Healthy Schools Campaign

Kids Love Fruit!

by Jean Saunders, HSC School Wellness Director

According to researchers at the NPD group, fruit is the favorite snack food of children under six, followed by cookies, milk, crackers and juice.

"Kids younger than ten are motivated to choose foods in large part because they're perceived as fun and they want a treat or reward," said Harry Balzer, NPD vice president and food industry expert.

This comment goes a long way to explain the ways that adult behaviors can influence kids’ snack preferences – too often away from fruit and toward less-healthy snacks. If kids are given candy and cookies as rewards, they’ll begin to prefer those over the fruit they would otherwise naturally choose. If adults are shocked when kids want fruit – and if we comment that junk food is a fun treat – then kids’ interest in fruit is likely to dwindle.

Balzar goes on to say, "Kids account for almost one-third of all consumption of snack-oriented, convenience food products. Among those products, fruit is the top choice consumed by kids, but consumption frequency for fruit declines markedly as children age."

In her article in Food Navigator, Laura Crowley summarizes the NPD study which shows how kids’ snack preferences have changed over time.

As the parent of an eleven year old, I know that it’s up to me to help stack the odds that my son has plenty of fruit and vegetables in his diet. I have to make sure that it’s easy for him to snack on fruit. I’ve made it hard to miss the basket of fruit on the kitchen table and have strategically placed cut-up fruit and veggies in the refrigerator. With his desire for increased independence, it’s important for him to have the opportunities to make choices – and up to me to make sure that he chooses among tasty, healthy options.

Good News and Bad News in New Childhood Obesity Data

by Rochelle Davis, HSC Founding Executive Director

Last week the Journal of the American Medical Association (JAMA) published an important paper about the trends in childhood obesity.  Dr. Katherine Kaufer Christoffel, MD, MPH, the Medical/Research Director for the Consortium to Lower Obesity in Chicago Children (CLOCC) offered this useful analysis of the data:

This week, the Journal of the American Medical Association published an important paper about trends in childhood obesity in the US, entitled, High body mass index for age among US children and adolescents, 2003-2006. The study, by a group at the National Center for Health Statistics led by Cynthia Ogden, PhD, contains some good news, some bad news, and, of course, some questions that remain unanswered. CLOCC members -- and others working to combat the childhood obesity epidemic -- need to be familiar with all of these.

The good news is that childhood obesity rates have been stable for almost a decade. Analysis of 4 waves of data from the National Health and Nutrition Examination Survey (NHANES 1999-2006) shows that levels of overweight and obesity have been stable during this time for several groups defined by age, sex, and race/ ethnicity.  Thus the rapid rise in rates that occurred between the 1970s and the 1990s has slowed, if not ended. (Earlier analyses, which did not include the latest data, indicated that rates rose through 2003-2004, but this stronger analysis does not support that finding.)

The bad news has at least three parts. First, rates remain high, particularly for the most obese.  This study reports on rates of BMI above the 85th, 95th, and 97th percentiles for age and sex. The NHANES data on children ages 2-19 years allow for 2005-2006 national estimates: 11% above the 97th percentile, 15% above the 95th percentile, and 30% above the 85th percentile. The percentile norms are from years before rising child obesity, so the recent levels are well above historical ones. Further, about 2/3 of those with BMIs above the 95th percentile have BMIs above the 97th percentile, indicating much severe obesity.

Second, disparities remain by age and race/ethnicity.  In general, rates of overweight are higher for older children than for preschoolers, and higher for minorities than for white children. For example: Among Mexican American boys, those above the 97th percentile BMI included 16% of 2-5 year olds, 21% of 6-11 year olds, and 16% of 12-19 year olds. Among 12-19 year olds, those above the 97th percentile BMI included 20% of non-Hispanic black girls, 18% of Mexican American boys, and 9% of white girls.

Third, NHANES is not designed to provide data at the State or City level. Thus we do not know if the national rates reported in this study apply directly to Chicago and Illinois.

By promoting healthy food and physical activity in schools, HSC continues our efforts to combat the health disparities and very high rates of childhood obesity that affect today’s students.

Young Lives at Risk: Series Explores Perspectives on Childhood Obesity

by Rochelle Davis, HSC Founding Executive Director

Beginning on May 17, The Washington Post launched an extensive five-day series on childhood obesity.

The series explores the issue of childhood obesity from many perspectives, ranging from the latest medical research to public health information, efforts to address the problem, and policy solutions including responses from Senators Clinton, McCain and Obama. A number of stories in the series discuss the role of schools in addressing childhood obesity.

One of the articles quotes acting U.S. Surgeon General Steven Galson, who labels childhood obesity nothing less than "a national catastrophe." The article goes on to document the alarming fact that if the obesity epidemic is left unchecked, obesity related illness will cause this generation of children to be the first to live less healthy lives and to die younger than the previous generation.

We commend The Washington Post for giving this issue such serious and comprehensive treatment and encourage you to take a look at the series of articles. Click here to view the series. (A free registration to the Washington Post is required.)

Richard Simmons: Amend NCLB to Encourage Physical Education

by Rochelle Davis, HSC Founding Executive Director

Fitness Guru Richard Simmons has been hitting the talk shows in a build-up to support American Heart Association’s national lobby days to promote the FIT Kids Act.

As we’ve discussed in previous blogs, one of the unintended and dangerous consequences of No Child Left Behind has been a dramatic decrease in physical education and the time that children have to be physically active at school.  The FIT Kids Act would enable schools to prioritize PE along with other subjects.

