worse is that kids from low income homes—who have less access to wholesome food out of school—get this low quality food at school for lunch and breakfast.</p>
<p>Please share your thoughts.</p>
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		<title>What’s for (school) lunch?</title>
		<link>http://www.drgreene.com/perspectives/whats-for-school-lunch/</link>
		<comments>http://www.drgreene.com/perspectives/whats-for-school-lunch/#comments</comments>
		<pubDate>Tue, 16 Feb 2010 13:32:19 +0000</pubDate>
		<dc:creator>Ayala Laufer-Cahana MD</dc:creator>
				<category><![CDATA[Perspectives]]></category>
		<category><![CDATA[Nutrition]]></category>
		<category><![CDATA[School Age]]></category>
		<category><![CDATA[Teen]]></category>

		<guid isPermaLink="false">http://www.drgreene.com/?p=18050</guid>
		<description><![CDATA[What kind of meal does $1 buy? The government provides $2.68 for the kids qualifying for a free lunch, $2.28 for a reduced price lunch, and $0.25 cents for all other kids.  That sum includes the overhead and facility costs associated with the meal, which leaves just $1—or less—for the food itself. Clearly not enough [...]]]></description>
				<content:encoded><![CDATA[<p></p><p><a href="http://www.drgreene.com/guest-author-posts/whats-for-school-lunch/"><img class="alignnone size-full wp-image-18051" title="What’s for (school) lunch?" src="http://www.drgreene.com/wp-content/uploads/Whats-for-school-lunch.jpg" alt="What’s for (school) lunch?" width="443" height="270" /></a></p>
<p>What kind of meal does $1 buy?</p>
<p>The government <a href="http://www.fns.usda.gov/cnd/Lunch/AboutLunch/NSLPFactSheet.pdf" target="_blank">provides</a> $2.68 for the kids qualifying for a free lunch, $2.28 for a reduced price lunch, and $0.25 cents for all other kids.  That sum includes the overhead and facility costs associated with the meal, which leaves just $1—or less—for the food itself. Clearly not enough money to fund from-scratch cooking or quality fresh produce.<span id="more-18050"></span></p>
<p>A <a href="http://www.adajournal.org/article/S0002-8223(08)02055-5/abstract" target="_blank">study</a> in <em>The Journal of the American Dietetic Association</em>, based on a sample of almost 400 public schools and about 2,300 students, grades 1 to 12 looked at what’s served and what kids actually eat while in the school cafeteria for lunch.</p>
<p>It is a worrying picture.</p>
<p>Here’s the menu:</p>
<ul>
<li><strong>Milk</strong>: Milk is offered in practically all schools—the majority of milk offered is <strong>flavored</strong> (i.e. sweetened).</li>
<li><strong>Fruit</strong>: 94 percent of schools offered fruit or fruit juices but <em>only 50 percent of it is fresh fruit</em>&#8211;the rest is <strong>canned fruit or fruit juice</strong>.</li>
<li><strong>Vegetables</strong>: This study considers starchy vegetables such as white potatoes a vegetable. By that classification, 96 percent of kids had a vegetable offering at lunch. But note that while 45 percent of high schools offered French fries (!) <em>only 39 percent of schools offered lettuce salad, only 29 percent offered orange or dark green vegetables, and only 10 percent offered legumes</em>.</li>
<li><strong>Grains/bread</strong>: The vast majority of grain products (bread, rolls, bagels, crackers etc.) were made of refined white flour. <em>Only 5 percent of grain offering was whole wheat</em>.</li>
<li><strong>Combination entrée</strong>: The most commonly offered combination entrée depended on age; in elementary school, 28 percent of combination entrees were peanut butter sandwiches, followed by meat sandwiches; in middle school the most commonly offered combination entree was pizza with meat, followed by cheeseburgers and sandwiches with breaded meat or poultry.</li>
<li><strong>Dessert</strong>: Those were offered in 47 percent of high schools, 41 percent of middle schools and 37 percent of elementary school. The leading deserts were cookies, cakes and brownies.</li>
</ul>
<p>&nbsp;</p>
<p>This is what the kids actually ate for school lunch:</p>
<ul>
<li><strong>Milk</strong>: 75 percent of kids drank milk, mostly 1 percent fat, and mostly <strong>flavored</strong>.</li>
<li><strong>Fruit</strong>: Forty-five percent of kids ate some fruit; most of the fruit eaten was canned. Only 16 percent of kids overall had fresh fruit, and among high school kids it was only 8 percent.</li>
<li><strong>Vegetables</strong>: Fifty-one percent of kids overall had some kind of vegetable, but that includes French fries. Lettuce salads were eaten by 6 percent of kids, orange or dark green vegetables were eaten by 6 percent, and legumes by 2 percent. <em>French fries were eaten by 34 percent of high school kids!</em></li>
