Creating Supportive Environments for Healthy Eating

1. Creating Supportive Environments for Healthy Eating Mary McKenna, PhD, RD Ontario Society for Nutrition Professionals in Public Health Toronto May 2007

2. Overview • Reports and recommendations • Legislation and policies • Resources • Research and information • Monitoring and evaluation • Upcoming • What’s left?

3. Reports and Recommendations

7. Ontario Medical Association • The evidence that current behaviour patterns of children and youth may accelerate life-style related disease processes . . . is compelling. • The long range impact, if not addressed, has staggering implications, both for the quality of life of Canadians as well as economic costs associated with treatment. • Children and adolescents must therefore learn to eat and enjoy healthy foods in moderate amounts and to exercise regularly as part of an ongoing lifestyle.

8. Institute of Medicine (2007) • Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth • http://www.iom.edu/CMS/3788/30181/42502.aspx

9. Legislation and Policies

10. Canada • Guidelines for Food and Beverage Sales in BC Schools • Nutrition Guidelines for Schools (Saskatchewan) • Healthy Foods and Beverages in Elementary School Vending Machines (Ontario)

11. Canada • Healthier Foods and Nutrition in Public Schools (NB, 2005) • School Food Guidelines (N&L) • http://www.ed.gov.nl.ca/edu/k12/pdf/school_food_guide_.pdf • Food and Nutrition Policy for Nova Scotia Schools

12. Food and beverages sold in school Portion sizes Drinking water Fundraising Special functions Promotion and advertising Food as a reinforcer Vulnerable students Food safety Nutrition education Time to eat Local produce and products Environmental considerations Role models School partnerships and commitment Food and Nutrition Policy for Nova Scotia Schools

13. USA: Local Wellness Policy Child Nutrition and WIC Reauthorization Act • Nutrition education, physical activity, and other wellness activities • Nutrition guidelines for all foods available on each school campus • Guidelines for school meals • Measuring implementation

14. Resources

16. Canadian Resources • Making It Happen: Healthy Eating at School (BC) • http://www.knowledgenetwork.ca/makingithappen/ • Foundations for School Nutrition Initiatives in Alberta • http://www.achsc.org/download/Foundations%20for%20School%20Nutrition.pdf • Manitoba School Nutrition Handbook: Getting Started with Guidelines and Policies • http://www.gov.mb.ca/healthyschools/foodinschools/documents/handbook.pdf • School Nutrition Handbook: Feeding the Future • http://www.calgaryhealthregion.ca/hecomm/nal/ProgramsServices/SchoolNutritionProgram/SchoolNut.htm

17. US Resources • CDC Division of Adolescent and School Health • http://www.cdc.gov/HealthyYouth/ • Action for Healthy Kids • http://www.actionforhealthykids.org/resources_wp.php • School Nutrition Association • http://www.schoolnutrition.org/Index.aspx?id=1075

18. Research and Information

19. Food Availability 2004 Secondary Schools (CDC Profiles) Percentages Drinks (soft, sports, fruit) 95 Salty snacks not low in fat 75 Non-chocolate candy 68 Chocolate candy 65 100% fruit juice 84 Low-fat salty snacks 80 Bottled water 94 Fruits or vegetables 45 :

20. Food Environments • An à la carte program was associated with lower intakes of fruits and vegetables and higher intakes of calories from total and saturated fats. • Students without à la carte • Ate 0.5 servings more of fruit per day • Met USDA recommendations for total fat • The availability of snack vending machines was associated with lower intakes of fruit. Kubik, et al, AJPH 2003; 93:1168-1173

21. Adults Support Change • US 2005 survey (RWJ Foundation): • 91% supported the inclusion of nutrition in school curricula • 85% supported offering only healthy lunches in schools • 2005 survey (AFHK) found that 83% of parents were unaware of Local Wellness Policy

22. Monitoring and Evaluation

23. Policy Impact • Belgium-Flanders: school nutrition policies influenced soft drink and snack availability • California: food items changed, meal participation increased, competitive foods decreased

24. Policy Impact • San Francisco and Los Angeles: Increase in number of healthful options, decrease in less healthful options; impact on students in school • Texas: changes in school meals offset by increase in school vending machines

25. Policy Impact • Arkansas Act 1220 of 2003 to Combat Childhood Obesity • http://www.uams.edu/coph/reports/#Obesity • http://www.uams.edu/coph/reports/2006Act1220_Year3.pdf

26. Upcoming

27. PEI policy evaluation • NB SHAPES data • School Health Policies and Programs Study (CDC) • School Nutrition Dietary Assessment (SNDA-III -- USDA) • National Association State Boards of Education

28. What’s Left?

29. There’s more to do • Increase Canadian evaluation (process and outcome) monitoring, research, and evidence base • Establish networks for support and sharing • Enhance school, family, and community linkages

30. Mary McKenna, PhD, RD Faculty of Kinesiology, UNB e-mail: mmckenna@unb.ca Tel: 506-451-6872