Take a look at this clip from MyFox New York where Simmons says that the intent of NCLB was to make sure our children have a well-rounded education, but the result is that they are now “well-rounded” themselves. Click here to learn more about the FIT Kids Act.

Fatty Liver Disease in Children: Without a Cure, Looking to Prevention

Today we have a guest blog from Emily Nuzzo, Educational Program Coordinator for the American Liver Foundation, Illinois Chapter. (Emily is also a former HSC intern!)

An obesity epidemic is sweeping the country, yet we as a society continue to lean toward reactive rather than preventive care: we tend to wait until we’re faced with the consequences of health problems before taking action. But we can’t afford to keep waiting, especially when it comes to children’s health. As we’re seeing more frequently, many obesity-related diseases simply don’t have easy cures.

Last week, the Chicago Tribune featured a story on fatty liver disease in children, Obesity takes toll.  It’s devastating to hear increasingly common stories such as this one about chronic medical conditions, once affecting only  adults, striking youth.

Andy, the child featured in the story, was diagnosed with fatty liver at eight years old.  He is currently 33 pounds over his ideal body weight.  He and his family are learning and practicing new healthful eating habits and exercising regularly.  Like the other parents featured in the story, Andy’s mother is making all the changes she can to help her son’s health.

As another mother explained, though, making time for exercise and healthy cooking can be difficult when working a full-time job requiring a two hour commute and a part-time job on the weekends.  There are times, she says, when fast food becomes a convenient option. As the article explains, “making lifestyle changes isn't easy, even when the stakes are high.”

I currently work as the Educational Program Coordinator for the American Liver Foundation, Illinois Chapter.  Through this position, I’ve learned that fatty liver disease is considered the next epidemic of liver diseases, due in part to the obesity epidemic.  Fatty liver occurs due to excess fat in the liver as a result of high-fat food consumption. 

There is no current medication available to treat patients with fatty liver disease, and no cure for the disease. Only a change in lifestyle can help reduce the disease’s negative impact.

Today, I was surprised by Andy’s story.  Even though I know the statistics, I’m still surprised when I hear about very young children suffering from obesity-related diseases. I’m afraid, though, that stories like Andy’s will become all too common if we do not begin focusing seriously on prevention. The increased incidence of fatty liver disease in children is a dangerous one which requires an ongoing  fight for systemic change in addressing the health of children.   

Rather than waiting until children have health problems before focusing on healthy eating and active lifestyles, we need to do what we can to make these healthy habits a normal part of children’s lives. This involves efforts to make healthy foods more accessible and convenient for all families and, importantly, making healthy eating, physical activity and food education a part of the school day.

Children spend a good part of every day at school, and a healthy school environment can play a huge role in preventing  obesity-related chronic diseases such as fatty liver. 

My life’s mission is to increase the fruit and vegetable intake of every individual in the United States.  Being a young, idealistic, twenty-something, fresh out of graduate school. . . I want to believe that this big goal is achievable. When we look at diseases such as fatty liver that have no cure – and no treatment other than a healthy lifestyle – it seems that too much is at stake for our society not to make this type of change. Schools are a great place to start.

Junk Food Islands: Transforming Communities to Combat Childhood Obesity

by Guillermo Gomez, HSC Chicago Director

A recent article published in the Robert Wood Johnson Childhood Obesity Digest suggests that one-third of schools in the nation have at least one fast food restaurant or convenience store within walking distance. The researchers found that schools in low-income neighborhoods had more fast food restaurants and convenience stores than those in higher income neighborhoods.

Just as we have food deserts in lower socio-economic neighborhoods, we also have junk food islands with high concentrations of fast food restaurants and convenience stores.

Clearly, this has an impact on health and wellness efforts in school. As the researchers write, "this study suggests that curbing obesity in adolescents will require addressing the food environment surrounding schools as well as within schools."

Healthy Schools Campaign and Parents United for Healthy Schools, a coalition we brought together to make healthy changes at schools in Chicago’s Latino neighborhoods, work to combat childhood obesity in part by creating school wellness teams and working with parents to promote healthy lifestyles at home and at schools.

As this research shows, it appears that if we want to have any significant impact in fighting the obesity epidemic, then we need to address the community environment as well as the school and home environments.  If we start at home by creating a healthy lifestyle and take that message to schools, we also have to look at the community surrounding the school.

In Parents United for Healthy Schools work in Chicago’s Little Village, for example, we began by engaging parents in the healthy lifestyles message. These parents then took the message to schools, forming school wellness teams and advocating for healthy food and increased physical activity.

But the parents also took the message to the community, talking with restaurant owners about using healthier oils (and less of it) and sharing their recipe for healthier tamales with a popular local caterer. They worked with other parents to plant backyard gardens that provide fresh vegetables, started walking clubs, and have essentially made the wellness message part of the fabric of a community.

This creates an environment in which the community is more receptive to healthy changes at school and, importantly, where children receive the same wellness messages from teachers, parents and the adults in their neighborhood.

If we are to succeed in fighting obesity in communities with "junk food islands," then we must develop a strategy to address the junk food – and the messages – that surround our  schools.

Happy New Year! Resolving to Bring Fun Physical Activity to Kids

by Jean Saunders, HSC School Wellness Director

Happy New Year!

