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The Federal Budget Process: Effects on Child Feeding Programs. Keith-Thomas Ayoob, EdD, RD, FADA March 2, 2009 School Nutrition Association. Where we came from. NSLA of 1946 General national policy Focus on protecting kids against nutritional deficiencies Outlet for surplus commodities.

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The federal budget process effects on child feeding programs

The Federal Budget Process:Effects on Child Feeding Programs

Keith-Thomas Ayoob, EdD, RD, FADA

March 2, 2009

School Nutrition Association

Where we came from
Where we came from

  • NSLA of 1946

    • General national policy

    • Focus on protecting kids against nutritional deficiencies

    • Outlet for surplus commodities

Where we came from1
Where we came from

  • Child Nutrition Act of 1966

    • School breakfast established

    • To help meet the nutritional needs of low income families

    • First large-scale entitlement feeding program for children

Where we came from2
Where we came from

  • Dietary Guidelines for Americans of 1995:

    • Standard established for school meals

    • Goal: to minimize risk of chronic diet-related diseases

    • Prevention of more than just nutritional deficiencies

    • Beyond commodities

  • And then………………..

Old problem malnourished kids

Old Problem: “Malnourished Kids”


New Problem:

Brave new world

  • Kids have food everywhere

  • Kids eat food everywhere

  • Kids got fatter

Brave new world1

  • “Childhood obesity is the #1 health problem in children”

  • “Today’s kids will have shorter lives than their parents”

  • “SOMEONE is to blame for this…”

Where we need to be

  • “Optimal nutrition”

  • Obesity prevention

  • Disease prevention

but there’s just one thing……....

The local wellness policy
…the “local wellness policy”

  • A festival of individualization at the district level

  • Community-driven, parent-focused

  • Budget can conflict with reality

  • Often where philosophy trumps the science

Local policy wish list components include
Local policy “wish list” components include…

  • Organic food

  • Organic local food

  • No sugar

  • No HFCS

  • No gluten

  • No eggs

  • No dairy

  • No peanuts

  • Nothing that could possibly cause an allergy

  • Low-glycemic foods only

What you need one national policy

  • Meets the needs of MOST children

  • Supplies the good stuff

  • Minimizes the bad stuff (excesses, including LNED foods)

What you need one national policy1

  • Keeps up with DGAs without “overachieving”

  • National policy means national funding

  • Can drive reformulation of foods by industry

Why school meals work
Why school meals work

  • Breakfast & lunch participants:

    • 4 X more likely to drink milk

    • Eat more fruits and vegetables

    • Get more calcium & potassium – nutrients of concern

  • Non-participants:

    • More likely to eat LNED snacks & desserts

    • Drink more junk beverages – 4 X more likely

Gordon, et al, JADA 2009

Do they eat breakfast
Do they eat breakfast?

  • Children who eat breakfast…

    • score higher on tests3

    • have better school attendance2

    • have better diets

      • Iron, Zinc, Vitamin A, B Vitamins, Calcium1

    • may be less likely to be overweight

40% of children don’t eat breakfast everyday1

1 General Mills Bell Institute of Health & Nutrition Dietary Intake Research

2 Wahlstrom et al. Top Clin Nutr 1999

3 Murphy et al. Arch Pediatr Adolesc Med 1998

How it s working
How it’s working

  • Fresh fruit offered (50% of menus vs. 41%)

    • i.e. an increase of 25%

  • Whole milk decreased by 40%, flavored skim milk increased by 40% -- a GOOD thing

Where you have problems
Where you have problems

  • Competitive foods, especially LNED ones

  • Compliance with national standards

    • Too much sodium

    • Low fiber

    • Too much fat & saturated fat

How often is it the only meal for the day
How often is it “The only meal for the day?”

February 2, 2006:

“In New York Schools,

Whole Milk Is Cast From the Menu”

  • Also removed (2006):

    • 2% milk

    • 1% chocolate milk

    • All other flavored milk

RESULT: Milk consumption drops 10% in 2006

Flavored milk friend or foe
Flavored milk: Friend or foe?

  • 2763 children 6-11 years

    1125 teens, 12-17 years

  • 3 groups:

    • Non-consumers of flavored milk

    • 0-240 g

    • >240 g

Johnson, R et al, 2002, JADA

Flavored milk
Flavored milk

  • Flavored milk drinkers had:

    • More calcium ~100-150 mg/day

    • No additional intake in added sugars

    • Lower intake of soft drinks/fruit drinks

Johnson, R et al, 2002, JADA

Aap policy statement prevention of pediatric overweight obesity
AAP Policy Statement:Prevention of pediatric overweight & obesity

“Dietary practices should be fostered that encourage moderation rather than overconsumption, emphasizing healthful choices rather than restrictive eating patterns.”

What rds want and where a national standard could help
What RDs want (and where a national standard could help)

  • Update to 2005 DGAs

  • Age-appropriate portions

  • Cut fat and sodium where possible

  • Make participation cool again

  • Address competitive foods

Follow the 2005 dgas
Follow the 2005 DGAs

  • Whole grains

  • Fruits and vegetables (attn: legumes)

  • Low-fat/fat-free milk

Age appropriate portions and calories
Age-appropriate portions and calories

  • Base on age and ACTIVITY level

  • Currently: 1989 REA for active kids

Cut fat sodium
Cut fat & sodium

  • More unprocessed entrees

    • Semi-scratch cooking

  • Work with vendors to drive reformulation

  • Advocate for USDA to lower fat/sodium in commodities

  • Ditch the deep-fries

Make it cool again
Make it cool again

  • Emphasize green aspects of healthier eating

    • Less meat/fat/processed food, more plant-based food

  • Fewer competitive foods mean more participation

  • Emphasize that “kids who eat school meals have healthier diets overall”

Communication research
Communication Research

Journal of the American

Dietetic Association

June 2003

Implications from research
Implications from Research

  • Students and parents: common interests but different information needs

    • Students—“fun,” “cool,” and “not boring”

    • Parents—“quick,” “easy to use,” and “credible”

  • Redefine “fitness,” “healthy eating,” and “health”

  • Facilitate communication between students, parents, and school nutrition personnel

Address competitive foods
Address competitive foods

  • Participation goes up when they’re not around

  • Often a nutritional nightmare

  • Usually an image problem

  • Responsible for a day’s worth of “discretionary calories” just at lunch

  • Keep vending machines to “better-for-you” options

What sna needs most

  • Legislation for a single national wellness policy

  • Ensure all legislation is FUNDED

Address the role of parents
Address the role of parents

  • Necessary partners with SNA

  • Primary influencers

    • Family meals

    • Expose kids to a wide range of foods

    • Model good eating behavior

Remember the goal


Keith-Thomas Ayoob, EdD, RD, FADA

Associate Clinical Professor of Pediatrics

Albert Einstein College of Medicine

718-430-3970 x6412

[email protected]