<li><strong>Grains/bread</strong>: 34 percent of kids had grain products. <em>Only 1 percent of grain products eaten were whole wheat</em>.</li>
<li><strong>Combination entrée</strong>: 75 percent of kids selected these entrees, the most popular of which were pizza, sandwiches with breaded meat, fish or poultry, hamburgers or hot dogs.</li>
<li><strong>Dessert</strong>: 38 percent of kids had dessert, mostly consisting of cookies cake and brownies or candy.</li>
</ul>
<p>&nbsp;</p>
<p>In assessing the quality of the school meals and the school food environment, the study authors compare the school food to the recommendations set by the Dietary Guidelines for Americans. By these standards:</p>
<ul>
<li>The school lunch menu meets the standards for key nutrients such as <strong>protein, vitamins and minerals</strong>.</li>
<li>The majority of lunches exceeded the recommendations for total <strong>fat</strong> (in over 80 percent of schools) and <strong>saturated fat</strong> (in 72 percent of schools)</li>
<li><strong>Only 6 percent of schools met the standards for all nutrients</strong></li>
<li>Very few schools offered lunch that was adequate in <strong>fiber</strong>.</li>
<li>Practically all school lunches contained <strong>too much salt</strong>.</li>
</ul>
<p>&nbsp;</p>
<p>That’s the analytical take of the findings.  I’ll offer a more practical view of the data in tomorrow’s post.</p>
<p>I’d love to hear your analysis.</p>
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		<title>Are school meals healthy?</title>
		<link>http://www.drgreene.com/perspectives/are-school-meals-healthy/</link>
		<comments>http://www.drgreene.com/perspectives/are-school-meals-healthy/#comments</comments>
		<pubDate>Mon, 15 Feb 2010 13:39:58 +0000</pubDate>
		<dc:creator>Ayala Laufer-Cahana MD</dc:creator>
				<category><![CDATA[Perspectives]]></category>
		<category><![CDATA[Nutrition]]></category>
		<category><![CDATA[School Age]]></category>
		<category><![CDATA[Teen]]></category>

		<guid isPermaLink="false">http://www.drgreene.com/?p=18052</guid>
		<description><![CDATA[Feeding our kids is a fundamental nurturing act we perform daily, and parents do their best to provide their kids a good nutritional foundation for optimal health. But what happens when kids are out of the home? Does the school food environment promote health? Congress will be reauthorizing the school lunch, school breakfast, and other [...]]]></description>
				<content:encoded><![CDATA[<p></p><p><a href="http://www.drgreene.com/guest-author-posts/are-school-meals-healthy/"><img class="alignnone size-full wp-image-18053" title="Are school meals healthy?" src="http://www.drgreene.com/wp-content/uploads/Are-school-meals-healthy.jpg" alt="Are school meals healthy?" width="443" height="297" /></a></p>
<p>Feeding our kids is a fundamental nurturing act we perform daily, and parents do their best to provide their kids a good nutritional foundation for optimal health.</p>
<p>But what happens when kids are out of the home? Does the school food environment promote health?<span id="more-18052"></span></p>
<p>Congress will be reauthorizing the school lunch, school breakfast, and other child nutrition programs this year, a process that occurs every five years, so I’d like to take this five guest post opportunity to look at what kids eat at school, and what we can do about it.</p>
<p><strong>A short introduction to the school meal program:</strong></p>
<p>In 1946 the National School Lunch Act created the <a href="http://www.fns.usda.gov/cnd/Lunch/AboutLunch/ProgramHistory_4.htm" target="_blank">National School Lunch Program</a> (NSLP) with a dual purpose—to feed kids and prevent dietary deficiency <em>and</em> to provide an outlet for surplus agricultural commodities.  One can already see that the dual purpose of the program throws in some problematic conflicts of interests, but let’s go on. The school lunch program operates in all public schools and in many private schools too.</p>
<p>The School Breakfast Program was established in 1975 to help meet the nutritional needs of kids from low-income families and is offered in fewer schools.</p>
<p><strong>On any average school day more than 30 million kids eat a school lunch, and 10 million kids eat a school breakfast</strong>. Fifty-nine percent of the kids eating a school lunch are from low-income homes, as are 80 percent of school breakfast eaters.</p>
<p>So what’s for lunch?</p>
<p>The third School Nutrition Dietary Assessment Study, which evaluates the school meal program, came out recently. <em>The Journal of the American Dietetic Association</em> devoted over 130 pages in a <a href="http://www.adajournal.org/issues/contents?issue_key=S0002-8223(08)X0017-3" target="_blank">special supplement</a> to its findings. There’s much to read and think about in its data.  I’ll be looking at the menu of the school lunch tomorrow.</p>