With the beginning of a new year come New Years Resolutions! Fitness goals or resolutions showed up on every list of popular resolutions that I’ve seen. The USA.gov site lists some of the most popular resolutions (along with practical resources for sticking to them):

• Pay Off Debt
• Save Money
• Get a Better Job
• Get Fit
• Eat Right
• Get a Better Education
• Drink Less Alcohol
• Quit Smoking Now
• Reduce Stress Overall
• Reduce Stress at Work
• Take a Trip
• Volunteer to Help Others

There are plenty of good reasons to resolve to make regular exercise a part of our daily routines – either on its own or as a way to help achieve other resolutions such as getting fit or reducing stress. A Google search of “the benefits of exercise” today generated more than 1.6 million results; when I added “for children,” I came up with 300,000 results!

With no shortage of information about the benefits of exercise to our children’s health and their ability to learn – and with thousands (no, millions!) of us setting activity goals and resolving to get more exercise – still less than half of us get the amount of exercise recommended by the American Heart Association and the American College of Sports Medicine. A study conducted by the CDC showed that in 2005, 23.7 percent of adults reported no leisure-time physical activity.

The North County Times reported the CDC’s findings that as many as one-third of high school students do not take part in regular physical activity during a typical week and even fewer take part in daily gym classes at school.  This article says that a lot of parents don't see a problem and that polls show parents believe a majority of children are in good or excellent health.

Adults – family, teachers, coaches, neighbors – are role models for children. We set the tone, particularly for exercise.

Experts suggest that if we make exercise fun, not work, children will be more likely to participate. They also suggest that we encourage kids to exercise through activities they like to do: soccer, dancing, swimming, jumping rope, skating, even navigating an obstacle course in the backyard.

I hope that the North County Times article inspires you to be physically active this year and, importantly, to encourage the children in your life to be active. Be sure to read all the way to the bottom of the article for practical and inexpensive ideas for integrating more exercise opportunities for children into daily routines both at home and at school.

My goals for 2008 include learning to do a flip turn so that I can move out of the slow lane of the Masters Swim program at my local YWCA. What’s on your list?

Fresh Fruit, Nutrition Ed, Local Purchasing: Senate Farm Bill Includes Some Good News for School Food

by Rochelle Davis, HSC Founding Executive Director

After much debate, the Senate has voted on a farm bill that includes some good news for school food and nutrition education.

The bill expands the Fresh Fruit and Vegetable Program to all 50 states and increases funding from $9 million to $225 million per year. This will expand the number of schools that are able to offer and promote free fresh fruits and vegetables and dried fruit throughout the school day.

As a pilot, this program has been successful in increasing student exposure to fresh produce and increasing student consumption of fresh fruits and vegetables. It also introduces children to a variety of fruits and vegetables that they may otherwise not have the opportunity to try, an important part of establishing lifelong healthy eating habits.

This simple step is especially important in a climate where children have easy access to so much unhealthy food and often have limited access to good, fresh produce.

The farm bill also includes a clarification of language that now specifically allows schools to designate a geographic preference in purchasing food. This means that schools can now specifically request locally-grown ingredients in their food purchasing plans.

An important complement to providing fresh, healthy food is offering students the nutrition education that helps them make smart food choices. The farm bill includes funding to encourage the expansion of nutrition education by providing grants to projects that can be replicated in schools. 

The School Nutrition Amendment that I discussed in a previous blog did not come up for a vote, so it will not be part of this year’s farm bill. The activity surrounding the amendment built a strong coalition in support of school nutrition standards and the amendment’s main sponsor, Sen. Harkin, has announced his intention to bring up school nutrition legislation when the Senate re-convenes in January 2008.

Now, the Senate version and House version of the farm bill will go to a committee that will work out differences in the two bills. 

School Nutrition Amendment to Farm Bill Represents a Step in the Right Direction

by Rochelle Davis, HSC Founding Executive Director

The U.S. Senate is preparing to vote on the farm bill.  While the debate about farm subsidies dominates the headlines, it is important to realize that the provisions of the farm bill address many aspects of U.S. food policy, including school food.  (Federal school food programs are part of the U.S. Department of Agriculture.) 

One of the amendments that senators will soon vote on would establish national standards for food available in schools.  There has been much public attention to the problem of childhood obesity, and the prevalence of junk food in schools has been well documented.   

The common-sense notion that it is important to offer students nutrition education reinforced by the availability of healthy food and the opportunity for physical activity is well supported by research. 

The School Nutrition Amendment to the farm bill, offered by Sens. Harkin and Murkowski, provides a national standard for food available in schools.  This standard, which is far better than the federal government’s outdated definition of foods with minimum nutritional value,  offers food manufacturers one standard to create products that are healthier for our children, rather than having to negotiate many state standards that have minor differences.

While this amendment has attracted the support of a diverse coalition of public health advocates and industry leaders, it has also generated controversy from critics who worry that it oversteps the appropriate role for the federal government and, on the other hand, those who worry that the standards it sets are not strict enough.

Healthy Schools Campaign supports the amendment because it represents a strong and much-needed step in the right direction.

Like all legislation, it required compromise and is not a perfect solution: but it is an important step forward and sends a clear message that school wellness and children’s health are significant issues worth addressing on a large scale. In fact, federal requirements already exist for school food but were written before vending machines and junk food had such a huge presence is schools. This amendment would bring a critical update to these important but obsolete standards.

The national standards would supersede standards set by states, but allow school districts to set their own standards that are stronger than the national ones. Close analysis of state standards and the proposed national standards shows strengths and weaknesses of each, but that the national standards would be at least as valuable overall as state standards. And, national standards offer the additional benefit of providing a set structure within which companies can develop affordable healthy products for schools.

Happy Halloween! But What About All That Candy?

by Jean Saunders, HSC School Wellness Director

Happy Halloween! The big day has arrived!

