Vending and Ala Carte

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NAHPERD/AFHK

• Vending and Ala Carte
• in Schools
• October 2005
• Peggy Johnson-Beatrice Public Schools
• Connie Stefkovich-Nebraska Department of Education

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Two Sad Facts

• We eat too much
• We move too little

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• Overweight and obesity have reached epidemic
  proportions. The statistics are staggering. Seven
  out of every ten deaths are traceable to obesity.
  We are just too darned fat.
• Secretary Thompson, HHS
• www.smallstep.gov

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What is obesity

• An excessive amount of body fat
• Determined by Body Mass Index (BMI)

BMI equals Weight (in pounds) divided by Height
(in inches)2 multiplied by 703
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Example

• Height 5 5 equals 65 inches
• 652 65 X 65 4,225
• Weight 140 lbs.
• 140 divided by 4,225 0.033136
• 0.033136 X 703 23.3 BMI

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Adult BMI and Weight Status
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Childhood Overweight definition

• Children at or above the 95th percentile of BMI
  for age -- Overweight
• Children between the 85th and 94th percentile of
  BMI for age--
• At Risk for Overweight

Source CDC Growth Chart
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Prevalence

• Obesity is catching up with tobacco use as the
  leading cause of preventable death.
• In 2000, 400,000 deaths were due to obesity, just
  behind the 435,000 deaths due to smoking and
  tobacco use.
• Between 1990 and 2000, deaths due to poor diet
  and physical inactivity increased by 33.

Source CDC
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The Obesity Epidemic

• Nearly one-third of US adults are obese
• Another one-third of US adults are overweight
• 129.6 million people (BMI 25)

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The Obesity Epidemic

• 15 children (about 9 million children) ages 6-19
  are overweight (BMI 95th percentile)
• 15 children ages 6-19 are considered at risk of
  becoming overweight (BMI 85th to 94th
  percentile)
• In addition, 10 children age 2-5 are overweight.

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Source Ogden CL, Flegal KM, Carroll MD,  Johnson
CL. Prevalence and trends in overweight among US
children and adolescents, 1999-2000. JAMA
2881728-32. 2002.
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BMI Classifications for Nebraska Students (K-12)
2002-03
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Why is childhood obesity a concern?

• Leading cause of pediatric hypertension
• Associated with type II diabetes
• Increases the risk of CHD
• Increases stress on the weight-bearing joints
• Lowers self esteem
• The economic cost of obesity in the United States
  was about 117 billion in 2000.

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Causes of Childhood Obesity

• Modifiable causes
• Physical activity
• Sedentary behavior
• Socioeconomic status
• Eating habits
• Environment
• Non-changeable causes
• Genetics

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Genetics

• Parental obesity
• Heredity
• Children with two obese parents are more than six
  times likely to become obese than children with
  non-obese parents.

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Eat too much and Move too little
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Nutrition Concerns
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Nutrition Concerns - portion size value
6½ ounces 88 calories
12 ounces 160 calories
20 ounces 266 calories
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Portion distortion
Bagel
20 years ago
Today
3-inch diameter140 calories
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Portion distortion
Bagel
20 years ago
Today
3-inch diameter140 calories
6-inch diameter350 calories
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Portion distortion
Turkey Sandwich
Today
20 yeas ago
320 calories
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Portion distortion
Turkey Sandwich
20 yeas ago
Today
320 calories
820 calories
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Super Sized Fast Food
1610 Calories 63 gm fat
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Too Much Fat and Sodium
Percentage of Children Meeting Selected Dietary
Recommendations
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High Intake of Added Sugar
Percentage of Food Energy From Added Sugars
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Most Children Fail to Follow Food Guide Pyramid

• Only 2 of children actually meet the
  recommendation of the Food Guide Pyramid
• Only 30 consume the recommended milk group
  servings
• Teenagers today drink twice as much carbonated
  soda as milk

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Beverage Intake Among Adolescents Aged 11-18,
1965-1996
Source Cavadini C et al. Arch Dis Child
20008318-24 (based on USDA surveys)
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• 1/3 of the RDA for select nutrients
• 30 of calories from fat

What about a la carte?
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1/3 of the RDA for select nutrients 30 of
calories from fat
What about vending machines?
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It Adds Up

• Consumed twice a week for 36
• weeks in addition to the 1/3 RDA
• for calories provided by NSLP
• ½ cup of oven french fries
• 1 cup of oven french fries
• 1½ cups of oven french fries

Potential increase in body weight in one school
year 2.3 lbs. 4.5 lbs. 7 lbs.
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Healthy School Environment School Venues Where
Food Is Sold or Offered

• School dining room
• Vending machines and school stores
• Parties and classroom snacks
• Concession stands
• After school programs
• Fundraising activities
• Staff and parent meetings

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What types of foods should be accessible to
students? Two
perspectives

• Healthy Choice
• Schools have a responsibility to provide only
  those foods that are consistent with the
  education they provide.

• Personal Choice
• It is pointless to prohibit the sale of
  certain foods or beverages, because students can
  get those items outside of school.

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• Healthy Choice
• Offering only nutritious choices an help
  reinforce a positive nutrition message every day
  of school.