<p>In the meantime, an adventurous school teacher vowed to eat the school lunch every day this year, and she’s posting musings and photos of her cafeteria meal in a daily <a href="http://fedupwithschoollunch.blogspot.com/" target="_blank">blog</a>.</p>
<p>Take a look at the pictures.  Take note of the amount of packaging.</p>
<p>I’d love to hear your first impressions.</p>
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		<title>School food: Parents can make a huge difference!</title>
		<link>http://www.drgreene.com/perspectives/school-food-parents-can-make-a-huge-difference/</link>
		<comments>http://www.drgreene.com/perspectives/school-food-parents-can-make-a-huge-difference/#comments</comments>
		<pubDate>Mon, 15 Feb 2010 03:42:28 +0000</pubDate>
		<dc:creator>Ayala Laufer-Cahana MD</dc:creator>
				<category><![CDATA[Perspectives]]></category>
		<category><![CDATA[Nutrition]]></category>
		<category><![CDATA[School Age]]></category>

		<guid isPermaLink="false">http://www.drgreene.com/?p=18035</guid>
		<description><![CDATA[Many parents commented on my previous school lunch posts, and told me that they opt to pack a lunch for their kids. It’s sad to say, but for most American kids the only potential source for a healthy nutritious lunch may be the lunchbox from home. No matter how you approach the school lunch and [...]]]></description>
				<content:encoded><![CDATA[<p></p><p><a href="http://www.drgreene.com/guest-author-posts/school-food-parents-can-make-a-huge-difference/"><img class="alignnone size-full wp-image-18036" title="School food: Parents can make a huge difference!" src="http://www.drgreene.com/wp-content/uploads/School-food-Parents-can-make-a-huge-difference.jpg" alt="School food: Parents can make a huge difference!" width="443" height="280" /></a></p>
<p>Many parents commented on my previous school lunch posts, and told me that they opt to pack a lunch for their kids. It’s sad to say, but for most American kids the only potential source for a healthy nutritious lunch may be the lunchbox from home.<span id="more-18035"></span></p>
<p>No matter how you approach the school lunch and school’s foods for sale issue, I&#8217;m convinced that we as parents have more influence on our kids’ food choices–through what we do, what we say and how we eat–than anyone else. It’s within our reach to exert our influence to better our kids&#8217; diet and health.</p>
<p>A few initial steps:</p>
<ul>
<ul>
<li>Find out what’s served in the school cafeteria &#8211; Unfortunately, the school lunch in many schools isn’t a healthy one. What’s more, competing with the school lunch are junk foods sold through vending machines and other sources. Find out what is served in your kids’ school, and if it doesn’t meet your standards, do something about it: Send your kids to school with a lunchbox and healthy snacks from home; speak up and try to effect change in the school lunch program in a practical and positive way.</li>
<li>Say no to the endless snacking &#8211; While celebrating birthdays with home-made cupcakes used to be a lovely, wholesome joy, many kids encounter way too many unhealthy snacking opportunities at school and in after school activities.  From bake sales, candy fund-raisers to snack foods as incentives, prizes or rewards, our kids have treats that are no longer treats, and every day is a special occasion.</li>
</ul>
</ul>
<p>&nbsp;</p>
<p>It’s amazing to see how many calorie dense, salty sugary and fatty snacks a school kid encounters every day in a typical American school.  No wonder a third of our kids are overweight or obese!</p>
<p>If your kids’ school-day offers too many snacking opportunities talk to your school officials.  Write about it.  A school can enact new snacking policies by just deciding to do so!</p>
<p>The Obama administration will ask Congress to improve childhood nutrition by removing sugary snacks and drinks in school vending machines.  Agriculture Secretary Tom Vilsack is planning some bold steps to revamp school nutrition programs.  I hope legislation will be part of changing the school food landscape, but our activity as parents will always be the most important tool in effecting the change we need to better our kids’ nutrition and health.</p>
<p>For further reading and involvement:</p>
<p><a href="http://www.healthyschoollunches.org/index.cfm" target="_blank"> http://www.healthyschoollunches.org/index.cfm</a></p>
<p><a href="http://www.farmtoschool.org/" target="_blank">www.farmtoschool.org/</a></p>
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