At my house, Halloween marks the time of the year when we dust off the sewing machine, pull out the art supplies, rummage through the recycling bin and visit our local art supply stores to gather what we need to make my son's costume. This year, our efforts focused on creating an  iPod costume (exactly seven times larger than an actual iPod!) for the Halloween parade at school and for neighborhood trick-or-treating this evening with my son’s friends. I love Halloween!

Well, maybe I don't love everything about it.

October 31 marks more than the height of creative costume-making and pumpkin carving—it can also represent the pinnacle of candy consumption by kids. School parties, trick-or-treating and other related festivities often focus on candy, sugar cookies, cupcakes and other sweet treats.

Teachers and  parents alike are faced with the dilemma of trying to balance the demands (and traditions) for candy, pumpkin-shaped cookies and sugary drinks with more healthy food and beverage offerings that are consistent with the messages about wellness we hope to pass along to our kids. 

So, what's a grown-up to do? Ban the sweet treats entirely (like these schools did), or turn a blind eye to the goodies that make their way to school? Should wellness policies require that there be no edible treats at Halloween celebrations?

I participated in several heated debates on this topic at our school district's wellness committee meeting and at my son's school. 

The solution that worked for my son's school community was that our celebration wouldn't require giving up all the treats, but would keep the quantity reasonable and would not make candy and sweets the focus of the events. We decided to keep in mind the multiple celebrations that many of the students participate in with their sports teams, in after-school care, in the community and at friends' houses.

I applaud my son's principal's efforts to navigate this potentially divisive minefield. She set the tone for moving to a more healthful Halloween celebration by meeting with teachers and parents (together) to gain their support in limiting the sweets.

Classroom teachers were provided with resources for creating more healthful celebrations in their classrooms, like these ideas [pdf] from Center for Science in the Public Interest.

Room parents were given specific guidance for bringing in healthy options such as fruit kabobs, 100 percent juice drinks and just one sweet treat. Any candy brought into the classroom will be sent home in a sealed bag, so parents can decide when and how much candy their children consume.

This approach reflects the recommendations that the National Alliance for Nutrition and Activity (NANA) provides in their model wellness policy regarding school celebrations that involve food:

Schools should limit celebrations that involve food during the school day to no more than one party per class per month. Each party should include no more than one food or beverage that does not meet nutrition standards for foods and beverages sold individually. The district will disseminate a list of healthy party ideas to parents and teachers.

During our annual debate about what to give to trick-or-treaters who visit us on October 31, my son advocated for “something that kids like because I don't want them to think that we don't like Halloween.” In the next breath, he said that he thought it would be better if the pumpkin I'd carved had been scarier. I like to think this means that he really does believe Halloween isn't about the candy!

P.S. Next year my son will be 11 years old -- I wonder if he will still want my help with the costume construction?

Beyond Peanut Brittle: Successful Fundraising Without Junk Food

by Jean Saunders, HSC School Wellness Director

Last week, I went to the first PTA meeting of the school year. The lineup of PTA sponsored activities planned for my son’s school this year sounds really, really cool: The PTA will fund visiting artists, musicians for performances and even a mosaic artist who will create a mural for a new amphitheater. Wow! It's wonderful that children at our neighborhood school will have access to all of these opportunities and resources.

As the meeting continued, it became clear that it takes a lot of hard work to raise the funds necessary to support these enrichment opportunities. We were encouraged to shop at Target, collect box tops, buy school spirit wear, participate in the annual silent auction, and purchase wrapping paper, home gifts and "gourmet edibles" from a company that structures its product sales for school fund-raisers.   

The "edibles" for sale include "Old Fashioned Peanut Brittle," "Chocolate Delight Caramel Popcorn," "Peppermint Stick Creams,". . . the list goes on! For me, this sends the wrong message to my son and his schoolmates.

Enlisting school children to sell junk food undermines the education that parents, teachers, food service directors, school nurses and many others in our school community are sending about the importance of healthy eating.

According to Margo Wootan, public policy director of the Center for Science in the Public Interest, "Health-conscious parents have a hard enough time without schools pressuring their children to buy even more junk food to help pay for their own education."

"Why put parents in that position," she asks, "when there are perfectly good fund-raisers that don’t jeopardize children's health?"

I'll suggest to our PTA's Ways and Means Committee that instead of selling chewy chocolate caramels, they consider some of the good options for fund-raising without junk food:

• Book fairs. The publishing company Scholastic, for example, sponsors more than 100,000 book fairs per year, which promote literacy in addition to raising funds.
• Scrip and grocery store fund-raisers. eScrip is a gift card for use at local retail stores, which schools purchase at a discount. Many grocery chains have programs that disburse a percentage of shopper’s purchases to a school they designate.
• Recycling fund-raisers. Used cell phones, empty printer cartridges, and even re-usable clothing can all be collected by schools in exchange for cash. Millions of printer cartridges are thrown away each year, yet schools can earn between $.06 and $2.20 per cartridge, depending on the model.

For more non-food fund-raising ideas, check out the Documents & Resources section of  HSC's Quick & Easy Guide to School Wellness.

What non-food fund-raisers have worked for you? If you have any ideas, please send them my way!

Proposed Bottled Water Tax Sends the Wrong Message

by Guillermo Gomez, HSC Chicago Director

Recently, Chicago Alderman George Cardenas (12th Ward) proposed a new tax on bottled water purchased in the city. Although the proposed tax of 10 to 25 cents per bottle may help reduce garbage, its main goal is to help cover a $217 million gap in the city's budget.