• Personal Choice
• Students will learn to make better decisions
  in their day-to-day lives if they are provided
  with a wide assortment of food choices.

Research shows that children, especially young
children are less likely to make nutritious
choices when other choices are available
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• Personal Choice
• There is no such thing as a bad food or
  beverage. All food can fit into a healthy eating
  pattern therefore, there is no reason to
  prohibit the availability of certain foods.

• Healthy Choice
• The current state of childrens eating habits
  proves that they could benefit from assistance
  that guides their eating choices.

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• Healthy Choice
• Schools establish students course of study,
  dress codes, and rules for behavior. These
  decisions are based on educational principles
  the same should apply to food and beverage
  options.

• Personal Choice
• Banning specific food and beverage items in
  schools is counter-productive students will see
  them as forbidden fruit and be more likely to
  desire them.

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• Healthy Choice
• Small improvements in students eating habits
  can have an impact on their health. Young people
  will choose nutritious products when they are
  presented in appealing, attractive packages and
  are appropriately prices.

• Personal Choice
• Prohibiting less nutritious items from schools
  will have little impact on students overall
  dietary intake, but will decrease school revenues
  raised from food and beverage sales.

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School District Determines Scope
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Influence food and beverage contractsSchool
Choices

• Vending contracts provide selling rights in
  return for cash or non-cash benefits
• Schools can negotiate contracts that encourage
  healthy eating

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Vending Contract Issues
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Response from one soft drink company

• Schools choose beverages
• No soft drinks sold in elementary schools
• Juices and water offered if soft drinks are sold
• Water sold at the same price/ comparable
  packaging as soft drinks
• New vending machines feature images of
  non-carbonated beverage choices, physical
  activity or educational activities

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Why increase healthful choices?

• Students cannot make healthful choices if
  nutritious foods are not available
• Students who see various nutrient-rich items may
  begin to see healthful items as normal choices

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Make More Healthful Foods and Beverages Available

• Schools can add more nutrient-rich items to all
  areas providing food
• Schools can reduce the number of
  high-fat/high-sugar items

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Market Healthful Choices

• Identify and offer PRODUCTS
• that meet student needs
• PLACEMENT of products in locations so they are
  easy to choose
• PROMOTION of products so students know about
  them
• Setting the PRICE of products so students will
  want to buy them

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Limit Student Access to Competitive Foods

• Reduce the number of places students can obtain
  competitive foods
• Changing the locations where foods and beverages
  are sold
• Prohibiting the sale of competitive foods during
  specified times

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Current requirements in Nebraska Schools

• Foods of minimal nutritional value as defined by
  USDA cannot be sold in the cafeteria during meal
  service
• No foods or beverages can be sold in competition
  with the school meal program from ½ hour before
  to ½ hour after meal service.

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Use Fundraising Activities and Rewards that
Support Student Health

• Sell nutritious foods and beverages
• Sell non-food items
• Raise money through activity-related events
• Reward students with non-food items or activities

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Food Standards to Promote a Healthy School
Environment

• Action for Healthy Kids
• Portion control
• Nutrient/Calorie Control

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Elementary Students

• Reduce influence of unhealthy food options.
• Eliminate sale of foods not meeting the a la
  carte standards

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Secondary Students

• Make healthy options available all day
• Control portion size

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Healthy Snack Turn
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Using the Wheel to Determine Calories from Fat

• Place arrow on calories 120
• 4g or less fat 30 or less calories from fat
• 1.5g 04 less saturated/trans fat 10 or less
  calories from saturated fat

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Using the Wheel to Determine Calories from Sugar

• Find serving size in box below Sugar
  (35)
• 28.3g (1 oz.) would be limited to 10g sugar or
  less to be less than 35 calories from sugar
• Label indicates 9g sugar in the 28g serving

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Less than 30 calories from Fat
Less than 35 calories from Sugar
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www.fns.usda.gov/tn/library.html
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The Choice is Yours!

• MAIN LINE LUNCH
• SALAD BAR
• HOAGIE BAR
• COMBO LINE

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Salad Bar-Fresh Is Best!
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Make Your Own Lunch From These Choices
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Hoagie Sandwich Bar
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Fresh Sandwiches Made to Order
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Build A Lunch From These! The Choice Is Yours.
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Whats For Dessert? Fruit Of Course!
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Dont Forget The Veggies!
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Cold Milk-What Could Be Better?
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Milk VendingA Better Choice All Day
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Ala Carte Food SalesMoving Toward Healthier
Habits

• Average teen may receive up to 1/3 of their
  calorie intake from snacks
• Portion sizing is a major determinant of caloric
  intake

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Smart Snacks 150 Calories Or Less5 Grams Of Fat
Or Less
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Student Response-Expect Some Backlash!
Where have all the cookies gone?
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Well Fed And Educated Students!
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Dont be afraid to take a big step if one is
indicated. You cant cross a chasm in two small
jumps.

• David Lloyd George
• Former British Prime Minister

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Healthy School Nutrition Environment
Be the change you want to see in the
world. Mahatma Gandhi
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People Want Everything
Taste
Nutrition
Convenience
Affordability
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Americas Balancing Act
Time
Cost
Taste