Will More Nutritious School Lunches “Fix” Our Obesity Epidemic?

There was an interesting article in The New York Times today (Wednesday, September 5, 2007). The article was entitled “The School Cafeteria, on a Diet,” and written by Andrew Martin. It is probably noteworthy that the article appeared in the Business Day section of the newspaper; there is quite a lot of money at stake for soda drink manufacturers and for the schools themselves given how much revenue schools currently generate from sales of mostly soda drinks and other “junk” food.

What’s wrong with school food?

I remember the good old days, when for one thin dime, a guy could buy two slices of white bread smothered in gravy for his school lunch. Those days are long gone as schools are beginning to consider offering reasonably nutritious meals. There is considerable pressure to do this, prompted mostly by the alarming data on rates of childhood obesity (about 20% of children 6-18 years of age based on data from the CDC). According to the article, there is a federal requirement in place that mandates each school district develop a wellness plan to help students eat healthier foods. Such federal rules have already been in place for some time for the subsidized lunch program- remember, tomato ketsup is considered a vegetable! I am pleased to learn that under current federal guidelines jelly beans and Popsickles are banned because they have “minimal nutritional value,” while Snoickers and Dove bars are “in” because they contain some nutrients. Can they really be serious about this?

How can we bring some measure of good judgment to all of this?

I think it’s just fine that the schools improve their food offerings, both in the school cafeteria and in their snack machines. Actually, I would recommend that schools eliminate the snack machines entirely (oh, I know you need the revenue). I can’t think of any good reasons why students shoul be buying snacks during the school day, even “healthy” ones. Also, there is the cost factor- have you ever calculated how many peanut butter crackers a student could bring from home for the cost buying of a package of 3?

One big problem is how do we decide what is nutritious vs. not nutritious? To say that a Dove candy bar is more nutritious than jelly beans is ridiculous. They are both highly processed foods which raises another whole set of issues. But, for example, there are no convincing data to show that jelly beans or sugar-containing sodas are less nutritious than any other food with the same quantity of carbohydrate. Also, what’s wrong with pizza? Children like it better than tofu (for the record, I like tofu just fine).

I contend that we are not going to have any significant impact on childhood or adult obesity by focusing on the quality of school lunches, at least the way we have been approaching things. Did you know that data show it is on vacations from school that children gain the most weight! The problems are deep-seeded and we should be careful of what we expect the schools to do in terms of public health (is obesity a public health issue?). The schools have been very effective in promoting better childhood immunization rates (e.g., “your kid can’t go to school without the following immunizations…..”).

I don’t think the schools can help very much with our obesity problems unless there is a broad educational effort on both nutrition and physical activity starting at the kindergarten level and continuing through high school. Maybe we could even reintroduce regular physical education classes- many schools now offer little or no physical education. We need to teach what is good nutrition (of course, no one can agree on what that is) and how to eat in a healthful manner. I think it is much less important that the school food offerings be what some expert panel decides is nutritious, but rather, what children are likely to be willing to eat, with an emphasis on more fruits and vegetables and fewer processed foods (not easily done since the highly processed foods tend to be the least expensive to serve).

Doesn’t anybody bring lunches from home anymore?

One last thing. I encourage many of my patients, particularly those with diabetes or problems with overweight, to bring lunch from home. First, it’s much cheaper than buying school lunch (unless one has a free or reduced cost lunch funded by the feds). Also, the child can help select the foods and the parents can encourage the child to eat a reasonably balanced meal. In some instances, there are powerful social pressures to eat school lunch rather than to bring lunch from home. I don’t know what to do about that problem. One big plus for home-prepared lunches are the cool lunch boxes that are available (if I still ate lunch at school, I’d surely want to bring my lunch from home- I now know that bread and gravy is not a great lunch choice- and I’d get a Star Wars lunch box).

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