Bottled water has come under a lot of fire lately for its environmental impact: The New York Times reported on a trend of feeling guilty for buying bottled water, MSNBC covered a movement of upscale restaurants removing bottled water from the menu, and the St. Louis Post-Dispatch described a private school removing water from its vending machines and giving students reusable water bottles instead.  But this would be the first effort to actually tax it.

Now, we love our sturdy reusable water bottles here at HSC. They help us stay hydrated without creating garbage or using natural resources to produce plastic bottles and transport them across the country. They help us save money, too.

At the same time, we're aware of the epidemic levels of obesity that kids today face, and the complications such as diabetes that go with childhood overweight. We're also aware of the billions of dollars spent every year to market sugary soft drinks and nutritionally empty "juice drinks" to kids.

In this climate where sodas, sugary smoothies, fattening coffee drinks and high-calorie artificial fruit drinks seem to be sold on every corner, it's alarming that anyone would consider making it more difficult to choose the healthiest option:  water.

A tax that would discourage the purchase of bottled water seems dangerously close to encouraging the purchase that other drink that comes in a plastic bottle but has the negative consequence of contributing to the obesity epidemic.

It's ideal when schools give kids reusable water bottles and have plenty of working water fountains. But the truth is that in a lot of schools – especially older schools in low-income communities – you can't find a working water fountain to get a sip or refill your bottle.

When kids are faced with a choice of buying bottled water or buying a sugary drink, the last thing they need is a tax to discourage them from drinking water.

Presentation Matters!

by Jean Saunders, HSC School Wellness Director

This week, CNN reported that preschoolers believe food presented in a McDonald’s wrapper tastes better than non-branded food. According to the article:

Anything made by McDonald's tastes better, preschoolers said in a study that powerfully demonstrates how advertising can trick the taste buds of young children.   Even carrots, milk and apple juice tasted better to the kids when they were wrapped in the familiar packaging of the Golden Arches. The study had youngsters sample identical McDonald's foods in name-brand and unmarked wrappers. The unmarked foods always lost the taste test.

Chefs and home cooks alike know that we taste first with our eyes. If food looks appealing, we are likely to enjoy it more.

A quick review of the literature affirms this old adage:  I found hundreds of articles and papers about the relationship between visual cues and taste.

Many of these studies looked at how the color of a food can greatly affect the way we perceive its taste. Brightly colored foods frequently seem to taste better than bland-looking foods, even when the flavors are identical.

With this research in mind, the results of this taste test shouldn’t come as a surprise. Kids believe that food with the (colorful) McDonald’s logo on the wrapper looks more appealing and think it will taste better than food in a plain or bland wrapper.

On top of this, most kids believe that McDonald’s = Fun. Of course, McDonald’s spends billions of dollars reminding us (adults and kids alike) about the perceived connection between their brand and fun.

According to Advertising Age, McDonald’s ranked 16th in advertising spending among U.S. companies in 2006, at $1.75 billion. In the context of that advertising, it’s not much of a leap to see that food associated with fun tastes better to kids.

Besides the quite obvious and important discussions about food advertising to children that these findings raise, I think there is something else we can learn from the CNN report.

This is an excellent reminder to parents, food service directors and everyone who is working to encourage healthy eating among children that presentation, packaging, color and context are critical considerations.

Encouraging kids to make healthy food choices with the promise that "it’s good for you" is not enough. 

When given a choice, kids must believe that the healthy options look as familiar, fun, and appealing to them as the junk food options.

Walk Across Illinois School Fitness Program

Today we have a guest entry by Lt. Governor Pat Quinn, who began the Walk Across Illinois program.  

In less than two years, 10,000 participants in the Walk Across Illinois program, an online fitness initiative, have logged more than a million miles –- the equivalent of two round-trip journeys from the Earth to the moon!

Those numbers illustrate the popularity and accessibility of Walk Across Illinois, an interactive virtual trek from the town of Rock Island, on the Mississippi River, to Chicago’s Lake Michigan shoreline.

Walking is an easy and fun activity that everyone can do at their own pace. It’s also an easy way to improve your health, one step at a time.

Obesity, high blood pressure and inadequate exercise are community health problems which challenge us all. By encouraging everyone in Illinois to walk on average just one-half mile daily for a year, the Walk Across Illinois initiative can help boost the life expectancy and well-being of all Illinois residents.

In 2001, I hiked 167 miles across Illinois with my 78-year-old doctor, Dr. Quentin Young, to promote decent health care for everyone. The lessons I learned about wellness, activity, civic engagement and Illinois history had a tremendous impact on me –- and now I hope that Walk Across Illinois can bring this experience to everyone in our state.

Now, we’re expanding the program to include specific tools and resources for teachers and school children. 

Elementary school teachers can use the Walk Across Illinois School Fitness Program to help their students develop a lifelong pursuit of physical fitness. Participating schools receive professional development training, curriculum guides, teacher and classroom incentives, and much more.

The program is open to all Illinois public and private elementary schools with 4-8th grade classrooms.

For more information on the Walk Across Illinois School Fitness program and how you can bring it to your school, please visit www.WalkAcrossIllinois.org or call 312-814-5220.

Is Nutrition Education Really Failing?

by Jean Saunders, HSC School Wellness Director

The news wires buzzed last week after an AP review of research was published around the country in articles such as “Nutrition education efforts failing” in the Chicago Tribune.

The assertion that nutrition education is not effective was based on the review of 57 scientific studies of such education programs, four of which showed positive results or effectiveness in changing behavior.

"Any person looking at the published literature about these programs would have to conclude that they are generally not working," said Dr. Tom Baranowski, a pediatrics professor who studies behavioral nutrition at Houston's Baylor College of Medicine.

Baranowski’s research is directed toward understanding why children eat the foods they eat and engage in the physical activities they do. He is also working on designing and evaluating programs to help change these dietary and physical activity behaviors.

If a leading contributor to the field of pediatrics research asserts that the programs are not working, should we abandon the considerable efforts underway to provide nutrition education to school-aged children?

Before we do that, let’s see if we can learn something from other important aspects of Baranowski’s work.

In an effort to understand why programs to increase physical activity among children have varied levels of success, Dr. Baranowski has been examining the factors that come between the physical activity programs and the desired results.

He describes these factors as the moderating and mediating variables—the external factors that affect how well programs work. These include gender differences, for example, as well as family support and the availability of space or equipment for physical activity.  No matter how great an education program to increase physical activity is, it's unlikely to yield long-term results if children don't have time or space to be active outside of the program.

The results of these investigations have led Baranowski to develop a model showing how outside influences play a role in the success of program.  With this model, Baranowski has begun to design programs to change the mediating variables – that is, to change the outside influences as well as the education programs.

“It’s the changes in mediating variables that lead to behavior change,” Dr. Baranowski explains.

Like Dr. Baranowski, I would like to know about the “mediating variables” in those four nutrition education programs that were successful.

Why were those interventions successful? It's likely that the “mediating variables” in the successful studies included the school food environment, opportunities for physical activity, and support from teachers and parents. With the right factors in place, nutrition education yields positive results.

The Tribune article includes the statement that few nutrition education programs hold “promise as weapons against childhood obesity."

Dr. Baranowski’s work affirms that programs do not offer a simple answer or a silver bullet to reverse the disturbing growth in childhood obesity.

Offering nutrition education without changing the factors that affect children's food choices – such as improved school food or the availability of fresh fruit as snacks – is unlikely to yield stellar results. When education is accompanied by appropriate changes in the environment, though, children are more likely to make healthy choices.

With an integrated approach that accounts for the factors surrounding education programs, we can make a real difference in children's health behavior

The Wise Choice: Beyond Extra-Extra Wide Chairs

by Mark Bishop, HSC Deputy Director

Sometimes people ask about the connection between HSC's work with wellness and our work with school environmental health. (When we talk about wellness, we mean food and fitness; when we talk about school environmental health, we mean issues related to healthy buildings and indoor air quality.)

We see the connection all the time -– such as in the school where the poor indoor air quality prevented students from exercising in the gym, where inadequate kitchen facilities hinder the preparation of healthy food, or in this report which connects healthy food and asthma risk reduction –- but rarely is the connection illustrated so vividly as in the advertisement I came across recently in the print version of School Construction News.  (Yep, it's true – we at HSC are avid readers of School Construction News!)

Take a look at the ad:

A publication for those interested in school building issues includes this advertisement for an extra-wide (or "wise") chair that "effectively supports a wider variety of body types, particularly taller and larger students."

In other words, chair manufacturers are explicitly marketing products to comfortably support obese students. And the officials involved with school facilities must address the issues that skyrocketing obesity rates raise for health and safety in their buildings.

The childhood obesity epidemic affects every aspect of the school experience for children today – even the chairs they sit on.

But the adjustments that schools need to make in response to this epidemic go far beyond the purchase of wider chairs. Recognizing the tremendous lifelong health impacts of childhood obesity, people need to step forward to do everything they can to halt and begin reversing this dangerous trend in our schools, in our homes and in our communities.

Daily physical education, recess, healthy food and smart nutrition education would be the truly "wise" investments.

Federal Spending on Diabetes Highlights Need for Obesity Prevention

by Rochelle Davis, HSC Executive Director

When working to create school environments which promote healthy eating and lifestyles, we are motivated by our concern for children's health and ability to learn. A recently released study conducted by Mathematica Policy Research Group for the National Changing Diabetes Program calls attention to another important ramification of obesity epidemic. 

According to the study, one out of every eight U.S. Federal health care dollars is spent treating people with diabetes, one of the most common medical conditions resulting from obesity. Using 2005 data, the student found that the government spends more than $79.7 billion more to treat people with the disease, or some 12 percent of the $645 billion in total federal health care spending.

This is another compelling reason why political, corporate and education leaders need to band together to prevent obesity. Research suggests that a school environment that serves healthy food, teaches students about nutrition and provides opportunities for physical activity can have an impact on children's lifestyles. This study provides the federal government with another compelling reason to take action now to support schools in their efforts to create this type of healthy environment. 

One of the ways in which Congress could make a difference is by supporting a number of provisions of the Farm Bill that set standards for food available in schools, support farm-to-school programs or provide funding for fresh fruits and vegetables.

Shaq's Big Challenge: Real Problems, Questionable Solutions

by Mark Bishop, HSC Deputy Director

It can't be a bad thing when one of the world's biggest sports stars elevates the problems of childhood obesity. In Shaquille O'Neal's new "reality" television show, "Shaq's Big Challenge," Shaq won't be taking on the NBA, but will be taking on America's youth –- and trying to make them fit.

He does a pretty good job of hitting some of the important issues, though he seems to be lacking in his solutions.

What was the first thing that he said when asked by ESPN about the problems of childhood obesity? "[O]nly six percent of all schools in America have mandatory gym. When I was growing up, I changed schools 10 times, and they all had mandatory PE."

Shaq goes on to talk about the prevalence of fast food, limited physical activity –- all the right issues. Bringing in high profile stars is great a raising awareness and it can engage parents and help them understand these important issues.

However, the solutions the show comes up with include putting kids through tough drills and a mini exercise boot camp (check out this review in the L.A. Times). Binge exercising and dieting don't work very well for adults in the long-term, and I have a hard time thinking they will work for 12-year-old kids.

Hopefully this will help the six children in the show, but sustainable solutions need to integrate parents, schools and the community.

These changes do not need to be dramatic and painful, but they do need to be sustainable and long-term. Let's walk more, play fewer computer games, eat less junk food, eat more fresh vegetables, learn about cooking and nutrition and learn to enjoy physical activity. 

The only "reality" depicted in this show are the problems of childhood obesity, not the solutions.

School's Out! Summer Poses Challenges, Opportunities for Kids' Nutrition

by Jean Saunders, HSC School Wellness Director

Summer is here and the living is easy! What’s not to love about summer? Well, for many children, it is the addition of unwanted extra pounds.

The April 2007 edition of the American Journal of Public Health reported on a study designed to determine whether school or non-school environments contribute more to children becoming overweight by comparing children’s gains in body mass index (BMI) when school is in session (during the kindergarten and first-grade school years) with their gains in BMI when school is out during summer vacation. 

The study found that "growth in BMI was typically faster and more variable" during summer break than during the school year.

The results also showed that the gain was particularly acute for three at-risk subgroups: black children, Hispanic children, and children who were already overweight at the beginning of kindergarten.

Summer can be a challenging time for families with limited resources.

With school closed, many low-income children aren’t able to get a free or reduced price school breakfast or lunch. Family food dollars must be stretched even further, leaving many children at risk of hunger or inadequate nutrition. As Rochelle discussed at HSC's blog last week, unhealthy food is often less expensive than healthy food.

In The New York Times article "When School Is Out, Getting Good Food In," Jane Brody provides some great ideas for promoting nutrition to children during the summer.

Sadly, though, not all families have the resources to take advantage of Brody's suggestions. Many families instead rely on government-sponsored summer food programs.

During the summer, The Food and Nutrition Division of the USDA operates the Summer Food Service Program (SFSP). This program began in 1968 in response to concerns that children who depended on school lunches for adequate nutrition did not have enough food in the summer.

Program sponsors (school districts and community organizations) typically establish meal sites in neighborhoods where more than half the families have low incomes. These sites often provide other activities, such as sports or recreational programs, arts and crafts, or summer school classes. In general, any child can come to a site for meals; no individual income eligibility test is required.

Our hope is that these SFSP sites across the country will take advantage of summer’s bounty – fresh fruits and vegetables  – and that students across the country take advantage of this program. It's time to ensure that summer is no longer the season of unwanted weight gain among young school aged children. 

BMI Report Cards Don't Make the Grade

by Rochelle Davis, HSC Executive Director

The trend of schools reporting students' body mass index (BMI) to parents continues to be a hot topic in the media and among school health advocates. We addressed the issue on our blog a few months ago, and this week Jeff Stier, associate director of the American Council on Science and Health, wrote about BMI report cards at the Huffington Post. 

While Stier believes in the importance of addressing childhood obesity, he writes that BMI report cards are "misguided" and "unlikely to produce the desired effect and may even result in some serious negative consequences."

Stier goes on to suggest an approach that HSC continues to advocate: that schools and governments use public funding to address the obesity crisis in a constructive way, through wellness education and real opportunities for children to be active and eat nutritious food. Stier writes:

If we're going to approach obesity from a legislative standpoint, let's use our government's energies to launch public health education campaigns and give parents some useful resources for treating the problem, such as information on how to shop for healthy foods and how to find ways to exercise with their children, rather than simple numbers and restatements of obesity/disease links. Placing BMIs on report cards does little to motivate parents or create solutions.

I could not agree more.

As I commented on Stier's post, state governments should establish nutritional guidelines for school food, provide adequate funding so that schools can offer a healthy school meal, require schools to offer daily physical education, provide financial incentives for schools to make necessary capital improvements (such as adequate gym facilities, appropriate playgrounds, kitchen facilities and upgrades to cafeterias) and include comprehensive and ongoing nutrition education in the states learning standards.

As Stier says, the solution to our childhood obesity epidemic "might be in any number of school-based approaches, but it won't be found printed on the report card."

 

Pork Rinds & Marshmallow Fluff? The Struggle to Eat Healthily for $3 a Day

by Rochelle Davis, HSC Executive Director

Last week, Rep. Jan Schakowsky (D-Ill.), appeared on the "The Colbert Report" to talk about her participation the "Food Stamp Challenge."

For one week, Schakowsky spent only $3 a day on food, the amount the average food stamp recipient receives.  (Take a look at Schakowsky's blog entries from the challenge to see what she was able to eat for $21 per week –- and what she learned from the experience.) 

Stephen Colbert, known for his biting satire, asserted that $3 was plenty -- just eat pork rinds dipped into marshmallow fluff. (Of course, Colbert then snacked on this combo while talking with Schakowsky).  Check out the video here:

Colbert had a point. Healthy food is more expensive that unhealthy food.  This helps explain how we can have, at the same time, an obesity epidemic and a hunger problem. 

While Schakowsky was attempting to demonstrate the inadequacy of the food stamp program, the same could be said about the school food program. 

Maybe we should get all of the cafeterias on Capitol Hill to serve a lunch that only costs $2.40, the amount that schools have to provide a meal to students.

Obama's Healthcare Policy Includes Focus on Schools

by Rochelle Davis, HSC Executive Director

While some people might think that healthy school food and access to recess and gym class are not critical public policy issues worthy of the attention of our national leaders, we're constantly working to show how essential it is for leaders at all levels to recognize that these are public health issues that ultimately affect everyone.

It's mind boggling to consider that children today might be the first generation to have a shorter life expectancy than their parents -- all because of the increase in the rate of childhood obesity and related health complications.

Illinois Sen. Barack Obama recently released his healthcare policy [pdf] and I was very pleased to see that he recognized the seriousness of childhood obesity. In fact, he dedicated a section on school systems to the issue:

A generation ago, nearly half of all school-aged children walked or biked to school. Today, nearly 9 out of 10 children are driven to school. And once there, children are not very physically active- only 8 percent of elementary schools require daily physical education. Childhood obesity is nearly epidemic, particularly among minority populations, and school systems can play an important role in tackling this issue. For example, only about a quarter of schools adhere to nutritional standards for fat content in school lunches. Obama will work with schools to create more healthful environments for children, including assistance with contract policy development for local vendors, grant support for school-based health screening programs and clinical services, increased financial support for physical education and educational programs for students.

These are all initiatives that we've been supporting. We will continue to bring these issues to the attention of political leaders -- and look at how other candidates are addressing these concerns.

French Paradox in the School Cafeteria?

Today we have a guest entry by Shanny Peer, Director of Policy Programs at the French-American Foundation.

Physicians, researchers, and calorie-conscious American tourists have noticed for years that French people enjoy delicious, rich food over leisurely four-course meals without ever seeming to gain weight. French men and women, despite having a diet that is relatively high in saturated fats – think about all those croissants and cream-filled pastries – enjoy less coronary heart disease, lower rates of obesity, and longer lives than Americans. One theory for this “French paradox” is that drinking red wine may limit the incidence of coronary disease for those on a relatively fat-rich diet. (Apparently, this news caused red wine consumption to increase noticeably in the United States.)

Recent books such as French Women Don’t Get Fat have turned the French paradox and slimmer French physiques into self-help advice for dieting Americans.  Guess what?  French children don’t get fat either.  And it’s not because they’re drinking red wine with their school lunch. 

Okay, admittedly, this is an exaggeration.  Some French children are in fact overweight – currently about 4 percent of French children aged 7 to 11 are obese, and another 14 percent are overweight.  Obesity rates and concerns about them are rising in France as they are in every other country in Europe and North America.

But Americans still tip the scale heavily. Obesity rates are rising much more rapidly in the U.S., which has experienced the largest increase of childhood obesity in recent decades – up 60 percent - while France has experienced one of the smallest increases, of 28 percent. (For a brief historical perspective on the French response to concerns about child obesity dating back to the 1930s, when French child health educators began urging mothers to adopt the healthy norms that still prevail today, see Greg Critser’s Fat Land: How Americans Became the Fattest People in the World, pages 36-37.)    

Does the French approach to school food help keep obesity and related health problems in check among school-age children in France?  Are there other important public policy measures that complement the efforts of schools in fighting back against child obesity? The French-American Foundation would like to find out, and that’s why I participated in the recent International Exchange Forum on Children, Obesity, Food Choice and the Environment, along with Jean Saunders, HSC's director of school wellness.

We are currently developing a new policy program comparing French and American approaches to school food and their potential impact on child obesity and child wellness. As with earlier policy programs at the French-American Foundation, focused on early childhood education, maternal and child health, and child care, we hope this program can have an impact on public debates and policy making in the U.S. by informing American policy makers, opinion leaders, and other stakeholders about potential lessons the French approach may offer to the U.S. 

This exploration is not about copying the French, or lifting lessons directly from their books. Rather, it is about examining the differences in our countries' approaches to see how we might learn from each other.

During the exchange forum, our visits to several school cafeterias in France highlighted some of the important differences in approach.  French children drink only water with their meals instead of the flavored milk (often whole milk) offered in many American school cafeterias. School meals are typically prepared in well-equipped kitchens by trained chefs who use mostly fresh produce and many other fresh ingredients, locally procured when possible, to prepare real food from scratch.

Although some American schools are trying to move in that direction, their efforts are hampered by many things, including under-equipped kitchens, limited resources for staff development, insufficient funding, and poor quality ingredients or prepared foods.

French schools spend more money per child – nearly three times as much – to pay for higher quality meals, with costs shared by parents and local governments. 

Whereas many American schools cater to the limited (and often unhealthy) preferences considered normal for American children, offering the same fare of chicken nuggets, pizza, hamburgers, and French fries featured on children’s menus in restaurants across the country, French school chefs prepare a wide variety of foods, including appetizers such as radicchio or fresh beets, mache or asparagus with vinaigrette – and they view expanding children’s palettes as an important part of their job.  And all the children who stay at school during the two-hour period allotted to a leisurely lunch and recess eat the same school lunch together – no lunch boxes come in from home.

One last important difference: France banned vending machines from schools by law three years ago, and we saw no evidence of “competitive foods” in the schools we visited. 

What might these differences mean for American school lunches? Would we want to examine ways that variations on these practices might be integrated into our schools? If so, what would an "American version" of the practice look like?

None of us – in France or in the U.S. – knows the perfect answer to the question of how we should address childhood obesity. But isn’t that good food for thought?

Plus: Jean Saunders, HSC's director of school wellness, will lead two Lunch & Learn discussions addressing International Perspectives on Childhood Obesity and School Food. The first will be held on Wed. May 16th in Lombard and the second on Thurs. May 24 in Chicago. For details, click here or call 312-419-1810.